• Title/Summary/Keyword: operative

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Arthroscopic Repair versus Non-operative Treatment of First-time Traumatic Anterior Shoulder Dislocations: A Numbers-needed-to-treat Analysis for Prevention of Recurrent Dislocations

  • Park, Jihong;Cosby, Nicole L.
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.110-116
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    • 2016
  • Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision.

Etiologic Study of Tarsal Tunnel Syndrome by Operative and MRI Findings (수술 소견과 자기공명영상 소견을 통한 발목터널 증후군의 원인 연구)

  • Son, Min-Ki;Park, Hong-Ki;Lee, Yeong-Bae
    • Annals of Clinical Neurophysiology
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    • v.13 no.2
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    • pp.87-92
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    • 2011
  • Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy that occurs in the ankle. Previous studies reported that this disease was due to physiologic factors and structural lesions in the ankle or foot. The authors investigated the causative factors of TTS and their frequency via operative findings. The diagnostic value of MRI was also evaluated based on the concordance between the operative findings and the MRI findings. Methods: This study was performed in retrospective by using medical record of the patients who underwent operations with TTS from August 2003 to May 2010. Physical examination, nerve conduction study, and MRI were conducted on patients who visited department of neurology or orthopedic surgery due to pain and sensory abnormality of their ankle and foot. Results: 34 patients underwent the operation. Ganglion accounted for the largest portion of the operative findings. In addition, varicose veins, intrinsic foot muscle hypertrophy, tenosynovitis, and fascia thickening were mainly observed. Of the 34 patients, 33 patients underwent pre-operative MRI, of whom 18 patients showed MRI findings consistent with the operative findings. Conclusions: Space-occupying lesions accounted for the majority of the causative factors in TTS patients who underwent the surgical treatment. In this study, the MRI appeared useful for identifying causes of TTS.

The Inpatients' Awareness of Co-operative Treatment System on Western Hospital and Oriental Hospital (양방과 한방병원의 협진체계에 대한 입원환자의 인식도)

  • Jin, Sam-Kon;Nam, Eun-Woo
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.134-164
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    • 1998
  • The purpose of this study is to provide the data for the co-operative treatment of western and oriental hospital. The studies were made a questionnaire to analyze inpatients' awareness on the systems of co-operative treatment and to observe the differences in medical service satisfaction between inpatients who had experienced the co-operative treatment of western and oriental hospital(Group 1) and those who did not (Group 2). The survey was conducted in February 1998, on 250 inpatients who were in a hospital which provided co-operative treatment of western and oriental medicine in Pusan. Korea. The results of this study were disclosed as follows: 54.2% of western hospital inpatients and 90.5% of oriental hospital inpatients suffered from diseases of the nervous system 88.9% of Group 1 and 72.2% of Group 2 believed that the co-operative treatment of western and oriental hospital was more effective in curing diseases of the nervous system. 33.5% or inpatiens in the western hospital and 87.4% of inpatients in the oriental hospital had received the co-operative treatment. In the case of the oriental hospital inpatients who had experienced western treatment, 36.8% received an examination radiologic, 30.7% received a laboratory test, 17.8% received physical therapy, and 14.1% received medication. Whereas, in case of the western hospital inpatients who had experienced oriental treatment, 71.8% received acupuncture, 23.9% received herbal medicine, and 2.8% received oriental medical tests. As to the opinion on the systems of co-operative treatment, 49.6% of Group 1 agreed that 'New medical institutions that adopt the merits of both western and oriental medicine are absolutely necessary.', and 48.9% of Group 1 agreed that 'Since there are strong points and weak points in both western and oriental medicine, partial and gradual introduction of the two systems would be better.' Whereas, 49.6% of Group 2 agreed that the partial and gradual introduction, and 35.7% of Group 2 agreed that the necessity of the new medical institutions. As to the motives for visiting the hospital, the most popular reason for all the inpatients was "others' advice". In the case of Group 1, however, the most popular reason was "the possibility of co-operative treatment". In regards to medical cost, the oriental hospital inpatients felt that their medical cost was too expensive. On the other hand, a smaller percentage of the western hospital inpatients felt that western hospital medical cost were too expensive. And between Group 1 and Group 2, a higher percentage of Group 1 felt that their medical cost was too expensive.

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The Characteristics and Policy Implications of Co-operative Education in a Regional Public University : The Case of Central Washington University, USA (지역 대학의 장기현장실습(Co-op) 활성화를 위한 사례 분석 및 정책적 시사점 - 미국 센트럴워싱턴대학교를 사례로 -)

  • Lee, Jong-Ho;Chae, Min-Soo;Jang, Hoo-Eun
    • Journal of the Korean association of regional geographers
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    • v.21 no.4
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    • pp.639-648
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    • 2015
  • There is a growing interest in Co-operative education as an important way of university-industry collaborations for improving employment competitiveness, recruiting talented human resource, and promoting university-industry collaborations. In this study, we recognize that the paradigm of professional practice have to be changed from internship to Co-operative education. This paper examines the characteristics of Co-operative education in a regional public university through a case study of Central Washington University(CWU), USA. The results of the study and policy implications are as follows. First, the professional practice program of CWU is centered upon Co-operative education and has a high local and regional connectivity in terms of location of institutions that students work for professional practices. Second, the professional practice program of CWU has a high connectivity between majors and jobs, and is characterized by an active participation of students majoring in humanities, social sciences, arts and education. Third, the qualifications of Co-operative education are strict, but programs of Co-operative education are flexibly operated according to the characteristics of departments and colleges. We emphasize that universities in Korea need to focus upon the employment connectivity, the major connectivity, the local and regional connectivity, Therefore, when attempting to introduce Co-operative education. In addition, the management and governance of Co-operative education should be flexible.

