• Title/Summary/Keyword: Day-surgery center

Search Result 377, Processing Time 0.031 seconds

Clinical Study for Ten Cases, who Complains Abdominal Pain after Surgery -Laparoscopic Gynecological Surgery- (부인과 질환관련 복강경 수술 후 발생한 복통 환자 10예의 임상적 고찰)

  • Lee, Ja-Young;Seung, Jun-Ho;Park, Young-Sun;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.22 no.3
    • /
    • pp.236-245
    • /
    • 2009
  • Purpose: The purpose of this study was to report the effect of TKM (Traditional Korean Medicine) to abdominal pain after laparoscopic gynecological surgery(LGS). Methods: 10 patients who visited the department of gynecology in OO medical center from 1st August 2007 to 31st December 2008 with abdominal pains after laparoscopic operation. They complained abdominal pain and other pains such as back pain, shoulder pain and vaginal bleeding etc. We treated patients with herb medicine, acupuncture and moxibustion treatment. The progress of signs and symptoms was evaluated by checking the change of visual analog scale(VAS). Results: The mean age was 45.1 years(range 38-49), parity 2(0-3) and previous abdominal surgery case was 5. The mean of hospital admitting day was 20 days(range 9- 51) and taken for reducing VAS 10 to 3 were 10 days(range 4-24). After taking TKM, patient's signs and symptoms were alleviated or resolved and Hb, Hct were increased. Conclusion: After laparoscopic gynecological surgery, patients had taken pain such as abdominal pain, shoulder pain, back pain etc. TKM treatment is effective on the recovery after laparoscopic surgery.

Clinical Experiences for Primary Cardiac Tumors (원발성 심장 종양의 임상적 고찰)

  • Yu Song Hyeon;Lim Sang Hyun;Yoo Kyung Jong;Park Young Hwan;Chang Byung Chul;Kang Meyun Shick;Hong You Sun
    • Journal of Chest Surgery
    • /
    • v.38 no.4 s.249
    • /
    • pp.301-307
    • /
    • 2005
  • Primary cardiac tumors are known to be rare. We studied the surgical results for primary cardiac tumors. Material and Method: Between August 1980 and December 2003, we classified 86 patients who had operation for primary cardiac tumors in our center into 3 groups; myxoma, nonmyxoma benign tumors, and malignant tumors. The mean age was $44.3\pm20.8$ years and 59 patients $(66.3\%)$ were female. In postoperative pathologic diagnosis, there were 81 cases $(94.2\%)$ of benign tumors in which myxoma was the most common tumor $(70\;cases,\;78.7\%);$ 5 fibroma $(5.6\%)$, 3 rhabdomyoma $(3.4\%)$, and 5 malignant tumors $(5.8\%)$. Result: $86.4\%$ of benign tumor was myxoma and the mean age was $50.4\pm15.4\;(range\;7\~80)$ years. Tumor was more common in females (49 cases) and most common preoperative symptom was dyspnea $(62.9\%)$. 57 cases were located at left atrial septum and only one case, which was located at right ventricular septum, was resected incompletely. There were no hospital deaths and one patient had mitral valve replacement on the first operative day due to newly developed postoperative mitral regurgitation. The mean follow up period was $109.3\pm71.8$ months and there was no evidence of recurrence in this period. 11 cases $(12.8\%)$ were non myxoma benign tumors; 5 fibromas, 3 rhabdo-myomas, etc. There were two hospital deaths and the causes of death were fungal endocarditis and hypoxia. There were no reoperations in nonmyxoma benign tumors. Malignant tumors were in 5 cases $(5.8\%);$ undifferentiated sarcoma in 2, rhabdomyosarcoma in 1, etc. Although there were no hospital mortalities, 3 patients who were followed up died from complications of tumors. Conclusion: Myxomas showed very excellent prognosis after complete resection and nonmyxoma benign tumors showed relatively good results for relief of symptoms. Surgery helped to relieve symptoms for malignant tumors, but the prognosis was poor.

