• Title/Summary/Keyword: Repeated surgery

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Sports Injury of the Elbow (주관절의 스포츠 손상)

  • Sin, Hyeon-Dae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.8-14
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    • 2008
  • Elbow joint injuries during exercise mostly occur by repeated stress to the joint than direct trauma. A pitcher who uses his arm above his head is most likely to be injured. So learning the right way to exercise and gaining the strength by maturating the body are essential for diminishing the chance of injury. On lateral ulnar tendon injury, which is most commonly injured area on elbow joint, pitchers generally complain of pain in arm movement above head and reduction of velocity, accuracy, and number of pitching. When there is pain on upper arm in harsh using, the stress fracture must be thought and epicondylar physis fracture of medial arm can occur by repeated abduction stress and contraction of flexors on forearm on children with immature skeleton. Osteochondritis dissecans of capitullum occur in young athletes who use there upper limb continuously lifting weights and gym work. And stress of abduction-extension includes damage of soft tissue and bone components, post medial crush syndrome, lateral ulnar ligament injury, extensor-abductor injury, stress of radius- capitullum are in this category.

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Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury (둔상성 간손상 환자의 손상 통제술 후 발생한 심낭압전)

  • Ye, Jin Bong;Sul, Young Hoon;Go, Seung Je;Kwon, Oh Sang;Kim, Joong Suck;Park, ang Soon;Ku, Gwan Woo;Lee, Min Koo;Kim, Yeong Cheol
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.211-214
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    • 2015
  • The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment. Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.

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Combined Surgery of Pulmonary Resection and Coronary Artery Bypass Grafting (CABG) (폐절제와 관상동맥 우회술의 동반 수술 치험 3예)

  • Kim Jin Sun;Lee Young Tak;Kim Jhingook;Kim Kwhanmien;Choi Yong Soo;Sung Kiick;Shim Young Mog
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.253-257
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    • 2005
  • The patients with primary lung cancer who have symptoms of angina pectoris commonly have underwent coronary artery bypass grafting (CABG) prior to lung resection. Recently, there are attempts to conduct simultaneous operation of CABG and lung resection to reduce disadvantages of staged operation, such as repeated general anesthesia, two wound incisions and delay of lung operation. These attempts generally report good results. Three patients underwent lung resection and CABG simultaneously, and had good post operative status without recurrence of cancer and angina pectoris. We conceive these as worthy cases to report.

Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry

  • Joh, Yewon;Park, Hyun Soo;Yang, Hoon Joo;Hwang, Soon Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.48.1-48.7
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    • 2019
  • Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

Significance of Contrast Enema in One-stage Transanal Endorectal Pull-through Operation for Hirschsprung Disease (히르슈슈프룽병의 One-stage Transanal Endorectal Pull-through 술식에서 대장조영술의 의의)

  • Shin, Man Sik;Lee, Mi Jung;Kim, Myung Joon;Hong, Young Ju;Chang, He Kyung;Han, Seok Joo;Oh, Jung-Tak
    • Advances in pediatric surgery
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    • v.18 no.2
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    • pp.75-82
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    • 2012
  • In one-stage transanal endorectal pull-through operation (TERPT) for Hirschsprung disease, preoperative evaluation by contrast enema (CE) is important tool in aspect of planning of surgical procedure as well as diagnosis. This study was to evaluate the significance of CE for identifying the extent of aganglionic bowel. A retrospective analysis was performed in 40 patients who underwent TERPT between 2003 and 2011. The authors reviewed the CE studies and their correlation with pathologic extent of aganglionosis. Total 66 contrast enemas were performed in 40 patients. Twenty patients underwent single CE, but 20 patients required multiple CEs. In single CE group, 17 had clear radiographic transition zone, but 3 had less definite transition zone. In multiple CE group, 17 patients who had equivocal finding in first or second CE had definite radiographic transition zone, but 3 patients of this group had less definite radiographic transition zones. Overall, 34 patients (85%)had clear radiographic transition zone by single or repeated CE. One (2.9%) out of 34 patients with clear radiographic transition zone had discordance between radiographic and pathologic transition zone. In contrast 4 (66.7%) out of 6 patients with equivocal radiographic transition zone had discordance between radiographic and pathologic transition zone. Observation of clear radiographic transition zone is important in preparation of TERPT, and repeated CE is helpful to reduce the discordance between radiographic and pathologic transition zone. Awareness of the possibility of discordance is also important if radiographic transitional zone is not clear.

