• Title/Summary/Keyword: experience report

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First Experience of Cardiac Surgery using da $Vinci^{TM}$ Surgical System in Korea (da $Vinci^{TM}$ 수술로봇을 이용한 심장수술 - 첫 번째 치험 보고)

  • Park, Seong-Yong;Lee, Sak;Joo, Hyun-Chul;Yang, Hong-Suk;Park, Young-Hwan;Park, Har-Ki
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.128-131
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    • 2007
  • da $Vinci^{TM}$ Surgical System is an advanced mode of minimal invasive surgery, using 3-dimensional imaging system and robotic arms which can mimic the dexterity of the human hand. Thus, various operations can be performed with minimal incision and limited surgical field and the merits of minimal invasive surgery can be maximized by using it. We report our first experience of robotic open heart surgery using the da $Vinci^{TM}$ Surgical System for repairing atrial septal defect.

Endovascular Treatment of Dural Arteriovenous Fistulas : Single Center Experience

  • Oh, Jae-Sang;Yoon, Seok-Mann;Oh, Hyuk-Jin;Shim, Jai-Joon;Bae, Hack-Gun;Lee, Kyeong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.59 no.1
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    • pp.17-25
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    • 2016
  • Objective : Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods : Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results : All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ${\geq}2$ times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion : Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route.

Experiences of thoracic esophagectomy with laparoscopic gastric pull up in thoracic esophageal cancer patient in single center

  • Jun, Jin-Woo;Kim, Wooshik;Park, Jong-Min
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.95-101
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    • 2018
  • Purpose: The standard treatment of esophageal cancer is the Ivor-Lewis operation, which consists of an abdominal phase involving gastric tube formation, and a chest phase involving esophagectomy and anastomosis. We aimed to report our experience of performing thoracic esophagectomy with the laparoscopic gastric pull up (LGPU) technique and its surgical outcomes. Methods: Clinicopathologic data and short-term surgical outcomes of 14 patients who underwent LGPU for thoracic esophageal cancer from August 2008 to May 2016 were retrospectively reviewed. Results: Mean age of the patients was 62.3 years and mean body mass index was $21.7kg/m^2$. Eleven patients had medical comorbidities. Patients' mean American Society of Anesthesiologists score was 2. Mean operation time was 428.5 minutes, with the mean abdominal operation time being 138.9 minutes. There was no open conversion case. Three patients had pneumonia, three patients had surgical site infection, and one patient had subcutaneous emphysema within 30 days after surgery. One patient had minor anastomosis site leakage. There was one 30-day mortality case. One patient with postoperative aspiration pneumonia developed acute respiratory distress disease, and died due to sepsis. Mean postoperative intensive care unit stay was 3.5 days, and mean postoperative hospital stay was 20.6 days. Nasogastric tubes were removed on average at 3.4 days, and mean oral intake time was 3.4 days. Conclusion: If the gastrointestinal surgeon has extensive experience in laparoscopic procedures, LGPU will be a safe and feasible technique for thoracic esophagectomy in patients with intrathoracic esophageal cancer.

One-year experience of oral substrate reduction therapy in three patients with Gaucher disease type I

  • Sohn, Young Bae;Kim, Yewon;Moon, Ji Eun
    • Journal of Genetic Medicine
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    • v.17 no.2
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    • pp.62-67
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    • 2020
  • Purpose: Eliglustat is an oral substrate reduction therapy (SRT) approved for adults with Gaucher disease type I (GD1) who are extensive, intermediate, or poor CYP2D6 metabolizers. Here we report one-year experience of eliglustat switch therapy from long-term enzyme replacement therapy (ERT) in three adult patients with GD1. Materials and Methods: Medical history, clinical (hemoglobin concentration, platelet count, and bone mineral density) and biochemical parameters (angiotensin converting enzyme, total acid phosphatase, and lyso-gb1) of the patients were collected and evaluated by retrospective review of medical records at every 3, 6, or 12 month after switch to SRT. Results: Patient 1 was a 43-year old female diagnosed GD1 and her clinical and biochemical parameters were stabilized for more than 20 years by ERT. Due to the burden of regular hospital visit, she switched to SRT. During one-year of SRT, clinical parameters and biomarkers were maintained stable. However, after suffering acute febrile illness during SRT, she decided to re-switch to ERT due to concerns about drug interaction. Patient 2 was 41-year old male, younger brother of patient 1 and Patient 3 was 31-year old male. They switched to SRT in clinically stable condition with long-term ERT. The one-year SRT was tolerable without specific safety issue and the clinical parameters were maintained stable. Conclusion: One-year eliglustat therapy in three adult patients with GDI was generally tolerable and effective for maintaining the clinical parameters and biomarkers. However, the drug compliance, concurrent drug interactions, and long-term safety of eliglustat should be carefully monitored.

