• Title/Summary/Keyword: Cardiac rehabilitation

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Relationship between Pain-related Variables and Extent of Heart Disease (심장질환자에서 흉부 통증 특성과 심장질환 정도와의 관계)

  • Kim, In-Ja
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.1
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    • pp.7-13
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    • 2003
  • Purpose: To identify the essential characteristics of pain which nurse have to obtain for patients with chest pain, 92 patients who were admitted in medical units to take intensive tests for heart disease were investigated cross-sectionally. Method: Duration, severity, stress, anxiety, perceived severity, number of painful area, number of accompanying symptoms, triggering activity, and pattern were included as the characteristics of pain. Ejection fraction of left ventricle and number of involved area detected by ultrasonography and number of diseased coronary artery detected by cardiac catheterization were assessed as the variables of heart disease extent. Result: Severity of pain was found to be correlated with all three variables of heart disease extent. Perceived severity and number of accompanying symptoms were correlated with two of them. Anxiety, number of painful area and pattern were related with the number of involved area. Conclusion: Pain severity reported by patients is found to be the most important variable to be obtained from patient. Variables such as perceived severity, number of accompanying symptoms, anxiety, number of painful area and pattern also have to be carefully assessed to anticipate the extent of heart disease.

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Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team (성인 단장증후군 환자의 다학제 장 재활: 국내 단일 기관 다학제 장재활 클리닉의 경험)

  • Yoon, Sojeong;Lee, Sanghoon;Park, Hyo Jung;Kim, Hyun-Jung;Yoon, Jihye;Min, Ja-Kyung;Seo, Jeong-Meen
    • Journal of Clinical Nutrition
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    • v.10 no.2
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    • pp.45-50
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    • 2018
  • Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

Immunohistochemical Localization on the Central Nuclei Innervating Rat Parotid Gland Using Virus as a Neural Tracer (신경로추적자로 바이러스를 이용한 흰쥐 귀밑샘지배 중추신경핵의 면역조직화학적 동정)

  • Kim Jin-Sang;Chae Yoon-Won;Lee Heung-Shik;Kang Tae-Chun;Yi Seoung-Joon;Lee Jae-Hyun;Choi Jin-Ho;Kim Dong-Dae
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.117-126
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    • 1997
  • This Study was carried out to investigate the secondary cental nuclei innervating rat parotid gland. PRV-BaBlu as a neuronal tracer was injected into the left parotid gland and brains obtained through cardiac perfusion were treated by immunohistochemical staining. The results were as follows: L. The secondary central nuclei innervating rat parotid gland were paraventricular nucleus and central part of amygdaloid complex largely in diencephalon. 2. The paraventricular nucleus and central part of amygdaloid complex in diencephalon showed morphological asymmetry between PRV-BaBlu injected site and uninjected one. 3. The Ratio between total neurons and PRV-BaBlu infected neurons in paraventricular nucleus was $27.62{\pm}16.23\%$ in left and $12.78{\pm}8.69\%$ in right. 4. The Ratio between total neurons and PRV-BaBlu infected neurons in central part of amygdaloid nucleus was $14.25{\pm}9.26\%$ in left and $8.35{\pm}6.26\%$ in right.

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Minimally Invasive Cardiac Surgery - Three different approaches - (최소 침습성 심장수술 -세가지 다른 접근법-)

  • Chung, Sung-Hyuk;Yang, Ji-Hyuk;Nam, Hye-Won;Kim, Ki-Bong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.438-441
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    • 1999
  • Background: Minimally invasive cardiac surgery has emerged as a new approach to the conventional median sternotomy. The suggested advantages of the minimally invasive technique includes improved cosmesis, simplicity of opening and closing the chest, less postoperative pain, less risk of infection and bleeding, early rehabilitation, and reduced length of hospital stay. Material and Method: Between March 1997 and December 1997, we performed 36 cases of minimally invasive cardiac surgery via three different approaches ; right paramedian, transverse sternotomy and mini-sternotomy with upper sternal split. Result: There was no operative mortality. Postoperative complications were atrial fibrillation in 4 patients, bleeding that required reoperation in 1 patient, and delayed wound closure in 1 patient who underwent 3rd redo operation. Average length of skin incision was 9.1${\pm}$0.9 cm. Average duration of stay in the intensive care unit was 48${\pm}$29 hours and the patients were discharged 10${\pm}$7 days after the operation. Conclusion: In spite of the difficulties in defibrillation, deairing, and cardiac decompensation, minimally invasive approaches will be applied increasingly because of the suggested advantages.

