• 제목/요약/키워드: post-operation

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성인병 여부에 따른 백내장 수술 효과의 차이 연구 (A Study on the Difference of Cataract Surgery Prognosis between Adult Diseases and Non-adult Diseases)

  • 조선아
    • 한국안광학회지
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    • 제21권3호
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    • pp.275-280
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    • 2016
  • 목적: 본 연구는 성인 한국인에게 많이 발생하는 성인병인 녹내장, 고혈압, 당뇨가 백내장에 어느 정도 영향을 미치는 위험 요인을 분석하여 수술 효과에 따른 차이를 밝히는데 목적을 갖는다. 방법: 분석방법은 전남 지역 소재 병원에서 백내장 수술을 받은 환자를 대상으로 수술 전 후 진료 결과에 영향을 미칠 수 있는 변수로 진료의 투입적 변수인 환자 특성과 의료 특성을 진료의 과정적 변수로 기능적 상태, 일반적 상태, 임상적 결과를 분석방법에 반영하였다. 결과: 성인병 중 녹내장, 고혈압, 당뇨가 있는 환자들은 기본적으로 백내장 수술 전부터 성인병이 없는 환자보다 시력이 약 10%정도 낮은 것으로 나타났으며 수술효과 또한 상대적으로 수술 후 시력과 굴절력에서 약 16%정도의 차이가 나는 것으로 나타났다. 결론: 이상의 연구 결과를 통해 성인병 환자의 녹내장, 당뇨, 고혈압이 백내장과 밀접한 상관성을 가짐을 확인하였으며 이들 성인병의 유병 정도에 따라 백내장 또한 수술 전 후 시력 및 안구 굴절력이 기존 일반 성인 대조군과 비교할 때 낮고 큰 차이를 나타내는 것을 확인할 수 있었다.

주말농원 참여자의 현황 및 재배작목 다양화에 대한 요구도 분석 (Analysis of the Degree in Demand for Diverse Cultivation Species by Current Status of Allotment Garden Participants)

  • 김영;김은자;이상영;이승주
    • 한국지역사회생활과학회지
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    • 제19권4호
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    • pp.659-672
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    • 2008
  • There is a need to develop diverse cultivation species with reference to the favorites and farming experiences of allotment garden participants, in addition to the crops being cultivated in the gardens. In this study, therefore, a survey on the status of cultivation and the demand for herb crops for the garden participants was conducted. Current trend of the programmes related to allotment garden for city dwellers, executed by various relevant organizations was analyzed. A questionnaire was accomplished by adult participants experiencing farming in allotments. Likewise, interview with farm proprietors was conducted. The results showed that the number of crop species cultivated in allotments was about ten species. The purchase of seeds and nursery plants was mainly dependent on the farmland proprietors. The selection of the crops was made by both wife and husband. The status of herb utilization indicated that 5.7% of participants were cultivating or had cultivated herb plants. Sixty-two percent of participants were not cultivating herb plants because they did not know how. The purposes of using herbs were for medicine and beauty (22.0%), for spices (22.0%) and for enjoyment (29.0%). Thirty-four percent (34.0%) of participants were interested or would like to use the herbs in the future for medicine and beauty, 39.0% for spices and 31.7% for enjoyment. It is expected that the demand for herbs would increase. Also, 78.3% of participants had the intension or had taken into consideration to cultivate the herb plants, if the farmland proprietors would provide the plants. And, they had interest in planting, management and post harvest utilization and if a reference material would be provided as well. An approach to plant new crops might be possible to those who have more than four years of farming experience and possess relatively high level of cultivation techniques. In conclusion, the favorable crop cultivation strategy corresponding to the participants' abilities; and rental process were essential for the sustainable operation of allotment gardens and expanded number of participants. Moreover, there is a need to pay attention to the city dwellers who have a lot of farming experiences in allotment gardens to maintain agriculture and rural community. This is so, because they are interested in agriculture and rural community and most of them replied that they had intentions to move to rural areas in the future.

