• Title/Summary/Keyword: Postoperative treatment

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Pain Occurrence after Partial Pulpotomy by using Endocem MTA and ProRoot MTA: a Clinical Study (Endocem MTA와 ProRoot MTA를 이용한 부분치수절단술 후 통증 발생에 관한 임상 연구)

  • Kwak, Sang Won;Kim, Hyeon-Cheol
    • The Journal of the Korean dental association
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    • v.57 no.1
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    • pp.18-25
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    • 2018
  • Objectives: This study aimed to compare the postoperative pain and clinical performance after partial pulpotomy by using ProRoot MTA and Endocem MTA. Materials and Methods: Twenty-eight teeth requiring partial pulpotomy due to deep dental caries or traumatic injury were included in this study. After 2mm removal of exposed pulp and bleeding control, the ProRoot MTA or Endocem MTA was randomly adjusted to the exposed site. 1, 2, 4, and 12 weeks after the final restoration, the patients were recalled to check the postoperative pain or another unfavorable signs. Pearson's chi-square test was used for statistical analysis to evaluate any differences among tested materials. Results: 3 of 28 teeth showed postoperative pain and cold positive during follow-up period (10.7%). There were no statistically differences in pain occurrence between two tested materials (P > 0.05). Conclusions: In the limitations of this study, partial pulpotomy by using Endocem MTA showed the advantages of short setting time and lower postoperative pain incidence, allowing one visit treatment.

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Total Ankle Arthroplasty Management and Rehabilitation (족관절 인공관절 치환술 후 관리 및 재활)

  • Lee, Kwang-Bok
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.3
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    • pp.118-122
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    • 2022
  • Although total ankle arthroplasty (TAA) has increased considerably in the past ten years, reflecting improvements in implant design and survivorship, the clinical outcomes have been less satisfactory than total hip or total knee arthroplasties. Several issues under debate include postoperative management and rehabilitation in TAA. Especially, there is no consensus or evidence for the most appropriate postoperative management and rehabilitation for patients undergoing TAA. This study was therefore undertaken to suggest appropriate postoperative management and rehabilitation in TAA, after reviewing published articles and focusing on the following topics: prehabilitation, hospital stay, immobilization type and duration, weight-bearing management, pharmacological treatment, and adopted rehabilitation protocols. In previous studies, the postoperative management and rehabilitation proposed depended on the surgeon's preference, the patient's characteristics, and the associated surgical procedures performed after TAA. Nonetheless, our research indicates the best approach is to include a prehabilitation program, immobilization in the early postoperative stage (2~4 weeks), range of motion exercise with partial weight-bearing ambulation, followed by full weight-bearing ambulation after six weeks. Further studies are required to develop a standardized rehabilitation protocol and improve the overall quality of care after TAA.

Sequential Changes of Plasma C-Reactive Protein, Erythrocyte Sedimentation Rate and White Blood Cell Count in Spine Surgery : Comparison between Lumbar Open Discectomy and Posterior Lumbar Interbody Fusion

  • Choi, Man Kyu;Kim, Sung Bum;Kim, Kee D.;Ament, Jared D.
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.218-223
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    • 2014
  • Objective : C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often utilized to evaluate for postoperative infection. Abnormal values may be detected after surgery even in case of non-infection because of muscle injury, transfusion, which disturbed prompt perioperative management. The purpose of this study was to evaluate and compare the perioperative CRP, ESR, and white blood cell (WBC) counts after spine surgery, which was proved to be non-infection. Methods : Twenty patients of lumbar open discectomy (LOD) and 20 patients of posterior lumbar interbody fusion (PLIF) were enrolled in this study. Preoperative and postoperative prophylactic antibiotics were administered routinely for 7 days. Blood samples were obtained one day before surgery and postoperative day (POD) 1, POD3, and POD7. Using repeated measures ANOVA, changes in effect measures over time and between groups over time were assessed. All data analysis was conducted using SAS v.9.1. Results : Changes in CRP, within treatment groups over time and between treatment groups over time were both statistically significant F(3,120)=5.05, p=0.003 and F(1,39)=7.46, p=0.01, respectively. Most dramatic changes were decreases in the LOD group on POD3 and POD7. Changes in ESR, within treatment groups over time and between treatment groups over time were also found to be statistically significant, F(3,120)=6.67, p=0.0003 and F(1,39)=3.99, p=0.01, respectively. Changes in WBC values also were be statistically significant within groups over time, F(3,120)=40.52, p<0.001, however, no significant difference was found in between groups WBC levels over time, F(1,39)=0.02, p=0.89. Conclusion : We found that, dramatic decrease of CRP was detected on POD3 and POD7 in LOD group of non-infection and dramatic increase of ESR on POD3 and POD7 in PLIF group of non-infection. We also assumed that CRP would be more effective and sensitive parameter especially in LOD than PLIF for early detection of infectious complications. Awareness of the typical pattern of CRP, ESR, and WBC may help to evaluate the early postoperative course.

