• Title/Summary/Keyword: 외래에서 시행하는

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Efficacy and Safety of Polyethylene Glycol(PEG) with Electrolytes for Disimpaction in Children with Chronic Functional Constipation (소아에서 만성 기능성 변비의 분변 박힘 제거에 대한 전해질이 함유된 Polyethylene Glycol(PEG)의 효과 및 안전성에 관한 연구)

  • So, Hong Seop;Bae, Sun Hwan;Yoon, Hei Sun;Hwang, Jin Soon
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1089-1094
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    • 2003
  • Purpose : Polyethylene glycol(PEG) with electrolytes has been used for intestinal clearance for colonoscopy and operations in children. But its efficacy and safety for disimpaction in children with chronic functional constipation has been studied little. Methods : This study enrolled 26 patients with chronic functional constipation(11 children had failed to disimpaction by conventional management at OPD) who were admitted to the Eul-Ji Hospital between May 2000 and July 2003. PEG with electrolytes was administered per oral and/or rectal enema. We observed the effects for disimpaction by measuring the frequency and consistency of stools, and by simple abdominal X-ray. We evaluated the safety by measuring serum electrolytes and osmolarity in three hours after PEG with electrolytes administration, and by observation of the clinical status of the patients. The protocol of PEG with electrolytes was a dose of 60-80 mL/kg within three hours per oral and/or of 15-25 mL/kg by rectal enema. Results : In all patients, simple abdominal X-ray films showed improvements of fecal impaction. Consistency and frequency of stool were improved in all patients except one. As for side effects, diarrhea developed in three patients(11.5% of all patients). Headaches developed in one patient(3.8% of all patients) but it improved without treatment. Serum electrolytes was checked in 16 patients after PEG with electrolytes management and mild hypernatremia(146 mmol/L) was checked in one patient. Serum osmolarity was checked in 11 patients after PEG with electrolytes management and was normal in all patients. Conclusion : PEG with electrolytes was effective and safe for disimpaction in children with chronic functional constipation, including patients who had failed in disimpaction by conventional management.

Experience with a Safe Anastomotic Method for Ivor Lewis Operation (Ivor Lewis 수술 후 발생되는 문합 부위 합병증을 예방하기 위한 술식 평가)

  • Kim, Jeong-Won;Lee, Yong-Jik;Chang, Yong-Jin;Park, Chang-Ryul;Jung, Jong-Pil
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.625-629
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    • 2008
  • Background: When it comes to esophageal cancer operations, the prevalence of anastomotic complications that adversely affect quality of life is related to the type of anastomotic procedure and the operative site. We studied outcomes related to a safe anastomotic method used in Ivor Lewis esophagogastrectomy for preventing anastomotic leakage and stricture formation. Material and Method: Between May 2003 and April 2007, 18 patients with esophageal cancer underwent this type of esophagogastrectomy. Four people were lost to follow-up. There were 17 men (94.4%) and 1 woman. The mean patient age was 61 years (range, $46{\sim}73$ years). Result: The mean follow-up period was 17.2 months (range, $1{\sim}45$ months). There was no anastomotic leakage. There was one benign anastomotic stricture (5.6%) requiring esophageal balloon dilatation, which was accomplished with a 25 mm circular stapler. Conclusion: We experienced relatively good postoperative results using a safe anastomotic method in the Ivor lewis operation for preventing anastomotic complications. These results suggest that this anastomotic method is effective in reducing the incidence of benign anastomotic complications.

Study on Standardization of Korean Version of Psychiatric Diagnostic Screening Questionnaire(K-PDSQ) (한국판 정신장애 진단 선별 질문지의 표준화 연구)

  • Choi, Hyeong-Keun;Jung, Sung-Won;Jo, Hyun-Ju;Kim, Jeong-Bum;Jung, Chul-Ho
    • Anxiety and mood
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    • v.9 no.1
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    • pp.31-37
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    • 2013
  • Objective : The PDSQ is a brief and psychometrically strong self-report scale designed to screen for common DSM-IV Axis I disorders in clinical settings. In this study, the K-PDSQ was compared with the M.I.N.I.-Plus (Mini-International Neuropsychiatric Interview-Plus) for diagnostic validity and availability of the K-PDSQ as a part of standardization of the K-PDSQ. Methods : The 640 patients were evaluated with the K-PDSQ and the M.I.N.I.-Plus. Diagnosing with the M.I.N.I.-Plus, the diagnostic correspondence, administering time, sensitivity, specificity, ROC curve, and AUC of the K-PDSQ were evaluated. Results : For the diagnostic correspondence of the K-PDSQ, Cohen's kappa coefficient was .66 between the K-PDSQ and the M.I.N.I.-Plus. The administering time of the K-PDSQ was $18.2{\pm}11.80$ minutes. Both sensitivity and specificity of the K-PDSQ were higher: the mean sensitivity across 10 subscales of K-PDSQ was 86%; the mean specificity was 84%. All AUCs of each subscale were above .80, which were statistically significant. Conclusion : The K-PDSQ is valid and available as a diagnostic screening tool. It will be widely used in clinical settings for screening DSM-IV Axis I diagnosis because of its simplicity and high reliability.

