• Title/Summary/Keyword: 수술불안

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The Effects of Foot Massage on Anxiety and Sleep Satisfaction Response in Preoperative Patients Undergoing Abdominal Surgery (발마사지가 복부수술 전 환자의 불안과 수면만족도에 미치는 효과)

  • Kim, Geum-Ran;Oh, Sang-Eun
    • Journal of Home Health Care Nursing
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    • v.16 no.2
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    • pp.108-114
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    • 2009
  • Purpose: This study utilized a nonequivalent control group pre-post test design to test the effects of foot massage on anxiety and sleep satisfaction response in preoperative patients undergoing abdominal surgery. Method: There were 40 subjects in the study (20 in the experimental group and 20 in the control group). The experimental group received foot massage once a day for 2 days before their operation. Data were analyzed with descriptive statistics including mean, percentage, Chi-square, and t-test. Results: There were significant differences between experimental group and control group in the level of the state anxiety, pulse rate, and sleep satisfaction. Conclusions: Foot massage was effective in reducing anxiety and improving sleep satisfaction in abdominal surgical patients before their operation. Thus, foot massage may be used as an independent nursing intervention. This intervention can be performed anywhere, requires no special equipment, is noninvasive, and does not interfere with patients' privacy.

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Scapula in Throwing Athletes

  • Choe, Chang-Hyeok
    • 대한정형외과스포츠의학회:학술대회논문집
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    • 2007.04a
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    • pp.52-57
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    • 2007
  • 투구운동은 견관절에 반복적인 압박력 및 신장력을 가하게 되며, 이는 견관절의 정적 안정력의 약화를 유발하게 된다. 초기의 경도의 불안정성은 근육 동 동적 안정력의 작용으로 안정적인 운동상태를 유지할 수 있으나, 반복적인 운동이 지속될 경우 근육이 피로해 져서 동적 안정력의 보상작용을 통한 안정성을 얻을 수 없게 된다. 이는 일차적으로 견관절의 불안정성을 유발할 뿐만 아니라, 이차적으로 견봉하충돌증후 및 내적충돌증후 등의 증상을 나타내기도 한다. 과 투구로 인한 대부분의 운동손상은 보존적 치료로 좋은 결과를 볼 수 있으며, 이는 일차적으로 투구를 중지하여 관절을 안정시키며 진통 소염제나 물리치료 등을 통한 항 염증치료, 그리고 회전건개 및 견갑골주위근육의 강화운동 둥의 단계로 진행된다. 적절한 보존적 치료에도 불구하고 증상이 지속될 경우 정확한 진단에 근거한 수술적 치료 및 조절된 재활운동 프로그램을 통해 조기 운동 복귀를 기대할 수 있다.

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Clinical and MR Predictors of Retro-Odontoid Pseudotumor Regression Following Posterior Fixation in Patients with Atlantoaxial Instability (환축 불안정 환자에서 후방 고정술 후 치상돌기 후방 가성종양 퇴행의 임상 및 자기공명영상 예측 인자)

  • Jisu Kim;Youngjune Kim;Eugene Lee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.754-768
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    • 2024
  • Purpose To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability. Materials and Methods We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann-Whitney and Fisher's exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression. Results We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31-84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression. Conclusion Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.

Midterm Results of Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femoral Fractures Using a Type 3C Cementless Stem (불안정성 대퇴골 전자간 골절에 3C형 무시멘트 대퇴 스템을 이용한 고관절 반치환술의 중기 결과)

  • Chung, Woochull;Cho, Hong Man;Kim, Sun do;Park, Jiyeon;Kwon, Kihyun;Lee, Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.503-510
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    • 2020
  • Purpose: Bipolar hemiarthroplasty is used as an alternative to open reduction and internal fixation for unstable intertrochanteric fractures in elderly patients. Recent advances in medical systems and technologies have resulted in increased survival rates after intertrochanteric fractures of the femur, requiring selection of the appropriate femoral stems considering the mid- to long-term duration of survival. Hemiarthroplasty was performed for unstable intertrochanteric fractures using a double tapered quadrilateral femoral stem (C2 stem), and the clinical and radiological results were evaluated as a five-year follow-up post-surgery. Materials and Methods: From January 2004 to December 2013, 43 patients (43 hips) who underwent hemiarthroplasty with a C2 stem were enrolled in this study. Their mean age was 78.6 years (range, 70-84 years), and the mean follow-up period was 85.4 months (range, 60-96 months). During the follow-up period, clinical parameters, such as the changes in pain, walking ability, and functional status, were examined. Radiologically, changes in the proximal femur, such as osteoporosis and bone resorption of cortical bone, were noted. Complications that occurred during the follow-up period, such as dislocation and prosthetic features, were also reviewed. Results: Initially, the pain was relieved postoperatively, but it increased four years after surgery. The walking ability was reduced by two steps in nine patients after 60 months, and the Harris hip score was reduced significantly postoperatively after two to three years. Radiologically, cortical osteoporosis occurred in 14 patients. Five patients developed cortical bone resorption. Four of them showed nonunion of the trochanteric fracture fragments, and three of them suffered reverse oblique fractures. Conclusion: Careful selection considering the general health condition and remaining lifespan of the patient would be necessary for primary hip hemiarthroplasty using a 3C type cementless femoral stem for unstable intertrochanteric fractures in elderly patients with osteoporosis.

