• Title/Summary/Keyword: Operative method

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Early Result of the Coronary artery Bypass Surgery (Analysis with the Postoperative Coronary artery Angiography) (관상동맥 우회수술의 조기성적 (술후 혈관조영술을 통한 분석))

  • 류경민;김삼현;박성식;류재옥;서필원
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.487-493
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    • 2000
  • Background: Early patency of the coronary artery bypass grafting is determined mainly by surgical technique and status of coronary artery. We analyzed the early result, focusing on the relationship between postoperative angiographic findings and the patency rate. Material and method: During the period of July 1997- August 1999, 86 cases of CABG were performed and the postoperative coronary artery angiography was done in 76 cases on postoperative day 7 to assess the graft patency. Result: Overall graft patency was 90.2% on the angiographic finding. Factors influencing the early graft occlusion were the surgeon's experience, small coronary artery size less than 1.5mm in diameter, coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site(p<0.001). Operative mortailty was 2.3%. Early recurrence of the symptom was 19.8% during the follow up period. Conclusion: We examined the postoperative coronary angiography and found that the surgeon's experience, small coronary artery size less than 1.5mm in diameter, bypass surgery on the coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site were the factors for the graft occlusion.

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Comparison of the Muscle Contractile Properties on Lower Extremity Between Non-injury and Injury in Subjects with Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술 환자에 대한 비손상측과 손상측 간의 하지 근수축 특성 비교)

  • Kim, Han-il;Seo, Young-joon;Kim, Young-myoung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.1
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    • pp.31-37
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    • 2018
  • Background: The purpose of this study was to identify the comparison of the muscle contractile properties on lower extremity between non-injury and injury in subjects with anterior cruciate ligament reconstruction (ACLR). Methods: Twenty-four subjects on the post-operative ACLR participated in this study. Measurement method were using tensiomygraphy to analyze the displacement maximum(Dm) and contraction time(Tc) on the both quadriceps. Results: Compared difference of the Dm between non-injury and injury, the rectus femoris (RF) and vastus lateralis (VL) increased significantly (p<.01). However, vastus medialis (VM) no significantly difference between non-injury and injury. Compared difference of the Tc between non-injury and injury, the RF increased significantly (p<.01) but VL and VM no significantly difference between non-injury and injury. Conclusions: These findings suggest that occurred muscle atrophy of the RF and VL and change properties of muscle fibers on the RF from fast muscle fibers to slow muscle fibers on the injury side of post-operative ACLR. Therefore, when apply to rehabilitation of lower extremity for post-operative ACLR, we should consider the enhance of RF and VL on injury side.

Minimally Invasive Radio-guided Parathyroid Surgery (최소침습 방사능 유도 부갑상선 수술)

  • Chung Woong-Yoon;Chang Hang-Seok;Lee Jong-Doo;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.194-199
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    • 1999
  • Introduction: Since 1996, Dr. James Norman has successfully performed mimimally invasive radio-guided parathyroidectomy(MIRP) using intraoperative nuclear mapping with $^{99m}Tc$ sestamibi scanning and radioactivity detection probe. Objectives: We aimed to introduce this new surgical technique and evaluate it's efficacy by our own experiences. Method: From May to October 1999, five consecutive patients with primary hyperparathyroidism underwent parathyroidectomy by using modified MIRP technique. $^{99m}Tc$ sestamibi scanning was performed 1.0 or 1.5 hour before operation. After intraoperative localization of the tumor under the guidance of quantitative gamma counting with a NEVIGATOR probe, an unilateral small skin incision(3.0-4.0cm) was placed. Without a skin flap, the strap muscle was directly divided with the use of a Harmonic scalpel. After careful dissection, the parathyroid tumor was removed. Result: In all patients, a single adenoma could be easily detected and removed by this new technique. Mean incision length was 3.2cm(3.0-4.0cm) and operative time ranged from 40 to 110minute. All the patients were discharged within 2 days of surgery without any complication. Conclusion: This new operative technique could become the most minimally invasive alternative to the standard operative procedure for parathyroid adenoma.

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Rewarming Intervention Program for Abdominal Surgery Patients (복부 수술 환자의 저체온 예방 중재 프로그램)

  • Ahn, Hye-Young;Eom, Mi-Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.2
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    • pp.220-230
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    • 2010
  • Purpose: This study was done to identify differences in three groups of operative patients (Forced Air Warming, Electrical Blanketrol, Control) for discomfort and pattern of body temperature during surgery and post operatively. Methods: The sample consisted of 3 randomized 3 groups of abdominal surgery patients admitted to an university hospital in D-city : The Bair Hugger and upper body blanket were used with the first group, electrical blanketrol with PVC Film with the second, and the third group was the control. ANOVA was used with the WIN SPSS 17.0 program to analyze the data. Results: Significant differences were found among the three groups for tympanic and esophageal body temperature at 1 hour after starting surgery. There was significant difference in tympanic body temperature during the 15 minute stay in the post anesthetic room. There were no significant differences in thermal discomfort while in the post anesthetic room. or There among the three groups for serum cortisol during surgery. Conclusion: According to the results of this study, application of a Bair Hugger or electrical blanketrol improves maintenance of body temperature of operative patients as well as body temperature of post operative patients, and is a clinically significant warming method providing a more consistent body temperature.

