• Title/Summary/Keyword: Day surgery

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Comparison of Wound Healing in Porcine Skin with Continuous-Wave and Pulsed Mode $CO_2$ Laser Incisions (돼지에서 연속형 $CO_2$ 레이저와 펄스형 $CO_2$ 레이저를 이용한 피부절개시 창상치유 평가)

  • Lee, Jae-Yeon;Cho, Sung-Whan;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.647-651
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    • 2010
  • The advantages of the $CO_2$ laser are offset by the delay in laser wound healing secondary to thermal damage. To minimize the undesirable thermal damage of the $CO_2$ laser, investigators have developed technical advances in the delivery system of the laser energy. This study compared tissue healing of the continuous and the pulsed modes $CO_2$ laser wounds in an animal surgery model. Five healthy Landrace and Yorkshire mixed breeds of both genders were used (45-51 kg, 4-6 months old, three males and two females). A full thickness wound of skin ($2{\times}2{\times}2cm^2$) was made over on the each pig's both sides of dorsal midline at 0, 7, 14, and 18 days. The wounds created at 18, 14, 7 and 0 days were named post-wounding day (PWD) 3, 7, 14 and 21, respectively. In each pig, one wound (left side) was treated pulsed $CO_2$ laser and the other wound (right side) was treated continuous wave $CO_2$ laser. Each wound was closed with two interrupted suture of 3-0 sutures. At 21 days after initial wounding, each wound was taken for histological evaluations. The degrees of reepithelialization were performed more prominently in the pulsed mode group than in the continuous mode group. The degrees of granulation were greater significantly in pulsed mode group than those in the continuous mode on PWD 3 (p < 0.05). The degrees of fibroblasts in the pulsed mode group were greater significantly in comparison to those in the continuous mode group on PWD 7, (p < 0.05). In conclusion, reepithelialization, granulation and fibroblasts in the pulsed mode group were greater markedly in comparison to those in the continuous mode group. It was considered that pulsed mode $CO_2$ laser was more suitable for the skin incision than the continuous mode $CO_2$ laser.

Phosphodiesterase III Inhibitor Cilostazol Protects Amyloid β-Induced Neuronal Cell Injury via Peroxisome Proliferator-Activated Receptor-γ Activation (Amyloid β에 의해 유도된 신경세포 손상에 대한 phosphodiesterase III inhibitor인 cilostazol의 신경보호 효과)

  • Park, Sun-Haeng;Kim, Ji-Hyun;Bae, Sun-Sik;Hong, Ki-Whan;Choi, Byung-Tae;Shin, Hwa-Kyoung
    • Journal of Life Science
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    • v.21 no.5
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    • pp.647-655
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    • 2011
  • The neurotoxicity of aggregated amyloid ${\beta}$ ($A{\beta}$) has been implicated as a critical cause in the pathogenesis of Alzheimer's disease (AD). It can cause neurotoxicity in AD by evoking a cascade of apoptosis to neuron. Here, we investigated the neuroprotective effects of cilostazol, which acts as a phosphodiesterase III inhibitor, on $A{\beta}_{25-35}$-induced cytotoxicity in mouse neuronal cells and cognitive decline in the C57BL/6J AD mouse model via peroxisome proliferator-activated receptor (PPAR)-${\gamma}$ activation. $A{\beta}_{25-35}$ significantly reduced cell viability and increased the number of apoptotic-like cells. Cilostazol treatment recovered cells from $A{\beta}$-induced cell death as well as rosiglitazone, a PPAR-${\gamma}$ activator. These effects were suppressed by GW9662, an antagonist of PPAR-${\gamma}$ activity, indicative of a PPAR-${\gamma}$-mediated signaling. In addition, cilostazol and rosiglitazone also restored PPAR-${\gamma}$ activity levels that had been altered as a result of $A{\beta}_{25-35}$ treatment, which were antagonized by GW9662. Furthermore, cilostazol also markedly decreased the number of apoptotic-like cells and decreased the Bax/Bcl-2 ratio. Intracerebroventricular injection of $A{\beta}_{25-35}$ in C57BL/6J mice resulted in impaired cognitive function. Oral administration of cilostazol (20 mg/kg) for 2 weeks before $A{\beta}_{25-35}$ injection and once a day for 4 weeks post-surgery almost completely prevented the $A{\beta}_{25-35}$-induced cognitive deficits, as did rosiglitazone. Taken together, our findings suggest that cilostazol could attenuate $A{\beta}_{25-35}$-induced neuronal cell injury and apoptosis as well as promote the survival of neuronal cells, subsequently improving cognitive decline in AD, partly because of PPAR-${\gamma}$ activation. The phosphodiesterase III inhibitor cilostazol may be the basis of a novel strategy for the therapy of AD.

