• Title/Summary/Keyword: 비만 수술

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The In-hospital Analysis of Outcome of Off-pump CABG and On-pump CABG (비체외순환 및 체외순환하에서의 관상동맥우회로술의 임상 고찰)

  • 안재범;김인섭;정성철;배윤숙;유환국;김병열;김우식
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.762-767
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    • 2004
  • With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method: From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p<0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

Comparison between Surgical and Non-Surgical Treatment of Squamous Cell Carcinoma of Tonsil:Retrospective Analysis of 87 Patients (편도 편평상피암의 수술적 치료와 비수술적 치료의 비교:87명 환자의 후향적 분석)

  • Koo, Dong-Hoe;Lee, Sang-Wook;Song, Si-Yeol;Kim, Sang-Yoon;Nam, Soon-Yuhl;Choi, Seung-Ho;Roh, Jong-Lyel;Cho, Kyung-Ja;Ahn, Jin-Hee;Kim, Sung-Bae
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.3-8
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    • 2007
  • 연구목적:국소적 진행성 편도암환자에서 수술적치료와 비수술적치료의 결과를 비교 분석하고자 하였다. 연구방법 : 수술 후 보조방사선요법을 시행한 군과 유도화학요법 시행 유무에 상관없이 근치적 방사선 치료 또는 항암화학-방사선 동시치료를 받은 비수술군의 임상결과를 후향적으로 분석하였다. 연구결과:52.4개월의 중앙 추적기간결과, 대상환자의 중앙 연령은 53세 이었다. 대상 환자 중 병기 Ⅲ, Ⅳ기 환자는 72명(82.8%)이었고, 49명(56.3%)이 수술적 치료를, 38명(43.7%)명이 비수술적 치료를 받았다. 방사선 조사량외에 양군간의 차이는 없었다 (수술군:60.4Gy, 비수술군:70.2Gy, p=0.02). 비수술군의 전체 생존율은 81.6%이었다. 수술군의 8명(16.3%), 비수술군의 6명 (15.8%)에서 재발이 발생하였다. 흥미로운 사실은 원격재발은 2명 모두 수술군에서 발생하였다. 병기 III, IV기의 5년 무병생존율과 전체생존율은 수술군이 각각 82.1%, 86.9%이고, 비수술군이 각각 83.3%, 83.1%이었다(p=0.96, p=0.96). 결론:수술적 치료에 비해 비수술적 치료가 활동능력이 불량한 환자에게 선호되었을 가능성이 있었음에도 불구하고, 치료성적은 비슷하였다. 편도암에서 수술적 치료와 비수술적 치료의 전향적 무작위 비교연구가 필요하다.

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients (고도비만환자에서 베리아트릭 수술 (Bariatric Surgery) 후 영양교육이 체중감량에 미치는 효과)

  • Jeong, Eun-Ha;Lee, Hong-Chan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.30-45
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    • 2015
  • Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

Outcome of Non-surgical and Surgical Treatments in Dogs with Cervical Intervertebral Disc Disease: 60 cases (개에서 경추 추간판 탈출증의 비수술적 치료와 수술적 치료의 결과 : 60 증례)

  • Sung, Gyu-Jin;Ryu, Hak-Hyun;Park, Sung-Su;Kang, Byung-Jae;Lim, Sung-Jun;Kim, Yong-Sun;Lee, Seung-Hoon;Cho, Sung-Ho;Kim, Jun-Young;Yoon, Jung-Hee;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.713-717
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    • 2010
  • Outcomes of non-surgical and surgical treatments for thoracolumbar intervertebral disc disease (IVDD) are well-reported. However, little is known regarding the outcome for treatments of cervical IVDD. This study systematically reviewed the outcomes in dogs with cervical IVDD that were managed non-surgically and surgically. Clinical success rates for surgical treatment were significantly higher (100%) than for non-surgical treatment (51.4%). In the non-surgical treatment group, clinical success rates were negatively correlated with spinal cord compression rates. Based on the results of this study, surgical treatment is deemed more effective than non-surgical treatment for dogs with cervical IVDD. Also, the degree of spinal cord compression on computed tomography or magnetic resonance imaging is a useful prognostic indicator before non-surgical treatment.

Rotator cuff tears: Operate when? What happens if not? (회전근 개 파열: 언제 수술하나? 안 하면 어떻게 하나?)

