• Title/Summary/Keyword: pre and postoperative surgery

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The Effects of Muscle Strengthening Exercise for Postoperative Lumbar Spinal Surgery on Pain, Exercise Self-Efficacy, Activities of Daily Living (요추수술 후 운동요법이 통증, 운동 자기효능감과 일상생활활동 장애에 미치는 효과)

  • Kim, Hwa-Young;Eun, Young;Song, Myoung-Eun
    • Journal of muscle and joint health
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    • v.18 no.2
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    • pp.238-248
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    • 2011
  • Purpose: The purpose of this study was to examine the effects of exercise on pain, exercise self-efficacy, activities of daily living for postoperative lumbar spinal surgery. Method: The study used a nonequivalent control group pre- and post-test design in quasi-experimental research. The data were collected from April, 2010 to July, 2011. The subjects were 40 lumbar spine surgery patients who had been hospitalized in neurosurgery of G university hospital, 20 assigned for the experimental and 20 for the control group. Exercise of this study reformed to be adapted to lumbar spine surgery patients on the basis of William's flexion exercise and exercise for HIVD surgery patients developed by Kim(1995) and was practiced three times a day for 3 weeks. The data were analysed with ${\chi}^2$-test, t- test, Repeated measures ANOVA using the SPSS program. Result: There was a significant decrease in pain in the experimental group, but there was no significant increase in exercise self-efficacy and activities of daily living between the groups. Conclusion: Muscle strengthening exercise after surgery was effective in improvement of pain. Postoperative muscle strengthening exercise in lumbar spinal patients may be a useful intervention to reduce pain.

Changes of Serum Levels of Alpha 1-Proteinase Inhibitor in Pre-and Post Open Heart Surgery (개심술 전후의 Alpha 1-Proteinase Inhibitor 의 추이)

  • Jeong, Jong-Hwa;Kim, Song-Myeong
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.402-415
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    • 1989
  • Extracorporeal circulation leads to functional disorder and structural damage of organs, especially hematologic and pulmonary system, mainly by sequestration of neutrophils and deposition of macrophages at lung. Then, proteases are secreted, which insult vascular basement membrane of pulmonary capillary and alveolar septa of the lung. Among these, the most important protease at lung is elastase, because major component of lung is elastin. For prevention of lung injury, inactivators or antidotes to elastase should be necessary and Alpha 1-Proteinase Inhibitor is the elastase inactivator. Clinical experimental study was carried out to investigate the immediate postoperative change of serum Alpha 1-PI level following cardiopulmonary bypass for 20 heart cases [congenital 16 cases, acquired 4 cases] and 10 control [subtotal gastrectomy] cases. Also preliminary study was performed for 31 cases of open heart patients. The results were as follows: l. Immediate postoperative serum levels of Alpha 1-PI was significantly decreased at open heart surgery group [P< 0.005], but not decreased at control group. 2. There were no significant difference in change of serum Alpha 1-PI level between and membrane and bubble oxygenator group.Z 3. There were no significant difference in changes of serum Alpha 1-PI level between CHD and AHD. Alpha 1-PI is consumed at lung during cardiopulmonary bypass and increase after operation compensatedly and protect multiple organic damage especially lung. Therefore, Alpha 1-PI can be indicator for evaluation of prevention and treatment of pump-lung syndrome.

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Pre- and Postoperative Changes of Serum Levels of Slpha 1-proteinase Inhibitor in Patients with Bronchogenic Cancer (폐암 환자에서의 폐엽절제술 전후의 혈청 Alpha 1-Proteinase Inhibitor의 변화)

