• Title/Summary/Keyword: Post-operative

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THE EFFECT OF PRE-OPERATIVE MAXILLARY OCCLUSAL PLANE ANGLE TO POST-OPERATIVE SKELETAL STABILITY AFTER TWO-JAW SURGERY (수술 전 상악 교합평면각이 상하악 동시 수술 후 골격 안정성에 미치는 영향)

  • Choi, Youn-Mo;Ryu, Dong-Mok;Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.141-147
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    • 2007
  • The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

Impact of Peri-Operative Anemia and Blood Transfusions in Patients with Gastric Cancer Receiving Gastrectomy

  • Chang, Chih-Chun;Sun, Jen-Tang;Chen, Jing-Yuan;Chen, Yi-Ting;Li, Pei-Yu;Lee, Tai-Chen;Su, Ming-Jang;Wu, Jiann-Ming;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1427-1431
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    • 2016
  • Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.

THE CHANGES OF MANDIBULAR MOVEMENT AND MUSCLE ACTIVITY FOLLOWING ORTHOGNATHIC SURGERY IN PATIENTS WITH MANDIBULAR PROGNATHISM (골격성 III급 부정 교합을 동반한 악교정수술 환자에서 수술 전후의 하악기능 변화에 관한 실험적 연구)

  • Lee, Hyung Sik;Park, Young Chel
    • The korean journal of orthodontics
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    • v.22 no.1
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    • pp.67-88
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    • 1992
  • The purpose of this study was to investigate the changes of mandibular movement and muscle activity following orthognathic surgery in patients with mandibular prognathism. Lateral cephalogram, M.K.G., E.M.G. recordings were obtained immediately before surgery, and 2 months and 8 months after surgery. Among the patients who received orthognathic surgery, 19(13 men, 6 women) were selected for this study. Statistical analysis for each time interval differences were performed with the SPSS package. The results were as follows: 1. Compared with the pre-operative group (opening 349.7mm/sec, closing 313.1mm/sec), the mean values of the maximum opening and closing velocity in the skeletal Class III surgery group were significantly decreased in the 2 months post-operative (opening 232.9mm/sec, closing 206.9mm/sec), but the values tended to increase in the 8 months post-operative group (opening 280.9 mm/sec, closing 319.1mm/sec). 2. Compared with the pre-operative group (61.7 mm/sec), the maximum velocity of the terminal tooth contact increased in the 2 months (72mm/sec) and 8 months (105.7mm/sec) postoperative groups. 3. In the mean value of vertical freeway space, there was significant difference between the normal group and the pre-operative group, but not between the normal group and the 8 months post-operative group. 4. In the mean values of the maximum opening, the maximum anterio-posterior movement from centric-occlusion, and the lateral deviation from centric occlusion, there was no significant difference between the normal group and the surgery group (the pre-operative and the 8 months post-operative groups). 5. The mature swallowing pattern was 58% in the pre-operative group, but 90% in the 2 months post-operative group, and 63% in the 8 months post-operative group. 6. In the comparison of muscle activity, there was no significant difference between the normal group and the surgery group during the rest position. However, during cotton roll clenching, there was significant difference between the normal group and the pre-operative group, but not between the normal group and the 8 months post-operative group.

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THE EVALUATION OF REPRODUCIBILITY OF OPERATION PLAN WITH THE COMPARISON BETWEEN STO AND POST-OPERATIVE JAW POSITION IN ORTHOGNATHIC SURGERY (악교정 수술에서 STO와 술 후 악골위치 비교를 통한 이동량 재현성에 대한 평가)

  • Kwon, Seok-Woo;Jee, Yu-Jin;Lee, Baek-Soo;Lee, Deok-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.6
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    • pp.628-634
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    • 2008
  • The purpose of this study is to examine reproducibility of operation plan and 3-dimentional jaw movement patterns by comparing jaw position of STO with post-operative jaw position. Twenty patients with class III dental and skeletal malocclusion who were treated with Le-Fort I osteotomy and B-SSRO were reviewed. Lateral cephalometric radiographs were taken within two weeks before operation and two days after operation. Cephalometric radiographs were compared and analyzed with orthognathic computer program '$V-Ceph^{TM}$'. Post-operative maxillary advancement was insufficient compared to maxillary advancement through STO. Post-operative setback movement was over compared to mandibular setback movement through STO. But statistically this is not significant. Maxillary vertical location is insignificant on the whole. Especially post-operative maxillary clockwise rotation is significant compared to maxillary rotation through STO. Post-operative maxillary clockwise rotation tendency is generally observed in all patients. So surgeons and staffs must consider this tendency when operation plan is established ans operation is being performed. Using intra or extra oral marking points, face bow, and bite plate will make exact surgery possible.