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원치 않은 임신에 대한 아이의 부양비 (The Cost of Child Rearing for Wrongful Conception)

  • 봉영준
    • 의료법학
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    • 제12권2호
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    • pp.219-263
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    • 2011
  • "Wrongful conception" is a medical malpractice claim in which the plaintiff is the parent of a normal, healthy infant whose conception was unplanned and unwanted. Medical malpractice in wrongful conception can be the result of a failure to provide informed consent to a patient, failure to properly perform a surgery, or a physician's negligent handling of a patient's problems. In the concrete, wrongful conception cases fall into two categories; those involving pre-conception negligence, such as a failed contraceptive, sterilization or failing of the controlling of embryo-number on the IVF, and those involving post-conception negligence, such as a failure to diagnose a pregnancy or to perform an abortion procedure. In addition, Medical malpractice can be the result of a failure to provide informed consent to a patient. When bad results occur by medical malpractice or failure to provide informed consent to a patient, the range of recovery of damages is decided by a traditional civil liability law. However the calculation of damages for wrongful conception is not easy because the high value of life is included in that case. So many courts opinions in foreign country and Seoul High Court decision in 1996 allow damages for the pregnancy, birthing process and sterilization costs, but refuses to allow damages for child rearing expenses. As to the range of recovery of damages for wrongful conception, one approach says that to allow damages in a suit such as this would mean that the physician would have to pay for the fun, joy and affection which plaintiff will have in the rearing and educating of the plaintiff's baby. To allow such damages would be against the dignity of the baby based on article 10 of the Constitution. However another approach says that damages are recoverable for all expenses related to child birth as well as for child rearing costs. Because the damages that the parents should bear a burden to the tort damage done is not a baby itself but child rearing costs. In other words, although the baby is healthy or not, economic burden of the parents can not be disregard. And denial of compensation for costs of child rearing may invalidate the role of liability law, grant the physician with a exemption certificate of liability. As a result, the medical field of procreation can be easily isolated from a liability of reparation. Therefore, on the liability law like the other medical malpractice action, parents who became pregnant or gave a birth by physician, wrongfully performed sterilization operation, etc. should be compensated for all damages relevant to unplanned and unwanted conception or birth as well as costs of child rearing.

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비전공자 소프트웨어 교육에서 전공맞춤형 학습 콘텐츠의 효과에 관한 사례 연구 (A Case Study on the Effectiveness of Major-friendly Contents in Software Education for the Non-majors)

  • 서주영;신승훈
    • 디지털융복합연구
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    • 제18권5호
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    • pp.55-63
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    • 2020
  • 최근 대학의 비전공자 소프트웨어(SW) 기초교육에 대한 관심이 높지만 SW 비전공자에겐 학습의 어려움이 크다. 본 논문은 비전공 학생들의 학습 동기를 높여 SW교육 효과를 향상시키기 위해 기존 SW 전공자 대상의 학습 콘텐츠를 그대로 사용하기보다 비전공자들의 흥미를 반영한 전공맞춤형 콘텐츠를 활용한 수업 방안을 제안한다. 본 논문에서는 5년 이상 비전공자 SW기초교육을 운영 중인 A 대학의 사례 연구를 통해 동일한 교과과정에 대해 교육 대상의 전공에 맞춤된 학습 콘텐츠로 수업한 전, 후 학생들의 강의 만족도 변화를 비교 분석하였다. 그 결과 사회과학계열에선 국가의 사회, 문화 현상을 살펴볼 수 있는 공공 데이터를 이용한 콘텐츠에 학습 흥미를 느끼고, 인문계열에겐 소설, 역사서, SNS 글의 텍스트 콘텐츠가 학습 동기를 상승시켜 어렵게 느끼던 학습 내용에 대한 이해와 함께 강의 만족도도 크게 향상시키는 효과를 가져왔으며 전공맞춤형 콘텐츠가 비전공자 SW기초교육에 유용함을 보여준다.

소 족지 단중족증의 치료결과 - 합병증을 중심으로 - (The Outcome of the Treatment of Lesser toe Brachymetatarsia - focus on complications -)

  • 이호승;윤준오;박수성;김유진
    • 대한족부족관절학회지
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    • 제7권1호
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    • pp.13-20
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    • 2003
  • Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.

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동결 동종골의 구조적 삽입을 이용한 거골하 신연 유합술 (Subtalar Distraction Arthrodesis Using Frozen Allobone Graft by Interpositional Structural)

  • 최장석;곽지훈;전성수;박홍기
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.201-206
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    • 2011
  • Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.

