• Title/Summary/Keyword: Preoperative period

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The Distal Metatarsal Dorsal-Wedge Osteotomy Using Bio-Compression Screw for Advanced Hallux Rigidus (진행된 무지 강직증에서 생체흡수성 압박나사를 이용한 원위 중족골의 배측 쐐기 절골술)

  • Kim, Yong-Min;Cho, Byung-Ki;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Park, Kyoung-Jin;Park, Ji-Kang;Choi, Seung-Myung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.38-46
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    • 2012
  • Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

Clinical effect of Thymectomy for Patients in Myasthenia Gravis (근무력증 환자의 외과적 치료)

  • 정원상
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.152-157
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    • 1990
  • A clinical study for thymectomy for 23 patients in Myasthenia Gravis was done between May, 1982 and July, 1989. at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Han Yang University. Among Z3 patients, male to female ratio was 11: 12 and Age of onset was ranged from 15 years-old to 52 years-old. Previous symptom duration from diagnosis until operation was ranged from 2 months to 96 months, and Mean duration was 28.74 months. The severity of disease was classified by Osserman`s classification preoperatively. In histopathology of thymus, Thymic hyperplasia 7 cases, Thymoma 7 cases, Invasive thymoma 3 cases, Within Normal Limit 5 cases, and Thymic Atrophy 1 case. Correlation between preoperative symptom duration and postoperative clinical course was statistically significant. The shorter of preoperative symptom duration, The better of postoperative clinical course. Grading of postoperative course was classified by Papatestas in 1975. Follow-up for postoperative course was ranged from 3 months to 7 year and 4 months, Cases of complete remission 1 year postoperative period were 9 cases and cases of Improvement were 8 cases, So totally 17 cases among 23 cases[73.91%] found good results.

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The Effects of Tricuspid Annuloplasty on Funcional Tricuspid Regurgitation (기능적 삼첨판 폐쇄부전증 환자에서 판막륜 성형술의 효과)

  • 유경종
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.829-836
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    • 1995
  • Ninety-one adult patients underwent three different methods of annuloplasty and compared them by the amount of tricuspid regurgitation. Group I [n=17 is Kay method, Group II [n=46 is modified Kay method and Group III [n=28 is De Vega and modified De Vega method. Preoperative and postopeative size of the liver and its function, the cardiothoracic ratio, EKG and echocardiogram were analyzed. The follow up was done for all the patients [mean 20.0$\pm$ 8.5 months . The postoperative size of the liver, the postoperative cardiothoracic ratio and the postoperative systolic pressure of the right ventricle decreased significantly compared to preoperative size, ratio and pressure [p=0.0001, p=0.0001, p=0.0001 . But there were no differences between the groups. The results of annuloplasty revealed that tricuspid regurgitation improved postoperatively [p=0.0001 even though there was no statistically significant differences in relation to the methods of annuloplasty. The right ventricular systolic pressure and the amount of regurgitation decreased significantly during the postoperative period by performing 3 different methods of annuloplasty, although we could not find the differences between the three different methods.

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Accuracy of Preoperative Computed Tomography in Comparison with Histopathologic Findings in Staging of Lung Cancer (폐암의 병기결정시 임파절의 조직학적 소견과 전산화단층활영의 정확도에 관한 고찰)

  • 박기진;김대영
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.52-58
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    • 1996
  • Sixty six patients who were operated as lung cancer during the period from Mar. 1991 to Sep. 1993 at the department of Thoracic and cardiovascular surgery, were reviewed retrospectively and the accuracy of regional lymph node in preoperative CT were compared with histopathologlc report obtained from operation. The age ranged from 30 to 72 years old (mean age : 56.5), and 51 patients were male and 15 patients were female. The author analysed the true positive, true negative, false positive and false negative and sensitivity, specificity, positive predictive index, negative predictive index and accuracy of each nodes. The result is that there were differences between seven nodal groups in specificity, sensitivity, positive predictive Index, negative predictive index and accuracy. The range of each nodal group is from 81.7 to 98.3% The nodes of the most poor accuracy are aortopulmonary area and hilar area.