Effect of a simulation-based program for post-operative care of emergency patients (응급환자의 수술 후 관리를 위한 시뮬레이션기반 교육프로그램의 효과)

  • Chae, Min-Jeong;Choi, Soon-Hee;Kim, Jeoung-Suk
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.3
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    • pp.91-104
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    • 2014
  • Purpose: This study aimed to confirm the effects of a simulation-based program on knowledge and clinical performance in the post-operative management of emergency patients. Methods: This was a pre- and post-research design with a nonequivalent control group and randomly sampled 29 experimental and control groups, respectively from nursing department juniors for 4 weeks from September of 2014. The experimental group received lectures, team study, team simulation, and debriefing in post-operative management of simulation-based emergency patients and control group conducted in the traditional lecture-type setting. Educational learning effects were measured by using the knowledge and clinical performance measurement tools of 15 and 20 items, respectively. Data were analyzed by using the SPSS program, including frequency, ratio, and results from the Chi-square test, Fisher's exact test, Kolmogorov-Smirnov test, t-test. Results: Our research results indicate that, the experimental group showed significantly higher knowledge and clinical performance score compared with the control group. Conclusion: We confirmed that education on post-operative management of simulation-based emergency patients was an effective educational method to improve the knowledge and clinical performance of nursing students.

Isokinetic Evaluation of Trunk Flexors and Trunk Extensors in Normal Adult Subjects and Patients with Post-operative Herniated Intervertebral Lumbar Disc (정상 성인남자와 요추간판탈출증 수술후 성인남자의 요추부 굴곡근 및 신전근의 등속성 근력평가)

  • Oh Seung-Kil
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.81-98
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    • 1998
  • Isokinetic evaluation of trunk flexors and trunk extensors was performed at $60^{\circ}/sec\;and\;120^{\circ}/sec$ of angular velocity by using cybex 6000TEF Unit on 31 healthy male white workers and 15 post-operative HILD patients with no significant difference in mean age and mean body weight between two groups, and compared each other. The purpose of this study is to obtain the isokinetic normative strength values and endurance latins for Dunk extensors and trunk flexors, and is to provide a guideline for rehabilitation program of post-operative HILD patients. The collected data were analyzed by ANOVA, Duncan's Nyktuoke Range Test, and Pearson correlation coefficiency in PC-SAS program, The results obtained were as follow ; 1. Post-operative subjects has lower isokinetic values than normal subjects in peak torque, peak torque $\%$ by body weight, total work, total work $\%$ by body weight, average power, average power $\%$ by body weight, TAAE of trunk flexors and trunk extensors, and there are significant differences with statistic value in trunk extensors at $60^{\circ}/sec$ and in trunk flexors and trunk extensors at $120^{\circ}/sec$ between two groups(p<0.05). 2. Pest-ooperative subjects has lower values for angle of peak torque than normal subjects in trunk extensors, and there are significant differences with statistic value at $60^{\circ}/sec$ and $120^{\circ}/sec$ between two groups. 3. Post-operative subjects has higher values for endurance ratios than normal subjects in trunk extensors and flexors, but there are no significant differences with statistic value between two groups. 4. Post-operative subjects has higher values than normal subjects in peak torque ratios, total work ratios, average power ratios of trunk flexors to trunk extensors, and there are significant differences with statistic value between two groups(p<0.01). 5. There is significant positive-correlation with statistic valve between peak torque and height and body weight in normal subjects(p<0.05), but Thjere is significant negative-correlation between peak torque of trunk extensor at $120^{\circ}/sec$ and age (p<0.05). 6. There is significant positive-correlation with statistic value between peak torque of trunk flexors and body weight in post-operative subjects (p<0.05), but There is significant negative-correlation between peak torque of trunk extensor add age (p<0.05). In conclusion, post-operative subjects have greater weakness in trunk musculature than normal subjects, especially there is more significant weakness in trunk extensors than in trunk flexors

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Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

  • Prasetyono, Theddeus O.H.;Koswara, Astrid Felicia
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.164-172
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    • 2015
  • Background The use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet. Methods This retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test. Results Of the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05). Conclusions The one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.

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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Clinical Analysis of Anterior Lumbar Interbody Fusion for Failed Back Surgery Syndrome (Failed Back Surgery Syndrome에서 전방 요추체간 유합술의 치료성적분석)

  • Kim, Young Soo;Kuh, Sung Uk;Cho, Young Eun;Jin, Byung Ho;Chin, Dong Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.734-742
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    • 2001
  • Objective : To evaluate the role of anterior lumbar interbody fusion in treatment of failed back surgery syndrome, the authors retrospectively analyzed the result of anterior lumbar interbody fusion performed in our institute. Methods : Fifteen FBSS patients due to variable causes have been treated with anterior lumbar interbody fusion in our institute from April 1994 to June 1999. We analyzed clinical changes in 15 patients who were followed up for an average of 23 months. Results : The etiologies of FBSS were post operative discitis(6 cases), post operative instability(3 cases), post operative adhesion(5 cases), and recurrence(1 case). These fifteen FBSS patients were treated with anterior lumbar interbody fusion. The overall treatment outcome was satisfactory(excellent and good) in 11 cases. Three patients were slightly improved, but post operative low back pain was remained. One patient who had underwent nerve root injury due to pedicle screw insertion showed no improvement. Conclusion : We conclude that the anterior lumbar interbody fusion for FBSS seems to be safe and favorable treatment in selective patients, because low incidence of nerve injury risk and post-operative infection.

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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.