• Title/Summary/Keyword: 서울대학교병원

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Pop-up Chart for Managing CRRT Improves the Quality of CRRT Care (전자의무기록 팝업차트를 활용한 CRRT 관리의 질향상 활동)

  • Go, Su-Ryeong;Lee, An-Na;Kim, Ki-Pyo;Chin, Ho-Jun;Na, Ki-Young;Chae, Dong-Wan;Kim, Se-Joong
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.43-51
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    • 2019
  • Purpose: The time lag between the decision to initiate continuous renal replacement therapy (CRRT) and its actual initiation remains a major barrier in our intensive care units. We developed a CRRT pop-up chart on EMR for managing CRRT machines. Methods: This study measured time interval between the decision to prepare the CRRT machine and the actual use of the machine before and after using a CRRT pop-up chart. This study conducted a questionnaire of the medical staff to assess the changes in the quality of CRRT preparation. Results: A total of 95 patients on CRRT is analyzed. The time to find an available CRRT machine is decreased by 24.6%. The time to move a CRRT machine to the patient's bedside is decreased by 55.8%. Medical surveys of 44 nurses gave the following results. 1) The time to apprehend machines for 1 to 3 minutes is improved from 29.5% to 81.8%, and the time to apprehend machines over 3 minutes is decreased from 70.5% to 18.2%. 2) The number (6-all) of known machine locations is improved from 22.7% to 63.4%. 3) Interruption of a nurse's work due to telephone calls asking for the possession of movable CRRT equipment also is improved. Scores of 1-4 are improved from 15.9% to 41%. Scores of 5-7 are reduced from 52% to 15.9%. Conclusions: CRRT pop-up chart is shortened the time lag of CRRT machine preparation, reduced the nurse's phone workload and helped to improve the quality of CRRT care.

Sonographic Appearance of Steatocystoma: An Analysis of 14 Pathologically Confirmed Lesions (지선낭종의 초음파 소견: 조직학적으로 진단된 14개 병변의 분석)

  • Hyeyoung Yoon;Yusuhn Kang;Hwiryong Park;Joong Mo Ahn;Eugene Lee;Joon Woo Lee;Heung Sik Kang
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.382-392
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    • 2021
  • Purpose To evaluate the ultrasonographic characteristics of steatocystomas focusing on the features that aid in differentiating them from epidermal inclusion cysts and lipomas. Materials and Methods The ultrasonographic findings of 14 histologically proven steatocystomas in 10 patients were retrospectively reviewed. The following features were assessed: the layer of involvement, shape, margin, echogenicity, posterior acoustic features, and the presence of a visible wall or intralesional striations. The findings were compared with those of subcutaneous lipomas and epidermal inclusion cysts to identify those findings that aid in the differential diagnosis of steatocystomas. Results The majority of steatocystomas appeared as a subcutaneous mass (n = 6, 42.9%) or a mass involving both the dermal and subcutaneous layers (n = 6, 42.9%). Steatocystomas exhibited a well-defined smooth margin (n = 12, 85.7%) and homogeneous echogenicity (n = 9, 64.3%), and showed no specific posterior acoustic features (n = 9, 64.3%). The most important features that differentiated steatocystomas from epidermal inclusion cysts were a homogeneous internal echotexture (p = 0.009) and absent or less prominent posterior acoustic enhancement (p < 0.001). The features that distinguished steatocystomas from lipomas were the margin (p < 0.001), echogenicity (p = 0.034), internal echotexture (p = 0.004), and the absence of intralesional striations (p < 0.001). Conclusion Steatocystomas appeared as well-defined homogeneous masses with mild or absent posterior acoustic enhancement.

Imaging and Clinical Findings of Primary Malignant Fibrous Histiocytoma of the Urinary Bladder: A Case Report (방광의 일차 악성 섬유성 조직구종의 영상 및 임상 소견: 증례 보고)

  • Yoon Jung Lee;Eun Ji Lee;Jae Heon Kim;So Young Jin;Seong Sook Hong;Jiyoung Hwang;Yun-Woo Chang
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.654-660
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    • 2024
  • Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia. It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the "non-papillary tumor" and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.

A Case of Pediatric Subglottic Stenosis caused by Subglottic Cyst (성문하부 낭종으로 인한 소아 성문하부 협착 1예)

  • Oh, Hyeon Seok;Lee, Hye Ran;Lee, Jae Yong;Kim, Jae Wook
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.77-80
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    • 2018
  • Subglottic cysts have been reported as a relatively rare problem of pediatrics who have a history of premature birth and period of intubation. They may cause significant upper airway obstruction and many cases require tracheostomy to airway management. Endoscopic marsupialization by microinstruments or laser has been standard primary treatment but a high recurrence rate has been reported. A 19-month-old child presented with stridor who has history of ventilation via an endotracheal intubation in the newborn period for 7 days. Radiologic examinations were performed for aggravated dyspnea symptom and subglottic cystic mass was found, then it was marsupialized at operation room and tracheostomy was done at the same time. After decannulation of tracheostomy tube, there is no recurrence of cyst nor upper airway obstruction for 29 months. We report this case with a review of literature.

A Case of Solitary Metastatic Deposit in the Orbital Rim from Follicular Thyroid Cancer (단일성 안와 골병변으로 확인된 갑상선 여포암의 원격 전이 1예)

  • Jeon, Gyeong Hwa;Oh, Hyeon Seok;Choi, In Ho;Byeon, Hyung Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.105-109
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    • 2021
  • Follicular thyroid carcinoma (FTC) is the second most common thyroid cancer, following papillary carcinoma. Metastasis to the orbital rim from FTC is very rare. We recently experienced a case of FTC with metastasis to the orbital rim in a 74-year-old woman, who initially presented with a huge thyroid mass and an asymptomatic solitary orbital rim lesion. The solitary orbital rim lesion was suspected to be a separate disease entity such as lymphoma from the preoperative imaging, but bone metastasis from FTC was finally confirmed after orbital rim resection and total thyroidectomy. During follow-up, the patient presented multiple bone metastasis, so the solitary orbital rim lesion was considered a clinical sign of systemic metastasis from FTC. Therefore, we present this unique case with a review of the literature.

Unusual Lower Back Pain on the Non-Articulated Side in Patient with Bertolotti's Syndrome (가관절을 이루고 있지 않은 편측의 통증을 호소한 베르톨로티 증후군)

  • Kim, Inah;Lee, Jong In;Jang, Yongjun;Park, Hae-Yeon
    • Clinical Pain
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    • v.20 no.1
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    • pp.49-52
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    • 2021
  • Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.

A Thrombus within an Interventricular Membranous Septal Aneurysm Leading to Cerebral Infarction: A Case Report (심실간 막 중격류에 생긴 혈전으로 인한 뇌경색: 증례 보고)

  • Seongken Kim;Joon-Won Kang;Hyun Jung Koo;Dong Hyun Yang
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.210-214
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    • 2024
  • Interventricular membranous septal aneurysms are rare. Since these aneurysms can lead to complications such as obstruction of right ventricular outflow and thromboembolism, the detection of this aneurysm has clinical significance. Herein, we report a case of an interventricular membranous septal aneurysm with an internal thrombus thought to be the cause of a cerebral infarction.