The Effects of Aroma Self Massage in Hands on Pain, Depressive Mood and Anxiety in Breast Cancer Patients (유방암 환자의 통증, 우울 및 불안 증상 조절에 아로마 자가 치료의 효과)

  • Sohn, Keun-Joo;Kim, Myung-Ja;Lee, June-Young;Lee, Jae-Bok;Kim, Su-Hyun;Kim, Jong-A;Jung, Hoe-Hyun;Choi, Seung-Wan;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.18-29
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    • 2005
  • Purpose: Aroma therapy is one modality of alternative medicine. It was well known to have an analgesic, antidepressive and anxiolytic effects. This study is designed to investigate the effect of aroma self hand massage on vital signs, pain, depression, anxiety and stress in breast cancer patients. Methods: 32 female patient over 20 years old were divided into two groups by a non-blinded randomized controlled method. Patient in the aroma group (n=15) massaged their hands twice a day using aroma oil by themselves in their home for 2 weeks. However, those in control group (n=17) had not received my intervention during the study periods. Pain intensity, state anxiety, depression and stress of subjects were evaluated three times (0, 1, 3 weeks) using Visual Analogue Scale (VAS, $0{\sim}10cm$), State Trait Anxiety Inventory (STAI), Beck Depression Inventory Scales (BDIS), Brief Encounter Psychosocial Instrument (BEPSI revised edition). Also the change of patients' accompanying symptoms after aroma massage were analyzed using a structured questionnaire. Results: Pain Intensity decreased in the aroma group compared with control group (VAS changes $-0.83{\pm}1.01\;vs\;0.38{\pm}0.86$, P=0.005). The numbers of accompanying symptoms (P=0.044), depression score (P=0.001) and anxiety score (P=0.008) were significantly decreased in the aroma group, while in control group they increased after 2 weeks. However, the stress score showed no significant changes in both groups ($0.05{\pm}0.85\;vs\;0.04{\pm}0.20$, P=0.1519). The depression, anxiety and stress score showed negative correlation with compliance of aroma massage, but statistically no significant. The systolic blood pressure was a little increased in aroma group ($4.53{\pm}14.43\;vs\;0.0{\pm}7.22$, P=0.026), but was not significant clinically. Patients in the aroma group complained of several symptoms such as headache (20%), paresthesia (6.75%) and nausea (6.7%). However, there were no drop-out patients for those side effects. Conclusion: Aroma self massage during two weeks in breast cancer patients alleviates the pain intensity, depression and anxiety significantly.

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Effects of Dry Eye Symptoms on Work Productivity and General Activity in Newly Building (신축건물에서 안구건조증이 작업생산성과 일상활동에 미치는 영향)

