Oh, Yoon Jung;Sung, Nak Song;Choi, Won Jun;Yoon, Dae Sung;Choi, In Seok;Lee, Sang Eok;Moon, Ju Ik;Kwon, Seong Uk;Park, Si Min;Bae, In Eui
Journal of Minimally Invasive Surgery
/
제21권4호
/
pp.148-153
/
2018
Purpose: Single incision laparoscopic appendectomy (SILA) is a widely used surgical procedure for treatment of appendicitis with better cosmesis. However, many surgeons generally tend to choose conventional multiport laparoscopic appendectomy regarding with complicated appendicitis. The aim of this study is to demonstrate the safety and feasibility of SILA for treatment of complicated appendicitis by comparison with 3-ports conventional laparoscopic appendectomy (CLA). Methods: Retrospective chart review of patients diagnosed appendicitis at single hospital during January 2015 to May 2017 collected 500 patients. Among 134 patients with complicated appendicitis, we compared outcomes for 29 patients who got SILA and 105 patients who got CLA. Results: 179 and 321 patients were treated by SILA and CLA, respectively. 134 (26.8%) patients were treated for complicated appendicitis, 29 patients by SILA and 105 patients by CLA, respectively. There was no case converted to open or added additional trocar in both groups. There were no differences in demographics with regard to age, sex, body mass index (BMI), and American society of anesthesiologists (ASA) scores. There was no difference in mean operating time ($58.97{\pm}18.53$ (SILA) vs. $57.57{\pm}21.48$ (CLA), p=0.751). The drain insertion rate (6.9% vs 37.1%, p=0.001) and the length of hospital stay ($2.76{\pm}1.41$ vs. $3.97{\pm}2.97$, p=0.035) were lower in SILA group with significance. There was no significant difference in the rate of surgical site infection (6.9% vs. 6.7%, p=1.000). Conclusion: This study demonstrates that SILA is a feasible and safe procedure for treatment of complicated appendicitis.
Purpose: To analyze delayed diagnosis, we collected date on pediatric and adolescent patients who had been admitted to the Emergency Department with injuries due to minor trauma Methods: We retrospectively analyzed the age distribution, trauma mechanism, time interval for each affected body region at delayed diagnosis, hospital stay, and outcome for 161 pediatric and adolescent patients who had been admitted to the Emergent Department of Gachon University Gil Hospital from January 2006 to September 2008. Results: The incidence of delayed diagnosis in pediatric and adolescent trauma was 11.8% in our retrospective review of 161 pediatric and adolescent patients. Lengths of hospitalization were longer in patients with delayed diagnosis (p<0.05). Patients with delayed diagnosis were more often transferred to other hospitals than patients with non-delayed diagnosis (p<0.05). The time intervals for each different affected body regions at delayed diagnosis were significantly different, but the hospital stays were not. There were no statistical significance to age on affected body region. Conclusion: From this study, we found that admission result and hospital stay were statistically significant differences between the delayed-diagnosis patient group and the non-delayed-diagnosis patient group. Finally, we must follow up pediatric and adolescent patients with minor trauma, closely considering missed injuries.
The purpose of this study is to identify if dental patients discriminate between dental clinic and dental hospital and the related factors for choice of dental facilities. A self-administered questionnaire survey was conducted from March 21 to April 11, 2011. Among 430 dental patients who visited dental clinic or dental hospital twice or more in Daegu, 410 dental patients were included in analysis. A total of 73.6% of the dental clinic visitors recognized correctly that the visiting facility was dental clinic and 82.3% of dental hospital visitors did correctly. Therefore, it can be said that dental hospital visitors recognize better the type of dental care facilities they visit. When it comes to choosing the dental facility, there were not much differences between the clinic and hospital patients in this study. Human resources, facilities and equipment, service are factors for choosing dental clinic and dental hospital in order. However, modern dental facility and equipment were more important factor for patients to choose dental hospital than clinic. It will be necessary for dental clinic or dental hospital to develop its own specific service to fulfill dental patients' needs through further studies on factors for choosing dental facilities.
Background and Aims: Hepatitis B virus (HBV) reactivation was reported to be induced by transcatheter arterial chemoembolization (TACE) in HBV-related hepatocellular carcinonma (HCC) patients with a high incidence. The effective strategy to reduce hepatitis flares due to HBV reactivation in this specific group of patients was limited to lamivudine. This retrospective study was aimed to investigate the efficacy of prophylactic entecavir in HCC patients receiving TACE. Methods: A consecutive series of 191 HBV-related HCC patients receiving TACE were analyzed including 44 patients received prophylactic entecavir. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 copies/ml higher than nadir the level, and hepatitis flares due to HBV reactivation were the main endpoints. Results: Patients with or without prophylactic were similar in host factors and the majorities of characteristics regarding to tumor factors, HBV status, liver function and LMR. Notably, cycles of TACE were parallel between the groups. Ten (22.7%) patients receiving prophylactic entecavir reached virologic response. The patients receiving prophylactic entecavir presented significantly reduced virologic events (6.8% vs 54.4%, p=0.000) and hepatitis flares due to HBV reactivation (0.0% vs 11.6%, p=0.039) compared with patients without prophylaxis. Kaplan-Meier analysis illustrated that the patients in the entecavir group presented significantly improved virologic events free survival (p=0.000) and hepatitis flare free survival (p=0.017). Female and Eastern Cooperative Oncology Group (ECOG) performance status 2 was the only significant predictors for virological events in patients without prophylactic antiviral. Rescue antiviral therapy did not reduce the incidence of hepatitis flares due to HBV reactivation. Conclusion: Prophylactic entecavir presented promising efficacy in HBV-related cancer patients receiving TACE. Lower performance status and female gender might be the predictors for HBV reactivation in these patients.
Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.
Recently hospitals are trying to meet requests of patients by reflecting regular survey results of patients into hospital's management in order to increase patients' satisfaction and the rate of return visit. In this paper, degree of patients' satisfaction and the rate of return visit were analyzed using surveys of hospital selection factors and the characteristics of aesthetic plastic surgery. This analysis results can be used as data for setting up efficient management direction of aesthetic plastic surgery hospitals. In the main results, facilities and medical trust factor was the primary cause for aesthetic plastic surgery patients to select hospitals and the results showed that hospitals have to consider carefully not only aesthetic plastic surgery patients but also guardians such as parents or friends because patients are acquiring surgery information from them. The results also showed approachableness to hospitals was not important factor to select a hospital.
Objective: To compare the influence of breast-conserving surgery (BCS) and modified radical mastectomy (MRM) on the psychological state of breast cancer patients. Methods: Patients receiving MRM or BCS, and fulfilling the study criteria, were recruited. Patients were required to complete a self-reporting inventory (SCL-90) on admission and 6 months after surgery and a self-rating depression scale (SDS) when discharged from hospital and 6 months after surgery. Results: A total of 70 patients received MRM and 50 BCS. Compared with the national standard, patients suffered to some extent psychological problems on admission, at discharge from hospital and at 6 months after surgery. Patients received BCS had a higher score of SDS compared with those with MRM when discharged from hospital. However, 6 months after surgery, SDS score increased in MRM and decreased in the BCS group, so the difference was significant. Conclusion: The short-term psychological state of patients receiving BCS is worse than that with MRM but superior to MRM 6 months postoperatively. BCS imposed less influence on long term psychological state of breast cancer patients compared with MRM.
Purpose: This study was done to determine how a hospital life guidance movie enhanced the understanding of hospital life by elderly in-patients. Method: A non-equivalent control group post-test design was used for the study. The experimental group watched a movie on guidance for hospital life while an in-patient control group read corresponding guidance booklets. The understanding and satisfaction from the respective programs for the two groups were surveyed with a questionnaire. The data were analyzed using SPSS. Results: The group which watched the movie had a better understanding of hospital life than the group which read the booklets. The patients who watched the movie also expressed more satisfaction with their guide program than the patients who only read the booklets. Understanding of hospital life had relevance to satisfaction with the given program. Conclusion: The results of this study suggests that a movie on hospital life provides better guidance which helps the prospective patients understand and adapt better to their hospital life. Therefore, this type of movie is considered to be an effective medium to provide guidance to elderly in-patients.
Background: Esophageal perforation is an extremely lethal injury that requires careful management for survival,. Material and Method: We performed a retrospective clinical revi-ew of 14 patients treated for esophageal perforation at the Department of Thoracic and Cardiovascular Surgery hanyang University Hospital between July 1986 and August 1998. Cardiovascular Surgery Hanyang University Hospital between July 1986 and August 1998. Result: The ration between male and female patients was 12:2 and their ages ranged from 9 to 68 years( average: 446 years). Iatrogenic perforations were found in 6 patients(42.9%) spontaneous perforations in 3 patients(21.4%) traumatic perforations in 2 patients(14.3%) and caustic perforations foreign body origin and esophagel cancer in 1 patient (7.1%) each. Four of the patients(28.6%) had esophageal ruptures located cancer in 1 patient (7.1%) each. Four of the patients (28.6%) had esophageal ruptures located in the cervical esophagus and 10 patients (71.4%) in the thoracic esophagus, The most frequent location was in the mid third portion of the esophagus (35.7%) there were also 2 patients(14.3%) in the upper third portion and 3 patients(21.4%) in the lower third portion. Complications encountered included mediastinitis empyema or pleural effusion mediastinal or lung abscess sepsis and aspiration pneumonia. The most frequent complication that occurred was mediastinitis in 9 cases (57%) Three patients underwent conservative treatment. Among the patients who underwent surgical treatment 5 patients underwent primary closure 6 patients underwent open drainage and 2 patients underwent reconstrumction (1 patients had an initial primary closure and 1 patient had an initial open drainage procedure). The mortality rates for those with conservative and surgical treatment were 66.7% (2cases) and 9.1% (1 cases) respec- tively. Conclusion: Perforation of the esophagus although very rare has a high mortality rate and thus aggressive operative therapy is necessary.
Objectives : The purpose of this study is to investigate the effectiveness of treating low back pain patients with Foot acupuncture. Methods : Clinical study was conducted to 40 patients who were treated in Dept. of Acupuncture and Moxibusion, Woosuk University Hospital from March 1 to December 31, 2010. Subject were randomly divided into two groups. In one group(test group), patients were treated with both acupuncture and Foot acupuncture. And in the other group(control group), patients were treated with acupuncture. To estimate the efficacy of treatments, Visual Analog Scale(VAS) and Oswestry disability index(ODI) were checked. 12 patients were excluded and we investigated 14 patients of control group and 14 patients of test group entirely. Results : 1. In both two groups, VAS and ODI of patients were decreased significantly. 2. ODI of patients in test group were decreased more significantly than ODI of patients in control group. Conclusions : We suggest that cotreatment of acupuncture and foot acupuncture on low back pain patients can be recommended as a useful therapy.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.