• Title/Summary/Keyword: 외래에서 시행하는

Search Result 540, Processing Time 0.026 seconds

Postnatal Management of Antenatally Diagnosed Patent Urachus with Bladder Prolapse

  • Choi, Hyun-Shin;Kim, Hae-Eun;Kim, Eun-Sun;Oh, Soo-Young;Chang, Yun-Sil;Seo, Jeong-Meen;Park, Won-Soon
    • Neonatal Medicine
    • /
    • v.17 no.2
    • /
    • pp.262-264
    • /
    • 2010
  • A case of bladder prolapse through a patent urachus is reported in a female infant born with a large, red, tubular mass inferior to the umbilical cord. A cystic mass communicating with fetal bladder was detected by prenatal ultrasound performed at $20^{+2}$ weeks of gestation. A fetal MRI was also performed to confirm the diagnosis and to exclude associated fetal anomalies. At $40^{+4}$ weeks, the cystic mass was no longer present and a new small solid mass was noted at the fetal abdominal wall. After birth, a protruded mucosal mass inferior to the umbilical cord was noted, and catheterization confirmed communication between the protruded mass and the urinary bladder. On the second day of life, reduction of the bladder and partial resection of the urachus was performed. A voiding cystourethrogram showed good bladder capacity and no vesicoureteral reflux. The patient voided well and was discharged after 10 days. Here, we present a case of urinary bladder prolapse through a patent urachus, diagnosed by fetal sonography and this is the first case reported that was treated by simple excision without complication.

Development of Rule-based Expert System for Interpretative Report with Health Screening Tests (건강검진자를 대상으로 해석적 보고를 위한 전문가 시스템의 개발)

  • Lee, Chae-Hoon
    • Journal of Yeungnam Medical Science
    • /
    • v.24 no.2
    • /
    • pp.137-147
    • /
    • 2007
  • Background : Interpretative reporting is an important aspect of laboratory medicine. The large menu of laboratory tests available today makes it increasingly difficult for the non-specialist to order and interpret all laboratory tests. The aim of this study was to determine the usefulness of an expert system to interpret laboratory tests and help physicians order the appropriate tests. Materials and Methods : In order to interpret laboratory tests, a rules-based expert system was developed. In this module, if-then rules were used to interpret the given test result patterns (e.g. urinalysis, anemia, hepatitis B virus, hypercholesterolemia, glucose, syphilis, and tumor markers) and select matching text elements. The system was used to evaluate 535 subjects who visited a health-check program. Results : The overall abnormal rate was 50.5% in the expert system; 34% for cholesterol, 9.9% for urinalysis, 8.0% for anemia, 7.7% for thyroid function tests, 4.5% for tumor marker study, 4.7% for hepatitis virus antigen, 4.3% for serum glucose, and 1.1% for syphilis. Conclusion : These results indicate that the application of the expert system for the interpretation of laboratory tests may provide a useful method for the interpretation of reports. However more rules are needed for the application to in-patients.

  • PDF

Significance of Ultrasonography in Diagnosis of Medial Meniscus Tear (내측 반월상 연골 파열의 진단에서 초음파의 의의)

  • Kim, Jung-Man;Im, Dong-Sun;Kim, Tae-Hyung;Kim, Jong-Ick;Lee, Kyu-Jo
    • The Journal of Korean Orthopaedic Ultrasound Society
    • /
    • v.4 no.1
    • /
    • pp.1-6
    • /
    • 2011
  • Purpose: To evaluate the usefulness of ultrasonography in diagnosis of the medial meniscus tear as a screening tool before performing magnetic resonance imaging. Materials and Methods: From April 2009 to September 2010, magnetic resonance imaging (MRI) was taken in 147 knees out of 341 knees examined with ultrasonography (US) under the suspicion of medial meniscus tear. The sonographic findings were 16 without abnormality, 12 inhomogeneity, 4 cluster, 60 cleavage and 55 more than 5mm medial extrusion of medial meniscus. In Statistical analysis, sensitivity and specificity, positive predictive value and negative predictive values were calculated. Results: The MRI showed abnormality in 104 knees. Sensitivity and specificity of ultrasonography for MRI was 94.2% and 23.3%, respectively. Positive predictive value was 74.8%, negative predictive value was 62.5%. The positive predictive value of ultrasonography were 58.3% in heterogeneity, 100% in showing cluster, 75% in visible cleft and 80% in medial extrusion. Conclusion: The US is a useful tool in prediction of medial meniscus tear before confirming it in high-cost MRI.

  • PDF

Surgical Experience of the Remnant Thoracoabdominal Aortic Replacement after Aortic Surgery (대동맥수술 후 잔존 흉복부대동맥치환술에 대한 임상 경험)

  • Cho, Kwang-Jo;Woo, Jong-Su;Choi, Pil-Jo;Bang, Jung-Hee
    • Journal of Chest Surgery
    • /
    • v.41 no.1
    • /
    • pp.49-54
    • /
    • 2008
  • Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.

SATISFACTION OF PATIENTS WITH DISABILITIES ABOUT OUTPATIENT GENERAL ANESTHESIA AND NURSING CARE FOR DENTAL TREATMENT (외래전신마취 하 치과치료를 시행한 성인 치과장애인의 치과마취과 간호사에 대한 만족도 조사)

  • Kim, Hye-Jung;Han, Jin-Hee;Han, Hee-Jeong;Kim, Hyun-Jeong;Yum, Kwang-Won;Seo, Kwang-Suk
    • The Journal of Korea Assosiation for Disability and Oral Health
    • /
    • v.2 no.2
    • /
    • pp.136-141
    • /
    • 2006
  • The purpose of this study is to survey the status of oral care of adult patients with disabilities and satisfaction degree of outpatient general anesthesia for dental treatment. 30 adult patients who underwent general anesthesia for dental treatment at clinic for the disabled in Seoul National University Dental Hospital enrolled for telephone survey. Many patients (83.3%) had mental problems to do social communication. And someone of family members (mainly mother) had cared for the patient but there was only one patient who got regular oral care. The satisfaction level of outpatient general anesthesia and nursing care for dental treatment was very high(100%).

