• Title/Summary/Keyword: Surgical practice

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Multiple intraosseous cervical pneumatocysts: A case report of a rare incidental finding on cone-beam computed tomography

  • Jadhav, Aniket B.;Sarah, Sangeetha Gajendran;Cederberg, Robert;Wagh, Aditya;Kiat-amnuay, Sudarat
    • Imaging Science in Dentistry
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    • v.48 no.3
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    • pp.223-226
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    • 2018
  • This report presents a case of cervical pneumatocysts as an incidental finding on cone-beam computed tomography. Pneumatocysts are gas-containing lesions of unknown etiology. They usually present in the ilium or sacrum, adjacent to the sacroiliac joint. In the literature, 21 case reports have described cervical pneumatocysts. Cervical pneumatocysts should be differentiated from other lesions, such as osteomyelitis, osteonecrosis, and neoplasms, as well as post-traumatic and post-surgical cases. Computed tomography, cone-beam computed tomography, and magnetic resonance imaging are appropriate tools to diagnose cervical pneumatocysts.

Evaluation of Nursing Outcomes among Advanced Practice Nurses in a Tertiary Hospital (분야별 전문간호사의 전문간호업무에 대한 성과 평가: 일개 병원을 중심으로)

  • Seol, Miee;Yi, Myoung Sun
    • Journal of Korean Critical Care Nursing
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    • v.5 no.2
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    • pp.37-48
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    • 2012
  • Purpose: The purpose of the study was to evaluate how advanced practice nurses (APNs) recognized their work by analyzing nursing outcomes. The ultimate goal was to examine the utility of APNs by connecting their work to the outcomes. Methods: Cross-sectional survey was conducted to collect the data from 59 APNs in a tertiary hospital lovated in Seoul, Korea. The questionnaire with 84 outcome indicators for advanced practice nurses was used. Descriptive statistics were used to analyze the data. Results: Among 84 outcome indicators, 11 indicators were associated with the work of APNs. Majority of these findings were included in the categories of clinical results and satisfaction. Items identified to be associated with the work of APNs were different among oncology nursing area, surgical speciality area, emergency care area, and critical care area. Conclusion: The results of the study indicated that the works of APNs were relevant to education/counseling/training and interpersonal relationship with other health professionals. The results of the study could be helpful to delineate the work characteristics of APNs and increase the utility of APNs in Korea where roles of APNs are not yet clearly delineated in most clinical settings.

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The Value and Limitations of Guidelines, Expert Consensus, and Registries on the Management of Patients with Thoracic Aortic Disease

  • Pacini, Davide;Murana, Giacomo;Leone, Alessandro;Marco, Luca Di;Pantaleo, Antonio
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.413-420
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    • 2016
  • Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

Current Status of Clinical Practice for Gastric Cancer Patients in Korea -A Nationwide Survey- (전국 위암 환자 진료 현황에 관한 설문조사 결과)

  • ;Yang Han-Kwang
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.95-108
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    • 2004
  • This nationwide survey was conducted to evaluate the current status of clinical practice for gastric cancer patients in Korea. The Information Committee of the Korean Gastric Cancer Association (KGCA) sent questionnaires containing 45 items about the preoperative diagnosis, medical and surgical treatment, and postoperative follow-up for gastric cancer patients to all 298 KGCA members in 108 institutes. Response rates were $32.6\%$ (97/298) for individuals and $59.3\%$ (64/108) for institutes. Most university hospitals responded (response rate of university hospitals: $71.6\%$, 48/67). The preoperative staging work up was performed primarily by abdominal CT, followed by bone scans, abdominal ultrasound, endoscopic ultrasound, and so on. Gastric cancer patients with stages II, III, and IV usually received adjuvant chemotherapy after a curative operation. About half of the surgeons regarded 2 cm as a safe resection margin in early gastric cancer and 5 cm in advanced gastric cancer. More than half of surgeons usually performed a D2 lymph node dissection in early gastric cancer and D2+$\alpha$ lymph node dissection in advanced gastric cancer. About $20\%$ of surgeons performed less invasive surgery and/or function-preserving surgery, such as a pylorus-preserving gastrectomy, a laparoscopic wedge resection, or a laparoscopy-assisted distal gastrectomy.

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The use of mobile computing devices in microsurgery

  • Pafitanis, Georgios;Hadjiandreou, Michalis;Miller, Robert;Mason, Katrina;Theodorakopoulou, Evgenia;Sadri, Amir;Taylor, Kirsten;Myers, Simon
    • Archives of Plastic Surgery
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    • v.46 no.2
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    • pp.102-107
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    • 2019
  • Mobile computing devices (MCDs), such as smartphones and tablets, are revolutionizing medical practice. These devices are almost universally available and offer a multitude of capabilities, including online features, streaming capabilities, high-quality cameras, and numerous applications. Within the surgical field, MCDs are increasingly being used for simulations. Microsurgery is an expanding field of surgery that presents unique challenges to both trainees and trainers. Simulation-based training and assessment in microsurgery currently play an integral role in the preparation of trainee surgeons in a safe and informative environment. MCDs address these challenges in a novel way by providing valuable adjuncts to microsurgical training, assessment, and clinical practice through low-cost, effective, and widely accessible solutions. Herein, we present a review of the capabilities, accessibility, and relevance of MCDs for technical skills acquisition, training, and clinical microsurgery practice, and consider the possibility of their wider use in the future of microsurgical training and education.

