• Journal of Korean Academy of Nursing
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• v.51 no.6
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• pp.732-745
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• 2021

Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.387-391
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• 2002

Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.116-122
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• 2005

Background: Adverse effects of cardiopulmonary bypass can be avoided by 'Off-pump' coronary artery bypass (OPCAB) surgery. Recent studies have reported that OPCAB had the most beneficial impact on patients at highest risk by reducing bypass-related complications. The purpose of this study is to compare the outcome of OPCAB and conventional coronary artery bypass grafting (CCAB) in patients with poor left ventricular (LV) function. Material and Method: From March 1997 to February 2004, seventy five patients with left ventricular ejection fraction (LVEF) of $35\%$ or less underwent isolated coronary artery bypass grafting at our institute. Of these patients, 33 patients underwent OPCAB and 42 underwent CCAB. Preoperative risk factors, operative and postoperative outcomes, including LV functional change, were compared and analysed. Result: Patients undergoing CCAB were more likely to have unstable angina, three vessel disease and acute myocardial infarction among the preoperative factors. OPCAB group had significantly lower mean operation time, less numbers of total distal anastomoses per patient and less numbers of distal anastomoses per patient in the circumflex territory than the CCAB group. There was no difference between the groups in regard to in-hospital mortality $(OPCAB\; 9.1\%\;(n=3)\;Vs.\;CCAB\;9.5\%\;(n=4)),$ intubation time, the length of stay in intensive care unit and in hospital postoperatively. Postoperative complication occurred more in CCAB group but did not show statistical difference. On follow-up echocardiography, OPCAB group showed $9.1\%$ improvement in mean LVEF, 4.3 mm decrease in mean left ventricular end-diastolic dimension (LVEDD) and 4.2 mm decrease in mean left ventricular end-systolic dimension (LVESD). CCAB group showed $11.0\%$ improvement in mean LVEF, 5.1 mm decrease in mean LVEDD and 5.5 mm decrease in mean LVESD. But there was no statistically significant difference between the two groups. Conclusion: This study showed that LV function improves postoperatively in patients with severe ischemic LV dysfunction, but failed to show any difference in the degree of improvement between OPCAB and CCAB. In terms of operative mortality rate and LV functional recovery, the results of OPCAB were as good as those of CCAB in patients with poor LV function. But, OPCAB procedure was advantageous in shortening of operative time and in decrease of complications. We recommend OPCAB as the first surgical option for patients with severe LV dysfunction.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.189-198
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• 2009

Purpose: We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect. Materials and Methods: Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure. Results: The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of $8^{\circ}$ and $16^{\circ}$ less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness. Conclusion: The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.

• Proceedings of the Korean Information Science Society Conference
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• 2007.10b
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• pp.247-252
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• 2007

오늘날 컴퓨팅 환경은 점차 복잡해지고 있으며, 복잡한 환경을 관리하는 이 점차 중요해 지고 있다. 이러한 관리를 위해 어플리케이션의 내부 구조를 드러내지 않은 상태에서 환경에 적응하는 자가치유에 관한 연구가 중요한 이슈가 되고 있다. 우리의 이전 연구에서는 자가 적응 모듈의 성능 향상을 위해 스위치를 사용하여 컴포넌트의 동작 유무를 결정하였다. 그러나 바이러스와 같은 외부 상황에 의해 자가 적응 모듈이 정상적으로 동작하지 않을 수 있으며 다수의 파일을 전송할 때 스위치가 꺼진 컴포넌트들은 메모리와 같은 리소스를 낭비한다. 본 연구에서는 이전 연구인 성능 개선 자가 적응 모듈에서 발생할 수 있는 문제점을 해결하기 위한 방법을 제안한다. 1) 컴포넌트의 동작 여부를 결정하는 스위치를 확인하여 비정상 상태인 컴포넌트를 찾아 치유를 하고, 2) 현재 단계에서 사용하지 않는 컴포넌트를 다른 작업에서 재사용한다. 이러한 제안 방법론을 통해 파일 전송이 않은 상황에서도 전체 컴포넌트의 수를 줄일 수 있으며 자가 적응 제어 모듈을 안정적으로 작동할 수 있도록 한다. 본 논문에서는 명가를 위하여 비디오 회의 시스템 내의 파일 전송 모듈에 제안 방법론을 적용하여 이전 연구의 모듈과 제안 방법론을 적용한 모듈이 미리 정한 상황들에서 정상적으로 적응할 수 있는지를 비교한다. 또한 파일 전송이 많은 상황에서 제안 방법론을 적용하였을 때 이전 연구 방법론과의 컴포넌트 수를 비교한다. 이를 통해 이전 연구의 자가 적응 모듈의 비정상 상태를 찾아낼 수 있었고, 둘 이상의 파일 전송이 이루어 질 때 컴포넌트의 재사용을 통해 리소스의 사용을 줄일 수 있었다.위해 잡음과 그림자 영역을 제거한다. 잡음과 그림자 영역을 제거하면 구멍이 발생하거나 실루엣이 손상되는 문제가 발생한다. 손상된 정보는 근접한 픽셀이 유사하지 않을 때 낮은 비용을 할당하는 에너지 함수의 스무드(smooth) 항에 의해 에지 정보를 기반으로 채워진다. 결론적으로 제안된 방법은 스무드 항과 대략적으로 설정된 데이터 항으로 구성된 에너지 함수를 그래프 컷으로 전역적으로 최소화함으로써 더욱 정확하게 목적이 되는 영역을 추출할 수 있다.능적으로 우수한 기호성, 즉석에서 먹을 수 있는 간편성, 장기저장에 의한 식품 산패, 오염 및 변패 미생물의 생육 등이 발생하지 않는 우수한 생선가공, 저장방법, 저가 생선류의 부가가치 상승 등 여러 유익한 결과를 얻을 수 있는 효과적인 가공방법을 증명하였다.의 평균섭취량에도 미치지 못하는 매우 저조한 영양상태를 보여 경제력, 육체적 활동 및 건강상태 등이 매우 열악한 이들 집단에 대한 질 좋은 영양서비스의 제공이 국가적 차원에서 시급히 재고되어야 할 것이다. 연구대상자 특히 배달급식 대상자의 경우 모집의 어려움으로 인해 적은 수의 연구대상자의 결과를 보고한 것은 본 연구의 제한점이라 할 수 있다 따라서 본 연구결과를 바탕으로 좀 더 많은 대상자를 대상으로 한 조사 연구가 계속 이루어져 가정배달급식 프로그램의 개선을 위한 유용한 자료로 축적되어야 할 것이다.상범주로 회복함을 알수 있었고 실험결과 항암제 투여후 3 일째 피판 형성한 군에서 피판치유가 늦어진 것으로 관찰되어 인체에서 항암 투여후 수술시기는 인체면역계가 회복하는 시기를 3주이상 경과후 적어도 4주째 수술시기를 정하는 것이 유리하리라 생각되

