• Title/Summary/Keyword: Cuff

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Management of Acute Fulminant Myocarditis Using a Left Ventricular Assist Device - A case report - (좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 -)

  • Kang, Shin-Kwang;Park, Sang-Soon;Na, Myung-Hoon;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Seong, In-Whan
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.490-493
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    • 2001
  • A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.

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Free Vascularized Fibular Transfer with Double Barrel Fashion (혈관부착 생비골 중첩 이식술)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.54-61
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    • 1998
  • Free vascularized fibular is the most usuful bony donor of the long bone reconstruction in reconstructive microsurgical field. It has many benifits such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter with long pedicle, minimal donor site morbity too. In that situations of the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transfered. The bony circulation of the fibula has two ways, one from nutrient artery via peroneal artery through nutrient foramen which makes endosteal arterial network inside of the fibula, another way is periosteal network through outside encircling vascular network of the bone which distributed in muscle sleeves of the fibular diaphysis. Authors modified free vascularized fibular bone graft with transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to entry of the nutrient artery. This produces two vascularized bone struts that may be folded pararell to each other but that remain connected by the periosteum and muscle cuff surrounding the peroneal artery and veins. The proximal strut is vascularized by both a periosteal and endosteal blood supply, whereas the distal strut is vascularized by a periosteal blood supply alone. This procedure can call "doule barrel" free vascularized fibular graft. We performed 7 cases of doule barrel fashined fibular transplantation on distal femur and proximal tibial large defects. Average bone union time takes 7 months from that procedure. There were no significant bone union time differences between both proximal and distal struts. After solid union of the transfered double barrel fibular graft, there were no stress fracture in our series. We can propose double barrel free vascualized fibular graft is usuful method in that cases with very large bone defect on large long bones especially metaphyseal defects.

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Can prosthetic limbs made too quickly cause kidney damage?: a pilot study

  • Petrofsky, Jerrold S.;Browne, Mary;Jamshidi, Mahyar;Libo-on, Anthony;Lee, Haneul
    • Physical Therapy Rehabilitation Science
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    • v.3 no.2
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    • pp.119-124
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    • 2014
  • Objective: The use of chemicals for building prosthetic sockets present the possibility of being hazardous and unsafe due to off-gassing. The purpose of the present study was to investigate if freshly made materials used in prosthetic sockets causes off-gassing that would penetrate the skin and cause damage to the kidneys or blood. Design: Cross-sectional study. Methods: In this research, the off-gassing effects during the initial curing process of styrene monomer, vinyl ester resin, epoxy methacrylate resin, benzene-1, 3-dimethaneamine, trimethylhexanedlamine, and paratertiarybutylphenol were analyzed. Acid detection strips were placed inside newly fabricated mock-prosthetic sockets and left overnight in a closed environment to find out if acid was present in the invisible fumes. The plastic was worn by 9 subjects and urinalysis was made after 48 hours to test for any kidney or blood toxicity of the resins. Results: After wearing the plastic cuff for 48 hours, the ratio of protein to creatinine in the urine was raised to an abnormal level in five out of nine subjects. Four out of the nine subjects showed normal protein to creatinine ratios after wearing the device. The results showed that damage to the kidney occurred from wearing the resins after curing in half of the subjects. Conclusions: It is very important to conduct patient intakes which includes the assessment of renal function. Off-gassing in vented chambers may be needed to protect both prosthetists and patients.

Validation of the mobile wireless digital automatic blood pressure monitor using the cuff pressure oscillometric method, for clinical use and self-management, according to international protocols

  • Yoo, Sooyoung;Baek, Hyunyoung;Doh, Kibbeum;Jeong, Jiyeoun;Ahn, Soyeon;Oh, Il-Young;Kim, Kidong
    • Biomedical Engineering Letters
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    • v.8 no.4
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    • pp.399-404
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    • 2018
  • The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ${\pm}SD$, which ranged in $0.1{\pm}2.6mmHg$ for systolic blood pressure (SBP) and $0.5{\pm}2.2mmHg$ for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean${\pm}$SD) was $2.3{\pm}4.7mmHg$ for SBP and $2.0{\pm}4.2mmHg$ for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5 mmHg and a standard deviation that did not exceed 8 mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.

