• Title/Summary/Keyword: Observational procedure

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Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study

  • Keisuke Harada;Noritaka Imamachi;Yuhei Matsuda;Masato Hirabayashi;Yoji Saito;Takahiro Kanno
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.86-93
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    • 2024
  • Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

Regenerative Endodontic Procedure in Korean Children and Adolescents: A Case Report (한국 소아청소년 근관치료 영역에서 재생치료, 근관치료재생술에 대한 증례보고)

  • An, So-Youn;Kim, Jin-Kyoung;Shim, Youn-Soo
    • Journal of dental hygiene science
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    • v.16 no.4
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    • pp.317-322
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    • 2016
  • Mineral trioxide aggregate (MTA) is widely used in endodontic therapy as a pulp-capping material, root or furcal perforation repair material, and for apexification and obturation of the root canal system. The purpose of this study was to formally document cases of MTA application in South Korean children and adolescents. Through this research, the practice of using MTA will be introduced and familiarized to the clinical practitioners. This study involved endodontic treatment using MTA for fractured crowns in 11- and 12-year-old. The children were followed up for 12 months until the pulp vitality was confirmed; in young permanent teeth with immature roots, the pulp is integral to the process of apexogenesis. These observational results regarding the use of MTA as an apexification material in non-vital immature permanent incisors appear to provide promising results in the search for new materials to meet existing endodontic needs.

A Study on the Improvement and Problems of Marine Officer License Examination System (해기사 면허시험제도의 문제점 및 개선 방안 연구)

  • Kim, Dong-Geun;Kwon, Ki-Soo
    • Journal of Fisheries and Marine Sciences Education
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    • v.13 no.1
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    • pp.99-116
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    • 2001
  • Testing is a procedure used to measure a sample of behaviour in order to discover how well a seafarer performs, usually in comparison with others, or compared with identified performance criteria. In this context It is important that the test, in whatever form it is being used, yields consistent results by being valid, reliable and practical. Whilst we can only take a sample of a person's knowledge or comprehension about topic in this way, testing methods do provide a more reliable estimate of performance than most other observational techniques; unsystematic or irregular observation being too unreliable. The method of examination has been specified in the provisions of Regulation 12 of the Decree of the ship officers act as followings. Other necessary matters for conducting oral and written examinations have been set out by the Minister. But written examination is too shortage of period and small number of question to cover the qualification of each level and oral test is just simple and namely Traditionally, written examinations have been provided as the only means for determining the acquisition of knowledge by the mariner. Typically, the examination formats have taken the format of either an essay or multiple choice examinations. Essay items, used in the vast majority of subject examination(not in Korea), consisted of three basic types: situational, descriptive and computational. The level of certificate being examined determined the number and mix of the type of essay questions selected. Oral question has again been used by assessors of seafarer in a wide variety of contexts. Also, oral questioning is often used when observation of performance is undertaken to ask why a certain action has been taken, or to be broaden the scope of what has been observed. At end, Each techniques have their own advantage and disadvantage, so we have to choose some or all of the following techniques, depending upon the certificate, qualification or job for which the trainee is aiming. But in high lank, we have to use both of essay type and multiple choice and with enough time of oral test at least 30 minutes. Who would be the assessor? According to the STCW Code Section A-I/6, instructors, supervisor and assessors are appropriately qualified for particular types and levels of training or assessment of competence of seafarers either on board or ashore, as required under the Convention, in accordance with the provisions of this section.

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Regenerative capacity of augmented bone in rat calvarial guided bone augmentation model

