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1.
Clin Otolaryngol ; 44(6): 968-974, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31436019

RESUMO

OBJECTIVES: This study evaluated the efficacy of piezoelectric osteotomy in reducing oedema and ecchymosis during rhinoplasty via a systematic review with meta-analysis. DESIGN AND SETTING: Two authors independently searched the referenced databases. PubMed, Embase, SCOPUS, the Web of Science, the Cochrane library and Google Scholar databases were systematically searched from inception to January 2019. PARTICIPANTS: Sufficient data were retrieved for a meta-analysis of six trials with a total of 327 patients. MAIN OUTCOME MEASURES: They included studies that compared piezoelectric osteotomy (treatment groups) with conventional osteotomy (control group). The outcomes of interest were operative time, mucosal injury, oedema, ecchymosis and postoperative pain. Baseline study characteristics, quality of study, numbers of patients in the treatment and control groups and outcomes were extracted. RESULTS: Intraoperative mucosal injury was significantly lower in the treatment group vs the control group, but operative time was longer in the treatment group. Eyelid oedema and ecchymosis in the first seven days postoperatively were statistically decreased in the treatment group vs the control group. In addition, pain in the first three days postoperatively was statistically decreased in the treatment group vs the control group. However, in a subgroup analysis according to osteotomy visibility in the control group (blind osteotomy vs osteotomy under direct vision), there was no significant difference in oedema and ecchymosis between treatment and osteotomy under direct vision. CONCLUSIONS: Piezoelectric osteotomy during rhinoplasty can reduce eyelid oedema and eyelid ecchymosis compared to conventional osteotomy. However, piezoelectric osteotomy had no significant advantages in terms of postoperative oedema and ecchymosis compared to osteotomy under direct vision.


Assuntos
Equimose/prevenção & controle , Edema/prevenção & controle , Osteotomia/efeitos adversos , Piezocirurgia/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Rinoplastia/efeitos adversos , Equimose/epidemiologia , Edema/epidemiologia , Humanos , Complicações Pós-Operatórias/epidemiologia
3.
Adv Mater ; : e2400930, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38940323

RESUMO

Solar heating and radiative cooling are promising solutions for decreasing global energy consumption because these strategies use the Sun (≈5800 K) as a heating source and outer space (≈3 K) as a cooling source. Although high-performance thermal management can be achieved using these eco-friendly methods, they are limited by daily temperature fluctuations and seasonal changes because of single-mode actuation. Herein, reversible solar heating and radiative cooling devices formed via the mechanically guided assembly of 3D architectures are demonstrated. The fabricated devices exhibit the following properties: i) The devices reversibly change between solar heating and radiative cooling under uniaxial strain, called dual-mode actuation. ii) The 3D platforms in the devices can use rigid/soft materials for functional layers owing to the optimized designs. iii) The devices can be used for dual-mode thermal management on a macro/microscale. The devices use black paint-coated polyimide (PI) films as solar absorbers with multilayered films comprising thin layers of polydimethylsiloxane/silver/PI, achieving heating and cooling temperatures of 59.5 and -11.9 °C, respectively. Moreover, mode changes according to the angle of the 3D structures are demonstrated and the heating/cooling performance with skin, glass, steel, aluminum, copper, and PI substrates is investigated.