Development of a Clinical Nursing Practice Training Simulation Program using Standardized Patient for Nursing Students Focused on Infectious Respiratory

  • Hur, Jung
    • International Journal of Advanced Culture Technology
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    • v.9 no.4
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    • pp.169-179
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    • 2021
  • This study was conducted to develop and apply clinical nursing practice training simulation program using Standardized Patient for Nursing Students focused on infectious respiratory disease. This study is descriptive methodological study. Through prior consideration of documents and educational task of infectious respiratory disease was conducted with interview of clinical specialists of infection control managers. Development of educational task for infectious respiratory disease for Nursing Students went through the content validity. Finally, 10 educational tasks are developed 'knowledge of respiratory infections disease', 'hand washing', 'put on mask', 'lead to put on mask to patients and caregiver', 'intravenous injection via 3way', 'surgical aseptic technique', 'sterilization medical instrument', 'management of contaminated linen', 'infected personnel management manual'. The infectious respiratory disease simulation program was developed based on the ADDIE model and proceeded to 4 steps of analysis, design, development, implementation. The infection control education program included lectures (20 min), skill training (20 min), simulation using standardized patient (20 min), and debriefing (40 min), The collected data were analyzed by descriptive statistics with SPSS program for version 23.0. The results of this study confirmed that the clinical nursing practice training simulation program using standardized patients was effective in infectious respiratory disease of the nursing college students in knowledge of infectious respiratory disease and clinical nursing performance. we found this practical training program for nursing college students to improve knowledge and clinical competency of infection control. we expected that this developed program could be applied to practical training for various infectious control.

Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky-Kaban types and growth stages

  • Yang, Il-Hyung;Chung, Jee Hyeok;Yim, Sunjin;Cho, Il-Sik;Kim, Sukwha;Choi, Jin-Young;Lee, Jong-Ho;Kim, Myung-Jin;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.336-345
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    • 2020
  • Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky-Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx-Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx-Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky-Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky-Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky-Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

Clinical Practice Guidelines for the Medical and Surgical Management of Primary Intracerebral Hemorrhage in Korea

  • Kim, Jeong Eun;Ko, Sang-Bae;Kang, Hyun-Seung;Seo, Dae-Hee;Park, Sukh-Que;Sheen, Seung Hun;Park, Hyun Sun;Kang, Sung Don;Kim, Jae Min;Oh, Chang Wan;Hong, Keun-Sik;Yu, Kyung-Ho;Heo, Ji Hoe;Kwon, Sun-Uck;Bae, Hee-Joon;Lee, Byung-Chul;Yoon, Byung-Woo;Park, In Sung;Rha, Joung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.175-187
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    • 2014
  • The purpose of this clinical practice guideline (CPG) is to provide current and comprehensive recommendations for the medical and surgical management of primary intracerebral hemorrhage (ICH). Since the release of the first Korean CPGs for stroke, evidence has been accumulated in the management of ICH, such as intracranial pressure control and minimally invasive surgery, and it needs to be reflected in the updated version. The Quality Control Committee at the Korean Society of cerebrovascular Surgeons and the Writing Group at the Clinical Research Center for Stroke (CRCS) systematically reviewed relevant literature and major published guidelines between June 2007 and June 2013. Based on the published evidence, recommendations were synthesized, and the level of evidence and the grade of the recommendation were determined using the methods adapted from CRCS. A draft guideline was scrutinized by expert peer reviewers and also discussed at an expert consensus meeting until final agreement was achieved. CPGs based on scientific evidence are presented for the medical and surgical management of patients presenting with primary ICH. This CPG describes the current pertinent recommendations and suggests Korean recommendations for the medical and surgical management of a patient with primary ICH.

Development of Web-based Multimedia Contents for the Critical Care Practice of Nursing Students through Inter-College Collaboration (대학 간 통합 웹기반 중환자간호실습 콘텐츠 개발 및 적용)

  • So, Hyang-Sook;Bae, Yeong-Suk;Kim, Young-Ock;Kim, Su-Mi;Kang, Hee-Young;Choi, Ja-Yun;Yang, Jin-Ju;Kim, Nam-Young;Ko, Eun;Hwang, Seon-Young
    • Korean Journal of Adult Nursing
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    • v.20 no.5
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    • pp.778-790
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    • 2008
  • Purpose: This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. Methods: Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. Results: The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. Conclusion: The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

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Combined Orbital Fractures: Surgical Strategy of Sequential Repair

  • Hur, Su Won;Kim, Sung Eun;Chung, Kyu Jin;Lee, Jun Ho;Kim, Tae Gon;Kim, Yong-Ha
    • Archives of Plastic Surgery
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    • v.42 no.4
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    • pp.424-430
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    • 2015
  • Background Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. Methods We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. Results In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. Conclusions We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon.