• 제목/요약/키워드: hospital operations

검색결과 655건 처리시간 0.024초

무수혈로 진행한 대퇴골 원위부 골육종 사지구제술: 증례 보고 (Non Blood Transfusion Limb Salvage Operation in the Distal Femur Osteosarcoma Patient: A Case Report)

  • 박종훈;박시영;이대희;황역구;이현민
    • 대한골관절종양학회지
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    • 제20권1호
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    • pp.36-40
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    • 2014
  • 사지에 발생한 골육종에서의 사지구제술은 광범위 절제술을 기본으로 한다. 수술 전 항암 치료를 한 뒤에 시행하는 경우가 대부분이라 수술전에 빈혈인 경우가 많고 수술로 인한 출혈이 많아서 수술 전 후 빈혈 교정의 필요성이 대부분 존재한다. 수혈이 암 환자의 예후와 합병증 및 수술 후 치료 결과에 나쁜 영향을 미친다는 다양한 보고들이 있음에도 불구하고 사지 구제술에서 빈혈을 교정하기 위한 방편으로 수혈은 여전히 통상적인 치료로 간주되고 있다. 이에 저자들은 대퇴골 원위부에 발생한 골육종 환자의 사지구제술을 무수혈로 시행하였기에 문헌 고찰과 함께 증례 보고 한다.

무지 외반증의 수술비 및 보험 (Operation Fee and Insurance Charge of Hallux Valgus Surgery)

  • 송하헌;심대무;김동철;권석현;김종윤
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.238-241
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    • 2006
  • Purpose: The purpose of this study was to figure out the appropriate and systemic insurance charge for the hallux valgus operations. Materials and Methods: 5 Hospitals for hallux valgus operations were analyzed how they have been charging the national health insurance corporation for their operation fees and how to use the estimated guide and authoritive interpretation through the guide book of health insurance medical treatment grant expense and the guide book of Health insurance medical treatment. Results: There are nothing for guiding principle of hallux valgus operations in both books but a guide of Mcbride operation which is approved 'JA-93-KA and JA-31' for operation fee. So majority of hospitals have charged operation fee depending on their own interpretations they like. According to the guide books, there was a authoritive interpretation that simultaneous operation of osteotomy and tendon transfer for cerebral palsy and flat foot can be eatimated as 'osteotomy+JA-93-NA'. Conclusion: Distal soft tissue procedure should be approved as 'JA-93-NAx100%+JA-31x50%' according to the the estimated guide and authoritive interpretation if transected adductor hllucis is transfered to first metatarsal head. So distal chevron osteotomy could be 'JA-30-1-RAx100%+JA-31x50%', proximal metatarsal osteotomy could be 'JA- 93-NAx100%+JA-31-50%+JA-30-1-RAx50%', first metatarsocuneiform joint arthrodesis could be 'JA-93-NAx100%+ JA-31x50%+JA-73-RAx50%'.

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구강악안면 수술 환자의 스트레스와 관련된 요인들의 종류와 영향력의 규모 (THE KINDS AND IMPACT OF DEMOGRAPHIC AND CLINICAL FACTORS ASSOCIATED WITH STRESS OF PATIENTS GOING THROUGH MAXILLOFACIAL SURGERY)

  • 윤필영;김영균;이창수;송승일;최용근
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권6호
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    • pp.504-508
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    • 2004
  • Surgical process of oral and maxillofacial area as well as dental treatment are stressful situations to the patients. It is well known that serum level of stress hormones including adrenocorticotropic hormone(ACTH) and cortisol increase when the body is exposed to stress. However, there have been few studies on demographic and clinical factors related with stress. Therefore, the purpose of this study was to supply data to cope with stress more comprehensively and efficiently by analyzing the effect of factors related with stress in addition to surgical procedure. Prospective cohort study method was selected. Serum levels of ACTH and cortisol were measured by sampling bloods pre-operatively and post-operatively from 45 patients who had been operated at the Bundang Jesaeng Hospital department of oral and maxillofacial surgery. To evaluate factors associated with stress, patients were classified according to gender, age, method of payment(insurance or self), experiences of operation, kind of operations(expected operations or unexpected operations). Relative risk was calculated to assess relationships between changes of serum level of ACTH and cortisol and factors related with stress, whereas Chi-square analysis was executed to evaluate statistical significance. With regard to serum level of ACTH, relative risk was 1.3 in the group of the patients who were less than 40 years old. With regard to serum level of cortisol, relative risk was 1.8 for women compared with men, 1.4 in the group of the patients who were less than 40 years old and 1.6 in the group of the patients who had not experienced any other operations. In addition to surgical procedure, factors related with stress included gender, age, method of payments, experiences of operation and kind of operations. Therefore, we should provide comprehensive schemes to reduce stress of the patients going through oral and maxillofacial surgery.

일부 종합병원 급식소 위생관리 항목에 대한 중요도-수행도 분석 (Importance-Performance Analysis about Sanitation Management Items at General Hospital Foodservice Operations)

  • 송윤지;배현주
    • 한국식품조리과학회지
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    • 제29권1호
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    • pp.63-71
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    • 2013
  • The purpose of this study was to analyze the gap between importance and performance in perceived sanitation management for general hospital foodservice operations. Data were collected through surveys given to 168 hospital dietitians in the Seoul-Incheon, Gyeonggi-do, Daegu, and North Gyeongsang province. The 65 questionnaires from total questionnaires were usable and the response rate was 38.7%. All statistical analyses were conducted using the SPSS package program (version 20.0) for t-test, ANOVA, and importance-performance analysis (IPA). According to the importance and performance analysis for 26 items, the importance score was significantly higher than the performance score for 22 items. In addition, the results of IPA showed the following areas as improvement priorities: handling foods on working table and management of distribution temperature. In conclusion, the performance level of prerequisite programs applying to the hospital foodservice needs improvement, especially cross-contamination prevention and temperature control for distribution. Additionally dietitians should be educated about sanitation management items that perceived to be less important than the others.