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THE EVALUATION OF REPRODUCIBILITY OF OPERATION PLAN WITH THE COMPARISON BETWEEN STO AND POST-OPERATIVE JAW POSITION IN ORTHOGNATHIC SURGERY (악교정 수술에서 STO와 술 후 악골위치 비교를 통한 이동량 재현성에 대한 평가)

  • Kwon, Seok-Woo;Jee, Yu-Jin;Lee, Baek-Soo;Lee, Deok-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.6
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    • pp.628-634
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    • 2008
  • The purpose of this study is to examine reproducibility of operation plan and 3-dimentional jaw movement patterns by comparing jaw position of STO with post-operative jaw position. Twenty patients with class III dental and skeletal malocclusion who were treated with Le-Fort I osteotomy and B-SSRO were reviewed. Lateral cephalometric radiographs were taken within two weeks before operation and two days after operation. Cephalometric radiographs were compared and analyzed with orthognathic computer program '$V-Ceph^{TM}$'. Post-operative maxillary advancement was insufficient compared to maxillary advancement through STO. Post-operative setback movement was over compared to mandibular setback movement through STO. But statistically this is not significant. Maxillary vertical location is insignificant on the whole. Especially post-operative maxillary clockwise rotation is significant compared to maxillary rotation through STO. Post-operative maxillary clockwise rotation tendency is generally observed in all patients. So surgeons and staffs must consider this tendency when operation plan is established ans operation is being performed. Using intra or extra oral marking points, face bow, and bite plate will make exact surgery possible.

Comparative study on the osseous changes of the TMJ and mandibular asymmetry after conservative or operative treatment in condylar fracture patients

  • Yu Su-Kyoung;Kim Kyung-A;Kwon Ki-Jeong;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.33 no.4
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    • pp.223-229
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    • 2003
  • Purpose: To compare the effects of the conservative treatment and operative treatment by observation of osseous changes of the TMJ and mandibular asymmetry in condylar fracture patients. Materials and Methods: 33 condylar fracture patients (17 with conservative and 16 with operative treatment) were included in this study. After a minimum of 6 months after the surgical procedure, patients were given a follow up examination of the osseous changes using a transcranial view. Differences in the osseous changes of both groups were compared and the asymmetry indices were calculated on a postero-anterior skull view. Results: The TMJ of the operative treatment group showed more significant osseous changes than the conservative treatment group. The affected TMJ showed more significant osseous changes than the unaffected TMJ in the both groups. The unaffected TMJ of the conservative group and the affected TMJ of the operative group showed significant osseous changes. The mandibular asymmetry indices in the conservative and operative group were 5.12 and 7.30 respectively at the time of treatment, and 2.39 and 3.41 respectively at the follow-up. But the mandibular asymmetry between the both groups showed no statistical differences. Conclusion: The TMJ of the operative group showed more significant osseous changes than the conservative group, but the mandibular asymmetry between the both groups showed no statistical difference.

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Influence of Midazolam and Glycopyrrolate on Intra-operative Body Temperature in Abdominal Surgical Patients

  • Kim, Eun-Ju;Yoon, Hae-Sang
    • Journal of Korean Biological Nursing Science
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    • v.14 no.1
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    • pp.25-32
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    • 2012
  • Purpose: influence of benzodiazepine (midazolam)or cholinergic inhibitor (atropine or glycopyrrlate) on intra-operative body temperature remains unclear and controversial. This study compares intra-operative body temperature in 50 abdominal surgical patients under general anesthesia between the administration of midazolam and glycopyrrolate in combination, or glycopyrrolate alone. Methods: Patients who underwent abdominal surgery were recruited from September 2008 through October 2009 at Gachon University Gil hospital in incheon. Core body temperature was measured in the right ear using a tympanic membrane thermometer at induction of general anesthesia and at 1 hr, 2 hr, and 3 hr after induction. Results: There were no differences in core body temperature at any measurement point between either patient group (F=1.08, $p$=.377). Core body temperature decreased throughout the 3 hr after induction in both groups (F=9.22, $p$ <.001). Specially, core temperatures at induction of general anesthesia (p<.001), 1 hr (p<.001), 2 hr ($p$ <.001), and 3 hr ($p$ <.001) after induction were lower than before administration of midazolam and glycopyrrolate, or glycopyrrolate alone. Conclusion: We conclude that a cholinergic inhibitor (glycopyrrolate, 0.1 mg) therefore seems not to affect intra-operative body temperature of patients given a benzodiazepine (midazolam, 0.04 mg $kg^{-1}$), and not to increase body temperature in patients not given a benzodiazepine during the 3 hr after the induction of general anesthesia. Intra-operative warming therefore is needed to prevent hypothermia in surgical patients who receive pre-operative administration of midazolam and/or glycopyrrolate.

