• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.219-229
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• 2013

PURPOSE: The purpose of the study was to investigate a influence in Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise of shoulder adhesive capsulitis. METHODS: The methods of the study was to investigate a change in range of motion (ROM), an increase in ROM, visual analogue scale (VAS) and disability questionnaire by Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise on 32 patients who were diagnosed with shoulder adhesive capsulitis. RESULTS: There was no significant difference between the two groups who were treated in the Proprioceptive Neuromuscular Facilitation and self-assistive ROM exercise group for flexion, extension, internal rotation, external rotation, VAS and disability questionnaire. Both group's flexion, extension, internal ratation, and external rotation levels were significantly different before and after the treatment. And significant statistical decrease in VAS and disability was seen. The extension of the shoulder joint was closely related to external rotation (r=0.84). There was a close relationship between internal rotation and external rotation at the shoulder joint. There was no increased range of extension through the exercise method. However, flexion, extension, internal rotation, external rotation, VAS, and disability questionnaire of Proprioceptive Neuromuscular Facilitation groups were obviously higher than in the self-assisted ROM exercise group. CONCLUSION: Our study suggest that considering Proprioceptive Neuromuscular Facilitation for the patient who has shoulder adhesive capsulitis in clinic.

• Journal of the Korean Institute of Electrical and Electronic Material Engineers
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• v.21 no.8
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• pp.770-775
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• 2008

Autonomic nervous system of the anesthetized patients can be influenced by the many kinds of stimulations such as intubation, surgical incision and so on. The changes of the heart rates and blood pressures are surrogates of responses of the autonomic system to the external stimulations. Recently, the power spectral analysis of the heart rate variability (HRV) made it easy to know the fractions and changes of sympathetic and parasympathetic autonomic systems. In this study, the changes of pulse transit time, one of the response of vessels to stimulations, was investigated in relation to the HRV. Ten patients were examined and average age is 22.5 $\pm$ 11.04, average weight is 63 $\pm$ 14.4 kg. The patients were anesthetized only by sevoflurane inhalation. Pulse transit time is determined by calculating the difference of the time between the R peak of ECG and the characteristic point of the plethysmography. Power spectral density (PSD) of the HRV was achieved in the frequency of 0.04-0.15 (LF) and 0.15-0.4 (HF). Compared to preanesthetic period the values of LF and LF/HF ratio of HRV were decreased (p<0.05). HF and PTT was increased in anesthetic state with sevoflurane. Otherwise, after intubation, the HF was decreased and LF, LF/HF ratio and PTT were increased. PSD of the HRV is well-known for the index of the autonomic nervous activity. Not only HRV but PTT analysis also is a useful index reflecting the autonomic responses to various stimulations. And this analysis is useful in bed side monitoring because the calculating method is simple and it takes shorter processing time compared to the HRV analysis.

• The Korean Journal of Physiology
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• v.26 no.1
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• pp.27-35
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• 1992

We used the whole cell patch clamp technique to examine the ionic basis for the tail current after depolarizing pulse in single atrial myocytes of the rabbit. We recorded the tail currents during various repolarizations after short depolarizing pulse from a holding potential of -70 mV. The potassium currents were blocked by external 4-aminopyridine and replacement of internal potassium with cesium. The current was reversed to the outward direction above +10 mV. High concentrations of intracellular calcium buffer inhibited the activation of the current. Diltiazem and ryanodine blocked it too. These data suggest that the current is activated by intracellular calcium released from sarcoplasmic reticulumn. When the internal chloride concentration was increased, the inward tail current was increased. The current was partially blocked by the anion transport blocker niflumic acid. The current voltage curve of the niflumic acid sensitive current component shows outward rectification and is well fitted to the current voltage curve of the theoretically predicted chloride current calculated from the constant field equation. The currents recorded in rabbit atrial myocytes, with the method showing isolated outward Na Ca exchange current in ventricular cells of the guinea pig, suggested that chloride conductance could be activated with the activation of Na/ca exchange current. From the above results it is concluded that a chloride sensitive component which is activated by intracellular calcium contributes to tail currents in rabbit atrial cells.