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The Effect of Pre and Intra-Operative Warming Therapy on Tympanic Temperature Changes during Perioperative Phase in Receiving Patients with Total Hip Replacement (수술전과 수술중 피부가온요법 적응이 고관절 전치환술 환자의 수술 주기 고막체온 변화에 미치는 영향)

  • Kwon Young-Sook;Kim Eun-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.86-96
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    • 2000
  • The purpose of the study was to investigate the effects of Warming Therapy used with patients consistantly before and during surgery to on changes in their body temperatures. The data were collected from patients in a university hospital in Taegu between December 1, 1998 and May 31, 1999. The subjects were selected from patients who were hospitalized for total hip replacement surgery. Thirty participants were assigned to two groups : experimental(Warming Therapy) group and control group. Each group consisted of 15 patients. The research design was a repeated measurement design, using a nonequivalent control group. The Warming Therapy, using a forced-air warming blanket, that is a, 'Bair Hugger' was applied to subjects in the experimental group. The subjects in the group were treated with the 'Bair Hugger' to warm up the whole body for 40 minutes before surgery and upper body and face during the operation. The core temperature was measured using a tympanic thermometer. The body temperature of the patients was measured 13 times every 15 minutes during the surgery. After the operation the body temperature of the patients was measured 4 times every 15 minutes, from the time of arrivial in the recovery room to the time of leaving the recovery room. The SPSS Win 9.0 program was used for data analysis. Specific methods tested were done using ${\chi}^2-test$, t-test, repeated measures ANOVA. The findings of the study are as follows. 1. The first hypothesis, 'The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group during the operation', was supported (F=32.16, p=.000). 2. The second hypothesis, 'The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group after the operation', was supported.(F=33.36, p=.000) 3. During recovery, shivering was observed one patient in the experimental group and seven patients in the control group. In summary, the findings of the study suggest that the 'Warming Therapy' applied before and during the surgery was a very effective treatment for surgical patients in maintaining the core temperature during surgery

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Assessment of Validity and Reliability of Plantar Pressure in Smart Insole (스마트 인솔의 족저압 측정 결과에 대한 타당도 및 신뢰도 평가)

  • Kang, Ho Won;An, Yae Lynn;Kim, Dae-Yoo;Lee, Dong-Oh;Park, Gil Young;Lee, Dong Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.3
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    • pp.130-135
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    • 2022
  • Purpose: Smart insoles are wearable devices that are inserted into shoes. Smart insoles with built-in pressure and acceleration sensors can measure the plantar pressure, stride length, and walking speed. This study evaluated the validity and reliability of the plantar pressure measurements of smart insoles during walking on flat ground. Materials and Methods: Twenty one subjects were included in this study. After wearing smart insoles, I-SOL® (Gilon, Seongnam, Korea), the subjects walked a 10 m corridor six times at a rate of 100 steps/min, and the middle three steps, free from direction changes, were chosen for data analysis. The same protocol was repeated after wearing Pedar-X (Novel Corporation, Munich, Germany), an insoletype plantar pressure measurement equipment with proven validity. The average maximum pressure (Ppeak, kPa) and the time at which Ppeak appeared (Ptime, %stride) were calculated for each device. The validity of smart insoles was evaluated by using the interclass correlation coefficient (ICC) of Ppeak and Ptime between the two instruments, and Cronbach's alpha was obtained from the Ppeak values to evaluate the reliability. Results: The ICC of Ppeak was 0.651 (good) in the hallux, 0.744 (good) in the medial forefoot, 0.839 (excellent) in the lateral forefoot, and 0.854 (excellent) in the hindfoot. The ICC of Ptime showed 0.868 (excellent) in the hallux, 0.892 (excellent) in the medial forefoot, 0.721 (good) in the lateral forefoot, and 0.832 (excellent) in the hindfoot. All ICC values showed good or excellent results. The Cronbach's alpha of Ppeak measured in the smart insoles was 0.990 in the hallux, 0.961 in the medial forefoot, 0.973 in the lateral forefoot, and 0.995 in the hindfoot; all indicated excellent reliability in all areas. Conclusion: The plantar pressure measurements of smart insoles during walking on a flat ground showed validity compared to Pedar-X, and high reliability after repeated measurements.

