• Title/Summary/Keyword: operative

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Nonoperative Management of Blunt Liver Trauma (둔상성 간 손상환자의 비수술적 치료)

  • Baik, Jung Ju;Kim, Jung Il;Choi, Seung Ho;Choi, Young Cheol;Jun, Si Youl;Lee, Jun Ho;Hwang, Seong Youn
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.161-171
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    • 2005
  • Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

Assessing the Factors Influencing Patient Satisfaction after Receiving Laser in situ Keratomileusis (LASIK) (라식수술 후 환자만족도에 영향을 미치는 요인)

  • Cho, Woo-Hyun;Kim, Ji-Yoon;Choi, Yoon-Chung;Lee, Jong-Ho;Lee, Je-Myung;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.2
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    • pp.111-119
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    • 2004
  • Purpose : To identify those factors influencing the post-operative satisfaction in myopia patients receiving laser in situ keratomileusis (LASIK) Methods : This study included 288 consecutive patients who received LASIK between July and December 2001 from two eye clinics located in Seoul and Pusan. Factors that were considered to influence post-operative satisfaction included pre-operative baseline characteristics, pre-operative expectation for treatment outcomes, and treatment outcomes. Before undergoing LASIK, study subjects were asked to rate the degree of their expectation for the improvement of visual functions and symptoms after LASIK on a 5-point Likert-type scale: where 1 referred to 'somewhat worse,' 2 to 'no change,' 3 to 'somewhat improved,' 4 to 'improved,' and 5 to 'very improved.' Self-administered questionnaire was used to evaluate baseline visual functions and symptoms on a 5-point scale before LASIK. At 6 months after LASIK, the evaluation was repeated to measure treatment outcomes in terms of the difference in the score before and after LASIK. Post-operative satisfaction was also measured at 6 months on a 5-point scale. Multiple regression analysis was performed to examine the independent relationship between influencing factors and postoperative satisfaction. Results : A total of 171 patients (59.4%) participated in the 6-month follow-up investigation. The average expectation scores for the improvement in visual functions and symptoms were 3.8 and 3.4, respectively. The average score for the 7 questions assessing satisfaction was 4.0. The results of the regression analysis showed that the post-operative satisfaction increased with improvement in the visual function ($\beta$=0.16, p<0.05) and symptoms ($\beta$=0.25, p<0.05), the degree of preoperative refractive error ($\beta$ =0.26-0.67, p<0.05) and in male patients ($\beta$=0.31, p<0.1). The pre-operative expectation was not a statistically significant factor in explaining postoperative satisfaction in the regression model. Conclusion : The finding from this study was that patients with very severe myopia tended to be more satisfied with the treatment than those with mild myopia, which implies that LASIK can be more beneficial to those suffering from a severe visual condition. Patient satisfaction was also significantly affected by the treatment outcomes experienced after LASIK. This suggests that improving the clinical outcome is the most fundamental requirement for the improvement of patient satisfaction.

The Current Status of Co-operative Education Programs in Korean Universities and It's Implications for the Government Policy (대학의 현장실습 운영 실태 및 정책 과제)

  • Jang, Hoo-Eun;Heo, Sun-Young;Lee, Jong-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.2
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    • pp.493-500
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    • 2017
  • Co-operative education and internships are generally treated as an alternative way to increase the employment rate by resolving the mismatch between college education and the industrial needs of the job specification. Based on a questionnaire survey on Korean universities, this study examined the current status of programs and the operating mechanism for co-operative education and internship to provide policy suggestions for promoting the depth and width of co-operative education in Korean universities. The results of the survey shows that the majority of students carry out internships on a short-term basis and the universities usually lack the capabilities for effectively running the programs of co-operative education and internships. In particular, as a part of the academic curriculum, co-operative education should be focused on the balance and effective linkage between the occupations given to students and the majors in university.

Operative Treatment of Ipsilateral Fractures of Clavicle and Scapula (동측에 발생한 쇄골 골절과 견갑골 골절의 수술적 치료)

  • Park Jung Ho;Suh Seung Woo;Park Sang Won;Lee Kwang Suk
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.46-50
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    • 1998
  • The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.

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AN EXPERIMENTAL STUDY OF THE EFFECT OF FLUORIDES ON HUMAN DENTIN (불화물(弗化物)의 상아질도포효과(象牙質塗布效果)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Chun, Dong-Moon;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.23-38
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    • 1988
  • In order to investigate the material formed by application of fluoride on human dentin, exposed dentin of tooth cervix and sound dentin powder was treated by several fluoride solutions. The former was observed by scanning electron microscope and the latter was analysed by x-ray diffractometer and infrared spectrophotometer. The results obtained were as follows: 1. Application with NaF, $SnF_2$ and $Na_2PO_3F$ on exposed dentin of tooth cervix formed mineralized materials covered. 2. The amount of mineralized materials increased with time intervals of applying the fluorides. 3. The density of mineralized materials was highest in $Na_2PO_3F$ treatment group, and NaF treatment group was higher than $SnF_2$ treatment group. 4. $SnF_2$ remained in covering of mineralized materials. 5. Application with NaF and $Na_2PO_3F$ formed mineralized materials characterized apatitic crystals. 6. The crystallinity of mineralized materials was higher prominently in $Na_2PO_3F$ treatment group.

