• Title/Summary/Keyword: 수술적 치료 결과

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Percutaneous Cardiopulmonary Support (PCPS) for Patients with Cardioppulmonary Bypass Weaning Failure during Open Heart Surgery (개심술 중 심폐기 이탈에 실패한 환자에게 적용한 경피적 심폐순환 보조장치)

  • Ryu, Kyoung-Min;Park, Seong-Sik;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.604-609
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    • 2009
  • Background: Recently, percutaneous cardiopulmonary support (PCPS) has been widely used to rescue patients in cardiogenic shock or cardiac arrest. However, patients with cardiopulmonary bypass (CPB) weaning failure during open heart surgery still have very poor outcomes after PCPS. We investigated clinical results and prognostic factors for patients who underwent PCPS during open heart surgery. Material and Method: From January 2005 to December 2008, 10 patients with CPB weaning failure during open heart surgery underwent PCPS using the CAPIOX emergency bypass system ($EBS^{(R)}$, Terumo Inc, Tokyo, Japan). We retrospectively reviewed the medical records of those 10 patients. Result: The average age of the patients was $60.2{\pm}16.5$ years (range, $19{\sim}77$ years). The mean supporting time was $48.7{\pm}64.7$ hours (range, $4{\sim}210$ hours). Of the 10 patients, 6(60%) were successfully weaned from the PCPS While 5 (50%) were able to be discharged from the hospital. Complications were noted in 5 patients (50%). In univariate analysis, long aortic cross clamp time during surgery, mediastinal bleeding during PCPS and high level of Troponin-I before PCPS were significant risk factors. All of the discharged patients are still surviving $34{\pm}8.6$ months (range, $23{\sim}48$ months) post-operatively. Conclusion: The use of PCPS for CPB weaning failure during open heart surgery can improve the prognosis. More experience and additional clinical studies are necessary to improve survival and decrease complications.

A CLINICAL STUDY ON MANDIBULAR MOVEMENT AFTER ORTHOGNATHIC SURGERY (악교정 수술환자의 술전후 하악운동 양상변화에 관한 임상적 연구)

  • Baek, Sang-Heum;Jang, Hyun-Jung;Lee, Sang-Han;Kim, Hyun-Soo;Cha, Doo-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.239-249
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    • 2001
  • The purpose of this study is to evaluate the relationship of the factors which could be influenced by orthognathic surgery especillay SSRO. We measured the amounts of the maximum opening, lateral movements, maximum velocity and pattern of mandibular path during the opening and closing of mandible at the following times ; preoperative, 1 month after operation, 6 months after operation respectively using MKG. And the results were compared according to the categorized subgroups. Following results were obtained : 1. The change of the amounts of mandibular lateral movement and maximum opening velocity were statistically different between male and female (p<0.05), but the others were not. 2. According to the method of operation, there was no difference in the change of the mandibular movements between the group of SSRO and SSRO plus LeFort I osteotomy (p>0.05). 3. According to the amounts of mandibular movement, the recovery of left lateral movement of the group of $6{\sim}10mm$ was better than the other groups (p<0.05). 4. In the frontal pattern of the opening and closing of the mandible, the complex deflected type (F5), simple deflected type (F4), complex deviated type (F3), simple deviated type (F2), straight type (F1) were obtained in order at the time of preoperative, simple deflected type, simple deviated type, complex deviated type, straight type, complex deflected type in order at the time of 1 month after surgery, and the result at the time of 6 months after surgery was the same with that of the time of preoperative. In the sagittal pattern, non-coincident type (S2) was predominant at the time of preoperative, and coincident type (S1) was predominant at the time of 1 month after surgery. After 6 months, the result was also the same with that of the preoperative in sagittal pattern. 5. There was not a statistical difference in the change of the mandibular movement between group of presence of the preoperative TMJ symptoms and non-presence group (p>0.05). 6. There was not a statistical difference in the change of the mandibular movement between repositioning device applied group and non-applied group (p>0.05). 7. Sixty three percents of the patients who had preoperative TMJ symptoms were improved after surgery and preoperative TMJ symptoms were more improved after operation in the repositioning device non-applied group statistically (p<0.05).