Pulmonary Metastasectomy in Adult Patients with Synovial Sarcoma: A Single-Center Experience

  • Lee, Kanghoon;Kang, Moon Chul;Lee, Hae Won;Park, Jong Ho;Baek, Hee Jong;Cho, Sung Joon;Jeon, Dae-Geun
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.451-455
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    • 2016
  • Background: This study assessed the efficacy of pulmonary metastasectomy for synovial sarcoma in adult patients. Methods: Fifty patients, diagnosed with pulmonary metastasis from June 1990 to August 2010, were reviewed retrospectively. Twenty-eight patients underwent complete pulmonary metastasectomy, and their survival was evaluated. Age, sex, time to metastatic progression, laterality, number of tumors, size of largest nodule, and number of metastasectomies were analyzed as potential prognostic factors. Results: In all, 29 patients underwent at least one pulmonary metastasectomy, and 51 resections were performed. One intraoperative mortality occurred, and the 5-year survival rate was 58.4%. Bilateral metastases and early metastatic progression were associated with poor survival in multivariate analyses. Conclusion: Surgical resection can be a good option for treating pulmonary metastasis in patients with synovial sarcoma. Repeated resection was feasible with low mortality and morbidity.

End-to-End Anastomosis for Benign Esophageal Stricture-2 Cases (양성 식도협착에 대한 단단문합술 치험 2예)

  • Lee, Song-Am;Kim, Kwang-Taik;Son, Ho-Sung;Lee, Sung-Ho;Sun, Kyung;Kim, Tae-Sik;Kim, Yo-Han
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.617-621
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    • 2004
  • End-to-end anastomosis for benign esophageal stricture (BES) is technically easier and relatively lower in morbidity than esophago-enterostomy. We performed segmental resection and end-to-end anastomosis in 2 cases of short segmental BES who were failed repeated endoscopic dilatation. A 13-month-old female with postoperative stricture was treated successfully. However, a 27-year-old female with corrosive stricture required second operative management of esophago-colo-gastrostomy following end-to-end anastomosis. Our experiences suggested that end-to-end anastomosis for BES could be used as a valid procedure for well selected patients. However, further studty is needed to compare with esophago-enterostomy.

Thromboendarterectomy of Chronic Pulmonary Thromboembolism - A Case Report - (만성 폐색전증의 내막 절제술 1례보고)

  • Ban, Dong-Gyu;Kim, Hyuck;Kim, Young-Hak;Kang, Jung-Ho;Chung, Won-Sang;Jee, Heng-Ok;Lee, Chul-Bum;Jeon, Seok-Chol
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.792-796
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    • 2001
  • Chronic pulmonary artery thromboembolism is a relatively rare phenomenon causing hypoxia and pulmonary hypertension that eventually leads to respiratory failure and right heart failure. Patients with acute pulmonary artery thromboembolism are generally treated with antithrombotics and thrombolytics. However, in cases with chronic pulmonary artery thromboembolism the fibrinized thrombus is so strongly adhered to the pulmonary artery wall that medical treatment becomes ineffective and surgical treatment must then be considered. We report a 47year old patient, with a history of repeated admission due to unresolved chronic obstructive pulmonary disease and chronic pulmonary artery thromboembolism at a local hospital, who underwent a successful endarterectomy of pulmonary artery thromboemboli using intermittent total circulatory arrest.

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