• Title/Summary/Keyword: 일반외과

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Treatment of Ankylosing Spondylitis (강직성 척추염의 치료)

  • Kang, Byeong-Jik;Jo, Sung-Sin;Park, Ye-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.294-304
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    • 2021
  • Ankylosing spondylitis causes ankylosis of the spine due to ossification of the articular cartilage and ligaments around the vertebral body as well as the sacroiliac joint. This pathophysiology limits joint movement and, in many cases, causes pain and deformity of the spine. If this disease is left untreated, it ultimately causes ankylosis and ossification of the whole-body joints. The symptoms generally develop before age 30 years, and the gradual progression of the disease adversely affects the physical function, professional ability, and quality of life. This increases the likelihood of developing psychiatric disorders, such as depression. The authors are aware of this severity and introduce recent trends and studies to prevent surgical treatment with various medications before systemic ossification. This paper presents various surgical treatments and complications in patients who were unable to prevent progression and underwent surgical treatment.

Spontaneous Resolution of Iatrogenic Calcinosis Cutis after Parenteral Calcium Gluconate Therapy in Neonates (신생아에서 비경구적 칼슘 글루코네이트 요법 이후의 의인성 피부 석회침착증 후 자연관해)

  • Song, Kwang Soon;Lee, Si Wook;Kim, Du-Han;Min, Kyung-Keun;Yon, Chang Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.192-196
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    • 2019
  • Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.

Length of stay in PACU among surgical patients using data mining technique (데이터 마이닝을 활용한 외과수술환자의 회복실 체류시간 분석)

  • Yoo, Je-Bog;Jang, Hee Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3400-3411
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    • 2013
  • The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

Implementation of Strength Estimation Algorithm on the Metallic Plate Fixation (금속고정용의 강도 평가 알고리즘 구현)

  • Kin, Jeong-Lae;Kim, Kyo-Ho;Lee, Ki-Young
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.9 no.3
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    • pp.45-54
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    • 2009
  • This study was developed the metallic plate for bone fixation in the neurosurgery and general surgery and plates has a finn place in bone operating and treatment. The plates can be realized to bending strength and stiffness for strength estimation. Maximum point of bending curves has a bending point(P) with maximum load which to applied nearly 0.2% offset displacement. The device's sizing has a ${\Phi}13$ and ${\Phi}18$, and algorithm of strength estimation compared a plate(${\Phi}13$, ${\Phi}18$, ${\Phi}13-{\Phi}18$). The bending strength of the curved metallic plate has to evaluate maximum of a 311N, 387N, 410N, 474N. When a displacement preserve with a load, tensile stress through to press a plate is 274N, 324N, 382N, 394N. The algorithm of strength estimation can be used to support estimation of bending strength and stiffness. Their tool bring to settlement in the new basic algorithm for evidence with varied adjustment.

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Job Analysis of the Staff Nurse in Cardiac Surgery Intensive Care Unit (심장외과 중환자실 일반간호사의 업무분석)

  • Ko, Yu-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.2
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    • pp.265-282
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    • 2003
  • Purpose : This study was conducted to provide for a basic resource, which can be used to set up a efficient management system in Cardiac Surgery Intensive Care Units(CSICU). Method: 1) Questionnaires were administered and observation methods were used, to examine the nursing activities performed in the CSICU after having reviewed related literatures and a review by the experts. Thus, the nursing activities were designating 254 activities and classified into 28 categories. 2)The 22 nurses in the 2 CSICUs filled out questionnaires about nursing activities from 12 April, 2002 to 17 April, 2002. The frequency of the nursing activities in the 28 categories counted and new nursing activities added by directly observing 12 nurses by two trained research staffs for 4 day. 3)In terms of validity, the 264 nursing activities were analysed by the 25 experts. As a result, 231 nursing activities were found valid and remained as appropriate nursing activities to be used for the careful analysis of the nursing activities in CSICUs. Result: The 22 categories are as below: assessment, monitoring, respiration management, nutrition management, elimination/drainage management, mobility management, sanitation management, safety management, temperature management, specimens collection, preparation and assistance of treatment, skin/wound management, infection management, medication management, education/support, dying patient care, recording/keeping, supplies management, environment management, communications, evaluations, professional development Conclusion : The manifest job description of the staff nurse will contribute to improving the efficiency of the nursing activities and to reducing the role conflicts among the medical staffs.