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AN EXPERIMENTAL STUDY ON SEALING ABILITY OF VARIOUS ROOT CANAL SEALERS (수종(數種) 근관충진재(根管充眞材)의 근관폐쇄성(根管閉鎻性)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Park, Sun-Hee;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.113-120
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    • 1988
  • The purpose of this study was to evaluate and compare the sealing ability of ZOE, FR and AH-26. Seventy two upper and lower anterior and premolor teeth were randomly selected and instrumented in a conventional method with K-file. After instrumentation and dry the canal, the teeth were divided into 3 groups and twenty four teeth in each group were filled with ZOE, FR, and AH-26 respectively. All the specimens were immersed into Indian Ink and decalcified in nitric acid and cleared in methyl salicylate. The apical leakage was evaluated by measuring the degree of ink penetration with caliper at the intervals of 1 day, 7 days and 14 days. The results were as follows; 1. In AH-26 and FR groups, there was increase in penetration related to increased time of immersion in the ink. 2. FR group showed the least penetration in 3 groups. 3. Statistics showed that there was no significant difference among the each sealer groups.

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AN EXPERIMENTAL STUDY ON BOND STRENGTH OF REPAIRED POSTERIOR COMPOSITE RESINS (구치부용(臼齒部用) Composite resin의 부분재수복시(部分再修復時)의 접착강도(接着强度)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Chung, Inn-Gyo;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.131-137
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    • 1988
  • The purpose of this study was to investigate the interfacial bond strength of repaired composite resins, Lite-Fil P and Bis-Fil II, under different interfacial conditions. The matured composite resin specimen were prepared as Table I and divided into 9 groups. All specimens were stored in distilled water at $37^{\circ}C$ for 24 hours before testing. The results were as follows; 1. The bond strength of the groups that bonding agent was applicated was greater than that of the groups that bonding agent was not applicated. 2. The bond strength of the saliva contaminated groups was the lowest. 3. The bond strength of the group that chemical cured composite resin bonded to chemical cured composite resin was greater than that of the other groups. 4. The bond strength of the no-treated group was greater than that of saliva contaminated group, and lesser than that of the bonding agent applicated groups.

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Surgical Management of Coarctation of the Aorta: 12 Years of Experience (대동맥 교약증의 수술요법 -12년간의 수술경험-)

  • Kim, Won-Gon;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.36-45
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    • 1985
  • During the twelve-year period from March 1973 through July 1984, 23 consecutive operations for coarctation of the aorta were performed at Seoul National University Hospital. The patients included 19 male and 4 female in the range of 4 months and 16 years old. Associated cardiac anomalies were present in 19 patients [70%] and they were VSD+PDA [9 patients], VSD[2], PDA[1], VSD+ASD+PDA[1], VSD+MS+AS+PDA[1], D-TGA+VSD+PDA[1], P-ECD[1], MS[1], Al[1], and DORV+PDA[1]. The preoperative main symptoms included congestive heat failure, hypertension, subacute bacterial endocarditis and nonspecific symptoms. Congestive heart failure was the most common symptom in the group younger than 2 years and hypertension in the adult group. Operative techniques for coarctation of the aorta were resection and end to end anastomosis in 10 patients, prosthetic patch aortoplasty in 8, subclavian flap aortoplasty in 4, and LSCA-aortic anastomosis in 1. There were 4 operative deaths among the nine patients less than 2 years old[44.4% mortality]: all of these patients had associated cardiac anomalies. And only one operative death occurred in patients older then 2 years old[7.1% mortality]. No hospital death occurred in patients with isolated coarctation of the aorta. Operation of the coarctation was performed primarily in 6 patients associated with ventricular septal defect and subsequently underwent successful VSD closure except one operative death.

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Factors influencing the prognosis after total correction of tetralogy of Fallot (Fallot 4징증의 근치수술후 예후에 영향을 미치는 요소)

  • Min, Yong-Il;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.71-80
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    • 1987
  • Twenty six patients were operated a total correction of tetralogy of Fallot between Jan., 1984 and July, 1985 at the Dept. of thoracic and cardiovascular surgery, Chonnam University Medical School, and a comparison between the survived group [n = 18] and the dead group [n = B was performed to detect factors influencing laboratory data, cineangiographic findings, operative findings and methods, and pump time. Following results were obtained, 1. There was no significant difference between two groups in the preoperative P.O2 and hematocrit level. 2. The size of the interventricular defect was not related to the operative mortality. 3. There was a significant difference in mortality rate between combined type of stenosis of pulmonary artery, valve and infundibulum and other types of right ventricular outflow tract stenosis. 4. There was a significant difference in mortality rate between the transannular patch reconstruction and other types of operative procedure. 5. There was no significant difference between two groups in total bypass time and aortic time. 6. There was no significant difference between two groups in left ventricular end diastolic volume and right ventricular end diastolic volume. 7. The operative mortality was related to the ratio of the diameter of the pulmonary valve annulus or each pulmonary artery to the ascending or descending aorta in cineangiographic findings, but there was no statistical significance of which probably is due to the lack of the total number of patients.

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