• Title/Summary/Keyword: preoperative

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Disappearance of Serum Methylated p16 Indicates Longer Survival in Patients with Gastric Cancer

  • Lim, Han-Ki;Park, Joong-Min;Chi, Kyong-Choun;Lee, Eun-Ju;Jeong, Eun-Mi
    • Journal of Gastric Cancer
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    • v.13 no.3
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    • pp.157-163
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    • 2013
  • Purpose: The aim of this study was to assess clinical correlations with postoperative alteration of p16 DNA methylation, and to clarify whether postoperative changes in the serum DNA methylation status of p16 could be used as a reliable prognostic factor for gastric cancer. Materials and Methods: Fifty-three consecutive gastric adenocarcinoma patients who underwent gastric resection (Chung-Ang University Hospital, Seoul, Korea) were included. DNA methylation of p16 was evaluated by methylation-specific polymerase chain reaction using serum DNA preoperatively and at the 10th postoperative day. The correlation between changes in methylation status and patients' prognosis was analyzed. Results: p16 was methylated in 79.2% of preoperative serum DNA and in 54.7% of postoperative serum DNA, respectively. Methylation in p16 disappeared more frequently in patients who underwent standard D2 lymphadenectomy compared to those who underwent modified D1+ lymphadenectomy (P=0.016). Whereas methylation of preoperative serum DNA was not correlated with survival, patients with postoperative disappearance of p16 methylation showed longer survival than those without postoperative disappearance of p16 methylation in the patients who had gastric cancer with lymph node metastasis (P=0.042). Conclusions: Postoperative disappearance of p16 methylation could be an available prognostic factor for node-positive gastric cancer.

Influence of Pre-operative Fasting Time on Blood Glucose in Older Patients (수술 전 금식이 노인환자의 혈당에 미치는 영향)

  • Hong, Mi-Suk;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.41 no.2
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    • pp.157-164
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    • 2011
  • Purpose: This study was performed to identify changes in blood glucose at preoperative fasting time in surgical patients over 60 yr. Methods: Data collection was performed from July, 2008 through July, 2009. Participants consisted of 80 nondiabetic surgical patients. Blood glucose was checked from 3 to 5 times. The 5 times were 2-hr fasting on the pre-operative day (T1, n=80), 8 hr (T2, n=80), 10 hr (T3, n=17), 12 hr (T4, n=34) and 14 hr fasting on the day of the operation (T5, n=29). Results: Of the patients, 27.5% had a blood glucose level of less than 79 mg/dL at T2; 17.6% at T3; 32.4% at T4; and 17.2% at T5. Mean blood glucose levels were 93.8 mg/dL at T1; 88.4 mg/dL at T2; 91.7 mg/dL at T3; 87.4 mg/dL at T4: and 94.1 mg/dL at T5. Blood glucose was the lowest at T2 (p<.001). Conclusion: As 17.6-32.4% of the patients showed the blood glucose level of less than 79 mg/dL at 8-14 hr pre-operative fasting, the authors recommend that surgical patients p>60 yr-of-age be observed for hypoglycemia during pre-operative fasting of more than 10 hr and that surgical patients >60 yr-of-age with risks for hypoglycemia be scheduled for operation within 10 hr preoperative fasting.

Does cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images

  • Guerrero, Maria Eugenia;Noriega, Jorge;Castro, Carmen;Jacobs, Reinhilde
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.121-128
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    • 2014
  • Purpose: The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. Materials and Methods: One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image data-sets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. Results: All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Conclusion: Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

A SURVEY OF GENERAL ANESTHESIA IN PEDIATRIC CLINIC AT SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (서울대학교병원 소아치과에서 시행한 전신마취에 대한 연구)

  • Kim, Kwang-Hyon;Kim, Chong-Chul;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.154-158
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    • 2001
  • We tried to find out the information which can be drawn from the survey of general anesthesia in pediatric clinic at Seoul National University dental hospital from 1997 to 1999. The subjects were 37 patients Collected data were primary reasons for general anesthesia, preoperative physical status, age distribution, peformed dental treatment, complications, follow-up, and etc. Following were the results: (1) Most(97%) of patients treated under general anesthesia were handicapped and preoperative physical status was ASA Class I or Class II. (2) Majority(41%) of patients were between 11 and 15. (3) Average of 8.1teeth were restored and 3.3teeth were extracted. (4) In 32% of patients, there were mild complications. (5) 12(32%) of the patients responded to the six-month recall check.