개인용 컴퓨터를 이용한 심혈관의 질환의 분석;개심술 1,060례를 포함한 1,867례의 분석 (Analysis of 1,867 Cases of Cardiovascular Surgery Using Personal Computer; Including 1,060 Cases of Open Heart Surgeries)

  • 이홍섭;최비오;김창호
    • Journal of Chest Surgery
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    • 제26권11호
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    • pp.874-880
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    • 1993
  • A personal computer, IBM compatible 386, was utilized to analyse total series of 1867 cases of cardiovascular operations including 1060 cases of open cardiac surgeries performed at the Cardiac Center of Paik Hospital from 1986 to 1992.All data were first assembled from the operation files and the operation records from the patient charts. Code numbers were placed to the diagnosis, the operations and the diseases.The analysis revealed the distributions of 1867 cases of operations;819 cases[77%] of the congenital heart diseases and 207 cases[20%] of the acquired heart diseases among 1060 open heart operations. The operative mortalities were 3.7% for the congenital heart diseases and 6.3% for the acquired heart diseases.The vascular operations showed the operative mortalities of 11.8% for the aortic surgery under extracorporeal circulation and 0.7% for the other vascular surgery.

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병원 서비스품질 차이요인에 관한 연구 (A Study on the Difference Factors in Service Quality for Hospital Industries)

  • 박진영
    • 품질경영학회지
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    • 제32권3호
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    • pp.45-61
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    • 2004
  • This study is to identify the differences in service quality for the 2nd-scale hospital Industries. The subjects of this survey for the empirical analysis are limited to the 2nd- scale hospitals in Korea: data are collected in Seoul, Incheon and Kyungki areas. The results are as follows. First, the efficiency for hospital operations confirmed the differences in bed scale. Second, the high-efficiency hospitals attach importance to efficiency with more than 100 bad scale and the low-efficiency hospitals attach Importance to service quality with less than 100 bed scale.

Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data

  • Kang, Chang Hyun;Bok, Jin San;Lee, Na Rae;Kim, Young Tae;Lee, Seon Heui;Lim, Cheong
    • Journal of Chest Surgery
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    • 제48권5호
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    • pp.311-317
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    • 2015
  • Background: Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods: Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results: Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001) more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion: Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.

심장혈관질환의 수술치험 (clinical experience of cardiovascular surgery -An Analysis of 116 cases-)

  • 안병해;김성환;염욱
    • Journal of Chest Surgery
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    • 제19권2호
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    • pp.250-258
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    • 1986
  • From Aug. 1984 to May 1986, 116 cases of cardiovascular surgery including 85 cases of open heart surgery were performed at Korea Veterans Hospital. There were 108 congenital anomalies and 8 acquired valvular heart diseases. Among 108 congenital malformations 92 operations were done for acyanotic group, and 16 operations for cyanotic group. Thirteen cases of open heart surgery for infants or small children under 10kg of body weight were performed, which occupied 15.3 percent of total open heart surgery done in the same period. Common congenital cardiovascular anomalies were ventricular septal defect [40.7%], patent ductus arteriosus [29.6%], tetralogy of Fallot [12.[%], atrial septal defect [11.1%], and pulmonary stenosis [1.9%] in order of frequency. Valve replacement using lonescu-Shiley or Carpentier-Edwards valve was performed for 8 cases of acquired mitral valve disease, and valve replacement using St. Jude valve was done for a case of patent ductus arteriosus with severe mitral insufficiency. There was no mortality in acyanotic congenital malformations and acquired valve lesions, and 5 cases of mortality in cyanotic congenital malformations. Overall mortality was 4.3 percent for total cases and 5.9 percent for 85 cases of open heart surgery.

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Senning 및 Mustard 수술후 장기 성적 (Late Results of the Senning and Mustard Operations for TGA in Children)

  • 서경필
    • Journal of Chest Surgery
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    • 제22권1호
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    • pp.32-41
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    • 1989
  • We scrutinized the 64 cases of TGA and Taussig-Bing anomaly who underwent Senning and Mustard operations from Jan. 1981 to May 1988. The ratio of male to female was 45; 19, and the age at operation varied from 2 months to 18 years [mean 18.9*32.9 months]. The in-hospital mortality was in 24 cases [37.5%] and the major causes were myocardial failure and congestive heart failure associated with arrhythmias. The risk factors for hospital mortality were complex TGA, prolonged bypass time and high postoperative CVP. In addition, mortality increased during the first year the procedure was used. Late mortality occurred in 6 cases and the major causes was congestive heart failure, and there was not any significant risk factor noted in late mortality. Early arrhythmia developed in 37.5%, all of which were transient and self limited and 7 cases of early mortality were related to the arrhythmias. Late arrhythmias developed in 8 cases, but 7 cases were transient. One case died with junctional tachycardia. Of significance the one case that died late by arrhythmia had a similar junctional tachycardia in the early postoperative period. The survival rate in all cases disregarding initial in-hospital mortality 1YSR 89.8% and 5YSR 84.3%, but because of short duration of follow up this is not significant. We concluded that early hospital mortality could be decreased by operating at an earlier age and by adjusting the appropriate operation method.

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