• Title/Summary/Keyword: Operative findings

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The Effects of Gum-Chewing on the Recovery of Bowel Movement and Oral Cavity Discomfort after Abdominal Surgery (껌씹기가 개복수술 환자의 장운동 회복과 구강불편감에 미치는 효과)

  • Bang, Sul Yeong;Jung, Gum Ja;Jung, Hye Yeon;An, So Hyeon
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.15-25
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    • 2008
  • Purpose: This study was aimed to investigate the effects of gum-chewing on the recovery of bowel movement and oral cavity discomfort after abdominal surgery. Method: The nonequivalent control group, non-syncronized repeated treatment design was used. A total of 99 patients were participated in the study. The 44 patients were in the experimental group and the rest in the control group. The experimental group chewed gum three times a day until they passed gas. As the patient reported gas-passing, bowel movement time, subjective symptoms of oral cavity, and oral status were recorded precisely. The frequency, percentage, $x^2$-test and t-test were analyzed by SPSS PC 12.0. Results: There were significant differences in bowel movement, gas passing, oral cavity symptoms, and oral status scores between the experimental and the control group. Conclusion: The findings of the study demonstrated the fact that gum-chewing helps early recovery from post-operative ileus and thirst. It is because gum chewing stimulates bowel mobility and secretion of saliva. Thus gum-chewing seems to be an effective nursing intervention in reducing post-operative side effects for patients with abdominal surgery.

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The Value of Diagnostic Laparoscopy for Impalpable Testes (비촉지성 정류고환에서 진단적 복강경검사의 유용성)

  • Lee, Young-Guk;Park, Jae-Shin;Lee, Eun-Suk
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.66-71
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    • 2007
  • There have been no definitive preoperative diagnostic imaging studies for impalpable testes. We observed the effectiveness of laparoscopy for detecting impalpable testes not identified with ultrasonography (USG) or careful physical examination under general anesthesia. We retrospectively reviewed 117 patients (118 testes) who were operated upon for undescended testes from January 1998 to December 2004. The testes of these patients were palpable in 97(82 %) and impalpable in 21 (18 %). We analyzed the preoperative diagnostic method, site of the testes, operative method and operative findings of the 21 impalpable testes. Preoperative USG and physical examination under general anesthesia were performed on 20 patients, and 12 patients' testes could be localized. Eight patients whose testes could not be localized with USG and physical examination underwent laparoscopy. Seven of the 8 patients had testes in inguinal canal and 4 of these were atrophied and underwent orchiectomy because of atrophy (2) and vanishing (2). Only 1 patient had bilateral intraabdominal testes and one of the testes was atrophied. Laparoscopy was a useful method for detecting impalpable testes, but the clinical application might be limited because the location of atrophic or vanishing testes was mainly inferior to internal inguinal ring.

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A Study of Cause of Recurrent Pneumothorax (재발성 기흉의 유인)

  • Choe, Yong-Dae;Kim, Min-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1286-1291
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    • 1992
  • We have experienced 456 cases of spontaneous pneumothorax from January, 1981 to December, 1991 at the department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 102 cases were recurrent pneumothorax. These 102 cases were based on the retrospective clinical analysis, and the results were as follows: The ratio of male to female was 6.2: 1 in male predominance and the old aged patients, over 50 years old, occupied 46.8%a of all patients. Primary spontaneous pneumothorax was 43 cases[42.6%] and secondary spontaneous pneumothorax was 59 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis: 31 cases[30.4%], emphysema and chronic obstructive pulmonary disease: 27 cases[26.1%], Most frequent operative and pathologic findings in the primary and the secondary spontaneous pneumothorax was bullae and blebs at apex. The employed managements were only closed thoracostomy in 41 cases, open thoracot-omy in 61 cases. The operative procedures at thoracotomy were bullectomy or bullae ligation in 37 cases, bullae resection with wedge resection in 8 cases, bullae resection with segmentectomy in 6 cases, bullae resection with decortication in 3 cases, lobectomy in 5 cases, decortication in 2 cases. Complications were subcutaneous emphysema[5 cases], wound infection[1 case], and temporary pulmonary insufficiency[1 cases]

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Surgical Treatment of Discrete Subaortic Stenosis (대동맥판막하 막상협착증의 수술요법)

