• 제목/요약/키워드: Surgical intervention

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구강 악안면 근막간극 감염에 관한 임상통계학적 분석 (A CLINICO-STATISTICAL ANALYSIS ON THE FASCIAL SPACE INFECTIONS OF ORAL AND MAXILLOFACIAL REGION)

  • 주현호;원동환;이상휘;김일현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권5호
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    • pp.490-496
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    • 2000
  • We have conducted a retrospective study of 224 patients with the diagnosis of oral and maxillofacial infection who had been treated between 1988 and 1999 at Gyeong-Sang National University Hospital. This study was aimed to furnish the data of oral and maxillofacial infection and to aid diagnosis and treatment. The most common fascial space involved, as determined by clinical, radiologic, and operative findings, were the submandibular space(39.4%). The most frequent cause of oral and maxillofacial infection was odontogenic 68.8%. In the odontogenic cause, dental caries was the most common cause. Two-hundred three patients required surgical drainage of the abscess. Seventeen patients needed tracheostomy for airway control. The overall mortality was 0.9% despite aggressive anti-microbial therapy and early surgical intervention. All other patients had an uneventful recovery without major complication except osteomyelitis case(6.0%). The combination of early radiologic diagnosis, effective antimicrobial therapy, and intensive surgical management contributed to the good prognosis.

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Importance of immediate surgical intervention and antifungal treatment for rhinocerebral mucormycosis: a case report

  • Kim, Jin-Geun;Park, Hye Jeong;Park, Jung Hyun;Baek, Jiwoong;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권5호
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    • pp.246-250
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    • 2013
  • Rhinocerebral mucormycosis (RCM) is an opportunistic, potentially life-threatening fungal disease. This infective disease invades not only the facial sinuses, but also the maxilla, zygoma, and rhino-cerebral structures with a massive destruction of the facial skeletons and soft tissue. This disease progresses within various underlying diseases, such as diabetes mellitus, hematologic malignancy, renal failure, and systemic immunodepression. The relationship between mucormycosis and these underlying conditions have been discussed extensively in the literature. The authors studied 6 cases of RCM diagnosed by a tissue biopsy and treated at the department of oral and maxillofacial surgery, from 1997 to 2012. Patients were treated with several kinds of surgical interventions and antifungal agents, and their clinical & radiological signs, underlying conditions, surgical methods, and outcomes were analyzed.

소아의 위장관 중복증 (Gastrointestinal Duplications in Childhood)

  • 김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제7권1호
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    • pp.26-30
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    • 2001
  • Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.

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수술환자를 위한 동영상과 소책자를 활용한 자가통증조절장치 교육의 효과 (The Effects of Preoperative PCA Education with Multimedia and Brochure on Pain Management in Surgical Patients)

  • 강희영;이상윤;양경미
    • 기본간호학회지
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    • 제17권4호
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    • pp.498-507
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    • 2010
  • Purpose: The purpose of this study was to evaluate the effects of preoperative PCA (Patient-Controlled Analgesia) education on pain, patient attitude, and patient satisfaction in surgical patients. Methods: The study was a quasi-experimental research design. The participants were 54 patients who were admitted for surgery at I hospital in G city, Korea. Of the 54 patients, 26 were assigned to the experimental group and the rest to the control group. The PCA education was provided in the nurses' station, individually to patients in the experimental group the day before their operation. Multimedia and brochure, and a real PCA model were used. The control group received only verbal education about PCA. Results: The postoperative pain scores were significantly different for lapse of time in the experimental group compare to the control group. Patient attitude toward using pain medicine was significantly more positive in the experimental group than in the control group. The postoperative patient satisfaction with pain management was significantly higher in the experimental group than in the control group. Conclusion: The study findings indicate that preoperative PCA education could be an effective nursing intervention for pain management of surgical patients.

향기흡입법이 복부수술 환자의 수술 전 불안 감소에 미치는 효과 (The Effect of Aroma Inhalation Method on the Preoperative Anxiety of Abdominal Surgical Patients)

  • 최인순;이명선;류언나;박경숙
    • 성인간호학회지
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    • 제20권2호
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    • pp.311-320
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    • 2008
  • Purpose: The study was done to analyze the effects of aroma inhalation method on preoperative anxiety of abdominal surgical patients. Methods: The research design was a nonequivalent control group non-synchronized design. The data were collected from July 25 to October 21, 2005 at C Medical Center in Seoul. The patients were divided into two group of 24 subjects each. In order for measuring the all patient's anxiety before operation and aroma inhalation, Spidlberger(1975) trait anxiety, VAS(visual analogue scale) state anxiety, blood pressure, pulse rate were taken. After experimental group was taken aroma inhalation, VAS state anxiety, blood pressure, pulse rate were measured for two group. Results: After aroma inhalation, VAS state anxiety level, systolic blood pressure, diastolic blood pressure, pulse rate of the experimental group were decreased significantly than those of control group(p = .000, p = .000, p = .030. p = .000). Conclusion: The aroma inhalation method can be considered an effective nursing intervention that relieves the preoperative anxiety of abdominal surgical patients and stabilizes vital signs.

