• 제목/요약/키워드: postoperative therapy

검색결과 830건 처리시간 0.025초

고추파스를 이용한 수지요법 침점(K-D2) 자극과 예방적 항구토제의 병용요법이 부인과 복강경 수술 후 오심과 구토에 미치는 효과 (Combination Effects of Capsicum Plaster at the Korean Hand Acupuncture Points K-D2 with Prophylactic Antiemetic on Postoperative Nausea and Vomiting after Gynecologic Laparoscopy)

  • 정현정;박상연
    • 대한간호학회지
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    • 제43권2호
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    • pp.215-224
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    • 2013
  • Purpose: This study was done to evaluate the combination effects of capsicum plaster at the Korean hand acupuncture points K-D2 with prophylactic antiemetic on Postoperative Nausea and Vomiting (PONV). Methods: An experimental research design (a randomized, a double-blinded, and a placebo-control procedure) was used. The participants were female patients undergoing gynecologic laparoscopy; the control group (n=34) received intravenous prophylactic ramosetron 0.3mg, while the experimental group (n=34) had Korean Hand Therapy additionally. In the experimental group, capsicum plaster was applied at K-D2 of both 2nd and 4th fingers by means of Korean Hand Therapy for a period of 30 minutes before the induction of anesthesia and removed 8 hours after the laparoscopy. Results: The occurrence of nausea, nausea intensity and need for rescue with antiemetic in the experimental group was significantly less than in the control group 2 hours after surgery. Conclusion: Results of the study show capsicum plaster at K-D2 is an effective method for reducing PONV in spite of the low occurrence of PONV because of the prophylactic antiemetic medication.

뇌성마비아동의 하지건이동술과 물리치료 (Tendon transfer of the lower extremities and physical therapy in handicaped children)

  • 정석
    • 대한물리치료과학회지
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    • 제5권3호
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    • pp.617-624
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    • 1998
  • A variety of neuromuscular diseases in children cause muscle imbalance. impaired function, and resultant deformity of the lower extremities. Equinovarus, equinos, adductor contracture are common deformity of lower extremities in the children. Generally, the transfer was successful in improving or maintaining range of motion, stability of the joint and gait. Postoperative physical therapy is important. Physical therapy was instituted after cast removal. All children received stretching exercise, range of motion exercise for the joint, proprioceptive neuromuscular fascilitation and gait training was administered. This article describes our experience with the physical therapy for tendon transfered spastic cerebral palsy and discusses the therapeutic protocol.

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전이성 폐암의 외과적 고찰 (Surgical Management of Metastatic Lung cancer)

  • 김길동;정경영
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.281-286
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    • 1994
  • From 1973 through June 1993, 25 patients underwent pulmonary resection for pulmonary metastases from carcinoma or sarcoma at our institution. There were 11 carcinomas and 14 sarcomas. 24 patients[96% complete] could follow-up and the median follow-up time was 20 months with a range of 4 months to 271 months and total follow-up period was 1105 months-patients. In our patients, actuarial 5-year survival rate was 49%, mean survival time was 66.6$\pm$12.6 months and median survival time was 84 months. Patients with sarcoma, more than 24 months of the tumor-free interval, postoperative adjuvant therapy had a better survival than did those with carcinoma, less than 24 months of the tumor-free interval, no postoperative adjuvant therapy. But there were no statistical differences between two groups[P>0.05]. This results recommend more aggressive surgical treatment for pulmonary metastases.

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Eccrine porocarcinoma on the cheek

  • Seo, Bommie Florence;Choi, Hyuk Joon;Jung, Sung-No
    • 대한두개안면성형외과학회지
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    • 제20권1호
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    • pp.48-50
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    • 2019
  • Eccrine porocarcinoma is a rare malignant tumor arising from the intraepidermal ductal portion of the eccrine sweat gland. It develops either spontaneously or from a long standing benign eccrine poroma. This entity usually affects older people and is commonly located on the lower extremities, the trunk, and the head. We report a case of eccrine porocarcinoma on the left cheek in an 85-year-old male. In our case, the tumor was treated with wide excision and postoperative adjuvant radiation therapy. The patient recovered well without local recurrence and distant metastasis during the 14-month follow-up period. Wide excision and postoperative adjuvant radiation therapy can be considered as a safe and effective treatment option in treating patients with eccrine porocarcinoma.

