• Title/Summary/Keyword: Recovery Time Objective

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The Superior Approach in Hemiarthroplasty for Femoral Neck Fracture: A Comparative Analysis with the Posterior Approach

  • Kenta Kamo
    • Hip & pelvis
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    • v.36 no.3
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    • pp.211-217
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    • 2024
  • Purpose: The concept of a superior approach (SA) involves the use of a tissue-sparing posterior approach (PA), with exposure of the piriformis muscle and gluteus medius/minimus muscles. The objective of this study was to clarify the features of hip hemiarthroplasty (HA) using a SA in regard to early recovery and mid-term outcomes, with a comparison of the outcomes of SA-HAs and HAs using a PA (PA-HAs). Materials and Methods: A total of 120 HAs for treatment of primary femoral neck fracture with a healthy opposite hip joint were performed in our hospital from 2013 to 2018. Propensity score matching in regard to age, sex, body mass index, walking ability before injury, place of residence, time to surgery, and American Society of Anesthesiologists-Physical Status was performed for 79 patients with SA-HAs and 41 patients with PA-HAs. The final analysis included 34 patients who underwent SA-HAs and 34 patients who underwent PA-HAs. Results: The duration of surgery was 57.1 minutes and 72.1 minutes (P=0.001) for SA-HAs and PA-HAs, respectively. The scores for walking ability at postoperative one week were 4.9±1.4 and 4.2±1.0 (P=0.021) for SA-HAs and PA-HAs, respectively. The Barthel index (BI) at the start of rehabilitation was 26.2±18.7 and 17.4±16.3 (P=0.042) for SA-HAs and PA-HAs, respectively. The 4-year complication-free survival rates were 74.2% and 56.3% for SA-HAs and PA-HAs, respectively (P=0.310). Conclusion: SA-HA can be performed without torsion of the muscles and ligaments around the hip joint. Early recovery of walking ability and BI was a significant feature of SA-HAs.

Laryngeal Inhalation Injury (흡인성 화상에 의한 후두 손상)

  • 조정일;김영모;임정혁;김용재;이철우;이명택
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.12 no.1
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    • pp.11-16
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    • 2001
  • Background and Objectives : A burn injury to the glottis differs from a burn injury to the trachea, bronchi, and lung parenchyma, in that thermal injury does not occur to any significant degree below the level of the larynx, due to the effective cooling of air by the upper airway and to reflex closure of the vocal cords from a blast of hot air. Therefore, the laryngeal inhalation injury give rise to airway problem and voice change. The objectives of this study is to assess management of laryngeal inhalation injury and voice change after management. Materials and Methods : Voice choses and laryngeal injuries of eight laryngeal inhalation patients were analyzed through questionnaire, voice dynamic laboratory, and laryngeal stroboscopy. Operative management was performed to five patients for airway patiency and vocal cord movement on laryngeal pathology ind voice therapy was performed to all patients. One-year after, voice changes and laryngeal injuries were reanalyzed with same methods. Results : Vocal breathiness, decreased voice intensity, reduced voice range, and easy fatigability were major complaints of laryngeal inhalation patients. Glottic stenosis were developed to five of eight patients, and vocal cord atrophy, bowing were developed to others. Vocal cord mucosal waves were significantly decreased in all patients. Jitter(%), Shimmer(dB) were increased and Maximal phonation time(MPT) was decreased. One-year after, subjective voice changes and objective voice parameters were improved. And vocal cord mucosal waves were recovered in all patients. Conclusions : Subjective voice quality and objective voice parameters were improved after operative management for laryngeal pathology and voice therapy. And we observed recovery of vocal fold mucosal waves by laryngeal stroboscopy. We think that early preventable tracheotomy is necessary to reduce the laryngeal contact injury in laryngeal inhalation patients.

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Effects of treadmill training with real optic flow scene on balance and balance self-efficacy in individuals following stroke: a pilot randomized controlled trial