Recurrent Paravalvular Leakage after Mitral Valve Replacement with Annular Reconstruction for Paravalvular Leakage Due to a Paravalvular Abscess - A case report - (판막주위농양에 의해 발생된 판막주위누출 환자에서 승모판막 치환술과 승모판륜 재건술을 함께 시행한 후 재발된 판막주위누출 - 1예 보고 -)

  • Park, Chan-Beom;Kim, Yong-Han;Kweon, Jong-Bum;Park, Kuhn;Chung, Mee-Young;Jin, Ung;Roh, Tae-Ho;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.268-272
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    • 2008
  • Paravalvular abscess is defined as infective necrosis of the mitral annulus and surrounding tissue that requires debridement of the necrotic tissue and patch reconstruction before valve implantation. Paravalvular abscess is associated with high operative mortality, postoperative complications, and recurrence. We report here a case of a 59-year old woman that had undergone mitral valvular replacement with a mechanical valve 13 years ago. The patient was determined to have paravalvular leakage due to paravalvular abscess as seen during follow-up. The patient underwent repeat mitral valvular replacement with annular reconstruction. However, the patient with mitral annular reconstruction and valvular replacement on the fifteenth postoperative day due to recurrence of paravalvular leakage. The patient is now receiving follow-up eight months after surgery.

A Clinico-Statistical Study of the Biopsy Result of the Larynx (이비인후과외래에서 시행한 후두조직생검 142례의 임상통계적 고찰)

  • 고건성;유장열;황순재;임상혁;박현수;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.5.2-6
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    • 1978
  • The prognosis of the laryngeal diseases is highly dependent on the early diagnosis and treatment. The biopsy finding is inevitable for the cofirmed diagnosis. A clinico-statistical survey of the biopsy result of the larynx in 142 cases was done at the Department of the Otolaryngology Seoul National University Hospital during a period of 3 yrs from 1973 to 1975. Results are as follows 1. Of the 142 cases, 109 cases (76.8%) were males and 33 cases (23.2%) females. Sex ratio was 3.3 : 1. 2. Age distribution shows 41 cases (28.8%) in 5th decade, 41 cases (28.9%) in 6th decade. 3. Chief complaint was hoarseness 127 cases (89.4 %), dysphagia 7 cases (4.9%) and sore throat, dyspnea etc. The time lag from the onset of hoarseness to the hospital was 2∼6 Months, 56 cases (44.0%), 6 Months∼l yrs, 34 cases (24%), within 2 Months, 17 cases (13.4%) and 15 cases (11.8%) were over 3yrs. Average time lag was 8.1 Months. 4. The site of laryngeal biopsy was 76 cases (53.3 %) from ture vocal cord, 23 cases (16.2%) from false vocal cord, and 19 cases (13.3%) from epiglottis. 5. Biopsy result was carcinoma in 69 cases (48.6%), laryngeal nodule in 20 cases (14.0%), laryngeal tuberculosis in 12 cases (8.4%) and non specific inflamation in 7 cases (5.0%). 6. 13.4% of the clinically impressed laryngeal carcinoma proved to be laryngeal tuberculosis, nonspecific inflammation etc.

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Subannular Procedures in Mitral Valve Reconstruction (승모판 재건술의 승모판막하술식)

  • 이재원;정종필
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.146-151
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    • 1997
  • Between December 1993 and March 1996, 75 patients had undergone ubannular procedures in mitral valve reconstruction. Their mean age was 45 years and they consisted of 28 males and 47 females. The cause of mitral disease in 75 patients were classified as follow : 29 cases were degenerative, 40 cases were rheumatic, 3 cases were congenital, 2 cases were infectious and 1 case was ischemic. Average number of mitral anatomical lesion per patient was 3.1 and we used average 1.5 procedures on subannular structure in mitral valve per patient. Subannular procedures were chordae shortening 21, chordae transfer 22, new chordae formation 20, papillary muscle splitting 33, shortening of papillary muscle 2. Intraoperative transesophageal echocardiography was carried out for providing an immediate and accurate assessment of the adequacy of the reconstruction. There was no operative death. Patients have been followed up from 2 to 29months, mean 12.5. There were two failures that necessitated reoperation. The mean functional class (NYHA) was 3.19 preoperative and improved to 1.12 postoperatively. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data. In conclusion, subannular procedure in mitral valve repair when feasible is stable and safe with a low prevalence of reoperation.