• Journal of Korean Foot and Ankle Society
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• v.17 no.1
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• pp.52-59
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• 2013

Purpose: The purpose of this study is to evaluate treatment results of multidisciplinary approach of critical ischemic limb with diabetic foot. Materials and Methods: From March 2005 to March 2012, 674 diabetic foot patients were analyzed. Among them, 85 patients were neuroarthropathic type, 383 patients were infectious type, and 206 patients were ischemic type. The subjects were 206 patients who had critical ischemic limbs and major or minor amputations were done. Various single or combined treatment method before amputation was performed. We investigated their ABI, HbA1c, main occlusion lesion, limb salvage and hospitalization period by various treatment method. Results: Major amputation was 27 cases, minor amputation was 179 cases. Mean HbA1c was 8.2%, and mean ABI was 0.66. Main occlusion lesion was 6 cases at common iliac artery, 13 cases at external iliac artery, 9 cases at internal iliac artery, 11 cases at common femoral artery, 23 cases at deep femoral artery, 52 cases at superficial femoral artery, 35 cases at popliteal artery, 40 cases at posterior tibia artery, 35 cases at anterior tibial artery, 28 cases at peroneal artery, and 13 cases at dorsalis pedis artery. Major amputations were decreased, minor amputations were increased, and hospitalization period was reduced by treatment of multidisciplinary approach. Conclusion: Treatment of multidisciplinary approach, which include preoperation percutaneus transluminal angioplasty, vascular surgery, and amputation, of critical ischemic limb with diabetic foot had advantages of limb salvage and hospitalization period reduction.

• Health Policy and Management
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• v.7 no.2
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• pp.46-64
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• 1997

Background & Objectives : Korea is face with the social need for health care technology assessment so that it is urgently needed to found principles and methodology in technology assessment in health care. As a groundwork for health care technology assessment, we tried to prioritize medical technology for assessment. Among medical technologies, procedure is somewhat difficult to assess, compared to drug or equipment. In this study, we aimed at the prioritisation of medical procedure to be assessed, in terms of efficay, safety, and adequacy. Method : For the standardized classification of medical procedure, ICD-9-CM(International Classification of Diseases 9th edition - Clinical Modification) was used. Among the list the procedures coming under otorhinolaringjology and thoracic surgery were selected by three family physicians. The list of procedure was mailed to the board certified surgeons of both disciplines, with the question asking about the necessity for assessment in terms of efficay, safety, and adequacy. Replied questionnaires were analyzed in each procedure. Results : Of 560 otorhinolaryngologist and 480 thoracic surgeon, 114 surgeons replied. Of otorhinolaryngological procedure, incision, excision, and destruction of inner ear : fenestration of inner ear : stapedectomy and its revision were the most urgent technology to assess in the aspect of safety. For adequacy, operations on Eustachian tube: fenestration of inner ear: incision, excision, and destruction of inner ear were highly ranked in necessity, and for efficary, operations on Eustachian tube; external maxillary antrotomy; fenestration of inner ear. Thoracic surgeons replied thoracic procedures, lung transplantation; heart transplantation; implantation of heart assist system [pump] are most important for evaluation in terms of safety; and heart transplantation; Lung transplantation; Implantation of heart assist system [pump] in terms of adequacy, and surgical collapse of lung [Artificia니 pnemothorax or pnuexoperitoeum]; lung transplantation; periarterial sympathectomy in terms of efficacy. As a whole, surgeons regard safety evaluation is more urgent than adequacy or efficary. In addition, otorhinolaryngological surgeons regard evaluation of their procedures more urgent than thoracic surgeons regard theirs. Conclusion : By the questionnaire to board certified physicians, we get some preliminary data for prioritisation of technologies to assess. Through the questionnaire like this, much information would be gathered for technology assessment, especially for medical procedure, if not enough. In the near future, well structured expert opinion gathering research, such as modified Delphi or nominal group technique, should be done succeedingly.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.390-396
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• 2023

Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified. Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection. Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores. Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

• Journal of Korean Medical classics
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• v.33 no.3
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• pp.21-36
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• 2020

