• Radiation Oncology Journal
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• 제35권1호
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• pp.65-70
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• 2017

Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ${\leq}2cm$) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. Results: The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Conclusion: Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권1호
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• pp.19-25
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• 2015

Objectives: Quality of life (QoL) studies provide information about the impact of disease, the treatment of symptoms, and outcomes following treatment. The present study aims to evaluate the postoperative QoL of patients treated for oral cancer in a Nigerian government tertiary hospital. Materials and Methods: A prospective study on consenting patients with oral cancer was undertaken at Aminu Kano Teaching Hospital, Kano, Nigeria. The subjects completed the University of Washington QoL (UW-QoL) questionnaire one day prior to surgery and postoperatively after 7 days, 1 month, 3 months, and 6 months. Results: Sixty-eight patients with oral cancer were recruited. Of these, 38 were males, and 30 were females (male : female, 1.3 : 1). Twenty-four patients (12 males and 12 females) underwent surgery and completed postoperative QoL assessment using the UW-QoL questionnaire. Preoperative QoL mean score was 2.21, while postoperative mean scores after 1 week, 1 month, 3 months, and 6 months were 3.67, 3.46, 2.82, and 2.61, respectively. Conclusion: An improvement in QoL following surgical treatment for patients with oral cancer was observed. 'Appearance,' 'recreation,' and 'chewing' were identified as the most important determinants of postoperative QoL in patients with oral cancer in our study.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.516-518
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• 2011

Purpose: The prevalence of antibiotic-resistant Streptococcus pneumoniae meningitis has increased worldwide. There are some reports about postoperative antibiotic-resistant Streptococcus pneumoniae infection after craniofacial surgery, but, there is no report in Korea. We present a report on the treatment of postoperative multidrug-resistant Streptococcus pneumoniae (MRSP) meningitis and sepsis after craniofacial surgery based on our experience. Methods: The patient was a 7-year-old boy with Crouzon's disease who was treated by fronto-orbital bar advancement. Intraoperatively, frontal sinus opening was seen during osteotomy which was covered with forehead galeopericranial flap. MRSP meningitis was diagnosed after the surgery, he was treated with intravenous vancomycin, meropenem, and levofloxacin. Results: The patient was treated successfully after 3 weeks of intravenous antibiotics treatment. During the 8 month follow-up period, there was no neurologic sequelae. Conclusion: Postoperative infection after craniofacial surgery is an important phenomenon that needs immediate recognition. Prevention, early diagnosis, and treatment immediate after onset are important as countermeasures against postoperative drug-resistant bacterial infection. To prevent adverse outcome and reoperation, proper antibiotics treatment should be performed.

• 치과방사선
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• 제28권2호
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• pp.363-385
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• 1998

In orthodontics and orthognathic surgery. cephalogram has been routine practice in diagnosis and treatment evaluation of craniofacial deformity. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. Therefore, it is desirable that three dimensional object is diagnosed and evaluated three dimensionally and three dimensional CT image is best for three dimensional analysis. Development of clinic necessitates evaluation of result of treatment and comparison before and after surgery. It is desirable that patient that was diagnosed and planned by three dimensional computed tomography before surgery is evaluated by three dimensional computed tomography after surgery. too. But Because there is no standardized normal values in three dimension now and three dimensional Computed Tomography needs expensive equipments and because of its expenses and amount of exposure to radiation. limitations still remain to be solved in its application to routine practice. If postoperative three dimensional image is constructed by pre and postoperative lateral and postero-anterior cephalograms and preoperative three dimensional computed tomogram. pre and postoperative image will be compared and evaluated three dimensionally without three dimensional computed tomography after surgery and that will contribute to standardize normal values in three dimension. This study introduced new method that computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. and for validation of new method. in four cases of dry skull that position of mandible was displaced and four patients of orthognathic surgery. computer-simulated three dimensional image and actual postoperative three dimensional image were compared. The results were as follows. 1. In four cases of dry skull that position of mandible was displaced. range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -1.8 mm to 1.8 mm and 94％ in displacement of all co-ordinates values was from -1.0 mm to 1.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). 2. In four cases of orthognathic surgery patients, range of displacement between computer­simulated three dimensional images and actual postoperative three dimensional images in coordinates values was from -6.7 mm to 7.7 mm and 90％ in displacement of all co-ordinates values was from -4.0 to 4.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). Conclusively. computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. Therefore. potentiality that can construct postoperative three dimensional image without three dimensional computed tomography after surgery was presented.

• Journal of Periodontal and Implant Science
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• 제40권3호
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• pp.144-149
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• 2010

Purpose: The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. Methods: In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. Results: No further complications occurred after sinus re-augmentation. The dental implants placed in the re-augmented sinus were clinically osseointegrated, and the implant-supported restorations in the two cases of postoperative infection have been functioning very well for over 2 years. Conclusions: In the case of infection of the grafted sinuses, it is necessary to completely remove the graft materials and then administer a high dose of antibiotics to treat the acute infection, after which sinus re-augmentation is suggested.