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Hybrid Palliation for Functionally Single Ventricle with Systemic Outflow Obstruction (단심증에서의 Hybrid 고식술)

  • Cho, Won-Chul;Song, Kwang-Jae;Jung, Sung-Ho;Kim, Young-Hwee;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.927-930
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    • 2006
  • Hybrid procedure was performed for a thirteen-day-old girl with a functionally single ventricle, who weighed 2.2 kg and had been prematurely born at $32^{+5}$ weeks of gestation. She underwent bilateral pulmonary artery banding using 3.5 mm Gore-Tex graft, ductal stenting using balloon expandable stent, and reverse Blalock-Taussig shunt with 3.5 mm Gore-Tex vascular graft. After discharge, she was followed up for 4 months, and underwent 2nd stage operation(extensive arch reconstruction with Damus-Kaye-Stansel anastomosis, atrial septectomy, bilateral pulmonary artery angioplasty, bidirectional cavopulmonary shunt). She has been followed up for 4 months after the 2nd operation with an excellent clinical condition.

Surgical Treatment of Aortic Dissection Involving Ascending Aorta (상행대동맥을 포함한 대동맥박리에 대한 외과적 치료)

  • 유영선;김경렬
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.297-302
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    • 1996
  • From January 1989 to July 1995, 18 patients underwent aortic repair for type A dissections. The e were 9 male and 9 female patients aged 41 to 68 years(mean, 53.8). Thirteen patients underwent the procedure during the acute period, and 5 during the chronic period. During repair of acute dissection, procedures included graft replacement of the ascending aorta only (6 patients), ascending aorta plus partial aortic arch (3), ascending aorta plus total aortic arch (2), Bentall's operation (1), and Bentall's operation plus total aortic arch (1). During repair of chronic dissection, procedures included Bentall's operation (3 patients), ascending aorta only (1), and ascending aorta plus partial aortic arch (1). During repair of the arch, antegrade cerebral perfusion was applied in 4 patients and hypothermic circulatory arrest in 3 patients. There were 4 operative deaths(22.2%), 2 of hemorrhage. and 2 of left ventricular failure in the operating room. Follow-up has been 100% completed and ranged from 2 to 53 months (mean, 17 months). One late death resulted from sepsis following secon operation. Thirteen of the survivors are doing well.

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Thoracoscopic Sympathetic Nerve Reconstruction with using an Intercostal Nerve Graft after Thoracoscopic Sympathetic Clipping for Facial Hyperhidrosis (안면부 다한증에서 흉부교감신경차단수술 후 발생한 보상성 다한증에서 흉강경을 이용한 흉부교감신경 재건술)

  • Haam, Seok-Jin;Lee, Doo-Yun;Kang, Cheong-Hee;Paik, Hyo-Chae
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.807-810
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    • 2008
  • From October 2005 to August 2006, sympathetic nerve reconstruction with using the intercostal nerve was performed in 4 patients with severe compensatory hyperhidrosis following thoracoscopic sympathetic surgery for facial hyperhidrosis. The interval between the initial sympathetic clipping and the sympathetic nerve reconstruction was a median of 23.1 months. The compensatory sweating after sympathetic nerve reconstruction was improved for 2 patients, but it was not improved for 2 patients. Thoracoscopic sympathetic nerve reconstruction may be one of the useful treatment methods for the patients with severe compensatory hyperhidrosis after they under go sympathetic nerve surgery for hyperhidrosis.

Successful Conversion Arterial Switch Operation after Palliative Senning Operation (고식적 심방 전환술 후 시행한 전환 대혈관 치환술)

  • Kim Joon Bum;Park Jeong-Jun;Chung Sung Ho;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.140-144
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    • 2006
  • Six year-old female having TGA, VSD with severe PHT which was considered inoperable for anatomical correction, received palliative Senning procedure. During follow-up, she was given prostacyclin and at the age of 21, she received Senning takedown, arterial switch and VSD closure after a reevaluation of the hemodynamic status. Significant reduction in PHT was found and she is doing well without complication 3 months after the operation.