The Effect of Debriefing using Reflective Questions and Writing in Simulation Training - Post Operative Care of Abdominal Surgery (시뮬레이션 교육에서 성찰질문과 글쓰기를 이용한 디브리핑의 효과 - 복부수술 후 환자 간호에서)

  • Bang, SulYeong;Eun, Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.23 no.4
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    • pp.463-473
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    • 2017
  • Purpose: The purposes of study was to evaluate the effect of debriefing using reflection questions and writing on the critical thinking disposition, self-efficacy, and clinical judgement ability in simulation of post-operative care of abdominal surgery. Methods: The research method was a nonequivalent control group no-synchronized design. The study period was from August 22 to 30, 2016. The subjects were comprised of 34 people in the experimental group and 36 in the control group. In a simulation session for post-operative care of abdominal surgery, the treatment of the experimental group was to debrief for 30 minutes using Lasater's reflection questions and writing. For the control group, a typical debriefing was conducted in the same environment. Results: Critical thinking disposition, self-efficacy, and clinical judgement were significantly higher in the experimental group than the control group. Conclusion: To enhance the critical thinking disposition, self-efficacy, and clinical judgement of nursing students in simulation, it is recommended to debrief using reflection questions and writing.

The Operative Treatment of Displaced Intra-articular Calcaneal Fracture with Injectable Calcium Sulfate ($MIIG^{TM}$) (주사형 황산 칼슘($MIIG^{TM}$)을 이용한 전위성 종골 관절내 골절의 수술적 치료)

  • Ahn, Seong-Jun;Kim, Bu-Hwan;Song, Moo-Ho;Yoo, Seong-Ho;Seo, Sang-Hyok
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.221-225
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    • 2007
  • Purpose: To evaluate the clinical results of operative treatment of the intra-articular calcaneal fracture with injectable calcium sulfate ($MIIG^{TM}$). Materials and Methods: Between March 2004 and October 2006, a total 19 intra-articular calcaneal fracture (16 patients) with a large bony defect that underwent operative treatment with plate fixation and injectable calcium sulfate ($MIIG^{TM}$) with minimum follow-up of one year following. The mean age at time of surgery was 44.7 years (23 to 54). All of the cases were type 2 and 3 on the basis of Sanders classification. The lateral L shaped approach was used in all cases. Full weight bearing on the affected extremity was regained at an average 10 weeks postoperatively. Results: The mean Bohler angle was improved from $2^{\circ}$ ($-18.5{\sim}12.5^{\circ}$) preoperatively to $23.8^{\circ}$ ($12{\sim}37.5^{\circ}$) and the angle at last follow-up was $22.5^{\circ}$ ($11.5{\sim}37.5^{\circ}$), showing about 0.3 degree decline compared to postoperative Bohler angle. Only two case of whitish leakage of graft material but other complication were none. Conclusion: $MIIG^{TM}$ augumentation of displaced intra-articular calcaneal fracture with large bone defect seems to bo useful method for initial stabilized and plate fixation.

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Operative Treatment with the Plate Fixation in Intraarticular Calcaneal Fractures (관절 내 종골 골절에서 금속판 고정을 이용한 수술적 치료)

  • Hong, Ki-Do;Kim, Jae-Young;Ha, Sung-Sik;Sim, Jae-Chun;Kang, Jung-Ho;Park, Kwang-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.86-90
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    • 2007
  • Purpose: We evaluated the results of operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures. Materials and Methods: From August 2003 to July 2006, twenty intraarticular calcaneal fractures which were operated with open reduction and internal fixation with F or H plates and screws were evaluated retrospectively. According to the Essex-Lopresti classification, 3 cases were tongue type and 16 were joint depression type. With the Sanders classification, 2 cases were IIA type, 7 were IIB, 5 were IIIAB, 2 were IIIAC and 3 were IV. We have analysed the $B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal width in radiologic evaluation, and evaluated clinical result according to the Creighton-Nebraska Health Foundation Score. Results: Radiologic changes showed as follows: $B{\ddot{o}}hler$ angle improved from $5.8^{\circ}$ to $25.9^{\circ}$, Gissane angle from $119.0^{\circ}$ to $113.3^{\circ}$, and calcaneal width from 50.4 mm to 37.8 mm. In the clinical results, excellent cases were noted in 8 cases, good in 8 cases, fair in 2 cases, poor in 1 case. Conclusion: Operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures was thought to be a useful operative method allowing anatomical reduction.