3.5 mm T-shaped LCP (Locking Compression Plate) Fixation for Unstable Distal Clavicular Fractures (3.5 mm T형 잠김 금속판을 이용한 원위 쇄골 골절의 치료 결과)

  • Lee, Churl-Woo;Kim, Hee-Chun;Roh, Jae-Young;Park, Young-Su
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.41-45
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    • 2008
  • Purpose: To review the clinical and radiological results after an open reduction and internal fixation with a T-shaped LCP for unstable distal clavicle fractures. Materials and Methods: From February 2005 to June 2006, ten patients with distal clavicle Neer type II fractures were treated with an open reduction and internal fixation with a T-shaped LCP. Bony union was identified by plain radiography. The clinical results were analyzed according to the UCLA scoring system. Results: The mean time to fracture union was 9weeks and union was achieved in all cases. The mean UCLA score was 33.4 (30-35); excellent in 8 cases and good in 2 cases. In one case, loosening of one distal screw was occured and mild AC joint subluxation was observed in another case. Conclusion: 3.5 mm T-shaped LCP fixation is a useful technique for treating unstable distal clavicle fractures. This procedure provide stable fixation with no further AC joint injury.

Simultaneous Off-pump Coronary Artery Bypass Surgery and Total Gastrectomy (동시에 시행한 체외순환 없이 시행하는 관상동맥우회수술과 위전절제술)

  • Park, Jeong-Ok;Ryu, Jae-Wook;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.56-59
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    • 2007
  • A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

Treatment of Malunion (부정유합의 치료)

  • Kim, Joon-Woo;Park, Kyeong-Hyeon;Oh, Chang-Wug
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.117-124
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    • 2021
  • Although current surgical techniques have reduced the incidence of malunion, it is still observed because of the complexity of the fracture or associated injuries. Osteotomy is needed when the amount of malunion is expected to result in an overload of cartilage and instability of the joint. Preoperative planning is essential when performing an osteotomy for malunion. Inadequate planning can result in serious complications, such as iatrogenic malalignment, intraoperative fracture, postoperative recurrence of deformity, or soft tissue injuries. In addition, a poor functional result can occur secondary to poor patient selection. This review article includes the surgical indications and planning to correct malunion. Various methods of corrective osteotomy are described according to the kinds of plane and fixation implants.

Throwing injury of elbow

  • 최창혁
    • 대한정형외과스포츠의학회:학술대회논문집
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    • 2003.11a
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    • pp.158-166
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    • 2003
  • 반복적인 투구동작은 성장기의 주관절에 손상을 주기 쉬우며 투구 시 통증을 유발할 경우, 투구를 중지하고 관절의 능동적 휴식을 통해 유연성을 회복하고 점차 근력강화운동을 시행해야 한다. 유소년기 Little league elbow의 주된 병변인 상완골 내상과 골단염을 포함한 대부분의 손상은 보존적 요법으로 치료가 가능하며, 굴곡구축 등의 운동제한을 동반한 통증이나 관절 내 유리골편 등의 감입으로 인한 증상이 있을 경우 수술적 치료를 요하며, 성인의 경우 내측 측부인대의 만성 불안정성 둥에 대해서 인대 재건술 등의 수술적 치료가 고려된다. 투구 시 주관절의 손상은 대부분의 경우 과 사용으로 인한 것이며, 특히 성장기에 손상의 예방이 무엇보다 중요하다. 따라서 부모와 코치 그리고 경기 관계자 둥이 성장기 소년의 근력과 관절의 상태가 성인과 다름을 이해하고, 운동의 강도와 횟수를 적절히 조절하며 손상시 조기치료를 받을 수 있는 환경을 조성하는 것이 필요하다.

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Rehabilitation after Posterior Cruciate Ligament, Posterolateral Rotatory Instability, and Multiple Ligament Reconstruction (후방십자인대,후외측 회전 불안정성 및 다발성인대 재건술 후 재활 치료)

  • Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.91-92
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    • 2008
  • 후방십자인대 및 후외측인대 재건술 후 결과는 많은 발전이 있었지만, evidence medicine의 측면에서 재활 방법에 관한 전향적 연구는 없다. 현재까지의 재활 방법은 다양하게 소개되었지만 전방십자인대 재건술처럼 가속 재활을 하는 것은 바람직스럽지 않다. 후방십자인대, 후외측인대 그리고 다발성 인대 재건술 후 재활은 수술 방법과 환자의 재건된 인대의 상태, 하지 정렬 등에 따라서 개별화하여 점진적으로 진행하여야 할 것이고, 재활기간 동안 의사의 세심한 관찰이 필요하다.

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Remplissage Procedure (관절경하 극하건 고정술)

  • Kim, Young-Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.169-174
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    • 2010
  • 대다수의 견관절 전방 불안정성에서 관절와에 골 소실이 큰 경우는 Bankart 복원술을 튼튼하게 하였을지라도 상완골두를 지탱할 관절 궁이 감소되어 골에 의한 버팀이 줄어들므로 Bankart 복원이 실패할 가능성이 높다. 따라서 관절와 결손이나 상완골 두 결손이 큰 경우 정확한 측정으로 결손의 범위를 파악하여야 하며, 관절와 결손이 25% 이상이거나 상완 골 두 결손이 30% 이상인 경우 추가적인 수술적 처치가 요하여 최근 보고되고 있는 Latarjet 술식이나 관절경적 Remplissage 술식을 시행하는 것이 바람직하다.

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