• Journal of Chest Surgery
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• v.34 no.3
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• pp.240-242
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• 2001

임심 중 심폐바이패스를 사용하는 개심수술은 산모뿐 아니라 태아계에도 영향을 끼치기 때문에 중요하다. 임신 중 항응고제 투여을 부적절하게 하여 기계판막 기능부전이 초래된 임신 31주의 산모에서 심장 재수술에 앞서 제왈절개로 태아 출산 후 20시간 뒤 산모의 개시수술을 성공적으로 시행하였기에 보고하는 바이다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.11.1-11
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• 1987

1984년 3월부터 1987년 2월까지 3년동안 canal wall dorm tympanoplasty를 시행한 환자 27 명을 관찰하여 다음 결과를 우선 얻을 수 있었다. 수술후 추적기간은 평균 4.6개월(1개월부터 1년 반까지)로 남자 18명, 여자 9명이었으며 평균 연령은 23.4세(7세부터 44세까지)이었다. 수술시 병명은 진주종성 중이염이 17례 (63%), intact canal tympanoplasty with recurrent or residual cholesteatoma가 4례(15%), 중이 근치 수술이 4례(15%)이었다. 수술 중 소견은 malleus (M), incus(I), stapes(S)의 전체 괴사가 11례 (41%), M·I 괴사와 수평반규관 노출이 각각 5례 (38%)씩 차지했다. 청력증진은 청력증진술을 1차에 시행한 18예 중, 추적 가능한 15례 중에서 5례 (30%)가 수술 후 8주이상의 청력검사결과 평균 31.4/10.4㏈를 나타냈다. 수술후 합병증으로 외이도 성형술을 동시에 시행한 20례중 경미한 육아조직 발생이 6예(30%) 외이도 성형술을 시행치 않은 7례 중 경미한 농성이루가 3례 (43%)로 나타났다.

• The korean journal of orthodontics
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• v.28 no.4 s.69
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• pp.487-498
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• 1998

This study was conducted to investigate changes of airway size, tongue and hyoid position following orthognathic surgery in mandibular prognathism, and how they are adapted to new environment in time dependent manner. 37 patients, who had recieved orthognathic surgery, were selected for this study. lateral cephalogram of each patient was taken at preoperation, immediate postoperation, and over 6 month after operation, and were traced and analyzed The findings of this study were as follows : 1. The size of airway was not changed at PNS and Epiglottis level after operation, but it was changed slightly at 2nd cervical vertebra level. 2. The hyoid was moved inferoposteriorly at immediate postoperation, and then it shifted toward preoperative position, but it remained slightly inferoposterior position. The distance from hyoid to genial tubercle decreased continuously. 3. The position of tongue was moved inferoposteriorly at immediate postoperatioa and then it shifted toward preoperation position, but the root of the tongue remained inferoposteriorly. 4. The distance between tongue and hyoid was increased at immediate postoperation and slightly decreased during follow-up period. 5. The change of the mandibular position was not significantly correlated with changes of airway size, hyoid position, tongue morphology and tongue position.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.177-181
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• 2000

배경 및 목적: Theodor Kocker에 의해 일반화된 전통적인 갑상선 수술방법은 갑상선 질환의 종류 및 정도, 수술범위와 상관없이 광범위한 수술범위로 인한 조직 손상으로 인해 수술후 환자들의 여러가지 불편감은 물론 경부의 넓은 부위의 통증과 경부 피부부종, 장액종, 혈종 등과 같은 후유증을 동반할 수 있다. 최근 본 저자들은 이같은 전통적 갑상선 수술의 부작용을 최소화하기 위해 작은 피부절개($3{\sim}4.5cm$) 후 피하 피판(subplatysmal skin flap) 없이 직접 갑상선으로 접근하는 새로운 수술기법으로서 최소침습 갑상선 수술기법을 개발하였기에 그 술식을 소개하고 전통적인 갑상선 절제술에 대한 우월성을 확인하고자 본 연구를 시행하였다. 대상 및 방법: 1999년 1월 15일 부터 2000년 1월 14일까지 573예의 갑상선 수술 예 중 최소침습 갑상선절제술이 시행되었던 466예와 1998년 1월 15일부터 1999년 1월 14일까지 전통적 갑상선 수술을 시행한 549예 중 거대 종양(양성>6cm, 악성>5cm), 흉골하 선종, 국소진행암, 재발암, 측경부의 다발성 림프절 전이가 있었던 112예를 제외한 437예의 임상병리적 특성과 피부절개 길이, 수술 시간, 수술중 출혈양, 수술후 진통제 요구빈도 및 재윈기간, 수술 후 합병증 발생빈도를 비교 분석하였다. 결 과: 두 군간의 임상병리적 특성상의 유의한 차이는 없었다. 피부절개 길이($3.7{\pm}0.7cm,\;vs\;9.6{\pm}3.3cm$), 수술 시간($57.6{\pm}11.7$분 vs $85.2{\pm}32.3$분) 수술 중 출혈양($18.4{\pm}15.3ml\;vs\;43.1{\pm}21.8ml$), 수술후 재원기간($1.6{\pm}0.5$일 vs $4.3{\pm}1.6$일), 및 수술후 진통제 요구빈도가 전통적 수술군에 비해 최소침습 수술군에서 통계적으로 유의하게 감소되었으나(p<0.05), 수술후 장액종 및 혈종 형성, 일시적인 음색변화, 일시적인 저칼슘혈증과 같은 합병증의 발생빈도는 각각 4.3%(n=20)와 4.8%(n=21)로 두 군간에 유의한 차이가 없었다. 결 론: 최소침습 갑상선 수술법은 새로운 수술기구의 도입 없이도 갑상선 수술의 충분한 시야를 확보할 수 있고 안전하고 간단하게 시행할 수 있으며, 기존 수술법으로 인한 부작용을 최소화할 수 있어 전통적 인 수술법을 대치할 수 있는 새로운 방법으로 사료된다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2491-2496
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• 2010

The DFA(detrended fluctuation analysis) which is included the correlation property of the EEG is used to analysis the depth of anesthesia. We studied ASA I or II adult patients supported by the society of anesthesiologists. Patients with history of dementia and neurological disorder are excluded. Average age is $48.9{\pm}10.9$ old, average weight is $57.1{\pm}8.2$ kg and average hight is $158{\pm}6.6$cm of the patients under the operation. Anesthesia medicine is Sevoflurane and the stages of anesthesia are 6 stages, that is pre-operation, induction, right after induction, stop the medicine and post-operation. Among the scaling exponent ${\alpha}1$, ${\alpha}2$, ${\alpha}3$ we know that ${\alpha}1$, ${\alpha}3$, were well appeared to discriminate pre-operation, induction, right after induction, stop the medicine and post-operation. So we confirmed that the parameters is useful to the depth of anesthesia.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.576-582
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• 2003

During the Off-Pump Coronary Arterial Bypass surgery (OPCAB), the manipulation of the heart can depress cardiac contractility and cause hemodynamic instability. In this study, hemodynamic parameters were measured during operation and the laboratory and clinical data were investigated to evaluate their effects on postoperative outcome. Material and Method: From March 2001 to August 2002, 50 consecutive patients who underwent OPCAB were included in this study. During the same period, total number of CABG was 71 The blood pressure, pulmonary artery pressure, mixed venous oxygen saturation, and cardiac index were measured before manipulation, after application of stabilizer, and at the end of anastomosis. Postoperatively, we measured the cardiac enzymes such as CK-MB, troponin 1 and checked the amount of inotropes required, chest tube drainage, the amount of transfusion, duration of ventilator support, and duration of ICU stay. Result: The number of mean distal anastomoses was 2.8$\pm$0.9 per patient. On elevation and stabilization of the heart, systolic blood pressure was depressed and pulmonary artery pressure was elevated significantly, but during each anastomosis no significant changes were detected. The peak level of cardiac markers was 29.2$\pm$46.7 for CK-MB, 0.69$\pm$0.86 for troponin 1 on postoperative day f. Among the intraoperative hemodynamic parameters, the ischemic change of EKG and bolus injection of inotropes significantly affected the posteroperative cardiac enzymes. But, no difference other than the level of cardiac enzymes between the two groups with or without the ischemic change of EKG and bolus injection of inotropes was noticed. Conclusion: The significant hemodynamic changes occurred when the heart was elevated and stabilized, however during anastomoses there were no significant changes. Serum cardiac enzymes rose significantly in the group that showed the ischemic charge of EKG or needed the bolus injection of inotropes for maintaining hemodynamic stability intraoperatively, but it did not affect the postoperative outcome. In conclusion, the ischemic change of EKG and the need for bolus injection of intropes during operation may be very indicative for probable ischemia.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.961-969
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• 2003