Diagnostic and Therapeutic Laparoscopy for Abdominal Trauma: A Single Surgeon's Experience at a Level I Trauma Center

  • Jo, Hancheol;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.248-256
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    • 2021
  • Purpose: Laparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon's experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients. Methods: In total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages. Results: The mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups. Conclusions: Laparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.

Transarterial Embolization of Intracranial Arteriovenous Fistulas with Large Venous Pouches in the Form of Venous Outlet Ectasia and Large Venous Varix or Aneurysm : Two Centers Experience

  • Deniwar, Mohamed Adel;Ahmad, Saima;Eldin, Ashraf Ezz
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.30-39
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    • 2022
  • Objective : There are different types of cerebral vascular malformations. Pial arteriovenous fistulas (PAVFs) and dural arteriovenous fistulas (DAVFs) are two entities; they consist of one or more arterial connections to a single venous outlet without a true intervening nidus. The high turbulent flow of PAVFs and aggressive DAVFs with cortical venous reflux can result in venous outflow varix and aneurysmal dilatation. They pose a significant challenge to transvenous embolization (TVE), stereotactic radiosurgery, and surgical treatment. We aim to share our centers' experience with the transarterial embolization (TAE) for arteriovenous fistulas (AVFs) with large venous pouches and to report the outcome. Methods : The authors' two institutions' databases were retrospectively reviewed from February 2017 to February 2021. All patients with intracranial high flow PAVFs and aggressive DAVFs with venous outlet ectasia and large venous varix and were treated by TAE were included. Results : Fifteen patients harboring 11 DAVFs and four PAVFs met our inclusion criteria. All patients underwent TAE in 17 sessions. Complete angiographic obliteration was achieved after 14 sessions in 12 patients (80%). Four patients (25%) had residual after one TAE session. Technical failure was documented in one patient (6.7%). Fourteen patients (93.3%) had favorable functional outcome (modified Rankin score 0-2). Conclusions : TAE for high flow or aggressive intracranial AVFs is a safe and considerable treatment option, especially for those associated with large venous pouches that are challenging and relatively high-risk for TVE.

Influence of Learning Presence of Non-Face-to-Face Class Experience in Nursing Students on Academic Achievement: Mediating Effect of Learning Flow and Moderated Mediation of Digital Literacy (비대면 수업 경험 간호대학생의 학습실재감이 학업성취도에 미치는 영향: 학습몰입의 매개효과와 디지털 리터러시의 조절된 매개효과)

  • Ryu, Eui Jeong;Jang, Keum Seong;Kim, Eun A
    • Journal of Korean Academy of Nursing
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    • v.52 no.3
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    • pp.278-290
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    • 2022
  • Purpose: This study aimed to identify the mediating effect of learning flow and the moderated mediation effect of digital literacy on the effect of the learning presence of non-face-to-face class experience in nursing students on academic achievement. Methods: Participants were 272 nursing students from six universities in two different cities. A self-report questionnaire was used to measure learning presence, learning flow, digital literacy, and academic achievement. Analysis was performed using SPSS 26.0 and SPSS PROCESS Macro (4.0). Results: The mediating effect of learning flow on the effect of learning presence on academic achievement was 0.42, and the moderated mediation index of digital literacy was 0.17. Learning flow showed a mediating effect on the relationship between learning presence and academic achievement. Digital literacy had a moderated mediation effect on the relationship between learning presence and academic achievement that was mediated by learning flow. Conclusion: The intensity of the mediating effect of nursing students' learning presence on academic achievement through learning flow increases as the level of digital literacy increases. These results suggest that educational programs considering the level of learning presence, learning flow, and digital literacy are required to promote the academic achievement of nursing college students.