  • PDF

Atypical Thymic Carcinoid Tumor with Thymic Cyst - 1 case report - (흉선 낭종을 동반한 비정형 흉선유암종 - 1례 보고 -)

  • 정재일;김재욱;김승우;구본일;강윤경
    • Journal of Chest Surgery
    • /
    • v.35 no.8
    • /
    • pp.634-637
    • /
    • 2002
  • Thymic carcinoid or neuroendocrine tumor of thymus is a very rare disease and has poor prognosis due to frequent recurrence and distant metastasis. A 43-year-old man was refered to our hospital because of Rt. chest pain and tightness. Chest X-ray revealed $7{\times}8$cm sized mass on Rt. anterior mediastinum. Surgical excision was performed and light microscopic, immunohistochemical and electron microscopic findings were confirmed as atypical thymic carcinoid tumor with thymic cyst. The patient has been followed up without recurrence or distant metastasis postoperatively for 3 months to now. We report a case of atypical thymic carcinoid with thymic cysts.

Surgical Correction of Total Anomalous Pulmonary Venous Return (총폐정맥 환류이상증의 외과적 치료)

  • 금동윤;이광숙
    • Journal of Chest Surgery
    • /
    • v.29 no.3
    • /
    • pp.292-296
    • /
    • 1996
  • Total anomalous pulmonary venous return is a rare but serious cardiac malformation, accounting for only about 1.5~3% of congenital heart disease. Surgical results have been dramatically improved in the last two decades, largely owing to improved techniques of cardiopulmonary bypass and perloperative management. Seven patients ranging in age from 15 days to 11 years with total anomalous pulmonary venous return underwent repair between 1984 and 1995. The types of anomalous return were supracardiac in 5, and cardiac in 2. There were 5 boys and 2 girls. There were two hospital death, occurred in 15-day-old, and 40-day-old infants with supracardiac type. Follow-up periods have ranged from 3 months to 11 years, and all survivors have remained asymptomatic with normal growth and development.

  • PDF

A case of Congenital Cardiac Anomaly Associated with DiGeorge Syndrome (DiGeorge증후군에 동반된 선천성 심장기형 치험 1례)

  • 손영상;김태식;황재준;김학제;박선화
    • Journal of Chest Surgery
    • /
    • v.32 no.6
    • /
    • pp.584-587
    • /
    • 1999
  • The DiGeorge syndrome is a rare congenital abnormality consisting of aplasia or hypoplasia of the thymus and parathyroid glands resulting from malformation of the third and fourth pharyngeal pouches. This syndrome usually includes congenital cardiac anomalies and abnormal facial features. We experienced a case of congenital cardiac anomaly associated with DiGeorge syndrome. The patient was 1 month old boy weighing 3.5 kg. The congenital cardiac anomalies included ventricular septal defect, atrial septal defect, coactation of aorta, and patent ductus arteriosus. We performed one-stage operation with two separate incisions for these cardiac anomalies. Postoperative course was uneventful and the patient at 6 months of follow up is doing well.

  • PDF

Innovative Techniques for thoracic sympathectomy: Experience of 654 patients for essential hyperhidrosise (흉부 교감신경절 절제에 대한 수술기법의 변화)

  • 문동석;이두연;김해균
    • Journal of Chest Surgery
    • /
    • v.31 no.7
    • /
    • pp.703-710
    • /
    • 1998
  • We treated 654 patients with simultaneous bilateral sympathectomy for essential hyperhidrosis from March 1989 to September 1997(354 males and 300 females). The exposure afforded by thoracoscopy is actually superior to that seen at the time of either thoracotomy or axillary thoracotomy. The use of single-lumen intubation with alternating partially collapsed lung by CO2 inflation resulted in shorter anesthesia, shorter operative time, and shorter hospitalization. 2-mm extended thoracoscopic T2-sympathectomy is not only a time-saving method but also a very simple and effective one in the treatment of hyperhidrosis by experienced surgeons. The modification on our technique of thoracoscopic sympathectomy as described allowed us to significantly improve our previous results. A majority of the patients were relieved, and over 95% were satisfied initially.

  • PDF

VATS Resection for a Posterior Mediastinal Extramedullary Hematopoietic Mass: Resection of Extramedullary Hematopoiesis (후종격동 종괴로 발견된 골수외 조혈 종괴의 비디오 흉강경 수술을 이용한 절제 1예)

  • Chang, Jee-Won;Maeng, Young-Hee
    • Journal of Chest Surgery
    • /
    • v.43 no.5
    • /
    • pp.542-545
    • /
    • 2010
  • Extramedullary hematopoiesis is a common compensatory mechanism of chronic anemia, but an asymptomatic posterior mediastinal mass is rarely diagnosed as an extramedullary hematopoiesis after surgical resection. The differential from neurogenic tumors is important, but fine needle aspiration biopsy is not recommended because of the difficulty of approach and risk of bleeding. Although diagnosis and treatment can involve resection via thoracotomy, video-assisted thoracic surgery may also be a useful strategy. We performed video-assisted thoracic surgery on a 59-year-old man for posterior mediastinal extramedullary hematopoiesis, with no evidence of recurrence or related hematologic diseases.