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신속 조형 기술로 제작된 인체모형을 이용한 술전 모의 두개악안면성형수술 (3-Dimensional Model Simulation Craniomaxillofacial Surgery using Rapid Prototyping Technique)

  • 정경인;백롱민;임주환;박성규;허찬영;김명국;권순성
    • Archives of Plastic Surgery
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    • 제32권6호
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    • pp.796-797
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    • 2005
  • In plastic and reconstructive craniomaxillofacial surgery, careful preoperative planning is essential to get a successful outcome. Many craniomaxillofacial surgeons have used imaging modalities like conventional radiographs, computed tomography(CT) and magnetic resonance imaging(MRI) for supporting the planning process. But, there are a lot of limitations in the comprehension of the surgical anatomy with these modalities. Medical models made with rapid prototyping (RP) technique represent a new approach for preoperative planning and simulation surgery. With rapid prototyping models, surgical procedures can be simulated and performed interactively so that surgeon can get a realistic impression of complex structures before surgical intervention. The great advantage of rapid prototyping technique is the precise reproduction of objects from a 3-dimensional reconstruction image as a physical model. Craniomaxillofacial surgeon can establish treatment strategy through preoperative simulation surgery and predict the postoperative result.

소아 농흉의 임상적 고찰 (clinical analysis of childhood empyema)

  • 김범식
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.385-390
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    • 1986
  • Empyema is a severe infection encountered in the pediatrics. With advance of the antibiotics and chemotherapeutics, there was a marked decrease in number of empyema. Empyema complicated by staphylococcal pneumonia in infant and children has been distressing problem, and the management of this complication has been discussed repeatedly in the past. In Korea, tuberculous empyema is also troublesome. If empyema is localized within thick capsule, tube thoracostomy and closed drainage alone is unacceptable, and early open thoracotomy to eliminate the empyema has proved good result. A clinical analysis of 39 patients with thoracic empyema was done. They were managed surgical intervention at Dept. of Thoracic & Cardiovascular Surgery at Kyung-Hee University Hospital from Jan. 1974 to December, 1984. 1. Age and sex distribution, infancy 9, early childhood 11. late childhood 9, puberty 10. The male to female ratio was 21:18. 2. The highest seasonal incidence was winter [21 cases]. 3. Cardinal symptoms were cough [76%], fever and chill [66%], and dyspnea [40%]. 4. The location of the empyema was right in 27 cases [69%] and 12 cases in left side. 5. The most frequent lesion to predisposing factor was pneumonia [67%]. 6. The commonest organism was Staphylococcus aureus in 15 [38%] cases, and Mycobacterium tuberculosis in 10 cases [26%]. 7. The surgical treatment was performed in all patients. The surgical procedure was closed tube thoracostomy in 25 cases [64%], decortication in 7 cases [18%], pulmonary resection in 4 cases [10%], and decortication with curettage in 2 cases. 8. One patient died from sepsis complicated by lymphoma and in one patient bronchopleural fistula was developed postoperatively.

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심실중격결손의 Pulmonary Banding: 2 치험례 (Pulmonary Artery Banding for Ventricular Septal Defect: Report of 2 Cases)

  • 조범구
    • Journal of Chest Surgery
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    • 제5권1호
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    • pp.29-34
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    • 1972
  • Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

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연구개인두 폐쇄 부전 환자의 진단과 치료 (The Diagnosis and Management of Velopharyngeal Insufficiency)

  • 이용권;최재평;최진영
    • 대한구순구개열학회지
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    • 제11권1호
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    • pp.13-22
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    • 2008
  • Velopharyngeal insufficiency(VPI), characterized by hypernasal resonance and nasal air emission, is a speech disorder that can significantly compromise speech intelligibility. Cleft palate, previously repaired cleft palate and submucous cleft palate are associated with VPI. Less commonly, patients may acquire it after adenoidectomy with or without tonsillectomy or as a result of neuromuscular dysfunction. Comprehensive evaluation by a VPI team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, MRI and instrumental assessment. Options for intervention include speech therapy, intraoral prosthetic devices and surgery. Surgical methods can be categorized as palatal, palatopharyngeal or pharyngeal procedures. Each surgical approach has its strengths and limitations. Oro-maxillofacial surgeons are increasingly involved in the referral, evaluation, and treatment of velopharyngeal function. Therefore, understanding of physiology, anatomic structures, evaluation and treatment protocols in VPI is very important. This article presents protocol for evaluation of velopharyngeal function with a focus on indications for surgical interventions.

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Gracilis pull-through flap for the repair of a recalcitrant recto-vaginal fistula

  • Mok, Wan Loong James;Goh, Ming Hui;Tang, Choong Leong;Tan, Bien Keem
    • Archives of Plastic Surgery
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    • 제46권3호
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    • pp.277-281
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    • 2019
  • Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for recto-vaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap. The surgical goals in this patient were complete excision of the recto-vaginal fistula and introduction of fresh, vascularized muscle to seal the fistula. A defunctioning colostomy was performed 1 month prior to the present procedure. The gracilis muscle and tendon were mobilized, pulled through the freshened recto-vaginal fistula, passed through the anus, and anchored externally. Excess muscle and tendon were trimmed 1 week after the procedure. Follow-up at 4 weeks demonstrated complete mucosal coverage over an intact gracilis muscle, and no leakage. At 8 weeks post-procedure, the patient resumed sexual intercourse with no dyspareunia. At 6 months post-procedure, her stoma was closed. The patient reported transient fecal staining of her vagina after stoma reversal, which resolved with conservative treatment. The fistula had not recurred at 20 months post-procedure. The gracilis pull-through flap is a reliable technique for a scarred vagina with an attenuated recto-vaginal septum. It can function as a well-vascularized tissue plug to promote healing.