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Evaluation of the Prognosis in Esophageal Atresia (선천성 식도 폐쇄증의 예후 판정)

  • Kim, Hyun-Hahk;Jeong, Hyeon-A;Kim, Kyung-Hun;Kim, Jung-Han;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.1-6
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    • 2001
  • The aims of this study were to evaluate the prognostic predictabilities of the risk classifications (Waterston, Montreal, and Spitz), preoperative treatment of pneumonia and the length of esophageal gap in esophageal atresia. Twenty-five cases of esophageal atresia were reviewed retrospectively. The data was analyzed with Likelihood ratio test for trend and Fisher's exact test. Survival rates were 100.0 % in group A and B, and 60.0 % in group C according to Waters ton classification (p=0.027). By Montreal classification, 95.7 % in group I and 50.0 % in group II (p=0.086). By Spitz classification, 95.5 % in group I and 66.7% in group II (p=0.159). The survival rate was 85.7 % in the patients with pneumonia preoperatively treated and 94.4% in the patients without pneumonia. The difference was not significant (p=0.490). Survival rate in the patients with long gap (${\geq}$3cm) was 50.0 % and 100.0 % in patients with short gap (<3cm) with significant difference (p=0.020). The Waterston classification could be modified into two groups because the prognosis of both group A and B were the same. Preoperative pneumonia does not seem to be a risk factor. The length of the esophageal gap showed prognostic value.

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Nationwide Survey of the Database System on Gastric Cancer Patients (전국 위암 환자 데이터 관리에 관한 설문조사 결과)

  • Yang Han-Kwang
    • Journal of Gastric Cancer
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    • v.4 no.1
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    • pp.15-26
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    • 2004
  • This nationwide survey was conducted to evaluate the current status of the database system on gastric cancer patients in Korea. The Information Committee of Korean Gastric Cancer Association (KGCA) sent questionnaires about the database management to all 402 KGCA members in 110 institutes. In addition, we asked them to send the gastric cancer sheet and the pathologic report of gastric cancer used in their institutes. Response rates were $18.9\%$ (76/402) for individuals and $51.8\%$ (57/110) for institutes, respectively. Most of the university hospitals responded to the questionnaire (response rate of university hospital: $74.6\%$, 44/59). A regular conference of gastric cancer and a digitalization of the database on gastric cancer patients were performed in 29 ($50.9\%$) and 43 ($75.4\%$) out of 57 institutes, respectively. MS excel was most commonly used for the digitalization of the database, followed by MS access and SPSS. A regularly formed gastric cancer sheet and pathologic report were used in 38 ($66.7\%$) and 49 ($86.0\%$) institutes, respectively. Hospital computerization, such as an Order Communicating System, an Electric Medical Record, and a Picture Archiving/Communicating System had been set up previously or would be set up in the near future in most institutes. In 25 gastric cancer sheets collected, the mean number of total items was 72.9 ($15\∼177$). Identification datafor the patients, surgical data, and pathologic data were included on most of the sheets, but preoperative status, preoperative diagnostic data, and postoperative hospital course were not.

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Clinical Significance of Preoperative Inflammatory Parameters in Gastric Cancer Patients

  • Lee, Deuk Young;Hong, Seong Woo;Chang, Yeo Goo;Lee, Woo Yong;Lee, Byungmo
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.111-116
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    • 2013
  • Purpose: Chronic inflammation induces cancer and cancer induces local tissue damage with systemic inflammation. Therefore, the aim of this study is to investigate the potential relationship between the severity of inflammation and prognosis in cancer patients. Materials and Methods: This study enrolled 220 patients from January 2002 to December 2006 who underwent gastric surgery. We evaluated the relationship between preoperative inflammatory parameters (erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio) and other clinicopathological factors. Survival outcomes were compared according to the extent of inflammation. Results: Significant elevation of erythrocyte sedimentation rate was related with old age, increased neutrophil-to-lymphocyte ratio, decreased hemoglobin, increased carcinoembryonic antigen, increased tumor size and advanced TNM stage. Neutrophil-to-lymphocyte ratio was significantly correlated with old age, increased erythrocyte sedimentation rate and advanced TNM stage. In the univariate analysis, elevated erythrocyte sedimentation rate and increased neutrophil-to-lymphocyte ratio had significantly poorer survival than those without elevation (all P<0.05). However, the multivariate analysis failed to prove erythrocyte sedimentation rate and neutrophil-tolymphocyte ratio as independent prognostic factors. Conclusions: The elevation of erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio were correlated with poor prognosis in the univariate analysis and there was a strong correlation between inflammatory parameters (erythrocyte sedimentation rate and neutrophil- to-lymphocyte ratio) and tumor progression. Thus, erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio are considered useful as follow-up factors.

Preoperative Levels of Hematological and Biochemical Indices Affect Perioperative Variables in Adult Patients with Coronary Artery Bypass Graft Surgery

  • Choi, Seok-Cheol;Cho, Byung-Kyu;Lee, Yong-Hwan;Chang, Kyung-Soo
    • Biomedical Science Letters
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    • v.16 no.4
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    • pp.247-258
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    • 2010
  • The objective of this research was to evaluate the relationships of preoperative (Pre-OP) levels of hematological and biochemical indices to perioperative variables in patients that underwent coronary artery bypass graft surgery (CABG). Pre-OP levels of hematological factors [total white blood cells (T-WBC), erythrocytes, hemoglobin, hematocrit, glycohemoglobin A1c (HbA1c), or platelet] were negatively or positively related with biochemical indices [alanine aminotransferase (ALT), bilirubin, glucose, fructosamine, triglyceride, and high density lipoprotein cholesterol (HDL)]. Pre-OP levels of hematological factors and biochemical indices were negatively or positively correlated with echocardiographic variables. Pre-OP level of HbA1c had a relationship with C-reactive protein. Pre-OP levels of aspartate aminotransferase (AST), ALT, HDL, glucose, fructosamine, or blood urea nitrogen (BUN) were positively or negatively associated with Pre-OP levels of cardiac markers (brain natriuretic peptide, troponin-I, creatine kinase isoenzyme 2, or CRP). Pre-OP levels of hematological factors (excepting T-WBC) related with operation time (OPT), postoperative mechanical ventilation time (POMVT), intensive care unit-period (ICU-period) or hospitalization. Pre-OP levels of AST, ALT, bilirubin, triglyceride, HDL, low dwensity lipoprotein, fructosamine, or BUN were positively or negatively correlated with OPT, graft numbers, POMVT, ICU-period or hospitalization. Retrospective this study reveals that Pre-OP levels of hematological and biochemical markers are associated with echocardiographic variables, several cardiac markers and postoperative outcomes, suggesting that Pre-OP levels of hematological and biochemical markers may be useful predictors for the diagnosis and prognosis of coronary artery disease.

Personal Factors that Affect the Satisfaction of Female Patients Undergoing Esthetic Suture after Typical Thyroidectomy

  • Kim, Hyo Young;Kim, Jung Won;Park, Jin Hyung;Kim, Jung Hun;Han, Yea Sik
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.414-424
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    • 2013
  • Background In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome. Methods One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale. Results According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction. Conclusions The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.

Interposition Arthroplasty with Pectoralis Major Muscle Transfer for the Shoulder Arthropathy - 2 Cases Report - (견관절 관절증에서 대흉근 이전술을 이용한 삽입 성형술)

  • Park, Jin-Soo;Lee, Yong-Beom;Yoo, Jung-Han;Park, Yong-Wook;Rowe, Kyu-Cheol;Chung, Kook-Jin;Kim, Hong-Kyun;Hwang, Ji-Hyo;Kim, Hyung-Nyeon;Song, Young-Suk;Son, Won-Su
    • Archives of Reconstructive Microsurgery
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    • v.19 no.1
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    • pp.7-11
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    • 2010
  • Interpostion arthroplasty with allograft has been known as a useful option for the shoulder arthropathy, but it has a limitation to immune response. We performed the pectoralis major muscle transfer for shoulder arthropathy. From January 2007 to December 2007, we performed the pectoralis major muscle transfer in 2 patients. They were 1 man and 1 woman, and the mean age of the patients was 70 years (range, 65 to 75). The average follow-up after surgery was 13 months (range, 12 to 14). We analyzed the clinical results by the American Shoulder and Elbow Surgeons (ASES) Score, and evaluated the pain by Visual Analogue Scale. The level of pain reduced from a preoperative average of 10 to a postoperative average of 1. The ASES scores increased from a preoperative mean of 9 to a postoperative mean of 58. These results indicated that interposition arthroplasty with the pectoralis major muscle transfer is a reliable treatment method for the shoulder arthropathy improving shoulder pain, and patient satisfaction.

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