• 제목/요약/키워드: Postoperative Hemorrhage

검색결과 168건 처리시간 0.024초

Centrifugal biomedicus pump의 임상 응용 (Clinical use of Centrifugal Biomedicus Pump)

  • 강면식
    • Journal of Chest Surgery
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    • 제25권12호
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    • pp.1550-1555
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    • 1992
  • From June 1989 to July 1992, we used centrifugal Biomedicus pump[CBP] in 20 patients In 9 cases, CBP was used as ventricular assistance after heart surgery for those who could not be weaned off bypass even with intra-aortic balloon counter-pulsation and with maximal inotropic support In 8 patients, CBP was used as partial left heart bypass during repair of aortic aneurysms or congenital aortic anomalies. And in 3 patients, CBP was used as vena caval bypass during resection of renal cell carcinoma with tumor extension into the inferior vena cava. In 2 of 9 patients with ventricular assistance, they were weaned off the device successfully after 16 hours and 7 days respectively. But the patients died of intracranial hemorrhage and sepsis, 7 and 29 days after weaning from cardiac support, respectively. In all the patients who underwent aortic of vena caval surgery using CBP as shunt, there were no complications such as postoperative bleeding necessitating reoperation, renal failure or neurologic sequelae. In conclusion, the centrifugal type of ventricular assistance may be potentially life saving treatment modality in patients with severe postoperative low cardiac output syndrome. The CBP can be safely employed for resection of renal cell carcinoma with vena caval tumor extension and for repair of aortic aneurysms.

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Totally Laparoscopic Distal Gastrectomy with ROUX-EN-Y Reconstruction for Treatment of Duodenal Ulcer Obstruction

  • Kim, Min-Gyu;Kim, Beom-Su;Kim, Tae-Hwan;Kim, Kap-Choong;Yook, Jeong-Hwan;Oh, Sung-Tae;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • 제10권2호
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    • pp.75-78
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    • 2010
  • Because of advancement of medical treatment, surgical management of gastric or duodenal ulcer was indicated for treatment of perforation, massive hemorrhage and obstruction. The distal gastrectomy including ulcer was known as principle method of duodenal ulcer obstruction, but actually many surgeons have performed only bypass surgery for the difficulty of formation of duodenal stump. In our case, 61-year-old male with repetitive duodenal ulcer obstruction transferred with obstruction due to deformities and inflammations of duodenal ulcer. We had performed totally laparoscopic distal gastrectomy with ROUX-EN-Y reconstruction using the clear visibility of laparoscopy and fine dissections of harmonic scalpel. The patient started soft diet on postoperative day 5 and discharged on postoperative day 8. He returned to work after discharging immediately.

The effectiveness of gamification on nursing practice for undergraduate students: A systematic review

  • Hyun Kyoung, Kim
    • International Journal of Advanced Culture Technology
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    • 제10권4호
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    • pp.110-116
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    • 2022
  • The purpose of this study was to examine the effectiveness of gamification in nursing practice for undergraduate students, as well as to explore the use of gamification in nursing education. This study is a systematic review of RCTs evaluating the effectiveness of gamification in nursing practice for undergraduate students. A total of 7 articles were identified in a search of PubMed, Cochrane Library, and Embase, and the additional databases were CINAHL (in English) and RISS (in Korean) between September 28, 2022 to October 5, 2022. Themes related to the environment and personal behaviors between 2002 and 2021 were extracted. The intervention themes were blood transfusion, postoperative pediatric nursing, postoperative hemorrhage and brain trauma nursing, basic and advanced life support, disaster nursing, and neonatal resuscitation. The primary outcomes were knowledge in five studies, satisfaction in one study, and competency in one study. The secondary outcomes were satisfaction in three studies, confidence in two studies, performance in two studies, skills in two studies, and self-efficacy, motivation, professional attitude, cognition, gameful experience, and affective response in one study each. Therefore, gamification interventions can be utilized in nursing practice education instead of traditional teaching methods such as lectures and face-to-face clinical practice.

Finger reduction of nasal bone fracture under local anesthesia: outcomes and patient reported satisfaction