  • No, Jun-Ryang;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.165-173
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    • 1986
  • During the 4 year period from 1982 through 1985, twelve patients have undergone operations for discrete subaortic stenosis with good short-term clinical result at Department of Thoracic and cardiovascular Surgery, S.N.U.H. According to the cineangiographic and operative findings, nine of the 12 patients were classified as Deutsch type I, the other 3 as type II, and eleven of the 12 had one or more associated anomalies of the cardiovascular system such as PDA[5], VSD[5], left SVC[2], MS[1], COA[1], supramitral membrane[1], DORY[1], right aortic arch[1], DCRV[1], and TOF[1] [one with Shone`s complex], and three of them had secondary cardiac disorders such as aortic regurgitation[3],mitral regurgitation[2], and tunnel shaped dynamic obstruction of left ventricular outflow tract[2]. We have performed membrane resection via oblique aortotomy with retraction of the aortic cusps in 7 cases and via VSD from right cardiac chamber in 5 cases with large VSD and have also performed the operations on the correctable associated anomalies. There was only one operative death in patient with associated TOF due to neurologic complication and no other postoperative difficulties except in one patient with transient heart block resolved spontaneously on postoperative 3rd day. To our knowledge, this article is the first report of operation for discrete subaortic stenosis in Korean literature.

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A Study of Cause and Thoracotomy in Spontaneous Pneumothorax - A Report of 57 Cases - (자연기흉의 원인과 개흉술에 대한 임상적고찰)

  • 김성수
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.788-793
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    • 1989
  • We have observed 501 cases of spontaneous pneumothorax from January 1981 to June 1989 at the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 57 patients have undergone thoracotomy to treat the pneumothorax after closed thoracostomy. These 57 patients were based on this retrospective clinical analysis, and the results were as follows: The ratio of male to female was 4.2:1 in male predominance and the old aged patients, over 50 years old, occupied 47.3% of all patients. Primary spontaneous pneumothorax was 19 cases and secondary spontaneous pneumothorax was 38 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis emphysema and chronic obstructive pulmonary disease in 35 cases. The indications of thoracotomy were persistent air leakage in 23 cases recurrent pneumothorax in 21 cases, inadequate expansion in 13 cases. Rupture of bullae or blebs were most frequent operative and pathologic findings in persistent air leakage group and recurrent pneumothorax group. In inadequate expansion group, predominant finding was destructive lung lesion. Bullectomy and/or bullae ligation was most effective procedures in 36 cases [63%] for operative management of spontaneous pneumothorax. Duration of preoperative and postoperative chest tube indwelling day was 13.35 days and 8.05 days in persistent pneumothorax group, 8.92 days and 7.77 days in recurrent pneumothorax group, 13.23 days and 10.21 days in inadequate expansion group.

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The EFFECT OF DENTAL ADHESIVE R~SIN CEMENT ON THE DOGS' DENTAL PULP (접착성(接着性) 레진 세멘트가 가견치수조직(家犬齒髓組織)에 미치는 영향(影響))

  • Yang, Jung-Ok;Cho, Kyew-Zeung
    • Restorative Dentistry and Endodontics
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    • v.12 no.2
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    • pp.101-108
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    • 1987
  • The purpose of this study was to investigate the pulpal responses of dental adhesive resins. A total of 40 cavities of the permanent healthy teeth from 4 dogs were prepared. In the experimental group, the cavities were etched for 1 minute with citric acid and filled with experimental resins (ie. Super-Bond C & B$^{(R)}$). In the control group, the cavities were filled with calcium hydroxide base materials (ie. Dycal$^{(R)}$) without etching. The dogs were sacrificed at one, two, three and four weeks after the time of filling and the specimens were routinely prepared and stained with Hematoxylin-Eosin. The microscopic findings were as follows: Infiltration of inflammatory cells was not observed in both experimental and control groups. Change in the odontoblastic layer was not observed in all control groups but severe swelling was observed in deep dental pulp tissue of the control two and three week cases. Pulp tissue was recovered with plenty of fibrous component in the control four week case and reparative dentin formation was not occurred in all cases. Slight changes of the odontoblastic layer beneath the cavity were observed in the experimental one week case. In experimental two and three week cases, swelling of deep pulp tissue was increased and localized reparative dentin formation was observed. In the experimental four week case, odontoblastic layer was recovered with regular appearance and fibrous component of the pulp was increased, but reparative dentin formation was not evident.

