• Title/Summary/Keyword: short-term outcome

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Laparoscopy-Assisted Distal Gastrectomy for Early Gastric Cancer in the Elderly

  • Kim, Eun Ji;Seo, Kyung Won;Yoon, Ki Young
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.232-236
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    • 2012
  • Purpose: With an increase in life expectancy, more elderly patients are presenting with gastric cancer. As a result it is yet be resolved whether laparoscopy assisted distal gastrectomy is a suitable treatment for elderly patients with early gastric cancer. This study retrospectively compared surgical outcomes of laparoscopy assisted distal gastrectomy between elderly and nonelderly patients with gastric cancer. Materials and Methods: The study group was comprised of 316 patients who underwent laparoscopy assisted distal gastrectomy between April 2005 and December 2010. Of these patients, 93 patients whose ages were 65 years or more were compared with 223 patients who were younger. Results: There were no differences in the short term outcome or minor complication rate between the elderly patients and the nonelderly patients. The hospital stay was significantly longer and the major complication rate was significantly higher for the elderly patients compared with nonelderly patients. Conclusions: Laparoscopy assisted distal gastrectomy for early gastric cancer in the elderly patients had comparable operation time and blood loss with the nonelderly group. However, the safety and advantage of laparoscopy assisted distal gastrectomy in the elderly patients need to be further studied in higher volume trials.

Update of minimally invasive surfactant therapy

  • Shim, Gyu-Hong
    • Clinical and Experimental Pediatrics
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    • v.60 no.9
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    • pp.273-281
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    • 2017
  • To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death. Since then, the use of NIV as primary therapy for preterm infants has increased, but when and how to give exogenous surfactant remains unclear. Overcoming this problem, minimally invasive surfactant therapy (MIST) allows spontaneously breathing neonates to remain on CPAP in the first week after birth. MIST has included administration of exogenous surfactant by intrapharyngeal instillation, nebulization, a laryngeal mask, and a thin catheter. In recent clinical trials, surfactant delivery via a thin catheter was found to reduce the need for subsequent endotracheal intubation and mechanical ventilation, and improves short-term respiratory outcomes. There is also growing evidence for MIST as an alternative to the INSURE (intubation-surfactant-extubation) procedure in spontaneously breathing preterm infants with RDS. In conclusion, MIST is gentle, safe, feasible, and effective in preterm infants, and is widely used for surfactant administration with noninvasive respiratory support by neonatologists. However, further studies are needed to resolve uncertainties in the MIST method, including infant selection, optimal surfactant dosage and administration method, and need for sedation.

Raiofrequency Neurotomy for Lumbar Facet Joint Pain in the Patients with Failed Back Surgery Syndrome (척추수술 후 증후군 환자에서 관찰된 추간관절통에 대한 고주파신경절리술)

  • Lee, Jeong Hoon;Shim, Jae Chol
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.151-155
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    • 2005
  • Background: A significant number of patients complain of persistent pain or neurologic symptoms after lower back surgery. It is reported that facet joint pain plays a role in failed back surgery syndrome. To the best of our knowledge, there are few studies that have investigated the outcome of radiofrequency neurotomy in the patients with failed back surgery syndrome. Methods: The study group was composed of thirteen patients who were operated on due to their low back pain, and they displayed no postoperative improvement. All the patients underwent double diagnostic block of the lumbar medial branch of the dorsal rami with using 0.5% bupivacaine. The patients who revealed a positive response to the double diagnostic block were then treated with percutaneous radiofrequency neurotomy. The effect on their pain was evaluated with using a 4 point Likert scale. Results: Eleven patients revealed a positive response to the double diagnostic block. Ten patients were given percutaneous radiofrequency neurotomy. Nine patients showed sustained pain relief for 3 months after the percutaneous radiofrequency neurotomy. Conclusions: We found lumbar facet joint syndrome in the patients with failed back surgery syndrome by performing double diagnostic block and achieving pain relief during the short term follow-up after percutaneous radiofrequency neurotomy of the lumbar zygapophysial joints. This suggested that facet joint pain should be included in failed back surgery syndrome.