The purpose of this study was to evaluate the fate of left atrioventricular valve regurgitation(LAVVR) following repair of complete atrioventricular septal defects (AVSDs). Material and Method: Between July 1984 and March 2002, repair of complete AV defects were performed in 77 patients. Mean age at surgery was 30.23$\pm$69.11 months (range 1 to 456). Echocardiograms of all survivors after isolated AVSDs correction were reviewed. LAVVR were evaluated with color doppler echocardiography in 64 survival periodically. On each study, LAVVR severity was graded on a 1 to 4 scale, based upon the size of the regurgitated jet. Result: Mild deterioration of LAVV function was fairly common. LAVVR severity increased by >1 grade in 19 patients (30.2%) during the course of the study. However, the deterioration in LAVVR function occurred primarily between 12 and 24 months postoperatively. After the initial 24 postoperative months, LAVVR worsened on only 8 occasions and in each instance worsened by only 1 grade. Deterioration more than 3+ LAVVR occurred in only 3 patients. And deterioration to 4+ LAVVR was not observed after the initial 24 postoperative months but one. Survival curve analysis predicted a 88.2% of ten-year freedom rate from development of 4+ LAVVR after initial operation of complete AVSDs. Conclusion: Postoperative LAVVR remains fairly stable following AVSDs repair, Serious deterioration is rare after 24 postoperative months, especially after the initial 48 postoperative months. But serial follow-up study with echocariogram was need till 24 postoperative months after repair of complete AVSDs.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.4
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• pp.317-326
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• 2020

Deep blocking of consciousness alone does not prevent a reaction to severe stimuli, and copious amounts of pain medication do not guarantee unconsciousness. Therefore, anesthesia must satisfy both: the loss of consciousness as well as muscle relaxation. Muscle relaxants improve the intra-bronchial intubation, surgical field of vision, and operating conditions, while simultaneously reducing the dose of inhalation or intravenous anesthesia. Muscle relaxants are also very important for breathing management during controlled mechanical ventilation during surgery. Excessive dosage of such muscle relaxants may therefore affect neurological examinations during surgery, but an insufficient dosage will result in movement of the patient during the procedure. Hence, muscle relaxation anesthesia depth and neurophysiological monitoring during surgery are closely related. Using excessive muscle relaxants is disadvantageous, since neurophysiological examinations during surgery could be hindered, and eliminating the effects of complete muscle relaxation after surgery is challenging. In the operation of neurophysiological monitoring during the operation, the anesthesiologist administers muscle relaxant based on what standard, it is hoped that the examination will be performed more smoothly by examining the trends in the world as well as domestic and global trends in maintaining muscle relaxant.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.102-107
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• 2014

This study was conducted to analyze the results of inhalation anesthesia performed at the equine hospital of Korea Racing Authority (KRA) and to find out the influencing factors on mortality during and/or after inhalation anesthesia. Among 585 cases of anesthesia, orthopedic surgery (410) was performed the most frequently, followed by colic surgery (85) and upper airway surgery (45). Twenty out of 585 horses were either euthanized or died during and/or after anesthesia. Among those twenty horses, fourteen horses received colic surgery, three received orthopedic surgery, and three others received upper airway surgery. The major causes of mortality were rupture of intestine in colic surgery and airway obstruction during recovery in upper airway surgery. Myopathy, refracture, laminitis were the causes of mortality in orthopedic surgery. Consequently, the horses that received colic and upper airway surgeries showed significantly high mortality rate rather than horses that received orthopedic surgery (p < 0.01). According to the results, horses that received colic surgery showed the highest mortality rate from euthanasia due to poor and grave prognosis. To reduce the perioperative mortality of horses, it is recommended to perform perioperative intensive care for colic surgery and careful monitoring for upper airway surgery during recovery.

• Journal of the Korean Catholic Hospital Association
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• v.16 no.1
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• pp.47-49
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• 1985

1983년 5월부터 본협회가 주관한 천주교회 200주년 무료개안수술 사업으로 지난 '84년 말까지 전국 11개 지정병원에서 917명(1,084안)에 대한 개안수술을 실시하였다. 그러나 이 사업기간중 수술신청을 받고도 병원의 수용능력과 예산부족으로 아직 수술을 베풀지 못한 불우영세민 340명(약400안) 모두에게 빛을 찾아주기로 한 한국주교회의 배료에 의하여 200주년 지속사업으로 금년 10월까지 계속사업으로 실시중에 있다. 다음은 '85년 개안수술사업의 실시요령을 중심으로 실무에 참고될 사항을 요약한 것이다.<편집자 주>