4.
Laryngoscope ; 129(4): 800-807, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30593688

RESUMO

OBJECTIVES: Tranexamic acid might help control bleeding during surgery because of antifibrinolytic characteristics. We aimed to evaluate the effectiveness of systemic tranexamic acid compared to control in blood loss, operative time, and surgical field and incidence of postoperative emesis and thromboembolism in endoscopic sinus surgery. METHODS: Two authors independently searched six databases (PubMed, SCOPUS, Embase, the Web of Science, Google Scholar, and the Cochrane database) from their inception to July 2018. The included studies compared perioperative tranexamic acid administration (treatment group) with a placebo, and the outcomes of interest were intraoperative morbidities, including surgical time, operative bleeding, and hypotension; postoperative morbidities such as nausea and vomiting; and coagulation profiles. RESULTS: Seven studies comprising 562 participants were reviewed in this study. Operative time (standardized mean difference (SMD) = -0.60; 95% confidence interval (CI)[-0.93, -0.29]) and intraoperative blood loss (SMD = -0.66; 95% CI [-0.86, -0.46]) were statistically lower in the treatment group than placebo group; and the quality of the surgical field (SMD = -0.80; 95% CI [-1.12; -0.48]) and surgeon satisfaction (SMD = 1.74; 95% CI [1.36; 2.13]) were statistically higher in the treatment group than the placebo group. By contrast, there were no significant differences in the hemodynamic (SMD = 0.08; 95% CI [-0.20; 0.37]) and coagulation profiles (SMD = -0.18; 95% CI [-0.42, 0.07]) of the two groups. Additionally, tranexamic acid had no significant effect on emetic or thrombotic events compared to placebo. CONCLUSION: This meta-analysis showed that the systemic administration of tranexamic acid could decrease operative time and blood loss intraoperatively, increasing the satisfaction of surgeons. It did not provoke intraoperative hemodynamic instability, postoperative emetic events, or coagulation profile abnormality. Only a small number of studies were enrolled, so further trials are needed to confirm the results of this study. Laryngoscope, 129:800-807, 2019.


Assuntos
Antifibrinolíticos/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Endoscopia/efeitos adversos , Procedimentos Cirúrgicos Nasais/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Ácido Tranexâmico/uso terapêutico , Adulto , Endoscopia/métodos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Nasais/métodos , Duração da Cirurgia , Seios Paranasais/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/etiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Tromboembolia/epidemiologia , Tromboembolia/etiologia , Tromboembolia/prevenção & controle , Resultado do Tratamento
5.
Otolaryngol Head Neck Surg ; 158(1): 43-53, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28949804

RESUMO

Objectives Dexmedetomidine has sympatholytic, sedative, anesthetic, and analgesic effects, as well as vasoconstrictive effects, which may help prevent hypotension under general anesthesia. This meta-analysis aimed to perform a systematic review of the literature and investigate the effect of dexmedetomidine on perioperative morbidity following nasal surgery and its adverse effects. Data Sources MEDLINE, SCOPUS, and the Cochrane database. Review Methods Two authors independently searched the databases from their inception to March 2017. Studies were selected that compared perioperative dexmedetomidine administration (dexmedetomidine groups) with a placebo or remifentanil (control groups) with regard to intraoperative morbidity, including surgical time, bleeding amount, hypotension, and bradycardia during operation, and postoperative morbidity, such as emergence agitation, nausea and vomiting, and sedation after operation. Results Surgical time, intraoperative blood loss, dose of inhaled anesthetic gas, dose of fentanyl, postoperative pain, and incidence of emergence agitation were significantly lower in the dexmedetomidine group versus the placebo group. In contrast, there were no significant differences in intraoperative hemodynamic stability and postoperative residual sedation and nausea and vomiting between groups. Additionally, compared with remifentanil (a currently widely used agent), dexmedetomidine was superior in view of postoperative pain and intraoperative blood pressure control. Conclusion This meta-analysis shows that the systemic administration of dexmedetomidine can decrease surgical time, intraoperative blood loss, and doses of intraoperative inhaled anesthetic gas and fentanyl as compared with placebo. It can also decrease postoperative pain and incidence of the emergence agitation. Due to the small number of studies, further clinical trials are needed to confirm these results.


Assuntos
Anestesia Geral , Dexmedetomidina/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem , Procedimentos Cirúrgicos Nasais , Complicações Pós-Operatórias/prevenção & controle , Humanos
6.
Laryngoscope ; 128(5): E184-E193, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28895149

RESUMO

OBJECTIVES: This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children. DATA SOURCE: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017. REVIEW METHODS: Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers. The outcomes of interest were emergence agitation, postoperative pain intensity, rescue analgesic consumption, and other morbidities (nausea and vomiting and agitation). RESULTS: Fifteen studies with n = 1,552 met the inclusion criteria. Postoperative pain scores and the need for analgesics in the postanesthesia care unit (PACU) were significantly decreased in the dexmedetomidine group versus the control group. The incidence and degree of agitation and desaturation incidence in the PACU also were significantly lower in the dexmedetomidine group than in the control group. Additionally, there was no significant difference in the duration of staying PACU between both groups. In subgroup analyses by administration method (bolus injection or continuous injection), dexmedetomidine was shown to be effective at reducing postoperative morbidities regardless of administration method. CONCLUSION: Perioperative administration of dexmedetomidine can provide pain and agitation relief without side effects in children undergoing adenotonsillectomy. Considering the high heterogeneity of results within some parameters; however, further clinical trials with robust research methodology should be conducted to confirm the results of this study. Laryngoscope, 128:E184-E193, 2018.