TREATMENT OF MANDIBLE FRACTURES USING BIOABSORBABLE PLATES: PRELIMINARY STUDY (생흡수성판을 이용한 하악골 골절의 치료 : 일차보고)

  • Kim, Young-Kyun;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.570-575
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    • 2001
  • This study evaluated the short-term outcome of treating fractures of the mandible with bioabsorbable plates. Thirty-four fractures of the mandible in 27 patients were treated by open reduction and internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm, and 1.5-mm pre-tapped screws. The duration of intermaxillary fixation ranged from 0 to 23 days, with a mean of 5.3 days. Patients were evaluated for complications during the follow-up period, which ranged from 2 to 18 months. Five patients(18.5%) experienced complications. These included infection (four patients), and premature occlusal contact(one patient). Except for one case, all complications were minor and adequately managed with incision and drainage, elastic traction, and medication. Delayed infection (osteomyelitis) developed in a symphysis fracture and was treated by saucerization and antibiotics. The fracture line subsequently showed complete consolidation. Bioabsorbable plates can be selectively used for internal fixation in mandibular fractures with the advantage that they do not need to be removed.

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Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases

  • Lee, Sang-Hoon;Ryu, Da-Jung;Kim, Hye-Sun;Kim, Hyung-Gon;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.6
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    • pp.297-303
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    • 2013
  • Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.

The Clinical Effect of Korean Medical Rehabilitation Protocol for Total Knee Replacement: A Report of 4 Cases (슬관절 전치환술 후 한방 재활치료 프로토콜 적용의 임상적 효과: 증례 보고)

  • Han, Soo-Yeon;Kim, Mi-Hyun;Park, Eun-Sang;Kang, Jun-Hyuk;Kim, Dong-Yeong
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.219-231
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    • 2020
  • The objective of this study is to propose a Korean medical rehabilitation protocol for total knee replacement (TKR) and to report its effectiveness. This study was conducted as a retrospective study which analyzes the medical records of 4 patients undergoing Korean medical rehabilitation with protocol and continuous passive motion exercise for more than two weeks after TKR. We evaluated the outcome checking physical examination findings of the knee joint, numeric rating scale (NRS), Lysholm knee score (LKS) and walking state. After the treatment, we observed that the function of knee joint, NRS, LKS, walking state of patients were improved. This study showed that Korean medical rehabilitation protocol has effect on knee joint recovery after TKR. The limitation of this study was the insufficient number of cases and short-term follow up. Further studies should be done steadily to report the effectiveness of a Korean Medical rehabilitation protocol for TKR.

V-shaped Liver Retraction during a Laparoscopic Gastrectomy for Gastric Cancer

  • Oh, Dong-Kyo;Hur, Hoon;Kim, Jun-Young;Han, Sang-Uk;Cho, Yong-Kwan
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.133-136
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    • 2010
  • Purpose: The aim of this study was to evaluate the effectiveness of our retraction method for achieving a good operative field for the adequate lymph node dissection during laparoscopic gastrectomy in view of short term surgical outcome. Materials and Methods: This study prospectively enrolled 19 patients who underwent laparoscopic gastrectomy for early gastric cancer. The procedure was simply performed by putting the laparoscopic sigle suture in the phrenoesophageal ligament, and then the string was pulling and tying over the sternum. Surgical outcomes of these patients were evaluated. Results: Under V-shaped liver retraction, the mean operating time and mean number of retrieved lymph nodes was 166.3 minute and 31.37, respectively. And the results were satisfactory compared to open or conventional laparoscopic gastric surgery. Conclusions: V-shaped liver retraction requires no extra port or assistant's hands, and prevents additional injury to any intra-abdominal organ. And this method can easily, efficiently and safely enable to achieve a good operative field for the lymph node dissection near the lesser curvature of the stomach.