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Functional Electrical Stimulation : A Review of Clinical Application (기능적 전기자극의 임상 적용에 관한 고찰)

  • Cho, Mi-Suk;Lee, In-Hak;Kim, In-Sup
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.4 no.1
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    • pp.39-47
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    • 2006
  • Functional Electrical Stimulation(FES) cause paralysed muscles to contract in some clinical circumstances. Generally, FES has been thought of as a valuable tool in activating any skeletal muscle paralysed as a result of upper motor neuron damage. But, the function of cardiac and smooth muscle is also affected by upper motor neuron damage. Today, various applications of FES are investigated, including conditioning cardiovascular exercise, caugh and breathing assistant, improving bowel and bladder control, hand grasp, standing and walking etc. This review will focus on the literature reporting application of FES to control respiratory capabilities and internal organ function as well as increase muscular strength, hand grasp, standing and walking in patients with upper motor diseases.

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Assessment of autonomic function in Cerebral palsy patients during graded head-up tilt (뇌 손상 환자(Cerebral palsy)의 Head up Tilt 상태에서의 심박변동과 자율 신경 활동 평가)

  • Choi, J.J.;Cho, S.R.;Lee, J.H.;Lee, M.H.
    • Proceedings of the KIEE Conference
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    • 2002.07d
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    • pp.2693-2695
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    • 2002
  • In this paper, the power spectral analysis of heart rate variability(HRV) was performed to evaluate effects of orthostatic stress with head-up tilt on autonomic nervous system(ANS) for 20 healthy male subjects(age : 245 yr.) and a new method was proposed to assess the autonomic balance. The ECG signals wore recorded for 3 minutes in both the supine and 70 head-up tilt positions, and then the HRV signals underwent power spectrum analysis at each position. The results of this study suggest that cardiac autonomic functions, such as sympathetic tone in autonomic balance with the increment of sympathetic tone and the decrement of parasympathetic tone which occur during head-up tilt position, arc not sufficient to overcome tile orthostatic stress arising in Cerebral Palsy.

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The Principles and Practices of Immunocytochemical method in Light Microscopic Level (광학 현미경적 수준에서의 면역조직화학적 방법의 원리 및 실제)

  • Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.229-250
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    • 1991
  • The study was carried out to investigate and review the principles and practices of immunocytochemical method in light microscopic level. The results were as follows. 1. Immunocytochemistry is the method to search out the intracellular position of the specific meterials using antigen -antibody reaction. 2. The chief items in immunocytochemistry are antigen, antibody and chromogen. 3. The identifical fixation is cardiac perfusion fixation. 4. The tissue slides must be prepared by vibratomy. 5. All stainings are carried out with free floating staining method. 6. There are polyclonal and monoclonal antibodies used in immunocytochemistry.

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Influence of Home Based Exercise Intensity on the Aerobic Capacity and 1 Year Re-Hospitalization Rate in Patients with Chronic Heart Failure

  • Ryu, Ho Youl;Kim, Ki Song;Jeon, In Cheol
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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    • pp.181-186
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    • 2018
  • Purpose: This study investigated the effects of home-based exercise intensity on the aerobic capacity and 1 year re-hospitalization rate in patients with chronic heart failure (CHF). Methods: Forty seven patients with CHF (males 33, females 14, age $61.3{\pm}9.8years$) participated in this study. The patients were allocated randomly to 3 groups in accordance with home-based exercise intensity: no home based exercise (NHE, 40%, n=19), moderate intensity home-based exercise (MIHE, 43%, n=20), and high intensity home based exercise (HIHE, 17%, n=8). All patients completed the symptom-limited cardiopulmonary exercise (CPX) test safely at the cardiac rehabilitation hospital. Results: The NHE group significantly showed lower peak $VO_2$ and a higher $VE/VCO_2$ slope than the MIHE (p<0.05) and HIHE (p<0.01) groups. On the other hand, the NHE group did not show significant differences in the other hemodynamic responses, such as heart rate (HR) max, HR reserve, maximal systolic blood pressure (SBP), and SBP reserve. Nine out of 19 NHE patients (47%) were re-hospitalized related to heart disease and two out of 20 MIHE (10%) patients were re-hospitalized, but nobody in the HIHE group were re-hospitalized within 1 year from the CPX test. Conclusion: In patients with CHF, home-based self-exercise is one of the important factors for reducing the re-hospitalization rate. In addition, improved aerobic capacity is strongly associated with a lower re-hospitalization rate. In particular, re-hospitalized CHF patients showed significant differences in respiratory parameters and hemodynamic parameters compared to the non-re-hospitalized patients.

