• Title/Summary/Keyword: 수술중

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Factors Affecting Intraoperative Body Temperature in Surgical Patients with Laparotomy under General Anesthesia (전신마취하 개복술 환자의 수술중 체온에 영향을 미치는 요인)

  • Lee, Seohyun;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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    • pp.236-244
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    • 2015
  • Purpose: The study was conducted to identify factors affecting the intraoperative core body temperature (CBT) of surgical patients under general anesthesia. Methods: This study was performed through a prospective descriptive research design. The sample consisted of 138 patients who had undergone elective laparotomy surgery. Age, weight, height, the basal preoperative CBT, blood pressure, and heart rate were collected. CBT was again measured at induction of anesthesia, 1 hour, 2 hours, and 3 hours following induction of general anesthesia. Results: Factors affecting intraoperative hypothermia < $36^{\circ}C$ at 1 hour following induction, were CBT at induction and total body fat (TBF) ($R^2=.569$, p<.001); at 2 hours after induction, CBT at induction and TBF ($R^2=.507$, p<.001); at 3 hours after induction, CBT at induction (${\beta}=0.34$), TBF, age and the ambient temperature in the operating room ($R^2=.449$, p<.001). Conclusion: CBT at induction and TBF appear to be factors affecting intraoperative CBT within 2 hours after induction of anesthesia; CBT at induction, TBF, advanced age and the ambient temperature after 3 hours following induction. We recommend keeping surgical patients warm before induction of anesthesia and providing intraoperative warming for surgical patients of advanced age with low TBF and when the duration of general anesthesia will last more than 3 hours.

A Case of Recurred Paraganglioma of the Anterior Mediastinum A Case of Recurred Paraganglioma of the Anterior Mediastinum - A Case Report - (재발된 전종격동 부신경절종 치험 1례)

  • 김주현;김두상;성숙환;김영태
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.198-202
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    • 1998
  • The recurrence of an anterior mediastinal mass was discovered incidentally on the chest film for an asymptomatic 72-year-old female. She underwent the mass resection at the same site in 1989 and was diagnosed as a paraganglioma of the anterior mediastinum. She had poorly controlled hypertension which was converted into normal blood pressure after the first operation. During the follow up, the catecholamine levels were within normal limits, and there were no evidence of recurrence of the tumor. However, 6.3 years later, the mass recurred at the same anterior mediastinum. The patient had no hypertension and catecholamine levels were still within normal limits. The recurring mass was successfully removed and had the same histological findings - recurring paraganglioma.

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Development of Bubble Detector for Extracorporeal Circulation Support System (체외 순환 보조 장치 위한 공기방울 감지 장치 개발)

  • Lee, Hyuk-Soo
    • Journal of the Institute of Convergence Signal Processing
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    • v.11 no.4
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    • pp.298-302
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    • 2010
  • Extracorporeal circulation support system is a device for repiratory and heart failure treatment, and there have been many trials for development and clinical application in the world. These devices need to be careful while using is air embolism. Air embolism can be a lethal complication of surgical procedures during which venous pressure at the site of surgery is sub-atmospheric or air is forced under pressure into a body cavity or using extracorporeal circulation support system. To solve the problem, we developed the air detector using relative dielectric constant change. In experiments with a mock circulation system, the proposed system showed a signal difference depending on the amount of air in the tube.

Meniscus Allograft Transplantation; Surgical method (동종 반월상 연골 이식술의 술기)

  • Lee, B.S.;Chung, J.W.;Bin, Seong-Il
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.175-179
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    • 2010
  • 동종 반월상 연골 이식술은 불가피하게 반월상 연골이 소실된 환자에서 증상을 호전을 위한 매우 효과적인 치료이다. 관절연골의 보호 효과 등 장기적인 결과에 대해서는 아직까지는 많은 연구가 필요한 상태이지만, 이러한 환자에서 반월상 연골의 기능을 회복시키기 대안이 많아 점차 널리 시행되는 추세이다. 이식된 반월상 연골이 제 기능을 하기 위해서는 적절한 수술방법을 통하여 반월상 연골 이식물을 정확한 위치에 이식을 하는 것은 필수적일 것이다. 여러 저자들 마다 서로 다른 다양한 반월상 연골 이식술의 방법들을 사용하고 있지만, 어떤 방법을 선택하던지 간에 이식된 반월상 연골의 전각 및 후각을 해부학적인 위치에 견고하게 고정을 하는 것이 매우 중요하다. 술자의 선호도에 따라 다양한 방법중의 하나를 선택을 할 수 있지만, 어떤 방법이든 수술 술기상의 어려움이 있으므로, 철저한 준비와 노력이 필요할 것이다. 본 종설에서는 반월상 연골 이식술 중 개방적 방법에 대한 간단한 소개와 함께 저자들이 사용하는 관절경을 이용한 수술방법을 정리하였다.

