• Title/Summary/Keyword: Operative method

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Observation between Clinical Outcomes and the Size of the Syrinx with Magnetic Resonance Image

  • Hwang, Ju-Yeon;Kim, Young-Jin;Oh, Seong-Hoon;Kang, Jae-Kyu;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.169-174
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    • 2006
  • Objective : This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging[MRI] and symptom duration. Methods : The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records. pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. Results : Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. Conclusion : Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.

The Effect of Anesthetic Information on Pre-operative Anxiety, Glucose, Cortisol and Epinephrine of Patients Undergoing Tonsillectomy (마취관련 정보제공이 편도선 절제술 환자의 불안, 혈당, 코티졸 및 에피네프린에 미치는 효과)

  • Jeong, Gye-Seon;Yoon, Hae-Sang
    • Journal of Korean Biological Nursing Science
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    • v.9 no.2
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    • pp.143-152
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    • 2007
  • Purpose: The purpose of this study was to ascertain the effects of anesthetic information on preoperative state anxiety, plasma glucose, cortisol and epinephrine for patients under tonsillectomy and to provide generic data with anesthetic nursing intervention. Method: Data were collected from 60 patients who had tonsillectomy from November 1, 2003 to April 30, 2004. The group were divided into experimental group and control group: an experiment group of 30 patients was provided with an anesthetic information prepared by the researchers; a control group of another 30 patients was provided with general information. Data were analyzed through chi-squared test, t-test, repeated measure ANOVA using SPSS Program(version 12.0). Result: There were no significant difference between the experimental group and the control group in pre-operative state anxiety, glucose and cortisol. However, there were statistically significant difference between the above two groups in pre-operative pre-operative blood pressure(p=.001), heart beat(p=.000), and epinephrine(p=.035). Conclusion: The authors, with the results of this study, concluded that the preoperative anesthetic information for patients under tonsillectomy had direct effect on lessening pre-operative anxiety.

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Effect of a simulation-based program for post-operative care of emergency patients (응급환자의 수술 후 관리를 위한 시뮬레이션기반 교육프로그램의 효과)

  • Chae, Min-Jeong;Choi, Soon-Hee;Kim, Jeoung-Suk
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.3
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    • pp.91-104
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    • 2014
  • Purpose: This study aimed to confirm the effects of a simulation-based program on knowledge and clinical performance in the post-operative management of emergency patients. Methods: This was a pre- and post-research design with a nonequivalent control group and randomly sampled 29 experimental and control groups, respectively from nursing department juniors for 4 weeks from September of 2014. The experimental group received lectures, team study, team simulation, and debriefing in post-operative management of simulation-based emergency patients and control group conducted in the traditional lecture-type setting. Educational learning effects were measured by using the knowledge and clinical performance measurement tools of 15 and 20 items, respectively. Data were analyzed by using the SPSS program, including frequency, ratio, and results from the Chi-square test, Fisher's exact test, Kolmogorov-Smirnov test, t-test. Results: Our research results indicate that, the experimental group showed significantly higher knowledge and clinical performance score compared with the control group. Conclusion: We confirmed that education on post-operative management of simulation-based emergency patients was an effective educational method to improve the knowledge and clinical performance of nursing students.

Comparative Study of Posterior Lumbar Interbody Fusion via Unilateral and Bilateral Approaches in Patients with Unilateral Leg Symptoms

  • Seong, Ji-Hoon;Lee, Jong-Won;Kwon, Ki-Young;Rhee, Jong-Joo;Hur, Jin-Woo;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.363-369
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    • 2011
  • Objective : We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods : We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results : In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion : Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

Feasibility of Intra-Operative BNCT Using Accelerator-Based Near-Threshold $^7Li(p,n)^7$Be Direct Neutrons

  • Tanaka, Kenichi;Kobayashi, Tooru;Nakagawa, Yoshinobu;Sakurai, Yoshinori;Ishikawa, Masayori;Hoshi, Masaharu
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.157-160
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    • 2002
  • The dosage of intra-operative BNCT using near-threshold $^{7}$ Li(p,n)$^{7}$ Be direct neutrons was evaluated with the calculation method validated with the phantom experiment. The production of both neutrons by near-threshold $^{7}$ Li(p,n)$^{7}$ Be and gamma rays by $^{7}$ Li(p,p'gamma)$^{7}$ Li in a Li target was calculated using Lee's method and their transport in the phantom was calculated with MCNP-4B. As a result, the region satisfying the requirements of the protocol in intra-operative BNCT for brain tumors in Japan was acknowledged to be comparable to present BNCT, for the proton energy of 1.900 MeV for example. A boron-dose enhancer (BDE) introduced in this study to increase $^{10}$ (n,$\alpha$)$^{7}$ Li dose in a living body was effective. The void used to increase doses in deep regions was also valid with the BDE. It was found that intra-operative BNCT using near-threshold $^{7}$ Li(p,n)$^{7}$ Be direct neutrons is feasible.

