• Title/Summary/Keyword: Efficiency of Surgery

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Job Analysis of the Staff Nurse in Cardiac Surgery Intensive Care Unit (심장외과 중환자실 일반간호사의 업무분석)

  • Ko, Yu-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.2
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    • pp.265-282
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    • 2003
  • Purpose : This study was conducted to provide for a basic resource, which can be used to set up a efficient management system in Cardiac Surgery Intensive Care Units(CSICU). Method: 1) Questionnaires were administered and observation methods were used, to examine the nursing activities performed in the CSICU after having reviewed related literatures and a review by the experts. Thus, the nursing activities were designating 254 activities and classified into 28 categories. 2)The 22 nurses in the 2 CSICUs filled out questionnaires about nursing activities from 12 April, 2002 to 17 April, 2002. The frequency of the nursing activities in the 28 categories counted and new nursing activities added by directly observing 12 nurses by two trained research staffs for 4 day. 3)In terms of validity, the 264 nursing activities were analysed by the 25 experts. As a result, 231 nursing activities were found valid and remained as appropriate nursing activities to be used for the careful analysis of the nursing activities in CSICUs. Result: The 22 categories are as below: assessment, monitoring, respiration management, nutrition management, elimination/drainage management, mobility management, sanitation management, safety management, temperature management, specimens collection, preparation and assistance of treatment, skin/wound management, infection management, medication management, education/support, dying patient care, recording/keeping, supplies management, environment management, communications, evaluations, professional development Conclusion : The manifest job description of the staff nurse will contribute to improving the efficiency of the nursing activities and to reducing the role conflicts among the medical staffs.

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Comparisons between fresh and cryopreserved fat injections in facial lipofilling

  • Yang, Hyee Jae;Kang, Sang Yoon
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.15-21
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    • 2020
  • Background: Autologous fat is considered an ideal filler material, and the use of cryopreserved fat grafts is promising in terms of flexibility and efficiency. Therefore, cryopreserved fat grafts have become more common in recent years; however, their complications require further consideration. Methods: We evaluated 53 patients who underwent facial lipofilling at our institution to confirm the clinical usefulness and safety of cryopreserved fat. Fresh fat injections with or without cryopreserved fat were administered. At one or more sites, 22 patients had a single fresh fat injection, four patients had two or more fresh fat injections, 16 patients had one fresh fat injection followed by one cryopreserved fat injection, six patients had one fresh fat injection followed by two cryopreserved fat injections, and five patients had two fresh fat injections and one or more cryopreserved fat injections. Results: In total, 281 sets of injection procedures were performed at various sites, of which 170 involved one fresh fat injection, 89 involved one fresh fat injection and one cryopreserved fat injection, and 11 involved one fresh fat injection and two cryopreserved fat injections. One patient experienced self-resolving inflammation as a complication after the second injection in the right cheek. No statistically significant differences were found between the fresh and cryopreserved fat injections. Conclusion: We suggest that cryopreserved fat is a useful and safe resource for multiple fat injections, with advantages including aseptic fat handling and the delicacy of the technique.

Laparoscope Manipulator Control for Minimally Invasive Surgery (최소침습수술을 위한 복강경 매니퓰레이터 제어)

  • Kim, Soo-Hyun;Kim, Kwang-Gi;Jo, Yung-Ho
    • Journal of Institute of Control, Robotics and Systems
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    • v.17 no.7
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    • pp.685-696
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    • 2011
  • An efficient laparoscope manipulator robot was designed to automatically control the position of laparoscope via a passive joint on end-effector position. The end position of the manipulator is controlled to have corresponding velocity defined in the global coordinate space using laparoscopic visual information. Desired spatial position of laparoscope was derived from detected positions of surgical instrument tips, then the clinical viewing plane was moved by visual servoing task. The laparoscope manipulator is advantageous for automatically maintaining clinically important views in the laparoscopic image without any additional operator. A laparoscope is mounted to a holder which is linked to four degree of freedom manipulator via universal joint-type passive rings connection. No change in the design of laparoscope or manipulator is necessary for its application to surgery assistant robot system. Expanded working space and surgical efficiency were accomplished by implementing slant linking structure between laparoscope and manipulator. To ensure reliable positioning accuracy and controllability, the motion of laparoscope in an abdominal space through trocar was inspected using geometrical analysis. A designed laparoscope manipulating robot system can be easily set up and controlled in an operation room since it has a few subsidiary devices such as a laparoscope light source regulator, a control PC, and a power supply.

