• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.6985-6991
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• 2015

Purpose: Various new techniques in thyroid surgery have been developed to improve visualization and reduce risk of complications. New approaches for robotic endoscopic thyroidectomy help to prevent neck scarring and improve surgical ergonomics. The purpose of this study was to compare the efficacy and adventages of an axillo-breast approach (AB group) and an only-axillary approach (OA group) in robotic endoscopic thyroidectomy. Methods: Between November 2008 and July 2014, axillo-breast approach was performed in 128 patients and only-axillary approach was performed in 128 patients for robotic endoscopic thyroidectomy. We compared tumor characteristics, surgical outcomes, and postoperative complications between the two approaches. The homogeneity between two groups of general characteristics was analyzed by independent t-test, fisher's exact test, Chi-square test. Results: There were no differences in terms of tumor characteristics, extent of thyroidectomy, retrieved nodes, and postoperative complications between the two approaches. The patients in OA group can avoid breast scar. Conclusion: Our techniques of AB and OA approaches for robotic endoscopic thyroidectomy are safe, feasible, and cosmetically excellent procedures. Also the OA approach for robotic endoscopic thyroidectomy is an attractive surgical option for patients with thyroid tumor who want an avoid breast scar.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.44-52
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• 2009

Purpose: We assessed the radiographic and clinical results of one surgeon's experience treating proximal humerus fractures with a locked proximal humeral plate. Materials and Methods: Twenty patients with unstable proximal humerus fractures were treated with a locking compression plate between February 2005 and September 2007. The average age of the patients was 60.6 years, and the average postoperative follow-up period was 22.3 months. The clinical results were evaluated using the Constant and DASH scores. The radiologic results were evaluated by the Paavolainen method, which measures the neck shaft angle and humeral head height. Results: At the last follow-up examination, the mean Constant score was 75.3 and 15 cases (75%) had excellent or good results; the mean DASH score was 16.4. The mean neck shaft angle was $137.1^{\circ}$, and 19 cases (95%) had good results by the Paavolainen method. There was one delayed union, malunion, and screw loosening. Conclusion: The patients treated with a locking compression plate had relatively good clinical and radiologic results, and a low complication rate. Moreover, the patients could exercise earlier due to good reduction and initial stability. Treatment of unstable proximal humerus fractures with a locking compression plate is a reliable method.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.125-130
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• 1997

Separating the patient from hypothermic cardiopulmonary bypass(CPB) before achieving adequate rewarming often results in afterdrop, which can predispose to electrolyte disturbances, arrhythmia, hemodynamic alterations, and shivering-induced increase of oxygen consumption. In an attempt to find an adequate end point temperature of rewarming after hypothermic CPB, 50 pediatric cardiac surgical patients were r ndomly assigned for end point temperature of rewarming of 35.5$^{\circ}C$ (Group 1) or 37t (Group 2), rectal temperature. Thereafter the rectal temperature was measured half, one, four, eight, and 16 hour after arrival to the intensive care unit(ICU), with heart rate and blood pressure. Additionally the rectal temperature was compared with esophageal temperature during CPB, and axillary temperature luring stay in the ICU. Nonpulsatile perfusion with a roller pump was used in all patients and a membrane or bubble oxygenator was used for oxygenation. Both groups were comparable with respect to age, sex, body surface area, total bypass time, and rewarming time. There was no afterdrop in both groups, and there were no statistical differences in the rectal temperatures between two groups. There were also no statistical dilyerences with respect to the heart rate and blood pressure between two groups. At the end of rewarming the esophageal temperature was higher than the rectal temperature. The axil ary temperature measured in ICU was always lower than the rectal temperature. No shivering was noted in all patients. In conclusion, with restoration of rectal temperature above 35.5$^{\circ}C$ at the end of CPB in pediatric patients, we did not observe an afterdrop.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.75-80
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• 2006

Purpose: To evaluate the efficiency of Acutrak screw fixation for radial head fracture (Mason type 2) without considering the safe Bone of radial head. Materials and Methods: Consecutive seven radial head fracture of Mason type II underwent internal fixation with Acutrak screws from May 2001 to February 2003. The mean follow-up period was 1.2years (ranged, $6 months{\sim}2.5 years$). The mean age of patients was 47 years old (ranged, $36{\sim}60years$ old). The cause of injury were fall down -4 cases and traffic accident -3 cases. The results were evaluated by Mayo Clinic results scoring system. Results: Functional Rating Index of Mayo Clinic was excellent- 2 cases and good- 5 cases. There were no nonunion, loosening, heterotopic ossification, infection or degenerative changes. The postoperative range of motion in elbow joint is nearly full for flexion, extension, pronation and supination in this study Conclusion: Consideration of safe zone is not necessary when Acutrak screws are used for radial head fracture. It seems to be a useful method that Acutrak screw fixation for radial head fracture (Mason type II) could achieve good radiologic and clinical results without influencing proximal radio-ulnar joint and has powerful fixation.

