• 제목/요약/키워드: Efficiency of surgery

검색결과 247건 처리시간 0.022초

An objective assessment of the impact of tendon retraction on sleep efficiency in patients with full-thickness rotator cuff tears: a prospective cohort study

  • Ashley E. MacConnell;William Davis;Rebecca Burr;Andrew Schneider;Lara R Dugas;Cara Joyce;Dane H. Salazar;Nickolas G. Garbis
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.169-174
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    • 2023
  • Background: Sleep quality, quantity, and efficiency have all been demonstrated to be adversely affected by rotator cuff pathology. Previous measures of assessing the impact of rotator cuff pathology on sleep have been largely subjective in nature. This study was undertaken to objectively analyze this relationship through the use of activity monitors. Methods: Patients with full-thickness rotator cuff tears at a single institution were prospectively enrolled between 2018 and 2020. Waist-worn accelerometers were provided for the patients to use each night for 14 days. Sleep efficiency was calculated using the ratio of the time spent sleeping to the total amount of time that was spent in bed. Retraction of the rotator cuff tear was classified using the Patte staging system. Results: This study included 36 patients: 18 with Patte stage 1 disease, 14 with Patte stage 2 disease, and 4 patients with Patte stage 3 disease. During the study, 25 participants wore the monitor on multiple nights, and ultimately their data was used for the analysis. No difference in the median sleep efficiency was appreciated amongst these groups (P>0.1), with each cohort of patients demonstrating a generally high sleep efficiency. Conclusions: The severity of retraction of the rotator cuff tear did not appear to correlate with changes in sleep efficiency for patients (P>0.1). These findings can better inform providers on how to counsel their patients who present with complaints of poor sleep in the setting of full-thickness rotator cuff tears.

Open reduction and internal fixation of metacarpal fractures using a thermoplastic splint as a surgical instrument

  • Papavasiliou, Theodora;Park, Paul Dain;Tejero, Ricardo;Allain, Niklaas;Uppal, Lauren
    • Archives of Plastic Surgery
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    • 제48권4호
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    • pp.384-388
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    • 2021
  • Adequate positioning of the hand is a critical step in hand fracture operative repair that can impact both the clinical outcome and the efficiency of the operation. In this paper, we introduce the use of a thermoplastic splint with an added thumb stabilizing component as a means to increase the surgeon's autonomy and to streamline the patient care pathway. The thermoplastic splint is custom fabricated preoperatively by the specialist hand therapist. The splint is used prior, during, and post operation with minimal modification. The thumb component assists maintaining the forearm in a stable pronated position whilst drilling and affixing metal work. This is demonstrated in the video of removal of metal work and open reduction and internal fixation of a metacarpal fracture.

Rapid Prototyping and Reverse Engineering Application for Orthopedic Surgery Planning

  • Ahn Dong-Gyu;Lee Jun-Young;Yang Dong-Yol
    • Journal of Mechanical Science and Technology
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    • 제20권1호
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    • pp.19-28
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    • 2006
  • This paper describes rapid prototyping (RP) and reverse engineering (RE) application for orthopedic surgery planning to improve the efficiency and accuracy of the orthopedic surgery. Using the symmetrical characteristics of the human body, CAD data of undamaged bone of the injured area are generated from a mirror transformation of undamaged bone data for the uninjured area. The physical model before the injury is manufactured from Poly jet RP process. The surgical plan, including the selection of the proper implant, pre-forming of the implant and decision of fixation positions, etc., is determined by a physical simulation using the physical model. In order to examine the applicability and efficiency of the surgical planning technology, two case studies, such as a distal tibia comminuted fracture and an iliac wing fracture of pelvis, are carried out. From the results of the examination, it has been shown that the RP and RE can be applied to orthopedic surgical planning and can be an efficient surgical tool.

The efficiency of topical anesthetics as antimicrobial agents: A review of use in dentistry

  • Kaewjiaranai, Thanawat;Srisatjaluk, Ratchapin Laovanitch;Sakdajeyont, Watus;Pairuchvej, Verasak;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권4호
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    • pp.223-233
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    • 2018
  • Topical anesthetics are commonly used in oral & maxillofacial surgery to control pain in the oral cavity mucosa before local anesthetic injection. These anesthetic agents come in many forms, developed for different usages, to minimize adverse reactions, and for optimal anesthetic efficiency. Earlier studies have revealed that these agents may also limit the growth of microorganisms in the area of anesthetic application. Many topical anesthetic agents show different levels of antimicrobial activity against various bacterial strains and Candida. The dosage of local anesthetic agent used in some clinical preparations is too low to show a significant effect on microbial activity. Efficiency of antimicrobial activity depends on the local anesthetic agent's properties of diffusion within the bloodstream and binding efficiency with cytoplasmic membrane, which is followed by disruption of the bacterial cell membrane. The antimicrobial properties of these agents may extend their usage in patients to both control pain and infection. To develop the topical local anesthetic optimal usage and antimicrobial effect, a collaborating antiseptic agent may be used to benefit the local anesthetic. However, more research is required regarding minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of topical local anesthetic agents with drug interaction between anesthetics and antiseptic agents.