Cutoff Values for Diagnosing Hepatic Steatosis Using Contemporary MRI-Proton Density Fat Fraction Measuring Methods

  • Sohee Park;Jae Hyun Kwon;So Yeon Kim;Ji Hun Kang;Jung Il Chung;Jong Keon Jang;Hye Young Jang;Ju Hyun Shim;Seung Soo Lee;Kyoung Won Kim;Gi-Won Song
    • Korean Journal of Radiology
    • /
    • v.23 no.12
    • /
    • pp.1260-1268
    • /
    • 2022
  • Objective: To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard. Materials and Methods: A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity > 90% and specificity > 90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set. Results: Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%). Conclusion: In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.

Evaluation of Backpain after Continuous Epidural Analgesia by Pressure Algometer (지속적 경막외진통법후 Pressure Algometer에 의한 요통의 평가)

  • Kwon, Young-Eun;Park, Seong-Hee;Kim, In-Ryeong;Lee, Jun-Hak;Lee, Ki-Nam;Moon, Jun-Il
    • The Korean Journal of Pain
    • /
    • v.9 no.2
    • /
    • pp.363-367
    • /
    • 1996
  • Background: Recently postoperative pain control with continuous epidural analgesia has been increased. This study aimes to evaluate backpain following continuous epidural analgesia by pressure threshold meter (algometer). Methods: After informed consent, 50 ASA physical status I or II patients undergoing elective gynecologic surgery were selected. After placing epidural catheter, patients received morphine 0.05mg/kg with 0.25% bupivacaine 5 ml followed by continuous infusion of 0.125% bupivacaine 100 ml with morphine 4 mg for 48 hours. backpain was measured by pressure algometer over lumbar paraspinalis at the L4 level, 5 and 7 cm from the midline on preoperative, operation day, 1st, 2nd, 3rd, and 4th postoperative days. Results: Postoperative mean pressure thresholds of were higher than preoperative value (p<0.05). Conclusion: The continuous epidural analgesia dose not provide or aggravate postoperative backpain, but it must be evaluated for long term follow-up.

  • PDF

Patient-Controlled Analgesia (PCA) for Post-operative Patients - A Study on Differences according to Who Controls the Analgesic (수술환자의 자가통증조절기 사용 방법에 관한 조사 연구)

  • Lee, Yoon-Young
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.14 no.3
    • /
    • pp.315-322
    • /
    • 2007
  • Purpose: The purpose of this study was to examine the effect of three kinds of modes using bolus button of PCA on level of pain and side effects of analgesic and amount of drug consumption in post-operative patients according to whether the medication is controlled by the patient, the caregiver or the nurse. Method: The participants were 684 patients using PCA after an operation. The data collection period was from March 19 to April 6, 2007. Results: It was found that there were statistical differences in gender, age, type of surgery, pain on first post-operative day, amount of drug consumption, nausea, and vomiting. The ratio for patient controlled medication was 55.7% for women, and 70.5% for men, and for care-giver controlled medication, 35.1% for women, and 20.0% for men. Average pain scores for the first post-operative day were $3.9{\pm}2.2$ for patient controlled medication and $4.5{\pm}2.3$ for care-giver controlled medication. There were statistical differences according to mode used for PCA for amount of drug consumptions, nausea and vomiting but not for pain, operation day or pruritus. Conclusion: This study was carried out to examine risks according to who controls the PCA for post-operative patients. The results can help to develop education program for everyone who is involved in PCA, patients, caregivers, nurses and doctors.

  • PDF

Rehabilitation of an Amur Leopard Cat (Prionailurus bengalensis) with Complex Injury by a Road Accident

  • Sungryong Kim;Sungin Lee;Ok-Joo Lim;Ki-Jeong Na;Dong-Hyuk Jeong
    • Journal of Veterinary Clinics
    • /
    • v.39 no.6
    • /
    • pp.411-416
    • /
    • 2022
  • A 2.2 kg adult female Amur leopard cat (Prionailurus bengalensis) injured in a road accident was rescued. Severe abrasions on the left chin were washed daily with an antiseptic and silver sulfadiazine ointment was applied. Corneal edema of the oculus sinister (OS) was treated with ofloxacin and 5% sodium chloride eye drops. The skin wounds gradually improved, but the eye condition did not improve and the lens was also found to be detached. In addition, on the 6th day of hospitalization, melena was observed. On radiographic examination, foreign bodies in the stomach and a fracture of the sternum were confirmed. Subsequently, endoscopic removal of foreign bodies and enucleation of the OS using an electrothermal vessel sealer were performed sequentially over several days. However, corrective surgery of the fractured sternum was not carried out because a natural union of the fracture had occurred, which was found to be fairly stable. The patient completely recovered on the 83rd day and was successfully released into the wild on the 97th day, after two weeks of adaptation training in a natural environment. This report describes the rehabilitation of a wild Amur leopard cat injured in a road accident through a series of diagnostic and treatment steps until its eventual return to the wild and highlights some improvements needed in the process.

