Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.
Objective : The authors retrospectively analysed the factors affecting the favorable outcomes in the treatment of the Failed Back Surgery Syndrome(FBSS) or six years. Method : From March 1991 to December 1996, seventy-five patients were diagnosed as FBSS and its incidence was 3.4% of admitted patients with back pain in our department. We analysed the demographic data, etiologies, clinical menifestations, outcomes according to methods of operation, numbers of previous surgery, and time intervals between initial operation and final operation. Result : The most common etiology and previous surgical method of FBSS were insufficient surgery(54.7%) and partial laminectomy(53.3%). Patients were managed as followings ; Total laminectomy and spinal fusion with instrument in 41 cases(54.7%), total laminectomy without fusion in 23 cases(30.7%), and only partial laminectomy in 11 cases(14.7%). The overall treatment outcome was satisfactory in 48 cases(64%). Satisfactory results were observed in those patients who were treated by spinal fusion after complete laminectomy(34 cases), who had underwent only one operation previously(45 cases), and when the time interval between the initial operation and reoperation is shorter than 12 months(43 cases). Conclusion : The treatment outcome in FBSS was favorable in cases of the complete total laminectomy and spinal fusion with instrument, only one previous back surgery, and short time interval between initial and final operations.
Overcrowding in an Emergency Department (ED) of hospital is a common phenomenon. To improve the service quality and system performance of the ED, a task assignment rule for the Registered Nurses (RNs) is proposed in this paper. At each task assignment point, the rule prioritizes all treatment requests based on the urgency which is determined by the multiple attributes such as accomplishment time of treatment task, elapsed time of treatment request, total remain time to patient discharge, and number of remain treatments. The values of partial urgency with a single criterion are determined and then overall urgency is computed to find the most urgent one among current requests with the importance weights assigned to the criteria. Through computer simulation, the performance of the proposed rule is compared with current rule in terms of the length of stay and system throughput in a simplified ED system of the hospital M.
Objectives : This study was designed to evaluate clinical prognosis factors of Bell's palsy patients. Methods : The 100 subjects were chosen from 262 patients over 20years old who was diagnosised Bell's palsy through Acupuncture & Moxibustion and ENT medical specialist after visiting the hospital within 8days of onset of peripheral facial palsy and after Oriental-Western Medicine Treatment, recovered completely or had over three months cares because of incomplete recovery Oriental-Western Medicine Treatment included Acupuncture Treatment, Herb med treatment, medicines treatment, Physical therapy and Electrodiagnostic Test was operated after 7 to 10days after outbreaks of the disease. Clinical prognosis factors were analyzed using House-Brackmann grading system(HBGS) as a measurement of the degree of Facial Palsy. Collected data were analyzed as Chi-Square test, ANOVA test, Independent-Samples t-test regression analysis using SPSS 12.0 WIN Program. Results : 1. There was a significant difference in the results of treatment according to site of palsy, degree of initial palsy, time of initial recovery and existence of recovery after 3weeks from onset as clinical prognosis factors of Bell's Palsy, However, a statistically significant difference was not shown in the results of treatment according to gender, age, existence of Post Auricular Pain, Hypertension, Diabetes and existence of relapse. 2. As a result of overall treatment, 85% of patients were recovered almost entirely and 15% were not recovered completely. 3. There was a significant difference in the onset of Post Auricular Pain and duration of Post Auricular Pain according to the degree of Post Auricular Pain. 4. There was a significant difference in the degree of initial palsy and degree of palsy after 3weeks from onset according to the existence of Post Auricular Pain. However, a statistically significant difference was not shown in the period of time until initial treatment, The time of initial recovery, (H-B), The period from onset to recovey, ENoG value. Conclusions : Based on the above results, prognosis of Bell's palsy was affected by degree of initial palsy, time of initial recovery and existence of recovery after 3weeks from onset.
