• Title/Summary/Keyword: 초음파 수술도

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The Usefulness of Transesophageal Echocardiography During Heart Surgery (개심술을 시행하는 환자에서 경식도 심초음파의 이용)

  • 조규도;김치경
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1205-1213
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    • 1997
  • This study reviewed useful aspects of the intraoperative transesophageal echocardiography among the patients in whom heart surgery were undertaken between January 1996 and July 1996 at St.Pauls hospital, Medical College of Catholic University, Seoul, Korea. During that period, 61 patients were operated on because of valvular heart disease(25 patients), coronary artery disease(22 patients), congenital heart disease(13 patients), and combined coronary artery disease and valvular heart disease(1 patient). Two patients(1 redo-VSD and 1 valvular heart diease) needed repeated aortic cross clamping and complementary procedures because of incomplete initial procedures. There was no incidence of air embolism. We could observe significant relationship of cardiac output monitoring methods either by thermodilution technique and transesophageal echocardiography by linear regression analysis(p<0.001). We tested myocardial response(percentage of systolic wall thickness, PSWT) with low dose dobutamine challenge to predict post-CABG myocardial perfusion. And the test showed statistically significant resp.onse(sensitivity 76%, specificity 94.7%, positive predictive value 95%, negative predictive value 75%). These results suggest that cardiac surgeon could draw more benefits by intraoperative transesophageal echocardiography.

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Leakage of SuperEBA in root-end cavities prepared with 3 new ultrasonic tips : KaVo Isthmus, KaVo T-shape and KiS tip (KAVO ISTHMUS, KAVO T-SHAPE과 KIS TIP의 3종 초음파기구로 형성한 역충전와동의 SUPEREBA 변연누출에 관한 연구)

  • Lee, Woo-Cheol
    • Restorative Dentistry and Endodontics
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    • v.27 no.3
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    • pp.270-276
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    • 2002
  • 치근단 수술시 구동형 수술현미경과 미세수술기구들이 사용됨에 따라 치근단 절제술 후 역충전와동의 효과적인 형성 및 충전을 위해 새로운 초음파기구가 개발되었다 따라서 본 연구에서는 최근 상품화되어 사용되고 있는 초음파기구중 신속하게 역충전와동을 형성할 뿐아니라 충분한 깊이를 제공하여 역충전재료의 변연누출 감소에 효과적인 것으로 알려져 있는 3종의 초음파기구를 사용하여 역 충전와동을 형성 한 후 SuperEBA로 충전하여 그 변연누출을 비교하였다. 모두 56개의 근첨형성이 완료된 단근치를 선택하여 Profile .06를 사용하여 근관형성한 후 음성대조군 2개를 제외한 54개의 치아를 수직가압법으로 충전하였다. 근단부 3mm를 절제한 뒤 KaVo Isthmus, KaVo T-shape 그리고 KiS tip을 각각 18개의 치아에 사용하여 역충전와동을 형성하고 그중 각각 2개의 양성대조군 치아를 제외한 나머지 치아에 SuperEBA로 충전하였다. 각치아는 1% methylene blue dye에 침윤시켜 1주일 후 종절단하여 그 색소침투정도를 측정, 비교하였다. 실험결과 측정된 평균 변연누출은 KaVo Isthmus가 $1.5\pm$1.4mm, KaVo T-shape이 1.7$\pm$1.2mm이고 KiS tip은 1.1$\pm$0.7mm 이었으며, 통계적으로 유의할만한 차이는 없었다. 따라서 초음파기구를 사용한 역충전와동의 임상시술 성공여부는 술자의 편의도와 임상적 사용시 조작능력에 달려 있는 것으로 사료된다.

Perioperative Pain Management Using Regional Nerve Blockades in Shoulder Surgery: Ultrasound-Guided Intervention (견관절 수술 시 국소신경 차단술을 이용한 통증 관리 - 초음파 유도하 중재술 -)

  • Oh, Joo Han;Lee, Ye Hyun;Park, Hae Bong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.67-75
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    • 2014
  • There are several kinds of regional nerve blockades, such as interscalene brachial plexus block, C5 root block, suprascapular nerve block, and axillary nerve block, which can be applied for anesthesia and postoperative pain control after shoulder surgeries. These regional nerve blockades have shown good results, but high failure rate and serious complications, such as phrenic nerve palsy, pneumothorax, and nerve injury, still remain. Ultrasound-guided intervention can increase the success rate of nerve blockades and reduce complications. We described the method of ultrasound-guided intervention for the regional nerve blockades around shoulder.

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A Pedunculated Cavernous Hemangioma located beneath the Inferomedial Scapular Area -A Case Report- (견갑골 내측부 하방에 발생한 자루를 동반한 해면 혈관종 -증례 보고-)

  • Park, Tae Soo;Kim, Sung Jae;Ryu, Jeong Ah
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.93-96
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    • 2011
  • We reported a patient with a large pedunculated cavernous hemangioma located beneath inferomedial border of the scapular bone and the trapezius muscle checked by ultrasonography before and after the operation. In ultrasonographic finding, the peduncle was difficult to be visualized preoperatively due to acoustic shadowing.