The Effect of Physical Function on Operative Treatment of Colorectal Cancer Patients (대장암환자 수술치료가 신체기능에 영향을 미치는 요인)

  • Lee, Seong-Ran
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3412-3416
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    • 2010
  • The purpose of this study was attempted to identify the effect of physical function on operative treatment of colorectal cancer patients. Colorectal cancer patients(110 persons) who visited a general hospital in Seoul were examined with questionnaires and interview from December 15, 2009 to January 30, 2010. The results of this study are as follows ; First, operative treatment side-effects were significantly higher in patients before ileostomy repair than in patients after ileostomy repair(t=5.284, p<0.001). Secondly, sexual satisfaction were higher in pre-operative radiotherapy patients than in post-operative radiotherapy patients(t=1.946, p<0.05). Thirdly, micturition problems were significantly higher in discomfort symptom of stoma patients than in nonstoma patients(t=1.537, p<0.05). In conclusion, in order to improve physical function on operative treatment of colorectal cancer patients, it is necessary to develop intervention program about the improvement of function status and discomfort symptoms.

Impact of Using Intra-Operative Ultrasound Guided Breast-Conserving Surgery on Positive Margin and Re-Excision Rates in Breast Cancer Cases with Current SSO/ASTRO Guidelines

  • Thanasitthichai, Somchai;Chaiwerawattana, Arkom;Phadhana-Anake, Oradee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4463-4467
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    • 2016
  • Purpose: To review the impact of using intra-operative ultrasound guided breast conserving surgery with frozen sections on final pathological margin outcome with the current guidelines set forth by the Society of Surgical Oncology (SSO) and the American Society of Surgical Oncology (ASTRO). Materials and Methods: A retrospective review including all cases of intra-operative ultrasound guided breast conserving surgery was performed at the National Cancer Institute Thailand between 2013 and 2016. Patient demographics, tumor variables, intraoperative frozen section and final pathological margin outcomes were collected. Factors for positive or close margins were analyzed. Results: A total of 86 patients aged between 27 and 75 years with intra-operative ultrasound guided breast conserving surgery were included. Three cases (3.5%) of positive margin were detected by intra-operative frozen section and 4 cases (4.7%) by final pathology reports. There were 18 cases (20.9%) with a close margin (<1 mm). Factors affecting this result comprised multi-foci, presence of invasive ductal carcinoma (IDC) combined with ductal carcinoma in situ (DCIS) and invasive lobular carcinoma (ILC). Conclusions: With the current SSO/ASTRO for adequate margin guidelines, using intra-operative ultrasound to locate the boundary for resection with breast conserving surgery provided a high success rate in obtaining final pathology free margin outcomes and minimizing re-operation risks especially when combined with intra-operative frozen section assessment. The chance of finding positive or close margins appears higher in cases of IDC combined with DCIS, ILC and with multi-foci cancers.

Effect of Peripheral Blood CD4 + CD25 + Regulatory T Cell on Postoperative Immunotherapy for Patients with Renal Carcinoma

  • Zhang, Chao-Hua;Huang, Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2027-2030
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    • 2016
  • Objective: To investigate the effect of peripheral blood CD4 + CD25 + regulatory T cell on postoperative immunotherapy in patients with renal carcinoma. Methods: 38 patients with renal cell carcinoma were recruited, and 20 patients from the operation group purely underwent the radical nephrectomy therapy, 18 patients from the combined group successively underwent the radical nephrectomy therapy and IFN-${\alpha}$ adjuvant immunotherapy. Additionally, 12 healthy subjects were recruited in the same period of time and regarded as the control group. Flow cytometry was used to detect CD4 +, CD8 +, CD4 + CD25+ T lymphocyte subset content and the ratio of all parts in the pre-operative period, in the first post-operative week and in the third post-operative month, compare and analyze its variation trend. Results: The CD4+CD25+ T lymphocyte subset content of individual renal carcinoma patients was significantly higher than that of the control group, also increases with the progression in the tumor stage (P<0.05). The post-operative CD4 + CD25+T lymphocytes of individual operation group and combined group patients showed different degrees of increment, but the increment of the combined group was significantly lower than that of the operation group (P<0.05). For the combined group patients with less pre-operative CD4 + CD25+T lymphocytes, their levels would increase after the immunotherapy, while the pre-operative patients with more CD4 + CD25+ T lymphocytes were the opposite situation. Conclusion: The detection of peripheral blood CD4+CD25+ regulatory T lymphocyte subset can reflect the anti-tumor immune status of renal cell carcinoma patient body. It can contribute to predict the prognosis of immunotherapy and provide reference for the choice of renal carcinoma post-operative adjuvant immunotherapy.