• 제목/요약/키워드: Operative findings

검색결과 410건 처리시간 0.027초

간질성 폐렴과 폐암수술 (Interstitial Pneumonia and Lung Cancer Surgery)

  • 사영조;왕영필;박재길
    • Journal of Chest Surgery
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    • 제39권4호
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    • pp.304-309
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    • 2006
  • 배경: 간질성 폐렴(IP)은 폐암의 발생과 깊은 관련이 있으나 수술 후 경과에 미치는 영향은 아직 밝혀진 바 없다. 본 연구의 목적은 술전 간질성 폐렴과 수술 후 급성 호흡부전의 발생과의 관련성을 알아보기 위한 것이다. 대상 및 방법: 1997년 1월부터 2005년 3월까지 가톨릭대학교 의과대학 부속병원에서 근치적 수술을 시행받은 원발성 폐암환자 672예를 대상으로 후향적인 검토를 시행하였다. 수술 전 흉부 HRCT소견이나 수술 표본의 병리조직 판독서에서 간질성 폐렴이 확인된 환자들을 간질성 폐렴(IP)군으로 구분하여, 비합병(non-IP)군과의 사이에 수술 전 검사치와 암 관련 사항들을 비교 분석하였다. 또한 IP군에서는 급성 호흡부전의 발생군과 비발생군 사이에서 급성 호흡부전의 발생에 영향을 줄 수 있는 상이점들을 분석하였다. 결과: 근치적 수술을 시행 받은 672예 중 28예(4.2%)에서 수술 후 급성 호흡부전증이 합병되었으며, 672예 중 수술 전에 IP의 동반이 확인되었던 증례는 53예(7.9%)였다. IP 동반례에서는 6예(11.3%)에서 수술 후 급성 호흡부전증이 합병되었으며, IP가 없었던 619예에서는 22예(3.6%)에서 합병되었다. 급성 호흡부전증의 합병환자 28예 중 21예에서 사망하여 사망률은 75%였다. 결론: 간질성 폐렴은 폐암 수술 후 급성 호흡부전의 발생과 관련이 있다고 생각되었다.

점진적 걷기프로그램이 폐절제술 환자의 신체활동량, 운동능력, 회복력 및 합병증 발생에 미치는 효과 (Effects of a Progressive Walking Program on Physical Activity, Exercise Tolerance, Recovery, and Post-Operative Complications in Patients with a Lung Resection)

  • 김인아;이해정
    • 대한간호학회지
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    • 제44권4호
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    • pp.381-390
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection. Methods: A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0. Results: A higher proportion of patients in the experimental group showed adequate levels of physical activity (p=.001), shorter period of chest tube retention (${\leq}7$ days; p=.011), and shorter stay in the hospital (${\leq}10$ days; p=.036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p=.032) and lower levels of dyspnea (p=.049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications. Conclusion: The findings of this study suggest that the PW could be a useful strategy for improving patients' post-operative health and reducing cost after lung resection.

식도에 발생한 거대 신경초종 (Giant esophageal schwannoma)

  • 김민재;송준철;김일;윤진탁;김영우;최영;주연호;강창현
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.21-24
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    • 2016
  • Esophageal schwannoma is a very rare submucosal tumor. We report successful management of esophageal schwannoma in a 41-year-old man who complained of progressively worsening dysphagia. A huge submucosal tumor was found via endoscopy and a chest computed tomography scan. Esophagectomy was performed with no post-operative complications. Post-operative immunohistochemistry staining showed a positive result for S-100 and negative results for c-kit and CD34. The post-operative mild dysphagia persisted, and the follow-up endoscopic findings revealed anastomosis site stenosis. Approximately 2 months later, we performed endoscopic balloon dilatation. We report herein a case of esophageal schwannoma with reviews.