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AN EXPERIMENTAL STUDY ON THE MORPHOLOGIC CHANGES OF DIFFERENT SIMULATED CANALS ACCORDING TO THE PREPARATION METHOD (근관형성방법(根管形成方法)에 따른 모의근관형태(模擬根管形態)의 변화(變化)에 대(對)한 실험적(實驗的) 연구(硏究))

  • Hwang, Ho-Keel;Cho, Jae-O;Cho, Young-Kgon
    • Restorative Dentistry and Endodontics
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    • v.13 no.1
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    • pp.161-171
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    • 1988
  • The purpose of this study was to examine the morphological changes of different simulated canals according to the preparation procedures. With the use of clear casting resin, simulated straight and curved canals were created so that canal preparation procedures could be directly visualized and compared. Thirty clear polyester casting resin blocks which contained four simulated canals divided into three groups; Group A($0^{\circ}$), Group B($15^{\circ}$), and Group C($30^{\circ}$). In each block, 3 canals were prepared different preparation techniques, which were conventional method, step-back method, and giromatic filing. But, one canal was not prepared as a control group. The results were as follows: 1. There was no difference on canal shape among three canal preparation methods in straight canals (Group A). 2. When conventional method and Giromatic filing were used in curved canals (Group B, C), elbow, zip and hour-glass shape were formed in apical third. 3. When conventional method and Giromatic filing were used in curved canals (Group B, C), tear-drop appearance developed at the site of the canal exit in curved canals. 4. In curved canals (Group B, C), file tend to straighten within the canal. 5. There was no difference on canal shape according to curved angle in step-back method (p > 0.1). But there was significant difference on canal shape according to curved angle in conventional method and Giromatic filing (p < 0.001). 6. Step-back method was significantly more effective than conventional method and Giromatic preparation in morphologic aspects of apical third of original canals.

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Early Intervention for Low-Temperature Burns: Comparison between Early and Late Hospital Visit Patients

  • Choi, Matthew Seung Suk;Lee, Ho Joon;Lee, Jang Hyun
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.173-178
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    • 2015
  • Background Various focal heating devices are popular in Korea under the cultural influence of the traditional ondol under-floor method of home heating. These devices can cause severe burn-like injuries resulting from device malfunction or extended with low heat contact. In addition to injuries under these high heat contact, burns can be occurred by low heat exposure with prolonged periods despite the devices are properly functioning. In order to develop strategies to reduce the duration of periods of illness due to low-temperature burns, we analyzed and compared treatment methods and therapeutic periods for this type of injury. Methods This retrospective study included 43 patients burned under low heat conditions. Patients were divided into an operative group and a conservative group. The patients in the operative group underwent at least one surgical excision, and were further subdivided into early and late visit groups. The conservative group was treated only with dressings. We compared the treatment periods between the operative group and the conservative group, and also compared the preparation periods and treatment periods between the two operative groups. Results The average treatment period was significantly shorter in the operative group (P=0.02). In the early visit operative group, both wound preparation and treatment were briefer than in the late visit group. Conclusions We recommend that early proper burn care and early surgical intervention, including appropriate excision, are feasible ways to reduce the treatment period of lowtemperature burn patients.

Operative Treatment of Old Neglected Freiberg's Infraction (Comparison of Three Techniques) (진구성 Freiberg병의 수술적 치료(3가지 방법의 비교))

