Sixteen clinically healthy New Zealand white rabbits of either sex were divided into two equal groups I and II of 8 animals each. Under thiopental sodium (2.5%) anaesthesia a linear full thickness abdominal wall defect of 3 cm in length was created and repaired with continuous suture pattern using 3000 filaments of carbon fibres and 1~0 black braided nylon suture, ingroup I and II respectively. Increased vascularity was observed in carbon fibres (group I) and on day 30 the carbon fibres were covered by white fibrous tissue. Significantly higher (P < 0.05) values of glucose was seen on day 14 in group I, whereas, decrease in glucose value was observed in group II. Histopathologically, the carbon fiber implant induced extensive fibrous tissue (collagen fiber) reaction. Negligible inflammatory cells in the stroma indicate the host tissue tolerance to carbon fibers. Histochemically, gradually increased alkaline phosphatase activity up to day 14 in group I, suggested the proliferation of fibroblasts in early stages.
This study was performed to investigate the effect of dietary magenesium on stress reactions in rats having abdominal surgery. Sixty three male rats of sprague-dawley strain were blocked into 3 groups : rats fed regular magnesium (0.05% Mg: control) rats receiving regular magnesium with surgery(Mg-adeq : S) Five weeks after feeding abdominal surgery was performed and randomly chosen 7 rats from each group were sacrificed on 1, 3 and 5 days after surgery. Te following were found ; 1) Rats fed marginal magnesium showed significantly elevated urinary urea nitrogen urinary potassium and plasma glucose compared controls only one day after abdominal surgery but not 3 days or 5 days after surgery 2) Rats fed adequate magnesium did not show any significant change in metabolic stress indicator after surgery. 3) Plasma free fatty acid and cortisol level were not different among groups. 4) Decreased plasma magnesium and potassium level were found in rats fed marginal magne-sium and sacrificed one day and three days after surgery.
Open reduction and rigid internal fixation is the most popular treatment method for maxillofacial fracture patients, and it is unevitable that postoperative pain can be developed. Many surgeons including oral & maxillofacial surgeons have made constant efforts to decrease postoperative pain. This study is a comparison of postoperative analgesia and intramuscular analgesia in patients with mandibular fractures. In this study, twenty-one patients (Experimental group) were randomly selected and they were injected with IV patient-controlled analgesia (PCA; Walkmed$^{(R)}$, USA). For control group another twenty-one patients were injected with intramusclar non-steroid anti-inflammatory drugs (Rheoma$^{(R)}$, Samsung Pharm. Co.). And then, we measured visual analogue scale (VAS) scores from first postoperative day to second day at regular time interval. The following results were uptained; 1. In patient group who with open reduction and rigid internal fixation, there was significant difference of postoperative analgesic effect during the first postoperative day(p<0.05). 2. In patient group with over 90 minutes surgery time, there was significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p<0.05). 3. In patient group with less than 90 minutes surgery time, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 4. In patient group with surgery of open reduction using rigid internal fixation at single fractured site, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 5. In patient group with surgery at two fractured sites, there was significant difference of postoperative analgesic effect during the first postoperative day when compared between experimental group and control group(p<0.05). As mentioned above, it suggest that patient-controlled analgesia is more effective for postoperative pain relief than intramuscular injection in patients with rigid internal fixation by open reduction after mandibular fracture occurred. Especially, it is considered that in patient with more than 90 minutes surgery time or in cases with multiple fractured sites had more effective results with PCA therapy than conventional intramuscular analgesics.
In acute pancreatitis group, all the dogs are showed increase of amylase and lipase after the 1st day of surgery, and amylase and lipase activity were significantly more increased than those of control group. The methemalbumin was increased significantly after the 2nd day of surgery in the acute pancreatitis group. In pancreatitis group, ultrasonographic findings included thickened duodenal wall and poorly circumscribed hyperechoic lesion of pancreatic mass after the 2nd day of surgery. And the lesion was exacerbated until the 4th day and reduced after the 6th day of surgery. To identify the lesion of pancreas, it is considered that transverse view is more useful Than sagittal view. Gross findings showed increase of pancreatic parenchymal consistency, surface nodule, and extensive pancreatic necrosis. Necrosis of peripancreatic fat tissue was also a prominent feature. The microscopic appearance of the pancreas was characterized by pancreatic acinar cell necrosis, hemorrhage, infiltration of the inflammatory cell and fat necrosis and saponification were also observed.
A analysis of CPK & LDH Isoenzyme was done on the consecutive patients undergoing thoracic operations from July 1982 to October 1982 in the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital. Eighteen patients were analysed by three groups, such as open heart surgery [group A], major thoracic operation [group B] , minor thoracic operation group [group C]. In all patients serial determination of total level and Isoenzyme of CPK, LDH wad done on preoperative operative and up to 8th post-operative day, The results obtained are as follows. 1. The average value of serum CPK before the operation was 61 IU/L. The value of serum CPK was increased following the operation mainly MM portion and reached to the maximal level of 536107 IU/L in A group 1200191 IU/L in B group, 306150 IU/L in C group on the first postoperative day. The enzyme activity was gradually decreased thereafter and returned to the normal range on the 3rd or 4th day after the operation. 2. The average value of serum LDH before the operation was found to be 83 IU/L. The value was increased during the operation and reached to the maximal level of 481108 IU/L in group A, 14827 I U/L in group B, 10035 IU/L in group C on the second day after the operation. The enzyme activity was gradually decreased thereafter and returned to the normal range on the seventh day after the operation. The enzyme activity was dependent to the duration of operation, severity of muscle damage, type of thoracotomy, effect of extracorporeal circulation, state of disease.
