• Title/Summary/Keyword: Early outcomes

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Advantages of Function-Preserving Gastrectomy for Older Patients With Upper-Third Early Gastric Cancer: Maintenance of Nutritional Status and Favorable Survival

  • Masayoshi Terayama;Manabu Ohashi;Satoshi Ida;Masaru Hayami;Rie Makuuchi;Koshi Kumagai;Takeshi Sano;Souya Nunobe
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.303-314
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    • 2023
  • Purpose: The incidence of early gastric cancer is increasing in older patients alongside life expectancy. For early gastric cancer of the upper third of the stomach, laparoscopic function-preserving gastrectomy (LFPG), including laparoscopic proximal gastrectomy (LPG) and laparoscopic subtotal gastrectomy (LSTG), is expected to be an alternative to laparoscopic total gastrectomy (LTG). However, whether LFPG has advantages over LTG in older patients remains unknown. Materials and Methods: We retrospectively analyzed data of consecutive patients aged ≥75 years who underwent LTG, LPG, or LSTG for cT1N0M0 gastric cancer between 2005 and 2019. Surgical and nutritional outcomes, including blood parameters, percentage body weight (%BW) and percentage skeletal muscle index (%SMI) were compared between LTG and LPG or LSTG. Survival outcomes were also compared between LTG and LFPG groups. Results: A total of 111 patients who underwent LTG (n=39), LPG (n=48), and LSTG (n=24) were enrolled in this study. To match the surgical indications, LTG was further categorized into "LTG for LPG" (LTG-P) and "LTG for LSTG" (LTG-S). No significant differences were identified in the incidence of postoperative complications among the procedures. Postoperative nutritional parameters, %BW and %SMI were better after LPG and LSTG than after LTG-P and LTG-S, respectively. The survival outcomes of LFPG were better than those of LTG. Conclusions: LFPG is safe for older patients and has advantages over LTG in terms of postoperative nutritional parameters, body weight, skeletal muscle-sparing, and survival. Therefore, LFPG for upper early gastric cancer should be considered in older patients.

Current status and clinical outcome of endoscopic hemostatic powder in gastrointestinal bleeding: a retrospective multicenter study

  • Zie Hae Lim;Seung In Seo;Dae-Seong Myung;Seung Han Kim;Han Hee Lee;Selen Kim;Bo-In Lee
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.620-627
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    • 2024
  • Background/Aims: Few multicenter studies have investigated the efficacy of hemostatic powders in gastrointestinal (GI) bleeding. We aimed to investigate the clinical outcomes of hemostatic powder therapy and the independent factors affecting rebleeding rates. Methods: We retrospectively recruited patients who underwent a new hemostatic adhesive powder (UI-EWD; Next-Biomedical) treatment for upper and lower GI bleeding between January 1, 2020 and March 1, 2023. We collected patients' medical records and bleeding lesions. The primary outcomes were clinical and technical success rates, and the secondary outcomes were early and delayed bleeding rates refractory bleeding rate, mortality rate, and factors affecting early rebleeding rates. Results: This study enrolled 135 patients (age: 67.7±13.6 years, male: 74.1%) from five hospitals. Indications for UI-EWD were peptic ulcers (51.1%), post-procedure-related bleeding (23.0%), and tumor bleeding (19.3%). The clinical and technical success rates were both 97%. The early, delayed, and refractory rebleeding rates were 19.3%, 11.1%, and 12.8%, respectively. Initially elevated blood urea nitrogen (BUN) levels (p=0.014) and Forrest classification IA or IB compared with IIA or IIB (p=0.036) were factors affecting early rebleeding. Conclusions: UI-EWD showed high clinical and technical success rates; however, rebleeding after UI-EWD therapy in patients with initially high BUN levels and active bleeding, according to the Forrest classification, should be considered.

Evalution of Practial Application of high early Strength Concrete using Early strength type material (조강형 재료를 사용한 초조강 콘크리트의 적용성 평가)

  • Yang, Hoon;Park, Kyu-Yeon;Lee, Sang-Soo
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2013.11a
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    • pp.48-49
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    • 2013
  • This test investigates early strength and durability of concrete using early strength type materials(cement, Polycarboxylate acid). The goal of this test is to secure the strength of 5.0 MPa in 12 hours early age and strength of 14 MPa for 24 hours correspondingly. This type of admixtures, concrete curing temperature, amount of binder and other concrete properties were confirmed by experimental factors. Comparing outcomes from two cases on using early strength type materials and common materials resulted in reducing of costs and shortening of the construction period, that determined the economical benefits of using early strength materials in construction.

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Impact of Patients' Level of Participation in Rehabilitation on Functional Outcome in Patients With Stroke (뇌졸중 환자의 재활참여가 기능회복에 미치는 영향)

  • Won, Jong-im
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.63-69
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    • 2020
  • Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients' high motivation and committed participation. Patients' motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients' participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients' level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients' participation at early intervention were important determinants of functional outcome. These findings suggest that patients' participation should be encouraged in order to achieve successful stroke recovery.