Background: Lung carcinoma is the leading cause of cancer mortality worldwide. Although the 5-year survival rate nearly tripled from 5-15% over the last 25 years, the estimated number of deaths still exceeds 1.3 million annually. The overall 5-year survival of lung cancer is only 10% in Europe and 15% in the United States. The aim of the current study was to determine the long-term survival and the effect of certain prognostic factors on survival of patients with lung cancer in Yazd city, Iran. Methods: In this cross-sectional descriptive study, we retrospectively reviewed hospital records and follow-up data of 148 patients with histological proven lung cancer using the cancer data registered between 1998 and 2005 in the pathology department of Shahid Sadoughi educational hospital, Yazd, Iran. Data were extracted from patient documents that included sex, age, clinical manifestations, histopathological report of the tumor and type of treatment given. Results: Overall survival time in all patients was 8.5 months after diagnosis and there was no significant difference in survival according to sex (p=0.958). Histological analysis revealed that squamous cell carcinoma was the most common histologic type (35%). Kaplan-Meier statistical methods estimated the average survival time for SCC to be better (22.6 months) in comparison with the other types of histology (all of them below 10 months). There was a trend towards significance between type of histology and duration of survival (p=0.08). Conclusion: It is reasonable to expect that early lung cancer detection, and appropriated treatment, may improve surgical morbidity and mortality. Low survival of lung cancer in our center patients show our shortages in screening programs for early diagnosis. Designing studies with larger sample size that take some other variables like staging of patients is now necessary.
Objectives The purpose of this study is to find a relation between hospitalization time and the overall outcome of treatment, and suggest an optimal hospitalization date. Methods We analyzed the medical records of patients who received admission treatment at Mokhuri Neck and Back Hospital in April, 2018. Results By analyzing the difference in visual analog scale (VAS) scores according to the hospitalization date, it was shown in this study that when hospitalization was held out by the fourth day of accident there was a significant difference in the improvement of symptoms than any other day. There were no statistically significant differences in initial VAS scores and admission periods. Conclusions It is the most effective for a traffic accident patient to receive hospitalization within the first four days of accident for the most effective reduction in overall pain.
Background: The aim of this study was to analyze the patterns of relapse and survival outcomes in Northern Thai women with recurrent endometrial cancer (EC). Materials and Methods: Medical records were abstracted from EC patients who underwent primary surgery from 1999 to 2012. Data on clinicopathologic variables, sites of first recurrence, time to relapse of disease, and overall survival (OS) was analyzed. Associations between the clinicopathological variables and the rates of disease recurrence were determined. Results: Among 1,204 reviewed records, 42 eligible patients were identified with recurrent disease. The median age was 55 years and the median follow-up time was 26.0 months. The median times to recurrence (TTR) after completion of the initial treatment in the group of local relapse (LR) and distant/combined sites of recurrence (DCSR) was 6.6 (95% CI=4.6 to 8.6 months) and 16.9 months (95% CI=5.6 to 28.2 months), respectively (p=0.36). The 2-year survival and 3-year survival probability in the group of LR was 54.2% (95% CI=27.2 to 81.3%) and 34.7% (95% CI=9.2 to 60.2%), compared to 50.4% (95% CI=41.1 to 59.7%) and 42.1% (95%CI= 24.1 to 60.1%) for those with DCSR. Distant recurrence was the most frequent pattern of relapse. Overall survival was not significantly different in patients with local relapse when compared to those with DCSR (p=0.69). Conclusions: Patients with recurrence of EC after primary treatment had a worse prognosis and clinical aggressiveness. LR and DCSR occurred most during the first three years. The common sites of relapses were vaginal cuff, pelvis, and lungs. No significant clinicopathological predictor for survival outcomes was identified.
