• Journal of Chest Surgery
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• v.33 no.1
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• pp.51-59
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• 2000

Background: Magnesium is one of the important intracellular cations. Hypomagnesemia is common after an open heart surgeryand may affect the development of posoperative arrhythmias. The aims of this study were to identify 1) the severity of the hypomagnesemia 2) the adequate dose of the magnesium replacement and 3) the effect of magnesium replacement on the postoperative arrhythmias. Material and Method: The serum magnesium level was measured in 20 patients in whom magnesium was replaced postopertively(6gm at the operative day 4gm at the 1st postoperative day and 2gm at the 2nd postoperative day) and compared with that of the 13 patients in whom magnesium was not replaced postopertively The serum magnesium level was normalized after magnesium replacement. We analyzed the development of arrhythmias in the patients groups who did not receive magnesium and were operated on between Oct. 1994 and Oct. 1995(Group I; n=206) and who received the magnesium postoperatively and were operated on between Nov. 1995 and Aug. 1996(Group II; n=133) Result: There were no differences in the preoperative risk factors and the rate of postoperative supraventricular or ventricular tachyarrhythmia occur-rences irrespectivel of the magnesium replacement. Magnesium replacement could prevent the aggrevation of the occurrence of postoperative arrhythmias in high risk groups of ventricular tachyarrhytnmia in old age but magnesium could not prevent postoperative arrhythmia in other high risk groups. Conclusion: The magnesium replacement after open heart surgery could prevent the development of ventricular tachyarrhythmias especially in old age groups but could not prevent atrial tachyarrhthmias.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.182-194
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• 2005

Objectives: After the discontinuance of the Women's Health Initiative (WHI)clinical trial in the U.S. in July 2002, I thought that the domestic medical field would come to a crisis in hormonal treatment for perimenopausal and postmenopausal women. However, the domestic condition of HRT has barely changed. This study was designed to investigate world research trends in HRT and bring forward the response of the Traditional Korean Medicine (TKM) Research Group. Methods: I investigated recent domestic ;md world research trends about HRT and climacteric syndrome. Based on this analysis, I predicted western medical research trends and direction for HRT and medical care of perimenopausal and postmenopausal women. Results and Conclusions: I propose that we (TKM Research Group) have to explain the side effects of HRT for postmenopausal women and try to suggest complementary therapy for it. For that aim, the Association of Korean Medicine's effort is very important, as well as personal practitioner's actions.

• Safety and Health at Work
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• v.2 no.1
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• pp.1-8
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• 2011

The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women.

• Genomics & Informatics
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• v.3 no.4
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• pp.172-174
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• 2005

Recent anti-cancer approaches have been based to target tumor-specifically associated and/or causative molecules such as RNAs or proteins. As this specifically targeted anti-cancer modulator, we have previously described a novel human cancer gene therapeutic agent that is Tetrahymena group I intron-based trans-splicing ribozyme which can reprogram and replace human telomerase reverse transcriptase (hTERT) RNA to selectively induce tumor-specific cytotoxicity in cancer cells expressing the target RNA. Moreover, the specific ribozyme has been shown to efficiently retard tumor tissues in xenograft mice which had been inoculated with hTERT-expressing human cancer cells. In this study, we assessed specificity of trans-splicing reaction in cells to evaluate the therapeutic feasibility of the specific ribozyme. In order to analyze the trans-spliced products by the specific ribozyme in hTERT-positive cells, RT, 5'-end RACE-PCR, and sequencing reactions of the spliced RNAs were employed. Then, whole analyzed products resulted from reactions only with the hTERT RNA. This study suggested that the developed ribozyme perform highly specific RNA replacement of the target RNA in cells, hence trans-splicing ribozyme will be one of specific agents for genetic approach to revert cancer.

• Journal of Korean Academy of Nursing
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• v.43 no.3
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• pp.352-360
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• 2013

Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.124-129
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• 2013

Background: Mitral valve repair for posterior mitral leaflet (PML) prolapse has been considered to be a standard treatment because of its high success rate and high level of patient satisfaction. The aim of this study was to evaluate the clinical results of two different techniques of PML prolapse, quadrangular resection (QR) and chordal replacement (CR). Materials and Methods: The subjects consisted of 56 patients who had undergone mitral valve repair for PML prolapse between November 1997 and December 2010. The patients were divided into two groups according to surgical technique. Among them, 31 patients underwent QR (group QR) and 25 patients had CR (group CR). We reviewed the medical records of the patients retrospectively to compare the clinical outcomes of both groups. Results: After mitral valve repair, the degree of mitral regurgitation (MR) in both groups decreased to the to a mild degree or less and the amount of remnant MR was slightly higher in the CR group but it was not statistically different. Three patients received mitral valve-related reoperation (2 in the QR group and 1 in the CR group). Freedom from mitral valve-related reoperation at 7 years was 93% for the QR group and 96% for the CR group and was not significantly different between the two groups. Conclusion: Both QR and CR showed excellent long-term results and were considered equally effective methods for PML prolapse.