Developing a Collaborative Model for Early Childhood Teacher's Knowledge on Early Childhood Curriculum at First Career Period (유치원 초임교사의 교육계획안 개발에서 실천적 지식 함양을 위한 협력 모형 구안)

  • Hwang, Yoon-Se;Kang, Hyeon-Suk
    • Korean Journal of Child Studies
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    • v.28 no.5
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    • pp.233-251
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    • 2007
  • This study explored the contents of practical knowledge about educational planning in early childhood curriculum as constructed by kindergarten teachers at early career stages and then developed a collaborative model of educational planning. Subjects were 6 teachers at early career stages. Using the ethnographic method, data were collected by in-depth interviews. Research outcomes were : (1) teachers specifically worked on 'difficulties in adapting to the teaching job', 'age of children that the teacher cares for', 'integration of theory and practice', and 'variety of actual teaching situations.' (2) A model for collaborative educational planning was constructed on the basis of review of the literature on teachers' knowledge, educational planning for early childhood curriculum, and learning of community.

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Nutritional strategy of early amino acid administration in very low birth weight infants

  • Lee, Byong Sop
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.77-83
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    • 2015
  • Relative to a fetus of the same gestational age, very low birth weight (VLBW) infants are more likely to be underfed and to undergo growth restriction during their early hospital stay. The current trend towards "early and aggressive" nutritional strategies in VLBW infants aims to overcome the early nutritional deficiency and thereby boost postnatal catch-up growth, simultaneously improving long-term neurodevelopmental outcomes. Although the minimum starting amino acid (AA) dose to prevent negative nitrogen balance is well established, the upper limit and the rate of increase of early AA doses are controversial. Most randomized controlled trials show that early and high-dose (target, 3.5 to 4.9 g/kg/day) AA regimens, with or without high nonprotein calories, do not improve long-term growth and neurodevelopment. High-dose AA supplementation may lead to early metabolic disturbances and excessive or disproportionate plasma AA levels, particularly in infants of very low gestational age. Further large studies are needed to clarify the optimal strategy for early administration of parenteral AA doses in VLBW infants.

Literature Review on Universal and Residual Services of Early Family-Intervention: Implications for Korean Society (건강가정지원을 위한 보편적 복지와 선별적 복지에 관한 문헌고찰: 조기 가족-개입을 위한 제언)

  • Yoon, Chong Hee
    • Journal of Families and Better Life
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    • v.33 no.3
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    • pp.49-66
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    • 2015
  • The purpose of the study was to review literature on universal and residual services of early family-intervention. The review was focused on early family-intervention cases proven effective in empowering children, parents and families, which, in turn, brought about positive synergy effects to the community at large. Literature review was presented in the following order: first, the universal needs for early family-intervention; second, critical components and strategies of early family-intervention for successful outcomes; third, on-going international projects of early family-intervention, both universal and residual services, proven effective on a long-term basis. In conclusion, findings of the study were summarized and the theoretical, practical and political implications for Korean society were further discussed.

Occupational Therapy Intervention for Malunion of Distal Radial Fracture: A Case Report

  • Noor Mohammad;Nahid Khan
    • CELLMED
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    • v.13 no.6
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    • pp.6.1-6.3
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    • 2023
  • Objective: Malunion of distal radial fracture can result in pain, stiffness, and decreased function of the affected limb. Occupational therapy intervention can improve outcomes in these patients, but there is limited research on the effectiveness of such interventions. Case Description: This case report describes the occupational therapy intervention and outcomes for a 44-year-old female patient with malunion of left distal radial fracture. The patient received 8 weeks of occupational therapy intervention consisting of therapeutic exercises, joint mobilization, and fine motor activities. The patient demonstrated significant improvements in range of motion, grip strength, and activities of daily living (ADL) in her left hand. The patient also reported less pain and greater ease in performing activities of daily living. Conclusion: Occupational therapy intervention can be effective in improving outcomes for patients with malunion of distal radial fracture. This case report highlights the importance of early intervention and interdisciplinary collaboration among healthcare professionals to optimize patient outcomes. Further research is needed to explore the effectiveness of occupational therapy interventions for patients with malunion of distal radial fracture.

Single-incision Laparoscopic Gastrectomy for Gastric Cancer

  • Lee, Yoontaek;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.17 no.3
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    • pp.193-203
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    • 2017
  • The implementation of national cancer screening has increased the detection rates of early gastric cancer (EGC) in Korea. Since the successful introduction of laparoscopic gastrectomy for gastric cancer in the early 1990s, this technique has demonstrated improved short-term outcomes without compromising long-term oncologic results. It is associated with reduced pain, shorter hospitalization, reduced morbidity rates, better cosmetic outcomes, and equivalent mortality rates as those for open surgery. Laparoscopic gastrectomy improves patients' quality of life (QOL) and provides favorable prognosis. Single-incision laparoscopic gastrectomy (SILG) is one extremely minimally invasive method, theoretically offering improved cosmetic results, less postoperative pain, and earlier recovery after surgery than conventional multiport laparoscopic gastrectomy. In this context, SILG is thought to be an optimal method to promote and maximize patients' QOL in the acute postoperative phase. However, the technical difficulties of this procedure have limited its use. Since the first report describing single-incision distal gastrectomy in 2011, only 16 studies to date have evaluated SILG. Most of these studies have focused on the technical feasibility and safety of SILG because its long-term outcomes have not been reported. This article reviews the advantages and limitations of SILG.

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

  • Choi, Sun Ah;Kim, Ki Joong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.321-327
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    • 2019
  • Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.