A Long-Term Follow-up Study for the Treatment of Snoring after Using Patterned Non-Ablative Erbium: YAG 2,940 nm Laser

Abstract Introduction Laser uvulopalatoplasty is an established operation for the treatment of snoring with good results on a short-term basis, while long-term follow-up studies, in addition to their scarcity, had conflicting results regarding recurrence, the change of snoring quality, and complications. Objective To assess the long-term follow-up results of using nonablative 2,940 nm Erbium: YAG for the treatment of snoring regarding outcomes and recurrence. Methods This 2-year follow-up study was conducted on 76 patients operated upon by non-ablative 2940 nm Erbium: yttrium-aluminum-garnet (YAG) using a PS01 patterned headpiece. Subjective evaluation of the treatment was performed relying on a smartphone application to record snoring in addition to a questionnaire specially designed to report recurrence and change in the quality of snoring reported by a patient's spouse. The objective evaluation was done by computed tomography (CT) imaging of the soft palate. The patients were evaluated preoperatively, 6 weeks postoperatively and after a 2-year follow-up period. Results Six week after the procedure, there was a significant improvement in 52 patients (68.4%). Out of the 52 patients, only 43 completed the 2-year follow-up; however, 15 of them complained of recurrence. Nevertheless, the patients who suffered from recurrence showed subjective improvement in snoring quality. Conclusions The nonablative mode of Erbium: YAG 2,940 nm laser proved to be efficient in soft palate tightening for the management of snoring. However, there was recurrence in 34.8% of the patients who presented objective and subjective improvement of the complaints, 6 weeks postoperatively and after a 2-year follow-up period.

Assessment of pain management intervention for treatment of long bone fractures in tertiary care hospital

Background: Musculoskeletal trauma represents a considerable global health burden. Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. So the purpose of the study was to do assessment of pain management intervention, post-op analgesics for treatment of long bone fractures.Methods: All adult patients (more than IS years) reporting to Emergency Medicine Department of a tertiary care hospital with long hone fractures of lower limb were included in the study. Patient pain management was assessed by visual analogue score (VAS). Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. The entire data is statistically analyzed using SPSS software. p-values less than 0.05 are considered to be statistically significant.Results: 74 cases got operated, 64 cases (86.5.0%) did not have any intra-op complications and 10 cases (13.50%) had intra-op complications .Postoperative analgesia the 74 cases operated was as follows: 17 cases (23.0%) epidural anaesthesia 41 Cases (55.4%) had epidural + intravenous analgesics. Recent was managed with 1.V, analgesics alone; 12 cases (16.20%) had tramadol, 2 cases (2.7%) received paracetamol and 2 cases (2.7%) had dynaper for post-operative analgesia.Conclusion: Adequate pain management on arrival in the Emergency Department is an important aspect in patient care and is not at all difficult to achieve. Femoral nerve block in Proximal lower limb fractures is very effective and easy to perform.

Expression and Significance of Plasmic Inflammatory Factor during Perioperative and Follow-up Periods after Endovascular Stents in Patients with Cerebral Arterial Stenosis / 中国康复理论与实践

@#Objective To observe expression and significance of inflammatory factor during perioperative and follow-up periods after endovascular stents in patients with cerebral arterial stenosis.Methods 54 patients diagnosed as cerebral arterial stenosis by digital substraction angiography (DSA) were selected as the stent group and treated with endovascular stents; another 32 subjects had the same disease but not accepted stenting were considered as the control group. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) contents were measured at different time points during perioperative and follow-up periods in the two groups. Stage A represented as day one before angiography or catheterization; stage B as 6 hours postoperatively (stent group) or 6 hours after diagnostic angiography (control group); stages C～I as 12, 24, 48, 72 hours, 1 and 6 months after stent insertion (stent group) or the same time points after angiography (control group).Results Contents of IL-6 and hs-CRP of the stent group were similar as the control group in the stage A ( P>0.05), but significantly higher than that of the control group during stages B～I ( P<0.01～0.05). Among 54 patients of the stent group, 21 cases had restenosis 6 months postoperatively (38.89%). Contents of IL-6 and hs-CRP of the patients were similar as those without restenosis in stages A～F postoperatively ( P>0.05), but significantly higher than that of the cases without restenosis in stages G and I postoperatively ( P<0.01～0.05).Conclusion Endovascular stents can increase the contents of IL-6 and hs-CRP of patients with cerebral arterial stenosis; in addition, high expression of them is the risk factor of post-stent restenosis during follow-up period.

