• Title/Summary/Keyword: 조기퇴원

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Surgical Correction of Total Anomalous Pulmonary Venous Connection in Early Infancy (조기 영아에서 전폐정맥연결이상의 외과적 교정)

  • 성시찬;방정희;전희재;조광조;최필조;우종수;이인규;이형두
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.510-517
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    • 1999
  • Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

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A Study on Monitoring of Liver Function Based on Voice Signal Analysis for u-Health System (u-Health 시스템을 위한 음성신호 분석 기반의 간 기능 모니터링에 관한 연구)

  • Kim, Bong-Hyun;Cho, Dong-Uk
    • The KIPS Transactions:PartB
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    • v.18B no.6
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    • pp.389-396
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    • 2011
  • There is getting worse to various liver diseases due to change in eating habits, stress, alcohol etc in modern society. Therefore, we proposed methodology to diagnose early for liver disease to study the influence on voice in liver diseases. To this end, we carried out experiment to apply parameter of voice analysis to collect each voice inpatients and patients by treatment of liver diseases patients. Particularly, we carried out experiment to apply element value of pronunciation and the third formant frequency bandwidths about velar sounds associated liver in oriental medicine, then to produce objective index resonance cavity and influence vocalization in liver diseases. In addition, we carried out to study about design of system to monitoring a liver function in u-Health environment based on result by experiment.

Clinical Experience of Spontaneous Hemopneumothorax (자연성 혈기흉의 임상적 경험)

  • Moon, Hyeon-Jong;Hwang, Seong-Wook
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.669-674
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    • 2010
  • Background: Spontaneous hemopneumothorax is characterized by the accumulation of air and more than 400 mL of blood in pleural cavity without any apparent cause. It is a rare disease and can cause life-threatening situation. We analyzed clinical reviews of two medical centers to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with 18 spontaneous hemopneumothorax patients was made. Result: These 18 patients were comprised of 15 male and 3 female with average 24.6 years (range 15~46 years). Almost patients (16) underwent a closed thoracostomy initially and 15 patients received video-assisted thoracic surgery (VATS). Mean postoperative chest tube removal was 2.9 days and one complication was post-removal pneumothorax. During the follow-up periods there were no other complications and recurrence. Conclusion: Proper initial diagnosis and management of spontaneous hemopneumothorax prevent significant hypovolemic shock. Video-assisted thoracic surgery should be considered an early surgical management in spontaneous hemopneumothorax. However conservative manage without bleb excision may be effective in selected patients.

Enhancing the Client Satisfaction through Improving the Quality of Hospital Administration Services (병원행정 서비스의 품질 향상을 통한 고객만족도 제고 방안)

  • Kim, Yoo-Ho;Lee, Ju-Ho;Ryu, Sang-Il;Lee, Jae-Eun
    • The Journal of the Korea Contents Association
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    • v.9 no.7
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    • pp.233-240
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    • 2009
  • The purpose of this study is to suggest plans to enhance client satisfaction through improving the quality of hospital administration services. For accomplishing the purpose, we conducted empirical research with classifying hospital administration services into administrative staff service, medical staff service, facility service, and institutional service. Based on the results of this study, suggestions were made as follows for improving the quality of hospital administration services. First, in administrative staff service, detailed explanations should be provided about the items of medical bills, and patients' waiting time should be reduced through fast processing and smooth cooperation among departments. Second, in medical staff service, the process of medical service should be simplified for the accurate observance of appointment schedules, and the time to start outpatient service and the time to complete the discharge process should be earlier than now. Third, in facility service, convenient facilities and resting places should be prepared, parking facilities should be expanded, and menus should be improved for clients. Fourth, in institutional service, detailed medical service costs contents should be disclosed and plans should be made for the efficiency of services.

SIADH Caused by the Synergistic Effect of S-1 and Thiazide (S-1과 티아지드 상승효과에 의한 항이뇨호르몬과다분비증후군 1예)

  • Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.198-201
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    • 2006
  • Hyponatremia is a dangerous electrolyte disturbance in patients on chemotherapy and may cause sudden death if not detected early. SIADH (syndrome of inappropriate antidiuretic hormone) is one of the known causes of hyponatremia in patients undergoing chemotherapy. Few chemotherapeutic agents, however, are reported to cause SIADH. The current study reports that SIADH developed in a 55 year old woman on S-1 ($80\;mg/m^{2}$) and cisplatin ($60\;mg/m^{2}$) chemotherapy for the peritoneal metastasis of gastric cancer. The patient underwent a total gastrectomy, a splenectomy, and a segmental resection of the transverse colon for gastric cancer. She had used thiazide and ${\beta}-blocker$ to treat hyperiension for 12 years. She admitted to our hospital with complaining of general weakness, dysarthria, loss of appetite, and urinary discomfort. The serum level of sodium and potassium were 94 mEq/L and 2.2 mEq/L respectively. The hyponatremia completely resolved uneventfully after 3% saline infusion, which led to normalized electrolyte balance. The patient was discharged on the 13th hospital day.

