• Title/Summary/Keyword: 외래 기반 수술

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Clinical Applications of Office-Based Laryngeal Surgery With KTP Laser (KTP 레이저를 이용한 외래 기반 후두 수술의 임상적 적용)

  • Cho, Jung-Hae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.3
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    • pp.118-123
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    • 2021
  • The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

Dental Treatment for Handicapped Patients in Day Care Units: 2 Years' Experience at Seoul National University Dental Hospital (서울대학교 치과병원 장애인 진료실의 외래마취 하 치과치료)

  • Park, Chang-Joo;Yum, Kwang-Won;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.1 s.2
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    • pp.21-26
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    • 2002
  • 연구배경: 장애인의 치과치료는 일반인의 치과치료와는 달리 많은 문제점들을 가지고 있다. 이러한 장애인 환자의 치과치료를 위하여 서울대학교 치과병원에서는 치과마취과를 중심으로 임상 각과가 협진하여 외래마취 기반 하에 1999년부터 장애인 진료실을 운영하고 있다. 이번 연구에서는 서울대학교 치과병원 장애인 진료실의 치료방법을 소개하고 그 동안 치료받은 장애인 환자들의 자료를 바탕으로 마취과적인 특징을 분석하였다. 방법: 2001년 1월부터 2002년 5월까지 치료받은 총 54명의 장애인 환자들의 치료기록지와 마취, 그리고 회복실 기록지를 검토하였다. 환자의 성별, 나이, 전신질환, 수술 전 시행된 검사, 치료에 참여한 협진과, 마취 유도제와 유지제, 총 마취시간과 회복실 체류시간, 그리고 회복실에서 관찰된 합병증을 조사하였다. 결과: 총 54명의 환자들을 대상으로 58건 치과치료가 시행되었다. 한 건의 의식진정 법을 제외하고는 모두 전신마취 하에서 치과치료가 시행되었다. 마취유도제는 thiopental sodium, 근이완제는 vecuronium과 succinylcholine가 가장 많이 사용되었으며 마취 유지를 위해서는 enflurane과 isoflurane의 흡입마취제를 이용하거나 TCI를 이용한 propofol 지속정주를 이용하였다. 총 마취지속시간은 $160.2{\pm}55.5$분이었으며 회복실에서의 체류시간은 $132.8{\pm}50.1$분, 그리고 완전한 회복을 확인하기 위해 병동에 단기 입원시킨 소아환자에서는 $58.7{\pm}16.8$분이었다. 회복실에서 심각한 합병증은 발생하지 않았다. 지속적인 감시를 위하여 4명의 환자가 입원을 권유받았으나 특별한 합병증 없이 다음 날 퇴원하였다. 결론: 서울대학교 치과병원 장애인 진료실은 외래마취에 대한 기존의 연구들보다 긴 마취시간과 회복실 체류시간을 보였다. 그러나 별다른 합병증 없이 일회 방문으로 장애인 환자들에게 필요한 치과치료를 모두 제공할 수 있었다.

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Implementation of PACS using PDA System on Medical Images (PDA기반 의료영상의 전송시스템 구현)

  • Ji, Yeon-Sang;Dong, Kyung-Rae;Kim, Chang-Bok
    • The Journal of the Korea Contents Association
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    • v.9 no.4
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    • pp.247-253
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    • 2009
  • PACS(Picture archiving communication system) is a system that enables medical images such as X -ray, CT, MRI, PET to be stored electronically viewed on computer screens so that doctors and other authorized people can access search the information as needed. But if they are not in hospital area for example on holiday or at night, that are not able to access the PACS system instantly. We have to solve this problem for more efficient patient care. So we try to suggest a method that use the PDA system that wireless LAN and CDMA cellular phone are equipped. This system may help to access easier to PACS system regardless of the location and can also attribute the development of telemedicne.

Informally Patients Prediction Model of Admission Patients (입원환자 데이터를 이용한 예약부도환자 이탈방지 모형 연구)

  • Kim, Eun-Yeob;Ham, Sung-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3465-3472
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    • 2009
  • The aims of this study is to medical record data warehouse which had been collected from hospital information systems. continuous patient 2,118 60.5%, informally patient 1,385 39.5%. In using survival factors sex, age, area, insurance, admission-course, medical treatment, out-patient lesson, out-patient form, conference diagnosis, operation, cancer, medical reservation. As a result of making a predictive modeling using the logistic regression, the fitness of the predictive modeling of informally patient was 66.0% and neural network, the predictive was 66.72% and CHAID, the predictive was 63.25%, which is a data mining. The expected modeling of the informally patients, the hospital through the continuous patient management and trust of hospital.

Development of Nursing Activity Cost Calculation Program Using Time-Driven Activity-Based Costing (TD-ABC) (병동 간호활동 원가계산 프로그램 개발 :시간동인 활동기준원가계산 기반으로)

  • Lim, Ji Young;Kang, Sung Bae;Lee, Hyun Hee
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.480-494
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    • 2018
  • The purpose of this study is to develop a nursing activity cost calculation program based on Lee's doctoral dissertation using TD-ABC. The developed program has been supplemented with data storage, print out, and graph conversion functions to expand the application possibility. The development of the program consisted of three steps: program requirements analysis, program design and development, and program validation. This program was designed not only to do the cost calculation, but also to compare the cost-effectiveness and cost consumption trends. Consequently, this program is meaningful in that the nursing manager can obtain the cost information necessary for nursing unit management and extend the utilization so that the cost management strategy can be established based on the cost information. Therefore, we propose that the cost-management capacity of clinical nurses should be strengthened and the nursing performance measurement research should be expanded by applying it to various actual clinical nursing management settings. It is suggested that this program should be used as a training medium to strengthen nurse cost management capacity by combining nursing management curriculum at undergraduate level.

Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor (족관절 내과 절골술 및 대형신연기를 이용한 제3형 거골 경부 골절의 치료 결과)

  • Park, Sung Hae;Lee, Jun Young;Lee, Jung Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.45-51
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    • 2019
  • Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.