The Outcome of Nutrition Support of Surgery Patients with Hypermetabolic Severity by Total Parenteral Nutrition and Enteral Nutrition and Biochemical Data (경장영양과 중시정맥영양을 공급받는 외과계 수술 환자의 과대사 정도에 따른 영양 섭취량 및 생화학적 검사 결과)

  • Rha Mi-Yong;Kim Eun-Mi;Cho Young-Y.;Seo Jeong-Meen;Choi Hay-Mie
    • Korean Journal of Community Nutrition
    • /
    • v.11 no.2
    • /
    • pp.289-297
    • /
    • 2006
  • This study evaluated the nutrition intake and changes in laboratory data of surgery patients with hypermetabolic severity on nutrition support. From January 2002 to September 2002, 66 hospitalized surgery patients who had received enteral nutrition (EN, n=19) and total parenteral nutrition (TPN, n=47) for more than 7 days were prospectively and retrospectively recruited. The laboratory data was examined pre-operatively, and on the post-operative 1, 3, 7 day and at the time of discharge. The characteristics of the patients were examined for the hypermetabolic severity, The hypermetabolic scores were determined by high fever ($>38^{\circ}C$), rapid breathing (>30 breaths/min), rapid pulse rate (>100 beats/min) , leukocytosis ($WBC>12,000/{\mu}l$), leukocytopenia ($WBC>3,000/{\mu}l$), status of infection, inflammatory bowel disease, surgery and trauma. The scores for the hypermetabolic status were divided into three groups (mild 0-10, moderate 11-40, severe>41). According to the results of the study, 38.3% (n=23), 45.4% (n=30) and 19.6% (n=13) were in the mild, moderate, and severe groups, respectively. There was a decrease in the serum albumin level and weight loss according to the hypermetabolic severity. However, the white blood cells (WBC), fasting blood sugar (FBS), c-reactive protein (CRP), total bilirubin, GOT, and GPT increased. The nutritional intake was TPN (32.5 kcal/kg, protein 1.2 g/kg, fat 0.25 g/kg), EN (28.1 kcal/kg, protein 1.0 g/kg, fat 1.01 g/kg). The serum albumin, hemoglobin and cholesterol were higher in the EN group than in the TPN group. But the FBS, total bilirubin, GOT and GPT were higher in the TPN group than the EN group. In conclusion, there was a negative correlation between the changes in the laboratory data and the hypermetabolic severity. There was an increase in the number of metabolic complications in the TPN group.

Experience with the Treatment of Patients with Major Trauma at the Department of Trauma Surgery in One Regional Emergency Medical Center for One Year (일개 외상외과에서의 중증외상환자 1년 치료 경험 분석)

  • Kim, Tae-Yoen;Jung, Kyoung-Won;Kwon, Jun-Sik;Kim, Ji-Young;Baek, Suk-Ja;Song, Seo-Young;Gang, Chan-Suk;Lee, Kug-Jong
    • Journal of Trauma and Injury
    • /
    • v.24 no.1
    • /
    • pp.37-44
    • /
    • 2011
  • Purpose: Recently, social interest in an organized trauma system for the treatment of patients has been increasing in government and academia and the establishment of trauma center is being considered across the country. However, establishing such a system has not been easy in Korea, because enormous experiences and resources are necessary. The objectives of this study were (1) to estimate a trauma patient's demands during the course of treatment and (2) to provide appropriate direction for trauma centers to be established in Korea. Methods: The records of 207 patients who were admitted to the Department of Trauma Surgery in Ajou University Medical Center due to trauma were retrospectively reviewed for a 1 year period from March 2010 to February 2011. Patients were reviewed for general characteristics, number of hospital days, numbers and kinds of surgeries, numbers and kinds of consultations, ISS (Injury Severity Score) and number of patients with ISS more than 15. Results: All 207 patients were enrolled. The average number of hospital days was 36.7 days. The ICU stay was 15.9 days, and the general ward stay was 20.8 days. Admitted patients occupied 9.02 beds in ICU and 11.80 beds in the general ward per day. The average number of surgeries per patient was 1.4, and surgery at the Department of Trauma Surgery was most common. Number of consultations per patient was 14.23, and consultations with orthopedic surgeons were most common. The average ISS was 18.6. The number of patients with ISS more than 15 was 141 (61.8%) and the average number of patients treated per trauma surgeon as a major trauma patient was 94.3. The number of mortalities was 20, and the mortality rate was 9.7%. Conclusion: To reduce mortality and to provide proper treatment of patients with major trauma, hospitals need some number of beds, especially in the ICU, to treat patients and to prepare them for emergent surgery. An appropriate number of trauma surgeons and various specialists for consultation are also needed.

