• 대한족부족관절학회지
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• 제8권2호
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• pp.176-181
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• 2004

Purpose: We evaluated the clinical results of operative treatment of the intraarticular calcaneal fracture according to fracture classification. Materials and Methods: There were 25 cases (24 patients) which had at least one year follow up, 17 men and 7 women who were treated from June 1997 to March 2003. We have analysed the Bohler's angle, cruciate angle, width and posttraumatic osteoarthritis in radiological evaluation, and evaluated clinical results according to the Creighton-Nebraska health foundation score. Results: Excellent results were noted in 7 cases, good results in 6 cases, fair results in 4 cases and poor results in 8 cases. Radiological changes showed as follows: Bohler angle $17^{\circ}$, Crucial angle $0.1^{\circ}$, Width 6mm. Conclusion: Type II showed satisfactory results and type IV showed unsatisfactory results in Sanders classification. Proper evaluation of the intraarticular calcaneal fracture by X-ray and CT scan is necessory to predict prognosis and decise method of operative treatment.

• Journal of Chest Surgery
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• 제21권3호
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• pp.479-487
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• 1988

Valve replacements in 82 children, aging up to 15 years[mean 11.67 years] were done at Seoul National University Hospital during 13 years period from 1974 to 1986. The patients were composed of 5] males and 31 females and 50 patients had acquired heart disease and 32 patients congenital heart disease. 75 patients received single valve replacements, 6 patients double valve replacements, 1 patient triple valve replacement, and among all of them, 11 patients redo-replacements. The bioprosthetic valves have been applied to 58 patients and prosthetic valve to 24 patients and the latter was the main artificial valve since 1984. Among the 69 patients who had definite post-operative records, the overall mortality was 27.5%[20.3% was early mortality and 7.2% late mortality] and the overall mortality was lowered to 4.3% since 1984. There were early post-operative complication rate of 26.1% and late complication rate 34.8%, and among the latter, the valve failure rate was 11.4% patient-year, and the thrombo-embolism rate 1.76%/patient-year. 55 patients among the survivals after post-operative 1 month, were received follow-up with various anticoagulating medication for total 2046 patient-months[mini-mum 1 month to maximum 90 month, mean 37.2*25.44 months] and actuarial survival rate was 82*8% at 5 years and valve failure free and thrombo-embolic free survival rate were 61*8% and 90*3% respectively. And among them, valve failure free survival `rate of tissue valve were 91*6% at post-operative 2 years, 78*3% at 3 years, 59*9% at 4 years, 54*10% at 5 years, 53*15% at 6 years, so markedly decreased at 3-5 years post-operatively. These results suggest that cardiac valve replacement in children have been effective therapeutic method though various problems are still remained, and the choice of valve should be prosthetic valve mainly due to its durability at the present.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권1호
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• pp.47-53
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• 2017

Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

• Journal of Gastric Cancer
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• 제18권2호
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• pp.182-188
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• 2018

Purpose: Despite the fact that there are several reports of single-port laparoscopic distal gastrectomy (SPDG), no analysis of its learning curve has been described in the literature. The aim of this study was to investigate the favorable factors for SPDG and to analyze the learning curve of SPDG. Materials and Methods: A total of 125 cases of SPDG performed from November 2011 to December 2015 were enrolled. All operations were performed by 2 surgeons (surgeon A and surgeon B). The moving average method was used for defining the learning curve. All cases were divided into 10 cases in a sequence, and the mean operative time and estimated blood loss data were extracted from each group. Results: Surgeon A performed 68 cases (female-to-male sex ratio, 91.1%:8.82%), and surgeon B performed 57 cases (female-to-male sex ratio, 61.4%:38.5%). The operative time of surgeon B significantly decreased after 30 cases ($157.8{\pm}38.4$ minutes vs. $118.1{\pm}34.5$ minutes, P=0.003); that of surgeon A did not significantly decrease before and after around 30 cases ($160.8{\pm}51.6$ minutes vs. $173.3{\pm}35.2$ minutes, P=0.6). The subgroup analysis showed that the operative time significantly decreased in the patients with body mass index (BMI) of <$25kg/m^2$ (<$25kg/m^2$:${\geq}25kg/m^2$, $159.3{\pm}41.7$ minutes: $194.25{\pm}81.1$ minutes; P=0.001). Conclusions: Although there was no significant decrease in the operative time for surgeon A, surgeon B reached the learning curve upon conducting 30 cases of SPDG. BMI of <$25kg/m^2$ was found to be a favorable factor for SPDG.

• Journal of Korean Biological Nursing Science
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• 제9권2호
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• pp.125-134
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• 2007

Purpose: To examine knowledge and attitudes of nurses on post-operative pain, and to find the factors that hinder pain management by the nurses. Method: Data was collected using a questionnaire from all the nurses working in the surgical units and intensive care units in a hospital in Seoul between March 12 and 22, 2007. Data was analyzed with descriptive statistics, t-test, $x^2$ test, and Pearson Coefficient Correlation. Result: The average knowledge score on pain was $9.33{\pm}1.55$, and that for analgesics was $6.89{\pm}2.00$. There was a significant difference in knowledge of analgesics in terms of career(p=0.012), present work place(p=0.024) and education(p=0.042). The knowledge on pain etiology was significantly different in career. Around 61.1% of respondents answered that they would administer analgesics immediately if patients complaint pain, and 94.1% re-administer analgesics if the VAS score is over 5.69.3% thought that their knowledge was adequate for pain management. The attitudes of pain management were significantly different in career. Conclusion: We found that a further improvement on nurses' knowledge on pain management and analgesics is necessary. This study also suggests a need for professional education for nurses on post-operative pain management.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.144-148
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• 2006

The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because postoperative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.