슬관절치환술 환자의 Cephalosporin계 항생제 사용에 대한 경제효율성 비교연구 (A Comparative Study of Use of Cephalosporins in Total Knee Replacement Surgery in Terms of Economic Efficiency)

  • 조동선;송현주;박성욱;손의동
    • 약학회지
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    • 제52권2호
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    • pp.101-110
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    • 2008
  • Total Knee Replacement (TKR) surgery is one of the invasive procedures for patients with late-stage knee joint disorders. In the present study, economic efficiency was compared between uses of the 2nd and 3rd generation cephalosporins for the prophylaxis before and after the surgery using frequency analysis in terms of various factors such as medication costs, the number of days of antibiotic use and hospitalization due to TKR surgery. The results showed that the 3rd generation cephalosporins did not reduce the infection rate and total medication costs, but rather raised antibiotic cost in comparison with the 2nd ones. A frequent use of the 3rd ones is closely related to emergence of resistant bacterial strains. Therefore, we suggest that unnecessary prescriptions for the broad spectrum antibiotics should be avoided.

The anesthetic efficiency of retromolar infiltrations with two local anesthetic solutions of the same concentration in lower third molar surgery

  • Sayphiboun, Phouthala;Boonsiriseth, Kiatanant;Mahardawi, Basel;Pairuchvej, Verasak;Bhattarai, Bishwa Prakash;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권3호
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    • pp.137-146
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    • 2020
  • Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

Enhancing generation efficiency of liver organoids in a collagen scaffold using human chemically derived hepatic progenitors

  • Myounghoi Kim;Yohan Kim;Elsy Soraya Salas Silva;Michael Adisasmita;Kyeong Sik Kim;Yun Kyung Jung;Kyeong Geun Lee;Ji Hyun Shin;Dongho Choi
    • 한국간담췌외과학회지
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    • 제27권4호
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    • pp.342-349
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    • 2023
  • Backgrounds/Aims: Liver organoids have emerged as a powerful tool for studying liver biology and disease and for developing new therapies and regenerative medicine approaches. For organoid culture, Matrigel, a type of extracellular matrix, is the most commonly used material. However, Matrigel cannot be used for clinical applications due to the presence of unknown proteins that can cause immune rejection, batch-to-batch variability, and angiogenesis. Methods: To obtain human primary hepatocytes (hPHs), we performed 2 steps collagenase liver perfusion protocol. We treated three small molecules cocktails (A83-01, CHIR99021, and HGF) for reprogramming the hPHs into human chemically derived hepatic progenitors (hCdHs) and used hCdHs to generate liver organoids. Results: In this study, we report the generation of liver organoids in a collagen scaffold using hCdHs. In comparison with adult liver (or primary hepatocyte)-derived organoids with collagen scaffold (hALO_C), hCdH-derived organoids in a collagen scaffold (hCdHO_C) showed a 10-fold increase in organoid generation efficiency with higher expression of liver- or liver progenitor-specific markers. Moreover, we demonstrated that hCdHO_C could differentiate into hepatic organoids (hCdHO_C_DM), indicating the potential of these organoids as a platform for drug screening. Conclusions: Overall, our study highlights the potential of hCdHO_C as a tool for liver research and presents a new approach for generating liver organoids using hCdHs with a collagen scaffold.

역공학과 쾌속조형공정을 이용한 정형외과수술기법 개발에 관한 연구 (Investigation into the Development of Technology for Orthopeadic Surgery Utilizing Reverse Engineering and Rapid Prototyping Technology)

  • 안동규;이준영;양동열;한길영
    • 한국정밀공학회지
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    • 제21권6호
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    • pp.188-196
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    • 2004
  • The objective of this paper is to propose a new technology of the orthopaedic surgery using the combination of reverse engineering (RE) based on CT data and rapid prototyping (RP). The proposed technology utilizes symmetrical characteristics of the human body and capability of the combination of RE and RP, which rapidly manufactures three-dimensional parts from CT data. The original .stl data of injured extents are generated from the mirror transformation of .stl file fur uninjured extents. The physical shape before injuring is manufactured from RP using the original .stl data. Subsequently, pre-operative planning, such as a selection of proper implants, preforming of the implant, a decision of fixation locations and an insert position for the implant, an estimation of the invasive size, and pre-education of operators are performed using the physical shape. In order to examine the applicability and the efficiency of the proposed surgical technology, various case studies, such as a distal tibia commented fracture, a proximal tibia plateau fracture and an iliac wing fracture of pelvis, are carried out. From the results of case studies, it has been shown that the proposed technology is an effective surgical tool of the orthopaedic surgery reducing the operational time, the operational cost, the radiation exposure of the patient and operators, and morbidity. In addition, the proposed technology could improve the accuracy of operation and the speed of rehabilitation.

Analgesic efficiency of dexketoprofen trometamol in third molar surgery: a systematic review and meta-analysis

  • Bishwa Prakash Bhattarai;Diane Isabel Selvido;Dinesh Rokaya
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제24권5호
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    • pp.305-318
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    • 2024
  • This study aims to compare the analgesic efficacy of dexketoprofen trometamol (DT) with other analgesic drugs for pain relief after third molar surgery. The PubMed, Scopus, and Web of Science databases were searched to identify randomized controlled trials comparing DT with other analgesics for third molar surgery. The outcome measures were the sum of pain intensity differences (SPID), total pain relief (TOTPAR) at the 6th and 8th postoperative hours, time to rescue medication, and tolerability. In total, four studies met our inclusion criteria. A total of 660 third molar surgeries were performed: 365 in the DT group and 295 in the active control group. Compared to other analgesics, DT produced significantly better pain relief at the 6th postoperative hour: SPID (MD, 0.33; P = 0.01) and TOTPAR (MD, 0.41; P = 0.02). However, there were no statistically significant differences in the efficiency of pain relief at the 8th postoperative hour, time to rescue medication, or tolerability. Overall, a 25 mg dose produced the best results for pain relief. In conclusion, DT (25 mg) is a viable alternative to contemporary analgesics for pain relief after third molar surgery, particularly during the early postoperative period.