• Title/Summary/Keyword: 수술중

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Critical Pathway for Management of Primary Spontaneous Pneumothorax (원발성 자연기흉의 치료지침)

  • 전상훈;이응배;조준용;장봉현;이종태;김규태;배지훈;강형석;김병호
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.43-47
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    • 2002
  • Background: With the advances of video technology, thoracoscopic surgery has been applied to various areas of the thoracic surgical fields including major surgeries. Now a days,-thoracoscopic surgery is Performed as a procedure of choice for primary spontaneous pneumothorax. But the operative indication for the primary spontaneous pneumothorax has not been changed since the last few decades, although the procedure of choice was changed from open thoracotomy to thoracoscopy. Therefore, we thought new treatment strategy will be necessary for the management of primary spontaneous pneumothorax. Material and Method: Between January 1998 and December 1999, 149 primary spontaneous pneumothorax patients were admitted to the Kyungpook National University Hospital. Result: Of these patients, 177 were first attack pneumothoraces and the number of total attacks were 250. Conclusion: Analyzing the amount of pneumothorax, methods of treatment, number of recurrences, recurrence rate and hospital stay, we propose a critical pathway for establishing new treatment strategy for the management of primary spontaneous pneumothorax.

CLINICAL STUDY ON ORTHOGNATHIC SURGERY FOR 8 YEARS IN OUR DEPARTMENT (최근 8년간 본교실에서 시행한 악교정수술의 임상적 검토)

  • Kwon, Tae-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.1-9
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    • 1995
  • We observed 117 orthognathic surgery cases with dentofacial deformity for 8 years from Jan. 1986 to Dec. 1993. The ratio of male female was 1 : 1.4 and the mean age was 23.0 years ranged from 16 to 35 years. The most dominant group was related to mandibular prognathism (75.0%). Surgery method were divided into 88 cases of mandible surgery, 6 cases of maxilla surgery and 23 cases of two jaw surgery. Sagittal split osteotomy were performed on 84 cases (71.8%). Rigid fixation was increased after 1989 and total percent of rigid fixation was 66%. We used autotransfusion method from 1992 to all orthognathic surgery patient. Lower lip numbness caused by Inferior alveolar nerve injury is the most common problem after operation, and it was 63 cases (53.8%) of total operation cases. In our clinic, we performed 5 cases of re-operation because of segment malalignment, condylar sag, and fixation instability.

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Reconstruction of the Superior Vena Cava with Extra-luminal Bypass Shunt (우회단락을 사용한 상대정맥증후군의 수술)

  • Shin Jae Seung;Jo Won-Min;Min Byung Zoo;Chung Won Jae;Lee In Sung
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.68-71
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    • 2006
  • We operated on a 41-year-old man using venous bypass shunt for superior vena cava (SVC) syndrome caused by mediastinal fibrosis. The patient had substantially high venous pressure and high risk of postoperative neurologic deficits. The collateral veins were deemed to be interrupted during the surgical reconstruction of SVC. Treatment included resection of the obstructed SVC and innominate vein and reconstruction with an autologous pericardial tube graft. During the operation, venous drainage from upper body was maintained with an extraluminal bypass shunt. The shunt was effective at prompt relief of venous hypertension, eliminating the time constraints, and preventing the postoperative complications.

Effects of MBO and Job Commitment on Nursing Performance in Operating Room Nurses (수술실 간호사의 목표관리특성과 직무몰입이 간호업무성과에 미치는 영향)

  • Lee, Youn Hwa;Seomun, GyeongAe
    • Journal of Digital Convergence
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    • v.15 no.4
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    • pp.309-316
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    • 2017
  • This study aimed to examine the effect of management by objectives(MBO) and job commitment on the nursing performance of operating room(OR) nurses. The study was conducted on 226 OR nurses from tertiary healthcare institutions in Seoul. Multiple regression analysis was performed to determine the effect of OR nurses on nursing performance. In results, the factors that affect the nursing performance of OR nurses included the concreteness of goals, job commitment, and measurability of objectives in that order, and these variables explained 25.9% of the nursing performance. Therefore, in order to improve the performance of the nursing work, it is necessary to make efforts to create a work environment where nursing can be carried out due to the nature of the nursing operation. In addition, it is essential to develop a strategy to further the influence of the concreteness and measurability of goals among other attributes, thereby enhancing the job performance of OR nurses.