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A STUDY ON THE MICROSTRUCTURE TRANSFORMATION IN SPHERICAL-DISPERSED TYPE AMALGAM (아말감충전물(充塡物)의 미세구조(微細構造) 변화(變化)에 관(關)한 연구(硏究))

  • Chang, Sang-Kohn;Min, Byeong-Sun;Park, Sang-Jin;Choi, Ho-Young
    • Restorative Dentistry and Endodontics
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    • v.9 no.1
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    • pp.81-87
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    • 1983
  • The purpose of this study was to observe and identify the phases of amalgam and to know the transformation of microstructure in the set amalgam by lapse of time. In this study, shofu spherical-D alloy was used. After trituration of amalgam alloy and mercury (Wig-L-Bug), it was filled in the stone dies. This specimens being polished and etched by usual method was observed under optical microscope using metallurgical microscope. And then X-ray diffractometer was used to analyze the phases contents and transformation of microstructure at $2{\frac{1}{2}}$ hours, 15 hours, 28 hours and 2 years after being amalgamated. The following results were obtained: 1. Shofu spherical-D alloy powder was composed of ${\gamma}$ phase, ${\epsilon}$phase and Ag-Cu eutectic phases. 2. ${\gamma}_2$ phases were appeared at $2{\theta}$ values ($32.0^{\circ}$ and $43.8^{\circ}$) in the amalgam which was analyzed at $2{\frac{1}{2}}$ hours and 15 hours after trituration with mercury. 3. In the amalgam at 28 hours, ${\gamma}_2$ phase was found at $2{\theta}$ value ($43.8^{\circ}$) at 35 hour, $r_2$ phase was appeared at $2{\theta}$ value $32.0^{\circ}$. 4. No ${\gamma}_2$ phases were observed in the 2 years old amalgam. But ${\eta}$ ($Cu_6Sn_5$) phases were found at $2{\eta}$ values $29.4^{\circ}$ and $42.4^{\circ}$.

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A STUDY OF SEALING ABILITY OF DENTIN BONDING AGENT AS ROOT CANAL SEALER (Dentin Bonding Agent의 근관폐쇄(根管閉鎖) 효과(效果)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Min, Hyo-Kie;Min, Byung-Soon;Choi, Ho-Young;Park, Sang-Jin
    • Restorative Dentistry and Endodontics
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    • v.13 no.1
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    • pp.103-111
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    • 1988
  • The purpose of this study was to, examine the sealing ability of the denting bonding agent, when used with gutta percha cone, as a root canal sealer. Seventy two upper and lower extracted human teeth with single root were randomly selected and instrumented in a conventional method with K-file. After instrumentation and dry the canal with paper point, there were divided into three groups and twenty four teeth in each group were filled with the following material; In group I: Scotchbond in combination with gutta percha cone. In group II: AH 26 in combination with gutta percha cone. In group III: Tubli-Seal in combination with gutta percha cone. All specimens were immersed in Indian Ink, decalcified, and cleared. The depth of dye penetration into the canals were evaluated by caliper at the intervals of 1 day, 1 week, 2 weeks. The results were as follows; 1. Depth of dye penetration for all groups increased with time. 2. As to difference in mean dye penetration at time interval of 1 day and 14 days, Scotchbond group exhibited the smallest value as 0.53mm and Tubli-Seal group exhibited the largest value as 0.70mm. 3. There was the difference of dye penetration between each group, but its difference was not significant, statistically.

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Clinical Analysis of Varicose Veins in the Lower Extremities - an analysis of 227 operative cases - (하지정맥류의 임상양상 - 227 수술예의 분석 -)

  • 최수승
    • Journal of Chest Surgery
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    • v.32 no.11
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    • pp.1036-1041
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    • 1999
  • Background: To know the clinical aspects of varicose vein and the effectiveness of operative treatment, the patients who had been operated during the five and a half years were reviewed. Material and Method: From September 1993 to February 1999, 227 patients with varicose vein were operated upon. These patients were reviewed with history taking, physical examination, laboratory tests, operation and follow up visits at an out patient department. Result: The ages of the patients were from 20 to 69 years, mean 40.2 years. varicose veins. Occupations of the patients include housewives, store or factory owners, cooks, waiter or waitresses in a restaurant, salary men(women), teachers, hair stylists, professional athletes, in sequence, most of them require standing all day long. The 126 women had experienced child birth, among them 116 patients delivered more than 2 babies. All patients had protruding leg veins as the symptom. Most of them(61%) had pain. Other additional symptoms were heaviness, heatness, tingling, cramp, fatigue, etc. 68.3% of the patients had the symptoms for more than 10 years. Anatomical location of varicose vein was in long saphenous vein in 157 patients, in small saphenous vein in 27, and in other regions(combined or perforating vein) in 43 patients. There was no operative mortality. There were 2 patients who underwent reoperation due to recurrence during this study period. In one patient, it recurred in the distal perforating vein in small saphenous vein. The other patient had recurrence at the saphenofemoral junction in groin. The patients are doing well after the reoperation, but a long term observation is needed. Conclusion: Clinical aspects of varicose vein were reviewed. For the patients with varicose vein who had saphenofemoral regurgitation, operative treatment seemed to bea safe and effective modality of treatment.

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