폐에 전이된 거대 연조직 육종(혈관외피세포종, 활막육종) -수술치험 2례- (Metastatic Giant Pulmonary Soft Tissue Sarcomas (Hemangiopericytoma, Synovial Sarcoma) -Two Case Report-)

  • 김길동;정경영;신동환
    • Journal of Chest Surgery
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    • 제27권1호
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    • pp.63-67
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    • 1994
  • We report two cases of giant soft tissue sarcomas metastatic to the lung from lower extremities. The lung metastasis occurred 2 years later from original diagnosis in 27-year-old woman with hemangiopericytoma and 8 years later in 54-year-old woman with synovial sarcomtt. We had performed pleuropneumonectomies with partial resection of pericardium involved. The postoperative courses were uneventful and postoperative adjuvant therapy was begun.

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두개강내 척삭종 및 연골육종 : 수술 및 방사선 치료의 효능 (Intracranial Chordomas and Chondrosarcomas : The Effectiveness of Surgery and Radiation Therapy)

  • 정영섭;곽호신;정희원;박홍준;백선하;김동규;김현집
    • Journal of Korean Neurosurgical Society
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    • 제29권7호
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    • pp.910-917
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    • 2000
  • Introduction : The management of chordomas and chondrosarcomas in the skull base is difficult due to the critical location, locally aggressive nature, and high recurrence rate. The authors present the effectiveness of surgical removal and radiation therapy on survival and tumor recurrence. Material and Methods : Thirty cranial base chordomas and chondrosarcomas from 23 patients(14 patients with chordomas and 9 patients with chondrosarcomas) were operated in our institution between 1985 and 1998. There were 15 men and 8 women, with a mean age of 40.7 years. The largest diameter of tumors ranged from 15 to 70mm (mean 41.5). The extent of surgical removal was subtotal or total in a half(15 operations). In nineteen operations, tumors were removed by conventional approaches and skull base approaches were applied in 11 operations. Postoperative radiation therapy was performed in 16(70%) patients. The mean duration of follow up is 50 months(1- 156 months). Results : The 3- and 5-year survival rates(YSR) of overall patient are 75% and 67%, respectively. The analysis showed that 1) skull base approach to chordomas and chondrosarcomas showed a tendency to remove more portion of the tumors(p=0.058) but leave more frequent incidence of new deficits(p=0.047) : 2) larger tumor diameter af-fected the extent of removal(p=0.028) : 3) the extent of removal seemed to be the determining factor for overall survival and recurrence-free survival(the 5-YSR and RFSR of subtotal or total removal group are 92% and 80% vs. 40% of partial removal or biopsy group) : 4) conventional radiation therapy improved patient survival(5-YSR of patients who received RT is 76% whereas 5-YSR of those who didn't receive RT is 43%) but failed to prolong long-term recurrence-free survival. Conclusion : The extent of removal and postoperative radiation therapy are determining factors of patients' survival in skull base chordomas and chondrosarcomas. However, none of these factors significantly influenced the survival in multivariate analysis. Aggressive surgical removal of more than subtotal resection combined with postoperative radiation therapy seems to be the choice of therapy in the management of these tumors.

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직장풍선을 삽입한 전립선암 환자의 수술 후 방사선 치료 시 용적변조와 세기변조방사선치료계획 비교 평가 (Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon)

