• Title/Summary/Keyword: outpatient surgery

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The Effectiveness of Ultrasonography-guided Injection at Infraspinatus of Shoulder in Patients with Posterior Shoulder Pain Induced Horizontal Adduction Test (수평내전에 의해 악화되는 견관절 후방 통증 환자에서 초음파하 극하근 주사요법의 효과)

  • Pak, Chi Hyoung;Moon, Young Lae;Lee, Hyeon Jun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.1-5
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    • 2015
  • Purpose: The purpose of this study was to analyze the effectiveness of local steroid injection for infraspinatus under ultrasonographic guidance in patients with posterior shoulder pain during horizontal adduction test. Materials and Methods: Twenty one cases of patients, from May 2013 to May 2014, showed positive horizontal adduction test were retrospectively analyzed. We performed ultrasonography-guided infraspinatus injection using steroid to these patients in the outpatient clinics. We evalulated results for visual analogue score (VAS) for pain, UCLA score for these patients before injection, following 3 months and 6 months after injection. Results: After ultrasonography-guided infraspinatus injection using steroid, there were clinically significant improvements in VAS and UCLA score at 3 month's follow-up period (p<0.05). But there were no significant differences in VAS and UCLA score between 3 months and 6 months (p>0.05). Fourteen of 21 (67%) cases showed much improved and improved satisfaction. Respectively, seven of 21 (33%) cases showed not improved and aggravation satisfaction. Conclusion: Ultrasonography-guided infraspinatus injection using steroid is an effective treatment method for the patients with exacerbated posterior shoulder pain during horizontal adduction test.

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The Effectiveness of Ultrasonography-guided Suprascapular Nerve Block in Patients treated with Arthroscopic Rotator Cuff Repair (관절경하 회전근개 봉합술을 시행한 환자에 대한 초음파 유도하 상견갑 신경차단술의 효과)

  • Moon, Young Lae;Kang, Jeong Hoon;Kim, Hyun Hak
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.84-88
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    • 2014
  • Purpose: The purpose of this study was to analyze the effectiveness of suprascapular nerve block using platelet-rich-plasma (PRP) under ultrasonographic guidance in patients treated with arthroscopic rotator cuff repair. Material and Methods: 50 cases of patients, from March 2013 to March 2014, treated with arthroscopic rotator cuff repair were retrospectively analyzed. We performed ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP) to these patients in the outpatient clinics at the 6 weeks follow-up after operation. We evalulated results for visual analogue score (VAS) for pain, range of motion (ROM), Constant Shoulder Score (CSS) for these patients before arthroscopic operation, following 6 weeks and 3 months after operation. Results: There was clinically significant improvement in VAS, ROM, CSS after ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP). Conclusion: Ultrasonography-guided suprascapular nerve block using platelet-rich-plasma (PRP) is an effective treatment method not only for around shoulder pain but also postoperative residual shoulder pain and limitation of shoulder motion.

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Prostate Cancer Screening in a Healthy Population Cohort in Eastern Nepal: an Explanatory Trial Study

  • Belbase, Narayan Prasad;Agrawal, Chandra Shekhar;Pokharel, Paras Kumar;Agrawal, Sudha;Lamsal, Madhab;Shakya, Vikal Chandra
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2835-2838
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    • 2013
  • Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.

Analysis of Factors Affecting Length Of Stay for A Serious Patients Using Medical Records (의무기록자료를 이용한 중증질환자의 재원일수에 미치는 요인 분석)

