Seo, Joong-Bae;Yoo, Jae-Sung;Ryu, Jee-Won;Shin, Yong-Eun
Clinics in Shoulder and Elbow
/
v.19
no.4
/
pp.192-196
/
2016
Background: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. Methods: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. Results: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). Conclusions: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.
Background: Tetralogy of Fallot (TOF) is a well-recognized congenital heart disease. Despite improvements in the outcomes of surgical repair, the optimal timing of surgery and type of surgical management of patients with TOF remains controversial. The purpose of this study was to assess outcomes following the repair of TOF in infants depending on the surgical procedure used. Methods: This study involved the retrospective review of 120 patients who underwent TOF repair between 2010 and 2013. Patients were divided into three groups depending on the surgical procedure that they underwent. Corrective surgery was done via the transventricular approach (n=40), the transatrial approach (n=40), or a combined atrioventricular approach (n=40). Demographic data and the outcomes of the surgical procedures were compared among the groups. Results: In the atrioventricular group, the incidence of the following complications was found to be significantly lower than in the other groups: complete heart block (p=0.034), right ventricular failure (p=0.027) and mediastinal bleeding (p=0.007). Patients in the atrioventricular group had a better postoperative right ventricular ejection fraction (p=0.001). No statistically significant differences were observed among the three surgical groups in the occurrence of tachycardia, renal failure, and tricuspid incompetence. The one-year survival rates in the three groups were 95%, 90%, and 97.5%, respectively (p=0.395). Conclusion: Combined atrioventricular repair of TOF in infancy can be safely performed, with acceptable surgical risk, a low incidence of reoperation, good ventricular function outcomes, and an excellent survival rate.
Background: The purpose of this study is to investigate clinical outcomes and radiological findings of cyst formation in the glenoid around suture anchors after arthroscopic Bankart repair with either biocomposite suture anchor or all-suture anchor in traumatic anterior shoulder instability. We hypothesized that there would be no significant difference in clinical and radiological outcomes between the two suture materials. Methods: This retrospective study reviewed 162 patients (69 in group A, biocomposite anchor; 93 in group B, all-suture anchor) who underwent arthroscopic Bankart repair of traumatic recurrent anterior shoulder instability with less than 20% glenoid defect on preoperative en-face view three-dimensional computed tomography. Patient assignment was not randomized. Results: At final follow-up, the mean subjective shoulder value, Rowe score, and University of California, Los Angeles shoulder score improved significantly in both groups. However, there were no significant differences in functional shoulder scores and recurrence rate (6%, 4/69 in group A; 5%, 5/93 in group B) between the two groups. On follow-up magnetic resonance arthrography/computed tomography arthrography, the incidence of peri-anchor cyst formation was 5.7% (4/69) in group A and 3.2% (3/93) in group B, which was not a significant difference. Conclusions: Considering the low incidence of peri-anchor cyst formation in the glenoid after Bankart repair with one of two anchor systems and the lack of association with recurrence instability, biocomposite and all-suture anchors in Bankart repair yield satisfactory outcomes with no significant difference.
Kim, Donghee;Kwon, Bo Sang;Kim, Dong-Hee;Choi, Eun Seok;Yun, Tae-Jin;Park, Chun Soo
Journal of Chest Surgery
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v.55
no.2
/
pp.151-157
/
2022
Background: We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods: Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results: The median age and body weight at operation were 9 months (interquartile range [IQR], 3-238 months) and 7.5 kg (IQR, 5.8-49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39-195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6-112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion: Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.
Park, Jin-Young;Lee, Jae-Hyung;Oh, Kyung-Soo;Chung, Seok Won;Choi, Yunseong;Yoon, Won-Yong;Kim, Dong-Wook
Clinics in Shoulder and Elbow
/
v.24
no.3
/
pp.135-140
/
2021
Background: We hypothesized in this study that the characteristics of retear cases vary according to surgeon volume and that surgical outcomes differ between primary and revision arthroscopic rotator cuff repair (revisional ARCR). Methods: Surgeons performing more than 12 rotator cuff repairs (RCRs) per year were defined as high-volume surgeons, and those performing fewer than 12 RCRs were considered low-volume surgeons. Of the 47 patients who underwent revisional ARCR at our clinic enrolled in this study, 21 cases were treated by high-volume surgeons and 26 cases by low-volume surgeons. In all cases, the interval between primary surgery and revisional ARCR, degree of "acromial scuffing," number of anchors, RCR technique, retear pattern, fatty infiltration, retear size, operating time, and clinical outcome were recorded. Results: During primary surgery, significantly more lateral anchors (p=0.004) were used, and the rate of use of the double-row repair technique was significantly higher (p<0.001) in the high- versus low-volume surgeon group. Moreover, the "cut-through pattern" was observed significantly more frequently among the cases treated by high- versus low-volume surgeons (p=0.008). The clinical outcomes after revisional ARCR were not different between the two groups. Conclusions: Double-row repair during primary surgery and the cut-through pattern during revisional ARCR were more frequent in the high- versus low-volume surgeon groups. However, no differences in retear site or size, fatty infiltration grade, or outcomes were observed between the groups.