  • 정해윤;석진용;홍주완;장남준;최병돈;박진홍
    • 대한방사선치료학회지
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    • 제27권1호
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    • pp.45-52
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    • 2015
  • 목 적 : 전립선암의 방사선치료는 치료기법에 따라 주요장기와 정상조직의 선량분포에 차이가 나타난다. 본 연구에서는 전립선암 환자의 수술 후 방사선치료 시 직장풍선을 삽입한 환자에게 회전수를 달리한 용적변조회전치료(volumetric modulated arc therapy, VMAT)계획과 세기변조방사선치료(intensity modulated radiation therapy, IMRT)계획을 각각 수립하여 선량분포 특성을 비교하고 치료의 효율성을 평가하고자 한다. 대상 및 방법 : 본원에서 전립선암 수술 후 방사선 치료를 시행한 10명의 환자를 대상으로 하였다. 직장풍선을 삽입한 환자의 CT영상을 3 mm 두께로 획득하고 Eclipse (Ver 11.0, Varian, Palo Alto, USA)를 사용하여 HD120MLC가 장착된 Truebeam STx (Varian, Palo Alto, USA)의 10 MV 에너지를 적용하였다. 환자마다 1 Arc, 2 Arc VMAT계획과 7조사면의 IMRT계획을 수립하였으며 각 치료계획의 선량체적제한과 plan normalization 값은 동일하게 적용하였다. 수립된 세 가지 치료계획을 평가하기위해 PTV의 coverage, conformity index (CI), homogeneity index (HI)를 비교하였고, PTV주변 정상조직의 선량퍼짐정도를 알아보기 위해 50% 등선량체적과 PTV체적의 비($R_{50%}$)를 산출하였다. 결정장기 (organ at risk, OAR)에서는 직장의 $D_{25%}$와 방광의 $D_{mean}$을 비교하였고 치료의 효율성을 평가하기 위해서 총 MU와 조사시간을 측정하였으며, 각 평가항목별 결과는 환자 10명의 평균값으로 비교분석하였다. 추가적으로 선량전달 정확도를 검증하기 위해 EPID를 이용한 portal dosimetry를 진행하였다. 결 과 : 각 치료계획에서 나타난 PTV coverage와 HI의 차이는 크지 않았지만 CI는 1A-VMAT, 2A-VMAT, 7F-IMRT에서 각각 1.036, 1.035, 1.230으로 VMAT에 비해 7F-IMRT가 높았고(p=0.00), $R_{50%}$는 3.083, 3.054, 3.991로 2A-VMAT이 제일 낮았고 7F-IMRT에서 가장 높게 나타났다(p=0.00). 치료계획에 따른 직장의 $D_{25%}$는 VMAT에서 비슷했지만 7F-IMRT가 약 7% 높게 나타났고(p=0.02), 방광의 $D_{mean}$은 큰 차이가 없었다(P>0.05). 총 MU는 1A-VMAT, 2A-VMAT, 7F-IMRT에서 각각 494.7, 479.7, 757.9로 7F-IMRT가 가장 많았고(p=0.00), 조사시간은 65.2초, 133.1초, 145.5초로 1A-VMAT이 확연히 짧았다(p=0.00). portal dosimetry 검증에서는 모든 치료계획에서 99.5% 이상의 gamma pass rate(2 mm, 2%)을 보였다(P=0.00). 결 론 : 본 연구결과 직장풍선을 삽입한 전립선암 환자의 수술 후 방사선치료 시, 치료기법에 따른 PTV coverage의 차이는 크지 않았지만 1A, 2A-VMAT이 7F-IMRT에 비해 정상조직과 직장선량을 낮추는데 효과적이었다. VMAT중에서는 $R_{50%}$와 MU가 2A-VMAT에서 다소 낮았지만 조사시간이 짧은 1A-VMAT이 치료에 더 효율적이며 환자의 치료 중 움직임 또한 줄일 수 있을 것으로 사료된다.

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하악 제3대구치가 하악 우각부골절 정복술후 감염에 미치는 영향에 관한 연구 (EFFECT OF THIRD MOLAR ON POSTOPERATIVE INFECTION AFTER REDUCTION OF THE MANDIBULAR ANGLE FRACTURE)

  • 최문기;민승기;이동근;오승환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권3호
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    • pp.217-225
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    • 2001
  • Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particulary in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1. There were no statistical significance between the time from injury to operation and postoperative infection. 2. There were no statistical significance between eruption state of third molar and postoperative infection. 3. In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4. There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.

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방사선 치료후 흉골에 발생한 악성 섬유성 조직구종 -흉골 전절제 및 흉벽 재건술 1례 보고- (Malignant Fibrous Histiocytoma in Sternum after Radiation Therapy -Total Sternectomy and Chest Wall Reconstruction, A Case Report-)

  • 조유원;박승일
    • Journal of Chest Surgery
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    • 제29권1호
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    • pp.115-119
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    • 1996
  • 방사선 치료 후 발생한 악성 섬유성 조직구종은 아주 드물며 일반적으로 예후가 나쁘다. 52세 남자환자가 6개월 전부터 발견된 흉골부위에 발생한 동통성의 종괴을 주소로 입원하였다. 환자는 5년전 식도암으로 방사선 치료를 받은 병력이 있었다. 종괴는 절개생검상 흥골육종으로 진단되어 항암약물요법을 5회 시행하였으나, 종괴가 점점 커져 수술을 시행하였다. 수술은 흥골을 덮고있는 피부와 늑연골을 포함하여 흥골 전절제술을 시행하였고 이로 인한 결손부위는 자가늑골 이식, 양측 대흥근 근육판과 피부이식으로 흥벽재건술을 시행하였다. 수술후 조직소견은 악성 섬유성 조직구종에 일치하였다. 수술후 경과는 순조로왔으며 36일째에 퇴원하였다.

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