• Title/Summary/Keyword: long term complications

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Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Zhang, Feng-Wa;Zhou, Zhao-Yu;Wang, Hai-Lin;Zhang, Jv-Xia;Di, Bao-Shan;Huang, Wen-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9985-9996
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    • 2014
  • Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.

Factors affecting the survival of implants: a long-term retrospective study (임플란트의 생존에 영향을 미치는 요인에 대한 장기간의 후향적 연구)

  • Song, Susanna;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.1
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    • pp.10-19
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    • 2015
  • Purpose: The aim of the present study was to evaluate the long-term survival of implants retrospectively and determine the risk factors associated with implant failure. Materials and Methods: Of all implants that were placed at the Department of Periodontology of the Dental Hospital of Gangneung-Wonju National University from January 1998 to December 2012, 2265 implants that were followed up until June 2013 were included in this study. Data were collected from clinical and radiographic examinations from previous visits. The information gathered included gender, age, smoking status, implant diameter, implant length, surface of implant, location of implant within the dental arch, surgical techniques and existence of complications. Results: The survival rate before loading was 98.9%. The cumulative survival rate after 5 years of loading was 97.2%, and after 15 years of loading was 95.2%. In a simple logistic regression analysis, gender (P = 0.016), smoking status (P = 0.001), location of implant (P = 0.020) and existence of complications (P = 0.002) were statistically associated with implant failure and included in the multiple regression analysis. As a result of multiple logistic regression analysis, the variables statistically associated with implant failure (P < 0.05) were smoking status (P = 0.049) and existence of complications (P < 0.001). Conclusion: The cumulative survival rate of dental implants after 15 years of loading was 95.2% and that the variables statistically associated with implant failure were smoking status and existence of complications.

Nutritional Counseling for Obese Children with Obesity-Related Metabolic Abnormalities in Korea

  • Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.2
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    • pp.71-78
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    • 2017
  • Child obesity has become a significant health issue in Korea. Prevalence of obesity in school-age children in Korea has been alarmingly rising since 2008. Prevalence of obesity among infants and preschool-age children in Korea has doubled since 2008. Obese children may develop serious health complications. Before nutritional counseling is pursued, several points should be initially considered. The points are modifiable risk factors, assessment for child obesity, and principles of treatment. Motivational interviewing and a multidisciplinary team approach are key principles to consider in managing child obesity effectively in the short-term as well as long-term. Nutritional counseling begins with maintaining a daily log of food and drink intake, which could possibly be causing obesity in a child. Several effective tools for nutritional counseling in practice are the Traffic Light Diet plan, MyPlate, Food Balance Wheel, and 'Food Exchange Table'. Detailed nutritional counseling supported by a qualified dietitian is an art of medicine enabling insulin therapy and hypoglycemic agents to effectively manage diabetes mellitus in obese children.

Clinical Study of Duromedics Bileaflet Valve (Duromedics 판막의 임상적 연구)

  • Kim, Sang-Hyeong;Yu, Hong-Seok
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.667-675
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    • 1990
  • From June, 15th, 1987 to June, 14th, 1989, 105 Duromedics bileaflet cardiac valve prostheses were implanted in 81 patients. Mitral valve replacement was done in 42 patients, 7 underwent aortic valve replacement, 28 underwent double valve replacement, & 4 patients underwent triple valve replacement. Concomitantly used valves were 13 cases; 11 cases were St. Jude Medical valves[M: SJM #29 X4, #27 X5, #25 X 1, T: SJM #33] & two cases were Carpentier Edwards bioprostheses[T: C - E #31X2]. The early mortality rate[within 30 days] was 3.7%[2 patients] & the late mortality rate was 7.4%[3 patients]. Follow-up was done on 72 surviving patients; mean follow-up period was 21.17$\pm$5.36 months. Anticoagulant-related hemorrhage was observed in two patients, possible prosthetic valvular endocarditis was observed in one patient and other specific valve-related complications were none. We concluded, therefore, that good clinical results & a low complication rate could be achieved with Duromedics bileaflet valve in short-term follow-up, & long-term follow-up was also necessary.

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Impact of Enhanced Recovery Program on Colorectal Cancer Surgery

  • Lohsiriwat, Varut
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3825-3828
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    • 2014
  • Surgical outcomes of colorectal cancer treatment depend not only on good surgery and tumor biology but also on an optimal perioperative care. The enhanced recovery program (ERP) - a multidisciplinary and multimodal approach, or so called 'fast-track surgery' - has been designed to minimize perioperative and intraoperative stress responses, and to support the recovery of organ function aiming to help patients getting better sooner after surgery. Compared with conventional postoperative care, the enhanced recovery program results in quicker patient recovery, shorter length of hospital stay, faster recovery of gastrointestinal function, and a lower incidence of postoperative complications. Although not firmly established as yet, the enhanced recovery program after surgery could be of oncological benefit in colorectal cancer patients because it can enhance recovery, maintain integrity of the postoperative immune system, increase feasibility of postoperative chemotherapy, and shorten the time interval from surgery to chemotherapy. This commentary summarizes short-term outcomes and potential long-term benefits of enhanced recovery programs in the treatment of colorectal cancer.