제5 중족골 기저부 골절의 수술적 치료 (Operative Treatment of Fractures of the Fifth Metatarsal Base)

  • 서진수;김정훈;최준영
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.189-196
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    • 2008
  • Purpose: Nonunions and delayed unions are possible complications of fractures of fifth metatarsal base. We tried to report the results of the surgical treatment, which is not prevalent yet. Materials and Methods: Retrospective study of thirty nine patients undergoing operation at our institution between 2003 and 2008 was conducted. Six patients were excluded with loss of follow up before bony union, multiple trauma, pediatric fractures, stress fracture, open fracture. There were 18 males and 15 females with 45.1 years old mean age. The average follow-up period was 18.3 months. We used a midfoot scoring system of AOFAS for clinical assessment and radiologic findings to evaluate bony union, alignment. Results: According to Lawrence's classification, Zone 1 fractures were thirteen and Zone 2 were twenty. Average AOFAS score was 93.61. Conclusion: Early operative treatment with cannulated screw fixation in fractures of the fifth metatarsal base is thought to be an useful and easy treatment option with faster rates of union.

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관상동맥 우회수술의 조기성적 (술후 혈관조영술을 통한 분석) (Early Result of the Coronary artery Bypass Surgery (Analysis with the Postoperative Coronary artery Angiography))

  • 류경민;김삼현;박성식;류재옥;서필원
    • Journal of Chest Surgery
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    • 제33권6호
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    • pp.487-493
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    • 2000
  • Background: Early patency of the coronary artery bypass grafting is determined mainly by surgical technique and status of coronary artery. We analyzed the early result, focusing on the relationship between postoperative angiographic findings and the patency rate. Material and method: During the period of July 1997- August 1999, 86 cases of CABG were performed and the postoperative coronary artery angiography was done in 76 cases on postoperative day 7 to assess the graft patency. Result: Overall graft patency was 90.2% on the angiographic finding. Factors influencing the early graft occlusion were the surgeon's experience, small coronary artery size less than 1.5mm in diameter, coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site(p<0.001). Operative mortailty was 2.3%. Early recurrence of the symptom was 19.8% during the follow up period. Conclusion: We examined the postoperative coronary angiography and found that the surgeon's experience, small coronary artery size less than 1.5mm in diameter, bypass surgery on the coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site were the factors for the graft occlusion.

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전방십자인대 재건술 환자에 대한 비손상측과 손상측 간의 하지 근수축 특성 비교 (Comparison of the Muscle Contractile Properties on Lower Extremity Between Non-injury and Injury in Subjects with Anterior Cruciate Ligament Reconstruction)

  • 김한일;서영준;김영명
    • 대한정형도수물리치료학회지
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    • 제24권1호
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    • pp.31-37
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    • 2018
  • Background: The purpose of this study was to identify the comparison of the muscle contractile properties on lower extremity between non-injury and injury in subjects with anterior cruciate ligament reconstruction (ACLR). Methods: Twenty-four subjects on the post-operative ACLR participated in this study. Measurement method were using tensiomygraphy to analyze the displacement maximum(Dm) and contraction time(Tc) on the both quadriceps. Results: Compared difference of the Dm between non-injury and injury, the rectus femoris (RF) and vastus lateralis (VL) increased significantly (p<.01). However, vastus medialis (VM) no significantly difference between non-injury and injury. Compared difference of the Tc between non-injury and injury, the RF increased significantly (p<.01) but VL and VM no significantly difference between non-injury and injury. Conclusions: These findings suggest that occurred muscle atrophy of the RF and VL and change properties of muscle fibers on the RF from fast muscle fibers to slow muscle fibers on the injury side of post-operative ACLR. Therefore, when apply to rehabilitation of lower extremity for post-operative ACLR, we should consider the enhance of RF and VL on injury side.

