• Title/Summary/Keyword: Post operative evaluation

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POST OPERATIVE EVALUATION FOR RETROMANDIBULAR APPROACH OF SUBCONDYLAR FRACTURES (하악골 과두하 골절 시 후하악접근법 통해 ORIF 시행한 환자들의 술 후 추적조사)

  • Lee, Seul-Ki;Song, Kyoung-Ho;Kim, Jwa-Young;Song, Sang-Hoon;Yang, Byoung-Eun;Choi, Won-Cheul;Kim, Seong-Gon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.631-635
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    • 2007
  • Purpose: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. Material and methods: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 patients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. Result: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. Conclusion: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.

Evaluation of Response to Preoperative Chemotherapy Versus Surgery Alone in Gastroesophageal Cancer: Tumor Resectability, Pathologic Results and Post-Operative Complications

  • Marandi, Aref Kashefi;Shojaiefard, Abolfazl;Soroush, Ahmadreza;Abdegah, Ali Ghorbani;Jafari, Mehdi;Khodadost, Mahmoud;Mahmoudzade, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.231-237
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    • 2016
  • Gastroesophageal cancer is one of the most common types of cancer worldwide. Despite significant developments in management, 5-year survival in the developing world is less than 20 percent. Due to restricted research about the impact of preoperative chemotherapy (POC) on tumor resection, pathological response and postoperative complications in Iran, we designed and implemented the present retrospective cross- sectional study on 156 patients with gastroesophageal cancer (GEc) between 2013 and 2015 at Shariati Hospital of Tehran. Two groups were included, the first group had previously received preoperative chemotherapy and the second group had only undergone surgery. All patients were followed for at least one year after the operation in terms of tumor recurrence, relapse free survival and one-year survival. The two groups were eventually compared regarding tumor resection, pathological response, postoperative complications, recurrence rate and survival. The mean age was $66.5{\pm}7.3years$ and 78 percent were male. The tumor resectability, pathological response and postoperative complications in the group which received POC were 93.5%, 21.8% and 12.8%, respectively, and in the surgery alone group figures for tumor resection and postoperative complications were 76% and 29.5%, respectively. Also based on our study the 5-year survival in the POC group was better (79.5% vs. 66.5%). Using standard neoadjuvant regimens (preoperative chemotherapy/chemoradiotherapy) beforesurgery could increase tumor resectability, pathological response, and improve the general status of the patients. Therefore using POC may be recommended over surgery alone.

Human Acellular Dermis versus Submuscular Tissue Expander Breast Reconstruction: A Multivariate Analysis of Short-Term Complications

  • Davila, Armando A.;Seth, Akhil K.;Wang, Edward;Hanwright, Philip;Bilimoria, Karl;Fine, Neil;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • v.40 no.1
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    • pp.19-27
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    • 2013
  • Background Acellular dermal matrix (ADM) allografts and their putative benefits have been increasingly described in prosthesis based breast reconstruction. There have been a myriad of analyses outlining ADM complication profiles, but few large-scale, multi-institutional studies exploring these outcomes. In this study, complication rates of acellular dermis-assisted tissue expander breast reconstruction were compared with traditional submuscular methods by evaluation of the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) registry. Methods Patients who underwent immediate tissue expander breast reconstruction from 2006-2010 were identified using surgical procedure codes. Two hundred forty tracked variables from over 250 participating sites were extracted for patients undergoing acellular dermis-assisted versus submuscular tissue expander reconstruction. Thirty-day postoperative outcomes and captured risk factors for complications were compared between the two groups. Results A total of 9,159 patients underwent tissue expander breast reconstruction; 1,717 using acellular dermis and 7,442 with submuscular expander placement. Total complications and reconstruction related complications were similar in both cohorts (5.5% vs. 5.3%, P=0.68 and 4.7% vs. 4.3%, P=0.39, respectively). Multivariate logistic regression revealed body mass index and smoking as independent risk factors for reconstructive complications in both cohorts (P<0.01). Conclusions The NSQIP database provides large-scale, multi-institutional, independent outcomes for acellular dermis and submuscular breast reconstruction. Both thirty-day complication profiles and risk factors for post operative morbidity are similar between these two reconstructive approaches.

Evaluation of Post-Operative Residual Tumors Using $^{67}Ga$ Scintigram 1. Is the Blood Gallium Redistributed into the Surgical Wound? ($^{67}Ga$ 신티그램을 이용한 술후잔여종양의 평가 1. 혈중 $^{67}Ga$은 수술창상에 재분포하는가?)

