• International journal of thyroidology
• /
• 제11권2호
• /
• pp.109-116
• /
• 2018

It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.

• Journal of Chest Surgery
• /
• 제36권3호
• /
• pp.206-210
• /
• 2003

Hemangiomas in the esophagus comprise less than 3% of all benign esophageal neoplasms. They are frequently small and easily treated with resection via either endoscopy or thoracotomy. We report a cavernous hemangioma occurred in the distal esophagus successfully treated with circumferential myomectomy.

• Proceedings of the KSLP Conference
• /
• 대한음성언어의학회 1997년도 제8회 학술대회 심포지움
• /
• pp.257-257
• /
• 1997

1996년 10월부터 1997년 6월까지 안ㆍ이비인후과병원과 영동세브란스병원 이비인후과에 음성장애를 주소로 내원한 환자 중 성대양성질환으로 성대미세수술을 시행하고 음성검사를 시행한 환자들을 대상으로 하였다. 대상환자는 총 85명으로 후향적으로 의무기록을 검토하여 수술시 병명, 수술시 레이저(laser)사용유무, 수술 후 발성장애 유무를 확인하였으며 그 중 수술 후 지속적인 혹은 반복적인 발성장애를 보인 환자는 총 12명으로 발성장애의 원인과 치료의 종류 및 치료효과를 판정하기 위해 후두비디오스트로보 스코피 검사, 청각심리검사 및 음성분석을 확인하였으며 통계처리를 하였다. (중략)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• 제26권1호
• /
• pp.13-15
• /
• 2015

Intraoperative neuromonitoring of thyroid surgery has gained universal validity to help in nerve identification, safe nerve dissection, and prediction of postoperative vocal cord function. In this article, standard intraoperative neuromonitoring procedure, interpretation about loss of signal, and the indications covered by health insurance will be described.

• Journal of Clinical Otolaryngology Head and Neck Surgery
• /
• 제29권2호
• /
• pp.157-161
• /
• 2018

• The Korean Journal of Applied Statistics
• /
• 제12권2호
• /
• pp.325-333
• /
• 1999

경북대학교병원에서 1985년에서 1994년까지 위암 때문에 위 절제수술을 받은 1,192명의 환자에 대한 자료를 이용하여 5년 생존율에 관해 분석하고자 한다. 일반적으로 위암 진단을 받은 환자가 수술을 받으려고 할 때 또는 수술을 직후에, 환자의 임상적 특성들을 이용하여 수술후 생존시간과 수술후 5년 생존 여부는 큰 의미가 있다. 그러나 많은 경우에 있어서 실제 임상자료는 연구가 진행 중에 있으므로 생존시간이 우측 중도절단된 형태로 관측되어 기존의 판별분석과 로짓분석을 적용할 수 없다. 본 논문에서는 Buckley와 James가 제안한 의사확률변수를 이용하여 수술전과 수술직후, 두 시점에서 중도절단된 자료를 보완하고, 판별분석과 로짓분석을 통하여 수술전과 수술직후에 환자들의 각 특성이 5년 생존여부에 미치는 영향을 분석을 한다.

• Journal of Biomedical Engineering Research
• /
• 제20권4호
• /
• pp.401-407
• /
• 1999

A microsurgery telerobotic system has been developed to aid surgeons from physiological tremor, eye stram, hand tremor, contagious and radioactive hazard. This paper identifies four general areas of advanced microsurgery and analyzes the motion, tools, accuracy and applying forces with respect to microsurgery tasks, and proposes the criteria to design the microsurgical robot. The analysis of microsurgery can be helpful to clarify some basic concept and design of surgical robots. Based on this analysis results, we propose an efficient in-parallel-platform manipulator having a special kinematic structure suitable for microsurgery.

