Reoperations following cardiac surgery have an increased risk of the danger of damaging the heart, great vessels or extracardiac grafts because of adhesions to the sternum. We experimentally evaluated 3 different methods for pericardial closure. A standardized procedure for induction of pericardial adhesions was carried out in 30 rabbits. For closure of pericardium, animals were divided into 3 groups, 10 animals respectively: Croup 1 [simple pericardial closure]The pericardium was primarily resuture; Group 2 [Core-Tex surgical membrane as a pericardial substitute]- A Gore-Tex surgical membrane was interposed between the sternum and the heart; and Group 3 [pericardial tension releasing technique]-Three longitudinal overlapping incisions were made on the right side of the pericardium while the midline incison was sutured. Animals were put to death 4 weeks postoperatively and the pericardial space was examined for pericardial adhesions and epicardial reactions. The extent of adhesions and reactions were graded as: I-none; II-minimal; III-moderate; and IV-severe. Histologic studies of the pericardium, the pericardial substitute and the epicardium were also performed. The results were as follows: 1. In group 1 [simple pericardial closure], the degree of pericardial adhesions were grade I in 1 animal, grade II in 2, grade III in 4 and grade IV in 3. Epicardial reactions were grade I in 1 animal, grade II in 3, grade III in 5 and grade IV in 1. Histologic examination revealed thick fibrous tissue that obliterated the pericardial space in 7 animals. 2. In group 2 [Gore-Tex surgical membrane as a pericardial substitute], the degree of pericardial adhesions were grade I in 3 animals, grade II in 3, grade III in 2 and grade IV in 2. The degree of epicardial reactions were grade II in 1 animal, grade III in 5 and grade IV in 4. Histologic studies revealed a thin layer of dense fibrous tissue which covered the Gore-Tex surgical membrane and thick loose fibrous tissue on the epicardium just beneath the substitute. 3. In group 3 [pericardial tension releasing technique], the degree of pericardial adhesions were grade I in 3 animals, grade II in 4, grade III in 2 and grade IV in 1. The degree of epicardial reactions were grade 1 in 4 animals, grade II in 4 and grade III in 2. Severe epicardial reactions were not observed in this group. Histologic examination showed normal epicardium in 4 animals and the epicardium of the other 6 animals only revealed very thin fibrous layer compared to group I and group II. Pericardial adhesions more than grade III were 70% in group 1, 40% in group 2 and 30% in group 3. Pericardial adhesions were reduced in group 2 and group 3 compared to group 1, but statistically not significant. Epicardial reactions more than grade III were 60% in group 1, 90% in group 2 and 20% in group 3. Epicardial reactions were significantly reduced in group 3 compared to group 2. Author`s modified pericardial releasing technique provides marked augment of pericardial surface area and facilitates tension-free pericardial closure. Furthermore, pericardial adhesion and epicardial reaction will be reduced with the pericardial tension releasing technique.
Purpose: To examine the effects on skin injury, pain, and anxiety when nurses and children simultaneous wash their hands before IV injections. Method: A nonequivalent control group, non-synchronized design study was used with 61 children. For a month and a half, children in the experimental group(30) following hand-washing guidelines, washed their hands with nurses before IV insertion. Anxiety and pain were observed and recorded during IV insertion using the Anxiety Reaction Scale and FACES pain scale. After 48-72 hours on IV therapy with an arm-board, skin condition was checked by a research assistant according to guidelines for assessing skin injury developed by the researcher. t-test, ${\chi}^2$-test, Pearson correlation, and Kendall's tau b were used to analyze data with the SPSS program. Results: Children who washed their hands with the nurse before IV insertion showed less pain (p =.021) and skin injury (p <.001) compared to the control group. Conclusion: This finding suggests that simultaneous hand washing by nurse and child before IV injection has a strong effect on skin injury caused by arm-boards used to maintain IV therapy as well as on pain during IV insertion. This program demonstrates an effective intervention to prevent skin injuries in children on IV therapy.