  • Kubota, Tatsuya;Hasuike, Akira;Ozawa, Yasumasa;Yamamoto, Takanobu;Tsunori, Katsuyoshi;Yamada, Yutaka;Sato, Shuichi
    • Journal of Periodontal and Implant Science
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    • v.47 no.2
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    • pp.77-85
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    • 2017
  • Purpose: Guided bone regeneration (GBR) is the most widely used technique to regenerate and augment bones. Even though augmented bones (ABs) have been examined histologically in many studies, few studies have been conducted to examine the biological potential of these bones and the healing dynamics following their use. Moreover, whether the bone obtained from the GBR procedure possesses the same functions as the existing autogenous bone is uncertain. In particular, little attention has been paid to the regenerative ability of GBR bone. Therefore, the present study histologically evaluated the regenerative capacity of AB in the occlusive space of a rat guided bone augmentation (GBA) model. Methods: The calvaria of 30 rats were exposed, and plastic caps were placed on the right of the calvaria in 10 of the 30 rats. After a 12-week healing phase, critical-sized calvarial bone defects (diameter: 5.0 mm) were trephined into the dorsal parietal bone on the left of the calvaria. Bone particles were harvested from the AB or the cortical bone (CB) using a bone scraper and transplanted into the critical defects. Results: The newly generated bone at the defects' edge was evaluated using micro-computed tomography (micro-CT) and histological sections. In the micro-CT analysis, the radiopacity in both the augmented and the CB groups remained high throughout the observational period. In the histological analysis, the closure rate of the CB was significantly higher than in the AB group. The numbers of cells positive for runt-related transcription factor 2 (Runx2) and tartrate-resistant acid phosphatase (TRAP) in the AB group were larger than in the CB group. Conclusions: The regenerative capacity of AB in the occlusive space of the rat GBA model was confirmed. Within the limitations of this study, the regenerative ability of the AB particulate transplant was inferior to that of the CB particulate transplant.

Long-Term Survival Benefit of the Bronchial Arterial Embolization for Patients Presenting with Non-Traumatic Hemoptysis in a District Emergency Center (권역 응급의료센터에 내원한 비외상성 객혈 환자에서 기관지 동맥 색전술의 장기 생존 효과)

  • Chon, Song Bin;Jung, Sung Koo;Kwak, Young Ho;Suh, Gil Joon;You, Eun Young;Shin, Sang Do
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.148-159
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    • 2004
  • Background : This study was conducted to evaluate the survival benefit of the bronchial arterial embolization (BAE) for patients presenting with non-traumatic hemoptysis. Methods : The clinical data were retrospectively collected from the medical records and the Order Communicating Systems (OCS). The information dealing with death was collected from national death certificates. After enrolled patients were divided with two group such as BAE group (patients who were managed with BAE) and non-BAE group (patients who were managed with conservative modality), the survival benefit of BAE was estimated during the observational period of 24 months through using the Kaplan-Meier survival graph and the Cox-proportional hazard regression analysis. Results : The number of total cases was 272. Of these, BAE group involved 63 and non-BAE group involved 209. 69 cases had the malignant pulmonary lesions, 149 cases had non-malignant chronic lung lesion such as the mycobacteria infection, fungus ball, or bronchiectasis (BE), and 54 cases had the other pathologic conditions. For each sub-groups such as 'malignant lung lesion' group, 'non-malignant chronic lung lesion' group as well as about all cases, the adjusted hazard ratios (HRs) of BAE for death was not significantly different compared to the conservative management. But the adjusted HRs as to underlying causes such as 'malignant lung lesion' group and 'the other conditions' group increased significantly compared to 'non-malignant chronic lung lesion' group. Conclusion : There was no significant survival benefit by BAE procedure on survival in patients presenting with non-traumatic hemoptysis.

Kidney-sparing Management Versus Nephroureterectomy for Upper Tract Urothelial Carcinoma: a Systematic Review and Meta-analysis

  • Luo, You;She, Dong-Li;Xiong, Hu;Fu, Sheng-Jun;Yang, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5907-5912
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    • 2015
  • Purpose: To evaluate and update evidence for prognostic effects of kidney-sparing (KS) management and nephroureterectomy (NU) for upper tract urothelial carcinomas. Materials and Methods: Pubmed, Embase and the Cochrane Library were retrieved for the identification of comparative studies of kidney-sparing procedure and nephroureterectomy for upper tract urothelial carcinoma prior to December 2014. The data were extracted independently by 2 reviewers and the quality of the included studies was assessed. Review Manager 5.3 and STATA 13 were used to perform the meta-analysis. Results: Twenty-three observational studies including 1,587 KS and 3,996 NU were evaluated. The results of the meta-analysis showed that nephroureterectomy had no significant benefit with regard to intravesical recurrence (IRFS), metastasis (MFS), cancer specific survival (CSS) and overall survival (OS) except the total tumor recurrence (RFS) when compared with kidney sparing management. The respectively pooled outcomes were HR 1.36 (0.69-2.68, P=0.38) for IRFS, 1.09 (0.59-2.01, P=0.78) for MFS, 1.17 (0.77-1.79, P=0.47) for CSS, 1.50 (0.90-2.48, P=0.12) for OS and 1.61 (1.03-2.51, P=0.04) for RFS. Conclusions: On the whole, kidney-sparing management had equivalent prognostic effect on upper tract urothelial carcinoma as the standard nephroureterectomy except in tumor recurrence. However, the results should be interpreted with caution for lack of stage and grade stratification and multi-center randomized controlled trials are still needed to verify our results.

