• 대한물리치료과학회지
• /
• 제1권2호
• /
• pp.313-320
• /
• 1994

This article provids background information necessary to design orthopaedic physical therapy programs based on a patient's level of orthopaedic involvement during the acute, subacute, or chronic stage of soft-tissue healing. This approach was used whether the problem involved injury from trauma, insult from overuse, disease, surgical intervention. Soft-tissue lesions and clinical conditions were defined ; the stages of inflammation and repair were described with emphasis on how to manage soft tissues and joints with therapeutic exercise during each stage. A problem list with goals and plan of care was outlined to summarize each clinical situation. A list of clinical problems will be used as the foundation for designing exercise problems for each region of the body.

• Journal of Korean Neurosurgical Society
• /
• 제39권4호
• /
• pp.310-313
• /
• 2006

Although lipomyelomeningocele and dermoid cyst are formed during a similar embryologic developmental stage of 'neural tube formation', they are caused by entirely different embryologic mechanisms. We encountered a case, which has not been previously reported, that had a lumbar subcutaneous dermoid cyst associated with lipomyelomeningocele. A 52-year-old man presented with a slowly growing lumbar mass of 3 years duration, which had been present since birth. Lumbosacral magnetic resonance imaging[MRI] showed lipomyelomeningocele at the L3, 4 and 5 levels and a subcutaneous cystic mass of high signal intensity on the T2 weighted image and iso or low signal intensity on the T1 weighted image. He underwent total resection of the lumbar subcutaneous mass. Intraoperative findings and histological examination were consistent with the preoperative diagnosis of a 'dermoid cyst'. We demonstrate that the formation of a dermoid cyst might coexist with lipomyelomeningocele during the embryologic developmental stage.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제12권3호
• /
• pp.23-33
• /
• 1990

A clinical study of selected patients with intraoral squamous cell carcinoma which were managed in the Department of Oral Oncology of Korea Cancer Center Hospital from January 1982 to August 1989 was done. And following results were obtained. 1. Males were involved more than females by intraoral squamous cell carcinoma in a ratio of 4:1. and most of the cases occurred in the 7th and 6th decades (69%). 79% of total patients and 92.5% of males were. 2. The mean duration of symptomatic period was 5.9 months. 3. The common symptoms were swelling (63%), pain (40%), ulceration (33%), and trismus (23%) 4. In the histologic findings, well differentiation comprised 58.0%. 5. The primary sites were the upper alveolar mucosa (32%), the floor of the mouth (21%), the lower alveolar mucosa (19%), tongue (14%), retromolar trigone (8%), palate (7%) and buccal mucosa (3%). 6. According to TNM system, Stage I, Stage II, Stage III, and Stage IV comprised 4%, 15%, 32%, and 49% respectively. 7. In the management of intraoral squamous cell carcinoma, surgeries were done in the 32 cases, 23 cases of which were managed by radiation therapy or chemotherapy concurrently. And radiation therapy alone was received in 35 cases. 8. Overall 3 and 5-year survival rates without regarding to stage were 27.6% and 21.4%. 9. 3-year survival rate of female patients was 47.2% and that of male patients was 22.6%. 10. 5-year survival rate was 53.9% for "early" cancer (stage I and II) and 15.6% for "advanced"cancer (stage III and IV). Survival rate of patients in the early stages of cancer appeared to be higher than that of patients with stage III and IV(p<0.05).

• Advances in pediatric surgery
• /
• 제15권1호
• /
• pp.38-43
• /
• 2009

With the widespread use of the obstetrical ultrasound, identification of a fetal suprarenal mass becomes more common. Most of these masses prove to be congenital neuroblastomas (CNB) postnatally. However, the diagnosis is often confused with other benign lesions and the post-natal management remains controversial. The medical records of 13 patients that underwent primary surgical excision for an antenatally detected adrenal CNB, between January 1995 and April 2009, were reviewed retrospectively. The clinical, radiological, surgical, and pathological data on the suprarenal mass were collected. Staging evaluation was performed after histological confirmation of the CNB. Most of the CNBs were stage I (N=11), with 1 stage IV and 1 stage IV-S. Four patients (3 stage I and 1 stage IV-S) had N-myc gene amplification. The stage I patients were cured by surgery alone, and stage IV patients underwent 9 cycles of adjuvant chemotherapy and currently have no evidence of disease after 39 months of follow-up. The patient with stage IV-S is currently receiving chemotherapy. There were no post-operative complications. For early diagnosis and treatment, surgical excision should be considered as the primary therapy for an adrenal CNB detected before birth. The surgery can be safely performed during the neonatal period and provides a cure in most cases. Surgical diagnosis and treatment of CNB is recommended in neonatal period.