수리자극에 의한 지열저류층에서의 유도지진과 단층대의 변형에 관한 입자기반 개별요소법 모델링 연구 (Particle Based Discrete Element Modeling of Hydraulic Stimulation of Geothermal Reservoirs, Induced Seismicity and Fault Zone Deformation)

  • 윤정석;아미르 하킴하쉐미;아노 짱;귄터 찜머만
    • 터널과지하공간
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    • 제23권6호
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    • pp.493-505
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    • 2013
  • 본 수치해석논문에서는 절리와 단층대를 포함한 지열저류층에 수리자극을 가할 시 수반되는 유도지진과 단층대의 변형을 개별요소법을 사용하여 모델링하였다. 수채해석기법은 2차원 입자유동코드를 기반으로 하며 수리역학적 상호작용기법과 미소파괴음의 모멘트텐서 역산알고리즘이 결합되었다. 수치해석의 주요결과로는 시공간적으로 변하는 유도지진의 분포와 규모 그리고 단층대의 변형(파괴 및 전단변위)과 주입유체압력의 시공간적 분포와의 상관관계이다. 첫 번째 수치해석으로부터 절리가 분포하는 지열저류층에서의 수리자극에 의한 유도지진의 분포는 주입유체의 점성에 상당한 영향을 받는 것으로 나타났다. 주입유체의 점성이 낮은 경우 (1 cP), 유도지진의 발생범위가 큰 것으로 나타났으며, 주입 후 발생하는 유도지진의 개수와 규모 또한 높게 나타났다. 단층대가 존재하는 지열저류층의 수리자극 모델링의 결과, 주입정의 위치가 단층대와 가까운 경우 작은 주입수 압력분포(<0.1 MPa)로도 단층대의 파괴와 전단변형을 일으킬 수 있는 것으로 나타났다. 본 논문에서 소개한 수치해석기법은 수리자극을 통한 지열저류층 개발 시 유도지진의 분포와 규모를 실제 유체주입작업전에 예측할 수 있게 함으로써 지열에너지개발 분야에서 유용하게 사용될 수 있을 것으로 기대한다.

Clinical Results of Ascending Aorta and Aortic Arch Replacement under Moderate Hypothermia with Right Brachial and Femoral Artery Perfusion

  • Kim, Jong-Woo;Choi, Jun-Young;Rhie, Sang-Ho;Lee, Chung-Eun;Sim, Hee-Je;Park, Hyun-Oh
    • Journal of Chest Surgery
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    • 제44권3호
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    • pp.215-219
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    • 2011
  • Background: Selective antegrade perfusion via axillary artery cannulation along with circulatory arrest under deep hypothermia has became a recent trend for performing surgery on the ascending aorta and aortic arch and when direct aortic cannulation is not feasible. The authors of this study tried using moderate hypothermia with right brachial and femoral artery perfusion to complement the pitfalls of single axillary artery cannulation and deep hypothermia. Materials and Methods: A retrospective analysis was performed on 36 patients who received ascending aorta or aortic arch replacement between July 2005 and May 2010. The adverse outcomes included operative mortality, permanent neurologic dysfunction and temporary neurologic dysfunction. Results: Of these 36 patients, 32 (88%) were treated as emergencies. The mean age of the patients was 61.9 years (ranging from 29 to 79 years) and there were 19 males and 17 females. The principal diagnoses for the operation were acute type A aortic dissection (31, 86%) and aneurysmal disease without aortic dissection (5, 14%). The performed operations were ascending aorta replacement (9, 25%), ascending aorta and hemiarch replacement (13, 36%), ascending aorta and total arch replacement (13, 36%) and total arch replacement only (1, 3%). The mean cardiopulmonary bypass time was $209.4{\pm}85.1$ minutes, and the circulatory arrest with selective antegrade perfusion time was $36.1{\pm}24.2$ minutes. The lowest core temperature was $24{\pm}2.1^{\circ}C$. There were five deaths within 30 post-op days (mortality: 13.8%). Two patients (5.5%) had minor neurologic dysfunction and six patients, including three patients who had preoperative cerebral infarction or unconsciousness, had major neurologic dysfunction (16.6%). Conclusion: When direct aortic cannulation is not feasible for ascending aorta and aortic arch replacement, the right brachial and femoral artery can be used as arterial perfusion routes with the patient under moderate hypothermia. This technique resulted in acceptable outcomes.