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THE EFFECT OF GLASS IONOMER CEMENT ON THE DOG'S EXPOSED DENTAL PULP (글라스 아이오노머 세멘트가 가견(家犬) 노출(露出) 치수조직(齒髓組織)에 미치는 영향(影響))

  • Kim, Jae-Han;Cho, Kyew-Zeung
    • Restorative Dentistry and Endodontics
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    • v.12 no.2
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    • pp.73-80
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    • 1987
  • The present study was designed to help elucidate the effect of glass ionomer cements on the exposed dental pulp by means of histologic examination. A total of 40 cavities of class V were prepared on the teeth of 4 dogs with exposure of 1mm in diameter on the bases of them. 20 cavities were filled with glass ionomer cement as the experimental group and the other 20 cavities were filled with zinc oxide eugenol cement as the control group. The dogs were sacrificed at one, two, three, and four weeks after filling, and the specimens were routinely prepared and stained with Hematoxylin-Eosin. The obtained microscopic findings were as follows: Inflammatory cell infiltrations were observed in control in 1 week, which decreased markedly with time. In all control groups, hemorrhage around exposed pulp tissue and coagulation change of pulp were observed. Secondary dentin formation and thickened predentin were observed in 4 week cases, and the recovery of pulp tissue was favorable on the whole. Inflammatory cell infiltration was observed in all GIC groups. Proliferation of blood vessel and congestion were observed with coagulation changes around the exposed pulp tissue. Secondary dentin formation and thickened predentin were observed in 3 weeks. In the experimental 4 week case, secondary dentin formation was evident. On the whole, pulpal irritation of glass ionomer cement was relatively severe. Recovery of pulp tissue in GIC groups was less favorable compared with that of ZOE groups.

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Analysis of Relativity Between Invasiveness on Chest of Tomographic Finding and Histopathologic Invasiveness (종격동 종양의 전산화 단층촬영(CT)소견, 수술소견 및 병리조직학적 침윤도 사이의 상관성 분석)

  • 김용희;이현우
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.780-785
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    • 1997
  • Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

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Clinical Analysis of Pituitary Apoplexy (뇌하수체졸중의 임상적 고찰)

  • Kim, Jung Tae;Park, Bong Jin;Sung, Jung Nam;Kim, Young Joon;Cho, Maeng Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.724-728
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    • 2001
  • Objectives : Pituitary apoplexy is a well-described clinical syndrome resulting from pituitary hemorrhage, hemorrhagic infarction, or infarction, almost invariably occurring in the presence of an adenoma. We analyzed pituitary apoplexy with an emphasis on clinical presentation, pathology and predisposing factors. Methods : We reviewed 35 histologically proven pituitary adenomas, operated from January 1995 to August 1999, to select 8 cases which showed clinical or operative findings compatible with pituitary apoplexy. These patients were analyzed in terms of symptom and sign, hormonal status, and predisposing factors, pathologic findings. Results : Among 35 surgically treated tumors of the pituitary gland, 8 cases(23%) were diagnosed as pituitary apoplexy. The pathologic findings revealed hemorrhage(7 cases) and infarction(1 case) of pituitary adenomas. One case had predisposing factor of appendectomy. The most common presenting symptom and sign were sudden severe headache and visual disturbance. Conclusion : We treated pituitary apoplexy surgically and obtained good outcomes. Pituitary apoplexy due to massive infarction of the pituitary gland is very rare condition but surgical treatment by trans-spheniodal surgery showed a good result.

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A STUDY ON ELECTRON-MICROSCOPIC FINDINGS AFTER ACID ETCHING ON ENAMEL AND DENTIN (법랑질(琺瑯質)과 상아질(象牙質)의 산처리후(酸處理後)의 전자현미경(電子顯微鏡) 소견(所見)에 관(關)한 연구(硏究))

  • Kim, Yung-Hai
    • Restorative Dentistry and Endodontics
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    • v.9 no.1
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    • pp.115-119
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    • 1983
  • The purpose of this study was to compare the solubility of enamel and dentin to an etchant after fluoride application. Specimens were collected from extracted anterior and bicuspid and each tooth was cut into several pieces. These specimen were allocated in 7 group; 1%, 2%, 3% NaF, 1%, 8%, 20% $SnF_2$, and control group. Five specimens in each group was exposed to pre-determined fluoride solution for 3 minutes, and washed with running water. These specimens were etched by Hipol (commercial label) etchant for 30 seconds. Following are the findings obtained through S.E.M. 1. All specimens with acid etching revealed preferential removal of prism periphery leaving prism core. 2. Specimens treated with 1%, 2% NaF solution showed that the shape of prism tip was thin and sharp like a needle. The case of 3% NaF showed rather round shape at prism end. 3.1% of $SnF_2$ case showed similar findings with the control group but 8% and 20% $SnF_2$ case revealed needle shape at the prism and was less clear than NaF case. Preferential removal of prism periphery was partialy observed and un decalcified area is fused to prism forming reidge. 4. Dentine treated by fluoride compound in low concentration showed the orifice of dentinal tubule was clearly enlarged whereas in high concentration the orifice was not widened.

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