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Surgical Intensive Care Unit Patients' Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery (외과중환자실에 입실한 복부수술 환자의 수술 후 폐합병증 발생 위험요인에 대한 연구)

  • Joo, Soon Yeo;Kim, Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.1
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    • pp.32-41
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    • 2019
  • Purpose: The purpose of this study was to identify the risk factors for postoperative pulmonary complications (PPCs) after upper or lower abdominal digestive tract surgery. Methods: Participants in this retrospective observational study had undergone upper or lower digestive tract surgery and entered the surgical intensive care unit between March 1, 2016 and February 28, 2017. Data were collected from the medical records, operative records, results of laboratory test, and the nursing records of the hospitals. Results: Of the patients, 544 patients were enrolled in the study and PPCs -developed in 335 (61.6%) patients. On multivariate logistic regression analysis, significant risk factors of PPCs were identified: BMI (Body Mass Index; $kg/m^2$), preoperative serum BUN (Blood Urea Nitrogen; mg/dL), abdominal open surgery, or blood transfusion during operation. Conclusion: These risk factors could be used to help identify patients at risk for PPCs and then appropriate nursing interventions could be provided for patients at risk of PPCs.

Perianal Fistula: An Overview (항문주위 샛길의 개요)

  • Min Ju Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.565-585
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    • 2023
  • Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause serious morbidity and require surgical treatment due to a high risk of recurrence. MR imaging is a gold standard technique for the evaluation of perianal fistulas and provides accurate information on the anatomy of the anal canal, its relationship to the anal sphincter complex, accurate identification of secondary tracts or abscesses, and reporting associated complications. MR imaging can help monitor treatment effects and determine treatment methods. Crohn's disease-related fistulas often require medical rather than surgical treatment. The radiologist is required to know the anatomy and MR imaging findings of the perianal fistula to present an accurate diagnosis to the clinician.

Audit of Appropriateness of Fresh Frozen Plasma Transfusion (신선동결혈장의 적정수혈 분석)

  • Seo, Youkyung;Kim, Moon Jung;Kim, Sinyoung;Kim, Hyun Ok
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.136-144
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    • 2012
  • Background: Fresh frozen plasma (FFP) transfusion is administered primarily for management of acquired bleeding disorders. However, in practice, FFP transfusion is increasing without a solid rationale. Methods: We conducted an audit to evaluate the appropriateness of the indications for FFP transfusion during the period from July 2010 through June 2011. Assessment of the appropriateness of the indications was based on the national transfusion guidelines and the transfusion criteria promulgated by the Severance Hospital. Results: In total, 17,733 units of plasma were transfused to 1,949 patients over 4,982 events. We found that administration of FFP was not in compliance with the recommended guidelines in 1,990 events. The number of total FFP transfusions was higher in medical departments (Gastroenterology) than in surgical departments (Thoracic and cardiovascular surgery, General surgery). However, the proportion of cases of inappropriate transfusion was higher in surgical departments than in medical departments. Both the total number of FFP transfusion and the proportion of inappropriate transfusion were high in patient with neoplasm, disease of the digestive system, and diseases of the circulatory system. Conclusion: Continuous monitoring on appropriateness for FFP transfusion and feedback to the physician are critical in securing the transfusion safety as well as maintaining the quality of FFP transfusion. New-found indication for FFP transfusion should be investigated and applied in timely manner.

Stenosis of Individual Pulmonary Veins (개별 폐정맥의 협착)

  • Lee, Mira;Choi, Kil Soon;Kim, Nam Su;Yum, Myung Kul;Kim, Yong Joo;Sul, In Jun
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.610-614
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    • 2003
  • Pulmonary hypertension may be associated with variable conditions such as the hyperkinetic state or pulmonary vascular obstruction. In these, stenosis of the individual pulmonary veins without any cardiac or vascular malformation is very rare. We experienced stenosis of individual pulmonary veins in a 10 months old boy who was admitted with recurrent dyspnea and cyanosis and then underwent angiogram and a lung perfusion scan.

Factors Related to Surgical Site Infections in Patients Undergoing General Surgery (일반외과 환자의 수술부위 감염 관련 요인 분석)

  • Ahn You-Jin;Sohng Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.1
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    • pp.113-120
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    • 2005
  • Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.

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