The effects of extracorporeal circulation on plateler count were studied in 120 patients. We measured platelet count before, during, after extracorporeal circulation, and postoperative 0, 1, 3, 5, 7, 9, 11th days to evaluate the effects of total extracorporeal circulation time and types of oxygenator on changes of platelet count The patients were classified into group I [extracorporeal circulation time < 100 minutes, 45 patients], II [100 < extracorporeal circulation time < 200 minutes, 48 patients], III [extracorporeal circulation time >200 minutes, 27 patients], and also all patients were classified into group B [bubble oxygenator, 84 patients] and group M [membrane oxygenator, 36 patients]. The group I, II, III were subclassified into IB, IM, IIB, IIM, IIIB and IIIM according to the types of oxygenator. The results were as follows: 1. The platelet counts were reduced throughout extracorporeal circulation and in the early postoperative periods upto postoperative third day. 2. The platelet counts after postoperative 9th to 11th day increased significantly compared with those of preoperative levels. 3. After extracorporeal circulation, the platelet recovered gradually in all groups, especially faster in group I compared with those of group II and III. 4. The effect of the type of oxygenator on the recovery of platelet count was not significant. In conclusion, extracorporeal circulation time influenced the change of platelet count. Therefore, in order to prevent of decrease of platelet count associated with extracorporeal circulation time, the extracorporeal circulation time should be shortened.
Purpose: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. Method: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesII to IV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. Result: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. Conclusion: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.
Total 125 patinets with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 Patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to treatment groups and was $16.8\%$. Local 15 yr survival was $33\%$ and 8 yr survival of T-6 group was $64.9\%$. An analysis of time were pattern of recurrence of each group, and the correlation of with radiation dose with local recurrence done. This study concluded that intensive multiagent chemotherapy RT and/or surgery (T-6 regimen) reduced distant metastases, and produced significant increase in local control and survival.
Purpose: This study compared the walking ability of chronic stroke patients following either treadmill training with knowledge of the result (KR group) or treadmill training with knowledge of the performance (KP group). Methods: Nineteen patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a KR group (10 patients) and a KP group (9 patients). They received 30 minutes of neuro-developmental therapy and treadmill training 30 minutes, five times a week for three weeks. The gait parameters were measured before and after training using the Optogait system. Results: After the training periods, the KR group showed significant improvement in gait speed, cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait assessment compared to the KP group (p<0.05). Conclusion: The results showed that treadmill training with KR was more effective in improving the gait speed and cadence, step length of the unaffected limb, stance time of the affected limb, and functional gait ability than the treadmill training with KP. Therefore, to improve the walking ability of stroke patients, it is necessary to consider treadmill training with KR. If it can be combined with conventional neurological physiotherapy, it would be an effective rehabilitation for stroke patients.
Objectives : Research on the effect and satisfaction between Acupuncture Treatment, Physical Treatment and contemporary Treatments of Acupuncture and Physical of lumbago patients Methods : We separated lumbago patients into three groups. A group with only Acupuncture Treatment and a group with only Physical Treatment and a group with contemporary treatments of Acupuncture and Physical. Questionnaire survey and score of Visual Analog Scale(VAS) and Oswestry Disability Index(ODI) were examined for comparison. Results & Conclusion : 1. Of the 54 patients Acupuncture Teatment group had 17 patients with similar ratio of gender and the average age was 39.5 years old. For the Physical Treatment group the ratio of male was 75% of the 8 patients and had the youngest average age which was 29.1 years old and the group with contemporary Treatments the ratio of female was 62% of 29 patients and had the oldest average age which was 46.7 years old. 2. The Acupuncture Treatment group had the shortest treatment period because of many acute stage caused by lumber sprain and the improvement score was the best. The group of contemporary treatments had the longest history day and treatment period by serious disease like HIVD and spinal stenosis but the improvement score of VAS and ODI was good similar to the Acupuncture Treatment group. For the Physical Treatment group there was many patients with degenerative change but not severe pain. The VAS, ODI and the improvement score was the lowest before and after the treatment.
Lee, Jae-Hong;Yeom, Sang Yoon;Hwang, Ho Young;Choi, Jae-Woong;Cho, Hyun-Jai;Lee, Hae-Young;Huh, Jae-Hak;Kim, Ki-Bong
Journal of Chest Surgery
/
v.49
no.4
/
pp.242-249
/
2016
Background: We evaluated early and long-term results after heart transplantation (HTPL). Methods: One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results: Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion: Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients.