Assuntos
Analgésicos não Narcóticos/uso terapêutico , Dexmedetomidina/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Tonsilectomia , Analgésicos Opioides/uso terapêutico , Criança , Humanos , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Náusea e Vômito Pós-Operatórios/prevenção & controle , Agitação Psicomotora/prevenção & controle
7.
Clin Exp Otorhinolaryngol ; 11(3): 151-157, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29590744

RESUMO

We evaluated the effect of silicone stent use during endoscopic dacryocystorhinostomy on postoperative morbidities in comparison with versus without a silicone stent. Two authors independently searched six databases (PubMed, Embase, Scopus, the Web of Science, the Cochrane library, and Google Scholar) from inception of article collection to July 2017. The analysis included prospective randomized studies that compared intraoperative silicone stent insertion (silicone group) with no application of a silicone stent (control group), in which the outcomes of interest were success rate (lacrimal passage patent check with syringing, symptom relief, or endoscopic confirmation of fluorescein dye from the opening of Hasner's valve) and morbidities (e.g., postoperative bleeding, rhinostomy closure, granulation tissue, synechia, and eyelid problems) after certain follow-up periods (over 10 weeks). Nine studies involving a total of 587 participants were included. Functional success rates tended to be higher in the silicone group than in the control, but there was no statistically significant difference in success rates (odds ratio, 1.45; 95% confidence interval, 0.77 to 2.73). According to the surgical type such as mucosal removal and mucosal flap surgery, the results from types didn't demonstrate any significant effect, but the mucosal flap technique seemed to be more beneficial. Regarding postoperative morbidities, although the outcomes of the groups did not present any statistically significant difference, eyelid problems and postoperative bleeding tended to occur more frequently in the silicone group, but rhinostomy closure tended to occur more frequently in the control group. Success and morbidity rates showed no difference between the silicone stent group and control group in the meta-analysis. However, additional analyses revealed that the success rate of endonasal dacryocystorhinostomy using silicone intubation with mucosal flap has shown an improving trend, and morbidities such as granulation and synechia showed decreasing trends compared with the group without silicone intubation.

8.
Artigo em Coreano | WPRIM | ID: wpr-193607

RESUMO

Cytomegalovirus (CMV) is a potentially important pathogen in an immunocompromised host. CMV infection usually occurs in patients with severe immune deficiency, such as acquired immunodeficiency syndrome, organ transplantation, malignant disease, or immunosuppressive therapy. CMV can cause ulcerations anywhere in the GI tract ranging from the esophagus to the rectum, but the colon is the most susceptible organ in the GI tract. CMV infection rarely occurs but generally causes an asymptomatic or mildly symptomatic acute illness in immunocompetent patients. Some patients with gastrointestinal CMV disease do not require antiviral treatment such as ganciclovir and frequently recover with supportive therapy. Although in immunocompetent patients, antiviral therapy may be needed based on age, chronic illness, or treatment response. We experienced a case of CMV-induced multiple gastric ulcers with severe epigastric pain in an immunocompetent patient who fully recovered with supportive therapy including a proton pump inhibitor.


Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Doença Crônica , Colo , Citomegalovirus , Esôfago , Ganciclovir , Trato Gastrointestinal , Hospedeiro Imunocomprometido , Transplante de Órgãos , Bombas de Próton , Reto , Úlcera Gástrica , Transplantes , Úlcera
9.
Artigo em Coreano | WPRIM | ID: wpr-117056

RESUMO

To acquire the essential basic data to the establishment of control measure for the hazardous health effect that could be caused by harmful metals, the author measured the concentrations of trace metals in whole blood of women of 20-39 years old living in urban and rural area using atomic absorption spectrophotometer. The summarized results were as follows; 1. The mean concentration of zinc in whole blood was 10.69+/-8.07 microgram/ml in rural area. The frequency distribution by zinc concentration level was nearly L-type and the cumulative frequency distribution was showed bimodal type in both area. 2. The mean iron concentration in whole blood was 323.09+/-87.15 microgram/ml and 322.07+/-104.74 microgram/ml in urban and rural area, respectively. The frequency distribution was similar to normal distribution type in both area, but the cumulative distribution was unimodal type in urban area and bimodal type in rural area. 3. The mean magnesium concentration was 41.08+/-19.58 microgram/ml and 40.28+/-16.82 microgram/ml in the area, respectively. The frequency distribution type had skewness to the right and the cumulative frequency distribution was unimodal type in both area. 4. The mean copper concentration was 1.417+/-0.761 microgram/ml and 1.375+/-0.743 microgram/ml in the area, respectively. The frequency distribution type had skewness to the right and the cumulative frequency distribution was bimodal type in both area. 5. The mean manganese concentration was 0.079+/-0.039 microgram/ml and 0.07+/-0.058 microgram/ml in the area, respectively. The frequency distribution type had skewness to the right in both area but slight irregular in rural area and the cumulative distribution was unimodal and bimodal type in urban and rural area, respectively. 6. The mean cadmium concentration in whole blood was 0.031+/-0.026 microgram/ml in urban and 0.028+/-0.023 microgram/ml in rural area. The frequency distribution type had skewness to the right and cumulative frequency distribution was bimodal type in both area.


Assuntos
Feminino , Humanos , Absorção , Cádmio , Cobre , Ferro , Magnésio , Manganês , Metais , Zinco
10.
Artigo em Coreano | WPRIM | ID: wpr-117439

RESUMO

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most frequent agents of hospital infections. The aim of this study was to evaluate the polymorphism of MRSA strains from our hospital by pulsed-field gel electrophoresis (PFGE) and ribotyping, and to compare effectiveness of two methods for epidemiologic investigation. METHODS: A total of 40 MRSA isolates were studied. All strains were isolated from patients from October 1990 to May 1995: 13 isolates from NS ward, 9 from GS and OS ward, 11 from medical ward, and 7 from other medical centers. All strains were analyzed and classified by ribotyping and PFGE patterns. RESULTS: Eight different ribotypes (H1-H8) and ten ribotypes (E1-E10) were seen by HindIII and EcoRI digestion. The problem was that some isolates showed discordance between classifications by HindIII and EcoRI digestion and three isolates from other medical centers had same ribotypes with that of our hospital strains. PFGE analysis revealed 19 different types (A to S). The PFGE analysis showed ward specificity, 54% of isolates from NS ward and 54% of isolates from medical ward were PFGE types D and J respectively, and 33% of isolates from GS and OS ward was H type and 33% was G type. CONCLUSIONS: PFGE was a more effective epidemiological tool for the typing of MRSA strains but a combination with ribotyping could provide more detailed strain differentiation.


Assuntos
Humanos , Classificação , Infecção Hospitalar , Digestão , Eletroforese em Gel de Campo Pulsado , Estudos Epidemiológicos , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina , Ribotipagem , Sensibilidade e Especificidade
11.
Artigo em Coreano | WPRIM | ID: wpr-47630

