• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.585-596
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• 2001

The twenty one individuals with total knee replacement who were admitted to Kang-Dong Hospital for comprehensive physical therapy were studied in order to demonstrate the effectiveness of an isokinetic test program using the Cybex 6000 machine. The subjects were divided into three groups with the isometric exercise group receiving isometric exercise, the isokinetic eccentric exercise group, and isokinetic concentric exercise group receivind isokinetic exercise(eccentric, concentric) to knee flexors and extensors muscles for a six weeks' period using the Cybex 6000. The results are follow: 1. The extensors were increased significantly at all groups after 6 weeks training(p<.05). The flexors were increased significantly at isokinetic eccentric and isokinetic concentric group but no significantly differences at isometric group(p>.05) 2. At the effect of extensors and flexors after 6 weeks training. higher to 30$^{\circ}$ /sec of isokinetic concentric exercise, lower to 120$^{\circ}$ /sec of isometric exercise. 3. The peak torque was more increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups. 4. The total work was more increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups. 5. The ratio of peak torque to body weight were more increased significantly in the flexors and extensors of the isikinetic conccentric exercise among three groups. 6. The average power was more increased significantly in the flexors and extensors of the isikinetic conccentric exercise among three groups. 7. The average R.O.M in the pre-exercise and post-exercise was not different significantly in all three groups. According to the above results, In the muscle strength recovery for total knee replacement patients, isokinetic concentric exercise group was significantly greater than the isokinetic eccentric and isometric exercise groups after a six weeks training.

• Childhood Kidney Diseases
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• v.18 no.2
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• pp.98-105
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• 2014

Purpose: Nafamostat mesilate (NM), a synthetic serine protease inhibitor, has been investigated as an anticoagulant for adult patients with a high risk of bleeding, who need chronic renal replacement therapy (CRRT). However, little is known about the use of NM as an anticoagulant in pediatric CRRT. The aim of this study was to evaluate the ideal dosage, efficacy, and safety of NM in pediatric CRRT. Methods: We conducted a retrospective study of 40 pediatric patients who had undergone at least 24 h of venovenous CRRTs between January 2011 and October 2013. We divided the patients according to risk of bleeding. Those at high risk received no anticoagulation (group 1) or NM as an anticoagulant (group 2), while those at low risk received heparin (group 3). Results: Forty patients (25 male and 15 female; mean age, $8.2{\pm}6.6$ years) were enrolled. The mean duration of CRRT was 13.0 days, and the survival rate was 57.5%. The mean hemofilter lifespan was 39.3 h in group 1 and 11.3 h in group 3. In group 2, hemofilter lifespan was extended from 7.5 h to 27.4 h after the use of NM (P =0.001). The mean hemofilter lifespan with NM was greater than with heparin (P =0.018). No patient experienced a major bleeding event during treatment with NM. Conclusion: NM may be a good alternative anticoagulant in pediatric patients with a high risk of bleeding requiring CRRT, and is not associated with bleeding complications.

• Journal of Biomedical Engineering Research
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• v.40 no.6
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• pp.260-267
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• 2019

In the present study, we aimed to demonstrate that MV2000-MT(SU:M2)^® (MV, MEK-ICS, Paju, Korea), a domestic ventilator, is not inferior in terms of usability, safety, and medical staff satisfaction as compared to Hamilton G5 (G5, Hamilton Medical AG, Rhäzuns, Switzerland). A total of 39 patients who applied MV (group M) or G5 (group H) were included in the study sample. Usability was evaluated by the following factors: the number of alarm errors, replacement requirement of breathing circuit, replacement requirement of a right-angle connector, and ease of ventilator weaning. For safety evaluation, the number of ventilator replacements due to malfunction of the ventilator was evaluated. Items for medical staff satisfaction survey were as follows: the number of MV and G5 uses, hardware, and software assessment. In the usability evaluation, the replacement requirement of the right-angle connector was lower in Group M than in Group H (mean ± standard deviation, Group M: 7.39 ± 6.72, Group H: 14.19 ± 10.24, p = 0.021); however, the evaluations of other parts were not significantly different between the two groups. The number of ventilator replacements due to a malfunction of the ventilator did not differ between two groups. The number of MV and G5 uses was 3.0 [3.0-4.0] and 10.0 [5.0-10.0] (median [interquartile range], p < 0.001). Overall, the mean medical staff satisfaction score of Hamilton G5 was higher than that of MV2000-MT(SU:M2)^®. The usability of MV is comparable to that of G5. However, medical staff satisfaction with Hamilton G5 was higher than that with MV2000-MT(SU:M2)^®, and this difference could be due to the difference in the number of uses. In order to improve the penetration rate of the domestic mechanical ventilator, it is necessary to find ways to increase familiarity of medical staff with domestic mechanical ventilators.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.242-251
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• 2024

Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.619-629
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• 1988

