Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity. Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate. Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56-87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6-60 months). No intraoperative complications were observed. All patients' symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring. Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.
Background: Laryngeal cancer, the most common malignancy of head and neck, is being detected and treated in earlier and more effectively due to introduction of endoscope, continuous development of radiographic technology, and advancement in new surgical techniques such as laser surgery and conservation laryngeal surgery Objectives To compare the different treatment results for early laryngeal cancer to determine which methos provides the good prognosis. Materials and Methods: Retrospective study was done for 135 patients with early laryngeal squamous cell carcinoma(Stage I or II) who were treated at our institute between 1989 to 1996. There were 105 patients with glottic cancer(Stage I: 68 patients, Stage II:37 Patients) and 30 patients with supraglottic cancer(Stage I: 12 patients, Stage II:18 patients) Initial treatment included radiation therapy for 54 patients, endoscopic laser surgery for 8 patients, laryngofissure and cordectomy for 8 patients, vertical partial laryngectomy for 37 patients, supraglottic laryngecomy for 14 patients and supracricoid laryngectomy for 5 patiens, and total laryngectomy for 9 patients. Results : Salvage treatments, such as total laryngectomy, conservation laryngeal surgery, radiation therapy and neck dissection were performed for initial treatment failure with 9 patients after radiation therapy, 8 patients after conservation laryngeal surgery, 2 patients after endoscopic laser and 3 patients after total laryngectomy. Overall 3-year survival rate for glottic 71 was 92.4%, glottic f 84.3%, supraglottic 7172.7%, and supraglottic f was 63.%%. However, survival rate of the same stage was variable according to the choice of initial treatment. Conclusion New classification of the early laryngeal cancer was necessary and helpful for the choice of the initial treatment.
Background: A diagnosis of H. pylori infection can be made by invasive or non-invasive methods. Several noninvasive diagnostic tests based on the detection of H. pylori stool antigen (HpSA) have been developed. The Genx H. pylori stool antigen card test is a new rapid, non-invasive test that is based on monoclonal immunochromatographic assay. The aim of this study was to determine its sensitivity, specificity, and diagnostic accuracy for diagnosing H. pylori infection in adult patients. Materials and Methods: A total of 162 patients were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: Using the reference test, 50.6% of the samples were positive for H. pylori infection. The Genx H. pylori antigen test was positive in 19.7% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the Genx H. pylori antigen test were 51.6%, 96.0%, 88.8%, 76.1%, and 79.0%, respectively. Conclusions: The Genx H. pylori stool antigen card test is a new non-invasive method that is fast and simple to perform but provides less reliable results.
Currently, in the field of spinal surgery around the world, various new technologies have been rapidly developed and applied to patients. The author believes that it is necessary to discuss whether these new technologies are being fully reviewed for efficacy and safety before being applied to patients. To consider this issue, the author analyzed the basic research data and clinical application process of the intradiscal electrothermal therapy, which was developed as a new technology for discogenic pain disease in the 2000s and has been widely used worldwide. As a result, it was found that this procedure has been performed on patients in a state where there is insufficient base research on efficacy and safety. The author judges that this case reveals an essential problem related to the clinical operation of new medical technologies in the field of spine surgery. Therefore, the author believes that in order to minimize the side effects that new medical technology in the field of spinal surgery may have on patients, more full-fledged basic research and higher clinical acceptance standards should be established.
The purpose of this study is to develop comfortable patient gown for spinal surgery patients. The results of the survey confirmed inconveniences and problems with the current gown, and a new gown style was recommended. The recommended changes addressed design, pattern, and materials. The final experimental design for the top of the new patient gown is a wrap style that moves the center opening of the gown to the side and enables patients to control the length of the sleeves by attaching two snaps. The cutting line is aligned with the back brace location, and the issue of repeated bunching of the gown material by the brace was solved by substituting 100% knitted structure fiber. The sleeve length can be adjusted with snaps on the sleeve cap and hem. When lifting up the gown for treatment on specific areas of the body, doctors open the edge of the right side of the gown in order to lift up the top. The bottom of the new patient gown was made from 100% cotton knitted structure fiber, and it enables patients to control the length of pants by attaching two snaps on the side. The results of an on-site dressing suitability evaluation and a flexibility evaluation with respect to dressing/undressing indicated that the new patient gown was much better received than the existing gowns (A and B). Our hypothesis regarding new patient gowns was supported in both the fit and design categories.
During New year's day and Thanksgiving holiday, the 1339 Information Center in Gwangju and Jeonnam received an emergency medical situation and carried out the analysis as follows ; 1. The reason for the higher phone guidance(72%) of the hospital was based on the simple query for the pain control rather than emergency care. This was explained by the unfamiliar environment of the holiday movers. Pharmaceutical guidance(12.6%) in rural area was also given during the holidays. 2. The disease counselling(2.4%) and emergency treatment instruction(First Aid)(1.6%) decreased because of the small number of request for the diseases. This explained the decrease of the disease counselling. 3. The phone calls increased 8-13 times more than usual. Five-day holidays could have more emergency patients than three-day holidays. During New year's day and Thanksgiving day, the number of received phone calls was 6,444(25.7%) and this accounted for one fourth of the total number in 2007. 4. The number of the patients increased on New year's day and Thanksgiving day because most of the medical institutions and pharmacy were off duty. 5. The patients were centered in Internal medicine and pediatrics. This showed the food-borne diseases and air-borne infection such as common cold. 6. During Thanksgiving day, ophthalmologic patients having viral keratoconjunctivitis(Apollo eye disease) increased 8 folds than in New year's day. It was estimated from the continuous epidemic of Apollo eye disease. 7. There broke out the traffic accidents, food poisoning, infectious diseases, dermatological diseases due to seasonal and environmental changes during the holiday move.