The Effect of Treatment with Intrathecal Ginsenosides in a Rat Model of Postoperative Pain (백서를 이용한 수술 후 통증 유발 모형에서 척수강 내로 투여한 Ginsenosides의 효과)

  • Shin, Dong Jin;Yoon, Myung Ha;Lee, Hyung Gon;Kim, Woong Mo;Park, Byung Yun;Kim, Yeo Ok;Huang, Lan Ji;Cui, Jin Hua
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.100-105
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    • 2007
  • Background: Ginseng has been used to manage various types of pain in folk medicine. This study characterized the effect of treatment with intrathecal ginsenosides, the active components of ginseng in a postoperative pain model. Methods: Male Sprague-Dawley rats were implanted with lumbar intrathecal catheters. An incision was made in the plantar surface of the hindpaw. Withdrawal thresholds following the application of a von Frey filament to the wound site were measured. To determine the role of the opioid or GABA receptors following treatment with the ginsenosides, naloxone, bicuculline (a $GABA_A$ receptor antagonist), and saclofen (a $GABA_B$ receptor antagonist) were administered intrathecally 10 min before the delivery of the ginsenosides and the changes of the withdrawal thresholds after application of the von Frey filament were Observed. Results: Treatment with the intrathecal ginsenosides increased the withdrawal threshold in a dose dependent manner. Pre-treatment with intrathecal naloxone reversed the antinociceptive effect of the ginsenosides. However, pre-treatment with intrathecal bicuculline and saclofen failed to have an effect on the activity of the ginsenosides. Conclusions: These results suggest that ginsenosides are effective to alleviate the postoperative pain evoked by paw incision. The opioid receptor, but not GABA receptors, may be involved in the antinociceptive action of the ginsenosides at the spinal level.

Surgical Management of Edentulous Atrophic Mandible Fractures in the Elderly

  • Chee, Nam Seok;Park, Seong June;Son, Min Ho;Lee, Eoy Jung;Lee, Soo Woon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.5
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    • pp.207-213
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    • 2014
  • Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

Pectoralis Major-Rectus Abdominis Bipedicle Muscle Flap in Treatment of Postoperative Mediastinitis (개흉술 후 발생한 종격동염의 대흉근-복직근 양경근피판을 이용한 치료)

  • Kim, Bom Jin;Lee, Won Jai;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.421-427
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    • 2005
  • Although the incidence of mediastinal wound infection in patient undergoing median sternotomy for cardiovascular surgery is relatively low(less than 1%), it is not only a devastating and potentially life-threatening complication but also associated morbidity, mortality and cost are unacceptably high. During the past few decades various methods had been applied for the treatment of postoperative mediastinitis. Currently, chest wall reconstruction by using muscle flaps-especially pectoralis major muscle and rectus abdominis muscle are commonly selected for the reconstruction after wide debridement has become widely accepted. We performed bilateral pectoralis major-rectus abdominis muscles in-continuity bipedicle flap to overcome the limit of each flap for reconstruction of sternal defects in 17 patients. We analyzed the results of the surgery. Recurrent infection developed in 17.6% of cases and abdominal herniation was observed in one patient. There was no postoperative hematoma or death. We conclude that this flap is very valuable in reconstruction of the anterior chest wall defect caused by post-sternotomy infection because it provides sufficient volume to fill the entire mediastinum, and the complication rate compares favorably to that of other methods.

Treatment for Brachymetatarsia by Callotasis (가골 신연술을 이용한 단중족증의 치료)

  • Park, Yong-Wook;Yoo, Jung-Han;Park, Hong-Jun;Cho, Yang-Bum;Yu, Sun-O;Kim, Wan-Hong
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.73-79
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    • 2002
  • Purpose: To evaluate the effectiveness of callotasis using the external fixator for the treatment of brachymetatarsia. Materials and Methods: Eleven patients(15 cases) who underwent callotasis were available. Follow-up averaged 23 months(15-38 months). Both the patients' postoperative satisfaction and the postoperative radiographic results were retrospectively evaluated. Results: The duration from applying the external fixator to remove averaged 15 weeks (8-21 weeks). We did osteotomy again in two cases because of early consolidation at the osteotomy site during distraction period. All cases were evaluated mild claw toe deformity and motional pain in metatarsophalangeal joint, but all patients satisfied the postoperative results except one complained motional pain and stiffness in metatarsophalangeal joint. The metatarsal shortening averaged 13mm(9-18mm) before operation. The amount of distraction for shortened metatarsals averaged 15mm(5-22mm). We found the 6 cases of narrowing of the metatarsophalangeal joint, 2 cases of subluxation of the metatarsophalangeal joint. Conclusion: We think that callotasis with external fixator is good operative method for the brachymetatarsia.

