• Title/Summary/Keyword: Surgical smoke

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Respiratory Protection for LASER Users

  • Lee, Sang Joon;Chung, Phil-Sang;Chung, Sang Yong;Woo, Seung Hoon
    • Medical Lasers
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    • v.8 no.2
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    • pp.43-49
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    • 2019
  • The plume produced by vaporizing tissue with a laser contains a variety of contaminants called laser-generated air pollutants (LGACs). LGACs consist of a mixture of toxic gas components, biomicroparticles, dead and living cells, and viruses. Toxic odors and thick smoke from surgical incisions and the coagulation of tissues can irritate eyes and airways, as well as cause bronchial and pulmonary congestion. Because of the potential risk of the smoke, it is advisable to appropriately remove it from the surgical site. We recommend using a smoke evacuator to remove the smoke. Suction nozzles should be placed as close as possible to the surgical site in a range of 2 cm or less. In-line filters should be used between the inlet and outlet of the surgical site. All air filtration devices should be capable of removing particles below 0.1 microns in size. The filter pack should be handled according to infection control procedures in the operating room. The laser mask can be an auxiliary protective device if it is properly worn. Some smoke inhaled under the nose wrap or over the side of the mask will not be filtered. As in electrosurgical operations, a suitable mask should be worn while smoke is present.

Assessment of Tobacco Habits, Attitudes, and Education Among Medical Students in the United States and Italy: A Cross-sectional Survey

  • Armstrong, Grayson W.;Veronese, Giacomo;George, Paul F.;Montroni, Isacco;Ugolini, Giampaolo
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.3
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    • pp.177-187
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    • 2017
  • Objectives: Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students' tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions. Methods: From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students' tobacco use, attitudes and clinical skills related to patients' smoking, and elements of medical school curricula related to tobacco use. Results: Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient's smoking status during a routine history and not offering tobacco cessation treatment to patients. Conclusions: Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.

The Usefulness of Harmonic Scalpel During Pericardiectomy for Constrictive Pericariditis (교착성 심막염에 대한 심막절제술시의 Harmonic Scalpel의 유용성)

  • 김도형;이정철;정태은;한승세;이장훈;이동협
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.605-607
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    • 2002
  • Harmonic Scalpel(Ethicon Endo-Surgery, Cincinnati, OH) has many advantages including no muscular stimulation, low heat, less smoke, easy hemostasis using ultrasound and good operation field. In patient with constrictive pericarditis, Harmonic Scalpel was beneficial during pericardiectomy.

Comparison of $LigaSure^{TM}$ and Bipolar Vessel Sealing System for Laparoscopic Ovariectomy in Cats (복강경을 이용한 고양이의 난소 절제술에서 지혈기구인 $LigaSure^{TM}$와 양극 전기 응고 장치(bipolar)의 비교)

  • Jin, So-Young;Lee, Seung-Yong;Park, Se-Jin;Kim, Young-Ki;Seok, Seong-Hoon;Hwang, Jae-Min;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.477-482
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    • 2014
  • The aim of this study was to investigate and compare technique, surgical time, and complications of laparoscopic ovariectomy using $LigaSure^{TM}$ and bipolar vessel sealing system in cats. Laparoscopic ovariectomy was performed under general anesthesia on 10 healthy female cats admitted for elective ovariectomy. Surgery was performed through three midline portals. Each ovary was randomly-assigned to removal by use of either $LigaSure^{TM}$ or bipolar vessel sealing system. Duration of predetermined surgery intervals and complications were compared. Bipolar OVE ($2:16{\pm}1:14$ minutes) took significantly longer surgical time compared to the $LigaSure^{TM}$ OVE ($1:24{\pm}0:59$ minutes, P = 0.021). The ovarian pedicle fat and obesity did not influence surgery duration. Intraoperative hemorrhage occurred with bipolar OVE in three cats, but had no significant influence on surgical time. The results suggest that both $LigaSure^{TM}$ and bipolar devices appear to be effective, but $LigaSure^{TM}$ can be used as a stand-alone device that decreases surgical time and complication compared with bipolar vessel sealing system.