• Journal of muscle and joint health
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• v.29 no.2
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• pp.81-90
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• 2022

Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.

• Journal of muscle and joint health
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• v.21 no.3
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• pp.215-223
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• 2014

Purpose: The purpose of this study was to examine the effect of a progressive lower-extremity exercise program on pain, efficacy of exercise, and the life satisfaction among older women with TKRA. Methods: This study was a nonequivalent control group non synchronized design and was conducted from 12 September 2012 to 05 February 2014 in G-university hospital located in J-city. The sample was composed of an experimental group (n=20) and a control group (n=20). The progressive lower extremity exercise program was applied to the experimental group for 13 days. NRS scale was used to measure the pain, self-efficacy of exercise was measured by Exercise Self Efficacy, and life satisfaction was measured by 8 item questionnaire. Results: The experimental group was significantly lower in the degree of pain (F=73.53, p<.001), higher in the degree of self-efficacy of exercise (F=61.42, p<.001) and life satisfaction (F=80.91, p<.001) than the control group. Conclusion: The progressive lower-extremity exercise program for TKRA patients was useful to reduce pain and improve self-efficacy of exercise and life satisfaction, To reduce the pain and th improve the life satisfaction of older women with TKRA, we need to provide the progressive exercise at bedside during the postoperative recovery phase.

• Journal of Chest Surgery
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• v.25 no.2
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• pp.149-157
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• 1992

Total 145 cases mitral vlave replacement were performed in Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from May 1983 to July 1991. Sixty-one patients were male and 84 patients were female and the range of age was from 12 to 66 years old with the mean of 37.9[$\pm$11.6] years. Valvular lesions were 49 cases of mitral stenosis, 18 cases of regurgitation and 78 cases of combined lesion. Used valve were Ionescu-Shiley[42 cases], Bjork-Shiley[49 cases], Inact[6 cases], St. Jude Medical[11 cases] and CarboMedics[37 cases]. Mean size of valve was 29.8$\pm$1.68mm. Early morality was 13.8%[20 cases] and low output syndrome was most common cause[9 cases]. Age, functional classification and biventricular hypertrophy were risk factors. All survived cases were followed up without missing. Mean follow up period were 3 years and 3 months. Total 14 cases of death[9.7%] were observed and heart failure, unexplained sudden death and bleeding were the causes in that order. Common late complications were heart failure and bleeding related with anticoagulation. Actuarial survival rate at 5 years was 83$\pm$5.4% in overall, 78$\pm$7.2% in tissue valve group, 87$\pm$6.8% in mechanical valve group. The actuarial freedom rate from thromboembolism at 7 years was 89$\pm$8.3% in overall, 86$\pm$9.9% in tissue valve group and 97$\pm$1.9% in mechanical valve group. Actuarial freedom rate from bleeding at 5 years with anticoagulation was 88.9$\pm$4.2% in overall, 96$\pm$3.9% in tissue valve group, 86$\pm$4.6% in mechanical valve group. Reoperation was done in 3 cases with heart failure with tricuspid regurgitation and thromboembolism in 2 cases. The functional status of survived cases was I or II.

• Korean Circulation Journal
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• v.52 no.2
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• pp.136-146
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• 2022

Background and Objectives: There still are controversies on which type between bovine pericardial and porcine valves is superior in the setting of aortic valve replacement (AVR). This study aims to compare clinical outcomes of AVR using between pericardial or porcine valves. Methods: The study involved consecutive 636 patients underwent isolated AVR using stented bioprosthetic valves between January 2000 and May 2016. Of these, pericardial and porcine valves were implanted in 410 (pericardial group) and 226 patients (porcine group), respectively. Clinical outcomes including survival, structural valve deterioration (SVD) and trans-valvular pressure gradient were compared between the groups. To adjust for potential selection bias, inverse probability treatment weighting (IPTW) was conducted. Results: The mean follow-up duration was 60.1±50.2 months. There were no significant differences in the rates of early mortality (3.1% vs. 3.1%; p=0.81) and SVD (0.3%/patient-year [PY] vs. 0.5%/PY; p=0.33) between groups. After adjustment using IPTW, however, landmark mortality analyses showed a significantly lower late (>8 years) mortality risk in pericardial group over porcine group (hazard ratio [HR], 0.61; 95% confidence interval, [CI] 0.41-0.90; p=0.01) while the risks of SVD were not significantly difference between groups (HR, 0.45; 95% CI, 0.12-1.70; p=0.24). Mean pressure gradient across prosthetic AV was lower in the Pericardial group than the Porcine group at both immediate postoperative point and latest follow-up (p values <0.001). Conclusions: In patients undergoing bioprosthetic surgical AVR, bovine pericardial valves showed superior results in terms of postoperative hemodynamic profiles and late survival rates over porcine valves.