  • 이재성
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.221-227
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    • 1995
  • Malignancy is one of the several exogenous and endogenous factors that increase serum alpha 1-PI. In fact, serum levels of alpha 1-PI were significantly elevated in the patients with the nonresectable bronchogenic cancer. the purpose of this work was to determine if the immediate postoperative change of serum alpha 1-PI level following tumor resection relates to the patient`s postoperative course. Clinical experimental study was carried out to investigate the postoperative changes of serum alpha 1-PI level following operation for 20 cases of bronchogenic cancer and 10 cases of control, nephrectomy patients Alpha 1-PI concentrations in serum was quantitated by use of radial immunodiffusion technique.The results were as follows ; Preoperative serum level of alpha 1-PI was significantly elevated in patients with bronchogenic cancers [p < 0.001 , when compared to normal control levels. Immediate postoperative serum alpha 1-PI level was significantly increased in patients with bronchogenic cancer [p < 0.05 , but slightly decreased at control groups. The peak serum level of alpha 1-PI was the postoperative three days, and then gradually decreased at the 5, 9, 14 days, but slightly elevated comparing to preoperative alpha 1-PI levels. Serum alpha 1-PI level in patients with adenocarcinoma was elevated, when compared to squamous cell carcinoma, but not significantly. According to the stages of the bronchogenic cancer, each levels of the serum alpha 1-PI were slightly different, but the whole postoperative changes were the general similarity. There were no significant difference in changes of the serum alpha 1-PI level, according to the operative procedures. As the alpha 1-PI is acute reactant, that it was required at the reoperative state of the bronchogenic cancer and rapid response, consumption or requirement were occurred, postoperatively. Therefore, alpha 1-PI can be perioperative indicator for the evaluation of the bronchogenic cancer.

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Control of Femoral Cannulation with a ProGlide Pre-Closure Device during Cardiac Surgery: Is It Reliable?

  • Kim, Chang Hun;Ju, Min Ho;Lim, Mi Hee;Lee, Chee-Hoon;Je, Hyung Gon
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.179-185
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    • 2021
  • Background: The use of ProGlide as a percutaneous vascular closure device in cardiac surgery remains inconclusive. This study investigated the clinical outcomes of using ProGlide in the percutaneous cannulation of femoral vessels in adult cardiac surgery. Methods: From September 2017 to July 2018, 131 consecutive patients underwent femoral vessel cannulation during cardiac surgery. The ProGlide (Abbott Vascular Inc., Santa Clara, CA, USA) with percutaneous cannulation was used in 118 patients (mean age, 55.7±15.5 years). The accessibility of femoral cannulation was evaluated through preoperative computed tomography. For cannulation, sonography was routinely used. The postoperative ankle-brachial index (ABI) was used to evaluate femoral artery stenosis. Results: Of the 118 patients, 112 (94.9%) and 6 (5.1%) underwent minimally invasive cardiac surgery and median sternotomy, respectively. Most femoral cannulations were performed on the right side (98.3%) using 15F to 19F arterial cannulas. The technical success rate of cannulation with ProGlide was 99.2%, with no delayed bleeding or cannulation site-related complications during hospitalization. During follow-up, only 1 patient showed femoral artery stenosis with claudication and was treated with interventional balloon angioplasty. The postoperative ABI revealed no significant difference in functional stenosis between the cannulation and non-cannulation sides (n=86; cannulation vs. non-cannulation, 1.2±0.1 vs. 1.1±0). Conclusion: Percutaneous femoral cannulation with ProGlide was safe and feasible in adult cardiac surgery. This technique may be a good alternative option in patients requiring femoral vessel cannulation for cardiac surgery.

Indications of Postoperative Angiography after Surgical Treatment of Intracranial Aneurysms (뇌 동맥류 수술 후 혈관조영술의 적응증에 대한 분석)

  • Rhee, Woo Tack;Kim, Jae Min;Cheong, Jin Hwan;Bak, Koang Hum;Kim, Choong Hyun;Kim, Kwang Myung;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.717-723
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    • 2001
  • Objective : Subarachnoid hemorrhage(SAH) is still one of the most serious disease with high morbidity and mortality in the neurosurgical field. Clipping of the aneurysmal neck is the gold standard of the surgical treatment of aneurysmal SAH. The purpose of this study was to investigate the role of the postoperative angiography and to assess the risk factors related to the incomplete clipping. Materials and Methods : From July 1995 to June 1998, the pre- and postoperative angiography were performed in 50 patients among total 81 patients who have underwent the aneurysmal surgery. We reviewed the various contributing factors including age, sex, Hunt-Hess grade, Fisher grade and the premature rupture of aneurysm during operation retrospectively. Careful evaluation of pre- and postoperative angiography focusing on the size, shape, and remnant neck of the aneurysms and vasospasm was performed. According to the angiographic findings, the patients were divided into two groups ; a complete clipping group and an incomplete clipping group. The data were analyzed by using unpaired independent sample t test after F-test to compare the significance between two groups. Results : Incomplete clipping of aneurysms was found in 6(12%) patients through the evaluation of postoperative angiography. Among them, three cases were located on the middle cerebral artery territory. Whereas the patient age, sex, Hunt-Hess grade, and Fisher grade were not significant(p>0.05), an intraoperative premature rupture had a statistical significance(p<0.05). A severe vasospasm occurred in 24(48%) cases and one patient with anterior communicating aneurysm was reoperated due to residual sac. Conclusion : According to our experience, the surgeons' judgement is the most reliable factor in deciding the postoperative angiography. During the aneurysmal surgery, the premature rupture always disturbs a complete clipping of aneurysms. Therefore, the temporary clipping of parent arteries is considered essential for a successful clipping. We believe that the postoperative angiography has a role in decreasing the re-bleeding risk due to clip migration and an inaccurate clipping only in the selected cases.

