• 제목/요약/키워드: Outpatient surgery

검색결과 269건 처리시간 0.026초

간이식 수혜자의 자가간호이행, 사회적 지지, 생리학적 지표 (Self-care, Social Support, and Biological Markers in Liver Transplant Recipients)

  • 김현경;최모나;김소선;김순일
    • 성인간호학회지
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    • 제27권2호
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    • pp.170-179
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    • 2015
  • Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.

Chondrosarcoma Apoplexy in Thoracic Spine

  • Kim, Sang Woo;Kim, Min Su;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.46-48
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    • 2013
  • Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

정신지체 환아의 치과치료를 위한 외래마취관리 -증례보고- (Anesthetic Management of a Mentally Retarded Child during Dental Treatment -A case report -)

  • 서광숙;구미숙;김현정;염광원
    • 대한치과마취과학회지
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    • 제5권1호
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    • pp.22-24
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    • 2005
  • General anesthesia is often required for mentally retarded children undergoing extensive dental treatment. We experienced a case of dental treatment under general anesthesia in a 14-year-old boy with mental retardation. He was treated on an outpatient basis. He was diagnosed of Noonan syndrome and received heart surgery when he was six years old. Induction using thiopental and vecuronium was uneventful and nasotracheal intubation were carried out. General anesthesia was maintained with sevoflurane for 2.5 hours. After monitoring the patient for 2 hours and confirming his recovery, he was discharged from the day care unit. In summary, we report this successful anesthetic management of a mentally retarded child during dental treatment in as an out-patient.

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정신지체와 만성신부전을 동반한 결절성경화증 환자의 전신마취 하 치과치료 (DENTAL TREATMENT OF A PATIENT WITH TUBEROUS SCLEROSIS ASSOCIATED WITH ESRD AND MENTAL RETARDATION UNDER GENERAL ANESTHESIA)

  • 서광석;이소영;백경원;김현정;염광원
    • 대한장애인치과학회지
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    • 제1권1호
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    • pp.33-36
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    • 2005
  • Manifestations in tuberous sclerosis such as seizure, mental retardation, end-stage renal disease (ESRD), and heart problems present a number of challenges to the dentist and anesthesiologist. Lack of cooperation in addition to the severe medical condition makes dental treatment more difficult. General anesthesia is often required for mentally and physically handicapped patients undergoing extensive dental treatment. We experienced a case of dental treatment under general anesthesia in a 36-year-old male patient with tuberous sclerosis associated with ESRD and mental retardation. He was treated on an outpatient basis followed by hemodialysis without any complications.

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Acute Urinary Retention in a 47-month-old Girl Caused by the Giant Fecaloma

  • Park, Ji Sook;Park, Tae-Jin;Hwa, Jung Seok;Seo, Ji-Hyun;Park, Chan-Hoo;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권3호
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    • pp.200-205
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    • 2013
  • We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration

  • Yu, Hyun Jeong;Park, Chan Jin;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • 제29권2호
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    • pp.129-135
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    • 2016
  • Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

갑상선절제술을 받은 갑상선암 환자의 질병증상, 질병인식, 대처와 삶의 질과의 관련성 (Associations of Illness Symptoms, Perception of Illness, and Coping with Quality of Life of Thyroid Cancer Patients after Thyroidectomy)

  • 현재원;송효정;최재혁
    • Journal of Korean Biological Nursing Science
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    • 제23권1호
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    • pp.83-90
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    • 2021
  • Purpose: To determine associations of illness symptoms, perception of illness, coping with quality of life (QOL) of thyroid cancer patients and identify factors affecting their QOL. Methods: A cross-sectional study was performed using a self-administered questionnaire for 111 thyroid cancer patients after thyroidectomy. They were recruited from the outpatient clinic of one university hospital. Data collection was conducted from August 2018 to November 2018. Results: The QOL was significantly associated with interpersonal coping (β= 0.31, p< .001), monthly household income (β= 0.30, p< .001), illness symptoms (β= -0.22, p= .017), perception of illness (β= -0.20, p= .031), and education (β= 0.18, p= .037) in stepwise multiple regression. These factors explained 33.1% of QOL of thyroid cancer patients. Conclusion: Interpersonal coping is a major contributing factor to QOL. Therefore, thyroid cancer patients need good interpersonal coping for better quality of life.

Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus

  • Yetiser, Sertac
    • Journal of Audiology & Otology
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    • 제25권1호
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    • pp.43-48
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    • 2021
  • Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus

  • Yetiser, Sertac
    • 대한청각학회지
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    • 제25권1호
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    • pp.43-48
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    • 2021
  • Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

  • Joo Kyung Kim;Jae Hee Cheon
    • Journal of Yeungnam Medical Science
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    • 제40권1호
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    • pp.37-48
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    • 2023
  • Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD. Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics. Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.