• Journal of Chest Surgery
• /
• 제51권2호
• /
• pp.100-108
• /
• 2018

Background: The question of which type of prosthetic aortic valve leads to the best outcomes in patients in their 60s remains controversial. We examined the hemodynamic and clinical outcomes of aortic valve replacement in sexagenarians according to the type of prosthesis. Methods: We retrospectively reviewed 270 patients in their 60s who underwent first-time aortic valve replacement from 1995 to 2011. Early and late mortality, major adverse valve-related events, anticoagulation-related events, and hemodynamic outcomes were assessed. The mean follow-up duration was $58.7{\pm}44.0$ months. Results: Of the 270 patients, 93 had a mechanical prosthesis (mechanical group), and 177 had a bioprosthesis (tissue group). The tissue group had a higher mean age and prevalence of preoperative stroke than the mechanical group. The groups had no differences in the aortic valve mean pressure gradient (AVMPG) or the left ventricular mass index (LVMI) at 5 years after surgery. In a sub-analysis limited to prostheses in the supra-annular position, the AVMPG was higher in the tissue group, but the LVMI was still not significantly different. There was no early mortality. The 10-year survival rate was 83% in the mechanical group and 90% in the tissue group. The type of aortic prosthesis did not influence overall mortality, cardiac mortality, or major adverse valve-related events. Anticoagulation-related events were more common in the mechanical group than in the tissue group (p=0.034; hazard ratio, 4.100; 95% confidence interval, 1.111-15.132). Conclusion: The type of aortic prosthesis was not associated with hemodynamic or clinical outcomes, except for anticoagulation-related events.

• 동국한의학연구소논문집
• /
• 제9권
• /
• pp.127-138
• /
• 2000

잠양법(潛陽法)은 평간치법(平肝治法)의 일종으로 간양(肝陽)이 상항(上亢)해서 나타나는 두목혼훈(頭目昏暈), 수족추휵, 구안괘사, 설건어삽(舌乾語澁), 두통불지(頭痛不止), 졸연도지(猝然倒地) 등의 증상(症狀)에 쓰는 치법(治法)이며 중풍(中風)의 표실증(標實證)을 다스리는 목적으로 다용(多用)되고 있다. 중풍(中風)에서의 활용(活用)은 청대(淸代)에 이르러 본격화되었는데, 엽천사(葉天士)는 "자액식풍(滋液熄風), 유양영락(濡養營絡), 보음잠양(補陰潛陽)"을 사용하였고, 장백룡(張伯龍)은 "잠진섭납(潛鎭攝納)"하는 치료법을 사용하였다. 중풍(中風)의 병리(病理)가 본허표실(本虛標實)하므로 항상 자음(滋陰), 보수(補水)하는 치법(治法)과 상호보완적(相互補完的)으로 사용되고 있다. 잠양법(潛陽法)이 다용(多用)된 병증은 간신음허(肝腎陰虛), 풍양상요(風陽上擾)로 인한 중경락증(中經絡證)과 중장부증(中臟腑證) 중에서 양폐증(陽閉證)이며, 탈증(脫證)의 일부와 중풍일구(中風日久)로 인(因)한 전간(癲癎)에도 사용되었다. 잠양락(潛陽樂) 중 진주모(珍珠母), 석결명(石決明), 대모(玳瑁), 모려(牡蠣), 패치(貝齒), 구판(龜板), 별갑(鱉甲) 등 개류(介類)의 효력이 뛰어나고, 치방(治方)으로는 진간식풍탕(鎭肝熄風湯), 호잠환(虎潛丸), 고본단(固本丹), 복맥탕(復脈湯), 천마구등음(天麻鉤藤飮), 영양각탕(羚羊角湯) 등이 활용되고 있다.

