• Title/Summary/Keyword: Pre-surgery

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Comparing Pre- and Post-Operative Findings in Patients Who Underwent Laparoscopic Proximal Gastrectomy With a Double-Flap Technique: A Study on High-Resolution Manometry, Impedance pH Monitoring, and Esophagogastroduodenoscopy Findings

  • Hyun Joo Yoo;Jin-Jo Kim
    • Journal of Gastric Cancer
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    • v.24 no.2
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    • pp.137-144
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    • 2024
  • Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.

Effectiveness of Temporomandibular Joint Disorder Follow-Up Using Bone Scans

  • Ku, Jeong-Kui;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of Korean Dental Science
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    • v.8 no.1
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    • pp.1-9
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    • 2015
  • Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods: A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0. Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was $4.29{\pm}0.31$, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the post-treatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion: The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.

Diagnostic Value of Ultrasonography for Acute Tear of Tibiofibular Syndesmosis in Ankle (족관절 원위 경비 인대 결합의 급성 파열에 대한 초음파 검사의 진단적 의의)

  • Lee, Ho-Seung;Park, Soo-Sung;Kim, Ji-Wan;Shin, Myung-Jin;Kim, Sung-Moon;Lee, Sang-Hoon;Lee, Sang-Min
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.1-6
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    • 2004
  • Purpose: We studied the diagnostic value of ultrasonography to confirm the presence of the syndesmosis injuries in the ankle. Materials and Methods: Pre-operative ultrasonography were taken in 42 cases of ankle fractures to determine injury of syndesmosis between February 2000 and August 2003. Tear of syndesmosis was confirmed when they met the following criteria; widening of distal tibiofibular clear space greater than 7 mm on pre-operative AP X-rays, leakage of contrast dye during intra-operative arthrography, and operative findings revealing syndesmosis rupture. We compared these diagnoses with those made by pre-operative ultrasonography. Results: Syndesmosis injuries were confirmed in 23 cases among the total 42 cases. Ultrasonography revealed syndesmosis tear in 25 cases, with 20 cases corresponding with confirmed tear and 5 cases without tear in confirm. Syndesmoses were found to be intact in 17 cases of ultrasonograph, but 3 cases were actually confirmed tear. In ankle ultrasonography, the sensitivity was 90.9%, the specificity was 75.0%. Conclusion: Preoperative ultrasonography is a non-invasive and useful study to determine the syndesmosis injury in ankle fractures.

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Comparison of Renal Function and Clinical Outcomes between Diabetic and Non-diabetic Patients Underwent Off-Pump Coronary Artery Bypass Grafting Surgery

  • Moon, Seong-Min
    • Biomedical Science Letters
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    • v.17 no.4
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    • pp.337-345
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    • 2011
  • It is well recognized that conventional coronary artery bypass grafting (ONCAB) often leads to major organ dysfunction including renal injury. Diabetes mellitus is a major cause of nephropathy and poor clinical outcomes. The aim of this retrospective study was to evaluate the occurrence of adverse outcomes including renal impairment between diabetic (n=75, DM group) and non-diabetic patients (n=72, Non-DM group) underwent off-pump coronary artery bypass grafting surgery (OPCAB). Fasting glucose, hemoglobin A1c, fructosamine, fibrinogen and serum osmolality levels in the DM group were higher than those of the Non-DM group at pre-operative (Pre-OP) period ($P$ <0.05). History of hypertension and renal impairment in the DM group was higher than that of the Non-DM group ($P$ <0.05). Potassium ($K^+$), blood urea nitrogen and creatinine levels were higher, whereas sodium ($Na^+$) and glomerular filtration rate (GFR) levels were lower in the DM group than the Non-DM group at peri-operative period ($P$ <0.05). Fasting glucose levels at Pre-OP period had positive correlations with blood urea nitrogen and creatinine levels at peri-operative period, but negative correlations with GFR levels at peri-operative period in the DM group ($P$ <0.05). Incidences of renal impairment, diuretic therapy or continuous renal replacement therapy and fever in the DM group were higher than those of the Non-DM group at post-operative period ($P$ <0.05). These results suggest that blood glucose level should be tightly controlled at peri-operative period to avoid renal dysfunction in diabetic patients.

Factors influencing of uncertainty on patients with arthroscopic surgery (관절경 수술환자의 불확실성에 미치는 영향요인)

  • Jung, Ji-Young;Kim, Min-Suk;Cho, Yu-Na
    • Journal of the Korea Convergence Society
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    • v.9 no.6
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    • pp.311-319
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    • 2018
  • The purpose of this study was to identify the degree of uncertainty, uncertainty appraisal, and self-efficacy in pre-discharge arthroscopic patients and to investigate the effects of their uncertainty. This study was carried out from April to October 2016 as a descriptive research study. The subjects were presented with pre-discharge convenience sampling after arthroscopic surgery. The data of 131 patients were analyzed by t-test, ANOVA and Scheffe post-test, Pearson correlation coefficient calculation and multiple regression analysis using SPSS 18.0. As the results of this study, education level, presence of spouse, preoperative korean traditional medicine treatment experience and self-efficacy were found to have significant effects on uncertainty. The results of this study suggest that in hospital and pre-discharge education program development to reduce patient uncertainty after arthroscopic surgery.

