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Emi Ishikawa,Takayuki Hojo,Makiko Shibuya,Takahito Teshirogi,Keiji Hashimoto,Yukifumi Kimura,Toshiaki Fujisawa 대한치과마취과학회 2023 Journal of Dental Anesthesia and Pain Medicine Vol.23 No.1
Background: A high incidence (40–73%) of postoperative nausea and vomiting (PONV) has been reported following orthognathic surgery, and various risk factors have been associated with it. Identifying PONV risk factors based on initial onset time will help establish preventive measures. This study aimed to identify factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Methods: This study included 590 patients who underwent orthognathic surgery. Multivariate logistic regression analysis was performed to identify the risk factors that are significantly related to PONV. The objective variables were classified into three categories: no PONV, early PONV (initial onset time: 0–2 h after anesthesia), and late PONV (initial onset time: 2–24 h after anesthesia). The explanatory variables included relevant risk factors for PONV, as considered in previous studies. Results: Total intravenous anesthesia with propofol was a significant depressant factor for early PONV (adjusted odds ratio [aOR] = 0.340, 95% confidence interval [CI] = 0.209–0.555) and late PONV (aOR = 0.535, 95% CI = 0.352–0.814). The administration of a combination of intraoperative antiemetics (vs. no administration) significantly reduced the risk of early PONV (aOR = 0.464, 95% CI = 0.230–0.961). Female sex and young age were significant risk factors for late PONV (aOR = 1.492, 95% CI = 1.170–1.925 and unit aOR = 1.033, 95% CI = 1.010–1.057, respectively). Conclusion: We identified factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Total intravenous anesthesia with propofol significantly reduced the risk of PONV not only in the early period (0–2 h after anesthesia) but also in the late period (2–24 h after anesthesia).
안용찬,Shinichi Shimizu,Hiroki Shirato,Takayuki Hashimoto,Yasuhiro Osaka,Xiao-Qing Zhang,Tatsuya Abe,Masao Hosokawa,Kazuo Miyasaka 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.4
Herein is reported our experience of radiation therapy using a real-time tumor-tracking and gated radiotherapy (RTRT) system for inoperable pancreatic cancer. Three unresectable pancreatic cancer patients were treated with intraoperative electron beam radiation therapy, at the time of open biopsy, and postoperative external beam radiation therapy using an RTRT system with a 2.0mm diameter gold ball implanted into the pancreas. The total BED'sα/β=10 was intended to be equivalent to that of delivering 60 Gy by 2.0Gy/fraction, while the actual dose schedules were individualized. The movement of the pancreas was analyzed based on the 3-dimensional marker positions during the RTRT. The side effects and tumor responses were evaluated. During the RTRT course, the average movement of markers in the x (left to right), y (cranial to caudal) and z (dorsal to ventral) directions were 3.0mm (1.7-5.2mm), 5.2mm (3.5-6.8mm) and 3.5mm (2.7-5.1 mm), respectively. During and after the course of postoperative radiation therapy, no acute side effects of RTOG grade II or higher were detected. The objective tumor responses, as evaluated by CT scans 3 months after the treatment, were 2 partial responses and no response in one patient. Using the RTRT technique the margin of treatment planning and the possible errors in target localization were reduced, and the 3-dimensional movement of the internal marker implanted in the pancreas was able to be analyzed.