Guo, Jian-Rong;Jin, Xiao-Ju;Yu, Jun;Xu, Feng;Zhang, Yi-Wei;Shen, Hua-Chun;Shao, Yi
Asian Pacific Journal of Cancer Prevention
/
v.14
no.8
/
pp.4529-4532
/
2013
Background: Acute normovolemic hemodilution (ANH) has been widely used to prevent the massive blood loss during hepatic carcinoma. The influences of ANH on coagulation function are still controversy, especially in elderly patients. The study observed ANH effects on coagulation function and fibrinolysis in elderly patients undergoing the disease. Materials and Methods: Thirty elderly patients (aged 60-70 yr) with liver cancer (ASA I or II) taken hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n=15) and control group (n=15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (130/0.4) and Ringer's solution, respectively. Blood samples were drawn from patients in both groups at five different time points: before anesthesia induction (T1), 30 min after ANH (T2), 1 h after start of operation (T3), immediately after operation (T4), and 24 h after operation (T5). Then coagulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (CD62P and activated GP IIb/GP IIIa) were measured. Results: The perioperative blood loss and allogeneic blood transfusion were recorded during the surgery. The perioperative blood loss was not significantly different between two groups (p>0.05), but the volume of allogeneic blood transfusion in ANH group was significantly less than in control group ($350.0{\pm}70.7$) mL vs. ($457.0{\pm}181.3$) mL (p<0.01). Compared with the data of T1, the prothrombin time (PT) and activated partial thromboplastin time (APTT) measured after T3 were significantly longer (p<0.05) in both groups, but within normal range. There were no significant changes of thrombin time (TT) and D-dimer between two groups at different time points (p>0.05). SFMC and F1+2 increased in both groups, but were not statistically significant. PAC-1-positive cells and CD62P expressions in patients of ANH group were significantly lower than those at T1 (p<0.05) and T2-T5 (p>0.05). Conclusions: ANH has no obvious impact on fibrinolysis and coagulation function in elderly patients undergoing resection of liver cancer. The study suggested that ANH is safe to use in elderly patients and it could reduce allogeneic blood transfusion.
The prevalence of osteoporosis has been increasing globally. Recently surgical indications for elderly patients with osteoporosis have been increasing. However, only few strategies are available for osteoporotic patients who need spinal fusion. Osteoporosis is a result of negative bone remodeling from enhanced function of the osteoclasts. Because bone formation is the result of coupling between osteoblasts and osteoclasts, anti-resorptive agents that induce osteoclast apoptosis may not be effective in spinal fusion surgery, necessitating new bone formation. Therefore, anabolic agents may be more suitable for osteoporotic patients who undergo spinal fusion surgery. The instrumentations and techniques with increased pullout strength may increase fusion rate through rigid fixation. Studies on new osteoinductive materials, methods to increase osteogenic cells, strengthened and biocompatible osteoconductive scaffolds are necessary to enable osteoporotic patients to undergo spinal fusion. When osteoporotic patients undergo spinal fusion, surgeons should consider appropriate osteoporosis medication, instrumentation and technique.
Neuromuscular difference between normal subjects and low-back pain patients has been identified in terms of neural excitation signal measured by Electromyography (EMG) under the dynamic flexion/extension trunk motion. Ten healthy subjects and ten low-back pain patients were recruited for this study. New parameters and normalization technique were introduced to quantify the muscle excitation pattern among the flexor-extensor pairs of muscles : rectus abdominis (RA)-erector spinae (ES at L1 and L5 level), external oblique (EO)-internal oblique (IO), rectus femoris (quadricep : QUD)-biceps femoris( hamstring : HAM), and tibialis anterior (TA)-gastrocnemius (GAS). Results indicated that the temporal EMG pattern such as peak timing difference between the hip flexor (QUD) and extensor (HAM) and the duration of coexcitation between ES at L5 and RA muscle pairs showed a statistically significant difference between normal subjects and low-back pain patients. Improtantly, this study presented a new technique to identify the dynamic muscle excitation pattern that canb be least affected by EMG-length-velocity relationship. Further study can performed to validate this method for clinical application to quantitatively identify the low-back pain patients in the future.
Purpose: The purpose of this study was to describe the lived experience of the patients with cancer participating in a clinical trial for the development of a new drug. Method: This study was based on a phenomenological approach. The eight patients participating in a clinical trial were selected as the participations of this study. The data were obtained through in-depth interviews from the participants and were analyzed using the Giorgi method. Results: Essential experiences of the patients with cancer under a clinical trial consisted of anticipating recovery of physical health and a social role, passing the strict criteria of a clinical trial, diminishing economic burden, satisfaction with special treatment receiving, social contribution, concerns about side effects and withdrawal from the clinical trial, conflicts as a participant, pain, limited administration of other treatments, regret for giving up other treatments, strict compliance with instructions, prevention of side effects and maintaining desirable life-style. Integrated units of meaning of these components were hope, good luck, a sense of satisfaction, fear, distress, and the will of self-control. Conclusion: The most essential meaning of the cancer patients participating in a clinical trial was hope. Hope was found to be a primary factor reinforcing the will of self-management. The results of this study can be of great help to the research nurses to understand the lived experience of the patients with cancer and to plan an effective nursing intervention for the patients.
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