  • Kim, Hyojin;Park, Chan-Jung;Lim, Byung-Seo;Kim, Ho-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.3
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    • pp.389-396
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    • 2014
  • Purpose: The study examined dry eye symptoms of occupants in a newly constructed building and its effects on their work productivity and general activity. Methods: The study subjects were 33 office workers who spent more than eight hours per day on average in a new building constructed in the past three months. The indoor air quality of the new building was evaluated by measuring aldehydes, temperature and humidity. The level of dry eye symptoms was classified into normal, mild, moderate and severe by using the Ocular Surface Disease Index (OSDI). The experience of LASIK surgery, use of eye makeup, daily use time of a computer and smart-phone, and average daily working hours were also examined. The Work Limitation Productivity Questionnaire was used as the questionnaire about work productivity and general activity to measure the impairment level on a ten-point scale. Results: The concentration variation of formaldehyde in the office was $42.42{\pm}6.30{\mu}g/m^3$. The temperature and humidity were $26.2{\pm}0.70^{\circ}C$ and $40{\pm}1%$, respectively. The respondents with normal, mild, moderate and severe dry eye symptoms were 15.2%, 18.2%, 18.2% and 48.5%, respectively. The severity of dry eye symptoms and impairment of work productivity and general activity demonstrated high correlations of 0.599 and 0.655, respectively (p<0.001). Compared to the normal case, severe dry eye symptoms demonstrated significantly high impairment of work productivity and interruption of general activity (p<0.001). The case of serious dry symptoms showed the possibilities of having impairment level of work productivity and interruption of general activity above three points 3.26 times (p=0.032) and 2.25 times (p=0.045), respectively, higher than that of the normal case. Conclusions: It was confirmed that dry eye symptoms among office workers in a newly constructed building affects work productivity and general activity.

Effect of joint mobilization on improvement of knee pain, isokinetic strength, muscle tone, muscle stiffness in an elite volleyball player with knee injury (무릎손상 엘리트 배구선수에 관절가동운동이 무릎통증, 등속성 근력, 근긴장도, 근경직 개선에 미치는 효과)

  • Wang, Joong-San;An, Ho-Jung;Kim, Yong-Youn
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.326-333
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    • 2016
  • This case study identified the effects of joint mobilization on knee pain, isokinetic strength, muscle tone, and muscle stiffness in an elite volleyball player with a knee injury. The subject had experienced cartilage defects of the left knee joint and underwent surgery to correct the condition. The patient complained of continuous pain in the left knee joint in daily life in addition to pain during exercise. The study was conducted from August 5 to 12, 2015 and joint mobilization was applied to the left knee joint for 15 minutes once a day for 8 days. Knee pain was measured using a visual analogue scale, and the concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic muscular strength measurement device. The muscle tone and stiffness of the rectus femoris muscle, vastus medialis, and vastus lateralis on the injured side were measured using a myotonometer. All the measurements were conducted before and after the intervention. Joint mobilization was effective in reducing knee pain on the injured side, increasing the concentric peak torque of the quadriceps and hamstring muscles on both sides, and increasing the muscle stiffness of the quadriceps muscle on the injured side. Concentric peak torque of the quadriceps muscle on the injured side increased a great deal as the number of joint mobilizations was increased, largely diminishing the difference in concentric peak torque between the normal side and injured side. On the other hand, joint mobilization was ineffective in improving the hamstring to quadriceps strength ratio on the injured side. While this study suggests that joint mobilization can be an effective intervention to improve the knee pain, isokinetic strength, and muscle stiffness of elite volleyball players, it should be performed alongside training for an appropriate strength ratio.

The Effect of Freeze and Thaw for the Stabilized Soil Bottom Liners in the Landfill (폐기물 매립지 바닥층의 고화토 포설시 동결/융해 현상에 관한 연구)