Cell mediated immunity is depressed following surgical procedure and the degree of immunosuppression is directly related to the magintude of the procedure, blood transfusion, and length of operation. So we would expect cardiac operations to be highly immunosuppressive, although little is konwn about their immunosuppressive effect. The nearly complete consumption of complement factors and decreased levels of IgM and IgG resulting in an impaired opsonizing capacity. Additionally, peripheral blood mononuclear cell counts including T-and B-lymphocytes and T-cell subsets are reduced. Depression of cell-mediated immunity following open-heart surgery is potentially detrimental because it could increase the susceptability of patients to viral and bacterial infection. We reviewed 20 patients after cardiac operation to search for changes in peripheral blood lymphocyte subsets. Lymphocyte subsets were measured by flow cytometer and the preoperative values of lymphocyte subsets were compared with those from the first, fourth, and seventh days after operation. After cardiac operation, total mumbers of T lymphocyte was severely depressed on the first postoperative day and returned to the preoperative level by the seventh day after operation. CD3, CD4, and CD8 lymphocytes were decreased on the first postoperative day and returned to the preoperative level by the seventh day also. There was four cases of wound infection and these patients had increased CD4 lympocyte and more decreased CD19 lymphocyte compared with the non-infected group. It is concluded from these data that cell-mediated immunity is significantly depressed for at least one week following open-heart surgery and this result was closely related to the postoperative infection.
Kim, Kangmin;Lee, Hyun Joo;Park, Samina;Hwang, Yoohwa;Kim, Young Whan;Kim, Young Tae
Journal of Chest Surgery
/
v.50
no.5
/
pp.382-385
/
2017
A 47-year-old man with myasthenia gravis (MG) was admitted for a lung transplant. He had bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation due to acute myeloid leukemia. MG developed after stem cell transplantation. Bilateral sequential lung transplantations and a total thymectomy were performed. The patient underwent right diaphragmatic plication simultaneously due to preoperatively diagnosed right diaphragmatic paralysis. A tracheostomy was performed and bilevel positive airway pressure (BiPAP) was applied on postoperative days 8 and 9, respectively. The patient was transferred to the general ward on postoperative day 12, successfully weaned off BiPAP on postoperative day 18, and finally discharged on postoperative day 62.
Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients' medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.
This article is intended to study histopathological and immunohistochemical response after autogenous full-thickenss skin graft in rat. 12 male Sprague-Dawley rats were used as the experimental animals. A $1Cm{\times}1Cm$ skin(0.7mm diameter) was taken on the right inguinal area of the rat. Another full-thickeness skin graft($1Cm{\times}1Cm$) was taken from the left inguinal area of the rat. And it was transplanted to the right inguinal area of the rat. The left side wound was closed directly. Light microscopic observation was made at the postoperative $1^{\circ}3^{\circ}8^{\circ}16$ day, after the hematoxylin - Eosin staining of the 4u-thick paraffin embedded specimens and the immunoshitochemical staining of the 10u-thick frozen specimens with mouse anti-rat monoclone antibodies and ABC staining kit. The results were as follows. 1. Electromicroscopic studies revealed interstitial tissue bleeding of transplanted autogenous skin. The response was severe in the 1 day group after operation, moederate in 3 day group, mild in 8 day group, and almost resovled in the 16 days group. 2. Electromicrospic studied also revealed a mild monocyte response in the 3 day and 8 day group. A histiocytic infiltrate was observed. There was a mild response in the 3 day group and moderate response in the 8 day group. 3. Immunohistochmically studies revealed a few pan T cells in the 1 day group, mild appearance of pen T cells and cytotoxic T cells in the 3 day group, a moderate infiltrate of pan T cells and helper T cells in the 8 day group, and total resolution of pan T cells in the 16 day group. 4. According to these finding, a strong inflammatory response was observed around transplanted autogenous skin in the 3 & 8 day groups. In the 16 day group this response had resolved histopathologically and immunohistologically.
Lee, Hohyoung;Han, Sung Ho;Lee, Min Koo;Kwon, Oh Sang;Kim, Kyoung Hwan;Kim, Jung Suk;Chon, Soon-Ho;Shinn, Sung Ho
Journal of Trauma and Injury
/
v.32
no.2
/
pp.115-117
/
2019
Although hemothorax and pneumothorax are common complications seen in rib fractures, focal extrapleural hematoma is quite rare. We report a 63-year-old female patient that developed large focal extrapleural hematoma after falling off a second floor veranda. The patient had sustained 3, 4, 5th costal cartilage rib fractures and a sternum fracture. She had developed suspected empyema with loculations with small amount of hemothorax. She underwent a planned early decortication/adhesiolysis by video assisted thoracoscopic surgery at the 12th post-trauma day due to failed drainage. Unexpectedly, she had no adhesions or any significant retained hematoma mimicking a mass, but was found with the focal extrapleural chest wall hematoma. She was discharged on postoperative 46th day for other reasons and is doing fine today.
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