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The attrition pattern in Angle Class III malocclusion with facial astmmetry (안면비대칭을 동반한 Angle III급 부정교합자의 교모양상)

  • Son, Woo-Sung;Jeon, Eun-Ye;Kim, Sung-Jo
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.549-557
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    • 1997
  • This study was designed to investigate the attrition pattern in Angle Class III malocclusion with facial asymmetry. The sample consisted of three groups, the 20 subjects of normal occlusion group(Group I), the 12 subjects of class III malocclusion without facial asymmetry group(Group II) and 17 subjects of Class III malocclusion with facial asymmetry group(Group III). Attrition areas from canine to second molar on both sides in upper and lower arch, totally twenty, was marked by pencil and mesured by computer system(INTERGRAPH CO. USA) 2 times and the average value was used for date processing. Attrition areas from canine to second molar on both sides in upper and lower arch, totally twenty, was marked by pencil and mesured by computer system(INTERGRAPH CO. USA) 2 times and the average value was used for date Processing. All attrition areas were measured 2 times and the average value was used for data processing The data were statistically analyzed by SAS program. The results of this study were as follows. 1. Total attrition area in Group I was larger than in Group II and III. 2. There was no significant difference in attrition area between right and left side in each group, but attrition area in Group III was larger than in Group I and II. 3. In Group I, Maxillary attrition area was larger than mandibular attrition area, but in Group ll and III, there was no significant difference in attrition area between maxilla and mandible. 4. In Group III, the attrition area of deviated side was target than undeviated side 5. There was no significant difference in attrition area between chewing side and non-chewing side in each group. 6. The total attrition area was unaffected by gender.

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Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults (건강한 한국 성인남성의 자가약물복용력에 따른 간기능 장애 발생여부 조사)

  • Bae, Jong-Myon;Park, Byung-Joo;Lee, Moo-Song;Kim, Dong-Hyun;Shin, Myung-Hee;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.801-814
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    • 1996
  • Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.

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Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease (추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.122-127
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    • 2011
  • A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.

Improvement Way for Mobile X-ray Examinations by Rule Revision about Safety Management of Diagnosis Radiation Occurrence System (진단용방사선발생장치의 안전관리에 관한 규칙 개정에 따른 이동형 방사선검사의 개선방안)

  • Choi, Jun-Gu;Kim, Gyeong-Su;Kim, Byeong-Gi;Ahn, Nam-Jun;Kim, Hyeong-Sun;Kim, Sang-Geon;Lim, Si-Eun
    • Journal of radiological science and technology
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    • v.30 no.1
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    • pp.53-59
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    • 2007
  • A safety management rule of the diagnosis radiation system which opened a court 2006 February 10th was promulgated for safety of the radiation worker, patients and patients' family members. The purpose of this study is to minimize injury by radiation that can happen to patients and people around a sick ward when managing mobile X-ray system. This study analyzed sickroom environment of mobile X-ray examination and the statistical data of the Konkuk medical Information System(KIS) and the Picture Archiving Communication System(PACS). This study also investigated patient conditions, infection, relation information and related data, when the sickroom mobile X-ray examination is used. Through data analysis, many problems were expected such as restriction of space side, manpower and expense of business side, satisfaction degree decline of patient and protector of operation side. Therefore, we tried to restrict examination of multi bed sickroom, and to use treatment room in each ward to solve problem mentioned. As a result, the whole sickroom mobile X-ray examination rate decreased to near 50%, and mobile X-ray examination rate for inpatients decreased to more than 85%. This study shows that several attempts we did should be helpful for manpower, patients satisfaction and expenses. Also, they should protect patients in sickroom from unnecessary radiation exposure and could minimize inconvenience of patients and their family members from x-ray examination.

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Arthroscopic Decompression of Spinoglenoid Ganglion Cyst (견갑골 극관절와 결절종의 관절경하 감압술)

  • Hwang, Tae Hyok;Wang, Tae Hyun;Cho, Hyung Lae;Kim, Keun Young
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.92-98
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    • 2011
  • Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

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Complications Following and Supplementary Procedures for a Pancreas-preserving Total Gastrectomy (위 전절제술에서 췌장보존 비장적출술의 합병증 및 보완술식)

  • Lee, Moon Soo;Kang, Gil Ho;Cho, Gyu Seok;Kim, Yong Jin;Kim, Sung Yong;Baek, Moo Jun;Kim, Chang Ho;Cho, Moo Sik
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.31-37
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    • 2007
  • Purpose: A pancreas-preserving total gastrectomy (PPTG) was introduced to decrease the postoperative complications due to pancreatic resection. However, some complications, such as leakage of pancreatic juice, are still reported. Thus, the purpose of this study was to propose a supplementary procedure based on the results of treatment for gastric cancer at our hospital. Materials and Methods: From Jan. 1997 to Dec. 2004, the cases of 141 patients who underwent a PPTG for gastric cancer were reviewed retrospectively. The patients were divided into Group A (38 cases), patients who were treated using a conventional PPTG, and Group B (103 cases), patients who were treated using a new and improved PPTG. Their postoperative complications were compared. Results: No statistically significant differences in clinicopathologic data were noted between the two groups. The comparison of complications showed for groups A and B, respectively, 4 and 0 cases of pancreatic fistula, 1 and 0 cases of intraabdominal abscess, 2 and 0 cases of intraoperative pancreatic necrosis, and 2 and 2 cases of minor leakage. The difference in the prevalence of complications between the two groups was statistically significant (P=0.0001). Conclusion: In order to reduce the risk of PPTG-related complications, we used vascular clamps to observe the necrosis of the pancreatic tail before dividing the splenic artery, and this method resulted in a significant decrease in postoperative complications. Thus, we conclude that our use of vascular clamps in a PPTG is a simple and useful method for preventing postoperative complications.