Radiographic Liver Size Evaluation after Portosystemic Shunts Ligation in 13 Cases

  • Hong, Sung-kyun;Kim, Hye-jin;Lee, Si-heon;Kim, Wan-hee;Kweon, Oh-kyeong;Jung, Joo-hyun;Yoon, Jung-hee;Choi, Min-cheol
    • Journal of Veterinary Clinics
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    • v.34 no.3
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    • pp.189-192
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    • 2017
  • Thirteen dogs were diagnosed as congenital extrahepatic single PSS by intraoperative mesenteric portovenography or computed tomographic examination, repair surgery was performed by using an ameroid constrictor. Hepatic size was measured from the right lateral view using liver length/T11 length ratio. This measurement was performed on follow-up check of PSS ligation patients. Hepatic size parameter of pre-operative PSS patients is $4.13{\pm}0.13$ (range, 3.11-4.83). After surgery, hepatic size parameter of post-operative PSS patients is $4.79{\pm}0.19$ (range, 3.78- 5.93). Although follow-up periods varied 2 and 26 weeks, all patients showed increased liver size compared to that on pre-operative radiographs (P < 0.01). The increase rate was 1.01-1.46 times than those of preoperative radiographs. But in 5 patients, post hepatic liver size was small compared to the others, which showed low increase rate of body weight, total protein, albumin, and glucose level. It was thought that small value of hepatic size parameter was due to delay of hepatic regeneration. In conclusion, radiographic hepatic size parameter of pre- and post-operative patients is considered an effective evaluation for restoring after PSS surgery.

Fabrication of TiO2 Nanowires Using Vapor-Liquid-Solid Process for the Osseointegration (골융합을 위한 Vapor-Liquid-Solid 법을 이용한 TiO2 나노와이어의 합성)

  • Yun, Young-Sik;Kang, Eun-Hye;Yun, In-Sik;Kim, Yong-Oock;Yeo, Jong-Souk
    • Journal of the Korean Vacuum Society
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    • v.22 no.4
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    • pp.204-210
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    • 2013
  • In order to improve osseointegration for biomedical implants, it is crucial to understand the interactions between nanostructured surfaces and cells. In this study, $TiO_2$ nanowires were prepared via Vapor-Liquid-Solid (VLS) process with Sn as a metal catalyst in the tube furnace. Nanowires were grown with $N_2$ heat treatment with their size controlled by the agglomeration of Sn layers in various thicknesses. MC3T3-E1 (pre-osteoblast) were cultured on the $TiO_2$ nanowires for a week. Preliminary results of the cell culture showed that the cells adhere well on the $TiO_2$ nanowires.

Image quality assessment of pre-processed and post-processed digital panoramic radiographs in paediatric patients with mixed dentition

  • Suryani, Isti Rahayu;Villegas, Natalia Salvo;Shujaat, Sohaib;De Grauwe, Annelore;Azhari, Azhari;Sitam, Suhardjo;Jacobs, Reinhilde
    • Imaging Science in Dentistry
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    • v.48 no.4
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    • pp.261-268
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    • 2018
  • Purpose: To determine the impact of an image processing technique on diagnostic accuracy of digital panoramic radiographs for the assessment of anatomical structures in paediatric patients with mixed dentition. Materials and Methods: The study consisted of 50 digital panoramic radiographs of children aged from 6 to 12 years, which were later on processed using a dedicated image processing method. A modified clinical image quality evaluation chart was used to evaluate the diagnostic accuracy of anatomical structures in maxillary and mandibular anterior and maxillary premolar region of processed images. Results: A statistically significant difference was observed between pre and post-processed evaluation of anatomical structures(P<0.05) in the maxillary and mandibular anterior region. The anterior region was found to be more accurate in post-processed images. No significant difference was observed in the maxillary premolar region (P>0.05). The Inter-observer and intra-observer reliability of both pre and post processed images were excellent (>0.82) for anterior region and good (>0.63) for premolar region. Conclusion: The application of image processing technique in digital panoramic radiography can be considered a reliable method for improving the quality of anatomical structures in paediatric patients with mixed dentition.

Effect of ultrasound-guided ilioinguinal-iliohypogastric nerve block on chronic pain in patients undergoing open inguinal hernia surgery under spinal anesthesia: a randomized double-blind study

  • Rajendra Kumar Sahoo;Amit Pradhan;Priyadarsini Samanta;Laxman Kumar Senapati;Ganesh Chandra Satapathy
    • The Korean Journal of Pain
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    • v.37 no.4
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    • pp.332-342
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    • 2024
  • Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months.

The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center (외상 센터에서의 외상 진료 시스템 도입에 따른 변화: 단일 외상 센터에서의 초기 경험)

  • Kim, Hyung Won;Hong, Tae Hwa;Lee, Seung Hwan;Jung, Myung Jae;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.241-247
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    • 2015
  • Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

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