  • Moon, Tae-Yong;Sol, Chang-Hyo;Kim, Yong-Ki;Wang, Soo-Geun;Han, Kook-Sang;Choi, Chang-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.355-359
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    • 1992
  • The $^{67}Ga$ has somewhat long physical and biological half livies with 78 hours and 600 hours respectively, so we can get $^{67}Ga-scan$ images for 3 or more days after once injection of $^{67}Ga$. Furthermore $^{67}Ga$ scan would be useful to search some residual tumors after surgical removal of the tumors trapped with $^{67}Ga$. However $^{67}Ga$ bound with plasma proteins would be delayed in plasma clearance as approximately 10% of the dose remains in the plasma at 24 hours. If the remained $^{67}Ga$ in the plasma is redistributed into the surgical wound, we wouldn't evaluate the degree of the tumor remained after surgery. So the authors examined the amounts of the remained blood $^{67}Ga$ and the redistribution of the blood $^{67}Ga$ into the artificial wound with S or more centimeters in the diameter at the neck and chest of the rabbits. The results were as follows; 1) The $^{67}Ga$ remained in the plasma were 12%, 5.7%, 4.2% at 24, 48 and 72 hours after $^{67}Ga$ injection respectively. 2) The blood $^{67}Ga$ were redistributed into the artificial wound with 5.9% at 48 hours and 6.9% at 72 hours after $^{67}Ga$ injection.

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Performance and Importance of Nursing Jobs in General Hospitals according to Levels of Work Experience of Nursing Staff (종합병원 간호사의 근무기간 경력에 따른 직무수행도와 중요도)

  • Park, Sun-Hee;Kang, Hyun-Sook;Hyun, Kyung-Sun;Kim, Won-Ok;Sok, So-Hyune R.;Lee, Ji-A
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.2
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    • pp.267-273
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    • 2010
  • Purpose: In this study differences in levels of performance and importance of nursing jobs were explored in relation to levels of work experience. Method: The sample was chosen by convenient sampling (N=363) and a cross-sectional study design was used. Frequencies and percentages were used for descriptive statistics. ANOVA was utilized to examine differences in performance and importance of nursing jobs among three groups of nurses, divided based on levels of work experience (less than 1 year, 1 to 4 years, and 5 or more years). Results: Regarding performance of nursing jobs, novice nurses provided more support for patients, but provided less assessment of patients (i.e., investigation of levels of nutrition and exercise, and observation of verbal, and non-verbal behavior, and levels of cognition). Regarding the importance of nursing jobs, nursing linked to exercise and activities, and post-operative and excretion care were considered to be less important among novice nurses than among experienced nurses. Conclusion: Different training programs should be developed and provided to nurses according to levels of work experience. By doing so, it will be feasible to minimize differences in quality of nursing care triggered by different levels of work experience.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS WITH ACTIVE ORAL BLEEDING (구강내 과다출혈로 내원한 응급환자에 관한 임상적 연구)

  • Yoo, Jae-Ha;Kang, Sang-Hoon;Kim, Hyun-Sil;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.5
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    • pp.383-389
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    • 2002
  • This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

EVALUATION OF POSTOPERATIVE PROPHYLACTIC ANTIBIOTIC MEDICATION IN THIRD MOLAR SURGERY (하악 제 3대구치 발거 후 예방적 항생제의 투여에 관한 연구)

  • Jeon, Hee-Kyoung;Choi, Ju-Seok;Kim, Pyung-Soo;Ahn, Yung;Ko, Seung-O
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.474-480
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    • 2005
  • We evaluated the need for prophylactic postoperative oral antibiotic medication in extraction of asymptomatic impacted mandibular third molars. All patient didn't show sign of pain, inflammation, swelling and trismus at the time of extraction. In the experimental group, oral antibiotic medication(Amoxicillin) was carried out for 5 days postoperatively. In the control group, the patients received no antibiotic medication. All groups didn't use antibiotic irrigation solution. Rule of group composition randomized. The surgical technique was the same in all cases. Parameters that were evaluated were infection, pain, facial swelling, trismus. We could not find any significant difference between the experimental and control groups.(P<0.05) The results of our study show that post operative oral prophylactic antibiotic medication after the extraction of impacted mandibular third molars does not contribute to less infection, pain, facial swelling and increased mouth opening after surgery. Therefore we suggest that prophylactic postoperative oral antibiotic medication is not needed in extraction of asymptomatic impacted mandibular third molars.