• 대한지역사회작업치료학회지
• /
• 제6권1호
• /
• pp.41-48
• /
• 2016

목적 : 본 연구의 목적은 허혈성 뇌손상시 회복의 지연을 초래하는 당뇨에 복합운동프로그램을 적용하였을 때, 신경학적 효과와 당뇨의 개선효과를 확인하고자 하였다. 연구방법 : 본 연구는 경상북도 소재의 동물실험 연구실에서 실시하였고 허혈성 뇌손상 모델의 흰쥐에게 STZ(streptozotocin)를 투여하고 당뇨를 유발한 흰쥐 10마리를 사용하였다. 흰쥐에게는 4주간 복합운동프로그램을 실시하여 뇌기능회복을 확인하기 위해 미로검사(maze test)를 실시하였고, 당뇨의 개선효과를 보기위해서 혈당을 확인하였다. 결과 : 허혈성 뇌손상 모델 당뇨쥐에게 복합운동프로그램을 적용한 결과, 뇌기능회복을 확인하기 위한 미로검사에서는 실패횟수(error)가 3주 후부터 유의하게 감소하였고(p<.05) 탈출시간은 1주 후부터 유의하게 감소하였다(p<.05). 그리고 당뇨의 개선효과를 확인하기 위한 혈당 검사에서는 대조군에서는 유의한 변화가 없었고 복합운동프로그램을 적용한 실험군에서는 4주 후부터 유의한 효과가 있음을 알 수 있었다(p<.05). 결론 : 뇌졸중, 당뇨 등의 성인, 노인성 질환이 증가되고 있는 현 시점에서 환자들에게 재활은 여명수명동안 삶의 질 개선에 매우 중요하다. 본 연구는 허혈성 뇌졸중과 당뇨를 모두 가지고 있는 동물모델에게 치료사가 쉽게 시행할 수 있는 복합운동프로그램 적용을 통하여 뇌기능회복과 당뇨 개선효과를 확인할 수 있었다.

• International Journal of Automotive Technology
• /
• 제8권4호
• /
• pp.437-444
• /
• 2007

This paper experimentally investigates the effects of oxygen-enriched air (OEA) on the running behaviors of an LPG SI engine during both start/warm-up (SW) and hot idling (HI) stages. The experiments were performed on an air-cooled, single-cylinder, 4-stroke, LPG SI engine with an electronic fuel injection system and an electrically-heated oxygen sensor. OEA containing 23% and 25% oxygen (by volume) was supplied for the experiments. The throttle position was fixed at that of idle condition. A fueling strategy was used as following: the fuel injection pulse width (FIPW) in the first cycle of injection was set 5.05 ms, and 2.6 ms in the subsequent cycles till the achieving of closed-loop control. In closed-loop mode, the FIPW was adjusted by the ECU in terms of the oxygen sensor feedback. Instantaneous engine speed, cylinder pressure, engine-out time-resolved HC, CO and NOx emissions and excess air coefficient (EAC) were measured and compared to the intake air baseline (ambient air, 21% oxygen). The results show that during SW stage, with the increase in the oxygen concentration in the intake air, the EAC of the mixture is much closer to the stoichiometric one and more oxygen is made available for oxidation, which results in evidently-improved combustion. The ignition in the first firing cycle starts earlier and peak pressure and maximum heat release rate both notably increase. The maximum engine speed is elevated and HC and CO emissions are reduced considerably. The percent reductions in HC emissions are about 48% and 68% in CO emissions about 52% and 78%; with 23% and 25% OEA, respectively, compared to ambient air. During HI stage, with OEA, the fuel amount per cycle increases due to closed-loop control, the engine speed rises, and speed stability is improved. The HC emissions notably decrease: about 60% and 80% with 23% and 25% OEA, respectively, compared to ambient air. The CO emissions remain at the same low level as with ambient air. During both SW and HI stages, intake air oxygen enrichment causes the delay of spark timing and the increased NOx emissions.

• 대한지역사회영양학회지
• /
• 제17권3호
• /
• pp.341-352
• /
• 2012

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

• 한국치위생학회지
• /
• 제9권1호
• /
• pp.15-26
• /
• 2009

The purpose of this study was to prepare improved education guideline by grasping parts and items felt difficult to apply instruments by the students of the dental hygiene department in the practice of oral prophylaxis using manikin and analyzing factors influencing the satisfaction at the oral prophylaxis subject. To achieve this purpose, 285 senior students of the dental hygiene department located in the Kwangju. Jeonnam area who took theory and practice courses of oral prophylaxis but only practiced the manikin from the second semester of 1st year were selected as the subjects. The following results were obtained. 1. In the manikin, the most difficult part was maxillary anterior lingual in the use of explorer, sickle scaler, and universal curet, and maxillary right posterior lingual was in the use of gracey curet. In the dentiform, the most difficult item was instrument stroke in the use of explorer, sickle scaler, universal curet and gracey curet. 2. The highest stressor was the lack of knowledge and skill in practice of oral prophylaxis, followed by the lack of confidence, and difference between theory and practice in oral prophylaxis. The overall practice satisfaction was 3.23 at oral prophylaxis. The highest satisfaction was found in patient and operator position(3.51), followed by basic skill(3.34), the way to use hand instrumentation(3.16), and the way to use oral examination instrumentation(3.01). 3. According to school records, satisfaction at oral prophylaxis practice satisfaction was 3.36 of good, 3.24 of fair, and 3.06 of poor, suggesting significant difference(p<0.05). Students who participated just in practice during a school term showed 3.47 of satisfaction. The highest satisfaction was found in a full-time professor as a professor in charge(3.24) and there was significant difference(p<0.05). 4. The highest correlated factor between oral prophylaxis theory and practice satisfaction was curriculum satisfaction. The use of hand instrumentation was found to have the greatest effect on the practice satisfaction at oral prophylaxis, followed by basic skill, the way of basic instrumentation, and position. There was statistically significant difference(p<0.01).

