• Journal of Gastric Cancer
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• 제5권4호
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• pp.281-287
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• 2005

목적: UICC 분류에 의한 2기 위암환자의 임상병리학적 특징에 대하여 알아보고 수술 후 보조요법으로서의 항암, 방사선 치료가 5년 생존율에 미치는 효과에 대하여 알아보고자 하였다. 대상 및 방법: UICC에 의한 병리학적 분류로 병기2기로 판정된 954명을 대상으로 하였다. 항암치료는 수술 후 3주째부터 5-Fluorouracil $400mg/m^2/day$와 Leucovorin $20mg/m^2/day$를 사용하였으며 방사선 치료는 총 4,500 cGy를 25회로 나누어 시행하였다. 결과: 임상병리학적 인자들의 생존율분석에서 환자의 나이, 수술방법, 종양의 크기와 항암 및 방사선 치료가 의미 있는 예후 인자로 분석되었다. 수술 후 항암 방사선 치료에 따른 생존율 분석에서 보조요법을 시행하지 않은 425예의 5년 생존율은 67.9%, 항암 치료 군 187예는 79.8%, 항암방사선 치료 군 342예는 83.6%로 조사되어 통계적으로 유의한 차이를 보였으며(P<0.0001) 항암치료 군과 항암방사선 치료 군과의 생존율 비교에서는 항암방사선 치료 군에서 생존율의 향상을 보여주기는 하였으나 통계적으로 유의하지는 않았다(P=0.1264). 결론: 2기 위암환자에서 환자의 나이, 수술방법, 종양의 크기 및 수술 후 보조적인 항암 및 방사선 치료가 5년 생존율에 영향을 주는 의미 있는 예후인자로 조사되었다. 수술 후 보조요법의 시행이 통계적으로 의미 있는 생존율을 보였으나 임상병리학적 인자들을 고려한 무작위 연구를 통해 그 의미를 검증해야 할 것으로 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.109-129
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• 1995

Many patients with malignancies of the head and neck undergo radiation therapy, either as the only method of treatment or in combination with surgery. Radiation therapy has great effect in the case of fairly advanced malignancies which can't be operated radically. But the complication of radiation therapy arise because of damage to the peri- and operated area. It is fully known that irradiated tissue shows retarded healing process in the skin, mucosa and especially vascuslar tissue. The purpose of this study was to observe the healing process of irradiated free or island flap after operation. As Experimental Models, Femoral arterial and venous anastomosis (Group 1), Epigastric-island flap (Group 2) and free Epigastric falp(Group 3) with irradiated postoperative 24 hrs were made on 30 rats/group. As Control Model(Group 4), Free Epigastric flap was not irradiated after operation was chosen on 30 rats. The amount of irradiation was single fraction of 20 Gy using as linear megavoltage accelerator. Difference between Experimental and Control group was evaluated by the method of clinical examination, histopatholoical findings, biochemical analysis and DNA activity at postoperative 1, 3, 7, 14 and 28 days. The results were as follows, 1. Skin color and new epithelization in group 2 and 3 was similar to control group clinically. 2. Postoperarive patency of femoral artery and vien showed 5% and 22% of ischemity. 3. The externa, media and intima of irradiated femoral artery and vein were similar to control group histopathlogically. 4. Granulation and collagen tissue accumulation of irradiated groups were more active due to degenerative and fibrotic changes than control group at postoperative 7 days histopathologically. 5. The hydroxyproline content of all experimental groups were reduced till 14 days and the group 2 was most prominent at postoperative 7 and 28 days(p<0.05). 6. DNA activities of all groups were reduced till 3 days, but begun to recover at 7 days and more activities in control group than irradiated group(p<0.05). Based on the above results, the clinical healing process of free flaps with irradiated postoperative 24 hrs little difference from control group without complications.

• Radiation Oncology Journal
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• 제12권3호
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• pp.369-376
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• 1994

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권4호
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• pp.267-275
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• 2022

Background: Various instrument kinematics used in single-visit endodontics influence the occurrence of pain after endodontic therapy. This study aimed to evaluate the occurrence of pain after mechanical instrumentation with Hyflex EDM (HEDM) and WaveOne Gold (WOG) during single-visit endodontic therapy. Methods: Sixty patients diagnosed with asymptomatic irreversible pulpitis and normal apical tissues in mandibular premolar teeth were included in the study for single-visit root canal therapy. The patients were divided into two groups (n = 30) according to the rotary instrument used during root canal preparation (group A [HEDM] and group B [WOG]). Pain was evaluated after endodontic therapy at 8, 24, and 48 h intervals using the visual analog scale (VAS). Data obtained were analyzed using the chi-square test, independent t-test, MannWhitney U test, and Wilcoxon matched-pairs test. Results: Statistically significant differences were observed between the two groups (P < 0.001) at 8, 24, and 48 h, with WOG exhibiting less pain than HEDM files. Conclusion: Postoperative pain was lower in the WOG file system than in the HEDM file system after single-visit root canal therapy at 8, 24, and 48 h.