The Effect of Modified Blalock-Taussig Shunt to Cyanotic Heart Disease (청색증 심장기형에 대한 Modified Blalock-Taussig shunt의 효과)

  • 김경렬
    • Journal of Chest Surgery
    • /
    • v.28 no.8
    • /
    • pp.754-758
    • /
    • 1995
  • Between February 1987 and April 1994,30 modified Blalock- Taussing shunts[MBTS were carried out at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Dongsan Medical Center.The operation consists of interposing between the subclavian artery and the pulmonary artery a polytetrafluoroethylene graft.There were 19 boys and 11 girls.The average age at the time of shunt construction was 14 months [range 4 days to 5 years .Seventy-six percent [23/30 were less than 1 year of age.Cardiac defects treated with MBTS included tetralogy of Fallot[10 , pulmonary atresia with ventricular septal defect[8 , pulmonary atresia with intact ventricular septum[4 , uni-ventricular heart[3 , and other complex cardiac anomalies[5 .Prosthesis of 4mm were used in 13 cases, and 5mm in 17.Of the 30 operations, 21 were performed on the right side and 9 on the left side.The hemoglobin level decreased from 21.1 gm/dl preoperatively to 16.3 gm/dl postoperatively and systemic oxygen saturation level increased from 60.5 % preoperatively to 85.4 % postoperatively.In the 30 patients who recieved MBTS, there were one early [3% and three late deaths [10% .Seven patients have had an corrective operation and two patient required second palliative procedure.The remaining patients are awaiting further operation with ingestion of aspirin [5 mg/kg/day as an antiplatelet agent.These results indicate that the MBTS provide excellent palliation at a low operative mortality for most patients.

  • PDF

Rotational Stability of AcrySof Toric Intraocular Lens Over Time: Influence of Capsulorhexis Contraction

  • Kim, Joong Hee;Cho, Kyong Jin
    • Medical Lasers
    • /
    • v.9 no.1
    • /
    • pp.44-50
    • /
    • 2020
  • Background and Objectives To evaluate the rotational stability of AcrySof toric intraocular lenses (IOL) by considering lapse of postoperative time and influence of capsulorhexis contraction. Materials and Methods A prospective, masked, single center study was conducted on 19 patients who had undergone microcoaxial cataract surgery and AcrySof toric IOL implantation. Slit-lamp retroillumination photographs of anterior segments were obtained from all patients after 1 week, 1 month and 3 months post-surgery. The degree of alteration of the postoperative IOL axis alignment and the amount of anterior capsular shrinkage were analyzed using Adobe Photoshop software. Results The mean degree of toric IOL axis misalignment was 2.18 (±20.2) degrees at 3 months follow-up. Quadrant analysis of the capsulorhexis aperture area at 1 week and 1 month post-operative, showed counterclockwise IOL rotation when the capsule contraction was dominant in the haptic part as well as clockwise rotation when dominant in the non-haptic part (p = 0.015). Conclusion The direction and degree of AcrySof toric IOL rotation differed throughout the follow-up period. Since most misalignments were found on the first post-operative day, physicians should try to minimize peri-operative risk factors that influence IOL rotation. There was also a correlation between the part of anterior capsule contraction and the direction of IOL rotation.