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Effects of Head and Neck Massage on Anxiety, Pain, and Discomfort in Hysterectomy Patients (두경부 마사지가 자궁적출술 환자의 불안, 통증 및 불편감에 미치는 효과)

  • Kim, Eun-Young;Choi, Euy-Soon
    • Women's Health Nursing
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    • v.16 no.1
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    • pp.60-68
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    • 2010
  • Purpose: This study determined the effect of head and neck massage on anxiety, pain, and discomfort for hysterectomy patients. Methods: Subjects consisted of 48 hysterectomy patients at K hospital. Experimental group (n=23) received head and neck massage at 8 minutes per massage for five times: (at admission, before sleeping on preoperative day, at 4 hours after operation, before sleeping on operation day, before sleeping on the first postoperative day). Control group (n=25) received conventional treatment. As an effectiveness of this intervention, state of anxiety and BP was measured before sleeping on preoperative day. Pain and discomfort were measured before sleeping on the day of surgery and then on the first postoperative day. Data was analyzed descriptive statistics using $x^2$ test, Fisher's exact test, paired t-test, unpaired t-test, repeated measures ANOVA and Bonferroni multiple comparison. Results: 1. State of anxiety score and BP at post-treatment decreased significantly in the experimental group. 2. Pain score in experimental group was lower than that in control group, with no significant difference; whereas, 3. Discomfort level decreased significantly in the experimental group. Conclusion: Results indicate that head and neck massage could be an effective intervention for reducing preoperative anxiety and postoperative discomfort in hysterectomy patients.

Treatment of Epidural-Morphine-Induced Pruritus: Propofol Versus Naloxone (경막외 Morphie 투여시 생기는 소양증에 대한 Propofol과 Naloxone의 효과 비교)

  • Park, Chung-Hyun;Jung, Hyun-Jung
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.208-213
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    • 1997
  • Background: Pruritus is the most frequent undesirable symptom associated with epidural morphine. It is unpleasant and often difficult to treat. Naloxone is presently the drug of first choice for treating this symptom. Naloxone however decrease the pain threshold in some cases. Recently it was reported subhypnotic doses of propofol were efficient in relieving epidural-morphine-induced pruritus(EMIP). In a prospective. randomized, double-blinded clinical trial, we compared the efficacy of propofol and naloxone for treatment of EMIP. Methods: Forty patients with EMIP were allocated to receive either 20 mg propofol, or 1.5 ${\mu}g/kg$ naloxone intravenously. Pruritus and level of postoperative pain were assessed after 5 min, using pruritus rating scale and visual analogue scale. Results: The overall success rate in treating pruritus was similar in both groups (propofol 70% vs naloxone 65%). Twenty-five percent of the patients in the naloxone group had an increase in the level of postoperative pain versus none in the propofol group(P=0.018). Conclusions: These results suggest propofol and naloxone are equally effective in treating EMIP. However, the level of postoperative pain is significantly reduced when treated with propofol.

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Complex Korean Medicine Therapy for Hypoestrogenic Side Effects of Gonadotropin Releasing Hormone Agonist Administration to Postoperative Endometriosis Patient: A Case Report (자궁내막증 수술 후 GnRH-agonist 투여 중인 환자의 저에스트로겐 부작용에 대한 복합 한의 치료: 증례보고)

  • Park, Hye-Rin;Jo, Hee-Geun;Jo, Hyun-Jeong;Choi, Ji-Hyun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.188-196
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    • 2018
  • Objectives: This study is to report the clinical effectiveness of the complex Korean medicine therapy on a postoperative endometriosis patient's hypoestrogenic side effects who is treated with GnRH-agonist injection. Methods: The patient in this case was diagnosed with endometriosis and has been treated with GnRH-a injection after laparoscopic operation. The patient complained hot flash and sweating mainly after GnRH-a treatment. The patient received complex Korean medicine therapy during 10 days admission period. The clinical effects were evaluated through KI (Kupperman's Index) and SF-36 (36 item Short Form Health Survey). Results: After the complex Korean medicine therapy, the various clinical symptoms including hot flash and sweating were improved. Also, the quality of life was enhanced. Conclusions: This case report shows that the complex Korean medicine therapy was effective for treating hypoestrogenic side effects occurred after GnRH-a treatment in postoperative endometriosis patient.