• Title/Summary/Keyword: Surgical result

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Surgical Experience of the Kasabach-Merritt Syndrome (Kasabach-Merritt 증후군의 수술적 치험례)

  • Bae, Joon Sung;Choi, Yun Seok;Lim, Jin Soo
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.648-652
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    • 2005
  • In 1940, Kasabach and Merritt first described the association of a large vascular tumor and thrombocytopenia and termed this Kasabach-Merritt(KM) syndrome. It is characterized by a rapidly enlarging vascular anomaly and consumptive coagulopathy with thrombocytopenia, prolonged prothrombin time and partial thromboplastin time, hypofibrinogenemia, and the presence of D-dimer and fibrin split product, with or without microangiopathic hemolytic anemia. This is a potentially life-threatening condition with mortality rates from 20 to 30% as a result of severe sepsis, coagulopathy, or invasion of vital organs. Treatment modalities are corticosteroids, interferon alfa-2a or 2b, chemotherapy(vincristine, cyclophosphamide, etc.), aspirin, dipyridamole, com- pression, radiation therapy, embolization of feeding vessels and surgical excision. A standard treatment regimen for KM syndrome has not been established and most reports on definitive management of these complex vascular lesions have been anecdotal, involving small numbers of patients. The authors have successfully treated a patient of KM syndrome with actively bleeding huge hemangioma by surgical excision. They present it with the review of articles.

A Study on Modeling Index Literatures and Index Techniques for Establishing DB of Korean Acupuncture, Moxibustion and Surgical Techniques (한국 침구외과 지표기술 및 지표문헌 DB 구축을 위한 범위 설정과 모델링 연구 - 침구기법과 외과적 수기법을 중심으로 -)

  • Cha, Wung-Seok;Kim, Min-Seon;Kim, Dong-Ryul;Ahn, Sang-Woo
    • The Journal of Korean Medical History
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    • v.28 no.2
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    • pp.73-85
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    • 2015
  • This paper is the result of a research conducted for "Knowledge Resource Development by Excavation and preservation and DB Establishment of Traditional Home Remedy", a part of Korean Medicine knowledge infrastructure establishment and Korean Medicine therapy development project executed by Korea Institute of Oriental Medicine. This paper is a part of the plans to standardize Korean acupuncture and moxibustion and surgical techniques in order to make new techniques derived from Korean traditional medicine patentable, as presented in the Nagoya Protocol. By first reviewing traditional text sources and classifying them into index literature and index techniques, we can see a mutual relationship between these two categories. Based on current research papers, this study has established a total of 121 pieces of index literature as well as extracted 64 types of index techniques in acupuncture and surgery technique. Both index literature and index technique have been concurrently visualized in this paper in the "Korean Acupuncture & Moxibustion Technique and Surgical Manipulation Base Map".

Arachnoid Remodeling by Clipping Technique Facilitates Surgical Maneuverability during Transsphenoidal Surgery for Pituitary Macroadenoma

  • Kim, Eui Hyun;Park, Soo Jeong;Na, Minkyun;Moon, Ju Hyung;Kim, Sun Ho
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.591-597
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    • 2022
  • Objective : Pituitary adenomas frequently extend into the suprasellar space. After a suprasellar tumor is removed, the superiorly extended arachnoid becomes redundant and sinks down into the intrasellar space which often hiders visualization and accessibility to the hidden space behind the evaginated arachnoid. We introduced arachnoid remodeling by clipping technique, and evaluated its usefulness and safety during TSS. Methods : Total 223 patients who underwent arachnoid remodeling with our new clipping technique were included. Redundant arachnoid was clipped along the dural edge with multiple 2.6-mm titanium clips until the redundant arachnoid membrane no longer blocked the surgical route. To check for possible deterioration of hormonal function by this technique, we assessed anterior pituitary function of 166 patients who underwent arachnoid remodeling by clipping and compared this with those of other 429 control patients. Results : Our technique greatly enhanced the accessibility and visualization of intrasellar and parasellar spaces, both of which are generally hindered by redundant arachnoid during transsphenoidal surgery (TSS). We found no difference in anterior pituitary function between a clip-assisted arachnoid remodeling group and the control group, implying that this technique does not result in hypopituitarism. Conclusion : During TSS for pituitary adenomas with suprasellar extension, arachnoid remodeling by clipping technique is very useful and convenient for the management of the redundant arachnoid membrane to enhance visualization and surgical accessibility.