  • Kang, Hyungkyu;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.1 no.1
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    • pp.33-39
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    • 2012
  • Objective: The objective of this study is to investigate the effect of treadmill training with real optic flow scene on functional recovery of balance and balance self-efficacy in stroke patients. Design: Single blind, Randomized controlled trial. Methods: Nine patients following stroke were divided randomly into the treadmill with optic flow group (n=3), treadmill with virtual reality group (n=3), and control group (n=3). Subjects in the treadmill with optic flow group wore a head-mounted display in order to receive a speed modulated real optic flow scene during treadmill training for 30 minutes, while those in the treadmill with virtual reality group and control group received treadmill training with virtual reality and regular therapy for the same amount of time, five times per week for a period of three weeks. Timed up and go test (TUG) and activities-specific balance confidence scale (ABC scale) were evaluated before and after the intervention. Results: TUG in the treadmill training with optic flow group showed significantly greater improvement, compared with the treadmill training with virtual reality group and control group (p<0.05). Significantly greater improvement in the ABC scale was observed in the treadmill training with optic flow group and the tread mill training with virtual reality group, compared with the control group (p<0.05). Conclusions: Findings of this study demonstrate that treadmill training with real optic flow scene can be helpful in improving balance and balance self-efficacy of patients with chronic stroke and may be used as a practical adjunct to routine rehabilitation therapy.

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A Research on Quality of Life of Facial Palsy Patients (구안와사 환자의 삶의 질에 대한 연구)

  • Moon, Hyo;Park, Min-Cheol;Hong, Seok-Hoon;Youn, In-Hwan;Lee, Dong-Hyo;Lee, Chung-Ho;Kim, Nam-Kwon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.22 no.1
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    • pp.157-171
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    • 2009
  • Objective : The face is very important for human communication. So facial palsy patients experience not only physical disturbances but also serious emotional stress. Therefore the focus of treatment must be to not only aid the recovery of objective symptoms but also the improvement of subjective quality of life. However there has not been enough Oriental Medical study in this field until now. Thus this study was begun to suggest a useful index for the treatment of facial palsy. Methods : Grade of paralysis, sequelas, and quality of life were used for evaluation. To evaluate Grade of paralysis, House-Brackman Grade was used as the Gross scale and Kim's Grade was used as the Regional scale. Sequelas were evaluated by muscle contraction, synkinesis, NA, and grade of philtrum tilt. Quality of life was evaluated by SF-36v2, Facial Disability Index, and Vas. Results & Conclusion : 1. The change of grade of paralysis between the early and the present time reveals remarkable improvement statistically. 2. There was a remarkable improvement in all parts of quality of life except several areas of SF-36(RP, RE, MH, VT) 3. In only PF(Physical Function) of FDI, quality of life increased remarkably according to the improvement of grade of paralysis. 4. There is the positive relationship among Kim's grade, HB grade and Synkinesis 2. 5. Synkinesis among sequelas has the greatest effect on quality of life. And muscle contraction, change of NA, and grade of philtrum tilt also affect quality to some extent. 6. There was no remarkable relationship between the period of illness and change of quality of life. 7. Change of NA is shown after 3 months of illness and synkinesis becomes worse after 6 months of illness.

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Influence of Gas Pain, Post-operative Resilience, and Body Temperature Discomfort in Laparoscopic Myomectomy Patients after Thermotherapy (복강경하 자궁근종절제술 후 적용한 온열요법이 가스 통증, 수술 후 회복력 및 체온불편감에 미치는 효과)

  • Lee, JeongAe;Jeon, MyoungHwa;Park, EunJu;Lee, JinAh;Ahn, GonMyoung;Lee, SeungShin;Kim, JiIn
    • Women's Health Nursing
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    • v.25 no.1
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    • pp.4-18
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    • 2019
  • Purpose: The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies. Methods: The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, ${\chi}^2$-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18. Results: The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008). Conclusion: Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.

Vertical Dimension in Complete Denture : A Literature Review & Clinical Procedures (총의치 수직고경 설정에 대한 고찰)

  • Chung, Jun-Yong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.18 no.3
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    • pp.185-195
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    • 2002
  • Purpose This article describes the historic and clinical aspects of the determination of the vertical dimension of occlusion and the synoptic procedure of the determination of the vertical dimension of occlusion in complete denture. The determining procedure of the susceptible vertical dimension of occlusion is one of the most important steps in construction of complete denture and prosthodontic treatment. It is considered essential for the improvement and the recovery of facial esthetics and stomatognathic functions. Results Several methods have been suggested for measurement of the vertical dimension of occlusion in the construction of complete denture and the prosthodontic rehabilitation. These range from pre-extraction records to the use of physiologic rest position, swallowing, phonetics, esthetics and facial proportion, etc. But, there is no universally accepted or completely accurate method. There seems to be no significant advantages of one technique other than those of cost, time and equipment requirements, and seems to be in controversial in determining the vertical dimension. Conclusion The vertical dimension of occlusion should be determined and reinspected carefully by dentist for a successful prosthesis with several methods. The more investigations are necessary for more objective and scientific techniques in determining the vertical dimension of occlusion.