The increasing number of replacement of the substitute cardiac valves were seen in these 2 years. Out of a total 1,408 patients with cardiac valve replacement, 54 required replacement of the substitute valves. Fifty-nine substitute valves replaced were 43 in mitral, 14 in aortic and 2 in tricuspid positions; and they were 36 Ionescu-Shiley, 15 Hancock and 3 Angell-Shiley bioprosthetic valves and 3 St. Jude Medical and 2 Bjork-Shiley prosthetic valves. Primary tissue failure was the most frequent reason of replacement[38 patients] followed by paravalvular leak[9 patients], prosthetic valve endocarditis[6 patients] and valve thrombosis[1 patient] in order. The most pronounced pathology of the failed xenograft valves seen in the primary tissue failure group was calcification and fixation of the cusps with or without tear and defect of the cuspal tissue. The operative mortality rate was 7.4%. Fifty early survivors were followed up for a total of 82.6 patient-years and there was no late death. Actuarial survival rate was 92.3*3.8% at 6 years after surgery. Although the definite tendency toward early and accelerated degeneration of the xenograft valves has been seen in patients younger than 20 to 25 years of age, no strict age limit from where the tissue failure slows down could be determined. The requirement of the ideal substitute valves would be the durability of the recently developed mechanical prostheses armed with the low thrombogenicity of the bioprostheses. At the present time, the need of compromise in selection between less thrombogenic bioprosthetic and more durable mechanical valves should be stressed. The difficulty in choice is yet important in patients of middle age and children where the use of homograft valves may be one of the solution despite of certain limitations from sociomedical reasons.

• Journal of Sensor Science and Technology
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• v.30 no.2
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• pp.109-113
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• 2021

In this study, an automated culture media replacement system was developed to analyze changes in the contraction characteristics of cardiomyocytes according to the state of the culture media. For the long-term storage of culture media, a Peltier refrigerator with a temperature of 5 to 8℃ was provided and a pH of 7.4 was maintained. The cell culture media of the cardiomyocytes was continuously replaced using interlocking pumps at a flow rate of 0.83 μl/h. The cardiomyocytes in which the culture media was replaced automatically demonstrated lower heartbeats per minute compared to samples in which there was no replacement. However, these cardiomyocytes moved more uniformly and produced greater displacement in one heartbeat cycle. It was observed that the sarcomere length of the cardiomyocytes increased due to the automated culture media replacement system. These cardiomyocytes were found to demonstrate better maturation compared to the control group. The maturation of cardiomyocytes was verified through staining images. The proposed automated culture media replacement system generates a uniform heart rate and improvements in contraction force. Based on the study, patient-specific drug toxicity assessments can be conducted using differentiated cardiomyocytes in induced pluripotent stem cells.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.399-406
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• 1986

131 cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital in 1985. There were 116 congenital cardiac anomaly and 15 acquired heart diseases. Out of 116 congenital cardiac anomaly, 73 cases of acyanotic group and 43 cases of cyanotic group were noted. In 73 cases of acyanotic group, 17 ASD, 52 VSD and 4 other acyanotic anomaly were noticed. In 43 cases of cyanotic group, 4 Trilogy of Fallot, 34 TOF, 1 Pentalogy, 3 DORV and 1 DCRV were included. Of the 15 acquired valvular heart disease cases, individual incidence was in mitral valve 10, double valve 3, and simple aortic valve 2 cases. Total number of valve replaced was 16, and 13 for mitral, 2 for aortic, and 1 for tricuspid in position, including 1 cases of double valve replacement. Overall operative mortality for 131 cases of open heart surgery was 4.5%, and the operative mortality was 5.5% in congenital acyanotic group, 2.3% in congenital cyanotic group, 0% in TOF group and 6.7% in acquired group.

• Journal of East-West Nursing Research
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• v.17 no.2
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• pp.96-102
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• 2011

Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.8-14
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• 2019

Objective: Degenerative knee arthritis is the most common disease that occurs in older people. Constriction-induced movement therapy (CIMT) has been reported to be as an effective treatment for the impairments, such as asymmetric weight-bearing and reduced balance that occurs after receiving a total knee replacement (TKR). Game-based rehabilitation training for persons with TKR is interesting and provides a variety of feedback. Design: Randomized controlled trial. Methods: Thirty-six subjects with TKR were randomly assigned to either the CIMT game training (n=12), general game training (n=12), or the control (n=12) group. Each group underwent twelve sessions (30 min/d, 3 d/wk for 4 weeks). In the CIMT game training group, the application of CIMT adjusted the weight of the pressure delivered from the two boards used in Wii games. In the general game training group, the game was played without adjusting the weight of pressure. The game training used the Wii Fit's Ski Slalom application. Subjects were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities-specific Balance Confidence (ABC) Scale. Results: All three groups showed significant improvements in pain, stiffness and physical function, total WOMAC scores, and ABC scores after the intervention (p<0.05). Significant differences were observed in physical function, total WOMAC scores, and ABC scores of the CIMT game training group compared with the other groups (p<0.05). Conclusions: The CIMT game training and general game training exhibited improvements on stiffness, but the CIMT game training exhibited a larger effect on lower extremity function and balance confidence levels.

• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.60-66
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• 2023

Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet^® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin^® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.