• Journal of Korean Neurosurgical Society
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• 제39권6호
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• pp.419-422
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• 2006

Objective : Endotracheal tube cuff-pressure[ETCP] increases significantly during anterior cervical spine surgery with neck retraction. Clinically, postoperative hoarseness with sore throat is correlated with vocal cord edema due to longer intubation time and higher ETCP during neck retraction. Methods : Fifty patients of anterior cervical spine surgery were randomized to a control [no adjustment, 25 cases] and a treatment group [ETCP adjusted to 20mmHg, 25 cases]. Patients were blinded to their group assignments. They were questioned about the presence of ischemic symptoms [sore throat, dysphagia, hoarseness] postoperatively at different time points; 4 hours, 24 hours, and 1 week postoperatively. Results : No differences between groups at 4 hours and 1 week postoperatively were demonstrated. At 24 hours, 36% of patients in the treatment group complained of sore throat while 56% of control group patients did [p < 0.05]. Female patients correlated with development of all ischemic discomfort [p < 0.05 : sore throat, hoarseness, dysphagia]. Conclusion : Our results suggest that postoperative ischemic symptom following anterior cervical spine surgery may be associated with the two predictors; increased ETCP during neck retraction and female. The simple procedure of maintaining ETCP to 20mmHg can prevent postoperative tracheal ischemic symptom.

• 동의생리병리학회지
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• 제33권4호
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• pp.219-225
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• 2019

The objective of this study is to observe the effectiveness of complex Korean Medicine treatments on pain reduction of patients after meniscal surgery. We analyzed 16 patients who have been diagnosed as Meniscal injury on Magnetic Resonance Imaging(MRI) scan and had admitted to Dunsan Korean Medical hospital from January 30, 2014 to April 30, 2019. The analysis was conducted as retrospective study which analyzes patient's medical records. Statistical analysis was performed using the IBM SPSS statistics 25 program. We used Numeric Rating Scale to evaluate pain reduction, Five-point likert scale to asses treatment satisfaction. The result showed that there were statistically significant pain reduction on the postoperative meniscal injury patients treated with complex Korean Medicine treatments. In conclusion, we found that the complex Korean Medicine treatments showed a positive effect on pain reduction of postoperative meniscal injury patients. Further research is required to confirm the effectiveness of Korean Medicine treatment.

• Clinics in Shoulder and Elbow
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• 제24권4호
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• pp.239-244
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• 2021

Background: Radial neck fracture in children is rare. This study attempted to evaluate the outcome of surgically treated patients and any associated complications. Methods: This study evaluated 23 children under 15 years of age with radial neck fracture who were treated with open reduction between 2006 and 2016 to determine their range of motion, postoperative complications, and radiographic outcomes. The results were assessed clinically using the Mayo clinic elbow performance score. Results: The mean follow-up duration for patients was 34.6 months. The average postoperative angulation was 3.6°. Hypoesthesia was reported in only 9% of patients, and none of the patients complained of postoperative pain. The postoperative X-ray results were excellent in 60% and good in 40%. No radiographic complications were identified. The elbow score was excellent in 87% and good in 13% (mean score, 96.74). There was a statistical relationship between range of motion limitations and age, degree of fracture, initial displacement, and surgical pin removal time. Conclusions: Although most patients accept the closed reduction method as a primary treatment, the present study suggests that an open-reduction approach has been associated with optimal therapeutic outcomes for patients in whom closed reduction was not satisfactory or indicated.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권6호
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• pp.337-346
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• 2023

Background: This study aimed to investigate the effect of local anesthesia (LA) on postoperative pain and hemostasis after dental rehabilitation under general anesthesia (DRGA) in pediatric patients. Methods: A total of 43 patients, aged 3-7 years and rated ASA I or II, who had a definitely negative rating on Frankel's behavior rating scale, were included in this two-arm, parallel-design, single-blinded, randomized, controlled study. The patients were allocated equally into two main groups receiving both restorative treatments and tooth extractions. Two pain scales and one bleeding scale were used. In Group A, the treatment was done with LA, and in Group B, the treatment was done without LA. Results: The statistical analysis revealed no significant differences in the pain scores between the groups. It also revealed significant differences in the bleeding scores between the groups but no significant differences in the duration of bleeding. Conclusion: Within the limitations of this study, the use of LA in pediatric dental patients undergoing DRGA had no effects on postoperative pain reduction or bleeding duration after teeth extraction. We also observed that the use of LA had an impact on the reduction in the bleeding scores in pediatric dental patients undergoing DRGA.

• Journal of Chest Surgery
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• 제28권3호
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• pp.297-302
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• 1995

Video-assisted thoracic surgery [VATS is emerging as a viable alternatives to thoracotomy when surgical treatment of spontaneous pneumothorax is required.Apical blebs and bullaes of the lung can be resected,and pleural abrasion can be accomplished with minimal postoperative pain and a shorter postoperative stay in hospital. We compared our results with thoracoscopic management of spontaneous pneumothorax in 20 patients [group I with a group of 32 patients previously subjected to lateral limited thoracotomy [group II . Indications for operation, sex distribution, and average age [groupI, 24.7 years ; group II, 34.4 years were comparable. Operation time [112.42 54.7 min versus 124.8 35.3 min ; P 0.03 and chest tube duration [64.4 52.3 hours versus 97.7 45.4 hours ; P 0.01 were less in group I. Postoperative hospital stay was less in group I[3.84 0.99 days;P 0.01 , as was the use of parenteral narcotics after 48 hours. [5/20=25% versus25/32=78% . Pain was quantitated by verbal rating scale in postoperative 1 to 3 days. Patients undergoing VATS experienced significantly less postoperative pain. Postoperative complication was less in group I[1/20=5% versus 3/32=8.3% . In conclusion, Video-assisted thoracoscopic management of spontaneous pneumothrax allows performance of the standard surgical procedure while avoiding the thoracotomy incision.Video-assisted thoracic surgery [VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.