A multilayered Pauli tracking architecture for lattice surgery-based logical qubits

  • Jin-Ho, On;Chei-Yol Kim;Soo-Cheol Oh;Sang-Min Lee;Gyu-Il Cha
    • ETRI Journal
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    • v.45 no.3
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    • pp.462-478
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    • 2023
  • In quantum computing, the use of Pauli frames through software traces of classical computers improves computation efficiency. In previous studies, error correction and Pauli operation tracking have been performed simultaneously using integrated Pauli frames in the physical layer. In such a complex processing structure, the number of simultaneous operations processed in the physical layer exponentially increases as the distance of the surface code encoding logical qubit increases. This study proposes a Pauli frame management architecture partitioned into two layers for a lattice surgery-based surface code and describes its structure and operation rules. To evaluate the effectiveness of our method, we generated a random circuit according to the gate ratios constituting the commonly known quantum circuits and compared the generated circuit with the existing Pauli frame and our method. Simulations show a decrease of about 5% over traditional methods. In the case of experiments that only increase the code distance of the logical qubit, it can be seen that the effect of reducing the physical operation through the logical Pauli frame becomes more important.

The Results of Voice Assessment after Type IV Thyroplasty in a Transgender(Male to Female, MTF) - A Case Report - (갑상성형술 IV형을 시행 받은 성전환자의 수술 전후 음성검사 결과의 비교 - 증례보고 -)

  • 김한수;이성은;박태준;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.47-50
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    • 2003
  • The transgender is who has persistent discomfort with his of her sex or sense of inappropriateness in the gender role of that sex. Many transgenders have been undergone trans-sex operations after 1980's. But there were not so much experience of voice surgery for transgenders. Vocal pitch can be elevated by various surgical techniques. Type IV thryoplasty, which one of the cricothyroid approximation methods, increases tension to the vocal folds, thus increasing fundamental frequency and upper pitch range. We treated a transgender (MTF, Male to female) using this technique. Acoustic and aerodynamic measures were obtained both pre- and post-operatively. Clinically significant improvement was achieved in both study; increasing of vocal pitch, widening of pitch range, and improvement of vocal efficiency.

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Three-Dimensional Printing Technology in Orthopedic Surgery (정형외과 영역에서의 삼차원 프린팅의 응용)

  • Choi, Seung-Won;Park, Kyung-Soon;Yoon, Taek-Rim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.103-116
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    • 2021
  • The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.

Validation of Electronic Foot Function Index in Patients with Foot and Ankle Disease: A Randomized, Prospective Multicenter Study (족부 족관절 질환 환자에서 전자식 족부 기능 지수의 인증: 임의 배정, 전향적, 다기관 연구)

  • Lee, Dong Yeon;Kim, Yu Mi;Lee, Jun Hyung;Kim, Jin;Kim, Ji-Beom;Kim, Bom Soo;Choi, Gi Won;Seo, Sang Gyo;Kim, Jun Beom;Park, Se-Jin;Kim, Yoon-Chung;Choi, Young Rak;Lee, Dong-Oh;Cho, Jae-Ho;Chun, Dong-Il;Kim, Hyong Nyun;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.24-30
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    • 2019
  • Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

The Current Status of Adenovirus-based Cancer Gene Therapy

  • Shirakawa, Toshiro
    • Molecules and Cells
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    • v.25 no.4
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    • pp.462-466
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    • 2008
  • Adenoviruses are the most commonly used gene-delivery vectors due to the efficiency of their in vivo gene transfer. Since 1993, about 300 protocols using an adenoviral vector have been performed, although they have yet to be proven effective in clinical trials. The adenovirus-based vector has been continuously improved by modification of the adenoviral genome and capsid, and novel adenovirus-delivery systems, such as the carrier-cell delivery system, have been recently proposed. Adenovirus-based cancer gene therapy is fast becoming one component of a multi-modality treatment approach to advanced cancer, along with surgery, radiotherapy, and chemotherapy.