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Orbital wall restoration with primary bone fragments in complex orbital fractures

  • Jong Hyun Park;Dong Hee Kang;Hong Bae Jeon;Hyonsurk Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.52-58
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    • 2023
  • Background: Complex orbital fractures are impure orbital fractures because they involve the orbital walls and mid-facial bones. The author reported an orbital wall restoration technique in which the primary orbital wall fragments were restored to their prior position in complex orbital fractures in 2020. As a follow-up to a previous preliminary study, this study retrospectively reviewed the surgical results of complex orbital wall fractures over a 4-year period and compared the surgical outcomes by dividing them into groups with and without balloon restoration. Methods: Data of 939 patients with facial bone fractures between August 2018 and August 2022 were reviewed. Of these, 154 had complex orbital fractures. Among them, 44 and 110 underwent reduction with and without the balloon technique respectively. Pre- and postoperative Naugle exophthalmometer (Good-Lite Co.) scales were evaluated. The orbital volume and orbital volume ratio were calculated from preoperative and 6 months postoperative computed tomography images. Results: Among 154 patients with complex orbital fractures, 44 patients underwent restoration with the balloon technique, and 110 patients underwent restoration without it. The Naugle scale did not differ significantly between the two groups, but the orbital volume ratio significantly decreased by 3.32% and 2.39% in groups with and without the balloon technique and the difference in OVR was significantly greater in patients in the balloon restoration group compared with the control group. Postoperative balloon rupture occurred in six out of 44 cases (13.64%). None of the six patients with balloon rupture showed significant enophthalmos at 6 months of follow-up. Conclusion: The balloon rupture rate was 13.64% (6/44 cases) with marginal screw fixation, blunt screws, and extra protection with a resorbable foam dressing. Furthermore, we restored the orbital wall with primary orbital fragments using balloon support in complex orbital wall fractures.

The effects of lumbar extensors strengthening program on low back muscle power and mass, pain, return to work of patients who took laser operation for herniated lumbar disc (요부신전강화 운동프로그램이 단순추간판탈출증 수술환자의 요부근육 및 통증 그리고 사회복귀에 미치는 영향)

  • Hwang, Seong-Soo;Kim, Myung-Joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.2
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    • pp.45-56
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    • 2004
  • OBJECTIVE: The objective of this study was to know the effects of the postoperative lumbar extensor strengthening exercise program on back muscles strength and volume, pain, and the time of return to work. METHODS: A prospective controlled trial of lumbar extensor exercise program in patients who underwent microdiscectomy or percutaneous endoscopic discectomy for prolapsed lumbar intervertebral disc. Seventy-five patients were randomized into exercise group (20 male, 15 female) and non-exercise group (18 male, 22 female). Six weeks after surgery, patients in exercise group undertook a 12-week lumbar extension exercise (MedX) program. Assessment of spinal function was performed in all patients on postoperative 6 weeks, 18 weeks. The assessment included measures of lumbar extensor power, muscle mass of erector spinalis. All patients completed the visual analog scale (VAS) for evaluation of pain, and return to work. RESULTS: In muscle power, there were statistically significant improvements between pre and post test on muscle power in exercise group. But there were not statistically significant difference on muscle power in non-exercise group. In muscle mass, there were statistically significant difference between pre and post test on muscle mass in exercise group. But there were not statistically significant difference on muscle mass in non-exercise group. In the pain, there were statistically significant decrease between pre and post test on both group. But there were not statistically significant difference on fatty tissue and obesity in non-exercise group. The percentages of return to work in postoperative 4 months were significantly greater in the exercise group than in the non -exercise group. CONCLUSIONS: Postoperative lumbar extensor strengthening exercise program appears to be more beneficial to the patients who underwent operation for prolapsed lumbar intervertbral disc.

