• Title/Summary/Keyword: 수술주기

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Familial Atrial Myxoma with Carney's Complex - 1 Case - (Carney' Complex 소견을 보이는 가족성 심방 점액종 - 치험 1례-)

  • 김명천;이재영;박주철;유세영;조규석
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.816-819
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    • 1998
  • Myxomas are the most common form of intracardiac tumors and are found primarily in the left atrium. In rare cases, Carney and associates have described a syndrome called "the complex of myxoma" consisting of cardiac myxoma, which characteristically is familial, in assocation with two or more of the follow conditions: myxomatous masses (cardiac myxoma, cutaneous myxosma, and mammary myxoid fibroademoma), spotty pigmented lesions of the skin, and endocrine disorders. We report a case of familial atrial myxoma with Carney's complex in a 19-year old woman who has spotty pigmentations on her face, and left atrial myxomas, and myxoma on the right nipple. Her mother and sister share the left atrial myxoma. The myxomas originated in the septum of the left atrium and the anterior leaflet of the mitral valve were successfully excised. In conclusion, family members of affected patients should be screened periodically with echocardiography in an attempt to identify asymptomatic cardiac myxomas. Complete excision and postoperative follow up are necessary to rule out the muticentricity and high rate of recurrent lesions.

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Adaptation and Effects of the Evidence-based IPC Nursing Protocol on Prevention of Postoperative Venous Thromboembolism (외과적 수술 후 정맥혈전색전증 예방을 위한 근거기반 IPC(Intermittent Pneumatic Compression) 간호프로토콜의 수용개작 및 효과)

  • Kim, Nam Yong;Kim, Eun A;Sim, Jae Yeun;Jung, Soon Hee;Kim, Hye Young;Jang, Eun Hee;Shin, Jee Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.1
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    • pp.63-75
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    • 2017
  • Purpose: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. Methods: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. Results: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. Conclusion: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.

Endobronchial Leiomyoma - A case report - (기관지내 평활근종 -1례 보고-)

  • 김한용;황상원;이연재;유병하;안종운;김병헌
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.725-729
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    • 1998
  • Endobronchial leiomyoma is extremely rare and accounts for less than 2% of benign tumors of the lower respiratory tract. Leiomyomas are predominantly found in the young and the middle aged : of the average age being 35 years for bronchial and lung parenchymal lesions and 40.6 years for tracheal lesions. The symptom depends on the location of the tumor, its size, and changes in the lung distal to the lesion. A 37-year-old woman was admitted to our hospital complaining of coughing. Bronchoscopy revealed complete obstruction of the right main bonchus at the carina by an oval-shaped, nonulcerative, smooth, and pinkish-tan tumor with a broad margin and extended to the left main bronchus. A biopsy was performed and showed a benign spindle cell tumor. A right pneumonectomy was performed because of chronic infection, and the lung could not expanded during aeration. The histological diagnosis of the resected specimen was leiomyoma. The postoperative course was uneventful.

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A Case of Perineal Hypospadias with Os Penis Deformity and Unilateral Cryptorchidism in a Boston Terrier (보스턴 테리어에서 발생한 음경골 이형성과 편측 잠복고환증을 가진 회음부 요도하열)

  • Park, Woo-Young;Bae, Chun-Sik;Kim, Hwi-Yool;Cho, Ki-Rae;Park, Woo-Dae
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.185-188
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    • 2009
  • A six-month-old Boston terrier presented with an extruded penis caudally, incompletely formed preputial sheath, bifid scrotum, retained testicle and deformity of the os penis. On physical examination, the urethral orifice was located on the surface of the perineum and a fibrous band was observed running from the grans to the urethral orifice on the perineum. The dog also had urethritis that was infected by ascending bacteria entering through the contaminated urethral orifice. Corrective surgery was undertaken to excise the external genitalia and retained testicle. The prepuce, penis and retained testicles were successfully excised. After the urethral orifice was cleaned periodically and antibiotics were administrated, recurrent urethritis disappeared. Using this therapeutic regime it is not necessary to reconstruct the anomaly located urethral orifice, if the location of urethral orifice is not the cause of recurrent urethritis and urinary incontinence.