Relationship between Sexual Knowledge and Sexual Attitudes of Mongolian University Students (몽골 대학생의 성지식과 성태도의 관계)

  • Kim, Jin;Cha, Nam Hyun
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.70-77
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    • 2021
  • Purpose: The purposes of this study are to examine the relationship between sexual knowledge and sexual attitudes and identify factors that influence sexual attitudes among Mongolian university students. Methods: A cross-sectional study was used. Participants include 200 students from 23 universities in U city in Mongolia. Data were collected from 1 December to 30 December of 2019. A self-report questionnaire through Google survey was used. Data were analysed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression analyse with SPSS 26.0 for Window Program. Results: We found the differences between sexual knowledge and sexual attitudes according to participants' general characteristics, sex education, and sexual knowledge (t=5.43, p<.001) and sexual attitudes (t=2.21, p=.028), sexual experience and sexual knowledge. There was no correlation with marriage thought among sexual knowledge, sexual health and pregnancy and childbirth, and sexual attitudes. The correlations between the remaining variables were high. Sexual knowledge was the most influential factor on sexual attitudes followed by the sexual act (β=.30, p<.001), reproductive organs (β=.29, p<.001), solving sexual desire (β=-.25, p<.001), sexual experience (β=-.16, p=.021), and sex education (β=-.16, p=.028) with an explanatory power of 20.0%. Conclusion: The findings of this study may provide a basic data and help to understanding of sexual attitudes among Mongolia university students.

An Analysis Method and Environment for Team Project-Based Learning in Non-Face-to-Face Situation for Student Evaluation (비대면 팀 프로젝트 기반 수업 평가를 위한 분석 방법 및 평가환경)

  • Lee, Jaiyun;Han, Seyoung;Choi, Changbeom
    • Journal of Engineering Education Research
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    • v.25 no.3
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    • pp.3-10
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    • 2022
  • An educator may utilize various pedagogies such as hands-on practice, practicum, and project-based learning to enhance a student's competency. Among various pedagogies, project-based learning is one of the well-known pedagogies that may provide similar on-the-job experience. In general, an educator may divide the students into small groups and assign tasks to check students' cooperation skills and achievements during project-based learning. However, an educator may experience difficulties operating project-based learning due to the COVID-19 pandemic. Most of the team activities are done in non-face-to-face meetings, and as a consequence, the educator may not find an underachieving team easily and cannot intervene appropriately. This study introduces a rigorous analysis method to evaluate team activities to analyze individual students' participation and contributions. First, this study develops evaluation rubrics by conducting questionnaires to professors and students to find an appropriate weight value for the evaluation scale. Then, this research introduces an analysis environment to evaluate students automatically. The analysis environment collects dialog data from social network services and measures interactions among students in a team. After measuring interactions, the environment generates a report to visualize the team activities. We applied the proposed method and environment to the capstone design course to show the effectiveness of the method and environment. Based on the case study, the environment showed that the analysis method could easily indicate the teams' activities and check the level of participation.

Who is Lonely While Being Alone? The Relationship Between Solitude, a Sense of Power, and Loneliness (누가 혼자 있을 때 외로운가? 홀로 있음, 권력감과 외로움의 관계)

  • Lim, Nangyeon;Suh, Eunkook M.
    • Science of Emotion and Sensibility
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    • v.25 no.2
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    • pp.87-100
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    • 2022
  • People who spend more time alone tend to report higher levels of loneliness. However, whether people experience loneliness in solitude can differ The current research investigated the role of a sense of power as a predictor of loneliness among people who lack social interaction. investigated factors predicting loneliness in people with little social time large-scale survey data. As a result of discriminant analysis, a sense of power was verified as a factor that lonely non-lonely groups. a sense of power As a result, a causal relationship between a sense of power and social loneliness was confirmed. When people feel alone, a high sense of power can work as a buffer against loss of belongingness and the experience of social loneliness. This research focused on psychological rather than situational factors to alleviate loneliness in the current situation where social encounters are limited due to the increase of single-person households and the 19 pandemic.