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Biomarkers Screening Between Preoperative and Postoperative Patients in Pancreatic Cancer

  • Li, Pei;Yang, Juan;Ma, Qing-Yong;Wu, Zheng;Huang, Chen;Li, Xu-Qi;Wang, Zheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4161-4165
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    • 2013
  • Objective: To investigate discriminating protein patterns and potential biomarkers in serum samples between pre/postoperative pancreatic cancer patients and healthy controls. Methods: 23 serum samples from PC patients (12 preoperative and 11 postoperative) and 76 from healthy controls were analyzed using matrix-assisted laser desorption and ionization time-of-flight mass spectrometry (MALDI-TOF MS) technique combined with magnetic beads-based weak cation-exchange chromatography (MB-WCX). ClinProTools software selected several markers that made a distinction between pancreatic cancer patients and healthy controls. Results: 49 m/z distinctive peaks were found among the three groups, of which 33 significant peaks with a P < 0.001 were detected. Two proteins could distinguish the preoperative pancreatic cancer patients from the healthy controls. About 15 proteins may be potential biomarkers in assessment of pancreatic cancer resection. Conclusion: MB-MALDI-TOF-MS method could generate serum peptidome profiles of pancreatic cancer and provide a new approach to identify potential biomarkers for diagnosis and prognosis of this malignancy.

Flow Characteristics of Upper Airway After Neck Dissection and Reconstructive Surgery in Tongue Cancer Patients (설암 환자에서 경부청소술 및 재건술에 따른 수술 전 후 기도 내 공기 유동 특성)

  • Jae Min Song;Heerim Seo;Eunseop Yeom
    • Journal of the Korean Society of Visualization
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    • v.22 no.2
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    • pp.90-95
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    • 2024
  • This study examined changes in airway airflow characteristics before and after extensive surgery for tongue cancer, which includes neck dissection and reconstruction. Pre- and post-operative CBCT scans were used to model 3D upper airways. Computational fluid dynamics (CFD) simulations analyzed airflow and pressure variations. Results showed a significant reduction in airway volume post-surgery, especially in the posterior tongue and epiglottis areas, leading to increased airflow velocity and complex vortex formations. Pressure drop analysis revealed that post-surgery, higher negative pressure is required for inhalation, indicating increased breathing effort. This suggests that the surgical removal of cancerous tissues and lymph nodes, along with reconstruction, alters airway geometry significantly, potentially impacting respiratory function. The findings highlight the clinical importance of assessing airway changes in tongue cancer surgery to anticipate and mitigate postoperative respiratory complications.

The relationship of pulmonary arterial shunts and the operative results in tetralogy of Fallot (활로 4징증에서 폐동맥의 상태와 수술성적과의 관계)

  • An, Jae-Ho;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.644-656
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    • 1984
  • In Tetralogy of Fallot, the most common congenital cyanotic heart disease, the mortality is decreasing continuously with adequate type and timing of operation. At S.N.U.H., 195 patients were operated from January 1982 to December 1983 and 176 patients among them were analysed in the view of pre-operative pulmonary arterial condition measured by cardiac cineangiogram. The most common associated anomaly was PFO and ASD and they did not affect the postoperative course and mortality. The overall mortality rate was 8.5% in 1982 and 6.8% in 1983 but under 2 years of age, the mortality rate was relatively high as 25% in 1982 and 16.7% in 1983, and when transannular patch widening of Right Ventricular Outflow Tract was used, the mortality rate was 12.5% in 1982 and 27.3% in 1983. Preoperative angiographic measurements of the pulmonary arterial status for prediction of the ratio between the Left Ventricular and Right Ventricular peak systolic pressure were calculated retrospectively according to the Blackstones formula, and the predicted value of PRV/LV greater than 0.6 carried apparently high complication and mortality rate as 16.6% M.R. in 1982 and 11.1 % in 1983. Among postoperative complications, c-RBBB occurred most frequently about 50% but did not influenced to mortality, Low Cardiac Output Syndrome was developed in about 40%. If we select the patient who should have the staged operation including shunt operation and choose the type of RVOT relief, we expect the improvement of postoperative clinical results.

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