Complication of Intraoperative Radiation Therapy (IORT) in Gastric Cancer (위암의 수술중 방사선 치료의 합병증)

  • Kim Myung Se;Kim Sung Kyu;Song Sung Kyo;Kim Hong Jin;Kwan Koing Bo;Kim Heung Dae
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.187-192
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    • 1992
  • Local control is the important prognostic factor in cancer treatment because local control decrease the relative risk of metastatic spread and inclose distant metastasis free suwival. IORT is the modality which could increase local control without incressing complication, combined with curative operation. Eventhough we could achieve significant deacreased local failure by IORT and curative resection, it should not be committed as a main treatment modality without proving acceptable complications. Therapeutic Radiology Department of Yeungnam University Medical Center have tried 58 IORT from June 15, 1988, and performed 53 IORT En patients with gastric cancer. No local failure has been reported by regular follow up so far. Nine cases ($17\%$) of treatment related complicaiton were reported including intestinal obstrution, hemorrhage, sepsis, and bone marrow depression. These complications could be comparable to Jo's $25.2\%$ (chemotherapy + operation), Kim's $18\%$ (chemotherapy only in inoperable patients), because our treatment regimen is consisted of IORT (1500 cGy), external irradiation (--4500 cGy) and extensive chemotherapy(FAM, 5FU + MMC, BACOP).

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Factors Affecting Acceptance of Cosmetic Surgery Among Undergraduate Students (대학생의 미용성형수술 수용성 영향요인)

  • Kim, Young A;Chae, Duckhee;Kim, Hyunlye
    • The Journal of the Korea Contents Association
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    • v.17 no.1
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    • pp.455-464
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    • 2017
  • The purpose of this descriptive study was to investigate the level of cosmetic surgery experience, perception of side effects, self-esteem, acceptance of cosmetic surgery (ACS) and to explore factors affecting ACS among undergraduate students. A convenience sample of 255 students from three universities completed a self-administered questionnaire from May, 25, 2016 to May, 31, 2016. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple linear regression. As a results, 11.5% of students had at least one cosmetic surgery and the majority of them had blepharoplasty. A total of 86.3% of students had heard of cosmetic surgery side effects and the most common source of information were TV, newspapers, magazines and internet. ACS was significantly different by gender, school year, perception of side effects, and cosmetic surgery experience. ACS and self-esteem showed a negative correlation. Previous experience of cosmetic surgery, self-esteem, school year, and gender were identified as influencing factors on ACS which explained 19.0% of total variance. In conclusion, to help college students make rational decisions on cosmetic surgery, provision of sufficient information, improvement of self-esteem, and introduction of gender and school year based intervention are recommended.

Total Anatomic Correction of Complex Heart Anomalies Associated with Complete Atrioventricular Septal Defect (완전방실중격결손증을 동반한 복잡심장기형의 해부학적 교정술에 관한 연구)

  • 김현조;김기출
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.263-270
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    • 1996
  • Twenty two patients underwent total anatomic correction of complete atrioventricular septal defect associated with other cardiac anomalies between July 1986 and December 1994. Age ranged from 6 months to 11 years(mean 49.6 $\pm$ 35.8 months), and they were composed of 7 males and 15 females. Combined major cardiac anomalies were tetralogy of Fallot(TOF) in 11 cases, double outlet of right ventricle (DORV) in 6 ca es, and transposition of great arteries (TGA) in 5 cases. Down's syndrome was associated in 5 patients with TOF and 1 patient with DORV. They were classified as Rastelli type A in 3 patients, B in 2 patients, and C in 17 patients. Modified Blalock-Taussig shunt was performed.in 5 patients and Waterston shunt in 1 patient as a palliative procedure. There were 7 perioperative deaths(31.8%) and the causes were pump weaning failure, low cardiac output, acute renal failure, persistant pulmonary hypertension and hypertensive crisis, and sepsis. Reoperations were performed in 4 cases to repair atrioventricular valvular regurgitation or to relieve the right ventricular outflow tract (RVOT) or pulmonary arterial stenosis. One late death was due to aspiration pneumonia. Second reoperation was necessary for progressive worsening of left atrioventricular regurgitation and RVOT stenosis in one patient. Fourteen survived patients were followed up for a mean of 66.0 $\pm$ 26.7months and all of them w re NYHA functional class I or II.