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Clinical Analysis of Mitral Valvular Disease (승모판막 질환의 임상적 고찰)

  • 김창수
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.382-389
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    • 1991
  • The clinical observations on the 63 cases of the mitral valvular heart disease treated in the department of Thoracic and Cardiovascular Surgery, Kosin medical college, during the period of 5 years from January, 1986 to December, 1989, are as follows. 1. Total 63 cases, 23 were male and 40 were female with sex ratio of 1: 1.7. 2. The age distribution was widely varied from 7 years of the youngest to 65 years oldest, average age was 35.3 year old. 3. The main clinical symptom and sign were D.O.E, general weakness, fatigability, palpitation, chest pain, hepatomegaly, pitting edema and both neck vein distension. 4. The preoperative N.Y.H.A functional classification were class II, III, IV in 28%, 54%, 16%. 5. The preoperative diagnosis were MS - 6.3%, MR - 53.9%, MSR - 36.5%, MVP - 3.1%. 6. All 63 patients were operated on the under direct vision using extracorporeal circulation, MVR in 18 cases, MVR and Tricuspid annuloplasty in 24 cases, DVR in 3 cases, DVR and Tricuspid annuloplasty in 5 cases, TVR in 1 case, Mitral annuloplasty in 4 cases, mitral valvuloplasty in 7 cases and mitral commissurotomy in 2 cases 7. The operative mortality was 7.9%, and 5 years actuarial survival rate was 89%.

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Pulmonary Function Following Open Heart Surgery -early and late postoperative changes- (개심술후 폐기능 -수술직후 및 장기간의 추이에 대하여-)

  • 이성행
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.364-374
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    • 1980
  • Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

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Electrocardiographic follow-up after mitral valve replacement (심장판막치환환자의 심전도적 술후 추적)

  • 김종환
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.231-243
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    • 1984
  • Despite its known limitation in the diagnostic value, the electrocardiography is one of the most common and routine examinations in the management of the patients with cardiac problems. The clinical results of 291 patients who underwent isolated mitral valve replacement from October 1978 to June 1983 were already reported. Their electrocardiograms were studied to assess the value of electrocardiographic examination in following the patients after valve replacement. The patients were divided into 5 groups beforehand according to the types of valve lesion on the bases of preoperative diagnosis and operative findings: Groups I: stenosis, I1: stenosis-dominant mixed, II1: equally mixed, IV: insufficiency-dominant mixed, and V: insufficiency. Their preoperative cardiac rhythm was sinus in 39.2% and atrial fibrillation in 59.1% of the patients. Seventy-three [42.4%] of the patients with atrial fibrillation gained sinus rhythm after operation, occurring in 67 from the day of surgery, and 42 returned to atrial fibrillation while 37 kept sinus rhythm at the follow-up end [mean follow-up period, 13.4\ulcorner1.4 months]. The P waves on the electrocardiograms of the preoperative sinus rhythm in 114 patients were normal in 5.3% and the findings of left atrial enlargement in 94.7% of the cases. They were normal in 42.1% and the findings of left atrial enlargement in 57.9% of the 140 patients with sinus rhythm at the follow-up. The preoperative major chamber enlargement was the right ventricle in Group I while it was the left ventricle in Group V, and it was in-between in Groups II-IV. The postoperative regression of the findings in ventricular enlargement was statistically significant only in Groups I and V. These results may suggest the importance of the serial electrocardiograms in following the patients with mitral valve replacement on the bases of outpatient. The electrocardiographic follow-up data were presented in patients with suspected or proved tissue valve failures.

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Changes in oncogenic protein levels in peri-implant oral malignancy: a case report