• Journal of Chest Surgery
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• 제51권5호
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• pp.293-307
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• 2018

Physiotherapy has recently become an essential part of enhanced recovery protocols after thoracic surgery. The evidence-based practice of physiotherapy is essential for the effective management of postoperative patients. Unfortunately, only a small body of literature has discussed the rationale of the physiotherapy interventions that are routinely implemented following thoracic surgery. Nonetheless, we can integrate the available knowledge into our practice until new evidence emerges. Therefore, in this review, the principles of physiotherapy after thoracic surgery are presented, along with a detailed description of physiotherapy interventions, with the goals of enhancing the knowledge and practical skills of physiotherapists in postoperative care units and helping them to re-evaluate and justify their traditional practices.

• Clinical and Experimental Pediatrics
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• 제50권3호
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• pp.298-301
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• 2007

선천성 심장병의 수술후 발생되는 유미흉은 드문 합병증이다. 이는 수분, 전해질 및 영양의 불균형을 초래할 뿐만 아니라 감염에 취약함을 보이기도 한다. 지금까지의 보존요법에 대해 비교적 치료성적이 좋으나 치료에 반응하지 않는 경우에는 수술적 중재가 불가피하다. 저자들은 보존요법과 octreotide 주입을 병행하여 수술적 중재를 피하고 효과적으로 치료한 수술후 발생된 유미흉 2례를 보고하는 바이다.

• Journal of Chest Surgery
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• 제27권2호
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• pp.122-127
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• 1994

A retrospective study of 737 consecutive patients surviving the first 24 hours who underwent valve replacement surgery from July 1980 to June 1993 was undertaken to determine the prevalence, variables that could be used to predict outcome and results of therapy for postoperative acute renal failure[ARF]. Twenty-one patients[2.8 %] developed acute renal failure. Positive risk factors noted in the development of postoperative renal failure included age, New York Heart Association class III & IV, endocarditis and elevated preoperative concentration of serum creatinine. The duration of cardiopulmonary bypass, aortic cross-clamping and the total duration of the operation also closely correlated with the incidence of ARF. The mortality rate for established ARF was 38.1% and ARF was associated with a significant increase in the length of hospitalization, ventilator support and intensive care unit stay. The incidence and mortality rate of oliguric renal failure was 38.1% and 85.7%. The highest mortality rate was associated with two or more postoperative complications and serum creatinine value exceeded 5 mg/dl. We concluded that therapy should be aimed at prevention of oliguric renal failure, or at least its conversion to nonoliguric renal failure, and early institution of renal replacement therapy with intensive support probably gives the best chance for survival.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.141-146
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• 2021

Objective: This study was at investigated the effects of manual lymphatic drainage (MLD) on stress and pain in patients with postoperative breast cancer. Design: A randomized controlled trial. Methods: A total of twenty-two patients with postoperative breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD groups (n=12) and rest groups (n=12). The intervention was conducted in each group for twenty minutes a day, five times a week, for four weeks. Before and after the intervention, the participants measured sympathetic nerve, parasympathetic nerve, and pain by using a sphygmograph and short-form McGill pain questionnaire.An independent t-test was used to analyze pretest and posttest changes between the groups, a paired t-test was used to analyze pre-posttests within each group. Results: After analyzing, the MLD group has been shown a significant decrease in the sympathetic nervous system (p<0.05), a significant increase in the parasympathetic nervous system (p<0.05), and a significant increase in pain (p<0.05). However, the rest group was no significant difference between pre and post. Conclusions: The results of this study confirmed that MLD techniques are an effective method in reducing stress and pain in patients with postoperativebreast cancer. And it is thought that can be used as basic data and to develop programs on stress and pain management reduction for patients with breast cancer.

• 한국임상수의학회지
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• 제38권4호
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• pp.184-188
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• 2021

A 10-year-old spayed female Maltese with a history of vomiting and lethargy was referred to the hospital. Physical examination revealed dehydration and severe pain following abdominal palpation. A large mass was observed in the cranial abdomen through radiography and ultrasonography. Laparotomy was performed to find the origin of the mass. The mass was about 8 cm originating from the cecum and subsequently removed. Histopathologic evaluation revealed that the cecal mass was suspected to be a mesenchymal-derived tumor. Through immunohistochemistry, the mass was diagnosed as a gastrointestinal stromal tumor (GIST) based on the c-kit expression. Given its recurrence, postoperative preventive therapy was initiated with masitinib mesylate, which is a tyrosine kinase inhibitor. The animal did not show any side effects during the medication period. After 6 months of therapy, it was well controlled without any recurrence. In this case, we introduced a novel postoperative management of GIST using masitinib mesylate.

• Journal of Yeungnam Medical Science
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• 제41권4호
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• pp.235-251
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• 2024

Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.