• Title/Summary/Keyword: Abdominal Surgery Patients

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Therapeautic Exercise for Incontinece Patients (요실금 환자의 운동치료)

  • Park Don-Mork;Moon Hyang-Mee;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.183-193
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    • 1998
  • The Therapeutic pattern for the urinary incontinence in women should be chosen by means of the correct diagnosis. The therapeutic methods are various but drug therapy, electrical therapy and excercise therapy make the urinary incontinance be teated well, except some patient. This study carried out to investigate the therapeutic method fer urinary incontinence by the scope of excercise therapy. The excercise therapy demands the therapist of the correct diagnosis and evaluation. The patient should be Supine position not to increase the, abdominal pressure, and during the early excercise, the excercise should be applied by simple pattern to complex one. The change of position sod duration of therapy are to correspond with the sequels of patient and the patient has to abstrain from stimulant food such as coffee.

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Living Related Liver Transplantation in an Infant with Neonatal Hemochromatosis

  • Choi, Shin Jie;Choi, Jong Sub;Chun, Peter;Yoo, Jung Kyung;Moon, Jin Soo;Ko, Jae Sung;Kim, Woo Sun;Kang, Gyeong Hoon;Yi, Nam-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.2
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    • pp.147-151
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    • 2016
  • Neonatal hemochromatosis (NH) is a severe neonatal liver injury that is confirmed by extra-hepatic iron accumulation. Although a recent study described treating NH with exchange transfusions and intravenous immunoglobulin, liver transplantation should be considered for patients with severe liver failure that does not respond to other medical treatment. Herein, we report the case of a two-month-old female infant who presented with persistent ascites and hyperbilirubinemia. Her laboratory findings demonstrated severe coagulopathy, high indirect and direct bilirubin levels, and high ferritin levels. Abdominal magnetic resonance imaging presented low signal intensity in the liver on T2-weighted images, suggesting iron deposition. The infant was diagnosed with NH as a result of the clinical findings and after congenital infection and metabolic diseases were excluded. The infant was successfully treated with a living-donor liver transplantation. Living related liver transplantation should be considered as a treatment option for NH in infants.

Efficacy of Transdermal Piroxicam as Preemptive Analgesia (술후 제통에 사용된 Piroxicam 첩포의 선행진통효과)

  • Kook, Eun-Young;An, Yong-Mi;Lee, Cheol;Park, Cheon-Hee;Lee, Cheol-Seung;Kim, Won-Tae
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.70-74
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    • 1999
  • Background: Preemptive analgesia has been suggested recently as an another technique of postoperative pain control. Combination of low dose opioid and NSAIDs was used to lessen systemic opioid side effect, however, the use of NSAIDs may hinder their side effects in perioperative period. The local application of small dose at the target site can be effective without systemic effect. The aim of this study is evaluating the additive effect and side effect of transdermal piroxicam as preemptive adjuvant to intravenous nalbuphine on pain relief after major abdominal surgery. Methods: We reviewed the records of patients received piroxicam patch for preemptive analgesia before operation and compared it with control group. Two sheets of piroxicam patch to the skin incision site for 12 hours before operation were attached (Group 1, n=20) and no patch were applied (Group 2, n=20). Both groups were received nalbuphine continuously after operation using two days infuser (2 ml/hr) containing 80 mg (96 ml). Pain is evaluated by VAS score at each time; 30 min, 1, 6, 12, 24, 36, 48 hours after operation and side effects of NSAIDs were observed for 3days postoperatively. Results: There was no significant VAS score difference between two groups following time in progress. And no significant side effect was noted in both groups, either. Conclusion: There is no preemptive or synergistic analgesic effect of piroxicam patch attached at planned operation site before operation.

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Intralobar Pulmonary Sequestration Receiving Its Blood Supply from the Celiac Artery (복강 동맥에서 혈액 공급을 받는 엽내 폐 분리증 1예)

  • Jung, Ki-Hwan;Lee, Seung-Hwa;Lee, Ju-Han;Jo, Won-Min;Shin, Chol;Kim, Je-Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.6
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    • pp.358-362
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    • 2010
  • Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.