  • Yoo, Chong-Il;Jung, Chul-Yong;Kim, Byung-Cheol;Choi, Sung-Jong;Jung, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.142-148
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    • 2004
  • Purpose: We compared the results of three surgical procedures of the old neglected Freiberg's disease that was managed with metatarsal head reshaping, metatarsal head resection, and dorsal closing wedge osteotomy. Materials and Methods: From march 1996 to July 2002, five cases in six patients whose metatarsal head collapse already progressed underwent operative treatment. We compared the operative results in the view point of the radiographic follow-up and lesser toe metatrasophalangeal joint scale of AOFAS. Results: There were no further joint destruction and loose body formation. Also, lesser toe metatrasophalangeal joint scale of AOFAS improved from average score, 38.5 (range $22{\sim}49$) of preoperative one to average score, 86.6 (range, $72{\sim}100$). Especially, the 2 cases that underwent dorsal closing wedge osteotomy showed most favorable result and the 2 cases with metatarsal resection showed next favorable result. The 2 cases with intra-articular loose body removal and metatarsal reshaping showed the least effective result among three operative methods. Conclusion: Our Operative experiences of old neglected Freiberg's disease were all satisfactory irrespective of operative options and dorsal closing wedge osteotomy was thought to be most effective method.

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Operative treatment of aortic dissections - Experience with 27 patients over a 5-year period - (대동맥 박리증의 수술요법 -27례의 수술환자를 대상으로 한 5 년간의 성적-)

  • Kim, Jhin-Gook;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.497-509
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    • 1988
  • Current therapy of aortic dissections remains unstandardized because of the relative rarity of these catastrophic events and conflicting reported results of various therapeutic strategies. Hence, we reviewed our current results and planned to purify our method of interpretation of results and so, to standardize therapeutic managements. This study comprised unselected, consecutive 27 patients with aortic dissections who were operated at Seoul National University Hospital from Jan 1983 to March 1988. The results from analysis of their preoperative, operative and postoperative finding were as follows: 1] 7 patients had acute type A, 14 had chronic type A, 4 had acute type B, and 2 had chronic type B. 2] The causes of dissections were unclear, but 8 patients had Marfan`s syndromes, 2 had previous operative histories on cardiovascular systems and 2 had congenital heart diseases. 3] Multiple preoperative variables were found to correlate significantly with operative mortality and complications. The prevalences of such preoperative major complicating factors were significantly more frequent in acute than chronic [P < 0.05] and type A than type B [P < 0.01]. 4] Operations were performed according to the type of the dissections and whether it was acute or chronic. Usually dacron tube graft replacements were performed[25/26]. Intraluminal sutureless graft replacement was performed in 11 patients. Of the 14 patients with combined aortic regurgitation, concomitant aortic valve resuspension in 4, seperative aortic valve replacement in 1, and aortic valve replacement with coronary reimplantation were performed in 9 patients. 2 patients had concomitant arch vessel managements. 5] Over-all operative mortality rate was 33% and 54% for acute type A, 25% for acute type B, 29% for chronic type A, 0% for chronic type B respectively. The main causes of operative mortality were cardiovascular complications [mainly CPB-weaning failure] in acute cases and hemorrhagic complications in chronic cases.

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The Efficacy of Microvascular Decompression for Trigeminal Neuralgia (삼차신경통에 대한 미세혈관감압술의 효과)

  • Kim, Sung-Hoon;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.37 no.5
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    • pp.357-363
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    • 2005
  • Objective: The microvascular decompression(MVD) for trigeminal neuralgia(TN) is known as an effective surgical technique. But the failed MVD cases have been reported in long term follow-up studies. This study is to evaluate the efficacy of MVD through our operative techniques, offending vessels in operative field, failed cases with the review of the literatures. Methods: We analyzed total 63 cases of TN which underwent MVD from 1955 to 2003 according to characters of pain, operative findings, operative results related to causative vessel compression and operative method, progonotic factor. Statistical analysis was performed using paired t-test with SPSS Ver 11.0. Results: In TN, the most common offending vessel was superior cerebellar artery(45.0%). In compression group of nerve root by offending vessel, the cure rate was 91.7%. However, the cure rate of the contact group was 64.7% and the cure rate of the negative group was 37.5%. There was no statistical significance between the degree of compression by vessel and the operative result(p=0.076). In 51 cases with MVD only, the cure rate was 84.3% and in 3 cases with PSR only, 42.8% and in 2 cases with PSR(partial sensory rhizotomy) with MVD, 50.0%. TN recurred in 7 cases within the follow-up period and reoperations(PSR) were added in 2 cases of them. Conclusion: This study shows that MVD provided a high rate of success with a minor risk of complications, which has been regarded as the most safe and effective procedure for trigeminal neuralgia. Additional MVD in recurred TN by severe adhesion of teflon showed poor outcome. But, revisional operation(PSR) in recurred TN showed relatively good outcome. PSR should be considered for treatment of recurrent TN after MVD.