• 제목/요약/키워드: Inguinal

검색결과 279건 처리시간 0.022초

Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica

  • Kim, Jeong-Eun;Lee, Sang-Gon;Kim, Eun-Ju;Min, Byung-Woo;Ban, Jong-Suk;Lee, Ji-Hyang
    • The Korean Journal of Pain
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    • 제24권2호
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    • pp.115-118
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    • 2011
  • Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

2005년도 소아 서혜부 탈장치료 경향 (Trend (in 2005) of Repair of Inguinal Hernia in Children in Korea - A National Survey by the Korean Association of Pediatric Surgeons in 2005 -)

  • 김성민;김대연;김상윤;김성철;김우기;김재억;김재천;박귀원;서정민;송영택;오정탁;이남혁;이두선;전용순;정상영;정을삼;최금자;최순옥;한석주;허영수;홍정;최승훈
    • Advances in pediatric surgery
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    • 제12권2호
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    • pp.155-166
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    • 2006
  • Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.

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Partial transmission block 제작 시 real block과 MLC를 이용한 방법 중 효율적인 방법에 대한 고찰 (Partial transmission block production for real efficient method of block and MLC)

  • 최지민;박주영;주상규;안종호
    • 대한방사선치료학회지
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    • 제16권2호
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    • pp.19-24
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    • 2004
  • 목적 : Pelvis내에 존재하는 large lesion과 inguinal lymph node를 동시에 치료하고자 할때 femoral head에 과도한 선량을 피할 목적으로 partial transmission block(이하PTB)이 사용되어져 왔다. 그러나 field가 서로 overlap되거나 분리되는 문제를 해결하기 위한 다소 복잡하고 시간도 많이 걸리는 어려움이 있어 본 논문에서는 real block과 MLC를 이용하여 각각 PTB를 제작한 후 몇 가지 비교를 통하여 두 가지 중 실제 임상에 더 효율적으로 사용할 수 있는 방법을 연구하였다. 대상 및 방법 : 실제 치료 환자를 대상으로 디자인 된 PTB를 real block과 MLC를 이용하여 각각 제작한 뒤 아크릴 phantom으로 환자의 두께를 재현하고 치료 시와 동일한 조건으로 노광된 film을 획득하였다. field간에 overlap되는 부분과 분리되는 부분은 block을 미세 조장한 후 다시 촬영하였으며 오차가 1mm이내에 들어 올때까지 junction을 반복 tuning하였다. 두 block을 재현성, 제작 편의성, 제작 시간으로 나누어 비료 분석하였다. 재현성은 5회 반복 측정을 실시하였으며, 제작 편의성 및 제작 시간은 real block과 MLC가 각각 제작 시작 시간부터 완성되는 시점까지에 대하여 측정하였다. 결과 : PTB를 제작함에 있어서 real block과 MLC는 재현성 면에서는 유의할 만한 차이를 보이지 않았다. 그러나 제작 편의성에 있어서는 MLC가 junction tuning을 더 간편하게 수행 할 수 있었으며, 제작 시간 면에 있어서도 MLC가 real block에 비해 약$33\%$정도의 시간 절감 효과가 있음을 알 수 있었다. 결론 : PTB를 제작함에 있어서 real block과 MLC를 이용하는 것이 각각 장단점을 가지고 있으나 real block은 제작 편의성면에서 유연서이 떨어짐으로 각 fie의 junction을 tuning하는데 매우 어려움이 따름과 동시에 비교적 정확한 junction tuning을 시행할 수 있음을 알수 있었다. MLC특성상 발생되는 계단형태의 junction을 보완하여 PTB를 제작한다면 실제 임상에서 훨씬 간편하고 효율성 있는 업무를 수행할 수 있을 것으로 사료된다.