Clinical and Pathological Study on the Lung Cancer of the Pusan Paik Hospital (부산 백병원의 폐암 임상 및 병리학적 검색)

  • 석동수
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.376-381
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    • 1991
  • From June 1979 to July 1988 for 9 years, total 440 cases of lung cancer[including biopsy and surgical specimen] of the Pusan Paik hospital were examined for the clinical and pathology study. The findings of the study are as follows; [1] The incidence of lung cancer started to increase from 1982, and it again remarkably increased since 1987. Such increase was solely brought by the increase of male lung cancer. Male and female ratio is 5.6: 1. [2] Histopathologically, the most prevalent type is squamous cell carcinoma[60.ado], and next are adenocarcinoma[15.6%] and small cell carcinoma[15.0%]. But in female alone, the most prevalent type is adenocarcinoma[40.3%], and next are squamous cell carcinoma[37.3%] and small cell carcinoma[11.9%]. [3] The absolute number of adenocarcinoma are approximately equally distributed among both sexes until 60 years of age. Above 61 years of age, mostly male was shown while female was not. Most probably, many female patient.- of that old age simply did not visit general hospitals for surgery in Korea. [4] Surgical treatment was performed in 8% of total cases of lung cancer. And most cases showed stage I progression of the cancer. Average size of the cancer was 5 cm in diameter in the operated 35 cases suggesting that the cancer could be detected more than 10 years ago before the time of surgery. [5] Lung cancer affected more in the right lung [right: left=1.6: 1], and each upper lobe of both lungs are affected about 1/4 of cases indicating that about 1/2 of all lung cancer develop from the upper lobes. [6] There are more nonsmokers[67.6%] among the lung cancer patients[male 64.6%, female 82.1%]. Probably, this will mean that there are other potent carcinogenic agents in our environment like automobile exhaust beside tobacco smoke. For the past history of lung disease other than cancer, tuberculosis is the most prevalent disease[16.1%, male 17.4%, female 9.0%]. Most of them is probably not related etiologically though this possibility is not completely denied.

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Evaluation of Indoor Air Quality in a Hospital Operating Room During Laparoscopic Surgery (병원 수술실에서의 복강경 수술 중 실내공기질 평가)

  • Choi, Dong Hee;Kang, Dong Hwa
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.30 no.3
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    • pp.67-74
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    • 2024
  • Purpose: The identification and quantification of indoor airborne contaminants, including bio-aerosols, particulates, and gaseous contaminants, are crucial for maintaining acceptable indoor air quality for hospital operating rooms (ORs). Laparoscopic surgery has become widely accepted for various surgical procedures due to its rapid recovery rate and the low risk associated with small incisions compared to conventional open surgery. The objective of this study is to investigate the indoor air quality in hospital ORs and to identify indoor airborne contaminants generated during laparoscopic surgery. Methods: Measurements of an indoor environment, including temperature, humidity and air quality, were performed in an OR before and during a laparoscopic surgery. Indoor airborne contaminants, including volatile organic compounds (VOCs), formaldehyde, carbon monoxide (CO), carbon dioxide (CO2), sulfur dioxide (SO2), nitrogen dioxide (NO2), suspended indoor particles, and airborne bacteria, were measured simultaneously. Results: The study determined that the concentrations of indoor air particles and airborne bacteria increased during the surgery but were within acceptable levels. However, the concentration of CO2, reached a high level of 1,791 ppm due to the CO2 gas required for maintaining the pneumoperitoneum during the surgery. Implications: The results emphasized the use of ventilation and filtration in a laparoscopic surgery room to lower the concentration of filterable and non-filterable contaminants.

The observation about occurrence rate of HBs Antigen to waitress entertaing at restaurant business (일부 접객업소 여성 종사자들에 있어서의 간염 B 항원 발현빈도에 관한 관찰)

  • 윤기은;김태전;원종만;나동진
    • Journal of Environmental Health Sciences
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    • v.6 no.1
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    • pp.47-52
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    • 1979
  • Up to the present there were the blood transfusion and the use of apparatus not to sterilize at surgical operation and medical treatments in well known infectious ways of hepatitis B virus. But all its ways were still not surely known. As the other ways of hepatitis B virus infection, it was suggested that contagion such as kissing, sexual contact, homosexuality, and varieties discharged out human body urine, stool, tear, salivary, menstrual blood, Vaginal discharge etc, and low economic status, unsanitary environmental life, alcohol and smoking related to hepatitis B virus infection. From 800 waitress who frequently contact with a lot of drinker with low economic status and unclear environmental life, this study were investigated HBs Ag (Hepatitis B surface antigen) known marker for hepatitis B virus infection in their serum, and a few conditions of their private life in order to known dangerous rate b~ing exposed to the source of hepatitis B virus infection as comparison with control group. The results were summarlized as following 1. The positive rate of HBs Ag (4.3%) was significantly higher in waitress than in control group(1.1%). 2. In waitress old, 20-24 ages group was the most as 59.5%, and positive rate of HBs Ag was trend of higher in twenties than thirties. 3. Among the waitress, one that it was less than a year were the most (62.4%) in the period to work at restaurant business, and positive rate of HBs Ag was trend of higher in propotion to period to work at there. 4. Among the waitress, one who entertained to beer hall was the most (46%), and they were trend of higher in positive rate of HBs Ag (6.3%) than other waitress. 5. Among the waitress, one to drink with smoking, and only to drink, and only to smoke, and not to drink and smoke 66.1%, 21.5%, 4.6% and 7.8%. Espically in one to drink with smoking, ther was trend of indicating the high positve rate of HBs Ag, and it was made suspicion of the relationship of alcohol smoking, contact with a lot of drinker, unclear environment to hepatitis B virus infection. In the above results, it was found that dangerous rate being exposed in hepatitis B virus infection was high in the waitress. Therefore there are required for active preventions against hepatitis B virus infection them. Also as it is possible to be infectious source in public health that waitress infected to viral hepatitis, it is thought that appropriate rules about them.