혈관 수술 후 심장 합병증 발생을 예측하기 위한 선별 검사로서 심근 관류 단일 광자 단층촬영의 유용성에 대한 연구 (Myocardial Perfusion SPECT as a Screening Test before Planned Vascular Surgery for Predicting Perioperative Cardiac Complications)

  • 이형채;황윤호;위진홍;전희재;이양행;조광현
    • Journal of Chest Surgery
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    • 제43권1호
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    • pp.25-32
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    • 2010
  • 배경: 혈관질환 환자는 관상동맥질환 및 심장질환을 많이 동반함으로 인하여 혈관 수술 후 잠재되어 있는 심장질환이 악화 또는 유발될 수 있는 가능성이 있다. 이러한 심장질환을 확인하기 위한 검사중 비교적 간단하고 비침습적인 SPECT 촬영에 대한 효용성은 아직 논란이 되고 있다. 본 연구에서는 수술 전 SPECT를 촬영하고, 그 결과에 따른 검사 및 처치들이 혈관 수술 후 심장 합병증 발생에 미치는 임상적인 효과를 평가하고자 한다. 대상 및 방법: 2004년 4월부터 2007년 9월까지 3년 6개월간 본 병원에서 혈관 수술 전 아데노신 부하 Tc-99m 테트로포스민 SPECT를 촬영한 63명의 환자를 대상으로 하였다. 결과: SPECT 촬영 유소견의 심장 합병증 발생 예측에 대한 민감도와 특이도는 각각 41.2%와 52.2%로 비교적 낮게 나왔다. 그러나 비정상적인 SPECT 촬영결과를 보인 환자에게 관상동맥 조영술을 시행하고 관상동맥 병변에 대한 비정상 소견이 있을 때 관상동맥 중재적 시술 및 관상동맥 우회로술 등의 적극적인 처치를 한 경우 심장 합병증의 발생률이 낮은 경향을 보였다. 결론: SPECT 촬영은 혈관수술 후 심장 합병증 발생위험을 예측하기 위한 선별검사로서 효용성이 떨어진다.

코뼈골절 비관혈적 정복술 후 점막 유착에 대한 연구 (A Clinical Study of Nasal Synechiae Causing by Closed Reduction for Nasal Bone Fractures)

  • 최환준;이용석;최창용;탁민성
    • Archives of Plastic Surgery
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    • 제36권2호
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    • pp.188-193
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    • 2009
  • Purpose: Several authors reported about the post - traumatic nasal aesthetic complications. However, the study for functional or intra - nasal complications has been reported not enough. The aim of this study is to observe the incidence of intranasal synechia. Methods: We reviewed the data from 401 consecutive patients with nasal bone fracture from september 2006 to December 2007. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We classified the nasal bone fracture according to the anatomy and severity of fracture. Type I is nasal tip fracture(15%, n = 59), Type II is simple lateral without septal injury(38%, n = 152), Type III is simple lateral with septal injury(23%, n = 92), Type IV is closed comminuted(20%, n = 82), Type V is open comminuted or complicated(4%, n = 16). We studied 98 patients with nasal bone fracture who had postoperative symptoms or undergone postoperative endoscopic evaluation. And then we evaluated the postoperative endoscopic finding and nasal synechal formation after operation. Results: The incidence of intranasal synechiae was 15%(n = 62). According to the endoscopic findings, the incidence of intranasal synechiae was 10%(n = 6) in Type I, 8%(n = 12) in Type II, 16%(n = 15) in Type III, 24%(n = 20) in Type IV, and 56%(n = 9) in Type V. Additionally, the incidence of subjective nasal obstruction and olfactory dysfunction is 18%(n = 72) and 13%(n = 51). But the incidence of symptomatic synechiae of nasal obstruction and olfactory dysfunction is 92%(57/62) and 55%(34/62). Conclusion: We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae. Based on the results of this study, intranasal synechiae really caused airway obstruction(92%). Our data showed significant relationship between intranasal synechiae and severity of the fracture, because of increasing mucosal handling and destructive closed reductional procedures. First of all, education of delicate procedure regarding this subject should be empathized accordingly.