• Title/Summary/Keyword: non surgical

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만성 외측 발목 불안정증의 수술적 치료 (Surgical Procedures for Chronic Lateral Ankle Instability)

  • 양기원;이홍섭;황지선
    • 대한족부족관절학회지
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    • 제25권1호
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    • pp.17-24
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    • 2021
  • Surgical treatments for chronic lateral ankle instability include anatomic repair, anatomic reconstruction using an auto or allograft, non-anatomic reconstruction, and arthroscopic repair. Open anatomic repair using the native ligament with or without reinforcement of the inferior extensor retinaculum is commonly performed in patients with sufficient ligament quality. Non-anatomical reconstruction using the adjacent peroneus brevis tendon is typically used only in patients with poor-quality ligament remnants or when previous repair failed. Anatomical reconstruction can be considered in patients in whom anatomical repair is expected to fail and when performed using auto or allografts can provide good to excellent short-term results, although the long-term outcomes of these methods remain unclear. Arthroscopic repair can provide good to excellent short-term clinical outcomes, but evidence supporting this technique is limited. The advantages and disadvantages of various surgical methods should be compared, and appropriate treatment should be implemented based on patient characteristics.

만성 족관절 외측 불안정성의 수술적 치료: 봉합술과 재건술의 비교 (Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction)

  • 김근수;박영욱
    • 대한족부족관절학회지
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    • 제23권1호
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    • pp.1-5
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    • 2019
  • Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

A systematic review of treatment and outcomes in patients with mandibular coronoid process hyperplasia

  • Parmentier, Griet I.L.;Nys, Margaux;Verstraete, Laurence;Politis, Constantinus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권3호
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    • pp.133-148
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    • 2022
  • Treatment of mandibular coronoid process hyperplasia (MCPH) has been described and explored in the literature. This systematic review aims to provide a comprehensive overview of the surgical and non-surgical treatment options for MCPH in pediatric and adult populations. Three databases were searched for treatment of MCPH patients (MEDLINE, Embase, and Web of Science). Two reviewers selected case reports and case series based on titles and abstracts. Finally, 55 studies reporting a total of 127 cases were included for qualitative synthesis and data extraction. The mean age at symptom onset was 15.6 years, while the mean age at diagnosis was 23.5 years. Of the included cases, 83.7% were male, and the condition was bilateral in more than 81% of the cases. Coronoidectomy was performed in 82.7% of the included cases, while coronoidotomy was performed in 3.9% of the cases. In 85.0% of the surgically treated cases, the approach was intraoral. The mean maximal intraoperative mouth opening was 38.1 mm compared with 16.5 mm at diagnosis. The mean maximal postoperative mouth opening was 35.3 mm, and the mean follow-up period was 16.3 months. Maximum mouth opening was achieved intraoperatively, and non-surgical treatment after surgery aims to reduce the risk of relapse. Additional research with a higher level of evidence is necessary to confirm these findings.

SMS를 활용한 수술진행 정보제공이 간호요구 만족도에 미치는 효과 (The Effects of the Short Message Service Informing Patients' Operation Status on the Family Members' Nursing Satisfaction)

  • 윤재현;김영경
    • 임상간호연구
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    • 제16권2호
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    • pp.85-93
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    • 2010
  • Purpose: The purpose of this study was to investigate the effect of the SMS(Short Message Service) informing patients' surgical operation status to his or her family members on their nursing satisfaction. Methods: A non-equivalent control group non-synchronized design was used. The subjects were the family members of patients underwent spine surgery operation at a general hospital in B city. Twenty five subjects in the experimental group received SMS services whereas the other twenty five subjects in the control group received no intervention. Results: There was a significant difference in the level of nursing satisfaction in the experimental group compared to that of the control group(t=7.14, p=.001). Conclusion: The result above indicates that the level of nursing satisfaction of family members of the patients under surgical operation can be raised by providing SMS informing surgical operational status during the operation. This finding leads to the conclusion that such information service can be used as one of the efficient interventions for improving patient and family satisfactions with nursing care in a surgical unit.

하치조신경관으로 과충전된 근관치료 충전재에 의한 감각이상의 외과적 처치 (Surgical treatment for dysesthesia after overfilling of endodontic material into the mandibular canal)

  • 송재민;김용덕;이재열
    • 대한치과의사협회지
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    • 제54권11호
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    • pp.874-879
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    • 2016
  • Damage to the inferior alveolar nerve(IAN) is a relatively infrequent complication in endodontic treatment. However, endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve resulting in sensory disturbances such as pain, dysesthesia, paresthesia or anesthesia. Two mechanism(chemical neurotoxicity and mechanical compression) are responsible for the IAN injury. When absorbent materials overfilled, it can be treated as a non-surgical procedure. But early surgical intervention required when mechanical, chemical nerve damage expected. We report surgical removal of overfilled gutta-percha and IAN decompression through sagittal split osteotomy in case of dysesthesia after overfilling of endodontic material into the mandibular canal. Dysesthesia recovered 3 months after surgical treatment.

