• Title/Summary/Keyword: Outpatient surgery

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Angiomyoma on Face : A Case Report (안면부에 발생한 혈관근종의 치험례 : 증례보고)

  • Choi, Junho;Chang, Hak
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.48-50
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    • 2013
  • Angiomyoma is a rare, benign smooth muscle cell tumor. These tumors may be found anywhere in the body. They frequently occur in the lower extremities except venous type. Angiomyoma in the head and neck area is very rare, and only a few cases have been reported. A 63 year-old male patient visited to outpatient clinic due to size-growing nodule-like lesion in the Lt. alar area. Excisional biopsy was done for diagnosis. The lesion was totally excised with 2 mm safety margin. Frozen biopsy of the lesion was requested, and all resection margins were proved negative. To cover the raw surface, full thickness skin grafting was performed. The graft was harvested from Rt. posterior auricular area. Tie over dressing was applyed on Lt. alar area. The graft was well taken and healed without any complication in both short term and long term follow up periods of 2 weeks, 1 month, 2 months, and 6 months. Donor site completed healed without any complications. The leiomyoma is benign tumor originated from smooth muscle, and it can be classified into solid leiomyoma, angiomyoma, and epithelioid leiomyoma. Especially, the angiomyoma consists of smooth muscle cell and blood vessel, and it is originated from the tunica media of blood vessel. Angiomyoma alone frequently occurs in the lower extremities as solitary painless subcutaneous tumor. Venous type of angiomyoma in the oral cavity was reported in other references, but on the facial surface it may be the first case reported as paper. So this report can be very meaningful.

A Case of Lymphangioleiomyomatosis with Renal Angiomyolipoma (신장평활근종증을 동반한 폐임파관평활근종증 1례)

  • Kang, Soon-Bock;Park, Sung-Jin;Lee, Sang-Hoon;Jung, Do-Young;Yoo, Ji-Hoon;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Son, Dong-Sub;Kim, Mee-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.245-251
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    • 2001
  • Recently we have experienced one case of pulmonary lymphangioleiomyomatosis(LAM). A 49 year-old woman visited the outpatient department complaining of longstanding dyspnea, which was aggravated by exercise. Although the chest PA film showed nothing more than a slight increase in interstitial marking, a lung HRCT revealed multiple cystic lesions of a similar size that were scattered through out the whole field in both lungs. An abdominal CT detected an angiomyolipoma located in the midbody of the left kidney. Video-assisted thoracic surgery(VATS) was performed for the pathologic diagnosis. On gross examination of the biopsy lung, a pulmonary LAM was confirmed by a finding of smooth muscle proliferation in the interstitum of the lung. After the final diagnosis, oral medroxyprogesterone was prescribed and she is presently in a stable condition.

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The Necessity for a Trauma Surgeon and the Trauma Surgeon's Role in the Trauma Care System (외과의사 관점에서 외상전문의의 필요성과 과제)

  • Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.1-7
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    • 2008
  • When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor's specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

Evaluation of a Smart After-Care Program for Patients with Lung Cancer: A Prospective, Single-Arm Pilot Study

  • Yang, Hee Chul;Chung, Seung Hyun;Yoo, Ji Sung;Park, Boram;Kim, Moon Soo;Lee, Jong Mog
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.108-117
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    • 2022
  • Background: The efficacy of telemedicine among cancer survivors is uncertain. The Smart After-Care Program (SAP), which is an interactive, smartphone-based remote health monitoring system, was developed to help patients manage their health after leaving the hospital. This study was designed to evaluate the efficacy of our remote health care program for lung cancer patients. Methods: We enrolled 50 patients with lung cancer. Self-monitoring devices were supplied to all patients, who were instructed to enter their daily vital signs and subjective symptoms to the Smart After-Care app. The app also provided information about rehabilitation exercises and a healthy diet for lung cancer patients. All patients received health counseling via telephone once a week and visited an outpatient clinic during weeks 6 and 12 to assess satisfaction with the SAP and changes in quality of life and physical performance. Results: Overall satisfaction with the SAP was very high (very good, 61.9%; good, 26.2%). In the multivariate analysis to identify factors affecting satisfaction, the distance between the patient's residence and the hospital was the only significant independent factor (p=0.013). Quality of life improved along all functional scales (p<0.05). Muscle strength significantly improved in the lower limbs (p=0.012). Two-minute walk distance also significantly improved (p=0.028). Conclusion: This study demonstrated that the SAP was acceptable for and supportive of patients with reduced pulmonary function after lung cancer treatment. The SAP was found to be particularly useful for patients living far from the hospital.

Relationship between Readiness for Hospital Discharge and Self-care of Liver Transplant Recipients: A Single-center Prospective Study (간이식 환자의 퇴원 준비도와 자가간호와의 관계: 종단적 연구)

  • Park, SunBok;Choi, JiYeon;Joo, DongJin;Chu, SangHui
    • Journal of Korean Biological Nursing Science
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    • v.24 no.4
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    • pp.243-252
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    • 2022
  • Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p=.027), with fewer post-transplantation days (p=.027), absence of acute rejection (p=.004), or high self-efficacy (p<.001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β=0.29, p<.001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion: Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.