Davide Di Mauro;Mariannita Gelsomino;Angelica Fasano;Shahjehan Wajed;Antonio Manzelli
Annals of Hepato-Biliary-Pancreatic Surgery
/
v.26
no.2
/
pp.144-148
/
2022
Backgrounds/Aims: Splenectomy in patients with non-Hodgkin lymphoma (NHL) is performed to relieve abdominal symptoms, treat hypersplenism or confirm diagnosis. Excision of a very large spleen is technically challenging and data on outcomes of surgery in patients with NHL are scanty. The aim of study was to evaluate the impact of spleen size on the surgical outcome of splenectomy in patients with NHL. Methods: Patients with NHL who underwent splenectomy, between 2006 and 2017, were included and divided into two groups: group 1, spleen ≤ 20 cm; group 2, spleen > 20 cm. Surgical approach, operative time, postoperative morbidity, mortality, hospital stay and re-admission rates were retrospectively compared between groups. Non-parametric data were evaluated with the Mann-Whitney U test. Differences in frequencies were analyzed with Fisher's exact test. Results: Sixteen patients were included (group 1, 6; group 2, 10). Laparoscopy was successful in three patients of group 1, none of group 2 (p = 0.035), the intraoperative time did not differ significantly between groups. One patient in each group developed postoperative complications. The patient in group 1 died of pneumonia. Median length of stay was 8 days (range, 3-16 days) for group 1, 5.5 days (range, 3-10 days) for group 2, showing no significant difference between the two groups. No patient was readmitted to hospital. Conclusions: Spleen size does not affect the outcome of splenectomy in patients with NHL. If a mini-invasive approach is to be chosen, laparoscopy may not be feasible when the spleen size is > 20 cm.
Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients($95{\%}$) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus. and concurrent esophageal irradiation to 30 Gy. After that patients received 5-FU continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000mg/$m^2$ administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100mg/$m^2$ bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrentm chemoradiation twenty-six patients underwent radical esophagectomy. Results : Ninety-three patients could be examined for response assessment, By treatment modality, response rates were $85.1{\%}$ for radiation alone group and $86.3{\%}$ for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was $61.9{\%}$. The pathologic complete response were $15.4{\%}$ in operation group. Overall median survival was II months and actuarial 5-year survival rate was $8{\%}$. The median survival interval was 6 months for radiation alone group, 11 months for combined chemoradiation group and 19 months for operation group. And also median survival was 19 months for complete responder group that 8 months for noncomplete responder group. In univariative analysis, statistically significant prognostic factors were tumor size, clinical stage, tumor response, and operation. In multivariative analysis, significantly better survival was associated with clinical stage, tumor response, radiation dose, and operation. Conclusion : Compared with radiotherapy alone, combined multimodality may improve the median survival in patients with localized carcinoma of the esophagus and toxicity is acceptable.
Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.
The purposes of this study was to determine the effect of beach ball play in stroke patients, and to define the strategy to promote their depression, powerlessness, self-esteem, activity of daily living. The experimental design was designed non-equivalent control group, non-synchroniged design. The study method had been done by investigating the experimental group and control group through the questionnaire on 57 patients who had been in patient department in D University hospital in Pusan from January 5th 1998 to the end of February 28th, 1998. Beach ball play was carried out experimental group once per day for 10 minute's for two weeks period from Jan 1998 to Feb 1998. Data was collected before and after the experimenation. Collected data was analyzed by means of frequency, percentage, chi-square test, mean, S.D, t-test with SPSS/PC. The results were summarized as follows : 1. The 1st hypothesis : "The experimental group which received the beach ball play should be higher in depression than the control group" was supported(t=3.11, p=.003). 2. The 2nd hypothesis : "The experimental group which received the beach hall play should be higher in powerlessness than the control group" was supported(t=3.32, p=.002). 3. The 3rd hypothesis : "The experimental group which received the beach ball play should be higher in self-esteem than the control group" was not supported(t=-1.90, p=.064). 4. The 4th hypothesis : "The experimental group which received the beach ball play should be higher in activity of daily living than the control group" was not supported(t=-.47, p=.637). In conclusion, the patients who received beach ball play showed the increase in the degree of depression and powerlessness of stroke patients. So the beach ball play had been judged the nursing intervention to improve their emotional problem in stroke patients.
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