Objectives : The prescription of Semyung-Gangji-tang, designed for the treatment of hyperlipidemia and atherosclerosis, consists of herbs good for treating blood stasis and phlegm stagnancy. It invigorates the liver, kidneys and spleen. Its medical nature is not too cold or too hot and increases human vital energy. The purpose of this study is to examine the curative effects of Semyung-Gangji-tang on atherosclerosis in hyperlipidemic rabbits. Methods : Twenty-four male NZW rabbits, around 2kg of body weight, were divided into 4 groups. Group I served as the normal group. Group II served as the atherogenic model group, fed a 1 % cholesterol diet for 8 weeks and sacrificed. Group III served as the atherogenic control group, fed with a 1 % cholesterol diet for 8 weeks and with a normal diet for the next 4 weeks. Group IV served as the treatment group treated the same as the control group and medicated with Semyung-Gangji-tang for the last 4 weeks. Three animals of group I and six animals of group n were sacrificed at 8 weeks. Five animals of group I , five animals of group III and IV were sacrificed at 12 weeks. Pathological examinations and image analysis were performed on the collected tissue samples. Results : The percentage of lipid deposition area of thoracic aortas of group IV($41.74{\pm}8.93%$) at 12 weeks was decreased compared with the group III ($71.30{\pm}12.74%$) at 12 weeks, but a statistical difference was not observed. The percentage of group IV at 12 weeks was significantly decreased (P<0.05) compared with the group n ($76.41{\pm}7.43%$) at 8 weeks. Histopathologically, advanced atheromas with calcification of aortic arches were observed in all animals of the control group at 12 weeks, but were observed in 2 animals of the treatment group at 12 weeks. Histopathologically, atheromas with calcification of thoracic aortas were observed with major atherogenic lesions in control group at 12 weeks, but simple fibro-fatty streaks were observed major atherogenic lesions in treatment group at 12 weeks. Conclusions : These results indicate that Semyung-Gangji-tang has antiatherogenic effects on experimentally induced atherosclerosis in rabbits.
Objective : Retrospective analysis to compare the effect and complication of epidural patient-controlled analgesia (epidural PCA) with intravenous patient-controlled analgesia (IV PCA) for the treatment of the post-operative pain after posterior lumbar instrumented fusion. Methods : Sixty patients who underwent posterior lumbar instrumented fusion for degenerative lumbar disease at our institution from September 2007 to January 2008 were enrolled in this study. Out of sixty patients, thirty patients received IV PCA group and thirty patients received epidural PCA group. The pain scale was measured by the visual analogue scale (VAS) score. Results : There were no significant difference between IV PCA group and epidural PCA group on the PCA related complications (p=0.7168). Ten patients in IV PCA group and six patients in epidural PCA group showed PCA related complications. Also, there were no significant differences in reduction of VAS score between two groups on postoperative 2 hours (p=0.9618) and 6 hours (p=0.0744). However, postoperative 12 hours, 24 hours and 48 hours showed the significant differences as mean of reduction of VAS score (p=0.0069, 0.0165, 0.0058 respectively). Conclusion : The epidural PCA is more effective method to control the post-operative pain than IV PCA after 12 hours of spinal fusion operation. However, during the first twelve hours after operation, there were no differences between IV PCA and epidural PCA.
Ciesielski, Maciej;Kruszewski, Wieslaw Janusz;Szajewski, Mariusz;Walczak, Jakub;Spychalska, Natalia;Szefel, Jaroslaw;Zielinski, Jacek
Journal of Gastric Cancer
/
v.19
no.2
/
pp.202-211
/
2019
Purpose: Poor physiological reserve for withstanding major cancer surgery in older adults is an important concern in the selection of patients for oncologic gastrectomy. The present study aimed to analyze mortality patterns among patients who underwent gastrectomy for cancer according to age groups. The primary outcomes of this study were early- and middleterm results: 30-day and 3-, 6-, 12-, and 36-month mortality rates. Materials and Methods: A retrospective review of 288 patients who underwent surgical resection for gastric cancer in two centers was carried out. Patients were stratified into four groups according to age: 29-50 years (group I, n=27), 51-65 years (group II, n=117), 66-75 years (group III, n=81), and 76-92 years (group IV, n=58). Statistical calculations focused on the differences in the survival rates between groups I and II as well as between groups II and IV. Results: The middle-aged patients (group II) had significantly better 3-year survival than either the youngest (group I) or the oldest patients (group IV). The 6-month mortality rates were 16.9% in group III and 29.3% in group IV. Two-thirds of the patients from groups III and IV who died between 2 and 6 months after surgery had an uneventful postoperative course. Conclusions: Age is an important prognostic factor of middle-term survival after gastrectomy for cancer. Geriatric assessment and better patient selection for major surgery for cancer are required to improve the outcome of gastrectomy for cancer in patients aged over 75 years.
