• 제목/요약/키워드: surgical diseases

검색결과 934건 처리시간 0.024초

성대 용종의 예후 인자와 음성 위생법 치료 효과 분석 (Analysis for Risk Factors and Effect of Vocal Hygiene Education in Patients of Vocal Polyp)

  • 최나연;김동규;이길준
    • 대한후두음성언어의학회지
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    • 제32권1호
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    • pp.24-28
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    • 2021
  • Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.

Surgical outcomes in dogs with tracheal collapse treated with a novel cross-and-hook braided endoluminal stent

  • Uemura, Akiko;Ozai, Yusuke;Hamabe, Lina;Yoshida, Tomohiko;Tanaka, Ryou
    • Journal of Veterinary Science
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    • 제23권3호
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    • pp.46.1-46.8
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    • 2022
  • Background: Stenting is an effective treatment option for tracheal collapse in dogs. Cross-braided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs. Objectives: To evaluate the outcomes of cross-and-hook braided stent implantation in the treatment of tracheal collapse in dogs. Methods: The medical records of 22 client-owned dogs that underwent luminal placement of cross-and-hook braided Fauna Stents for the treatment of tracheal collapse between January 2018 and July 2021 were examined and data on canine signalment, clinical signs, diagnostic test results, surgical outcomes, and postoperative complications were retrieved and analyzed statistically. Results: Twenty-six stents were surgically implanted, with 20 dogs (90.9%) receiving one stent and the remaining two (9.1%) receiving two or more stents. All dogs survived the procedure. The median survival time at a median follow-up of 990 days was 879 days. At the final follow-up examination, loss or mild improvement of cough was observed in all dogs. Conclusions: Compared with conventional lumen stents, the cross-and-hook braided Fauna Stent offered a higher survival rate and improved clinical symptoms in all patients. The results of this study suggest that the Fauna Stent may be a promising treatment option for dogs with tracheal collapse.

Epidemiologic Study of Operative Treatment for Spinal Metastasis in Thailand : A Review of National Healthcare Data from 2005 to 2014

  • Luksanapruksa, Panya;Santipas, Borriwat;Ruangchainikom, Monchai;Korwutthikulrangsri, Ekkapoj;Pichaisak, Witchate;Wilartratsami, Sirichai
    • Journal of Korean Neurosurgical Society
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    • 제65권1호
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    • pp.57-63
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    • 2022
  • Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

포괄치위생관리 과정을 적용한 치주질환자의 비외과적 치주처치 효과 : 혼합연구방법 적용 (Effect of non-surgical periodontal therapy with the application of a comprehensive dental hygiene care process for periodontal disease patients: using mixed methods research)

  • 서가혜;문상은;김윤정;김선영;조혜은;강현주
    • 한국치위생학회지
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    • 제22권3호
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    • pp.161-170
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    • 2022
  • Objectives: This study aims to conduct in-depth research on the effect of non-surgical periodontal therapy (NSPT) with the application of a comprehensive dental hygiene care (CDHC) process, and provide basic data for the wide application of CDHC. Methods: From May 8, 2021 to September 24, 2021, mixed-methods research was conducted in 36 patients with periodontal diseases. A paired samples t-test was used to analyze the quantitative research data using IBM SPSS program(ver. 22.0; IBM Corp., Armonk, NY, USA) and qualitative research data were analyzed using the thematic analysis method. Results: With NSPT applying the CDHC process, the perception of periodontal health and self-efficacy of periodontal healthcare were increased (p<0.001). Presence of gingivitis, probing pocket depth, bleeding on probing rate, presence of subgingival calculus, and dental plaque index were reduced (p<0.001). Based on 195 meaningful statements, 26 concepts, 12 sub-themes, and 5 themes , , , and were drawn. Conclusions: The perception of periodontal health and the self-efficacy were improved, and substantial change in the clinical index. The CDHC application allowed the study participants to perceive the importance of dental care and professionalism of dental hygienists.