Comparison of Effects of Non-surgical Continuous and Intermittent Traction on Pain, Balance and Physical Function in the Treatment of Knee Osteoarthritis

  • Lee, Dong-Kyu;Jeong, Jin-Gyu
    • The Journal of Korean Physical Therapy
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    • v.32 no.6
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    • pp.348-353
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    • 2020
  • Purpose: This study examined the comparison of effects of non-surgical continuous and intermittent traction on pain, balance and physical function in the treatment of knee osteoarthritis. Methods: A total of 30 knee osteoarthritis patients were recruited and randomized to a continuous traction group (n=10), an intermittent traction group (n=10), and a control group (n=10). The continuous traction group and intermittent traction group received a non-surgical continuous and intermittent knee joint traction workout five times a week, for 4 weeks. All subjects were assessed with the numeric rating scale (NRS), timed up and go test (TUGT), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and after the 4-week treatment. Results: As a result of comparison within groups, the continuous traction group, intermittent traction group, and control group showed a significant difference for NRS, TUGT, and WOMAC after the experiment (p<0.05). According to the comparison of the three groups, the continuous traction group showed a more effectively significant difference than the intermittent traction group and the control group in the balance and physical functions before and after the experiment (p<0.05). Conclusion: This study showed that non-surgical continuous traction treatment was effective in improving pain, balance ability, and physical function in knee osteoarthritis patients.

The Effects of the Short Message Service Informing Patients' Operation Status on the Family Members' Nursing Satisfaction (SMS를 활용한 수술진행 정보제공이 간호요구 만족도에 미치는 효과)

  • Yun, Jae Hyoen;Kim, Yeong Kyeong
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.2
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    • pp.85-93
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    • 2010
  • Purpose: The purpose of this study was to investigate the effect of the SMS(Short Message Service) informing patients' surgical operation status to his or her family members on their nursing satisfaction. Methods: A non-equivalent control group non-synchronized design was used. The subjects were the family members of patients underwent spine surgery operation at a general hospital in B city. Twenty five subjects in the experimental group received SMS services whereas the other twenty five subjects in the control group received no intervention. Results: There was a significant difference in the level of nursing satisfaction in the experimental group compared to that of the control group(t=7.14, p=.001). Conclusion: The result above indicates that the level of nursing satisfaction of family members of the patients under surgical operation can be raised by providing SMS informing surgical operational status during the operation. This finding leads to the conclusion that such information service can be used as one of the efficient interventions for improving patient and family satisfactions with nursing care in a surgical unit.

Prevention and treatment of microstomia

  • Sae Hwi Ki;Tae Jun Park
    • Archives of Craniofacial Surgery
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    • v.25 no.3
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    • pp.105-115
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    • 2024
  • The mouth, located in the lower third of the face, is a uniquely visible structure. It serves as a vital organ both aesthetically and functionally, playing a key role in speech, expression, and fundamental oral functions. Consequently, any alterations or defects in its shape, due to various causes, can lead to aesthetic and functional deficiencies. These issues may also result in challenges with social interactions and a decrease in confidence. In cases of microstomia, various surgical approaches are proposed based on the location, extent, shape, and cause of the defect, leading to numerous case reports. Plastic surgeons are proficient in oral reconstruction; however, cases of microstomia are relatively rare, which reduces their familiarity and interest in these cases. Additionally, preferences for oral size and shape vary according to factors such as geographical region and ethnicity, further complicating the functional definition of microstomia. Therefore, both subjective patient and physician judgments play crucial roles in the diagnosis and treatment of microstomia, as these may vary depending on individual and societal aspects. This review aims to classify the various causes and definitions of microstomia, as well as its non-surgical and surgical treatment options, with the goal of the treatment of this condition.