UV radiation is the most dangerous stress factor among permanent environmental impacts on human skin. Consequences of UV exposure are aberrant tissue architecture, alterations in skin cells including functional changes. Nowadays new kinds of outdoor leisure-time activities and changing environmental conditions make the question of sun protection more important than ever. It is necessary to recognize that self-confident consumers do not consider to change their way of life, they demand modern solutions on the basis of new scientific developments. In the past one fundamental principle of cosmetics was the use of physical and organic filter systems against damaging UV-rays. Today new research results demonstrate that natural protecting cell mechanisms can be activated. Suitable biological actives strongly support the protection function not from the surface but from the inside of the cell. A soy seed preparation (SSP) was proven to stimulate natural skin protective functions. The major functions are an increased energy level and the prevention of DNA damage. These functions can I be defined as biological UV protection. The tumor suppressor protein p53 plays a key role in the regulation of DNA repair. p53 must be transferred into the phosphorylated form to work as transcription factor for genes which are regulating the cell cycle or organizing DNA repair. A pretreatment with SSP increases the phosphorylation rate of p53 of chronically UV-irradiated human keratinocytes significantly. According to the same test procedure SSP induces a dramatic increase in the expression of the tumor suppressor protein p14$^{ARF}$ that is supporting the p53 activity by blocking the antagonist of p53, the oncoprotein Mdm2. Mdm2, a ubiquitin E3-ligase, downregulates p53 and at the same time it prevents phosphorylation of p53. The positive influence of the tumor suppressor proteins explains the stimulation of DNA repair and prevention of sunburn cell formation by SSP, which was proven in cell culture experiments. In vivo the increased skin tolerance against UV irradiation by SSP could be confirmed too. We have assumed, that an increased repair potential provides full cell functionality.y.
We reviewed our 18-year surgical experience of biventricular repair for double-outlet right ventricle. Material and Method: One hundred twelve consecutive patients (80 males and 32 females) who underwent biventricular repair for double-outlet right ventricle between May 1986 and September 2002 were included. We assessed risk factors for early mortality and reoperation. Reoperation-free survival rate and actual survival rate were analysed. Result: Most common type of ventricular septal defect was subaortic (n=58, 52%) and non-committed type was second most common (n=32, 29%). Four different surgical methods were used: intraventricular baffle repair (n=71 , 63%): right ventricle to pulmonary ariery conduit interposition or REV with left ventricle to aorta baffle repair (n=24, 21 .4%): arierial switch operation with left ventricle to pulmonary artery baffle (n=14, 12.5%): Senning atrial switch operation with left ventricle to pulmonary artery baffle (n=3, 2.7%). Thirty four patients(30%) underwent palliative procedures before definite repair. Twenty three patients (21%) required reoperations. There were 12 (10.7%) early deaths and 4 late deaths. Age younger than 3 months at repair (p=0.003), cardiopulmonary bypass and aortic cross clamp time (p=0.015, p=0.067), type of operation (arterial switch operation) (p <0.001) and type of ventricular septal defect (subpulmonic type) (p=0.002) were revealed as risk factors for early death in univariate analysis, while age under 3 months was the only significant risk factor in multivariate analysis. Patients younger than 1 year of age (p=0.02), pulmonary artery angioplasty at definitive repair (p=0.024), type of ventricular septal defect (non-committed) (p=0.001), type of operation (right ventricle to pulmonary artery conduit interposition and REV operation) (p=0.028, p=0.017) were risk factors for reoperation in univariate analysis but there was no significant risk factor in multivariate analysis. Follow-up was available on 91 survivals with a mean duration of 110.8$\pm$56.4 (2~201) months. 5, 10 and 15 year survival rates were 86.5%, 85% and 85% and reoperation free survival were 85%, 71.5%, 70%. Conclusion: Age under 3 months at repair, subpulmonic ventricular septal defect and arterial switch operation were significant risk factors for early mortality. Patients with non-committed ventricular septal defect and who underwent conduit interposition or REV operation were risk factors for reoperation. With careful attention to chose best timing and surgical approach depending on morphologic characteristics, biventricular repair for double outlet right ventricle can be achieved with good long-term outcome.