Immediate effect of Nd:YAG laser monotherapy on subgingival periodontal pathogens: a pilot clinical study

  • McCawley, Thomas K.;McCawley, Mark N.;Rams, Thomas E.
    • Journal of Periodontal and Implant Science
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    • 제52권1호
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    • pp.77-87
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    • 2022
  • Purpose: This pilot study assessed the immediate in vivo effect of high peak pulse power neodymium-doped yttrium aluminum garnet (Nd:YAG) laser monotherapy on selected red/orange complex periodontal pathogens in deep human periodontal pockets. Methods: Twelve adults with severe periodontitis were treated with the Laser-Assisted New Attachment Procedure (LANAP®) surgical protocol, wherein a free-running, digitally pulsed, Nd:YAG dental laser was used as the initial therapeutic step before mechanical root debridement. Using a flexible optical fiber in a handpiece, Nd:YAG laser energy, at a density of 196 J/cm2 and a high peak pulse power of 1,333 W/pulse, was directed parallel to untreated tooth root surfaces in sequential coronal-apical passes to clinical periodontal probing depths, for a total applied energy dose of approximately 8-12 joules per millimeter of periodontal probing depth at each periodontal site. Subgingival biofilm specimens were collected from each patient before and immediately after Nd:YAG laser monotherapy from periodontal pockets exhibiting ≥6 mm probing depths and bleeding on probing. Selected red/orange complex periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Fusobacterium nucleatum, Parvimonas micra, and Campylobacter species) were quantified in the subgingival samples using established anaerobic culture techniques. Results: All immediate post-treatment subgingival biofilm specimens continued to yield microbial growth after Nd:YAG laser monotherapy. The mean levels of total cultivable red/orange complex periodontal pathogens per patient significantly decreased from 12.0% pretreatment to 4.9% (a 59.2% decrease) immediately after Nd:YAG laser monotherapy, with 3 (25%) patients rendered culture-negative for all evaluated red/orange complex periodontal pathogens. Conclusions: High peak pulse power Nd:YAG laser monotherapy, used as the initial step in the LANAP® surgical protocol on mature subgingival biofilms, immediately induced significant reductions of nearly 60% in the mean total cultivable red/orange complex periodontal pathogen proportions per patient prior to mechanical root instrumentation and the rest of the LANAP® surgical protocol.

Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study

  • Dal-Lae Jin;Kyoung-Hoon Kim;Euy Suk Chung;Seok-Jun Yoon
    • Journal of Preventive Medicine and Public Health
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    • 제57권3호
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    • pp.260-268
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    • 2024
  • Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

Impact of rumen cannulation surgery on rumen microbiota composition in Hanwoo steers

  • Minseok Kim;Tansol Park;Cheolju Park;Youl-Chang Baek;Ara Cho;Han Gyu Lee;Eunju Kim;Eun-Yeong Bok;Young-Hun Jung;Tai-Young Hur;Yoon Jung Do
    • Journal of Animal Science and Technology
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    • 제66권2호
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    • pp.353-365
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    • 2024
  • Rumen cannulation is a surgical technique used to collect rumen contents from ruminants. However, rumen cannulation surgery may potentially impact the composition of the rumen microbiota. This study aimed to examine the longitudinal alterations in the rumen microbiota composition of Hanwoo steers after cannulation surgery. In this study, eight Hanwoo steers were used; four steers underwent rumen cannulation surgery (cannulation group), while the remaining four were left intact (control group). Rumen samples were collected from all eight steers using the stomach tubing method on the day before surgery (day 0) and on postoperative days 1, 4, 7, 10, 14, 17, 21, 24, and 28, resulting in 80 samples (10 timepoints × 8 animals). The microbiota of all 80 samples were analyzed using 16S rRNA gene amplicon sequencing with Quantitative Insights into Microbial Ecology version 2 (QIIME2). There were no significant differences (p > 0.05) in all major phyla and most major genera representing at least 0.5% of total sequences across all 80 samples between the control and cannulation groups on the preoperative and postoperative days. However, while the alpha diversity indices did not differ (p > 0.05) between the two groups on the preoperative day, they significantly differed (p < 0.05) between the two groups on the postoperative days. Further, the overall microbial distribution based on both unweighted and weighted principal coordinate analysis plots significantly differed (p < 0.05) between the two groups on both the preoperative and postoperative days. Orthogonal polynomial contrasts indicated that major genera and microbial diversity in the cannulation group decreased following surgery but returned to their initial states by postoperative day 28. In conclusion, this study demonstrates that rumen cannulation surgery affects some major taxa and microbial diversity, suggesting that the rumen cannulation method can alter the composition of rumen microbiota in Hanwoo steers.