Rationale for Small Glenoid Baseplate: Position of Central Cage within Glenoid Vault (Exactech® Equinoxe® Reverse System)

  • Oh, Joo Han;Lee, Sanghyeon;Rhee, Sung-Min;Jeong, Hyeon Jang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.22 no.1
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    • pp.24-28
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    • 2019
  • Background: Glenoid baseplate location is important to good clinical outcomes of reverse total shoulder arthroplasty (RTSA). The glenoid vault is the determining factor for glenoid baseplate location, but, to date, there are no reports on the effect of central cage location within the glenoid vault on RTSA outcomes when using the $Exactech^{(R)}$ $Equinoxe^{(R)}$ Reverse System. The purpose of this study was to determine the appropriate cage location in relation to the glenoid vault and monitor for vault and/or cortex penetration by the cage. Methods: Data were retrospectively collected from the Samsung Medical Center (SMC) and Seoul National University Bundang Hospital (SNUBH). Patients who underwent RTSA between November 2016 and February 2018 were enrolled. Glenoid vault depth, central cage location within the vault were examined. Inferior glenoid rim-center distance, inferior glenoid rim-cage distance, and center-cage center distances were collected. Results: Twenty-two patients were enrolled. Three SNUBH patients had inappropriate central cage fixation (33.3%) versus 4 SMC patients (30.8%). All cage exposures were superior and posterior to the glenoid vault. Mean center-cage distance was 5.0 mm in the SNUBH group and 5.21 mm in the SMC group. Center-prosthesis distance was significantly longer in the inappropriate fixation group than in the appropriate fixation group (p<0.024). Conclusions: To ensure appropriate glenoid baseplate fixation within the glenoid vault, especially in a small glenoid, the surgeon should place the cage lower than usually targeted, and it should overhang the inferior glenoid rim.

The Volume of Subscapularis Muscle Remains Unaffected by Supraspinatus Tendon Tears: Three-dimensionally Reconstructed Magnetic Resonance Imaging Analysis

  • Jun, Yong Cheol;Moon, Young Lae;Bhardwaj, Havinder Dev;Lim, Jae Hwan;Cha, Dong Hyuk
    • Clinics in Shoulder and Elbow
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    • v.22 no.1
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    • pp.3-8
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    • 2019
  • Background: This study aimed to compare the subscapularis muscle volume between the intact groups (group I) and supraspinatus tendon tear groups (group T) based on the sex and three different age groups. Methods: Subjects with a group I and subjects with group T without any other lesions were retrospectively evaluated from among patients who received a magnetic resonance imaging (MRI) scan between January 2011 and December 2013. The MRI scans were studied by a consultant radiologist. The subscapularis muscle volume was compared according to the age and sex; the age groups were categorized as patients in their 40s, 50s, and 60s. The volume of subscapularis muscle was measured by three-dimensional reconstructed images acquired through the axial section of 1.5T MRI. Results: No statistically significant differences were observed between subscapularis muscle volume of the group I and group T, except for male patients in their 50s (group I: $100,650mm^3$ vs. group T: $106,488mm^3$) and 60s (group I: $76,347mm^3$ vs. group T: $99,549mm^3$) (p<0.05). Males had a larger mean volume of subscapularis muscle than females, and the subscapularis muscle volume decreased in a linear manner with increasing age. Conclusions: Decrease in subscapularis muscle volume was observed with increasing age, and the impact of supraspinatus tear on subscapularis muscle volume is age and sex dependent.

Rotating Arm Internally Can Change the Arthroscopic Diagnosis of a Partial-thickness Tear of the Subscapularis

  • Kim, Hyungsuk;Song, Hyun Seok;Kang, Seung Gu;Han, Sung Bin
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.135-138
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    • 2019
  • Background: The aims of this study were (1) to examine the footprint of the subscapularis tendon using the traditional posterior portal and $30^{\circ}$ arthroscope by simple internal rotation of the arm during surgery, and (2) to classify the pattern of a subscapularis partial-thickness tear. Methods: This study analyzed a total of 231 patients with a partial-thickness subscapularis tear from 550 consecutive patients undergoing an arthroscopic operation who had a visualization of the subscapularis tendon footprint by internal rotation of the arm. First, the patients were classified into four categories according to the tear pattern: (1) stable lamination, (2) unstable lamination, (3) avulsion, and (4) laminated avulsion. Randomized arthroscopic videos were reviewed blindly by two independent orthopedic surgeons. The pattern of the tear of the subscapularis at the neutral position and after internal rotating the arm were assessed and compared with the treatment decision (level IV case series). Results: Stable lamination, unstable lamination, avulsion, and laminated avulsion were observed in 9.1% (n=21), 20.8% (n=48), 41.1% (n=95), and 29.0% (n=67) of cases, respectively. In 145 out of 231 cases (62.8%), the decision was changed after inspecting the footprint after internal rotation of the arm, and the treatment method was changed in 116 (50.2%) cases. Conclusions: In a subscapularis tendon partial-thickness tear, inspecting the footprint of the subscapularis tendon is essential to diagnosing and deciding on the appropriate treatment. In addition, simply internal rotating the arm during surgery when using the traditional posterior portal and $30^{\circ}$ arthroscope can be a valuable method.

