• Journal of Chest Surgery
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• 제22권1호
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• pp.67-73
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• 1989

Forty two patients with chronic constrictive pericarditis, who were admitted to the Yonsei University College of medicine over a period of 18 years from January, 1970 to August, 1988, were analyzed retrospectively. Mean age of the patient was 33.5 year ranging from 6.8 to 60 years old. Male to female ratio was 1.3 to 1. Twenty-one cases [50%] were tuberculous origin [based on either associated pulmonary tuberculosis and/or caseous necrosis in thickened pericardial specimen] and 17 cases [40.5%] were idiopathic [non specific chronic inflammatory change was considered to be idiopathic]. Dyspnea on exertion was evident in 30 cases [71.4%] and abdominal distention in 21 cases [50%]. On physical examination, hepatomegaly [83.3%], neck vein distention [54.8%], distant heart sound [47.6%] and ascites were found. Thirty-nine patients showed low voltage of QRS and/or T wave flattening or inversion on EKG. Thirty-one cases had undergone cardiac catheterization which showed data compatible with chronic constrictive pericarditis. Midsternostomy group [n=15] had shown the most remarkable CVP decline [12.20 mmHg] as compared with bilateral submammary incision group [n=25, 8.96 mmHg] and left thoracotomy group [n=2, 7.75 mmHg] but difference was not significant statistically There was four early death among 42 patients [9.5%] including 3 cases of left ventricular failure and one cardiac tamponade. Main postoperative complications were wound infection [6 cases] and arrhythmia [3 cases]. Follow-up of 24 patients [mean; 55.3 months, ranging from 2 months to 155 months] revealed good functional status.

• Journal of Chest Surgery
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• 제7권1호
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• pp.93-100
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• 1974

This is a case report of successful surgical correction of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart anomaly was suspected at the sixth month after birth. Afterward there has been no embarrassing symptoms until the day of operation except slight dyspnea on exertion, The diagnosis of coarctation of the aorta and the patent ductus arteriesus detected by physical signs and X-ray studies including aortography. In the first place, coarctation of the aorta was corrected with following procedure: partial resections of the aortic wall just above and below the coarctating line of the aorta and removal of diaphragmatic structure of coarctation performed by. cross clamping aorta above and below coarctation, and then the defect of the aortic wall was closed by lateral aortorrhapic suture with atraumatic needle 3-0 silk continuously [Fig. 6]. In the second place, the patent ductus arteriosus was closed with double ligation method. The persistent left superior vena cava left as it has been, because there has been no evidence of hemodynamic abnormal shunt. After operation, excellent result was obtained; blood pressure in the upper and lower extremities was normalized and subjective complains of hypertension in the upper extremity was disappeared.

• Tuberculosis and Respiratory Diseases
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• 제68권3호
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• pp.125-139
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• 2010

Patients with chronic obstructive pulmonary disease (COPD) frequently complain of dyspnea on exertion and reduced exercise capacity, which has been attributed to an increase in the work of breathing and in impaired of gas exchange. Although COPD primarily affects the pulmonary system, patients with COPD exhibit significant systemic manifestations of disease progression. These manifestations include weight loss, nutritional abnormalities, skeletal muscle dysfunction (SMD), cardiovascular problems, and psychosocial complications. It has been documented that SMD significantly contributes to a reduced exercise capacity in patients with COPD. Ventilatory and limb muscle in these patients show structural and functional alteration, which are influenced by several factors, including physical inactivity, hypoxia, smoking, aging, corticosteroid, malnutrition, systemic inflammation, oxidative stress, apoptosis, and ubiquitin-proteasome pathway activation. This article summarizes briefly the evidence and the clinical consequences of SMD in patients with COPD. In addition, it reviews contributing factors and therapeutic strategies.

• 정신신체의학
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• 제15권2호
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• pp.65-72
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• 2007

정신과에 내원하는 환자들 중에서 피로를 호소하는 환자들의 비율이 높으며, 만성적인 피로감을 호소하는 환자들에서 다른 우울증과 같은 정신과질환이 공존하는 경우도 많다. 환자들은 많은 괴로움을 호소하나, 기저의 임상상태의 종류와 심각도에 대해서는 비특이적이므로 실제로는 임상가에 의해서 무시되는 경우가 많으며, 그 중요성이 과소평가되는 경우가 많아서, 적절한 처치를 받지 못하고 삶의 질에도 많은 영향을 받게 된다. 피로는 말초와 중추신경계 둘 다에서 영향을 받는 다차원적인 현상으로 이해하여야 한다. 환자가 호소하는 피로증상에 대해서 좀 더 적극적으로 조절하기 위한 여러 약물학적 및 비약물학적 접근법들이 시도되고 있다.

• 한국임상수의학회지
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• 제33권2호
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• pp.116-121
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• 2016

A 1.83 kg, 9-year-old, spayed female Yorkshire Terrier was referred to the Veterinary Medical Teaching Hospital of Konkuk University for evaluation of an intra-abdominal mass with a week history of vomiting and diarrhea. On physical examination, survey radiography, abdominal ultrasonography, and computed tomography, a huge firm mass was identified in the mid-caudal abdomen. Surgical exploration of the abdominal cavity was performed to remove the mass. The encapsulated mass adhered to the mesentery, tail of the spleen, small intestine, omentum, and right lobe of the pancreas was removed using blunt dissection with dry gauze and cotton swabs. Macroscopic and histopathological examination revealed that the mass was foreign-body granuloma consistent with gauze fiber. Plain abdominal radiography demonstrated no remarkable findings 8 months post-operatively. There was no evidence of vomiting, diarrhea, coughing, difficulty breathing, and cyanosis on exertion 13 months post-operatively.