• Journal of Chest Surgery
• /
• 제31권1호
• /
• pp.13-19
• /
• 1998

Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

• Journal of Chest Surgery
• /
• 제38권2호
• /
• pp.146-151
• /
• 2005

Background: Preoperative elevated serum creatinine values are associated with increased risk for both morbidity and mortality in patients undergoing on-pump coronary artery bypass surgery (CABG). We investigated the postoperative changes of renal function and proper management in the patients. Material and Method: Among 74 consecutive patients who underwent isolated on-pump CABG, 17 patients with increased serum creatinine level $(creatinine\;\geqq\;1.5\;mg/dL)$ within preoperative one week wereincluded in the study. Seven patients showed pre­operative serum creatinine level of 2.0 mg/dL or higher, and 3 of them had been undergoing hemodialysis. Preoperative hemodialysis was performed in the 3 patients due to end-stage renal failure (ESRD) the day before the operation. We started peritoneal dialysis immediately after the cardiopulmonary bypass in patients with ESRD or postoperative acute renal failure if it was necessary to remove intravascular volume and lower serum creatinine level. Result In most of the patients with CABG, postoperative serum creatinine level increased and recovered to the preoperative level at the discharge. In 2 of the 4 patients with serum creatinine level of 2.0 mg/dL or higher and 3 patients with ESRD, intravascular volume, serum creatinine level and serum electrolyte were controlled with peritoneal dialysis. Conclusion: Postoperative serum creatinine level increased transiently in most of CABG patients, and intravascular volume and serum creatinine level were controlled by peritoneal dialysis only in the patients with acute renal failure postoperatively and those depending on hemodialysis.

• Journal of Chest Surgery
• /
• 제32권12호
• /
• pp.1087-1092
• /
• 1999

배경 :경동맥 내막 절제술의 목적은 뇌졸중 예방에 있다. 경동맥 내막 절제술시 경동맥 혈류를 차단하였을 때 뇌허혈 상태를 초래하는지 가 가장 중요한 문제이다. 경동맥 혈류 역류압은 뇌내 측부혈류 상태를 반영하므로 경동맥 혈류 차단시 역류압과 뇌파검사 소견에 딸라 shunt 삽입여부 기준을 알아보려고 하였다 대상 및 방법 : 1996년 2월부터 1999년 3월까지 경동맥 내막 절제술을 시행받은 16명을 대상으로 하였다 남자가 14명있고 여자가 2명이었으며 평균연령은 66.35$\pm$6.53이었다 수술부위 경동맥 협착은 평균 73.8$\pm$12.33%였고 반대측 경동맥 협착은 평균 60.99$\pm$23.03%였다. 수술중 모든 환자에서 뇌파감시를 하였으며 경동맥 혈류압을 측정하여 40 mmHg 이하이거나 수술반대측 경동맥 완전폐색이 있는 경우 shunt를 삽입하였다 결과 : 술후 1례에서 사망이 있었는데 이 환자는 전, 중 뇌내동맥 영역에 큰 뇌경색이 있으며 동측에 심한 경동맥 협착이 있고 의식은 기면 상태여서 바로 응급수술을 하였다 수술시경동맥 혈류 역류압은 35mmHg 여서 shunt를 사용하였다 술후 1일째 의식이 혼수상태로 나빠져 뇌 단층촬영한 결과 뇌경색 부위에 출혈이 발생하여 사망하였다. 수술 직후 모든 환자에서 뇌허혈에 따른 합병증 및 사망은 없었고 1례에서 수술후 1일째 수술부위 반대편에 적은 뇌경색이 발생하였다 평균 21.5$\pm$11.85개우러의 외래 추적 검사에서 뇌졸중 재발이 없었다. 결론 : 뇌졸중이환후 경동맥 내막 절제술은 최소 4-6주 이상 안정화 시킨 다음 수술하는 것이 좋다고 생각된다 경동맥 내막 절제술은 뇌졸중 예방에 효과적인 치료방법이며 경동맥 혈류역류압이 40mmHg 이하일 경우 shunt를 설치하여 수술하는 것이 안전하다고 사료된다.