In this study, damaged composite laminates were repaired by a stepped patch repair method using halloysite nanotube(HNT) and milled carbon(MC) reinforced composite materials with different amount of the particles. And the mechanical and structural effects of the particles on the interface between the damaged and repair surfaces were analyzed. At this time, after exposing them to a harsh environment of high temperature and humidity for a long time, the recovery rate of the material properties relative to the material forming the damaged plate was compared. As a result, at $70^{\circ}C$ high temperature distilled water, the hygroscopicity of the HNT/GFRP composites was significantly different from that of the MC/GFRP composites. Especially, 0.5, 1 wt. % HNT was added, the moisture absorption rate was the lowest and this was the factor that contributed to the mechanical strength increase. On the other hand, MC showed a high hygroscopic resistance only with a small amount, and the strength was different according to the action direction of the load, and the addition amount was also different.
This study was designed to evaluate the mutagenicity and the primary mutagenic mechanism of chloropropanols by using various genotypes of E. coli WP2, E. coli TK and E. coli GW series strains. Chloropropanols showed the low mutagenic activities in E. coli WP2s and WP2 establishing the following order; 2,3-DCP> 3-MCPD>1,3-DCP. As compared with E. coli WP2s, the decrease of mutagenic activity and the increase of survival rate in E. coli WP2 $(WP2s\;uvrA^+)$ suggest that DNA lesions produced by chloropropanols could be easily removed by excision-repair system. From the diminution of mutagenic activity and survival rate in E. coli CM611 (WP2s lexA), it was confirmed that the mutagenesis by chloropropanols was dependent on the SOS-repair system. This fact could be also confirmed from the result that both the mutagenic activity and survival rate in E. coli TK610 (umuC) were much lower than those in E. coli TK603 $(umuC^+)$. In the experiment to examine the possibility that chloropropanols might have effects on the LexA of SOS response negative regulator, there was no variation in ${\beta}-galactosidase$ activities of E. coli GW1105 $[lexA3\;(Ind^-)]$ and GW1107 [lexA51 (Def)] by addition of the compounds, indicating that chloropropanols do not have any effects on the LexA, itself.
Most of meat spoilage bacteria area Gram negative, which are very sensitive to freezing ; for instance , 90% of E. coli cells are killed or sub-lethally injured by freezing at -3$0^{\circ}C$, and the freeze-injury rate is dependent upon freezing rate. Since the injured bacterial cells are sensitive to selective agents, they fail to multiply in selective media. Injured bacterial cells are, however, capable of spontaneous repair at appropriate environmental and nutritional conditions . Enumeration of injured bacterial cells involves artificial induction of repair at these conditions. Cubic beef samples(3$\times$3$\times$3cm) were frozen at -6$0^{\circ}C$, -4$0^{\circ}C$, or -18$^{\circ}C$. The samples frozen at each temperature were thawed at 4$^{\circ}C$, 2$0^{\circ}C$, or by microwave . After these respective freezing an thawing treatments, the percentage of sub-lethally injured total coliforms out of total surviving ones was measured and compared. The results were as follows: 1. The interaction between freezing and thawing on injury rate was not significant. 2. The injury rates(as means of all three thawing treatments post-freezing) by freezing at -6$0^{\circ}C$, -4$0^{\circ}C$, or -18$^{\circ}C$ were 32.2$^{\circ}C$ and 19.2$^{\circ}C$ respectively . 3. The injury rates(as means of all three freezing treatments)by thawing at 4$^{\circ}C$, 2$0^{\circ}C$, or by microwave were 49.3%, 11.7% and 21.0% respectively. The highest injury rate was caused by freezing at -6$0^{\circ}C$ and subsequent thawing at 4$^{\circ}C$. However since the injury rates by freezing treatment were not significantly different, freezing at -18$^{\circ}C$ and subsequent thawing at 4$^{\circ}C$ can also be recommended , from an economic perspective.
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