Epithelial-Myoepithelial Carcinoma of the Parotid Gland: A Case Report (귀밑샘의 상피세포-근상피세포 암종 치험례)

  • Pae, Woo-Sik;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo;Kang, Myoung-Jae
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.501-504
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    • 2011
  • Purpose: Epithelial-myoepithelial carcinoma (EMC) represents about the 1% of the malignant neoplasms in the salivary glands and clinically most commonly found localized, well defined and sometimes presents orofacial pain. Treatment of choice is surgical excision. Postoperative radiotherapy can be used when surgical margins are doubtful. We report our experience of EMC of the parotid gland. Methods: A 78-year-old man presented with a three-year history of a localized, painless, $7{\times}6cm$ sized recurred tumor in his right preauricular area. He was diagnosed as EMC of the right parotid gland. So a total parotidectomy was performed. In his old medical history, he had a mass in the same area 5 years ago. The diagnosis of pleomorphic adenoma was made and the mass excision was performed at the local clinic without further evaluation. Results: It was unable to visually discriminate between the tumor and the normal tissue. So a total parotidectomy was performed. The patient was got post-operative radiotherapy and was followed up for 9 months. There was no specific evidence of recurrence. Conclusion: We present a case of EMC of the parotid gland in right preauricular area, which is uncommon. So we report a uncommon case of EMC to discuss about our experience with relevant journal discussion.

Spinal Instability Following for Spinal Cord Tumors : Laminoplasty vs. Laminectomy (척수종양 수술 후 발생한 척추 불안정 : 추궁성형술과 추궁제거술의 비교 연구)

  • Kim, Sang Hyun;Chin, Dong kyu;Yoon, Young Sul;Jin, Byung Ho;Cho, Yong Eun;Kim, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.61-67
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    • 2001
  • Objectives : To demonstrate the preventive effect on post-operative spinal deformity of the laminoplasty compared with laminectomy for spinal cord tumor. Methods : Sixteen patients who underwent laminoplasty and 89 patients who underwent lamenectomy were reviewed retrospectively after removal of spinal cord tumors between February 1981 and December 1999. The mean follow-up period after laminoplasty and laminectomy were 29 months(range, 12-49 months) and 66 months(range, 6-120 months) respectively. Patients were observed neurologically and radiologically. Results : Postoperative kyphosis was observed 17 patients(19%) in the laminectomy group, but was not observed in the laminoplasty group. Postoperative slipping was observed 16 patients(18%) in the laminectomy group, but was not observed in the laminoplasty group. Complications such as postoperative scoliosis, rotation, and swan-neck deformity were observed in the laminectomy group, but were not observed in the laminoplasty group. Conclusions : Laminoplasty prevented postoperative spinal deformities after removal of spinal cord tumors, and afforded anatomic reconstruction of the vertebral arch. Additionally, appropriate patient selection maximizes the chance of optimal neurologic outcomes and minimizes complications. Laminoplasty appears to warrant further evaluation as an alternative to wide laminectomies for exposure of intraspinal tumors.

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Effects of Complex Korean Medicine Treatment on a Patient with Knee Pain and Ankylosis Following a Distal Femur Osteotomy: A Case Report

  • Park, Han Bin;Heo, Eun Sil;Yoo, Dong Hwi;Jang, Won Suk;Kwon, Oh Bin;Choi, Ki Won;Kwon, Min Jin;Kim, Tae Ju;Jang, Seon Woo;Kwon, Oh Hoon
    • Journal of Acupuncture Research
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    • v.39 no.2
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    • pp.134-138
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    • 2022
  • Distal femur osteotomy (DFO) is a controlled surgical break of the femur performed to allow realignment of the limb. Redistribution of the load aims to correct the abnormal mechanical weight-bearing axes in patients with abnormal alignment of the lower extremities, and degenerative changes in the knee joint. This report describes a complex Korean medicine treatment for a patient complaining of knee pain and stiffness following a DFO. Post-operative care for the patient lasted 78 days with treatment including pharmacopuncture, acupuncture, herbal medicine, cupping therapy, and physiotherapy. The effectiveness of the treatments was evaluated using the numerical rating scale, range of motion of the knee, and by physical examination. After treatment, these evaluation indicators improved, suggesting that the complex Korean medicine treatment received by the patient was an appropriate treatment for knee pain and stiffness following a DFO.