• Title/Summary/Keyword: Cuff

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The Changes of Cuff Pressure from Endotracheal Intubation for Long-term Mechanical Ventilation (장기간 기계호흡 환자에서 기관내 관의 기낭압의 변화)

  • Jung, Bock-Hyun;Park, Whan;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.156-165
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    • 2002
  • Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.

Delaminated Rotator Cuff Tear: Concurrent Concept and Treatment

  • Kim, Jung-Han;Jung, Soo-Hwan
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.159-170
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    • 2019
  • Delaminated rotator cuff tear pertains to the horizontal split of the tendon substance. As reported previously, the presence of a delaminated tear and incidence of delaminated rotator cuff tear ranges from 38% to 92%. The different strain intensities applied across the rotator cuff tendon, and the shear stress between the bursal and articular layers seem to play a role in its pathogenesis. In a delaminated rotator cuff tear, the degree and direction of retraction between two layers differ, with accompanying intrasubstance cleavage. A surgeon therefore needs to consider and carefully evaluate the tear characteristics when repairing delaminated rotator cuff tear. Delaminated rotator cuff tear is considered to be a poor prognostic factor after rotator cuff repair, but numerous surgical repair techniques have been introduced and applied to resolve this problem. Recent literature has reported good clinical outcomes after delaminated rotator cuff repair.

Design of Noninvasive Arterial Blood Pressure Measurement System by Using Double-Cuffs Oscillometric Method (이중 커프 오실로메트릭법을 이용한 비침습 동맥압 측정시스템의 설계)

  • Lee, Pil-Jae;Lee, Young-Jae;Kim, Dong-Jun;Lee, Jae-Ho;Lim, Min-Gyu;Lee, Jeong-Whan
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.61 no.6
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    • pp.885-890
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    • 2012
  • In this study, a new blood pressure measuring system was proposed and implemented. An additional small-cuff was placed on the center of a inner cuff to measure morphological signals and new oscillometric ratio. The proposed BP-measuring system is composed of an external cuff, an inner cuff and a small-cuff. Oscillation signal from small-cuff is interpolated with 7th-order fitting polynomials and SBP, DBP ratio were 22.2% and 87.7%. Experimental data were gathered from 20 volunteers ($25{\pm}4$ years) and arterial blood pressure values were compared with auscultation, sphygmomanometers, small-cuff and inner-cuff. As a result, the difference in systolic BP between auscultation and the small-cuff was 1.93(${\pm}1.28$) mmHg, and the inner-cuff was 4.53(${\pm}4.39$) mmHg, and sphygmomanometer was 6.68(${\pm}3.99$) mmHg, and the corresponding difference in diastolic BP was 2.50(${\pm}2.04$) mmHg, 3.50(${\pm}3.19$) mmHg, 7.35(${\pm}5.62$), respectively.

Reverse Total Shoulder Arthroplasty in the Massive Rotator Cuff Tear

  • Jeong, Jin Young;Cha, Hong Eun
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.145-150
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    • 2014
  • In the patients of retracted massive rotator cuff tears, there are much of difficulty to functional recovery and pain relief. Nevertheless the development of treatment, there are still debates of the best treatments in the massive rotator cuff tears. Recenlty various of treatments are introduced; these are acromioplasty with debridement, biceps tenotomy, great tuberoplasty with biceps tenotomy, partial repair, mini-open rotator cuff repair, arthroscopic rotator cuff repair, soft tissue augmentation, tendon transfer, flap, hemiarthroplasty, and reverse total shoulder arthroplasty. That there is no difference of result for reverse total shoulder arthroplasty between patients who have massive rotator cuff tear without arthritis and patients who have cuff tear arthropathy. Reverse total shoulder arthroplasty is one of reliable and successful treatment options for massive rotator cuff tear. Especially it is more effective for patients who have a pseudoparalysis.

New Retear Pattern after Rotator Cuff Repair at Previous Intact Portion of Rotator Cuff

  • Choi, Chang-Hyuck;Kim, Sung-Guk;Nam, Jun-Ho
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.237-240
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    • 2016
  • Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.