Objectives : This paper aims to understand the meaning of '少陰人 心之範圍' and to determine its clinical implication. Methods : First, the meaning of the verb '範圍' was examined in 『IChing·XiCi(周易·繫辭傳)』 from where it originated. Based on the findings, the meaning of '心之範圍' in the context of the nature and emotion[性情] of So-eumin as explained in the 『DongUisusebowon(東醫壽世保元)』 was further investigated. Moreover, the clinical significance of the observation of '心之範圍' in relation to determining prognosis was discussed in regards to 'visceral syncope[藏厥]' and 'exuberating yin separating yang[陰盛隔陽]' which come under the severe symptoms[危證] category in the disease pattern of So-eumin. Results : '範圍' as mentioned in 『IChing·XiCi(周易·繫辭傳)』 refers to the process of creating a framework that takes after the tendencies of the patterns of change of the external world that influences mankind. The objective of this process is to prepare for the excessiveness and insufficiency of the change that happens in the external world so as to ultimately protect all existences. The workings of '範圍' could be assumed on a personal level as well. As the nature and emotion of So-eumin is closely related to the purpose and object of '範圍', Yi Jema suggested that through observing whether the So-eumin exhibits '心之範圍' or not, that it could be determined whether his/her innate nature is being properly exercised or not. Conclusions : Whether one's agitation calms down or not even for a moment is the criteria for determining prognosis of the entire disease, while its calming-down relies on proper functioning of '心之範圍'. The way to determine this is through observation of the manifest attitude of the So-eumin. If the So-eumin displays a poised and autonomous[綽綽卓卓] attitude even for a moment, it could be understood as the '心之範圍' process being properly functioning, indicating the overall direction to be heading towards relief of the sense of instability, allowing for a positive outlook on treatment.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.190-198
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• 1983

The management of cardiac arrhythmias by cardiac pacing has increased greatly since the treatment of complete heart block with an external transcutaneous pacemaker in 1952, followed by the use of myocardial wires connected to an external pulse generation, by external transvenous pacing, and then by transvenous pacing with implantable components in thoracic wall.By now, the three bases of modern cardiac pacing for bradyarrhythmias had been established [1] an implantable device [2] the transvenous approach [3] the ability of the pacemaker to sense cardiac activity and modify its own function accordingly. In transvenous implantation of a pacemaker, any one of four vessels at the root of the neck is suitable for passage of the electrode - cephalic vein, external jugular vein, internal jugular vein, costo-axillary branch of the axillary vein. The new technique of direct puncture of the subclavian vein, either percutaneously or after skin incision only has been made, is invaluable & is used routinely. We have experienced one 25 years old patient who had rheumatic mitral stenosis & minimum aortic regurgitation with sinus bradycardia associated with premature atrial tachycardia & another 54 years old female patient who was suffered from sick sinus syndrome with sinus bradycardia & sinus arrest. The 1st patient was taken open mitral commissurotomy & aortic valvuloplasty and then was taken atrlal pace-maker implantation through If subclavian puncture method in post-op 14 days, and the second patient was taken atrial pacemaker implantation through If subclavian puncture method. Their postop course was in uneventful & were discharged, without complication. Their condition have been good to now.

• Korean Circulation Journal
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• v.54 no.7
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• pp.409-421
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• 2024

Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.

• Journal of The Institute of Information and Telecommunication Facilities Engineering
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• v.11 no.2
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• pp.29-33
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• 2012

ECG widely used in cardiac function test is a graph that is recorded by measuring the electrical impulses occurred in the heart. Normal ECG has the form of similar sections that are repeated, and each section has the information occurred in a heart beat. Thus, In order to make the correct diagnosis, correct grasp of the sections and formed analysis must be done. In this research, a system that detects the sections of ECG is proposed. The system is based on ECG stored in the form of files. The ECG can easily have a noise caused by an outside factor. The noise of ECG is easily caused by external factors. Through a band-pass filter, it can be removed. and then, to get this ECG without a noise, interval detection algorithm using R-peak is applied. The clean, intuitive interface will help the above functions to be used without any difficulties.