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A Study on "Beijijiufa" ("비급구법(備急灸法)"에 대한 연구(硏究))

  • Shin, Jae-Hyeok;Kim, Jang-Saeng;Kim, Jae-Jung;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.17 no.2
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    • pp.82-129
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    • 2011
  • "Beijijiufa" is a medical book republished by Sun Ju Qing in 1245. He compiled this book having added "Qizhumajiufa" and "Zhugejingyanbeijiyaofang" to the contents of "Beijijiufa" authored by Wen Ren Qi Nian. In "Beijijiufa" the author described treatment methods making use of moxibustion methods in connection with 22 cases of acute diseases. The author had collected the moxibustion methods used to treat acute diseases, which had been practiced by the medical practitioners of many generations, and quoted total 13 medical men's practices. In the book, the greatest parts of details were quoted especially from the writings of Sun Si Miao and Ge Hong, and this shows that the medical philosophies of both Sun Si Miao and Ge Hong were reflected onto "Beijijiufa". He had differed on his moxibustion practice: the size of moxa wool, the number of moxibustion treatment, and method of moxibustion for male and female were differed from one another according to the disease. As to the area of moxibustion, he chose the body parts around under four limbs and joints, and mostly used extraordinary acupoints rather than twelve main meridians. In his descriptions of finding meridian points, he did not describe it by its specific name of the reaction point, but explained the location of moxibustion points in detail through pictures. "Qizhumajiufa" is related to moxibustion method and prescriptions to treat surgical diseases, like skin boils or furuncle on the back, etc. He easily explained the method to find the meridian points for moxibustion treatment by using particular way through diagrams and pictures. Eight prescriptions he used were the collections among the historical practices of medical practitioners of many generations for skin boils which showed excellent therapeutic actions. In "Zhugejingyanbeijiyaofang", there are prescribed for 36 disease, also is the records of treatment methods for medical emergency which would be encountered easily in everyday life. As to therapeutic remedies, varied treatment methods, including the treatment by means of pasting and attaching medicinal substance to the spot, the treatment by means of mixing medicinal substance with alcoholic beverage, cleansing method, smoke inhalation remedy etc. were introduced. In "Beijijiufa" moxibustion was regarded as a top priority for treatment of acute disease, and the author strived to present remedies to the readers as easily as possible through 19 pictures. Regarding prescriptions, the author introduced diverse treatment methods with respect to various disease symptoms, and described the method to treat disease symptoms making use of medicinal ingredients which can easily be found in daily life. Likewise, "Beijijiufa" compiled by Sun Ju Qing was intended for clinical practice, and was indeed a medical book having been utilized for treatment of acute diseases in those days.

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Development of Ring Light for Shadowless Shooting for Medical Purpose (의료용 무영 촬영을 위한 링라이트 개발)

  • Cheon, Min-Woo;Cho, Kyung-Jae;Park, Yong-Pil
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.23 no.9
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    • pp.708-713
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    • 2010
  • In this research a ring light was developed so that a partial shadowless shooting for the patient's affected area at the medical treatment room and surgical operation room using high luminance light emitting diode (LED) for which attention is being paid as new lighting parts for medical purpose. LED which was applied to the development used high luminance three color LED for full color for which various color materialization and the adjustment of radiation intensity are possible and we can get white light in order to emphasize the delicate expression for generic tone of shooting object, strong highlight, simple shadow and three dimensional effect at the time of close-up shadowless shooting of the affected area. And at the time of design of ring light, the characteristics of LED and the loss of light at the time of penetrating light diffusion PC were considered so that intensity of illumination for over 150 lx can be obtained. The result of measurement of the intensity of illumination of the ring light that was developed revealed that maximum intensity of illumination of 225.7 lx was obtained, while smoke index was measured to be maximum 78 Ra in the case of Red(50%) Green(100%) and Blue LED(60%). We could confirm that response speed was also very fast as 1.72 ms.

Review of pediatric cerebrovascular accident in terms of insurance medicine (소아뇌졸중의 보험의학적 고찰)

  • Ahn, Gye-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.29-32
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    • 2010
  • Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

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