Arthroscopic Footprint Reconstruction of Bursal-side Delaminated Rotator Cuff Tears using the Suture-bridge Technique

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong;Yang, Jae-Hoon;Kim, Dong-Kyu;Kim, Pil-Sung
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.210-210
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    • 2009
  • For a bursal-side retracted laminated rotator cuff tear, simple repair of the retracted bursal-side rotator cuff might be insufficient because the repaired tendon could remain as an intratendinous tear of the rotator cuff. We present a repair method for intratendinous rotator cuff tears using the suture-bridge technique. We believe that this method helps to preserve the remnant rotator cuff tendon without tissue damage and restores the normal rotator cuff footprint in bursal-side delaminated rotator cuff tears.

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Sleep disturbances in rotator cuff pathology: insights into mechanisms and clinical implications

  • Mohammad Daher;Ryan Lopez;Oscar Covarrubias;Peter Boufadel;Mohamad Y. Fares;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • v.27 no.4
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    • pp.514-518
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    • 2024
  • Rotator cuff disease is highly prevalent and can have a detrimental effect on the quality of life of affected patients. One of the most common complaints from rotator cuff disease is sleep disturbance due to shoulder pain. Numerous studies have attempted to explore the relationship between rotator cuff disease and sleep disturbance, but results are inconsistent and limited. In this setting, the Pittsburgh Sleep Quality Index (PSQI) plays an important role in preoperative assessment and evaluation of sleep in rotator cuff patients. However, despite the current efforts, the literature presents conflicting results regarding the relationships between magnetic resonance imaging characteristics of rotator cuff tear and PSQI score, signifying a gap in understanding. That being said, it has been shown that rotator cuff repair surgery can alleviate sleep disturbances witnessed preoperatively in and can restore quality of life.

Arthroscopic Rotator Cuff Repair : Outcome of 1 to 4 years follow up (관절경적 회전근 개 봉합술 : 1 - 4년 추시 결과)

  • Park, Jin-Young;Chung, Kyung-Tae;Meng, Ye;Park, Hee-Gon
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.55-62
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    • 2002
  • Purpose : To compare and analyze the results of arthroscopic subacromial decompression and rotator cuff repair between partial rotator cuff tear and complete rotator cuff tear. Material and Methods : The authors studied 42 patients of rotator cuff tear with operation and followed over one year at Dankook university hospital from September, 1998 to March, 2001 The patient average age is 53 years and follow up period is 23 months (12-42mon1hs). We obtained 22 cases in the partial rotator cuff tear group and 20 cases in the complete rotator cuff tear group. In all cases, we used ASES methods to evaluated pain scale and function. Result : In the last follow up patients, the pain scale is decreased from 7.2 to 0.9 (ASES method : 34 to 91) in the partial rotator cuff tear group and from 7.6 to 1.2 (ASES method . 29 to 88) in the complete rotator cuff tear group, but there was no evidence of statistical difference between two groups (P>0.05). The range of motion after operation were increased in two groups. Excellent to good results were obtained 93% and 95% patients had pain relief and satisfied function. Conclusion : Arthroscopic subacromial decompression and arthroscopic rotator cuff repair showed good results for both of (ult-thickness and partial thickness rotator cuff tear patients in pain relief and improving the function.

Biological Characteristics of Rotator Cuff Tendon (회전근 개의 생물학적 특성)

  • Park, Hyung-Bin;Sung, Chang-Meen
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.175-179
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    • 2010
  • Purpose: Rotator cuff disease is the most common shoulder disease. Rotator cuff tear, which is related to cuff tendon degeneration, is commonly encountered in clinical practice. Materials and Methods: Knowledge about the biology of the normal rotator cuff is fundamental to understanding the pathophysiology of and degenerative processes in rotator cuff tendon tears. Furthermore, such basic knowledge provides a rationale for and facilitates the development of treatment modalities. Results and Conclusion: Therefore, we reviewed the biology of the normal rotator cuff tendon, theories to explain the pathophysiology of rotator cuff tendon tear, and current research on apoptosis of rotator cuff tenofibroblasts.

Partial-thickness rotator cuff tears: a review of current literature on evaluation and management

  • Ramesh Radhakrishnan;Joshua Goh;Andrew Hwee Chye Tan
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.79-87
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    • 2024
  • Rotator cuff disease is a common cause of shoulder pain for which partial-thickness rotator cuff tears occupy a significant proportion. Such tears are often difficult to diagnose and manage in the general clinic setting. A review of the available literature from well-known databases was performed in this study to provide a concise overview of partial-thickness rotator cuff tears to aid physicians in their understanding and management.