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INFLUENCES OF DRY METHODS OF RETROCAVITY ON THE APICAL SEAL (치근단 역충전와동의 건조방법이 폐쇄성에 미치는 영향)

  • Lee, Jung-Tae;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.166-179
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    • 1999
  • Apical sealing is essential for the success of surgical endodontic treatment. Root-end cavity is apt to be contaminated with moisture or blood, and is not always easy to be dried completely. The purpose of this study was to evaluate the influence of dry methods of retrocavity on the apical seal in endodontic surgery. Apical seal was investigated through the evaluation of apical leakage and adaptation of filling material over the cavity wall. To investigate the influence of various dry methods on the apical leakage, 125 palatal roots of extracted human maxillary molar teeth were used. The clinical crown of each tooth was removed at 10 mm from the root apex using a slow-speed diamond saw and water spray. Root canals of the all the specimens were prepared with step-back technique and filled with gutta-percha by lateral condensation method. After removing of the coronal 2 mm of filling material, the access cavities were closed with Cavit$^{(R)}$. Two coats of nail polish were applied to the external surface of each root. Apical three millimeters of each root was resected perpendicular to the long axis of the root with a diamond saw. Class I retrograde cavities were prepared with ultrasonic instruments. Retrocavities were washed with physiologic saline solution and dried with various methods or contaminated with human blood. Retrocavities were filled either with IRM, Super EBA or composite resin. All the specimens were immersed in 2% methylene blue solution for 7 days in an incubator at $37^{\circ}C$. The teeth were dissolved in 14 ml of 35% nitric acid solution and the dye present within the root canal system was returned to solution. The leakage of dye was quantitatively measured via spectrophotometric method. The obtained data were analysed statistically using one-way ANOVA and Duncan's Multiple Range Test. To evaluate the influence of various dry methods on the adaptation of filling material over the cavity wall, 12 palatal roots of extracted human maxillary molar teeth were used. After all the roots were prepared and filled, and retrograde cavities were made and filled as above, roots were sectioned longitudinally. Filling-dentin interface of cut surfaces were examined by scanning electron microscope. The results were as follows: 1. Cavities dried with paper point or compressed air showed less leakage than those dried with cotton pellet in Super EBA filled cavity (p<0.05). However, there was no difference between paper point- and compressed air-dried cavities. 2. When cavities were dried with compressed air, dentin-bonded composite resin-filled cavities showed less apical leakage than IRM- or Super EBA-filled ones (p<0.05). 3. Regardless of the filling material, cavities contaminated with human blood showed significantly more apical leakage than those dried with compressed air after saline irrigation (p<0.05). 4. Outer half of the cavity showed larger dentin-filling interface gap than inner half did when cavities were filled with IRM or Super EBA. 5. In all the filling material groups, cavities contaminated with blood or dried with cotton pellets only showed larger defects at the base of the cavity than ones dried with paper points or compressed air.

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Economic and Political Responses to Globalization: Economic Restructuring and Local Government as an Entrepreneur (세계화에 따른 경제${\cdot}$정치적 동향: 경제재구조와 기업가로서의 지방정부)

  • Koh, Tae-Kyung
    • Journal of the Korean Geographical Society
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    • v.31 no.4
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    • pp.662-671
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    • 1996
  • Since the world's economic and political structures have changed, the term 'globlization' has shown up as a dominant power and as a necessity for regional and national development. Each nation is responding to the globalization process economically and politically in various ways. In general, however, the economic response to the globalization is economic restructuring from the Fordist industries to 'flexible specialization'. And the political response to the globalization is 'global localization' as a new type of local politics(i.e., local policy activism or growth-enhancing local development policies). The crisis of Fordism shifted the role of local governments towards more involovement with local economic development. Local governments are mobilizing for loca economic development, they are taken into a process of institutional change that tends to redefine their responsibilities inside the state. Local governments thus tend to act as an entrepreneur in order to restructure theiir local economies and to compete with other national and international regions. State restructuring towards enerepreneurialism and efficient regional policy pursuing a pro-growth coalition trategy is chosen as a new mode of regulation for the post-Fordism at the local level. The flexible specialization as the post-Fordist economy and the local government as an entrepreneur are the global choice for globalization and a post-Fordist society. The paper focuses on the regulation theory which comprises the political economic perspective on resturcturing. Economic restructuring and state restructuring will be discussed in detail. And the paper tries to combine the economic globalization and the global localization as economic and political responses to globalization.

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