• The Journal of Korean Medicine
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• v.16 no.2 s.30
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• pp.177-194
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• 1995

The following conclusions were obtained after bibliographic investigation on the therapy of lung cancer by western, oriental, and integrated oriental and western medicine. 1. Lung cancer is classified into small cell lung cancer(SCLC) or non small cell lung cancer(NSCLC) in the treatment by western medicine, and applied with the means of surgery, radiotherapy and chemotherapy alone or combined, depending on the stage and the symptom. 2. Treatment by oriental medicine includes the means of strengthening body resistance to dispel pathogenic factors(扶正祛邪), combined approach of reinforcement and expulsion(攻補兼施), and reinforcing both qi and blood(氣血雙補), depending on the initial, middle, and terminal stage. And also treatment based on differentiation of symptom(辨證施治) is applied according to the type of symptom; deficiency of qi of both lung and spleen(肺脾氣虛), heat symptom of lung by deficiency of yin(肺熱陰虛), stagnation of damp-phlegm and blood(濕痰瘀阻), stagnation of qi and blood(氣血瘀滯), deficiency of both qi and yin(氣陰兩虛). Single or combined herb drug is used according to the symptom. 3. Treatment by integrated oriental and western medicine improved survival rate and quality of life. It promoted recovery and improved survival rate in the patients receiving surgery. Integrated radiotherapy and oriental medicine treatment reduced adverse effect by radiotherapy and improved therapeutic effect and survival rate. Integrated chemotherapy with oriental medicine treatment reduced side effect by chemotherapy and improved quality of life and survival rate. These results suggest that therapy of lung cancer should be applied with integrated oriental and western medicine from diagnosis to treatment for promoting therapeutic effect. And further study on this therapy should be ensued.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.242-248
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• 2007

Purpose: To study the effect of recombinant human epidermal growth factor (rhEGF) on oral mucositis induced by cisplatin and radiotherapy in a mouse model. Materials and Methods: Twenty-four ICR mice were divided into three groups-the normal control group, the no rhEGF group (treatment with cisplatin and radiation) and the rhEGF group (treatment with cisplatin, radiation and rhEGF). A model of mucositis induced by cisplatin and radiotherapy was established by injecting mice with cisplatin (10 mg/kg) on day 1 and with radiation exposure (5 Gy/day) to the head and neck on days $1{\sim}5$. rhEGF was administered subcutaneously on days -1 to 0 (1 mg/kg/day) and on days 3 to 5 (1 mg/kg/day). Evaluation included body weight, oral intake, and histology. Results: For the comparison of the change of body weight between the rhEGF group and the no rhEGF group, a statistically significant difference was observed in the rhEGF group for the 5 days after day 3 of. the experiment. The rhEGF group and no rhEGF group had reduced food intake until day 5 of the experiment, and then the mice demonstrated increased food intake after day 13 of the of experiment. When the histological examination was conducted on day 7 after treatment with cisplatin and radiation, the rhEGF group showed a focal cellular reaction in the epidermal layer of the mucosa, while the no rhEGF group did not show inflammation of the oral mucosa. Conclusion: These findings suggest that rhEGF has a potential to reduce the oral mucositis burden in mice after treatment with cisplatin and radiation. The optimal dose, number and timing of the administration of rhEGF require further investigation.