• Journal of Yeungnam Medical Science
• /
• 제13권2호
• /
• pp.225-233
• /
• 1996

허혈성 심질환의 치료로서 시행되는 관동맥우회술은 최근 국내에서도 보편적으로 시행되고 있는데 1992년부터 1996까지 영남대학교 의과대학 흉부외과학교실에서 시행한 63례의 관동맥우회술을 대상으로 수술성적 및 술전 위험인자들이 술후 합병증에 미치는 영향을 조사하여 다음과 같은 결론을 얻었다. 환자의 성별 및 연령을 보면 총 63례의 환자 중 남자가 44례, 여자가 19례였으며 연령 분포는 36세에서 71세까지 평균 $58.3{\pm}8.6$세였으며 50대와 60대에서 대부분을 차지하였다. 원위문합수는 환자당 평균 3.5개의 원위부 문합을 하였으며 수술사망은 6례였으며 술후 합병증으로 부정맥이 7례, 창상감염이 5례, 술후 출혈이 4례, 술중 및 술후 심근경색이 4례, 뇌졸증이 4례, 그리고 위장관 및 신장 합병증이 5례에서 발생하였다. 술후 합병증 발생의 요소를 분석해 본 결과 술전 관동맥질환 발생의 위험인자 중 흡연환자에서 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 술전 위험인자로 정맥으로 Nitroglycerin의 투여가 필요했던 경우와 대동맥 차단시간이 2시간 이상인 경우 합병증의 발생빈도가 유의하게 증가하였으며(p<0.05) 특히 65세 이상의 고령 환자의 경우 수술사망율이 유의하게 증가하였다(p<0.05). 이상의 결과로 흡연, 65세 이상의 고령, 술전 정맥으로 Nitroglycerin의 투여가 필요했던 경우 그리고 이식혈관의 수가 많아 대동맥 차단시간이 긴 경우 술중 및 술후 관리에 더욱 섬세한 주의가 필요함을 알 수 있었다.

• 대한물리치료과학회지
• /
• 제7권2호
• /
• pp.711-725
• /
• 2000

The purpose of this study was to determine the effects of knee flexor isokinetic training on the mean peak torque of knee muscles and hamstrings-to-quadriceps ratio(H/Q ratio) in hemiplegia able to walk independently for more than 10 meters, to analyze the effect of torque increasing on functional aspects; fatigability and ambulation times, also. Forty-one adult subjects with hemiplegia secondary to a stroke partipated in this study. All participants were in/out patients at the College of Medicine, Pocheon CHA University, Pundang CHA General Hospital. The patients were allocated to two groups: one group exclusively for isokinetic maximal voluntary knee flexor training at $150^{\circ}$/sec(n=20) and the other exclusively for isokinetic maximal voluntary knee flexor training from $30^{\circ}$/sec to $150^{\circ}$/sec (n=21) gradually. The allocation was performed according to patient age, sex, affected side to minimize imbalance between the two training groups. Training was carried out from February 14th, 2000 to April 15th, 2000. Analysis of the data was done by means of t-test, x2-test, paired t-test, ANOVA, and multiple regression analysis. The results of this study were as follows: 1. There were no significant differences between the two groups in mean peak torque of knee muscles and relative decreases in knee extensor mean peak torque with increased knee flexor velocities before training (P<.05). 2.There was no significant differences between the two groups in the H/Q ratio, and no relative increases with increased knee flexor velocities before training. 3. there were significant changes in mean peak torque in group A after training(P<.05), but no significant differences as the velocity increased 4.there were significant changes in mean peak torque in group B after training(P<.05), but no significant differences as the velocity increased 5.there were no significant differences between the two groups, and no significant differences in mean peak torque increase rate between the groups with increased knee flexor velocities after training 6.H/Q ratio increased with increased knee flexor velocities between the two groups, but not statistically And there was no significant differences between the groups with increased knee flexor velocities 7.After training, Ambulation time and its decreasing rate decreased significantly in group B (P<.05) 8Before and after training, there was no significant differences between the groups in the fatiguability 9. In the multiple regression analysis, mean peak torque increase rate of the knee extensor and flexor were higher in group B than A(P<.05), and significantly higher with increased knee flexor velocities (P<.05) Also, training method influenced on Ambulation times decreases significantly(P<.05). Results indicated that knee flexor isokinetic training was effective to knee extensor and flexor mean peak torque increase in the hemiplegia able to walk independently for more than 10 meters. Therefore, we were able to conclude that gradual training from low to high velocity was more effective in the increase of mean peak torque of knee joint and decrease of Ambulation times than training only at high velocity.