  • Kim, Seok Hwan;Lee, Jung A
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.2
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    • pp.69-80
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    • 2019
  • Objectives: In this study, we tried to analyze the factors affecting Length Of Stay for serious patients in Republic of Korea. Methods: The study included 139,172 serious patients in the 2012-2016 discharge details. Using the SPSS 23.0 program, we conducted a rank regression analysis with social and social demographic characteristics as control variables, medical institution characteristics and medical use characteristics as independent variables, and Average Length Of Stay as a dependent variable. Results: Average Length Of Stay for participants was found to be 9.92days. And the location and bed size of medical institutions were not statistically significant, the hospitalization path was more urgent(B=0.43) than the outpatient (p<0.001), and there was no secondary diagnosis(B=0.35). However, Average Length Of Stay was higher (p<0.001) than there was no main surgery(B=0.80). After discharge, Average Length Of Stay for funding(B=0.43) and death(B=0.72) was long (p<0.001). Average Length Of Stay for participants was found to be 9.92days. And the location and the bed size of the medical institution were not statistically significant, and the hospitalization pass had longer Length Of Stay for emergency patients(B=0.43) than for outpatients(p<0.001). There was a longer Length Of Stay(B=0.35) than none was diagnosed. There were longer Length Of Stay(p<0.001) than there was no major surgery(B=0.80). After discharge, the outpatients had longer Average Length Of Stay(B=0.43) and deaths(B=0.72) than those who returned home(p<0.001). Conclusion: As a result of analyzing the factors affecting Average Length Of Stay of the participants, it was confirmed that regardless of the location and bed size of medical institutions, hospitalization route, department diagnosis, main surgery, and whereabouts after discharge. Therefore, appropriate interventions and necessary support must be provided so that efficient Length Of Stay can be managed according to the medical use characteristics of serious patient.

Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years (20년 동안 증상없이 잔존한 수정체 내 이물제거 후 발생한 안내염)

  • Choi, Young;Eom, Youngsub;Choi, Soo Youn;Lee, Bo Young;Kim, Eun Jee;Kang, Su-Yeon;Song, Jong Suk;Kim, Hyo Myung
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.5
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    • pp.480-485
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    • 2019
  • Purpose: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. Case summary: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. Conclusions: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

Acceptability of Low Intensity Anticoagulation Therapy after Mechanical Heart Valve Replacement (기계식 인공 심장판막 치환술 후 낮은 강도 항응혈 관리의 적정성에 관한 연구)

  • Kim, Jong-Woo;Rhie, Sang-Ho;Kim, Young-Chun;Yang, Jun-Ho;Jang, In-Seok;Choi, Jun-Young
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.193-200
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    • 2009
  • Background: The long-term administration of oral anticoagulant to the patients with a mechanical heart valve prosthesis is mandatory. However, the appropriate intensity of oral anticoagulant therapy to prevent thromboembolic or hemorrhagic complications is still controversial. We tried to apply low intensity anticoagulant therapy for which the International Normalized Ratios ranged between 1.5 and 2.5, and we analyzed the anticoagulation-related long term outcomes. Material and Method: From January 1992 to December 2002, 144 patients who underwent a single cardiac valve replacement were included in the study, and their ages ranged from 15 to 72 years (mean age: $47.4{\pm}15.1$): there were 49 aortic valve replacements (AVR) and 95 mitral valve replacements (AVR). The patients were followed up monthly or bi-monthly at the outpatient clinic with clinical examinations and measuring the prothrombin time to adjust the International Normalized Ratios (INRs) within the low-intensity target range between 1.5 and 2.5. Result: The follow-up period was 835.3 patient-years (mean: $5.9{\pm}3.5$) and the INRs of 7,706 measurements were available for evaluation. The mean INRs of the aortic and the mitral valve replacement groups were significantly different (p<0.01). All the patients' INRs were within the target range in 61.9% of the measurements. The mean INRs $(2.16{\pm}0.23)$ of the patients with atrial fibrillation, which was found in 30.3% of the patients, were definitely higher than those $(2.03{\pm}0.27)$ measured in the patients with regular rhythm (p<0.01). Thromboembolic episodes occurred in 9 patients with an incidence of 1.08%/patient-year. Major bleeding occurred in 2 patients (MVR) with an incidence of 0.24%/patient-year. The patients who displayed better compliance showed a lower incidence of complications (p=0.000). Conclusion: The anticoagulation therapy with a low-intensity target range after MVR or AVR seems to be effective and feasible, and increasing the patients’ compliance should be done for achieving more effective anticoagulation therapy.