Timing and Causes of Vascular Compromise in Breast Reconstruction with Free TRAM flap (복직근 유리 피판을 이용한 유방 재건에서 혈관성 이상 소견에 의한 재수술의 시점 및 원인)

  • Kim, Ji yeon;Chang, Hak;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.555-558
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    • 2009
  • Purpose: The high success rate of free flap transfers is well documented in previous literature, and is possible due to the early detection of vascular compromise and timely reoperation. We specifically analyzed the operative results of immediate and delayed reconstruction with free transverse rectus abdominis musculocutaneous(TRAM) flap respectively in order to reveal its distinctive features on timing and causes of vascular compromise. Methods: The senior author operated on 158 patients, 161 cases of free TRAM flap for breast reconstruction. 51 patients underwent delayed reconstruction, whilst immediate reconstruction was performed in the other 107 patients. All patients were monitored every 3 hours for the first 3 days. We reviewed medical records of all patients, and tested statistical significance with the Fisher's test. Results: Reoperation was performed in 20 cases, but the cases include hematoma with bleeding focus and arterial anastomosis site rupture due to abrupt arm abduction. We performed reoperation in 15 cases of suspicious vascular compromise. Flap compromise was noticed mostly within 24 hours, but not longer than 72 hours. Venous compromise was dominant by 11 cases (73.3%). There was difference in the timing of flap compromise between immediate and delayed reconstruction. All the cases of delayed reconstruction did not show signs of vascular compromise after 12 hours postoperatively. On the other hand, cases of vascular compromise were observed until 72 hours postoperatively in cases of immediate reconstruction. Conclusion: Delayed reconstruction showed vascular compromise within 12 hours postoperatively, while immediate reconstruction showed compromised until the 3rd postoperative day. If more aggressive monitoring is maintained during this period, we believe salvage of flaps may be increased with more efficiency.

Usefulness of Microscopic Procedures in Composite Grafts for Fingertip Injuries

  • Jo, Dong In;Song, Yu Kwan;Kim, Cheol Keun;Kim, Jin Young;Kim, Soon Heum
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.9-13
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    • 2017
  • Purpose: Fingertip amputations are the most common type of upper limb amputations. Composite grafting is a simple and cost-effective technique. Although many factors have investigated the success of composite grafting, the success rate is not high. Therefore, this study was conducted to investigate whether the microscopic procedure process during composite grafts improves the success rate. Materials and Methods: Thirteen cases of unreplantable fingertip amputation underwent a microscopic resection procedure for composite graft in the operating room. The principle of the procedure was to remove the least devitalized tissue, maximize the clean tissue preservation and exact trimming of the acral vessel and to remove as many foreign bodies as possible. Results: All fingertips in the thirteen patients survived completely without additional procedures. Conclusion: Composite grafting allows for the preservation of length while avoiding the donor site morbidity of locoregional flaps. Most composite grafts are performed as quickly as possible in a gross environment. However, we take noticed the microscopic resection. This process is thought to increase the survival rate for the following reasons. First, the minimal resection will maximize the junction surface area and increase serum imbibition. Second, sophisticated trimming of injured distal vessels will increase the likelihood of inosculation. Third, accurate foreign body removal will reduce the probability of infection and make it possible to increase the concentration and efficiency in a microscopic environment. Although there is a need for more research into the mechanisms, we recommend using a composite graft under the microscopic environment.