The Evaluation of Exogenous Melatonin Administration in Supraspinatus Overuse Tendinopathy in an Experimental Rat Model

  • Kocadal, Onur;Pepe, Murad;Akyurek, Nalan;Gunes, Zafer;Surer, Hatice;Aksahin, Ertugrul;Ogut, Betul;Aktekin, Cem Nuri
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.79-86
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    • 2019
  • Background: Increased oxidative stress and inflammation play a critical role in the etiopathogenesis of chronic tendinopathy. Melatonin is an endogenous molecule that exhibits antioxidant and anti-inflammatory activity. The aim of this study was to evaluate the biochemical and histopathological effects of exogenous melatonin administrations in supraspinatus overuse tendinopathy. Methods: Fifty rats were divided into the following four groups: cage activity, melatonin treatment, corticosteriod therapy, and control. Melatonin (10 mg/kg, intraperitoneal; twice a day) and triamcinolone (0.3 mg/kg, subacromial; weekly) were administered to the treatment groups after the overuse period. Biochemical and histopathological evaluations were performed on serum samples and biopsies obtained from rats. Plasma inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were evaluated biochemically. Results: The TAS, TOS, OSI, iNOS, and VEGF values were significantly lower than the pre-treatment levels in rats receiving exogenous melatonin treatment (3 or 6 weeks) (p<0.05). TOS, iNOS, VEGF, and OSI values after 3 weeks of triamcinolone administration, and TOS, VEGF, and OSI levels after 6 weeks of triamcinolone application, were significantly lower than the pre-treatment levels (p<0.05). Conclusions: Exogenous melatonin application in overuse tendinopathy reduces oxidative stress and inflammation. Melatonin might be an alternative potential molecule to corticosteroids in the treatment of chronic tendinopathy.

The Effects of Leg Blood Flow Restriction Exercise on Muscle Size and Muscle Strength (하지 혈류제한 운동이 근육크기와 근력에 미치는 영향)

  • Kwon, Hae-Yeon;Ahn, So-Youn
    • PNF and Movement
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    • v.10 no.1
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    • pp.61-70
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    • 2012
  • Purpose : The purpose of this study was to investigate thigh muscle-bone CSA and leg strength during low-intensity exercise program with leg blood flow restriction by external compression to reduce muscle outflow. Methods : Eighteen health students gave informed written consent to participate in this investigation. An occlusion cuff was attached to the proximal end of the leg so that blood flow was reduced during the training. The training was conducted one times a day, three times a week, for 8 weeks using one sets of 30 minutes. The training program performed to squat with standing, lunge with standing and heel raise with one leg standing. Measurements of thigh muscle-bone CSA(cross-sectional area) and leg strength were evaluated pre and post-training. Statistical evaluation of these data was accomplished utilizing a paired t-test by SPSS 12.0 program for windows. Significance level was set at p <.05. Results : All data are reported as means and standard deviations(SD) for all variables. The result of the study is followed; After the training, muscle-bone CSA, gluteus maximus m, quadriceps m, hamstring m of both legs were significantly improved but not calf muscle(p<.05). There was no significant difference of change quantity between muscle-bone CSA and leg strength in Lt. and Rt. side. But the variation in leg muscle strength of Rt. leg(dominant) was much more increased than Lt. leg(non-dominant) after 8 weeks training. Conclusion : Low-intensity training with leg blood flow restriction offers a potentially useful method for improving leg muscle strength.

A study on the perception and design preference of new Hanbok one-piece dress (신한복 원피스에 대한 인식과 디자인 선호도에 관한 연구)

  • Heo, Seungyeun;An, Myungsook;Cha, SuJoung
    • Journal of the Korea Fashion and Costume Design Association
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    • v.23 no.1
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    • pp.129-142
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    • 2021
  • This study aims to identify the perception of New-Hanbok one-piece dresses that female consumers have purchased and to analyze the design preference based on design types and brands. Analysis was conducted on New-Hanbok brand websites, and additional research was carried out through a survey of 402 women in their 20s and older. The survey consisted of 36 questions, which were divided into categories including pattern, color, material, and recognition of the one-piece dress. The research results are as follows. First, the preferred design form of the New-Hanbok one-piece dress was long length, medium fit, princess line, round git, rectangular git, regular width git, V neckline, regular width dongjeong, front closing with a wide overlap of the chest are a, narrow goreum, a skirt part with moderate crease spacing and number of pleats, A-line skirt silhouette, long and narrow sleeves, diagonal shoulder line, and a cuff at the end of each sleeve. Second, the preferred colors of the New-Hanbok one-piece dress were bright, neutral, or light and were predominately monochromatic Third, the preferred fabric conveyed a contemporary atmosphere through its print pattern. The most favored fabric material was cotton. Through this study, more systematic design development research should be carried out focusing on the current situation and identifying problems, thereby improving traditional culture.