항결핵제와 수술적 병합치료를 시행한 진행된 결핵성 경부 임파선염 환자에 대한 연구 (Retrospective Study about Medical and Surgical Combination Therapy for Advanced Cervical Tuberculous Lymphadenitis)

  • 송하도;김종경;조동일;홍인표;유남수
    • Tuberculosis and Respiratory Diseases
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    • 제65권4호
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    • pp.277-284
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    • 2008
  • 연구배경: 결핵성 경부 임파선염은 항결핵제로 치료하는 것이 권고되고 있다. 그러나 저자들은 결핵성 경부 임파선염이 적절한 항결핵제 치료에도 불구하고 진행되어 수술적 절제가 필요한 경우를 경험하게 되었다. 이에 약물과 수술을 병합하여 진행된 결핵성 경부 임파선염을 치료한 환자를 대상으로 후향적으로 관찰해 보았다. 방 법: 결핵성 경부 임파선염을 진단받고 항결핵제로 치료하였으나 진행되어 치료가 어려워 수술을 시행한 13명에 관한 의무기록을 후향적으로 연구하였다. 결 과: 내과적 치료가 어려워 수술을 병합한 13명을 후향적으로 관찰하였을 때 임상 증상은 일반적인 결핵성 경부 임파선염의 양상과 비슷하였다. 수술 전 평균 항결핵제 투약 기간은 10.2개월이었고 수술 후 평균 투약기간은 15.2개월이었고 총 약물 투여 기간은 평균 25.4개월로 일반적 결핵성 경부 임파선염의 치료기간보다 길었다. 경과 관찰 중 2명은 재발되었다. 1명은 11번 부신경 손상의증의 수술합병증이 있었다. 결 론: 결핵성 경부 임파선염은 내과적 질환이라고 하 지만 경우에 따라서 외과적 치료가 불가피한 경우도 있었다. 수술이 필요했던 13명의 환자는 대부분 여자였고 폐결핵 및 다른 폐외결핵을 동반한 전신 결핵 환자였다. 수술적 치료로 13명 중 11명에서 비교적 외견상 성공적이었다고 할 수 있으나, 술전 및 술후 항결핵제 투약기간의 단축과 무관하였으며 수술 후에도 충분한 기간 항결핵제 사용이 필요하였다.

전통사회에서 외래종 작물인 고추의 효능 인식 - 한국 전통의서를 중심으로 - (Recognition of Medicinal Efficacy of Pepper as an Introduced Species in Traditional Medicine)

  • 오준호;권오민;박상영;안상우
    • 한국식생활문화학회지
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    • 제27권1호
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    • pp.12-18
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    • 2012
  • The aim of this study is to look at how pepper was used in traditional medicine. In other words, this study aims to take a look at the process by which the medicinal nature & efficacy of pepper in traditional society was perceived and arranged through the aspects of the use of pepper as an exotic crop for treating diseases. This study investigated cases of using pepper for medical treatments by referring to books on traditional medicine in Korea. The old records about pepper are mainly in empirical medical books from the late Chosun dynasty. Nevertheless, the records about pepper tend to decrease in medical text as time goes by. Such a phenomenon can be attributable to the fact that people began to use pepper for daily food life rather than for medicinal purposes. Pepper was used mostly for digestive trouble such as vomiting, diarrhea, and stomachaches, and it was also applied to mental and aching diseases caused by the sound of body fluids remaining in the stomach. In addition, there were many cases where pepper was used externally for surgical disorders. Such symptoms for treatment are linked to, or in a complementary relationship with, research results in modern times. Boiled pepper was generally taken in the traditional herbal decoction method, and in the case of surgical diseases, it was applied externally. The cases of using old pepper, using pepper with seeds or without seeds, and using pepper mixed with sesame oil belong to a sort of herbal medicine processing, which usually aimed at changing the medicinal nature of pepper. In addition, in relation to the eating habits at that time, pepper was used as seasoning and to make red pepper paste with or without vinegar. There are two words used for pepper in the medical textbooks, 苦椒 (gocho) and 烈棗 (yeoljo). These words are translated into Korean as gochu, so we can identify this word as a nickname for pepper.

Parenchymal-sparing anatomical hepatectomy based on portal ramification of the right anterior section: A prospective multicenter experience with short-term outcomes

  • Truong Giang Nguyen;Thanh Khiem Nguyen;Ham Hoi Nguyen;Hong Son Trinh;Tuan Hiep Luong;Minh Trong Nguyen;Van Duy Le;Hai Dang Do;Kieu Hung Nguyen;Van Minh Do;Quang Huy Tran;Cuong Thinh Nguyen
    • 한국간담췌외과학회지
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    • 제28권1호
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    • pp.25-33
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    • 2024
  • Backgrounds/Aims: Parenchymal-sparing anatomical hepatectomy (Ps-AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps-AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α-Fetoprotein was 25.2 ng/mL. All cases (100%) had Child-Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien-Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions: Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.