Clinical Study of St.Jude Medical Cardiac Valve (St.Jude Medical 판막의 임상성적)

  • Kim, Sang-Hyeong;Jang, Won-Chae
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.114-121
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    • 1994
  • St. Jude Medical cardiac valve replacement was performed in 135 consecutive patients from Aug.1986 to Dec. 1991.72 had mitral, 28 had aortic, 1 had tricuspid and 34 had double valve replacement. The hospital mortality rate was 4.4% & the late mortality rate was 3.7 %. Follow-up was done on 115 surviving patients:mean follow-up period was 29.78 $\pm$ 18.32 months. Paravalvular leakage was observed in two patients, possible prosthetic valvular endocarditis wasobserved in one patient and other specific valve-related complications were none. The overall actuarial survival rate at 6 years were 91.6% in total, 96.4% in aortic, 95.5 % in mitral and 81.9 % in double valve replacement.We concluded, therefore that good clinical results and a low complication rate could be achieved with St. Jude Medical valve in short-term follow-up & long-term follow-up was also necessary.

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Effectiveness of orthoses for treatment in patients with spinal pain

  • Choo, Yoo Jin;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.84-89
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    • 2020
  • Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients' lifestyle.

A retrospective study on survival rate of the most posterior single tooth implant (최후방 단일치 임플란트의 생존율에 대한 후향적 연구)

  • Jung, Sung-Woo;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.611-620
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    • 2008
  • Purpose: The purpose of this study was to assess the long term survival rates of the most posterior single tooth implant and to evaluate the influence of implant characteristics on implant survival. Material and Methods: This retrospective report presents findings on 37 patients with 43 implants replacing single molars. The inclusion criteria were having implants replacing a molar of the most posterior region and follow-up data over at least 6 months. Data were recorded regarding the incidence of complications and survival rates of these implants. Results: The range of follow-up was from 9 to 66 months(mean: 40.2 months). The cumulative survival rate of total implants was 93.0% which reflects the loss of three implants: one had broken neck, one implant failed because of infection, one implant showed failed osseointegration. Abutment- screws loosening occurred in five implants(11.6%). Conclusion: Within the limits of this study, a single tooth-implant can serve as a good long-term and predictable treatment modality to replace the most posterior teeth with low complication and failure rates.

Effects of a Footbath Program on Heart Rate Variability, Blood Pressure, Body Temperature and Fatigue in Stroke Patients (족욕프로그램이 뇌졸중 환자의 심박변이도, 혈압, 체온 및 피로에 미치는 효과)

  • Son, Yu Lim;Yoo, Myung Sook
    • Journal of Korean Biological Nursing Science
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    • v.18 no.1
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    • pp.51-59
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    • 2016
  • Purpose: This study was to examine the effects of a footbath program on heart rate variability, blood pressure, body temperature and fatigue of stroke patients with stroke-induced hemiparesis. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 40 stroke patients, twenty for the footbath program and twenty for the control group, who were hospitalized in a long-term rehabilitation hospital in G city of Korea, from February to April 2014. The twenty participants in the experimental group received the intervention of footbaths and an educational program focused on the prevention of stroke complications; Collected data were analyzed by the IBM SPSS WIN 20.0 program using a t-test, ${\chi}^2$ test, Mann-Whitney U test and repeated measures ANOVA. Results: Significant differences were found in heart rate variability, systolic blood pressure, hand and foot temperatures and fatigue between the two groups. But no significant differences were found in diastolic blood pressure, core temperatures, forehead temperatures, and hand temperatures between the two groups. Conclusion: The footbath program was an effective intervention for skin temperature change and fatigue reduction for stroke patients. Therefore, it is recommended that the footbath program can be utilized as an effective nursing intervention for stroke patients in long-term rehabilitation care hospitals.

The Relationship between the Compression Grade of Vertebrae and Outcome after Percutaneous Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures

  • Kim, Jung-Min;Lee, Jong-Won;Hur, Jin-Woo;Kim, Seung-Hyun;Lee, Hyun-Koo;Kim, Myoung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.350-354
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    • 2005
  • Objective : The aim of this study is to assess the immediate and long-term efficacy of percutaneous vertebroplasty for treating painful vertebral osteoporotic fractures. Methods : A retrospective review of 149patients who had undergone 167 vertebroplasty procedures for osteoporotic fractures was performed. Clinical, radiologic, and procedural datas were analyzed as parameters of prognostic significance, including age, sex, bone marrow density score, symptom duration, bone cement filling grade, number of fractured vertebrae, compression grade of vertebrae, leakage of bone cement, volume of bone cement injected and complications. Results : In 158 of the 167 procedures assessed, immediate pain relief was obtained [94.6%]. The extent of collapse of the vertebral body was assessed as a parameter for prognostic significance [p=0.015]. Three months postoperatively, no improvement of the pain was observed in four of the 167 procedures that had undergone the vertebroplasty [2%]. At long-term follow-up, the improvement of pain was not correlated with the compression grade of vertebrae [p=0.420]. Conclusion : The immediate outcome of vertebroplasty are less effective in vertebrae more collapsed.