수술 후 재활 사례에 적용한 임상 판단력 평가도구의 신뢰도 및 타당도 (Reliability and Validity of the Clinical Judgment Rubric on Simulation Practice with a Post-operative Rehabilitation Case)

  • 오혜경
    • 재활간호학회지
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    • 제18권2호
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    • pp.145-152
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    • 2015
  • Purpose: The purpose of this study was to evaluate the reliability and validity of the clinical judgement rubric on simulation practice with a post-operative rehabilitation case. Methods: Methodological study design was used to evaluate the reliability and validity of the clinical judgement rubric on simulation practice. The participants were 35 students in a college of nursing. Results: There were showed reliability and validity of the clinical judgement rubric on simulation practice with a post-operative rehabilitation case. In terms of internal consistency, the Cronbach's ${\alpha}$ for all columns was .821. Factor analysis showed that planning, intervention and evaluation domains with Eigen values of 69.87% were bound, unlike the original tool where four factors including noticing, interpretation, responding and reflecting domains were bound. Convergent validity was established by the correlation between the total clinical judgement score and critical thinking disposition before and after simulation practice. Discriminative validity was established by the correlation between the total clinical judgement score and simulation effectiveness score. Conclusion: The findings of this study suggested that clinical judgement rubric on simulation practice is reliable. Repeated studies are needed to objectively evaluate the clinical judgement rubric of simulation practice for applying various clinical situations.

수술 전 뇌조신티그라피에 의해 치료방침을 결정한 경막하 수활액낭종 1례 (Preoperative Cisternoscintigraphy As a Guide to Therapeutic Decision Making for Cystic Subdurnl Hygroma: Case Report)

  • 김성민;범희승;송호천;민정준;정환정;김지열
    • 대한핵의학회지
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    • 제34권4호
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    • pp.366-369
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    • 2000
  • We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.

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Mynol cement에 대한 치근단주위조직 반응에 관한 연구 (Periapical Tissue Reactions to Root Canal Filling with Mynol Cement)

  • 박상진
    • 대한치과의사협회지
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    • 제21권2호통권165호
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    • pp.167-172
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    • 1983
  • This study was to investigate the effects of mynol cement on the periapical tissues of 40 molars in ten dogs. Root canal fillings were placed with mynol cement and the animals were killed at different post operative periods ranging from 1 to 5 weeks. The teeth examined on the basis of microscipic findings. The following results may be drawn; 1. 1 week after root canal fillings, the necrosis of cementum and dentin including alveolar bone was to be seen. There were severe inflammatory changes in the periodontal ligament. 2. 2 weeks after root canal fillings, edematous changes and fibrosis in the periodontal ligament were revealed. 3. After 3-4 weeks, fibrosis was more prominent than 2 weeks. 4. 5 weeks after root canal fillings, the osteoblastic activity was found abundantly surrounding the alveolar bone.

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특발성 비후성 대동맥판하 협착증의 수술적 치험 1례 보 (Surgical Experience of Idiopathic Hypertrophic Subaortic Stenosis - Report of A case -)

  • 강경훈
    • Journal of Chest Surgery
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    • 제20권3호
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    • pp.610-618
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    • 1987
  • A 23-y-o male patient was suffered from intermittent fainting and dyspnea on exertion [NYHA Class IIIIV]. 2-D - Echocardiogram and cardiac catheterization with cineangiogram showed typical IHSS findings those were asymmetrical septal hypertrophy [ASH], systolic anterior motion of anterior mitral leaflet [SAM] which induced mild mitral regurgitation [Seller Grade I/IV] and pressure gradient about 60 mmHg between left ventricle and the aorta. Medical treatment with 8-adrenergic blockade [propranolol] and Ca" channel antagonist [Verapamil] had no response. So, we performed trans-aortic ventricular septal myotomy and mymectomy. Resected rectangular muscle bar was 1 Cm x 1 Cm x 4.5 Cm. Post-operative pressure gradient between the left ventricle and the aorta was less than 10 mmHg and SAM. was disappeared with decreased mitral regurgitation grade. Post-operative course was smooth and his symptoms and signs were free without any medication during 12 months follow-up.w-up.

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