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Early Result of Bentall Operation (Bentall 술식의 조기 성적)

  • 송명근
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.113-117
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    • 1998
  • From October 1993 to April 1997, 37 patients(30 male and 7 female patients), ranging in age from 23 to 73 years, were operated for annuloaortic ectasia with or without aortic dissection. Four patients were in New York Heart Association Class I, 10 in Class II, 20 in Class III, and 3 in Class IV. In cases of annuloaortic ectasia with aortic dissection, the surgical treatment in all cases consisted of total replacement of the ascending aorta with composite graft and reimplantation of the coronary arteries to the tube graft. The postoperative complication, as postoperative bleeding or LV dysfunction, was 18%(7 cases) and late mortality for entire group was 2.7%(one death). The period of follow-up ranged from 1 month to 36 months(average 9.6 months). In conclusion, Bentall operation for annuloaortic ectasia with or without aortic dissection is reliable method with low mortality and excellent short-term results.

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Duodenal Complication After Open Heart Surgery Report of Three cases (개심술후 발생한 십이지장궤양 합병증 -3례 보고-)

  • Heo, Jae-Park;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1251-1253
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    • 1997
  • Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.

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Left Ventricular Outflow Obstruction due to a Left Ventricular Myxoma (좌심실 점액종에 의해 발생한 좌심실 유출로 협착증)

  • Park, Jeong-Min;Ahn, Byung-Hee
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.98-101
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    • 2008
  • Once it is diagnosed, immediate surgical extirpation is desirable for treating left ventricle myxoma that's accompanied with stenosis of the left ventricle outflow tract. This is because this condition may potentially induce fatal complications such as cerebral infarction or myocardial infarction that's triggered by myxoma embolus, or even sudden death due to coronary malperfusion. An 18-year-old male with the chief complaint of NYHA class II exertional dyspnea was found to have a $4{\times}3\;cm^2$ sized mass on transthoracic ultrasonography, which was shown to move down the left ventricle outflow tract on the systolic phase. The mass was immediately extirpated by incision of the left ventricle; the mass was finally diagnosed as a myxoma. The patient was discharged on at the 10th day postoperatively without any complications. On the 22-month follow-up observation made at the out-patient clinic after discharge, there have been no noticeable, significant changes seen on physical examination or the cardiac ultrasonography.

Leiomyosarcoma of Small Intestine -Two cases report with literatural review- (소장의 원발성 평활근육종 2예)

  • Chung, Yong-Sik;Suh, Bo-Yang;Kwun, Koing-Bo;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.281-286
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    • 1985
  • Small bowel malignancy consists 1~2 % of overall gastrointestinal tract cancer and leiomyosarcomas of small intestine are 10~20% of small bowel malignancy. Small bowel leiomyosarcomas are rare in incidence and have no specific symptoms, signs or definite radiologic findings, so it is not easy to diagnose at early stage of disease. They are found occasionally by unknown origined gastrointestinal bleeding, abdominal pain, intestinal obstruction, perforation and palpable mass, and diagnosed mostly by operation. Recently annual case reports are increasing trend in Korea. We experienced two cases of small bowel leiomyosarcoma which was diagnosed finally by pathologic findings, so we report them With literatural review.

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Staphylococcal Scalded Skin Syndrome in a Healthy Adult: Easy to Misdiagnose (건강한 성인에서의 오진하기 쉬운 포도구균성 열상 피부증후군의 치험례)

  • Kim, Hong Il;Kwak, Chan Yee;Park, Eon Ju
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.271-276
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    • 2018
  • A 60-year-old male presented with a three-month history of redness and swelling on his left little finger. His medical history was not informative. Wound culture revealed methicillin-resistant Staphylococcus aureus. After vancomycin administration, the skin lesions became worse and whole body bullae and desquamation occurred. This was initially suspected to be a drug eruption; thus, we switched antibiotics from vancomycin to teicoplanin. However, biopsy revealed Staphylococcal scalded skin syndrome (SSSS). After several days, generalized skin symptoms improved. The patient recovered and is in good physical health without recurrence six months later. We describe a localized form of SSSS, which is very rare in healthy adults. Consequently, there is a high risk of misdiagnosis. Thus, we report a rare case of SSSS in a healthy adult and the importance of early histological examination for accurate diagnosis.