Effects of 37℃ Carbon Dioxide Pneumoperitoneum on Core Body Temperature, Systolic Blood Pressure, Heart Rate and Acid-Base Balance: A Randomized Double-blind Controlled Trial (복강경 수술에서 기복제 이산화탄소의 37℃ 가온이 수술 중 체온, 수축기압 및 심박동수와 산염기 균형에 미치는 영향)

  • Park, Jin il;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.76-85
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    • 2017
  • Purpose: The purpose of this study was to compare the effects of $21^{\circ}C\;CO_2$ and $37^{\circ}C\;CO_2$ pneumoperitoneum on body temperature, blood pressure, heart rate, and acid-base balance. Methods: Data were collected at a 1300-bed university hospital in Incheon, from February through September 2012. A total of 74 patients who underwent laparoscopic colectomy under general anesthesia with desflurane were randomly allocated to either a control group or an experimental group. The control group received $21^{\circ}C\;CO_2$ pneumoperitoneum; the experimental group received $37^{\circ}C\;CO_2$ pneumoperitoneum. The pneumoperitoneum of the two groups was under abdominal pressure 15 mmHg. Body temperature, systolic blood pressure, heart rate and acid-base balance were assessed at 30 minutes and 90 minutes after pneumoperitoneum, and again at 30 minutes after arriving at the Post Anesthesia Care Unit. Results: Body temperature in the $37^{\circ}C\;CO_2$ pneumoperitoneum group was significantly higher (F= 9.43, p< .001) compared to the $21^{\circ}C\;CO_2$ group. However, there were no statistically significant differences in systolic blood pressure (p= .895), heart rate (p= .340), pH (p= .231), PaCO2 (p= .490) and HCO3- (p= .768) between the two groups. Conclusion: Pneumoperitoneum of $37^{\circ}C\;CO_2$ is effective for the increase of body temperature compared to pneumoperitonium of $21^{\circ}C\;CO_2$, and it does not result in a decrease of blood pressure, heart rate or acid-base imbalance.

A Case of Primary Malignant Melanoma in the Mediastinum (종격동 종양이 주병소인 악성 흑색종 1예)

  • Koo, Bon-Sam;Jung, Yong-Seuk;Park, Hee-Bag;Ok, Cheol-Ho;Jang, Tae-Won;Jung, Man-Hong;Lee, Jae-Sung;Chun, Bong-Kwon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.409-413
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    • 1999
  • Malignant melanoma develops from the melanocyte and the most common primary site is skin, followed by mucosa and retina. Even though any other tissue where melanocytes reside could be the primary site of the malignant melanoma, the one developed in the mediastinum is rarely reported. We experienced a patients of 54 years old woman whose initial symptom was progressive dyspnea for one month, and proved to have the anterior mediastinal mass with pleural effusion and the small mass in the abdominal soft tissue. The needle aspiration biopsy from the mediastinal mass showed the consistent findings with malignant melanoma. We concluded the mediastinum was the primary site of the malignant melanoma of this patient because we couldn't find any other evidence of primary tumor in skin, oral and gastrointestinal mucosa, and retina. She has been treated with combined chemotherapy with dacarbazine, cisplatin and vinblastine. Her symptom was improved after chemotherapy and follow up chest CT after three cycles of chemotherapy showed the decreased tumor size in the mediastinum.

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Laparoscopic management of early primary peritoneal pregnancy: a case report

  • Koo, Hwa-Seon;Bae, Ju-Youn;Kang, Inn-Soo;Koong, Mi-Kyoung;Kim, Hye-Ok;Cha, Sun-Hwa;Choi, Min-Hye;Kim, Ji-Young;Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.2
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    • pp.109-114
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    • 2011
  • Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intrauterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

A Comparison of Patient-Controlled Analgesia and Conventional Intramuscular Opioid Regimen in Relation to their Post-Operative Pain Control and Side Effects (수술후 통증 관리의 Patient-Controlled Analgesia와 마약류의 전통적인 근육내 주사와의 비교)

  • Lee, Sang-Hun;Lee, Jin-Kyung;Lee, Kyn-Chang;Woo, Nam-Sik;Lee, Ye-Chul
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.55-59
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    • 1993
  • Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

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Effects of Early Oral Feeding versus Delayed Oral Feeding on Bowel Function, Gastrointestinal Complications and Surgical Recovery after Cesarean Section under Regional Anesthesia: Systematic Review and Meta-Analysis (부위마취로 제왕절개 수술을 받은 산모의 조기 경구섭취가 장 기능, 위장관 합병증 및 수술 후 회복에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, HyoJin;Jeon, YeongKyung;Yoon, SoYoung;Lee, GeumMoon
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.732-745
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    • 2021
  • Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

Measurements of the Hepatectomy Rate and Regeneration Rate Using Deep Learning in CT Scan of Living Donors (딥러닝을 이용한 CT 영상에서 생체 공여자의 간 절제율 및 재생률 측정)

  • Sae Byeol, Mun;Young Jae, Kim;Won-Suk, Lee;Kwang Gi, Kim
    • Journal of Biomedical Engineering Research
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    • v.43 no.6
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    • pp.434-440
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    • 2022
  • Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.