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Analysis of The Delayed Time in Patients with Acute Appendicitis (급성 충수 돌기염 환자의 대기시간 분석)

  • Park, Seung-Ik;Kim, Kwang-Beak
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2013.10a
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    • pp.889-892
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    • 2013
  • 본 논문에서는 급성 복증을 주소로 야간 응급실 내원 시 영상의학과 전문의 부재 등과 관련된, 급성 충수 돌기염 진단을 위한 복부 초음파 검사의 환자 대기 시간과 충수 돌기 절제술 시행까지 환자 대기 시간을 분석한다. 응급실 내원 환자 41.5%에서 초음파 검사 대기 시간은 10시간 이상으로 나타났고, 외래 내원 환자의 45.2%는 수술 대기 시간이 18시간 이상으로 나왔다. 이는 초음파 검사의 대기 시간이 수술 대기 시간에 영향을 미치는 것으로 카이제곱검증에서 유의하게 나왔다(p<0.05). 따라서 본 논문에서는 환자들의 대기 시간을 감소시키기 위한 방법으로 응급실 의료진의 초음파 검사 시행에 따른 유익성과 급성 충수 돌기염의 특징을 이용한 의료 영상 분석, 연구의 필요성을 제안한다.

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Clinical Efficacy of the Ultrasonography in the Diagnosis of the Palpable Soft Tissue Masses (촉지되는 연부조직 종괴의 진단에서 초음파 검사의 유용성)

  • Park, Tae Soo;Kim, Hong Sik;Kim, Sungjun;Ryu, Jeong Ah
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.59-65
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    • 2011
  • Purpose: To determine the clinical efficacy of the ultrasonography (US) for the diagnosis of the soft tissue masses comparing to the clinical diagnosis through the physical examination. Materials and Methods: 83 consecutive patients with palpable soft tissue masses were presented retrospectively. On the basis of the pathological diagnosis after the operation, the diagnostic accuracies were evaluated the cases diagnosed by history taking and physical examination, and the cases diagnosed by US before the operation. Results: The diagnostic accuracy of the cases using US was higher(86.7%) than that of the cases using physical examination and history taking. The accuracy of US of the epidermal inclusion cyst was 71.4%, ganglion cyst 85.7%, lipoma 88.6%, respectively. Accurate diagnosis were made 54 cases with 65.1% sensitivity in the cases diagnosed by history taking and physical examination. In this case, its accuracy of the ganglion cyst was 56.0%, and the lipoma was 67.9%. Conclusion: US is a useful diagnostic tool for the diagnosis of the palpable soft tissue masses before the operation.

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A Clinical Study of Hypertrophic Pyloric Stenosis (비후성 유문 협착증의 임상적 고찰)

  • Kim, Yoon Hee;Jung, Myung Sup;Byun, Soon Ok
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1389-1396
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    • 2002
  • Purpose : This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. Methods : We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. Results : The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be $4.95{\pm}0.99mm$($mean{\pm}SD$), pyloric diameter $14.42{\pm}2.64mm$, and pyloric length $20.17{\pm}3.92mm$. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was $5.11{\pm}1.01mm$, pyloric diameter $15.01{\pm}2.47mm$, and pyloric length $22.32{\pm}3.43mm$. Conclusion : There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.

Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

Ultrasound-Guided Femorosciatic Nerve Block (초음파 유도 대퇴좌골 신경 차단술)

  • Kang, Chan;Kim, Young-Mo;Hwang, Deuk-Soo;Kim, Joung-Hun;Park, Jun-Young;Lee, Woo-Yong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.74-78
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    • 2010
  • Since the extent of use of musculoskeletal ultrasound in orthopaedic surgery is expanding, popliteal block(sciatic nerve block) and femoral nerve block(saphenous nerve block) are easily and safely performed without complications such as nerve injury or incomplete block. Also, due to the expanding use of ultrasound, orthopaedic surgery of not only foot but also ankle and lower leg could be done without general anesthesia or spinal anesthesia. We describe a detailed technique for ultrasound-guided femorosciatic nerve block based on the experience over 120 cases.

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Papillary Fibroelastoma of the Aortic Valve: Discovered by Chance with Intraoperative Transesophageal Echocardiography - A case report - (수술실 내 경식도 심장초음파검사에서 우연히 발견된 유두상 섬유탄력종 - 1예 보고 -)

  • Kim, Jeong-Won;Jung, Jong-Pil;Park, Soon-Eun;Kim, Young-Min;Park, Chang-Ryul;Shin, Je-Kyoun
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.637-640
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    • 2007
  • Papillary fibroelastoma is a rare benign cardiac tumor with an elevated risk for embolization and most papillary fibroelastomas do not cause symptoms. In this report, we describe a case of previous undiagnosed masses of the aortic valve that were incidentally found on intraoperative transesophageal echocardiography during coronary artery bypass surgery. Upon surgery, masses were found on the left and right aortic cusps and the pathological findings were consistent with a papillary fibroelastoma.