A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

  • Kang, Suk-Hyung;Seo Yang, Jin;Cho, Steve Sungwon;Cho, Yong-Jun;Jeon, Jin Pyeong;Choi, Hyuk Jai
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.806-813
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    • 2020
  • Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated. Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery. Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months. Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.

Importance of the knowledge of pathological processes for risk-based inspection in pig slaughterhouses (Study of 2002 to 2016)

  • Sanchez, Pedro;Pallares, Francisco J.;Gomez, Miguel A.;Bernabe, Antonio;Gomez, Serafin;Seva, Juan
    • Asian-Australasian Journal of Animal Sciences
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    • v.31 no.11
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    • pp.1818-1827
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    • 2018
  • Objective: The objective of this work was to determine the prevalence of the pathologies that caused the condemnation of pig carcasses in an area of intensive pig farming and Mediterranean climatology and to evaluate their influence in a risk-based inspection procedure for slaughterhouses. Methods: A retrospective observational investigation was carried out from 2002 to 2016 into the pathological processes that caused the condemnation of pig carcasses in a slaughterhouse from South-eastern Spain. The seasonal effect on the causes of condemnation carcass was reported. Negative binomial model was used to evaluate the effect of season on the rate of antemortem rejections and post-mortem condemnations. Histopathological examinations were performed to confirm the diagnosis. Results: The risk of antemortem rejections (0.0564%) was significantly greater in summer (risk ratio [RR] = 1.57). Autumn was associated with higher rate (RR = 1.69) of the total postmortem condemnations (0.1046%). Significantly higher rates of pronounced anaemia (0.0111%) were observed in summer (RR = 3.20). The main causes of anaemia were observed gastroesophageal ulcers and haemorrhagic enteropathies. Significantly highest risk of erysipelas (0.0074%) were observed in autumn (RR = 5.485). About other zoonosis, only eight cases (0.0013%) of carcasses were declared unfit due to tuberculosis lesions. Porcine muscular cysticercosis was not detected. Nevertheless, nonspecific causes such as generalized infections and emaciation represented the half of the condemned carcasses (50.90%). Conclusion: The pathologies leading to the condemnation of carcasses in this study can be considered representative of the pathologies that affect the pig population from a region with a high intensive production and Mediterranean climatology because this slaughterhouse receives a lot of animals from many farms of different size in a high intensive pig production zone (Mediterranean region). Increased knowledge of environmental factors that may foment the appearance of the diseases is essential for implementing inspection programs based on risk assessment in pig's slaughterhouses.

Analysis of Measured Acceleration Data to Obtain Dynamic Characteristics of Bridges (교량의 동적 특성 분석을 위한 가속도 데이터의 해석)

  • 이선구;이성우
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 1995.10a
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    • pp.111-121
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    • 1995
  • In Extracting the dynamic parameters for estimating the load carrying capacity and integrity of bridges, both the instrumentation and the processing the data plays important role . When the fixed point can not be secured, it is difficult and expensive to measure dynamic displacements. Even if the displacement is obtained through the integration of the acceleration data, the results can be quite different from the real behavior, because the main frequency contents can be leaked during discretized data processing. The instrumentation is used for measurements, and every measurement involves error and uncertainty, such as systematic, conformance, environmental, observational, sampling, and ranmom error. Systematic and conformance error can be remedied through the proper sellection and installation of the instruments, but sampling and random errors could not have been corrected properly and it becomes the limitation for using acceleration data. In this paper, the errors which can be occurred in numerical processing of dynamic data are referred, and the method to sellect proper sampling rate for the structural frequency range are proposed. Using the proposed method, the displacement response of the structures can be economically obtained from the measured acceleration record, and this procedure can be used properly to estimate the integrity of the bridges and infrastructures subjected to dynamic loads.

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Relationship between subjective and objective measures of anticipatory anxiety prior to extraction procedures in 8- to 12-year-old children

  • Kalra, Namita;Sabherwal, Puja;Tyagi, Rishi;Khatri, Amit;Srivastava, Shruti
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.2
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    • pp.119-128
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    • 2021
  • Background: This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. Methods: An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child's temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as "easy," "slow to warm-up," and "difficult." The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. Results: The study included 60 children aged 8-12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety. A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001⁎) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = -0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. Conclusion: A high percentage (70%) of children aged 8-12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.