심근조영심초음파에서 심장의 움직임을 보정한 비침습적 심근관류모델의 정량적 평가

  • 이재훈;김희중;정남식;임세중;김기황
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.49-49
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    • 2003
  • 목적 : 심초음파는 비침습적이므로 반복적으로 정확히 심질환의 경과를 관찰하여 치료효과 및 수술시기를 정할 수 있는 검사로서 임상적으로 매우 유용하다. 실시간 심근조영심초음파에 의한 time intensity 평가는 부위별로 수행됨으로 연속적으로 위치하는 관심영역이 intensity에 있어 심장의 움직임 변화에 영향을 받는다. Time intensity 곡선의 최적의 곡선맞춤을 위해 주기적인 심장 운동 매개변수를 조합해 기존의 모델을 보정한 안정적인 측정방법을 제시한다. 방법 : 심장의 운동에 의한 특징적인 정보를 설명하기 위해 기존의 문헌에 제시된 지수 함수에 주어진 심박수로 만들어진 시간에 관한 일반적인 정형파 함수를 추가한다. C(t) = A[1 - exp($\beta$t)] + Dsine(2$\pi$ft + $\theta$) C(t): videointensity A: plateau videointensity (blood volume) $\beta$: capillary blood velocity (rate constant of rise in videointensity) t: pulsing interval (ms) D: displacement from the periodic variance of the curve (estimated motion field from the ejection point for the ratio between systole and diastole) f: heart rate $\theta$: transit time issue A $\times$ $\beta$ : myocardial blood flow 관상동맥의 관류 데이터에 대한 실험이 펄스간격에 대한 비디오 세기로 수행되었다. 그리고 이러한 결과들이 the sum of squares due to error, R square, root mean squared error로 평가되었다. 결과 : 실험결과, 주기적인 심장의 움직임과 심박출 시점으로부터의 변위를 잘 기술하고 곡선에서의 측정 점들이 예측된 심장 움직임에 따라 성공적으로 표시되었다. 뿐만 아니라 보정된 모델이 현저한 적합도의 향상을 보여주었다. 결론 : 제시된 접근방법은 각각의 측정에서 심장 운동 영역의 변화에 독립적이며 측정 시점에 의해 영향받지 않고 심근 관류의 안정적인 측정이 가능하다. 심장의 움직임에 관한 매개변수를 조합한 모델로 곡선접합을 수행함으로써 관류의 정량적 정보를 좀더 정확하게 얻을 수 있으며 임상적 이용을 가능하게 할 것으로 기대된다.

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Dual Stent Application on Congenital Tracheobronchial Stenosis - 1 case - (선천성 기관기관지 협착에서의 이중 스텐트의 적용 - 1례 보고 -)

  • 강문철;황성욱;김용진;김희수;김종성;성명훈
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.149-152
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    • 2002
  • We report successful application of dual trachcobronchial stcnt to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with COB retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stunt. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty Finally we applied dual tracheobronchial stent and resolved the airway obstruction.

Catamenial Hemoptysis Treated by Video-assisted Thoracoscopic Surgery (비디오 흉강경 수술로 완치된 월경성 객혈)

  • Cho, Chang Beom;Kim, Dong-Gyu;Kim, Changhwan;Park, Ji Young;Lee, Seok Won;Jang, Seung Hun;Jung, Ki-Suck;Jun, Sun-Young;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.29-33
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    • 2008
  • Catamenial hemoptysis is a rare condition that's characterized by recurrent hemoptysis occurring in association with menstruation, and this is associated with the presence of intrapulmonary or endobronchial endometrial tissue. The diagnosis of pulmonary endometriosis can be made according to a typical clinical history and with exclusion of other causes of recurrent hemoptysis. Treatment of pulmonary endometriosis can be medical or surgical; however, the optimal management of this condition is still a matter of debate. Medical therapy may be problematic, due to recurrence of symptoms despite hormonal ablation, and adverse effects from long-term hormone therapy can also be a problem. We report here on a case of pulmonary endometriosis in a 23-year-old woman who presented with hemoptysis that occurred during the first 3 days of menstruation, and this happened over a 4 month period. She was successfully treated by video-assisted thoracoscopic surgery (VATS). No more hemoptysis was noted during 12 months of follow-up.