• 디지털융복합연구
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• 제14권9호
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• pp.553-561
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• 2016

본 연구는 비장애인 휠체어 농구 선수 11명을 대상으로 휠체어트레드밀과 암 에르고미터의 점증부하운동검사 시 심폐기능, 운동자각도 및 젖산 농도를 비교하는데 목적이 있다. 연구방법으로는 휠체어트레드밀과 암 에르고미터의 점증부하운동검사 시 호흡가스분석기와 무선 심박수 측정기를 사용하여 심폐기능을 알아보았으며, 보그 스케일을 이용하여 운동자각도를 측정하였고, 젖산 분석기를 사용하여 안정 시, 운동직후, 회복기 2분, 4분, 6분, 10분의 혈중 젖산 농도를 측정하였다. 측정된 데이터는 SPSS 18.0 프로그램을 통하여 종속 t-검증(paired t-test)을 실시하여 분석하였고 통계적 유의수준은 .05로 설정하였다. 이 연구를 통하여 얻어진 결과는 다음과 같다. 첫째, 심폐기능 변인 중 최대산소섭취량은 암 에르고미터가 높게 나타났으며, 호흡교환율은 휠체어트레드밀이 높게 나타났으며, 최대 심박수는 휠체어트레드밀이 높게 나타났다. 둘째, 주관적 운동 강도에서는 종료 점에서 암 에르고미터에서 높게 나타났다. 셋째, 혈중 젖산 농도는 운동 직후 암 에르고미터에서 높게 나타났다.

• 대한간호학회지
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• 제27권4호
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• pp.807-819
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• 1997

The purpose of the study was to identify the effects of a 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited, eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the postest, measurements of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly higher for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

• Journal of Chest Surgery
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• 제14권1호
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• pp.49-59
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• 1981

This is one case report of surgically treated partial atrioventricular canal. The 22 year-old male patient had no definitive history of frequent respiratory infection and cyanosis in his early childhood. Since his age of 7 years, dyspnea was manifested on exertion. First appearance of congestive heart failure was at his age of 16 years old. The physical examination revealed that the neck veins were distended and heaving of precordium. A thrill was palpable on the left 3rd-4th intercostal space extending from the sternal border toward the apex and Grade IV/VI systolic ejection murmur was audible on it. Neither cyanosis nor clubbing was noted. Liver was palpable about 5 finger breadths. Chest X-ray revealed increased pulmonary vascularity and severe cardiomegaly (C-T ratio = 74%). EKG revealed LAD, clockwise rotation, LVH and trifascicular block. Echocardiogram showed paradoxical ventricular septal movement, narrowed left ventricular outflow tract and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted in large left to right shunt (Qp : Qs = 5.7: 1), ASD and moderate pulfllonary hypertension. Finally, left ventriculogram revealed typical goose neck appearance of left ventrlcalar outflow tract. On Oct. 10, 1980, open heart surgery was performed. Operative findings were: 1. Large primum defect ($6{\times}5$ Cm in diameter) 2. Cleft on the anterior leaflet of mitral valve. 3. The upper portion of ventricular septum was descent but no interventricular communication. 4. Downward attachment of the atrioventricular valves on the ventricular muscular septum. 5. Medium sized secumdum defect ($2{\times}1$ Cm in diameter). The cleft was repaired with 4 interrupted sutures. The primum defect was closed with Teflon patch and the secundum defect was closed with direct suture closure. Postoperatively atrial flutter-fibrillation in EKG and Grade U/VI apical systolic murmur were found. The postoperative course was uneventful and discharged on 29th postoperative day in good general conditions.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.486-492
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• 2001

Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

• 한국의류산업학회지
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• 제22권2호
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• pp.250-260
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• 2020

The purpose of the present study was to explore the most effective body region and cooling temperature to alleviate heat strain of workers in hot environments. We developed liquid cooling hood, vest, sleeves and socks and applied the water temperatures of 10, 15, 20, and 25℃ through the liquid cooling garments in a hot and humid environment (33℃ air temperature and 70% RH air humidity). A healthy young male participated in a total of 16 experimental trials (four cooling garments × four cooling temperatures) with the following protocol: 10-min rest, 40-min exercise on a treadmill and 10-min recovery. The results showed that rectal temperature, mean skin temperature, and ratings of perceived exertion during exercise; heart rate and diastolic blood pressure during recovery; and total sweat rate were lower for the vest condition than other garment conditions(p < .05). However, there was no differences in mean skin temperature among the four cooling garments when we compared the values converted by covering area(%BSA). When we classified the results by cooling temperature, there were no consistent differences in thermoregulatory and cardiovascular responses among the four temperatures, but 25℃ water temperature was evaluated as being the most ineffective cooling temperature in terms of subjective responses. In conclusion, the results indicated that wearing cooling vest with < 20℃ cooling temperature can alleviate heat strain of workers in hot and humid environments. If the peripheral body regions are cooled with liquid cooling garments, larger cooling area with lower cooling temperature than 10℃ would be effective to reduce heat strain of workers. Further studies with a vaild number of subjects are required.