Rapid Detection of Streptococcus mutans Using an Integrated Microfluidic System with Loop-Mediated Isothermal Amplification

  • Jingfu Wang;Jingyi Wang;Xin Chang;Jin Shang;Yuehui Wang;Qin Ma;Liangliang Shen
    • Journal of Microbiology and Biotechnology
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    • v.33 no.8
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    • pp.1101-1110
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    • 2023
  • Streptococcus mutans is the primary causative agent of caries, which is one of the most common human diseases. Thus, rapid and early detection of cariogenic bacteria is critical for its prevention. This study investigated the combination of loop-mediated isothermal amplification (LAMP) and microfluid technology to quantitatively detect S. mutans. A low-cost, rapid microfluidic chip using LAMP technology was developed to amplify and detect bacteria at 2.2-2.2 × 106 colony-forming units (CFU)/ml and its detection limits were compared to those of standard polymerase chain reaction. A visualization system was established to quantitatively determine the experimental results, and a functional relationship between the bacterial concentration and quantitative results was established. The detection limit of S. mutans using this microfluidic chip was 2.2 CFU/ml, which was lower than that of the standard approach. After quantification, the experimental results showed a good linear relationship with the concentration of S. mutans, thereby confirming the effectiveness and accuracy of the custom-made integrated LAMP microfluidic system for the detection of S. mutans. The microfluidic system described herein may represent a promising simple detection method for the specific and rapid testing of individuals at risk of caries.

The Effect of Preoperative Guidance and Operating Room Environment Experience Using Virtual Reality on Satisfaction with Preoperative Information and Anxiety Reduction (가상현실을 이용한 수술 전 안내 및 수술실 환경 체험이 수술 전 정보만족도와 불안 감소에 미치는 효과)

  • Oh, In Ohg;Baek, Eunjeong;Jeong, Jiyun;Choi, Eunyoung;Kim, Jong-Hee;Kim, Chihyang
    • Journal of East-West Nursing Research
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    • v.30 no.1
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    • pp.51-59
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    • 2024
  • Purpose: The purpose of this study was to determine the effect of preoperative guidance and operating room environment experience using virtual reality on increasing satisfaction with information and reducing anxiety in preoperative patients undergoing general anesthesia and local anesthesia. Methods: A non-equivalent control group quasi-experimental design was employed. The participants were 80 surgical patients from 4 wards (40 experimental group and 40 control group) of the general hospital located in Gyeonggi-do. Data collection was conducted from June to November 2023 after completing the control group survey in January 2023. Data were analyzed using Chi-square, t-test, and Mann-Whitney U test using SPSS 23.0 program. Results: Satisfaction with preoperative information was higher in the experimental group than that of the control group. Additionally, anxiety related to surgery in the experimental group was significantly lower than that of the control group. The preoperative state anxiety score in the experimental group was not significantly lower than that of the control group. Conclusions: These results suggest that providing patient education and information using virtual reality technology can not only alleviate patients' anxiety related to surgery, but also have the potential to be used as an effective intervention to improve positive patient experiences.

Spontaneous Resolution of a Large Chronic Subdural Hematoma Which Required Surgical Decompression

  • Lee, Gun Seok;Park, Young Seok;Min, Kyung Soo;Lee, Mou Seop
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.301-303
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    • 2015
  • We report on a case of an 87-year-old woman who showed spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. She had suffered from confused mentality and right side weakness of motor grade II for 10 days. The initial brain CT scan showed a 22 mm thick low density lesion located in the left fronto-temporo-parietal region with midline shift (12 mm) which required emergency decompression. However, because she and her family did not want surgery, she was followed up in the outpatient clinic. Five months later, follow up brain CT showed that the CSDH had disappeared and the patient became neurologically normal. The reasons for spontaneous resolution of CSDH remain unclear. We discuss the possible relation between mechanisms of physio-pathogenesis and spontaneous resolution of a large chronic subdural hematoma (CSH) in an elderly patient.

Herpes Zoster Meningitis Confirmed by Detection of Varicella-Zoster Virus DNA Using the Polymerase Chain Reaction -A case report- (중합효소 연쇄반응을 이용한 Varicella-Zoster Virus DNA 검출로 확인된 대상포진 수막염 -증례 보고-)

  • Heo, Hu Man;Choi, Yu Sun;Park, Seong Kyu
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.210-213
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    • 2005
  • Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

Ileal epithelioid leiomyosarcoma with omental and peritoneal seeding (그물막과 복막파종을 동반한 회장의 상피양 평활근육종)

  • Kim, Chung-Hyoun;Kim, Sun-Young;Jung, Chang-Kil;Choi, Jung-Pil;Seo, Keum-Soo;Lee, Jun-Ho;Choi, Jae-Hyung
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.132-136
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    • 2017
  • Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.