  • Seo, Mi Hyun;Myoung, Hoon;Lee, Jong Ho;Kim, Soung Min;Lee, Suk Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.46.1-46.9
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    • 2019
  • Background: Oral squamous cell carcinoma (OSCC) constitutes a group of tumors that exhibit heterogeneous biology, histopathology, and clinical behaviors. Case presentation: A 73-year-old male had a whitish leukoplakia-like lesion around inflamed peri-implant area (#42, #43, and #44), and this lesion had transformed to OSCC within 3 years. He underwent mass resection, selective neck dissection, and reconstructive surgery. To detect any carcinogenesis progression, we examined the removed tumor tissue as well as the patient's preoperative and postoperative sera to identify causative oncogenic proteins using immunoprecipitation high-performance liquid chromatography (IP-HPLC). Conclusions: The protein expression levels of p53, E-cadherin, β-catenin, MMP-10, HER2, NRAS, Met, HER2, and ERb were significantly lower in the serum collected on postoperative day 10 than in the preoperative serum, and if these proteins are consistently not elevated in the serum 3 months after surgery compared with the preoperative serum, these proteins can be potential oncogenic proteins. However, we also found that the serum extracted 3 months after the operation had elevated levels of oncogenic proteins compared with that of the preoperative and 10-day postoperative serum indicating the possibility of tumor recurrence. At postoperative follow-up period, ipsilateral neck metastasis and second primary lesion were found and additional surgery was performed to the patient. IP-HPLC using the patient's serum shows the possibility of oncogenic protein detection. However, follow-up IP-HPLC data is needed to find out patient-specific prognostic factors.

Effect of Preoperative Fatty Degeneration of the Deltoid and the Teres Minor Muscles on the Clinical Outcome after Reverse Total Shoulder Arthroplasty

  • Moon, Sung-Hoon;Nam, Woo-Dong;Rheu, Chang-Hyun;Lee, Jae-Woo
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.138-143
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    • 2015
  • Background: To evaluate the effect of preoperative fatty degeneration of deltoid and teres minor muscles on the clinical outcome in patient with reverse total shoulder arthroplasty (RTSA). Methods: Nineteen patients with RTSA were enrolled. The mean follow-up period was 16.1 months. The fatty degeneration of three distinct parts in each deltoid and the teres minor muscle was measured using a preoperative magnetic resonance imaging. Postoperatively, the muscle strengths for forward elevation (FE), abduction (Abd), and external rotation (ER) were measured using a myometer at the last follow-up. The parameters for clinical outcome were Constant Score (CS) and Korean Shoulder Score (KSS). Results: The number of cases was 10 in group 1 and 9 in group 2. The strength of FE and Abd were significantly higher in group 1 (p<0.001 and p<0.001, respectively), and the strength of ER was not different significantly between two groups (p=0.065). For the clinical outcome, both CS and KSS were higher in group 1 (p=0.002 and p=0.002, respectively). The number of patients in group A was 11, and group B was 8. Although there was not a significant difference in terms of FE and Abd between group A and B (p=0.091, p=0.238), ER was significantly higher in group A (p=0.012). We did not find a significant difference in the clinical scores (CS, p=0.177 and KSS, p=0.238). Conclusions: These findings suggest the importance of a preoperative evaluation of the fatty degeneration of deltoid and teres minor muscles for predicting postoperative strength and clinical outcome.

Surgical Outcomes of Intra-articular Fractures of Calcaneus using AO Calcaneal Plate (관절내 종골 골절에 대해 AO 종골 금속판을 이용한 수술적 치료 결과)

  • Kim, Seong-Tek;Youn, Te-Hyun;Park, Jin-Bum;Lee, Jun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.75-79
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    • 2009
  • Purpose: To evaluate the outcomes of intra-articular calcaneal fractures treated using AO calcaneal plate surgically. Materails and Methods: Total 15 cases of intra-articular calcaneal fracture that treated with open reduction and internal fixation using AO calcaneal plate were evaluated. The patients were followed over a mean period of 19.8 months. The mean age was 41.6 years. By Sanders classification, there were 2 cases of type II, 10 cases of type III, and 3 cases of type IV. We evaluated radiological outcomes by Bohler angle, Gissane angle, calcaneal hight, calcaneal width and clinical outcomes by Creighton-Nebraska health foundation score. Results: All fractures united at a mean duration of 13.3 weeks. Radiologically, the mean preoperative Bohler angle was $8.5^{\circ}$ and restored to $23.3^{\circ}$. The mean preoperative Gissane angle was $118.7^{\circ}$ and restored to $124.2^{\circ}$. The mean preoperative calcaneal hight was 30.8 mm and restored to 38.9 mm. The mean preoperative calcaneal width was 41.3 mm and restored to 35.3 mm. 10 cases had excellent and good clinical outcomes and 5 cases having fair outcome. Conculsion: In our study, open reduction and internal fixation using AO calcaneal plate showed good results with anatomical restoration of articular surface and stable fixation without late collapse.

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