The Development of Pc Based EGG-NIBP Patient Monitor (PC 기반의 심전도-비관혈식 혈압 환자감시장치의 개발)

  • 김남현;김경하;주기춘;라상원;송광석;한민수;김성민;이건기;최태영
    • Journal of Biomedical Engineering Research
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    • v.20 no.4
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    • pp.461-469
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    • 1999
  • In this paper, an ECG-NIBP patient monitor is designed. This is an essential equipment to measure and monitor patient's physical condition - electrocardiogram(ECG) wave, heart rate(HR), and noninvasive blood pressure(NIBP) - in ICU, CCU, and operating room. The ECG is an electrical waveform produced by relaxation and contraction of the cardiac muscle. Most physicians diagnose patient's cardiac states from ECG pattern. A blood pressure is one of the clinical indexes measured in a emergency room or operating room. In this paper, the blood pressure is measured in artery by using the nonivasive oscillometric method. The developed patient monitor was inspected and compared with other instruments in operating rooms. The results were 1bpm of maximum difference in the heart rate, 15mmHg in the systolic pressure, 16mmHg in the diastolic pressure, and 25mmHg in the mean blood pressure. But the total results were 0.15bpm of the mean difference in the heart rate, 5mmHg in the systolic pressure, 10mmHg in the diastolic pressure, and 9mmHg in the mean blood pressure. The designed ECG-NIBP patient monitor can measure the ECG wave, HR, and BP. And the multi-tasking module of pulse oximetry . respiration . temperature monitor will be added in the near future.

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The Effect of Pre and Intra-Operative Warming Therapy on Tympanic Temperature Changes during Perioperative Phase in Receiving Patients with Total Hip Replacement (수술전과 수술중 피부가온요법 적응이 고관절 전치환술 환자의 수술 주기 고막체온 변화에 미치는 영향)

  • Kwon Young-Sook;Kim Eun-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.86-96
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    • 2000
  • The purpose of the study was to investigate the effects of Warming Therapy used with patients consistantly before and during surgery to on changes in their body temperatures. The data were collected from patients in a university hospital in Taegu between December 1, 1998 and May 31, 1999. The subjects were selected from patients who were hospitalized for total hip replacement surgery. Thirty participants were assigned to two groups : experimental(Warming Therapy) group and control group. Each group consisted of 15 patients. The research design was a repeated measurement design, using a nonequivalent control group. The Warming Therapy, using a forced-air warming blanket, that is a, 'Bair Hugger' was applied to subjects in the experimental group. The subjects in the group were treated with the 'Bair Hugger' to warm up the whole body for 40 minutes before surgery and upper body and face during the operation. The core temperature was measured using a tympanic thermometer. The body temperature of the patients was measured 13 times every 15 minutes during the surgery. After the operation the body temperature of the patients was measured 4 times every 15 minutes, from the time of arrivial in the recovery room to the time of leaving the recovery room. The SPSS Win 9.0 program was used for data analysis. Specific methods tested were done using ${\chi}^2-test$, t-test, repeated measures ANOVA. The findings of the study are as follows. 1. The first hypothesis, 'The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group during the operation', was supported (F=32.16, p=.000). 2. The second hypothesis, 'The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group after the operation', was supported.(F=33.36, p=.000) 3. During recovery, shivering was observed one patient in the experimental group and seven patients in the control group. In summary, the findings of the study suggest that the 'Warming Therapy' applied before and during the surgery was a very effective treatment for surgical patients in maintaining the core temperature during surgery

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Aesthetic implant restoration with alveolar bone graft and digital method on maxillary central incisor: a case report (치조골이식과 디지털 방법을 활용한 상악 중절치 임플란트 심미 수복 증례)

  • Jang, Han-Sol;Pyo, Se-Wook;Kim, Sunjai;Chang, Jae-Seung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.168-174
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    • 2022
  • In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.