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CHEMOPREVENTION OF MAMMARY CARCINOGENESIS BY SYNTHETIC ANALOG OF VITAMIN D5.

  • Mehta, Rajendra G.;Hussain, Erum;Moriarty, Robert M.;Mehta, Rajeshwari R.;Das Gupta, Tapas K.
    • 한국독성학회:학술대회논문집
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    • 한국독성학회 2001년도 International Symposium on Dietary and Medicinal Antimutgens and Anticarcinogens
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    • pp.52-53
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    • 2001
  • In order for vitamin D to be active, it needs to get metabolized to 1, 25 (OH)$_2$D3. This active metabolite of vitamin D induces epithelial cell differentiation and is antiproliferative. However, at the efficacious concentration, the natural ligand for VDR is hypercalcemic and toxic to cells. Therefore, numerous analogs have been synthesized with the hope of generating a compound that retains vitamin D activity and is non-toxic.(omitted)

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CHEMOPREVENTION OF MAMMARY CARCINOGENESIS BY SYNTHETIC ANALOG OF VITAMIN D5.

  • Mehta, Rajendra G.;Hussain, Erum;Moriarty, Robert M.;Mehta, Rajeshwari R.;DasGupta, Tapas K.
    • 한국독성학회:학술대회논문집
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    • 한국독성학회 2001년도 International Symposium on Effects of Edible Phytochemicals and Their Synthetic Derivatives on Carcinogenesis and Mutagenesis
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    • pp.9-10
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    • 2001
  • In order for vitamin D to be active, it needs to get metabolized to 1, 25 (OH)$_2$D3. This active metabolite of vitamin D induces epithelial cell differentiation and is antiproliferative. However, at the efficacious concentration, the natural ligand for VDR is hypercalcemic and toxic to cells. Therefore, numerous analogs have been synthesized with the hope of generating a compound that retains vitamin D activity and is non-toxic.(omitted)

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Robotic Surgery for Lung Cancer

  • Ambrogi, Marcello C.;Fanucchi, Olivia;Melfi, Franco;Mussi, Alfredo
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.201-210
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    • 2014
  • During the last decade the role of minimally invasive surgery has been increased, especially with the introduction of the robotic system in the surgical field. The most important advantages of robotic system are represented by the wristed instrumentation and the depth perception, which can overcome the limitation of traditional thoracoscopy. However, some data still exist in literature with regard to robotic lobectomy. The majority of papers are focused on its safety and feasibility, but further studies with long follow-ups are necessary in order to assess the oncologic outcomes. We reviewed the literature on robotic lobectomy, with the main aim to better define the role of robotic system in the clinical practice.

만성 성인성 치주염 치료시 비외과적, 외과적 방법에 대한 의사결정 (Decision Making on the Non surgical, Surgical Treatment on Chronic Adult Periodontitis)

  • 송시은;이승원;조규성;채중규;김종관
    • Journal of Periodontal and Implant Science
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    • 제28권4호
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    • pp.645-660
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    • 1998
  • The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

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Effects of Massive Transfusion Protocol Implementation in Trauma Patients at a Level I Trauma Center

  • Sun, Hyun Woo;Lee, Sang Bong;Park, Sung Jin;Park, Chan Ik;Kim, Jae Hun
    • Journal of Trauma and Injury
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    • 제33권2호
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    • pp.74-80
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    • 2020
  • Purpose: This study was conducted to investigate whether rapid and efficient administration of blood products was achieved and whether clinical outcomes were improved by applying a massive transfusion protocol (MTP). Methods: From January 2016 to September 2019, the medical records of trauma patients who received at least 10 units of packed red blood cells (PRBC) at Pusan National University Hospital (level I trauma center) were retrospectively reviewed. The patients treated from January 2016 to January 2018 were designated as the non-MTP group, and those treated from February 2018 to September 2019 were designated as the MTP group. Results: During the study period, 370 patients received massive transfusions. The non-MTP and MTP groups comprised 84 and 55 patients, respectively. No significant between-group differences were found in the units of PRBC (23.2 vs. 25.3, respectively; p=0.46), fresh frozen plasma (FFP) (21.1 vs. 24.4, respectively; p=0.40), and platelets (PLT) (15.4 vs. 17.0, respectively; p=0.54) administered in the first 24 hours. No statistically significant differences between the non-MTP and MTP groups were found in the FFP-to-PRBC ratio (0.9 vs. 0.94, respectively; p=0.44) and or the PLT-to-PRBC ratio (0.72 vs. 0.72, respectively; p=0.21). However, the total number of cryoprecipitate units was significantly higher in the MTP group than in the non-MTP group (7.4 vs. 15.3 units, respectively; p=0.003) and the ratio of cryoprecipitate to PRBC in the MTP group was significantly higher than in the non-MTP group (0.31 vs. 0.62, respectively; p=0.021). The time to transfusion was significantly reduced after MTP implementation (41.0 vs. 14.9 minutes, respectively; p=0.003). Conclusions: Although no significant differences were found in the clinical outcomes of patients who had undergone severe trauma, rapid and balanced transfusion was achieved after implementing the MTP.