• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.374-380
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• 2021

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

• 임상간호연구
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• 제24권3호
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• pp.356-362
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• 2018

Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.

• Journal of Cardiovascular Imaging
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• 제31권4호
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• pp.214-216
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• 2023

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.19-22
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• 2009

Purpose: There are various approaches for open reduction surgery for orbitozygomatic fractures. After the incisions are performed, patients might have various complications. In this point of view, we conducted a retrospective study of the usability of infraorbital incision on elderly patients, generally more vulnerable to scleral show and ectropion. Methods: In this study, 20 patients who are relatively more vulnerable to scleral show and ectropion through snap-back test having infraorbital incision were reviewed. We monitored the duration of the surgery, and complications resulted from the incision. We evaluated the scars with the researcher's observations and with the patient's level of satisfaction on a scale of 1 to 5. Results: On average, 5 minutes was spent between the skin incision and the fracture exposure. No case of scleral show and ectropion occurred. One year follow-up observation revealed 4 cases of visible scars, 9 cases of barely visible scars, and 7 cases of invisible scars. The subjective satisfaction level of the patients' scar is an average of 4.0. Conclusion: Infraorbital incision has many advantages. First, it can reduce the complications such as scleral show and ectropion. Second, it can shorten the operation time. Third, it can diminish incision-related scars.

• Clinical and Experimental Pediatrics
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• 제60권2호
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• pp.31-37
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• 2017

Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care.

• Journal of Chest Surgery
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• 제46권3호
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• pp.202-207
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• 2013

Background: The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method. Materials and Methods: Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated. Results: There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%). Conclusion: Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.

• 임상간호연구
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• 제26권2호
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• pp.154-163
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• 2020

Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients' outcomes.

• 대한한방부인과학회지
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• 제27권3호
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• pp.124-134
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• 2014

Objectives: We designed this study to evaluate the effect of Korean medical treatment on complications of chemotherapy after curative resection in patient with ovarian carcinoma IV. Methods: The patient got total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) on 9/4 and received chemotherapy on 10/7, 10/28, 11/18. During this period, the patient suffered from anorexia, dyspepsia, nausea, weight loss and insomnia. We treated the patient with herbal medicine and acupuncture. The efficacy of treatment was evaluated with visual analog scale (Vas), weight and 36-item short form health survey instrument (SF-36). Results: After treatment, although the scale values went ups and downs according to chemotherapy schedule, abdominal pain Vas changed 7 to 0, weight changed 46 kg to 51 kg. Also, SF-36 scores increased. Conclusions: This case report shows that the Korean medical treatment is useful in the treatment of complications of chemotherapy after curative resection in patient with ovarian carcinoma IV.

• 한국임상수의학회지
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• 제36권2호
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• pp.93-97
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• 2019

Healing of 48 cases of radial fractures in small breed dogs treated with acrylic pin external fixation was evaluated retrospectively to investigate the factors affecting the healing of radial fractures. The mean age of the subjects was 15.02 months, the mean body weight was 3.48 kg, and the mean maximum length of the radius (MLR) was 90.77 mm. External skeletal fixation frames type 1a, 2a, and 3 were used; among them type 2a was used most frequently (75%). The mean time to clinical union (TCU) was 67.17 days, and the success rate was 95.8%. Age, bodyweight, MLR, and occurrence of complications increased TCU significantly. Among complications, pin loosening, swelling of the operated forelimb tissue for more than 2 weeks, and coexistence of two or more complications increased TCU significantly (p < 0.05). There was no relationship between location of the fracture and TCU. The results of this study may be useful to predict the prognosis of radial fractures in small dogs.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.684-690
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• 2017

Objective : As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods : We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years. We divided into 2 groups (A; 70-75 years, B; over then 76 years) according to the age. Surgical level of each groups, hospital day and postoperative day, co-morbidities, complications, clinical outcomes were analyzed. Operative reports, hospital and outpatient clinic charts, and radiographic studies were reviewed. Results : Group A was composed of 80 patients, their mean age was 72.21 and female dominant (n=46), and their mean surgically fused level was 1.52 level. Group B was 36 patients, their mean age was 78.83 and female dominant (n=20), and their mean surgically fused level was 1.36 level. Comparing between two groups, complications, postoperative hospital stay were slightly increase in group B and co-morbidity was statistically high in group B, however clinical outcomes were similar between two groups. Conclusion : Increasing age might be an important risk factor for complications in patients undergoing PLIF, however, we would like to recommend that if the situation of spine of extreme geriatric patients need PLIF, it should be in the surgeon's consideration after careful selection and clinical judgement.