• Journal of Korean Neurosurgical Society
• /
• 제63권5호
• /
• pp.607-613
• /
• 2020

Objective : Spontaneous intracranial hemorrhage is a life-threatening disease, and non-lesional spontaneous intraparenchymal hemorrhage (nIPH) and aneurysmal subarachnoid hemorrhage (aSAH) are the leading causes of spontaneous intracranial hemorrhage. Only a few studies have assessed the association between prior physical activity or triggering events and the occurrence of nIPH or aSAH. The purpose of this study is to investigate the role of specific physical activities and triggering events in the occurrence of nIPH and aSAH. Methods : We retrospectively reviewed 824 consecutive patients with spontaneous intracranial hemorrhage between January 2010 and December 2018. Among the 824 patients, 132 patients were excluded due to insufficient clinical data and other etiologies of spontaneous intracranial hemorrhage. The medical records of 692 patients were reviewed, and the following parameters were assessed : age, sex, history of hypertension, smoking, history of stroke, use of antiplatelet or anticoagulation agents, season and time of onset, physical activities performed according to the metabolic equivalents, and triggering event at onset. Events that suddenly raised the blood pressure such as sudden postural changes, defecation or urination, sexual intercourse, unexpected emotional stress, sauna bath, and medical examination were defined as triggering events. These clinical data were compared between the nIPH and aSAH groups. Results : Both nIPH and aSAH most commonly occurred during non-strenuous physical activity, and there was no significant difference between the two groups (p=0.524). Thirty-two patients (6.6%) in the nIPH group and 39 patients (8.1%) in the aSAH group experienced triggering events at onset, and there was a significant difference between the two groups (p=0.034). The most common triggering events were defecation or urination in both groups. Conclusion : Specific physical activity dose no affect the incidence of nIPH and aSAH. The relationship between the occurrence of intracranial hemorrhage and triggering events is higher in aSAH than nIPH.

• 한국산학기술학회논문지
• /
• 제17권12호
• /
• pp.371-380
• /
• 2016

본 연구의 목적은 성인 신체장애인을 부양하는 배우자의 부양스트레스, 우울, 장애인의 일상생활활동능력을 살펴보고, 각 영역들의 상관관계 및 장애인의 일상생활활동능력이 배우자의 부양스트레스와 우울에 미치는 영향을 알아보고자 하는 것이다. 2016년 7월부터 8월까지 S시와 K도에 소재한 2개의 병원에서 재활치료를 받고 있는 장애인들의 배우자 86명을 대상으로 연구를 진행하였다. 연구결과 부양스트레스 총점은 $71.43{\pm}17.78$점 이었으며, 부양스트레스 하위항목 중 경제적 스트레스와 심리적 스트레스가 다른 항목보다 높았다. 우울총점은 $50.34{\pm}26.41$점으로, 일반 정상 성인들의 평균점수보다 다소 높았다. 대상자의 일반적 특성에 따른 부양스트레스와 우울을 살펴본 결과, 연령이 많은 여성의 경우, 부양비에 대한 지출이 많고 부양시간이 많은 경우, 장애인의 연령이 젊고, 병명이 뇌졸중인 경우 부양스트레스와 우울지수가 높았다. 부양스트레스에 영향을 미치는 요인으로는 장애인의 연령, 장애기간으로 나타났으며, 장애인의 일상생활활동능력은 부양스트레스에 영향을 미치지 못하였다. 우울에는 장애인의 연령, 장애유형 및 등급, 장애인의 일상생활활동능력 모두 영향을 미치는 것으로 나타났다. 부양가족들의 스트레스 및 우울을 감소시키기 위하여 경제적, 신체적 혹은 심리적으로 도움을 줄 수 있는 실질적인 정책적 지원이 마련되어야 할 것이다.