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Success and failure of endodontic microsurgery (미세 치근단 수술의 성공과 실패)

  • Song, Min-Ju;Kim, Eui-Seong
    • Restorative Dentistry and Endodontics
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    • v.36 no.6
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    • pp.465-476
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    • 2011
  • In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles. Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus. Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

Recent Perspectives on Oncoplastic Breast Surgery in Korea (우리나라의 종양성형학적 유방암 수술에 대한 최신 동향)

  • Kang, Taewoo
    • Journal of Life Science
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    • v.30 no.6
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    • pp.563-569
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    • 2020
  • Oncoplastic surgery (OPS) combines oncologically safe tumor resection with aesthetically satisfying reconstruction of defects using established plastic surgery techniques. OPS is characterized by initial excision as extensive as is beneficial for oncological safety, and, once sufficient resection is complete, displacement or replacement techniques are selected based on remnant volume. The size of the lesion and the individual patient are important factors when considering the appropriate approach, and when pre-operative imaging, including MRI, is used to determine the technique, the complete removal of cancer cells by permanent pathology is essential. A frozen section is used during the operation to reduce the reoperation rate, but it is difficult to cover the entire margin surface theoretically and even harder in practice. A recent report about adequate margins has empowered OPS in its oncological safety. Considering the patients to whom each modality could be applied, basic breast volume is an important factor, and this is influenced by ethnic differences. In Europe or the US, for example, the average breast size is 36D (600 ㎤) and reduction mammoplasty is predominantly used. However, the average size of patients in our institution is 33A (300 ㎤), and so quite different approaches are selected in most cases. New techniques involving radiofrequency and fluorescence have been proposed as safe and easily accessible ways of reducing complications.

Preoperative Three Dimensional Ultrasonographic Evaluation of the Rotator Cuff Tear (회전근 개 파열에 대한 수술 전 3차원 초음파 검사의 유용성)

  • Yum, Jae-Kwang;Sin, Yong-Woon;Han, Jung-Il
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.24-28
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    • 2008
  • Purpose: We wanted to determine if preoperative three dimensional (3D) ultrasonographic evaluation for rotator cuff tear is useful to measure the real size of a torn rotator cuff for performing an operation Materials and Methods: This study included 15 cases (7 males and 8 female), and these patients were confirmed to have a full thickness tear of the rotator cuff by 3D ultrasonography and the operative findings, as well as on the magnetic resonance imaging (MRI). The average age of the patients was 55.4yrs. Results: The average difference between the 3D ultrasonographic and operative measurements of the full thickness tear of the rotator cuff was 0.7 mm in the transverse length and 2.0 mm in the longitudinal length. Conclusion: The low error between the 3D ultrasonographic and intraoperative measurements of rotator cuff tear shows the usefulness of preoperative 3D ultrasonographic evaluation for rotator cuff tear.

Evaluation of Surgical Outcome with Pre-and Post-operative Rest/Acetazolamide Tc-99m HMPAO SPECT in Children with Moyamoya Disease (어린이 모야모야병에서 휴식/아세타졸아미드 Tc-99m-HMPAO SPECT를 이용한 수술결과 평가)

  • Lee, D.S.;Hyun, I.Y.;Wang, K.C.;Cho, B.K.;Chung, J.K.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.314-324
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    • 1998
  • Purpose: This study was performed to evaluate the outcome of encephalo-duro-arterio-synangiosis (EDAS) surgery with rest/acetazolamide Tc-99m HMPAO SPECT in moyamoya disease. Materials and Methods: Rost/acetazolamide subtraction SPECT with consecutive acquisition were done before and 2 months after 21 EDAS surgeries in 18 patients. Perfusion decrease was graded visually for 14 areas of each hemisphere as 0 (normal) to 3 (defect) using 4 point scoring system. Postoperative rest perfusion or perfusion reserve was compared with preoperative ones. Results: Among 294 areas of 21 hemispheres, rest perfusion abnormality was found in 91 areas of 15 hemispheres. Decrease of perfusion reserve was found in 146 areas of 18 hemispheres. Six hemispheres having normal rest perfusion and 12 of 15 hemispheres having rest perfusion abnormality showed reserve decrease. Three having rest perfusion defect did not change after acetazolamide in preoperative SPECT. After operation, 16 patients (89%) demonstrated clinical improvement. Fifteen among 18 hemispheres (83%) with decreased reserve improved. Rest perfusion abnormality improved in 6 among the 15 hemispheres (40%). The areas having rest perfusion and/or reserve decrease improved in 87 among 146 areas (60%). Decrease of reserve, improved in 85% (68/80). However, areas without reserve decrease also improved in 29% (19/66). The better was preoperative rest perfusion in involved areas or the more decreased vascular reserve, the more improved perfusion and reserve after operation. Conclusion: We conclude that assessment of perfusion and Perfusion reserve using rest/acetazolamide brain perfusion SPECT predict the surgical outcome in patients with moyamoya disease.

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The Role of Surgery for the Treatment of Upper Esophageal Cancer (상부 식도암에서 수술적 치료의 유용성)

  • Park, Jae-Kil;Sa, Young-Jo;Nam, Sang-Yong;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.685-690
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    • 2007
  • Background: In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaker to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery. Material and Method: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 424 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival. Result: On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of post-operative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p<0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy. Conclusion: There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required.

Video-assisted Thoracoscopic Surgery for Mediastinal Lesions (종격동 질환의 비디오 흉강경 수술)

  • 김연수;김광택;손호성;김일현;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.40-45
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    • 1998
  • Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

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