1.Far-Infrared Radiation to Improve Clinical Outcomes after Arthroscopic Rotator Cuff Repair: A Prospective Randomized Comparative Clinical Study
Joo Hyun PARK ; Ji Young YOON ; Myeong Gon JEONG ; Hyeon Jang JEONG ; Joo Han OH
Clinics in Orthopedic Surgery 2023;15(5):826-833
Background:
The efficacy of far-infrared radiation (FIR) after rotator cuff repair has not been demonstrated yet. The aim of this study was to evaluate the effects of postoperatively applied FIR with regard to early pain, range of motion (ROM), and tendon-tobone healing after arthroscopic rotator cuff repair.
Methods:
A total of 64 consecutive patients who underwent arthroscopic rotator cuff repair with small- to medium-sized tears were enrolled in this prospective comparative study and randomly divided into an FIR group (n = 31) and a control group (n = 33).In the FIR group, FIR using a radiator device (Aladdin-H) was applied for 30 minutes per session twice daily from the first postoperative day. This application lasted for 10 weeks during the postoperative period. Clinical outcomes were assessed using a visual analog scale for pain (pVAS) at 5 weeks and ROM at 3 and 6 months postoperatively. Functional scores were evaluated at 6 months postoperatively. Healing of the repaired rotator cuff was also evaluated using ultrasonography at 3 months and magnetic resonance imaging at 6 months postoperatively.
Results:
In both groups, clinical and functional outcomes were improved up to 6 months compared with preoperative values. At 5 weeks and 3 months postoperatively, the average pVAS was significantly lower in the FIR group than in the control group (1.7 ± 1.0 vs. 2.8 ± 1.4; p = 0.002 at 5 weeks, 2.4 ± 1.3 vs. 3.2 ± 1.8; p = 0.041 at 3 months). However, there was no significant difference in ROM, functional score, or healing rate between two groups at each follow-up time point.
Conclusions
The application of FIR after arthroscopic rotator cuff repair could be a safe and effective procedure to decrease postoperative pain, especially in the early postoperative period. This effective application of FIR can be considered to facilitate painless rehabilitation in the postoperative period after arthroscopic rotator cuff repair.
2.The Clinical Experience of an Ultrasound-guided Vacuum-assisted Resection (Mammotome) for Benign Breast Lesions through a Core Needle Biopsy.
Jae Heok JEONG ; Hwi Gon KIM ; Ki Hyung KIM ; Ook Hwan CHOI
The Journal of Korean Society of Menopause 2013;19(1):9-17
OBJECTIVES: This study was performed to consider the clinical experience of an ultrasound-guided vacuum-assisted resection (Mammotome) for benign breast lesions through a core needle biopsy. METHODS: The authors carried out a core needle biopsy and Mammotome for 347 patients and investigated the pathologic results. RESULTS: The significant difference of core needle biopsy and Mammotome results was demonstrated, Spearman correlation coefficient is 0.413 in a correlation analysis. CONCLUSION: This experience suggest Mammotome is a useful procedure for providing more correct pathologic findings through complete resection of benign breast lesions.
Biopsy, Large-Core Needle
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Breast
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Breast Diseases
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Breast Neoplasms
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Humans
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Mammography
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Needles
3.The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea
Dong-gon HYUN ; Jee Hwan AHN ; Ha-Yeong GIL ; Chung Mo NAM ; Choa YUN ; Jae-Myeong LEE ; Jae Hun KIM ; Dong-Hyun LEE ; Ki Hoon KIM ; Dong Jung KIM ; Sang-Min LEE ; Ho-Geol RYU ; Suk-Kyung HONG ; Jae-Bum KIM ; Eun Young CHOI ; JongHyun BAEK ; Jeoungmin KIM ; Eun Jin KIM ; Tae Yun PARK ; Je Hyeong KIM ; Sunghoon PARK ; Chi-Min PARK ; Won Jai JUNG ; Nak-Jun CHOI ; Hang-Jea JANG ; Su Hwan LEE ; Young Seok LEE ; Gee Young SUH ; Woo-Sung CHOI ; Keu Sung LEE ; Hyung Won KIM ; Young-Gi MIN ; Seok Jeong LEE ; Chae-Man LIM
Journal of Korean Medical Science 2023;38(19):e141-
Background:
Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known.
Methods:
From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups.
Results:
Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582).
Conclusion
In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.