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1세 미만 여아 난소 탈장의 특성과 임상 경과 (Characteristics and Clinical Course of Ovarian Hernias in Infants)

  • 최경은;안소윤;김경아;고선영;이연경;신손문;한병희
    • Neonatal Medicine
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    • 제15권1호
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    • pp.80-83
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    • 2008
  • 목 적 : 서혜부 탈장은 소아에서 비교적 흔하지만, 여아 탈장의 15-31%를 차지하는 난소 탈장은 아직까지 정립된 치료 원칙이 없고 국내에서는 질병의 경과에 대한 보고가 없다. 이에 연구자들은 난소 탈장 환아들의 특성과 임상 경과에 대하여 알아보고자 하였다. 방 법 : 2001년 3월부터 2007년 2월까지 관동대학교의과대학 제일병원에서 난소 탈장으로 진단받은 1세미만 여아 8명을 대상으로 환아들의 재태 연령, 출생체중, 난소 탈장 발견시기와 주 호소, 수술 시기 및 수술법, 수술 후 합병증 여부, 현재의 상태, 서혜부 초음파결과를 의무기록지와 전화 통화를 통해 후향적으로 조사하였다. 난소 탈장은 서혜부 종괴 여부와 초음파 검사 결과 난소가 서혜부에 위치하는 경우에 진단하였다. 결 과 : 환아들의 재태 연령은 $32^{+5}-40^{+1}$주 범위였으며, 이 중 37주 미만 미숙아는 4명(50%)이고, 출생체중은 1,600-3,505 g 범위였다. 대상 환아 중 7명(87.5%)은 좌측 난소 탈장이 있었으며, 1명(12.5%)은 우측에 난소 탈장이 있었다. 종괴를 발견한 시기는 생후 13-144일 사이로 다양하였으며, 수술 받은 환아들의 수술시기는 생후 50${\pm}$15일(35-65일)이었다. 현재까지 8명중 5명이 탈장 봉합술을 시행 받았으며, 합병증은 없었다. 수술을 시행하지 않은 3명은 경과 관찰 중에 수술없이 저절로 정복되었으며, 종괴가 사라진 나이는 생후121${\pm}$46일(70-161일)이었고, 관찰 기간 중(69-1,925일)감돈이나 재발은 없었다. 결 론 : 미숙아 여아인 경우 탈장의 빈도가 만삭아에 비해 높으므로 신체 검진을 통한 대음순 종괴의 발견이 중요하며, 초음파 검사를 통하여 확진한다. 소아의 난소 탈장은 아직까지 일관된 치료 방침이 없고, 외과의 의견을 따라 가능한 한 빠른 시일 내에 수술을 시행하였었기에 경과를 제대로 알 수 없었으나, 저자들이 경과 관찰을 하던 3명의 여아에서 생후 6개월 이내에 난소탈장이 저절로 정복되는 예를 경험하였고, 관찰 기간동안 재발은 없었다. 난소 탈장의 환자를 대상으로 추적관찰을 하여 적절한 치료 방침을 마련하여야 하겠다.

한국형 진단명 기준 환자군(KDRG)별 간호수가 산정을 위한 간호행위 규명;9개 질환군을 대상으로 (Determination of Nursing Activities for Estimation of Nursing Fees Based on 9 KDRGs (Korean Diagnosis-Related Groups))

  • 이은영
    • 간호행정학회지
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    • 제5권3호
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    • pp.547-561
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    • 1999
  • The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

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소아서혜부탈장의 선택적 편대측 시험절개 (Selective Contralateral Exploration in Pediatric Inguinal Hernia)

  • 이명덕
    • Advances in pediatric surgery
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    • 제1권1호
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    • pp.18-26
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    • 1995
  • For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

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소아 서혜부 탈장환자에서 반대측에 대한 복강경 검사의 의의 (Laparoscopic Contralateral Exploration for Clinically Unidentified Patent Processus Vaginalis)