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Clinical Application for Video-Thoracoscopy in Lung Cancer Surgery Patients (폐암 수술환자에서 흉강경수술의 적용)

  • 김광호;한재열;윤용한;백완기;이응석;김형진
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.392-396
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    • 2002
  • Background: Video-thoracoscopy is known to be an useful method to provide accurate pre-resectional staging in patients with lung cancer in addition to the conventional radiologic studies and mediastinoscopy, for the pleural cavity is inspected directly and biopsy specimens call be obtained. This study is undertaken to evaluate how video-thoracoscopy can be used in deciding pre-resectional stage Material and Method: Video-thoracoscopy was performed in patients with lung cancer who were scheduled for surgical resection based on the radiologic staging and mediastinoscopic biopsy. 37 patients were included in this study. Pre-thoracoscopically 18 cases were in TNM stage 1, 7 in stage 2, and 12 in stage 3. Result: In 15 of 37 cases, video-thoracoscopy could not be performed effectively due to heavy adhesions in the pleural cavity, diaphragmatic and chest wall invasion of tumor and bulky tumor mass es. Mediastinal lymph nodes were positive postresectionally in 6 of these 15 cases. In 22 cases, video-thoracoscopy was performed as usual. Positive mediastinal lymph nodes were identified in 2 cases and exploratory thoracotomy was prevented. Surgical resection were carried out in remaining 20 cases and 5 cases among them had positive mediastinal lymph nodes. Conclusion: We believe that it is difficult to perform pre-thoracotorny video-thoracoscopy for all lung cancer patients for there were many cases that thoracoscory could not be undertaken doe to heavy adhesions in the pleural cavity, tumor involvement of the chest wall and/or diaphragm and bulky tumor mass. However we think it is helpful in preventing unnecessary exploratory thoracotomy for some patients with lung cancer whom pre-thoracotomy video-thoracoscopy was carried out.

Treatment of Atrial Fibrillation with Microwave (Microwave를 이용한 심방세동의 치료)

  • 조광현;최강주;강도균;전희재;윤영철;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.329-334
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    • 2003
  • Backgound: Cryoablation and radiofrequency ablation have been used to treat the atrial fibrillation. Some reports insisted that the microwave ablation Is a better method for a deep and extensive lesion. Material and Method: From December 2001 to July 2002, we peformed 8 microwave ablations in patients who needed mitral valve surgery (7 MVR, 1 MVR+AVR). There were 3 men and 5 women, and their mean age was 43.4$\pm$8.3 years and mean follow up period was 5.6$\pm$2.4 months respectively. The microwave was applied on endocardium or epicardium by Lynx (Afx, inc.) using a power of 45 watts for 25 seconds. We studied the left atrial dimension, the left atrial function and the sinus conversion with echocardiography and electro-cardiography at three times; 1) before the operation, 2) immediately after the operation, and 3) 6 months after the operation. Result: There was no complication and no mortality. The mean aortic clamping time was 104.6$\pm$25.0 minutes, and the mean total bypass time was 130.5$\pm$28.7 minutes. The rate of sinus conversion was 75%, A wave across the mitral valve was a mean of 77.0$\pm$24.8 cm/sec, and the AVE was a mean of 0.46$\pm$0.17 at 5.6 months postoperatively Conclusion: There was no difference in the early result of microwave ablation compared to other methods. The microwave ablation was an acceptable method due to its convenient application especially in beating heart.

Effect of Microsurgical Varicocelectomy on Human Sperm Nucleus DNA Integrity (미세술기를 이용한 정계정맥류절제술이 정자 핵 내 DNA Integrity에 미치는 효과)

  • Kim, Gi-Young;Lee, Jae-Seok;Chi, Hee-Jun;Kim, Jong-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.3
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    • pp.245-251
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    • 2010
  • Objective: Human sperm nucleus DNA damage may negatively affect pregnancy outcome, and the spermatozoa of infertile men have more DNA damage than that of fertile men. The aim of this study was to evaluate the effect of microsurgical varicocelectomy on human sperm nucleus DNA integrity. Methods: We reviewed the medical records of 18 subfertile male patients who underwent microsurgical varicocelectomy at our hospital from April 2006 to April 2007. Varicocele was diagnosed by physical examination and Doppler ultrasound. Standard semen analysis was performed in 18 patients before and 4 months after microsurgical varicoceletcomy using a computer assisted semen analyzer. Sperm nucleus DNA integrity was assessed by a single-cell gel electrophoresis (comet assay). Results: No recurrence of varicocele was observed after 4 months later. The DNA fragmentation index improved after varicocelectomy compared with pre-operatively (19.3 versus 13.7%, respectively, p<0.05). Semen analysis parameters (total count, concentration, motile sperm, viability, strict morphology) increased after varicocelectomy, but the difference did not reach statistical significance. Conclusion: Our data suggest that microsurgical varicocelectomy can improve semen analysis parameters and human sperm nucleus DNA integrity in infertile men with varicocele.