Outcome of Conservative Treatment of the Zone I, II 5th Metatarsal Base Fracture under Early Weight-Bearing (제5 중족골 제1, 2 구역 골절의 조기 체중부하의 비수술적 치료 결과)

  • Gwak, Heui-Chul;Park, Dae-Hyun;Kim, Jung-Han;Lee, Chang-Rack;Kwon, Yong-Uk;Kim, Dong-Seok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.150-156
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    • 2021
  • Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

Arthroscopic Full-Thickness Rotator Cuff Repair in Elderly Patients (고령 환자의 관절경적 회전근 개 봉합술의 결과)

  • Cheon, Sang Jin;Lee, Dong Ho;Park, Yong Geon;Son, Seung Min
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.38-45
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    • 2020
  • Purpose: To examine the clinical and structural outcomes of an at least two-year follow-up of arthroscopic full-thickness rotator cuff repairs with a single-row or suture-bridge technique in patients more than 65 years of age. Materials and Methods: Patients diagnosed with a full-thickness rotator cuff tear who were more than 65 years of age, underwent arthroscopic rotator cuff repair after at least six months of conservative treatment, agreed to take a follow-up magnetic resonance imaging (MRI) six months postoperatively, and visited outpatient for at least two years were enrolled in this study. Clinical evaluations were done using The University of California Los Angeles score, Constant Shoulder Score, and visual analogue scale evaluated two years after the surgery. The structural integrity was analyzed using follow-up MRI. During surgery, a suture-bridge technique was used if the rotator cuff tendon could cover half of the footprint under constant tension. Otherwise, single-row repair was performed. Results: The samples were 158 cases, consisting of 93 single-repairs and 65 suture-bridge repairs. A preoperative comparison of the age distribution, fatty degeneration of supraspinatus and infraspinatus muscle, medial retraction of torn cuff tendon, and tear size between the two groups were not significant. The clinical scores were improved significantly in all cases. The distribution of the structural integrity by Sugaya classification were 49 cases in type 1 (31.0%), 62 cases in type 2 (39.2%), 30 cases in type 3 (19.0%), 11 cases in type 4 (7.0%), and six cases in type 5 (3.8%). The re-tear rate of the single-row group was 9.7% (nine out of 93 cases) and 12.3% (eight out of 65 cases) for the suture-bridge group. Conclusion: Satisfactory clinical and radiological outcomes were achieved after arthroscopic full-thickness rotator cuff repair in patients more than 65 years of age. Both single-row and suture-bridge techniques would be beneficial for the elderly.

Factors Related to Sexual Function in Men with Rectal Cancer (직장암 남성의 성기능 관련 요인)

  • Woo, Sang Jun;Lee, Eun Sook;Kim, Hyeong Rok;Kim, Chang Hyun
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.3
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    • pp.91-100
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    • 2019
  • Purpose: The purpose of this study was to investigate the sexual function of male patients receiving rectal cancer and to analyze the factors related to sexual function. Methods: This study included 71 male patients undergoing outpatient treatment after surgery at C University Hospital, Chonnam, Korea from April 1 to September 1, 2014. The sexual function of males with colorectal cancer was calculated using the Korean Translation of International Index of Erectile Function(IIEF). Data analysis was performed using t-test, ANOVA, and regression analysis. The study was IRB approved. Results: The sexual function index scores of the subjects were 33.28±19.47 points. Regression analysis showed that sexual function increased as the duration after operation increased(p=.001), higher location of cancer(p=.007), age decreased(p=.013). The explanatory power (adj. R2) of the analysis model was 0.186. Conclusion: Sexual function of males with rectal cancer differed according to duration after operation, and location of cancer, age. Therefore, medical staff think that it can be used as basic data for appropriate education and counseling by age, time, and type of treatment to improve sexual function of men with rectal cancer.

An Analysis of the Outcome of Transforaminal Epidural Steroid Injections in Patients with Spinal Stenosis or Herniated Intervertebral Discs (요척주관 협착증 혹은 추간판 탈출증 환자에서 실시한 경추간공 경막외 스테로이드 주입의 결과에 관한 분석)

  • Hong, Ji Hee;Lee, Yong Chul;Lee, Han Min;Kang, Chul Hyung
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.38-43
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    • 2008
  • Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.