Literature Review of Postoperative Delirium in Geriatric Patients After Elective Gastrointestinal Cancer Surgery

  • Park, Da-In;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.20 no.3
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    • pp.177-186
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    • 2018
  • Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.

Surgical Treatment for Acute, Severe Brain Infarction

  • Park, Je-On;Park, Dong-Hyuk;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.326-330
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    • 2007
  • Objective : Stroke is the most prevalent disease involving the central nervous system. Since medical modalities are sometimes ineffective for the acute edema following massive infarction, surgical decompression may be an effective option when medical treatments fail. The present study was undertaken to assess the outcome and prognostic factors of decompressive surgery in life threatening acute, severe, brain infarction. Methods : We retrospectively analyzed twenty-six patients (17 males and 9 females; average age, 49.7yrs) who underwent decompressive surgery for severe cerebral or cerebellar infarction from January 2003 to December 2006. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : Of the 26 patients, 5 (19.2%) showed good recovery, 5 (19.2%) showed moderate disability, 2 (7.7%) severe disability, 6 (23.1%) persistent experienced vegetative state, and 8 (30.8%) death. In this study, the surgical decompression improved outcome for cerebellar infarction, but decompressive surgery did not show a good result for MCA infarction (30.8% overall mortality vs 100% mortality). The dominant-hemisphere infarcts showed worse prognosis, compared with nondominant-hemisphere infarcts (54.5% vs 70%). Poor prognostic factors were diabetes mellitus, dominant-hemisphere infarcts and low preoperative Glasgow Coma Scale (GCS) score. Conclusion : The patients who exhibit clinical deterioration despite aggressive medical management following severe cerebral infarction should be considered for decompressive surgery. For better outcome, prompt surgical treatment is mandatory. We recommend that patients with severe cerebral infarction should be referred to neurosurgical department primarily in emergency setting or as early as possible for such prompt surgical treatment.

Surgical Site Infection Rates according to Patient Risk Index after General Surgery (일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률)

  • Lee, Hye-Ryeong
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.1
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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Comparison of Surgical Hand Scrub Formulations and Scrub Methods for Antimicrobial Efficacy (손 소독제 및 소독방법에 따른 외과적 손 소독 효과)

  • Kim, Myoung-Sook;Kim, Kyoung-Ja;Shin, Young-Ran;Park, Kwang-Ok;Mun, Hyang-Mi;Jeong, Jae-Sim;Kim, Mi-Na
    • Journal of Korean Biological Nursing Science
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    • v.9 no.2
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    • pp.118-124
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    • 2007
  • Purpose: The purpose of this study was to compare three surgical scrub methods-4% chlorhexidine gluconate(CHG) with brush, 4% CHG without brush, and waterless scrub using 1% CHG and 61% ethanol combination(alcohol-based agent)-for antimicrobial efficacy. Method: "Glove-juice technique" was used to evaluate microbial hand counts before surgical scrubs, 1 min and 3 hr after surgical scrubs. Result: Waterless scrub using CHG and ethanol combination resulted in a 4.8-log reduction at 1 min and 4.0-log reduction at 3 hr. CHG without brush resulted in a 4.7-log reduction at 1 min and 3.3-log reduction at 3 hr. The traditional scrub using CHG with brush resulted in a 3.6-log reduction at 1 min and 0.8-log reduction at 3 hr. The waterless scrub and CHG without brush showed significantly higher log reduction(p<.05) than CHG with brush at 1 min and 3 hr after surgical scrub. Waterless scrub showed greater log reductions than CHG without brush, but there was no statistical difference between the two groups. Conclusion: Waterless scrub using alcohol-based agent showed more persistent and immediate antimicrobial efficacy than either CHG with brush or CHG without brush.

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