  • Park, Hyung-Bin;Sung, Chang-Meen
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.8-12
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    • 2011
  • Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

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Cardiac Function Changes According to the Type of Operation for Mitral Regurgitation (승모판막폐쇄부전증의 수술술식에 따른 심기능의 변화에 관한 연구)

  • 김진희;김종원;정성운
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.51-56
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    • 2001
  • 배경: 이상적인 판막의 개발이 있기 전에는 가능하다면 원래의 판막을 보수하는 것이 좋을 것이라는 생각이 당연하며 실제 임상연구가들은 기술적으로 가능하다면 판막재건술이 판막치환에 비해 대단히 좋은 임상경과를 취한다고 보고하고 있다. 그러나 판막 치환례에서 수술성적과 임상성적이 오히려 좋게 나타나는 경우 이유가 있을 것이고 그 근본원인은 심실의 기능에 따라 좌우되리라는 가설 하에 이를 규명하고자 하였다. 대상 및 방법: 순수승모판막폐쇄부전증으로 수술 받은 40명의 환자를 대상으로 하여 고전적 판막 치환술을 시행한 12례를 1군으로, 후엽을 보전한 18례를 2군으로 그리고 성형수술을 시행한 10례를 3군으로 나누어 수술전의 심에코 소견을 포함하여 입원시에 시행한 전신상태와 수술 후 4주 이내에 시행한 심에코도의 각종 지표를 시행하였다. 결과: 일반적인 환자의 상태변화로는 1군에 비해 2군, 3군에서는 더 나은 결과를 보였으나, 통계적인 차이는 발견할 수 없었다. 뉴욕 심장협회의 분류에 따라서는 수술전보다 많은 호전이 보였으나 세군간의 유의한 차이는 발견할 수 없었다. 심에코도에 따른 심기능을 비교한 바에 의하면 1군에서는 오히려 나빠졌으며 2군, 3군에서는 수술직후에는 술전에 비해 별 차이가 없으며 회복후에는 모든 지표에서 의미있는 호전을 발견할 수 있었으나, 구별분획에 있어 두 군간에는 수술전, 수술후, 회복후의 상호간의 통계적으로 의미 있는 차이는 발견되지 않았다. 결론: 심기능의 차이가 나므로 승모판막폐쇄부전증에 대한 수술로는 가능한한 판막 성형술이 좋고, 판막 성형술이 불가능한 변형이 많은 경우 판엽 일부를 보전이라도 하는 것이 좋다.

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Posterior Instability of the Shoulder (견관절 후방 불안정성)

  • Jeong, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.4-7
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    • 2011
  • Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

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Problematized obesity and standardization of treatment: Multiple translation in lapband surgery network (문제화된 비만과 치료의 표준화 과정: 랩밴드 수술 연결망에서의 다중번역)

  • Han, Gwang Hee;Kim, Byoung Soo
    • Journal of Science and Technology Studies
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    • v.13 no.2
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    • pp.137-172
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    • 2013
  • Globally, awareness about obesity is increasing rapidly. In Korea, obesity is recognized as a disease and steps are being taken to treat it. From the health governance point of view, such standardized measures amplify the risk of obesity and thus play an important part in the prevention of the disease. In this context, various obesity treatments act as a medium for the problem-solving process. In recent years, obesity surgery has been viewed as a rational solution to the problem of obesity. In the context of standardization of treatment, Callon's "Process of Translation" in STS theories highlights the importance of the central actor (Obligatory Passage Point; OPP). However, in the case of obesity, it is difficult to identify a single OPP to project different perspectives of an actor's needs. "Lapband surgery" often acts as a "boundary object" in this context. This article assesses this absence of central actors in the process of problem solving through a case study of adoption of Lapband surgery in Korea. Further, we attempt to suggest an analytical framework with a boundary object and multiple translation concepts to aid solving the problem of obesity.

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Plantigrade Foot (척행족)

  • An, Jong-Cheol
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.1-11
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    • 1991
  • 족부의 교정을 위해서는 비정상적인 상태 및 원인 그 치료법에 대해서 충분히 이해해야 할 것으로 생각되며, 비 척행족에 대해서는 먼저 정확한 원인 인자의 파악과 수술전 평가, 수술의 선택, 수술의 범위등을 정해야 한다. 이렇게 함으로써 변형에 대한 충분한 교정이 가능하며, 수술후 예후가 좋은 척행족으로 될 것이다. 그리고 위에서 밝힌 치료의 원칙은 변하지 않겠지만, 관절 고정술을 대체하여 다른 남은 관절에 영향을 주지 않으면서 더 많은 유연성을 가질 수 있는 기능있는 족부를 만들 수 있는 새로운 수술방법이(관절 치환술등) 더 개발되어 져야할 것으로 생각된다.

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계측 및 제어 기술을 이용하는 최소절개수술에 관한 연구 동향

  • Jo, So-Hyeong
    • Journal of the KSME
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    • v.54 no.3
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    • pp.42-46
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    • 2014
  • 전통적인 개복수술에 비해서 경감된 수술 후 회복기간 등 여러 가지 장점이 있는 최소절개수술은 수술자들에게는 훨씬 복잡하고 배우기 어려운 기법으로 알려져 있다. 이 글은 최소절개수술의 기법을 향상시키는 데 도움이 되는 다양한 계측 및 제어 기술을 검토하고 새로운 디바이스를 소개하는 데 초점을 둔다.

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