To assess survival outcomes in a retrospective study, recurrent epithelial ovarian cancer patients were divided into three groups according to the platinum free interval as follows: platinum refractory that included the patients with tumor progression during treatment; platinum resistant and platinum sensitive that included the patients with tumor progression less than or more than six months, respectively. Clinical data for tumor progression in epithelial ovarian cancer patients treated at Chiang Mai University Hospital between January, 2006 and December, 2010 were reviewed. Thirty-nine patients were in the platinum refractory group while 27 were in the platinum resistant group and 75 in the platinum sensitive group. The mean age, the parity, the administration of neoadjuvant chemotherapy and the serous type did not significantly different across groups while the mean total number of chemotherapy regimens, the early stage patients, the patients with complete surgery and the surviving patients were significant more frequent in the platinum sensitive group. Regarding subsequent treatment after tumor recurrence, 87.2% underwent chemotherapy. With the median follow up time at 29 months, the median overall survival rates were 20 months, 14 months and 42 months in platinum refractory, platinum resistant and platinum sensitive groups, respectively (p<0.001). In addition, when the platinum sensitive patients developed the next episode of tumor progression, the median progression free interval time was only three to four months. In conclusion, the outcomes for platinum refractory the and platinum resistant groups was poorer than the platinum sensitive group. However, subsequent progression in the platinum sensitive group was also associated with a poor outcome.
Background: We aimed to evaluate prognostic factors and response rates to various treatment approaches to patients with synovial sarcoma in an advanced setting. Materials and Methods: We retrospectively reviewed the medical records of 55 patients (18 pts; 32.7% women) diagnosed with synovial sarcomas. Twenty had metastatic disease at the time of diagnosis while the remainder of the study group consisted of patients who developed metastatic or inoperable locally advanced disease during follow up. Results: The median follow up time was 15 months (range: 1-53). Regarding outcomes for the 55 patients, 3 and 5 year overall survival rates were 26% and 14%, respectively. In univariate analyses among demographic factors female gender was associated with a better outcome (p=0.030). Patients with early progressing disease (<2 years) had a worse prognosis when compared to patient group with late relapse, but this difference did not reach statistical significance (p=0.056). According to multivariate Cox regression analysis patients who had undergone metastasectomy had a significant survival advantage (p=0.044). The overall response rate to different salvage chemotherapy regimens given as second line treatment was around 42.9-53.9% for all regimes. There were no statistically significant differences between chemotherapy regimens given in either second or third line settings in terms of overall survival. Conclusions: We observed no major differences in terms of response rate and survival between different salvage chemotherapy regimens. Although metastatic disease still carries a poor prognosis, metastasectomy was found to be associated with improved survival.
Kim, Poong-Ho;Lee, Hee-Jung;Jo, Mi-Ra;Kim, Ji-Hoe;Son, Kwang-Tae;Lee, Tae-Seek
Korean Journal of Fisheries and Aquatic Sciences
/
v.41
no.6
/
pp.440-445
/
2008
Ciprofloxacin is the most commonly used fluoroquinolones for treating bacterial disease in olive flounder (Paralichthys olivaceus) farming, but its withdrawal time for industrial-scale farming has not been established. The depletion of ciprofloxacin was investigated in the olive flounder under field conditions. Fish were kept in an inland fish farm and fed a commercial diet containing 5 mg/kg of ciprofloxacin for 13 days. Seven fishes per sampling time were examined during and after the treatment. Ciprofloxacin and its major metabolite, enrofloxacin, were analyzed using HPLC with a fluorescence detector. The concentrations of ciprofloxacin and enrofloxacin in muscle increased during the medication period, and then decreased rapidly. The ciprofloxacin and enrofloxacin concentration in the olive flounder peaked on days 11 and 13, respectively, with maximum concentrations in muscle of 0.58 and 0.73 mg/kg. Residual ciprofloxacin and enrofloxacin were eliminated rapidly; 6 days after treatment, the respective levels in muscle were 0.04 and 0.10 mg/kg and neither was detected 15 days post treatment. The level of ciprofloxacin accumulation at the beginning of oral administration was variable according to the farming conditions, but the overall exhaustion time was similar. In conclusion, an adequate withdrawal period for enrofloxacin is 15 days in the case of oral ciprofloxacin administration.
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