Myocardial atrophy in children with mitochondrial disease and Duchenne muscular dystrophy

  • Lee, Tae Ho;Eun, Lucy Youngmin;Choi, Jae Young;Kwon, Hye Eun;Lee, Young-Mock;Kim, Heung Dong;Kang, Seong-Woong
    • Clinical and Experimental Pediatrics
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    • v.57 no.5
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    • pp.232-239
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    • 2014
  • Purpose: Mitochondrial disease (MD) and Duchenne muscular dystrophy (DMD) are often associated with cardiomyopathy, but the myocardial variability has not been isolated to a specific characteristic. We evaluated the left ventricular (LV) mass by echocardiography to identify the general distribution and functional changes of the myocardium in patients with MD or DMD. Methods: We retrospectively evaluated the echocardiographic data of 90 children with MD and 42 with DMD. Using two-dimensional echocardiography, including time-motion (M) mode and Doppler measurements, we estimated the LV mass, ratio of early to late mitral filling velocities (E/A), ratio of early mitral filling velocity to early diastolic mitral annular velocity (E/Ea), stroke volume, and cardiac output. A "z score" was generated using the lambda-mu-sigma method to standardize the LV mass with respect to body size. Results: The LV mass-for-height z scores were significantly below normal in children with MD ($-1.02{\pm}1.52$, P<0.001) or DMD ($-0.82{\pm}1.61$, P =0.002), as were the LV mass-for-lean body-mass z scores. The body mass index (BMI)-for-age z scores were far below normal and were directly proportional to the LV mass-for-height z scores in both patients with MD (R =0.377, P<0.001) and those with DMD (R =0.330, P=0.033). The LV mass-for-height z score correlated positively with the stroke volume index (R =0.462, P<0.001) and cardiac index (R =0.358, P<0.001). Conclusion: LV myocardial atrophy is present in patients with MD and those with DMD and may be closely associated with low BMI. The insufficient LV mass for body size might indicate deterioration of systolic function in these patients.

Cardiopulmonary Response during Mechanical Horseback Riding Exercise in Healthy Adult (건강한 성인에서 기계승마 운동 동안의 심폐 반응)

  • Boo, Seung-Hyun;Noh, Se-Eung;Lee, Eun-Sun;Joo, Min-Cheol
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.4
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    • pp.243-249
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    • 2016
  • In this paper, we evaluate the effectiveness of mechanical horseback riding exercise training for cardiopulmonary responses in 26 healthy adults (male 14, female 12) and suggest its clinical applicability. Exercise was performed using a mechanical horseback riding machine, JOBA(R) (Panasonic Electric Works, Osaka, Japan) and riding movement speed was increased from level 2 (0.73Hz), to 4 (0.9Hz), to 6 (1.03Hz), to 8 (1.2Hz), to 9 (1.3Hz) and maintained 3minutes in each level. Heart rate, blood pressure, maximum oxygen consumption (VO2max) were measured by respiratory gas analysis system (TruOne 2400, Parvo Medics, USA) and exercise tolerance test system(Q Stress, Cardiac Science, USA). To measure exercise intensity, metabolic equivalent (MET) were measured and percent of Heart rate reserve (%HRR), percent of peak heart rate (%peak HR) and calorie consumption were calculated. The results were analysed by SPSS 18.0. We found that the exercise intensity of mechanical horseback riding exercise using JOBA(R) for 15 minutes is moderate in healthy adult who received pre-training.