Statement of problem. The current trend in prosthodontics is the adoption of a conservative approach to preparing dental prostheses by minimizing the amount of sound tooth structure removal during preparation. Purpose. The major disadvantage of the adhesion bridge is the inherently poor resistance to dislodgement that its use in areas subjected to high occlusal load is limited. The purpose of this study was to compare the dislodgement resistance of $Bio-pin^{(R)}$, conventional 3-unit and adhesion bridges. Material and methods. The experimental groups were classified as follows : Group I : 3-unit bridge cemented using $Super-Bond^{(R)}$ C&B Group II : Adhesion bridge cemented using $Super-Bond^{(R)}$ C&B Group III : $Bio-pin^{(R)}$ design adhesion bridge without incorporation of $Bio-pin^{(R)}$ (cemented using $Super-Bond^{(R)}$ C&B) Group IV-1 : $Bio-pin^{(R)}$ retained adhesion bridge incorporating a single $Bio-pin^{(R)}$ (cemented using $Super-Bond^{(R)}$ C&B) Group IV-2 : $Bio-pin^{(R)}$ retained adhesion bridge incorporating a single $Bio-pin^{(R)}$ (cemented using $Panavia^{(R)}$ F) Group V : $Bio-pin^{(R)}$ retained adhesion bridge incorporating two $Bio-pins^{(R)}$ (cemented using $Super-Bond^{(R)}$ C&B) Results. The results of this study were as follows : 1. Significant differences in dislodgement resistance of the restorations were found between Group I, Group II and Group III (p<0.05). No significant differences in dislodgement resistance of the restorations were observed between Group I Group IV-1 and Group V. However, there were significant differences in dislodgement resistance between Group II and the other groups (p<0.05). 2. No significant differences in dislodgement resistance of the restorations were observed between GroupIV-1 and GroupIV-2, both of which utilized a single $Bio-pin^{(R)}$. However, significant differences were observed when Group III was compared to either GroupIV-1 or Group V (p<0.05). 3. No significant differences in dislodgement resistance relative to the type of dental cements used were found. Conclusion. From the above results, it is concluded that the dislodgement resistance of $Bio-pin^{(R)}$ bridge restorations utilizing a single $Bio-pin^{(R)}$ is similar to that of a conventional 3-unit bridge. The results also suggest that $Bio-pin^{(R)}$ bridge restorations using a single $Bio-pin^{(R)}$ are a viable alternative to the conventional 3-unit bridge when minimal removal of sound tooth structure and fulfillment of both function and esthetic aspects are considered.
Purpose: The purpose of this study was to investigate the effect on pain of distraction with an operating doll in preschool children(3-6 years old) during an IV catheter insertion. Method: The research design was a nonequivalent control group posttest design, and the participants were 22 children in the experimental group, and 23 children in the control group. The children were hospitalized for enteritis and pharyngitis in a university hospital. The subjective pain was measured using FACES Pain Rating Scale by self report, and the pain behavior responses were scored using Procedure Behavior Check List by observing a film of the entire procedure, and changes in pulse and oxygen saturation as the physiological pain responses were measured by pulse oximeter. Data were analyzed with the SPSS Win 10.0 program. Result: The degree of subjective pain, pain behavior responses, and changes in pulse during IV catheter insertion were significantly lower in the experimental group. But there was no significant difference in $O_2$ saturation between the two groups. Conclusion: Distraction using an operating doll was effective in decreasing pain during inserting the IV catheter in preschool children.
