• 대한정형외과 초음파학회지
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• 제6권2호
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• pp.94-100
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• 2013

근골격계 초음파는 방사선 노출에서 자유로우며, MRI 에 비해 저렴한 가격, 외래에서 쉽게 시술할 수 있는 접근성, 또한, 이학적 검사와 함께 병행하면서 검사의 정확성을 더 높일 수도 있는 독특한 장점을 가지고 있다. 스트레스 검사와 함께 동적으로 시행하는 초음파 검사는 건, 인대, 신경 등의 숨은 병변을 확인하는 데에 유용한 것으로 알려져 있다. 주관절 초음파는 관절면, 활액막 공간에 대한 검사, 외측 상과염, 내측 상과염 등의 건 관련 질환이나 말초 신경의 병적 상태에 대한 진단 및 초음파 유도하 전, 후방 점액낭 및 관절내 주사를 위해 외래에서 손쉽게 사용될 수 있다.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.242-246
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• 2001

Objective : The short hospitalization or outpatient care for patients undergoing laminectomy is not popular practice in Korea. We evaluated the clinical and economical significance of short hospitalization for patients undergoing microdiscectomy for their lumbar disc herniation. Material and Methods : From March 1999 to December 2000, patients were hospitalized for intended short period hospitalization for lumbar disc surgery. Their radiological and clinical data were analyzed for their clinical and economical results. We compared these data with 20 patients who hospitalized conventionally. Results : Total of 64 patients were evaluated. Three were lost to follow-up. Mean postoperative hospitalization period is 2.0 days(excluding one patient). Excellent to good outcome was achieved in 90.6 % of the patients. They payed about half expenses for hospitalization compared with conventional group. Their mean number of outpatient visit was 3.0. Conclusion : Short hospitalization for lumbar disc surgery is an acceptable option in Korea. It is also economically beneficial while achieving acceptable clinical results.

• 한국병원경영학회지
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• 제7권1호
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• pp.88-104
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• 2002

According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

• 대한후두음성언어의학회지
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• 제20권1호
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• pp.36-41
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• 2009

Background and Objectives: Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic. Methods: We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated. Results: Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III. Conclusion : Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.222-228
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• 2007

Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.

• Journal of Chest Surgery
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• 제52권3호
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• pp.162-164
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• 2019

A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient's father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient's respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.

• Journal of Chest Surgery
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• 제49권3호
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• pp.207-209
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• 2016

A 4-month-old boy diagnosed with acute myocarditis was treated with extracorporeal membrane oxygenation (ECMO). Follow-up echocardiography eight hours after ECMO revealed intracardiac thrombosis involving all four heart chambers. Because of the high risk of systemic embolization due to a pedunculated thrombus of the aortic valve, we performed an emergency thrombectomy. After the operation, the patient had a minor neurologic sequela of left upper arm hypertonia, which had almost disappeared at the last outpatient clinic two months later. He was diagnosed with a major mutation in MTHFR (methylenetetrahydrofolate reductase), which is related to thrombosis.

• Journal of Chest Surgery
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• 제44권4호
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• pp.285-287
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• 2011

A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.

• Journal of Chest Surgery
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• 제51권3호
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• pp.202-204
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• 2018

We report a case of high-output chylothorax associated with thrombo-occlusion of the superior vena cava (SVC) and left innominate vein (LIV) following an arterial switch operation in a neonate. The chylothorax was resolved by 3 weeks after surgical reconstruction of the SVC and LIV using fresh autologous pericardium. We confirmed the patency of the SVC and LIV with a 1-year follow-up computed tomographic scan at our outpatient clinic.

• 대한치과마취과학회지
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• 제7권2호
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• pp.126-130
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• 2007

Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.