• Title/Summary/Keyword: Post operative period

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Nutrition Supply, Biochemical Nutrition Indexes and Patient Outcomes in New Born Babies with Open Heart Surgery according to Post Operative Fasting Period (선천성 심장병 신생아의 개심술 후 금식기간에 따른 영양공급량, 생화학적 영양지표 및 환아결과)

  • Jang, Ji-Young;Kim, Myoung-Hee
    • Child Health Nursing Research
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    • v.18 no.3
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    • pp.119-126
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    • 2012
  • Purpose: The purpose of this study was to examine and analyze the post operative fasting period of neonates in the intensive care unit (ICU) after receiving open heart surgery in order to provide optimal nutrition support for these neonates. The variables included biochemical nutrition indexes (albumin, total lymphocyte count, total cholesterol) and patient outcomes (duration of mechanical ventilation, ICU stay, hospital stay, infectious complication). Methods: The participants were 124 neonates in ICU after receiving open heart surgery, and the design of this study was to investigate their post operative fasting period retrospectively to analyze the biochemical nutrition indexes and patient outcomes according to post operative fasting period. Results: The results for 4 groups according to post operative fasting period showed that the group with less 48 hours of fasting had the best biochemical nutrition indexes and patient outcomes, followed by the 48-72 hour group, the 72-144 hour group, and the over 144 hour group. Conclusion: The results indicate that for new born babies receiving open heart surgery, the period of fasting after the operation should be minimized and tube feeding should be started as soon as possible.

Case report of Kimura's disease Treated by Radical resection and Post Operative Steroid therapy (기무라 병 환자에서 수술적 치료 및 술 후 스테로이드 병합요법의 치험2례)

  • Kim, Jeong Tae;Kim, Kee woong;Lee, Kyoung mook;Kim, Youn Hwan
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.229-232
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    • 2009
  • Purpose: Kimura's disease is a relatively rare head and neck tumor that frequently occurs in young orientals accompanied with eosinophila. We shared our experience of two cases of Kimura's disease, treated by radical resection and post operative steroid therapy, so we report the correlation of eosinophil counts and disease progression. Methods: A 25 years old male came to the clinic with a mass localized to the right cheek inferior to the right auricle. We could not resect the mass totally. During the follow up period, we checked the eosinophil counts, and steroid therapy was started 7 months after the surgery. A 34 year old female came to the clinic with a mass localized inferior to the left auricle reaching from the posterior portion of the auricle to the left temporal portion. We tried to remove as much tumor as possible, save the temporal region, in regard to the impairment of blood supply to the auricle. After operation, steroid therapy was started. Results: In the first case, the tumor was easily approachable, and radical resection of the tumor with post operative steroid therapy was an effective treatment. In tumors located at difficult regions to remove, as in the second case, optimal debulking and post operative steroid therapy was also effective in treating Kimura's. There were no recurrences in both cases. Eosinophil counts were always reduced after surgery and steroid therapy, and during the period with low eosinophil counts, there was no recurrence of Kimura's disease. Conclusion: Surgery and post operative steroid therapy were effective in treatment of Kimura's disease, and we could assume eosinophil counts as a good indicator for evaluation of the prognosis of Kimura's disease during the follow up period.

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.

Patient-Controlled Analgesia (PCA) for Post-operative Patients - A Study on Differences according to Who Controls the Analgesic (수술환자의 자가통증조절기 사용 방법에 관한 조사 연구)

  • Lee, Yoon-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.3
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    • pp.315-322
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    • 2007
  • Purpose: The purpose of this study was to examine the effect of three kinds of modes using bolus button of PCA on level of pain and side effects of analgesic and amount of drug consumption in post-operative patients according to whether the medication is controlled by the patient, the caregiver or the nurse. Method: The participants were 684 patients using PCA after an operation. The data collection period was from March 19 to April 6, 2007. Results: It was found that there were statistical differences in gender, age, type of surgery, pain on first post-operative day, amount of drug consumption, nausea, and vomiting. The ratio for patient controlled medication was 55.7% for women, and 70.5% for men, and for care-giver controlled medication, 35.1% for women, and 20.0% for men. Average pain scores for the first post-operative day were $3.9{\pm}2.2$ for patient controlled medication and $4.5{\pm}2.3$ for care-giver controlled medication. There were statistical differences according to mode used for PCA for amount of drug consumptions, nausea and vomiting but not for pain, operation day or pruritus. Conclusion: This study was carried out to examine risks according to who controls the PCA for post-operative patients. The results can help to develop education program for everyone who is involved in PCA, patients, caregivers, nurses and doctors.

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Observation between Clinical Outcomes and the Size of the Syrinx with Magnetic Resonance Image

  • Hwang, Ju-Yeon;Kim, Young-Jin;Oh, Seong-Hoon;Kang, Jae-Kyu;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.169-174
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    • 2006
  • Objective : This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging[MRI] and symptom duration. Methods : The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records. pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. Results : Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. Conclusion : Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.