Research trends in obesity & obesogenic environments in Korea

  • Lee, Myoungsook
    • Nutrition Research and Practice
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    • v.13 no.6
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    • pp.461-472
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    • 2019
  • BACKGROUND/OBJECTIVES: Globally, it has been projected that there will be 2 billion overweight and 1 billion obese individuals by 2030. In Korea, the prevalence of adult obesity (BMI > 25) increased from 29.7% in 2009 to 32.4% in 2015. Moreover, childhood obesity, which leads to adulthood obesity, has increasingly become a social problem. The purpose of this review is to summarize the scientific basis for the development of effective models and policies aimed at preventing obesity over a lifetime based on research modeling obesogenic environments. MATERIALS/METHODS: The review focuses on the characteristics of obesity prevalence and trends in 3P analysis (papers, patents, and products) as well as government-funded projects in Korean obesity obesogenic environments over the last 10 years. RESULTS AND DISCUSSION: As a result of the 3P analysis, studies on obesity risk factors were frequently carried out, according to two data bases RISS (4.9%) and PubMed (24.7%). Since there were only 17% patents related to the mechanism of preventing obesity in 7,951 Korean patents related to obesity, new paradigms of technologies to dominate the global obesity markets are needed. After government-funded projects were analyzed, communication and cooperation in multi-governmental departments were suggested to elucidate the characteristics of Korean obesity. Government should also produce short- and long-term road maps to develop a practical, successful outcome. Although the rate of obesity in Korea is currently lower than in other developed countries according to WHO criteria, without adequate governmental intervention, obesity rates will approach those of the top countries with high incidence rates of obesity within the next 10 years.

The Effects of Passive Exercise on Upper Extremities Muscle Spasticity, Finger Edema and Depression for Chronic Stroke Patients at Long-term Care Hospitals (상지수동운동이 만성 뇌졸중 노인 환자의 상지경직, 손가락부종 및 우울에 미치는 효과)

  • Nam, Song Mi;Eun, Young
    • Journal of muscle and joint health
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    • v.25 no.3
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    • pp.167-175
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    • 2018
  • Purpose: The aim of this study was to test the effects of passive exercise on upper extremities muscle spasticity, finger edema, and depression for chronic stroke patients. Methods: A non-equivalent pretest-posttest design was employed for this study. The subjects were 30 elderly patients who were hospitalized to treat chronic stroke. 15 patients were assigned to the experimental and control groups respectively. Passive exercise for 20 minutes per day, five days a week for 8 weeks (total 40 times) was provided for the experimental group. Outcome measurements included manual spasticity test to measure upper extremities' muscle spasticity, the ring measurement method for finger edema and the Korean version of Short-form Geriatric Depression Scale (SGDS-K) for depression. Results: The upper extremities' muscle spasticity (Z=-2.52 p=.012) and the degree of depression (F=5.56, p=.006) in the experimental group were significantly reduced compared to those of the control group. But the degree of finger edema did not significantly differ between the two groups (F=1.46, p=.240). Conclusion: Passive exercise for upper extremities should be encouraged for elderly patients with chronic stroke to enhance the upper extremities' functional capacity as well as depression.

Comparison of porcine and human acellular dermal matrix outcomes in wound healing: a deep dive into the evidence

  • Saricilar, Erin Cihat;Huang, Sarah
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.433-439
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    • 2021
  • Acellular dermal matrices (ADM) are a novel graft. The goal of this systematic review is to evaluate the evidence behind differences in human and porcine ADM, irrelevant of manufacturing method, and to determine if there is enough of an evidence base to change clinical practice. An extensive literature search was performed through MEDLINE and Embase with search terms defining a population, intervention and outcome. Title and abstract exclusion were performed with other exclusion criteria. In 191 articles were found after exclusion of duplicates, with only 29 remaining following exclusions. Ten studies were found to have level I and II evidence (I=3, II=8), of which two were histopathological, one was an animal model, one was a systematic review, and six were clinical. The remaining studies were reviewed and considered for discussion, but did not hold high enough standards for medical evidence. Strong clinical evidence already exists for the use of human ADM, but questions of access, cost, and ethics require consideration of a xenograft. Histopathologically, evidence suggests minimal long-term differences between human and porcine ADM, although there is a short acute immune response with porcine ADM. Clinically, there is limited difference in outcomes, with a small range in effect of different ADM preparations. Considering the effectiveness of ADM in wound healing, more high-level research with appropriate statistical analysis to facilitate a future meta-analysis is recommended to justify a transition from human to porcine ADM.