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Aortic Stenosis: New Insights in Diagnosis, Treatment, and Prevention

  • Saki Ito;Jae K. Oh
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.721-736
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    • 2022
  • Aortic stenosis (AS) is one of the most common valvular heart diseases and the number of patients with AS is expected to increase globally as the older population is growing fast. Since the majority of patients are elderly, AS is no longer a simple valvular heart disease of left ventricular outflow obstruction but is accompanied by other cardiac and comorbid conditions. Because of the significant variations of the disease, identifying patients at high risk and even earlier detection of patients with AS before developing symptomatic severe AS is becoming increasingly important. With the proven of efficacy and safety of transcatheter aortic valve replacement (TAVR) in the severe AS population, there is a growing interest in applying TAVR in those with less than severe AS. A medical therapy to reduce or prevent the progression in AS is actively investigated by several randomized control trials. In this review, we will summarize the most recent findings in AS and discuss potential future management strategies of patients with AS.

Bilateral cleft lip repair with simultaneous premaxillary setback and primary limited rhinoplasty

  • Park, Young-Wook;Kim, Chan-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.43.1-43.5
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    • 2018
  • Background: Functional closure of the orbicularis oris muscle and esthetic reconstruction of nasolabial components are impossible in patients with severely deformed premaxilla. Here, we review a surgical strategy for patients with unremedied premaxilla retrospectively. Results: Vomerine ostectomy and premaxillary setback with nasolabial repair were performed in 12 patients with bilateral cleft lip and palate. The mean age of patients was 21.7 months. The extent of ostectomy varied between 3 and 11 mm. There were no serious complications from defective perfusion to the premaxilla or the philtral flap. The follow-up period ranged from 2 to 25 months. Proper positioning of the premaxilla and satisfactory nasolabial esthetics were achieved in all patients. Conclusions: We performed nasolabial repair after premaxillary setback without jeopardizing the premaxillary segment or the philtral flap. Our surgical strategy could be recommended in poor socio-economic circumstances due to the cost effectiveness of limiting the number of surgeries.

Five Cases of the Patients with the Nummular Eczema Treated with Hwaseup-tang (화습탕으로 호전된 화폐상 습진 환자 치험 5례 증례보고)

  • Lee, Jae-Hwi;Bang, Hyun-Jin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.1
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    • pp.92-103
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    • 2019
  • Objectives : The purpose of this study is to report the clinical effect of Hwaseup-tang for nummular eczema patients. Methods : This study was conducted with five nummular eczema patients who have visited Ryoum Korean Medicine Clinic. They were treated with Hwaseup-tang and acupuncture. In order to evaluate the results of these treatments, we observed the itching condition of the patients and took photographs of the lesions. Results : After Hwaseup-tang medicine treatment, the nummular eczema lesions of five patients were remarkably disappeared and their itching condition was also improved rapidly. Conclusions : These five cases indicate that Hwaseup-tang may be effective in the treating of nummular eczema patient, although the number of cases was limited to five.

An Analysis of the Difference between Early and Older elderly in Leisure Activities Satisfaction in Geriatric Hospitals (요양병원의 여가활동 만족도에 대한 전·후기 고령자간의 차이 분석)

  • Cho, Duk Young
    • The Korean Journal of Health Service Management
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    • v.12 no.4
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    • pp.43-57
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    • 2018
  • Objectives: This study analyzes whether the leisure activities satisfaction of elderly and older elderly patients differs with population sociology characteristics for the leisure activities services provided by geriatric hospitals, and to provide basic information to make reasonable decisions. Methods: Difference Analysis of the difference (T-test, ANOVA) in leisure activities satisfaction was conducted for the elderly and older elderly patients hospitalized in nine hospitals. Results: First, In the planning stage of leisure activity program, it is necessary to consider the tendency of men and women to prefer gender-based leisure activity service. Second, It was found that old elderly patients were more in number than elderly patients. Third, managers of geriatric hospitals in Busan and Kyungnam area should consider the needs of the patients in the planning and implementation of leisure activities and improve their leisure activity programs or develop more programs for better customer satisfaction.

A Study on the Projected Workforce of Nephrology Clinical Nurse Specialist(CNS) in Korea (신장전문간호사 수요추계에 관한 연구)

  • 오복자;신성례
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.284-292
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    • 2003
  • Purpose: The purpose of this study was to study the projected workforce of nephrology CNS in Korea. Method: Need models, ratio methods and expert opinion were used for projecting needs for the nephrology CNS. Result: In 2001, there are 28,046 ESRD(end stage of renal disease)patients, 304 renal replacement centers and 1695 nephrology nurses in Korea. the hemodialysis patients per hemodialysis nurse was 12. The number of nephrology CNS required to meet the demand for caring of ESRD patients in 2002, 2005 and 2020 was estimated at 616, 837 and 3105, respectively. 47 ESRD patients per nephrology CNS was revealed as a workforce standard before 2005. After 2005, It was 31 ESRD patients per nephrology CNS. Conclusion: This study founded the need to project future increments and development in supply of qualified nephrology CNS.