  • 박일경;목우균
    • Advances in pediatric surgery
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    • 제13권2호
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    • pp.194-202
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    • 2007
  • 저자들은 2000년 3월부터 2005년 9월까지, 건양대학교병원 외과에서 반대측에 대한 잔존 복막 초상돌기 개폐 여부를 복강경으로 확인한 환자 280명을 포함하여, 서혜부 탈장으로 고위 결찰술을 시행받은 만 15세 이하의 환자 601명을 대상으로 임상분석을 실시하여 다음과 같은 결과를 얻었다. 환자의 성비는 3.8:1로 남아에서 호발하였고, 진단 당시의 발생부위는 오른쪽이 57.7%, 좌측이 32.1%, 양측이 10.1%였으며, 복강경으로 반대측 잔존 복막 초상돌기를 확인한 군의 결과도 유사하였다. 복강경으로 복막 초상돌기의 개방을 확인한 결과, 1세 이하에서는 25%, 1세에서 5세 이하에서는 29%, 5세 이상에서는 18%로, 복막 초상돌기의 자연 폐쇄를 확인 할 수 없었다. 편측 서혜부 탈장 수술 후 반대측 탈장이 생긴 경우는 14명(2.5%)이었으며, 복강경으로 반대측 잔존 복강 초상돌기의 개폐 유무의 확인이 가능했던 2003년 3월 이후에는 발견되지 않았다. 추적 기간 중 반대측 탈장이 생긴 경우, 1세 이하에서 증상이 나타난 경우와, 첫 증상이 왼쪽에서 생겼을 때가 통계적으로 유의하였으며 이는 일반적인 반대측 탈장 발생의 고위험군과 일치하는 결과이다.

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흉벽에 발생한 Sparganosis;1례 보고 (A Case of Sparganosis in the Chest Wall)

  • 김상익
    • Journal of Chest Surgery
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    • 제25권11호
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    • pp.1240-1244
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    • 1992
  • Human sparganosis caused by Sparganum mansoni, the larval plerocercoid worm of the genus Spirometra, is not uncommon in Korea and is mostly found in subcutaneous or adipose tissue of the abdominal, thoracic wall and inguinal region, but is rarely found in the orbital cavity, brain and breast. It, at present, is a surgical disease because its diagnosis depends almost on the demonstration of the larva[e] from lesion or finding the worm section in surgical pathology specimens. We experienced a case of human sparganosis from a 48 years old woman who had a history of eating a raw frog. We report the case and review the related literatures.

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개에서 림프종의 2증례 (Lymphoma in Two Dogs)

  • 이기창;정주현;서민호;최호정;장동우;원성준;장진화;정우조;최을수
    • 한국임상수의학회지
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    • 제18권4호
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    • pp.482-486
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    • 2001
  • A seven year old dog with a history of vomiting for one month, icterus for one week yellowish urination for a few weeks, weight loss (1.5 kg loss/wk), and swelling of submandibular, prescapular, axillary, inguinal and popliteal lymph nodes and then a 3 year old dog with mild vomiting history and multifocal mass(neck, shoulder, mammary glands) were diagnosed as lymphoma by radiography, ultrasonography and ultrasound-guided fine needle aspiration and died all thereafter without any chemotherapeutical treatment.

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Canine Necropsy Dissection Procedures

  • Cho, Doo-Youn
    • 한국수의병리학회:학술대회논문집
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    • 한국수의병리학회 2002년도 추계학술대회초록집
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    • pp.81-85
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    • 2002
  • Dogs are laid on their left sides (Puppies may be placed on their back). 1. Lift the right forelimb, insert the knife in the axillary region, and cut its muscular attachment to thorax. Reflect the limb dorsally until it lays flat on the table. 2. Lift the right hindlimb, cut the inguinal area skin and the adductor muscles, and disarticulate the coxofemoral joint. Reflect the limb dorsally until it lays flat on the table. 3. A midline skin incision is made from the symphysis of the mandible to the anus, circumventing the umbilicus and male external genitalia. (omitted)

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