RESUMO

For the purpose of providing the basic data for health management of workers who are exposed to chromium and for improving the quality of working environment, the authors evaluated blood and urinary level of chromium, the occupational history, AST, ALT, Hb, Hct, nasal specular examination on 287 workers who have been dealed chromium compounds in 56 manufacturing industries of five types, that is, 38 metal plating services(plating), 4 manufacture of other fabricated metal products (fabricated metal product), 5 manufacturing of dyestuff(dyestuff), 6 dressing and dyeing of leather (leather), 3 others (manufacture of pottery and ceramic household wares, motor vehicles, electronic valves and tubes and other electronic components) and also measured the level of chromium in air from February to october 1993. The results were as follows; 1. The utilized type of chromium compounds was the hexavalent state in plating, fabricated metal product, dyestuff leather and the trivalent state in other, and atmospheric chromium concentration as geometric mean was 0.0138m3(0.001~0.068 mg/m3) in plating, 0.0115 mg/m3(0.006~0.015 mg/m3) in fabricated metal product, 0.068 mg/m3 (0.002~0.019 mg/m3)in dyestuff, 0.0083 mg/m3(0.002~0.028 mg/m3) in leather, 0.0039 mg/m3(0.003~0.005 mg/m3) in other by the type of industry and it exceeded TLV-TWA (0.05 mg/m3) in five(13.6%) of plating services. 2. The geometric mean of chromium in blood was 1.54 microgram/dl(0.10~3.62 microgram/dl) in planting, 0.94 microgram/dl(0.27~2.82 microgram/dl) in fabricated metal product, 0.51 microgram/dl(0.10~3.25 microgram/dl) in dyestuff, 0.87 microgram/dl(0.15~8.00 microgram/dl) in leather 0.55 microgram/dl(0.20~2.28 microgram/dl) in other by the type of industry(P<0.001). 3. The geometric mean of chromiurn in urine was 14.47 microgram/l(6.90~28.00 microgram/l) in planting, 4.63 microgram/l(0.24~43.00 microgram/l) in fabricated metal product, 5.93 microgram/l(1.00~33.00 microgram/l) in dyestuff. 11.09 microgram/l(0.80~48.00 microgram/l) in leather, 12.41 microgram/l(10.10~41.00 microgram/l) in other by the type of industry(P<0.001). 4 As the result of nasal specular examination, twenty four cases(8.4%) of nasal septal perforation among 287 total subjects was observed, and there were 17(9.7%) cases in plating, 4 cases(14.3%) in dressing and dyeing of leather. In the comparison of chromium concentration in blood and urine between the perforated group and nonperforated group the perforated group showed a significantly higher value as 1.883+/-3.055 microgram/dl and 0.793+/-0.815 microgram/dl(P<0.001). 21.31+/-34.610 microgram/L and 9.304+/-11.079 microgram/L(P<0.001). 5. The mean concentration of chromium in blood, urine and the mean level of AST, ALT, Hb and Hct in exposure group were higher than those of control group(P<0.001).


Assuntos
Bandagens , Cerâmica , Compostos de Cromo , Cromo , Galvanoplastia , Características da Família , Veículos Automotores , Perfuração do Septo Nasal , Plantas , Níveis Máximos Permitidos
12.
Artigo em Coreano | WPRIM | ID: wpr-44025

RESUMO

In order to prepare the fundamental data for the improvement of noisy working environments and the effective hearing conservation program on workers exposed to industrial noise, the authors surveyed the working processes and evaluated the noise levels on 56 manufacturing industries in Pusan area from April to July in 1985. The results were summarized as follows: 1. The noise level was the highest in shipbuilding and repairing(95.6 dBA), and followed by steel rolling(92.9 dBA), manufacture of motor vehicles(93.1 dBA), manufacure of fishing nets(92.9 dBA), manufacture of testiles(92.5 dBA), iron and steel foundries(89.3 dBA), manufacture of metal products(89.1 dBA), preserving and processing of marine foods(87.0 dBA), manufacture of rubber products(85.3 dBA), manufacture of plywood(84.9 dBA) and manufacture of paints(84.5 dBA). 2. Among fifty surveyed working processes, the noise level of twenty-one processes(42%) exceeded the threshold limit value for 8 hours per day. 3. As the allowable exposure times by governmental threshold limit values to industrial noise level(dBA), cocking of shipbuilding and repairing and plating(CGL) of steel rolling were the shortest(30 minutes), and followed by assembling(rivet) of manufacture of motor vehicles(1 hour) weaving of manufacture of textiles and shot, machine, pipe laying of shipbuilding and repairing(2 hours). 4. By the result of octave band analysis on noisy working processes in excess of 90 dBA, the sound level was the highest at 2,000 Hz or 4,000 Hz. 5. It was recognized that the measurement of overall sound pressure level was also effective as octave band analysis in evaluating the industrial noise.


Assuntos
Audição , Ferro , Ruído , Borracha , Aço , Têxteis , Níveis Máximos Permitidos
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