  • Lee, Song;Lee, Jai-Young;Kim, Heung-Suck
    • Journal of the Korean Geotechnical Society
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    • v.16 no.1
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    • pp.179-189
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    • 2000
  • The purpose of this research is to complement the existing researches on landfill bottom liners behavior during the periods of freeze and thaw. Landfill-related researches have been typically focused on small-scale soil samples that are often compacted under conditions different from those used in the field. Although these tests have been invaluable in clarifying the problem of freeze and thaw, extending the results of such experimental studies to prototype landfills are questionable. In this investigation, the author utilized a large scale laboratory simulation allowing inclusion of the field depth of the cover systems, layered soil profiles, rainfall simulation, a cold climate and boundary conditions similar to those encountered in the landfill. The soil materials were stabilized soils (mixed clays, cements, and minerals) instead of clays. The bottom liners are made up of drainage layer (30 cm), stabilized layer (75 cm), and leach collection layer (60 cm). The stabilized layers are made up of supporting layer (45 cm) and low permeable layer (30 cm) - consisting of $P_A\; and\; P_B$ layer. As a results, depths of penetration increased by about 2~5 more centimeters at rainfall simulated designs than those at no rainfall simulated designs (that is design 3, design 5 and design 7) - it increased by about 20mm/day in the bottom liners and frost heaves also increased it by a few millimeters. Also, a few cracks appeared partly. According to these results, we can surmise that the compacted stabilized soil is more reliable than the compacted clay liners for construction of the landfill liners.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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The Effect of Follicle-Stimulating Hormone Receptor (FSHR) Polymorphism on Outcomes of Controlled Ovarian Hyperstimulation (COH) and In-vitro Fertilization and Embryo Transfer (IVF-ET) (체외수정시술시 난포자극호르몬 수용체 유전자 다형성이 과배란유도 및 임신 결과에 미치는 영향)

  • Yoon, Ji-Sung;Choi, Young-Min;Lim, Kyung-Sil;Hur, Chang-Young;Kang, Young-Je;Jung, Jae-Hoon;Lee, Won-Don;Lim, Jin-Ho;Hwang, Kyu-Ri;Jee, Byung-Chul;Ku, Seung-Yup;Suh, Chang-Suk;Kim, Seok-Hyun;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.2
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    • pp.133-139
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    • 2004
  • Objective: To investigate the association of FSH receptor (FSHR) polymorphism at position 680 with outcomes of controlled ovarian hyper-stimulation for IVF-ET in Korean women. Design: Genetic polymorphism analysis. Materials and Methods: The FSHR polymorphism was analyzed by PCR-RFLP in 172 ovulatory women below the age of 40 year. Patients with polycystic ovary syndrome, endometriosis, or previous history of ovarian surgery were excluded. Results: Genotype distribution was 41.9% for the Asn/Asn, 47.7% for the Asn/Ser, and 10.5% for the Ser/Ser FSHR genotype group. There was no difference in age of subjects and infertility diagnosis between genotype groups. When the patients were grouped according to their FSHR genotype, the basal levels of FSH (day 3) were significantly different among the three groups ($6.0{\pm}0.3\;IU/L$ (mean $\pm$ SEM), $5.8{\pm}0.3\;IU/L$, and $8.6{\pm}1.2\;IU/L$ for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.002). The Ser/Ser group showed a higher total doses of gonadotropins required to achieve ovulation induction, and a lower serum estradiol levels at the time of hCG administration compared with other two groups, but the differences were of no statistical significance. The numbers of oocytes retrieved were significantly different among the three groups ($8.6{\pm}0.8$, $9.9{\pm}0.6$, and $6.3{\pm}0.9$, for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively, p=0.049). Clinical pregnancy rates were 42.4%, 25.9%, and 29.4% for the Asn/Asn, Asn/Ser, and Ser/Ser groups, respectively. Conclusion: Homozygous Ser/Ser genotype of FSHR polymorphism at position 680 was associated with decreased ovarian response to gonadotropin stimulation for IVF-ET.