Surgical Experience of Acute Traumatic Posterior Fossa Subdural Hematoma : Study of 6 Cases and Review of the Literatures

  • Park, Jong-Tae;Kim, Dae-Won
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.441-444
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    • 2006
  • Objective : The goal of this study is to evaluate the clinical results in six patients who underwent surgical decompression for the acute subdural hematomas[ASDH] of posterior cranial fossa. Methods : Six patients [five males and one female] who had undergone surgery for ASDH of posterior cranial fossa between 2000 and 2005, were evaluated retrospectively with regard to clinicoradiological findings and surgical outcomes. The mean age was 45.8 years [range $9{\sim}67\;years$]. Results : Preoperative computed tomography showed ASDH on cerebellar hemisphere in four patients and on midline in two. All patients had the associated lesions such as subarachnoid hemorrhage, epidural or subdural hematoma, intraventricular hemorrhage, contusion or pneumocephalus in supratentorial area. Fracture of occipital bone was noted in two patients. Of the four patients who had 13 to 15 of Glasgow coma scale score at the time of admission, three were deteriorated within 24 hours after trauma. Of these three patients, delayed subdural hematoma developed 1 hour after initial normal CT finding in one patient and increased in thickness in another one. Postoperative outcome showed good recovery in three patients and moderate disability in one. Two patients were expired. Conclusion : This study supports that early diagnosis based on strict observation and prompt surgery in the patients with ASDH in posterior fossa will lead to the best results.

Delayed Cranial Nerve Palsy after Microvascular Decompression for Hemifacial Spasm

  • Han, Jae-Suk;Lee, Jeong-Ah;Kong, Doo-Sik;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.288-292
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    • 2012
  • Objective : Microvascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve (VI, VII, and VIII) palsy following MVD and its clinical courses. Methods : Between January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss. Results : DFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve. Conclusion : Delayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.

Clinical Observation on Oculomotor Nerve Palsy Treated by Moxibustion

  • Woo, Hyun-Su;Seo, Dong-Min;Kim, Jong-Deog;Park, Sang-Min;Kim, Hyun-Dong;Byun, Im-Jeung;Kim, Chang-Hwan
    • The Journal of Korean Medicine
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    • v.24 no.4
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    • pp.149-153
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    • 2003
  • Objective : Moxibustion is one of the primary remedies in traditional oriental medicine. We successfully treated a one patient who complained of oculomotor nerve palsy related to diabetes mellitus with moxibustion. Methods : We performed moxibustion treatment on the protuberances surrounding the Mok-chang acupoint and adjacent frontal scalp of the patient's head at the same time every day and observed the recovery of eye movement and changes of ptosis. Results : After about I week of moxibustion treatment, there were some changes of ptosis and eyeball movement. The patient felt better opening his eyes than before and seemed to reduce his paralytic condition. After 14 days, ptosis was remarkably improved, although slight diplopia remained, and eye movement had recovered to almost normal. Furthermore, his blood glucose was on the decrease and revealed an average 120 mg/dl. Conclusions : Moxibustion treatment performed on the Mok-chang acupoint remarkably improved ptosis and limited eye movement arising from oculomotor nerve palsy related to diabetes mellitus. We hope moxibustion is used for treating nerve palsies and similar diseases in the future.

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Significance of Oligoclonal Bands after Stem Cell Transplantation in Multiple Myeloma Cases

  • Liu, Ai-Jun;Zong, Hong;Yang, Guang-Zhong;Zhai, Yu-Hua;Li, Li-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1483-1486
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    • 2012
  • Objective: To determine the characteristics of oligoclonal bands that are frequently detected by serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) after stem cell transplantation. Methods: We retrospectively analyzed 56 patients with multiple myeloma (MM) undergoing transplantation, and standard immunofixation electrophoresis was used to identify and quantify paraproteins. Results: The median follow-up was 35 months (range, 10-76months) and 21 patients relapsed. Twelve (25.0%) demonstrated oligoclonal bands after a median time 1.4 months (range, 1-3months), with a median duration of 5.8 months (range, 1-15months). The majority patients with oligoclonal bands had normal quantities of immunoglobulins and the one year event free survival (EFS) was 92%, even higher than for patients without OBs (P=0.002). Conclusion: Oligoclonal bands frequent develop post-transplantation in MM cases. In the vast majority of patients, they may not represent relapsed disease, and more likely represent a transient phenomenon representing recovery of impaired immunoglobulin production.