Improvement of Parent and Family Satisfaction by Offering Informational Interventions throughout Surgery (수술 중 정보제공을 통한 환자 부모 및 가족의 만족도 증진)

  • Hong, Hee Jung;Lee, Myoung Ae
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.90-104
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    • 2000
  • Background : This study was designed to assess the effects of information on the satisfaction of parents and families whose children underwent elective surgery in the Pediatric Operating Room. Methods : We measured parent and family satisfaction with information given before and after offering informational interventions. The data were collected from 510 patients parents and families whose children had undergone elective surgery in the Pediatric Operating Room of Seoul National University Hospital in Seoul. South Korea. The data collection ran from May 3. 1999 to May 30. 1999 and from September 6, 1999 to September 30, 1999. The research instrument consisted of four categories (pre-operative period, intra-operative period, post-operative period, others) and 24 questionnaires. SPSS was used to analyze the data. Results : The major findings of this study are summarized as follows: 1. Before surgery, the satisfaction with the following was increased: the explanations of the necessary preparation for the surgery (6.0%), the time the patient would enter the operating room (20.6%), the operative procedure (2.0%), and the use of the waiting room (10.0%). 2. During the operation, the satisfaction with the situation board (15.1%), public announcements in the waiting room (8.4%), and the answering of the families questions (12.2%) was increased. however, the satisfaction with the surgeons explanations of the surgical outcomes decreased by 8.3%, even though the frequency of these explanations increased by 5%. 3. After surgery, the satisfaction with the following was increased: the explanations of patient's status of recovery(10.3%) the time the patient would be moved from the recovery room (17.6%), how the patient would be transferred to the ward (19.2%), and post-operative care (6.3%). Conclusion : Based upon the above findings, we concluded that pre-, intra-, and post-operative informational interventions were effective in increasing the satisfaction of the parents and families of children undergoing elective surgery.

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Spouse Support, Sexual Satisfaction and Marital Intimacy of Post-mastectomy Patients (유방절제술 환자의 배우자 지지, 성생활 만족도 및 부부 친밀도)

  • Yoo Yang Sook;Cho Ok Hee
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.148-156
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    • 2001
  • Data were collected using questionnare to 102 post-mastectomy patients visiting the out-patient department at Catholic University St. Mary Hospital and Kang Nam St. Mary Hospital from October, 1998 to January, 1999 in order to provide the basic data for development of nursing intervention which can help patients' emotional and sexual adaptation to treatment outcome as well as increase quality of life by studying spouse support, sexual satisfaction and marital intimacy of patients. Spouse support and sexual satisfaction were measured with the tool developed by Soon-bok Jang (1989). Marital intimacy was measured with the tool developed by Waring (1984) and improved by Sook-nam Kim (1998). Data were analyzed using t-test, ANOVA, multiple comparison by Duncan. Pearson correlation coefficients, and stepwise multiple regression. The results were as follows ; 1. Spouse support in the group of 6 month or less post-operative period was higher than that of 13 to 36 month period. 2. Sexual satisfaction in the group college graduation or above was higher than that of high school and middle school graduation. 3. Marital intimacy in the group of 61 month or above post-operative period was higher than that of 6 month or less and 13 to 36 month period. 4. The higher spouse support results in the higher sexual satisfaction and the higher marital intimacy according to a positive correlation. 5. The main effective variable on marital intimacy was spouse support. and the effectiveness showed $31.09\%$, while it was $43.06\%$ including sexual satisfaction and post-operative period.

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Influences of Perceived Treatment Effect and Perceived Physical Suffering on Hope of Cancer Patients in Post-operative Period (치료 효과 감지정도와 신체적 고통 감지정도가 수술직후 암환자의 희망에 미치는 영향)

  • Ahn, Seong-Yoon;Kim, Dal-Sook
    • Korean Journal of Adult Nursing
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    • v.15 no.1
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    • pp.78-87
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    • 2003
  • Purpose: The purposes of the study were 1) to examine what relationships exist between PTE(perceived treatments effect) and PPS (perceived physical suffering) as the independent variables and hope as the dependent variable and 2) to examine whether PTE and PPS predict hope in cancer patients in their post-operative period within the Stotland's hope theory. Method: The Visual Analog Scale was used for measuring PTE and PPS and the Kim & Lee's Hope Scale which had acceptable reliability and validity was used for measuring hope. The data was collected from 38 hospitalized cancer patients who were in the post-operative period with a convenient sampling method. Result: There was a significant positive relationship between hope and the PTE in the low PTE group. There was a significant negative relationship between hope and the PPS in the low PPS group. There were no significant relationships between hope and the PTE in the high PTE group, and between hope and the PPS in the high PPS group. And the PTE explained hope with 71.2% of the variance in the low PTE group. Conclusion: PTE in the low PTE group and PPS in the low PPS group were identified as the factors to explain hope.

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Differentiation of Recurrent Rectal Cancer and Postoperative Fibrosis: Preliminary Report by Proton MR Spectroscopy (재발성 직장암과 수술 후 섬유화의 감별 진단: 수소 MRS에 의한 예비보고)

  • Jeon Yong Sun;Cho Soon Gu;Choi Sun Keun;Kim Won Hong;Kim Mi Young;Suh Chang Hae
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.24-31
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    • 2004
  • Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

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CONSIDERABLE FACTORS FOR FINAL OCCLUSION IN PRE-ORTHODONTIC LOWER ANTERIOR SEGMENTAL SURGERY AND ITS AVAILABILITY (교정전 하악전치부 분절골절단술 시행시 고려사항 및 그 유용성)

  • Lee, Baek-Soo;Choi, Hyun-Jung;Nam, Kwang-Ho;Ryu, Dong-Mok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.1
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    • pp.43-47
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    • 2003
  • Anterior set back segmental surgery has been used for shortening the period of orthodontic treatment in case of bimaxillary or maxillary protrusion. In most cases, it requires pre-operative orthodontic treatment. Through properly performed leveling and tooth aligning, the operative porcedure can be easier and post-operative occlusal stability can be increased. But it takes time for orthodontic treatment. Recently, we have been using anterior segmental surgery before orthodontic treatment and have reliable results from that. Therefore, we have to consider arch shape, curve of Spee, tooth selection to be extracted for obtaining of post-operative occlusal stability without pre-operative orthodontic treatment.