• 한국간호교육학회지
• /
• 제29권1호
• /
• pp.27-40
• /
• 2023

Purpose: The study aimed to examine the concept and attributes of the quality of clinical nursing education for new graduate nurses. Methods: This study adopted a hybrid model introduced by Schwartz-Barcott and Kim. In the theoretical stage, the meaning and attributes of the quality of clinical nursing education for new graduate nurses were determined by analyzing eight articles. In the fieldwork stage, data were collected using semi-structured interviews with five new graduate nurses and seven experienced nurses. The data were analyzed by qualitative content analysis methods developed by Elo and Kyngӓs. In the final analysis, a final result was arrived at comparing, contrasting, and integrating the attributes of the concepts derived in the theoretical and field-work stages. Results: The quality of clinical nursing education for new graduate nurses was identified as excellence or the standard of education for new graduate nurses that would support them in adapting to clinical settings and transitioning to professional nurses. The attributes of the quality of clinical nursing education were founded to possess three dimensions, six categories, and 18 attributes. The multidimensional attributes of the quality of clinical nursing education for new graduate nurses were confirmed as education resources, design, method, content, evaluation, interaction, and outcome under the three dimensions of input, process, and output. Conclusion: The concept and nature of the quality of clinical nursing education observed in this study can be utilized as a basis for the future development, evaluation, and improvement of clinical nursing education for new graduate nurses in healthcare organizations.

• Journal of Chest Surgery
• /
• 제21권5호
• /
• pp.856-862
• /
• 1988

The survival rate after resectional operation for carcinoma of the esophagus is still very low and many factors contribute to these poor results. We analyze the clinical results of 56 operated patients among 62 esophageal cancer patients between March, 1974 and July, 1988. Among the 62 patients, 52 patients were squamous cell carcinoma and 8 were adenocarcinoma, one was leiomyosarcoma and one was adenosquamous cell carcinoma. The classification of esophageal cancer was based on TNM classification of American Joint Committee on cancer". Among the operated patients, stage I was 5[9.6%], stage II was 13[25%], stage III was 26[50%], stage IV was 8[15.4%]. And its one year survival rate was 80%, 69%, 11.5%, 0% for each stages. The rate of resectability was 30.3% and resection of esophagus with esophagogastrostomy and extended lymph node dissection was performed on 17 patients without distant metastasis or adjacent organ invasion. Substernal esophago-colono-gastrostomy, Celestine tube insertion and feeding gastrostomy was performed on remained 39 patients. The analysis of postoperative survival duration revealed the superiority of esophagectomy with extended lymph node dissection over other palliative operation. [1 year survival rate: 79% versus 21%] We concluded that the survival rate of esophageal resection with lymph node dissection group was superior to nonresective palliative operation group. And transthoracic approach was superior to extrathoracic approach in involved lymph node dissection and esophageal resection in locally invaded cases.ases.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권1호
• /
• pp.79-86
• /
• 1997

Adenoid cystic carcinoma is characterized by sloe growth, multiple recurrence, a long clinical course and late metastasis. It is less than 1% of all head and neck malignancy, but most prevalent malignancy in salivary gland origin. During 14 years(from 1982 to 1995), 24 patients were diagnosed as adenoid cystic carcinoma in oral and maxillfacial area, in department of Oral and Maxillofacial Surgery, Korea Cancer Center Hospital. We studied clinically about their age and sex distribution, primary site distribution, TNM staging, treatment modalities, overall survival rates, survival rates according to stages. The age range were from 15 years to 79 years, average age weas 51 years. 15 were men and 9 Were women. Maxilla and palate were the most prevalent primary site. The most cases were in stage III(37%) and stage IV(46%). The 3 year and 5 year overall survival rate were 65.0% and 58.5%. The 5 year survival rate of the stage III cases was 66.7%, and that of the stage IV cases was 38.4%.