• Neonatal Medicine
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• v.18 no.2
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• pp.337-344
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• 2011

Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.512-516
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• 1997

We have experienced 66 cases of video assisted thoracic surgery(VATS) of spontaneous pneumothorax. The patients ranged in age from 1 Syears to 46years(mean age, 22.3years) and male patients were sixty three. The indications of video assisted thoracic surgery of spontaneous pneumothorax were recurrence, continuous air leakage, visible blabs on the chest X-ray & others. Infraoperative findings were as follows; blabs, pleural adhesion and pleural effusion. The operation was performed under general anesthesia wit double lumen endobronchial tube. Operative procedures included blebectomy and/or wedge resection of lung, vibramycin Pleurodesis with mechanical abrasion. In most cases, postoperative courses were uneventful and patients were discharged without significant complications. VATS provided the benefits of lesser postoperative pain, rapid recovery, short hospitalization, and smaller scar of wound. Conclusively VATS is a new interesting modality of surgical treatment of spontaneous pneumothorax and also can be extensively applicable in the diagnosis and treatment of other intrathoracic disease.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.121-129
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• 2019

This study aimed to develop a planned discharge nursing intervention guideline for patients with pneumothorax, and to examine its influence on drug compliance, knowledge about disease, compliance level with therapeutic regimen, and nursing satisfaction. Methods: The planned discharge nursing intervention guideline was developed based on comprehensive literature reviews and clinical experiences. Patients having video-assisted thoracoscopic surgery at a single general hospital were allocated to either intervention (n=30) or control group (n=29). Participants in the intervention group were administered planned discharge nursing intervention thrice, 30 minutes each, by a cardiovascular nurse. Standard care was provided to patients in the control group. Data were collected from March, 2010 to December, 2010. Results: Participants in the intervention group presented statistically significant improvement in drug compliance (t=-2.05, p=0.044), pill count (t=-2.61, p=0.011), knowledge about disease (t=-4.39, p=0.001), and nursing satisfaction (t=-4.13, p=0.001). No significant difference in compliance levels was observed with standard therapeutic regimen. Conclusion: Planned discharge nursing intervention can be successfully implemented for patients undergoing thoracoscopic surgery. Further research is required to evaluate long-term effects like complication or relapse.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.397-402
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• 1996

A clinical study of 36 cases of pulmonary tuberculosis that had had a surgical resection during the period of 13 years from January 1979 to December 1992 was performed in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital The ratio between male and female was 3.5 1 and the age of peak incidence was in the 2nd and 3rd decades. The common prodromal symptoms were chest pain (38.9 %) and hemoptysis or blood tinged sputum (36.1 %). Preoperative diagnostic examination of sputum positivity for AFB stain despite antituberculosis chemotherapy was noticed in 22.8 oyo . Surgical indications were destroyed lobe or segment with or without cavity (58.3 oyo), mass unable to differentiate from lung cancer (16.7 %), total destroyed lung (13.9 %), bronchostenosis with atelectasis and distal bronchiectasis (11.1 %). Types of resection were pneumonectomy in 16.7%, lobec omy and segmentectomy 2.7%, lobectomy 50 %, segmentectomy 27.8%, and wedge resection 2.7%. Postoperatively, pulmonary function Improved compared to the preoperative examination, although these changes were not statistically significant. One patient died of ulcerative colitis due to drug hypersensitivity, and the postoperative complications were remnant dead space in 11.1 %, spreading of tuberculosis in 5.5%, and empyema with BPF in 5.5%.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.236-241
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• 2011

Purpose: To report the usefulness of dynamic ultrasonography in subluxation of the long head of the biceps tendon, which is difficult to detect with static imaging such as plain radiography, static sonography, MRI and in a subtle physical examination. Materials and Methods: Two male patients suffered from subluxation of the long head of the biceps. This difficult diagnosis? was managed by surgery (biceps soft tissue tenodesis) with the aid of dynamic ultrasonography. At final follow up, we evaluated patients' symptoms and functional outcomes using KSS, UCLA and ASES scores. Results: We diagnosed and treated subluxation of the long head of the biceps easily using dynamic ultrasonography. At the final follow up, both patients' symptoms and functional outcomes were improved. There were no significant complications. Conclusion: Dynamic ultrasonography is a useful method in the difficult and subtle diagnosis of subluxation of the long head of the biceps.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.456-461
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• 2006

Background: Distal anastomosis using artificial vascular graft is difficult when luminal size mismatch occurred owing to severe occlusion of popliteal artery and its branches. So we reconstructed blood flow to ischemic lower limb by using autologous greater saphenous vein in situ graft (GSVISG) as vascular graft material. Material and Method: From July 2000 to July 2005, 26 patients treated using GSVISG. We analyzed clinical results retrospectively by chart review. Result: There was no in hospital or early postoperative death and 6 late deaths occurred during follow up period. Postoperative complications were 5 cases of early graft obstruction, 2 cases of wound dehiscence, 1 case of graft aneurysmal change, 1 case of seroma formation at inguinal wound and 1 case of graft injury during valvulotomy. Overall patency rate during follow up period was 69.3%. Conclusion: Greater saphenous vein in situ graft is acceptable vascular graft for arterial occlusive disease of lower extremity.