  • Lee, Young-Jae;Lee, Kyeong-Tae;Pyon, Jai-Kyong
    • 대한두개안면성형외과학회지
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    • 제20권1호
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    • pp.24-30
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    • 2019
  • Background: Closed reduction of the fracture under general or local anesthesia with elevators or forceps is widely used to treat nasal bone fractures. However, operating under general anesthesia increases the risk of morbidity and raises the cost of management. Furthermore, using forceps or elevators may cause undercorrection, new fractures, mucosal damage, and nasal hemorrhage. We therefore performed manual reduction under local anesthesia, using the little finger, to minimize the demerits of treatment under general anesthesia with forceps or elevators and aimed to assess functional and aesthetic outcomes, and patient satisfaction. Methods: Patients who visited the plastic and reconstructive surgery department between November 2016 and November 2017 with nasal bone fractures and treated by a single surgeon were prospectively followed up. Patients with simple unilateral or bilateral nasal bone fractures were treated with bedside finger reduction under local anesthesia and patients with comminuted nasal bone or septal fractures were scheduled for closed reduction under general anesthesia. Results: Of 84 patients, 28 met the inclusion criterion and underwent bedside finger reduction under local anesthesia. Twenty-seven patients (96.4%) were successfully contacted via telephone for survey. Twenty-three (85.2%) showed good and three (11.1%) showed fair results. All 27 patients (100%) were satisfied with their postoperative function and 25 (92.6%) were satisfied with their postoperative aesthetic result. Twenty-five patients (92.6%) preferred the finger reduction method under local anesthesia over closed reduction under general anesthesia. Conclusion: Finger reduction under local anesthesia in patients with mild unilateral or bilateral nasal bone fractures is an easy and efficient procedure with high patient satisfaction and favorable postoperative functional and aesthetic outcomes.

Waterston 수술이 Gas 값과 폐조직에 미치는 영향 (Blood Gas Analysis and Lung Histopathology in Waterston Operation)

  • 김세화;이홍균
    • Journal of Chest Surgery
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    • 제5권2호
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    • pp.87-96
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    • 1972
  • Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.

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원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구 (THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS)

  • 문원규;정영수;이의웅;권호근;유재하
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

Pituitary Apoplexy Following Mitral Valvuloplasty

  • Kim, Young Ha;Lee, Sang Weon;Son, Dong Wuk;Cha, Seung Heon
    • Journal of Korean Neurosurgical Society
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    • 제57권4호
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    • pp.289-291
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    • 2015
  • Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome caused by the sudden enlargement of a pituitary adenoma secondary to hemorrhage or infarction. Pituitary apoplexy after cardiac surgery is a very rare perioperative complication. Factors associated with open heart surgery that may lead to pituitary apoplexy include hemodynamic instability during cardiopulmonary bypass and systemic heparinization. We report a case of pituitary apoplexy after mitral valvuloplasty with cardiopulmonary bypass. After early pituitary tumor resection and hormonal replacement therapy, the patient made a full recovery.

Delayed Surgical Management of Traumatic Pseudoaneurysm of the Ascending Aorta in Multiple Trauma

  • Ma, Dae Sung;Kim, Sung Jin;Joo, Seok;Hyun, Sung Youl;Jeon, Yang Bin
    • Journal of Trauma and Injury
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    • 제31권1호
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    • pp.29-33
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    • 2018
  • Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.

하행흉부대동맥류(下行胸部大動脈瘤) 치험(治驗) 1례(例) (Aneurysm of the Descending Thoracic Aorta -Report of a Case-)

  • 이동준;김상형
    • Journal of Chest Surgery
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    • 제9권1호
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    • pp.44-49
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    • 1976
  • Aneurysm of the Aorta is a grave disease mostly producing disabling symptoms and ultimate death by rupture and hemorrhage without surgical intervention. The author recently experienced one case of surgical correction of descending thoracic aortic aneurysm treated with excision of the aneurysm and replacement of Dacron artificial vessel under temporary external by pass technique in November, 10th, 1975. 9mm internal diameter arterial cannula was inserted into upper and below the aneurysm. Bypass time was about 1 hour. The case was 35 years old women who had small egg sized saccular aneurysm in the upper third of the descending thoracic aorta involving the 1t. subclavian artery. Histopathological diagnosis was arteriosclerotic. Immediate postoperative course had been uneventful except low pressure and pulse of the left arm. The follow-up was possible up to date about 3 months. The patient has been doing well with ordinary activities except mild left chest discomfort.

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폐쇄식 고환앞 요도절개술을 통한 요도결석견 치유 2례 (Two Case Report of Treatment by Closed Prescrotal Urethrotomy in Two Dogs with Urethral Calculi)

  • 정순욱;이충헌;신영규
    • 한국임상수의학회지
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    • 제16권2호
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    • pp.501-505
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    • 1999
  • Two dogs were presented urinary disorder in the associated with urolithiasis. Clinical signs were increased frequency of urination with mild straining pollakiuria, general depression and anorexia. On physical examinations, the pain was revealed at the palpation of the urethral area. Urinalysis showed high specific gravity, high pH, and triple phosphates. Radiography showed an increased radiopacity, and ultrasonography showed hyperecho in the just behind of os penis. Urolithiasis was diagnosed on the basis of clinical signs, radiography, and ultrasonography. In the prescrotal urethrotomy, urethra on the midline was incised and uroliths were eliminated. After elimination of uroliths, incision area was closed with 4-0 synthetic absorbable suture. In postoperative, there was good prognosis without hemorrhage, inflammation, and urethral stricture.

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