• Journal of Chest Surgery
• /
• 제24권1호
• /
• pp.48-53
• /
• 1991

This report documents the clinical k pathologic features of 33 patients treated for thymoma for 11 years & 6 months between September 1977 and February 1989. At the Thoracic & Cardiovascular Surgery, Yonsei University, College of Medicine of the group, 31 patients treated with surgery were examined for the result of operation & prognosis. Mean age was 50 years. Thirteen were female and twenty were male. Dyspnea on exertion and chest discomfort were common in the patients without myasthenia gravis. Fourteen patients[42.6%] had myasthenia gravis and one patient had autoimmune thyroid disease. Four patients[12.1%] presented without symptoms attributable to their thymoma. Histologic review disclosed 12[36.4%] epithelial thymoma, 10[30.3%] mixed lymphoepithelial, 9[27.3%] lymphocytic, 1[3.0%] spindle cell and 1[3.0%] unknown cell thymoma. They were classified according to Masaoka`s clinical staging criteria; by these criteria, 8 patients were stage I, 5 patients were stage II, 15 patients were stage III and 3 patients were stage IV. Total excision of mass was possible in 20 patients. Partial excision of mass in 4 patients and biopsy in 7 patients were carried out during the operation. There was only one operation mortality. Follow-up was possible in 26 patients and follow-up ranged from 4 months to 10.5 years[mean 28.9 months]. One-year survival rates were 77.8% and eight patients expired during follow-up period. Eleven[78.6%] patients with myasthenia gravis were improved after the operation. This observation suggests that the most significant factor determining the survival is whether or not total surgical excision had been performed.

• 한국임상수의학회지
• /
• 제25권6호
• /
• pp.553-556
• /
• 2008

The urinary bladder retroflexion, flipped over backwards into the pelvic canal, by trauma has been rarely reported in dogs. This paper describes clinical and radiological features of urinary bladder retroflexion in two dogs with a history of traffic accident. The main clinical signs were hind limb lameness, severe pain and dysuria. Radiography and ultrasonography were performed to evaluate the patient's damages. No remarkable findings were observed except pelvic fracture on survey radiograph. On cystourethrography, caudal displacement and retroflexion of the bladders were identified. Cystopexy was performed and the bladders were repositioned. After surgery one dog with severe azotemia and bilateral hydroureteronephrosis was deteriorated noticeably and euthanized by request of the owner, while the other dog was recovered no recurrence of the problem by 12 months post-surgery. It should be considered that contrast study and serial assessment in urinary tract be important to demonstrate the evidence of bladder retroflexion and evaluate the prognosis in dogs with severe trauma.

• Clinical and Experimental Reproductive Medicine
• /
• 제24권1호
• /
• pp.111-118
• /
• 1997

Intracytoplasmic sperm injection (ICSI) recently has been utilized widely as the most successful technique to overcome the unfertilization problem in cases of severe male infertility in couples who could not be treated by conventional IVF. Recently, indications of ICSI have been extended further and more fertilized oocytes become available. Thus, it is necessary to examine the efficiency of freezing the surplus embryos obtained from ICSI. We compared the survival rate and the future outcome of cryopreserved embryos obtained either after conventional IVF or ICSI during the same period. After ICSI or IVF, five best-quality embryos from each patient were transferred in the stimulation cycle and the surplus pronuclear (PN) stage oocytes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propanediol (PROH) as a cryoprotectant. A total of 792 embryos from ICSI trial were thawed and 65.2% (516/792) survived. The survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 63.5%, 68.2%, 64.0%, respectively. After 111 transfers, 34 pregnancies were achieved, corresponding to a clinical pregnancy rate of 30.6% per transfers. We thawed 1033 embryos from IVF trials and 57.5% (594/1033) survived. In IVF cycle, the survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 58.2%, 65.2%, 40.2%, respectively. Thirty eight clinical pregnancies were established after 134 transfers, corresponding to a pregnancy rate of 28.4% per transfer. The cleavage rate of thawed PN stage oocytes from ICSI trial (61.3%) was significantly higher than those from conventional IVF (53.4%). The developmental rates of good embryo (${\geqq}$ grade II) in thawed PN stage oocytes obtained from conventional IVF and ICSI were 63% and 65%, respectively. We concluded that PN stage oocytes, multicellular embryos resulting from ICSI procedure can be successfully frozen/thawed with reasonable clinical pregnancy rates comparable to those of IVF.