A Case of Pharmacokinetics of Cisplatin in Concurrent Chemoradiation for Hemodialysis Patient with Advanced Head and Neck Cancer (혈액 투석을 받는 두경부암 환자의 동시화학방사선요법에서 Cisplatin의 약력학 조사 1예)

  • Jeon, Youn-Joo;Shim, Byoung-Yong;Kim, Hyung-Wook;Lee, Sang-Hun;Lee, Ho-Sang;Park, Cheol-Whee;Kim, Su-Zy;Kuh, Hyo-Jeong;Kim, Hoon-Kyo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.153-156
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    • 2007
  • Objectives : We study the feasibility and pharmacokinetics of cisplatin concurrent chemoradiation for advanced head and neck cancer patient undergoing hemodialysis. Materials and Methods : A 57-year old male with end stage renal disease developed stage III external auditory canal cancer. Complete resection surgery was done. Postoperative 6 months, local recurrence was occurred. Despite excision and adjuvant radiotherapy, local tumor was recurred. We decided to treat a cisplatin concurrent chemoradiotherapy. Cisplatin was administered at a dose of $20mg/m^2$ for 30 min. Hemodialysis was started 30 min after completion of the cisplatin infusion and performed for 4 hours. Hemodialysis was performed on day 3 and 5 of chemotherapy. Plasma samples were collected at specified times after administration of cisplatin. Result : At the end of the third cycle of cisplatin concurrent chemoradiotherapy, the tumor size was markedly decreased. The maximum plasma concentrations of plasma platinum and free platinum were 0.74 and $0.37{\mu}g/ml$ respectively. The area under the curve of plasma platinum and free platinum were 94.7 and $11.3{\mu}g{\cdot}h/ml$ respectively. Conclusion : We report a case of Cisplatin concurrent chemoradiation for hemodialysis patient with advanced head and neck cancer and suggest full dose cisplatin concurrent chemoradiotherpay is tolerable for these patients.

Results of Radiotherapy for the Uterine Cervical Cancer (자궁경부암의 방사선치료성적)

  • Kim, Chul-Yong;Choi, Myung-Sun;Suh, Won-Hyuck
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.63-73
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    • 1988
  • One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP. Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; in case of radiation therapy only, whole pelvic irradiation was given with Co-60 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. In satges Ia, Ib, and IIa with small primary lesion, external irradiation was initially given to pelvis up to $2,000\~3,000\;cGy/2frac{1}{2}\;-3frac{1}{2}$ weeks and then intracavitary insertion was performed using Fletcher-Mini-Declos Applicator with cesium-137 cources and followed by external irradiation of $1,000\~2,000\;cGy/1frac{1}{2}\;-2frac{1}{2}$weeks via AP and PA parallel opposing fields with midline shield to spare of bladder and rectum. However, if the primary lesion is large, external irradiation was given without midline shield. More than stages IIb, the patients were treated by external beam irradiation up to 5,400cGy/30f for 6 weeks via 4-oblique portals and at the dose of 5,040cGy/28f the field was cut 5cm from the top margin for spare of small bowel, and followed by intracavitary irradiation, If there was residual tumor an additional dose of $900\~l,200cGy/5\~7f$ was given to parametrium and/or residual tumor area. Total dose of radiation to A and B-point were as follows; A-point; In early stages, Ia, Ib, IIa; $8,000\~9,000$ B-point $5,000\~6,000 cGy$ A-point; In advanced stages IIb, IIIa, IIIb; $9,000\~10,000$ B-point $60,000\~7,000cGy$ The results were obtained and as fellows; 1 The patients distribution according to FIGO staging system were stage Ia 6, Ib 27, IIa 28, IIb 54, IIIa 12, IIIb 18, and stage IVa 9. 2. Value of CT scan were demonstration of cervix tumor mass, parametrial and pelvic side wall tumor spread, pelvic and inguinal lymph nodes metastases, and hydronephrosis. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. 3. Local control rate of tumor according to the size was $91.3\%$ for less than 5cm in size and $44.6\%$ in tumor over 5cm (p<0.0068). 4. Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the para-aortic lymph nodes were the most common site for distant metastases. 5. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. 6. The 5-year survival rates showed; stage la and Ib $95\%,\;stage\;IIa\;81\%\;stage\;lIb\;67\%,\;stage\;IIIa\;37.7\%,\;stage\;IIIb\;23\%$ and 3-year survival rate of stage IVa showed $11.6%$, retrospectively.

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