Postoperative recurrences of odontogenic keratocyst: The behavior and proposal of critical follow-up period

Post-operative recurrence of cystic lesion is a great concern for clinician, patients, and their family, especially in case of odontogenic keratocyst, which has aggressive behavior and high recurrence rate. The purpose of this study was to evaluation clinical characters of OKC, focusing of the recurrence rate and proposed critical follow-up period. 58 cases (aged 9 to 66, 33 males and 25 females) of OKC were reviewed for sex of patients, location, size, operative procedure type, radiographic findings, histopathologic findings, post-operative recurrence time, from 2000 to 2005 at Yonsei Medical Center, were selected. The computerized statistical analysis was carried out with SAS system. 18 of 58 cases (31.03%) were recurred and this study revealed no statistically significant difference in recurrence rate for sex, location, size, radiographic findings, histopatologic findings, operative procedure type, recurrence timing. 3 out of 18 cases (16.7%) showed one or more recurrence. This was statistically significant difference (P=.0264). In this study, 15 of 18 cases (83.3%) were observed recurrence during 4 years after removal of the OKCs, we suggest critical follow-up period during 4 years after operation.

A Follow-up Study of Endoscopic Sinus Surgery in Chronic Sinusitis-Assessment of Preoperative OMU-CT Gradings and Postoperative Follow-up Period- / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery has become an effective tool for the treatment of chronic sinusitis. The success of this procedure can be best determined by a long-term evaluation of the surgery results from patients who are grouped according to the prepoerative severity of the disease. In this study we attempted to evaluate the results of endoscopic sinus surgery according to the severity of the disease and the length of the follow-up period. MATERIALS AND METHODS: Questionnaires were sent out to 313 patients with chronic sinusitis who underwent endoscopic sinus surgery at our department from April 1992 to October 1995. Replies from 118 patients (37.69%) were analyzed. All patients had taken preoperative ostiomeatal unit computed tomography (OMU-CT) and their results were graded according to the Levine and May's grading system. The follow-up periods ranged from 7 to 51 months, with the mean of 27 months. RESULTS: All nasal symptoms including nasal obstruction, rhinorrhea, postnasal drip, anosmia and headache significantly improved. The nasal obstruction symptom improved by 76.8%, rhinorrhea 62.1%, postnasal drip 64.4%, anosmia 50.0% and headache 80.0%. However, no statistical significance could be drawn between the improvement rate and the different lengths of the follow-up periods. CONCLUSION: The results suggest that endoscopic sinus surgery might improve nasal symptoms in patients with chronic sinusitis regardless of the severity of disease and the length of follow-up period.

The Surgical Outcome of Intermittent Exotropia and the Prognostic Factors

Surgical results of intermittent exotropia have been reported variabiy according to the criteria of surgical success and the length of follow-up.There have been also controversies about the factors affect the surgical outcoine of intermittent exotropia The surgical outcome and the factors which may affect the surgical results were retrospectively investigated in 165 patients who had undergone surgery for intermittent exotropia with at least 6 months (average 16.6 months, range 6-60 months) of post-operative follow-up.A `satisfactory result` , defined as a final alignment of orthophoria,esotropia less than 5PD or exotropia less than 10PD at far primary position,was achieved in 123 patients (74.5%). The diplopia at. postoperative one day tended to ensure 8 more satisfactory result (P0.05).