Journal of Korean Academy of Fundamentals of Nursing
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v.21
no.2
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pp.131-140
/
2014
Purpose: This study was done to evaluate the efficacy of Nei-Guan acupressure on nausea and vomiting in patients undergoing laparoscopic prostatectomy with intravenous patient controlled analgesia (IV-PCA). Methods: Data were collected between August 13, 2012 and January 31, 2013 at a hospital in Busan. The participants were 45 men, who underwent the surgery laparoscopic prostatectomy, with IV-PCA. Data were analyzed using descriptive statistics, $x^2$-test, repeated measures ANCOVA and Games-Howell test with PASW 18.0. Results: Nei-Guan acupressure had an interaction effect on nausea between group and time (F=5.01, p<.001), group (F=10.80, p<.001), time (F=26.51, p<.001) in laparoscopic prostatectomy with IV-PCA and also an interaction effect on vomiting between group and time (F=2.77, p=.032), group (F=8.89, p=.001), time (F=4.01, p=.022). Conclusion: Results indicate that nei-guan acupressure is a potentially effective therapy for the prevention of nausea and vomiting which occur with IV-PCA. Therefore, if patients complain of nausea and vomiting when receiving IV-PCA, nurses can provide patients with information about nei-guan acupressure and help them with nausea and vomiting.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.3
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pp.516-526
/
2004
Polymerization shrinkage of photoinitiation type composite resin cause several clinical problems. The purpose of this study was to evaluate the shrinkage strain stress, linear polymerization shrinkage, compressive strength and microhardness of recently developed composite resins. The composite resins were divided into four groups according to the contents of matrix and filler type. Group I : $Denfil^{TM}$(Vericom, Korea) with conventional matrix, Group II : $Charmfil^{(R)}$(Dentkist, Korea) with microfiller and nanofller mixture, Group III : $Filtek^{TM}$ Z250(3M-ESPE, USA) TEGDMA replaced by UDMA and Bis-EMA(6) in the matrix, and Group IV : $Filtek^{TM}$ Supreme(3M-ESPE, USA) using pure nanofiller. Preparation of acrylic molds were followed by filling and curing with light gun. Strain gauges were attached to each sample and the leads were connected to a strainmeter. With strainmeter shrinkage strain stress and linear polymerization shrinkage was measured for 10 minutes. The data detected at 1 minute and 10 minutes were analysed statistically with ONE-way ANOVA test. To evaluate the mechanical properties of tested materials, compressive hardness test and microhardness test were also rendered. The results can be summarized as follows : 1. Filling materials in acrylic molds showed initial temporary expansion in the early phase of polymerization. This was followed by contraction with the rapid increase in strain stress during the first 1 minute and gradually decreased during post-gel shrinkage phase. After 1 minute, there's no statistical differences of strain stress between groups. The highest strain stress was found in group IV and followed by group III, I, II at 10 minutes-measurement(p>.05). In regression analysis of strain stress, group III showed minimal inclination and followed by group II, I, IV during 1 minute. 2. In linear polymerization shrinkage test, the composite resins in every group showed initial increase of shrinkage velocity during the first 1 minute, followed by gradually decrease of shrinkage velocity. After 1 minute, group IV and group III showed statistical difference(p<.05). After 10 minutes, there were statistical differences between group IV and group I, III(p<.05) and between group II and group III(p<.05). In regression analysis of linear polymerization shrinkage, group II showed minimal inclination and followed by group IV, III, I during 1 minute. 3. In compressive strength test, group III showed the highest strength and followed by group II, IV, I. There were statistical differences between group III and group IV, I(p<.05). 4. In microhardness test, upper surfaces showed higher value than lower surfaces in every group(p<.05).
Journal of the Korean Society of Physical Medicine
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v.9
no.4
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pp.485-492
/
2014
PURPOSE: This study aimed to examine the pain, range of motion (ROM), upper extremity task performance, and functional levels of patients after rotator cuff repair according to the timing of a closed chain exercise thereby presenting basic data for an effective rehabilitation program. METHODS: The intervention was applied three times per week, one hour per day, for four weeks to 40 participants, 78 of whom had undergone rotator cuff repair. The participants were divided into four groups and assigned to usual general physical therapy and an open chain exercise. Group I consisted of the open chain exercise only. The closed chain exercise was applied to group II after the 4 times, group III after the 7 times, group IV after the 10 times. Measurement were used ROM, visual analogue scale (VAS), box and block test (BBT), and shoulder pain and disability index (SPADI). A one-way analysis of variance was conducted to test differences. RESULTS: There were significant differences in the internal/external rotation between group I and group II. The VAS significantly differed between group II and group I, group III, and group IV. The BBT results of group II and group I were significantly different compared to those of group IV. The SPADI significantly differed between group II and group I and between group II and group IV. CONCLUSION: The closed chain exercise was effective for patients following rotator cuff repair from the second week after active exercise was prescribed, verifying its applicability in rehabilitation programs.
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