Prediction Factors of Fatigue in Patients with Fibromyalgia (섬유조직염환자의 피로 예측 요인)

  • Han, Sang-Sook
    • Journal of East-West Nursing Research
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    • v.11 no.1
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    • pp.42-50
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    • 2005
  • Purpose: The purpose this research was to provide with basic data in the control of the fatiguer found in the patients with fibromyalgia by analysing the factors that predict that. Method: At three university medical center, appointed 245 out-patients diagnosed of fibromyalgia according to the conditions by American College of Rheumatology (1990). The research instruments used in this study were graphic rating scale(Anxiety, sleep disturbance, pain, joint stiffness and depression), physical activity, the number of tender points, life satisfaction and Self-efficacy scale. In data analysis, SPSS 12.0 program was utilized and data were analyzed using descriptive statistics, Pearson's correlation coefficient and multiple regression. Result: The factors that predict the fatigue of patients with fibromyalgia were sleep disturbance, life satisfaction, pain, joint stiffness, illness duration, and anxiety which explained 50.1% of the fatigue. Conclusion: It has been confirmed that the regression equation model of this research may serve as a fatigue prediction factors in patients with fibromyalgia.

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Affecting Factor on Sleep Disorder in Patients with Fibromyalgia (섬유조직염환자의 수면장애에 영향을 미치는 요인)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.11 no.2
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    • pp.176-186
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    • 2004
  • Purpose: The purpose this research was to provide with basic data in the control of the sleep disorder found in the patients with fibromyalgia by analysing the main factors that affect that. Method: At two university medical center, appointed 171 out-patients diagnosed of fibromyalgia according to the conditions by American College of Rheumatology(1990). The research instruments used in this study were VAS Scale(Anxiety, fatigue, pain, joint stiffness and depression), physical activity family support, the number of tender points and Self-efficacy scale. In data analysis, SPSS 11.0 program was utilized and data were analyzed using descriptive statistics, Pearson's correlation coefficient and multiple regression. Result: The main factors that affect the sleep disorder of patients with fibromyalgia were fatigue, physical activity, and depressions which explained 46.2% of the sleep disorder. Conclusion: It has been confirmed that the regression equation model of this research may serve as a sleep disorder prediction factors in patients with fibromyalgia.

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Clinical Study of Hemoptysis in Patients with Pulmonary Tuberculosis (각혈을 동반한 폐결핵환자의 임상적 고찰)

  • 김기만
    • Journal of Chest Surgery
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    • v.22 no.6
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    • pp.1049-1055
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    • 1989
  • We have reviewed 73 patients who experienced hemoptysis with pulmonary tuberculosis to analyze the factors contributing hemoptysis and its management The result are; 1. The age group between 30 * 50 years old was major prevalent group [59%]. 2. Sexual ratio was 3.9 to 1, as 58 men and 15 women. 3. In 58 patients [79.5 %], the number of hemoptysis in frequency was less than 5 times. 4. The quantity of hemoptysis was ranged from less than 50 ml to more than 600 ml and 20 patients [27.4%] experienced bleeding more than 600 ml at once. 5. There was no seasonal difference in hemoptysis. 6. The common prodromal symptoms of hemoptysis were coughing, fatigability, hot foreign sensation of throat in order of frequency. 7. In chest roentgenographic finding, the cavitary lesion was the most common finding, 67% [51 cases], and the multiple cavity was 19.2%[14 cases]. 8. 23 patients [31.37%] were operated for control of hemoptysis and pulmonary tuberculosis itself, 7[30.43 %] of them suffered from complication of empyema, respiratory failure, empyema with bronchopulmonary fistula. 9. One patient [4%] was died due to respiratory failure after left thoracoplasty.

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Surgical Thrombectomy in Deep Vein Thrombosis (심부 혈전 증의 외과적 혈전제거술)

  • Kim, Seong-Ho;Lee, Sang-Ho
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1214-1219
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    • 1991
  • From July 1988 to January 1991 six patients, aged 29 to 70 years underwent transfemoral thrombectomy for the treatment of deep vein thrombosis. Preoperative venograms showed thrombi in the following locations: calf veins[five], superficial femoral or popliteal veins [four], common femoral veins[three], and iliac veins[three], Durations of symptoms before admission were from 1 day to 20days. Operations were performed under local anesthesia and all the patients were requested for doing Valsalva maneuver during thrombectomies. All patients were received heparin pre-and postoperatively, which was switched to Coumadin for preventing of rethrombosis. One patient was transferred to other hospital 4 months after operation due to regional reason, and the remained five patients were evaluated with a mean follow-up time of 20 months. There was no evidence of postoperative pulmonary embolism. Three of five patients were clinically asymptomatic. One complained of the heaviness of involved leg in the evening, and the other had discomfort on walking Even though our cases were a few in number, we concluded that thrombectomy is a valuable treatment modality of deep vein thrombosis.

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Design of a Three-Axis Force Sensor for Wrist Bending-Exercise Rehabilitation Robot (손목굽힘운동 재활로봇을 위한 3축 힘센서 설계)

  • Kim, Gab-Soon
    • Journal of Sensor Science and Technology
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    • v.22 no.2
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    • pp.118-123
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    • 2013
  • Most serious stroke patients have the paralysis of their wrists, and can't use of their hands freely. But their wrists can be recovered by rehabilitation exercise. Recently, professional rehabilitation therapeutists exercise the wrists of stroke patients in hospital. But the wrists of stroke patients have not rehabilitated, because the therapeutists are much less than stroke patients in number. Therefore, the wrist bending-exercise rehabilitation robot that can measure the bending force of the patients' wrists is developed. In this paper, the three-axis force sensor was designed for the wrist bending-exercise rehabilitation robot. As a test results, the interference error of the three-axis force sensor was less than 0.85%. It is thought that the sensor can be used to measure the wrist bending force of the patient.