• Restorative Dentistry and Endodontics
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• 제10권1호
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• pp.85-92
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• 1984

The aim of this study was to examine the influence of the speed of grinding and coolants on mercury vaporization during amalgam removal. Forty amalgam filled stone dies were stored at $37^{\circ}C$ and 100% relative humidity for 7 days prior to the beginning of the mercury vapor experiment and were divided into 4 different groups; In Group I; Used by high speed without coolant & evacuator during amalgam removal. In Group II; Used by high speed with coolant & evacuator during amalgam removal. In Group III; Used by low speed without coolant & evacuator during amalgam removal. In Group IV; Used by low speed with coolant & evacuator during amalgam removal. The amalgam specimens were removed in a 30-second time period and mercury vapor was collected with membrane filter at 27mm from the site of removal and 45 degree above there. Samples in Group II, IV were removed with coolant spray at a flow rate of 30 ml/min with high-velocity evacuator. Mercury vapor collected membrane filter was analysed by Atomic Absorption Spectrophotometer using cold vapor method. The results were as follows; 1. The mercury vapor levels were obtained all of the Groups. 2. The mercury vapor levels of the Group II, IV (with coolant & evacuator) were less than that of the Group I, III (without coolant & evacuator). 3. The highest mercury vapor level recorded during amalgam removal procedure was Group I (used by high speed without coolant & evacuator) and its record was $0.78{\pm}0.09\;mg/m^3$, which exceed the T.L.V. by 15 times. 4. The mercury vapor level of the Group IV (used by low speed with coolant & evacuator) was more than that of the Group II (used by high speed with coolant & evacuator), but its difference was not significant, statistically. (p > 0.05)

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권12호
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• pp.681-685
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• 2018

Background and Objectives This study was performed to evaluate the long-term effect of adenotonsillectomy on childhood growth by examining preoperative growth status and presenting symptoms. Subjects and Method One hundred and four patients who underwent adenotonsillectomy from January to December 2009 were enrolled in this study. Clinical data were collected from medical record reviews and through the administered questionnaire. We investigated symptoms and growth changes during 5 years following the surgery. Results The mean age of patients was $6.0{\pm}1.94$ years (range, 3-10), with the male to female ratio of 62:42. Pre-operative symptoms were significantly improved after the surgery. The mean pre-operative height and weight percentiles were $53.6{\pm}27.4$ and $59.6{\pm}29.2$ at initial evaluation, and $67.1{\pm}26.4$ and $59.6{\pm}28.6$ at 5 years post adenotonsillectomy (p<0.001, p=0.989), respectively. An increase in height percentile was more prominent in patients whose pre-operative height percentile was less than 50 compared to those with a percentile of 50 or more (p<0.001). Weight percentile was significantly increased in those with the pre-operative weight percentile of less than 50 and decreased in patients with a percentile of 50 or more. Conclusion Adenotonsillectomy has a positive effect on height growth in children with adenotonsillar hypertrophy, especially in patients whose height percentile is less than 50. Weight gain also can be expected in preoperative low-weight children.

• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.4.1-4.13
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• 2022

Objectives: This study evaluated the effects of different smear layer preparations on the dentin permeability and microtensile bond strength (µTBS) of 2 self-etching adhesives (Clearfil SE Bond [CSE] and Clearfil Tri-S Bond Universal [CTS]) under dynamic pulpal pressure. Materials and Methods: Human third molars were cut into crown segments. The dentin surfaces were prepared using 4 armamentaria: 600-grit SiC paper, coarse diamond burs, superfine diamond burs, and carbide burs. The pulp chamber of each crown segment was connected to a dynamic intra-pulpal pressure simulation apparatus, and the permeability test was done under a pressure of 15 cmH₂O. The relative permeability (%P) was evaluated on the smear layer-covered and bonded dentin surfaces. The teeth were bonded to either of the adhesives under pulpal pressure simulation, and cut into sticks after 24 hours water storage for the µTBS test. The resin-dentin interface and nanoleakage observations were performed using a scanning electron microscope. Statistical comparisons were done using analysis of variance and post hoc tests. Results: Only the method of surface preparation had a significant effect on permeability (p < 0.05). The smear layers created by the carbide and superfine diamond burs yielded the lowest permeability. CSE demonstrated a higher µTBS, with these values in the superfine diamond and carbide bur groups being the highest. Microscopic evaluation of the resin-dentin interface revealed nanoleakage in the coarse diamond bur and SiC paper groups for both adhesives. Conclusions: Superfine diamond and carbide burs can be recommended for dentin preparation with the use of 2-step CSE.

• Journal of Chest Surgery
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• 제24권5호
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• pp.463-469
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• 1991

Post-anastomotic leakage and stenoses remain major complications and are still responsible for many mortalities after esophageal reconstructive procedures. If the hand-suture is used, anastomotic leaks developed frequently than stenoses. But post-anastomotic leakages are more critical than post-anastomotic stenoses. If the stapler is used, anastomotic stenoses will develop frequently and not critical than anastomotic leakages. The stapler suture method is easier and quicker than the hand suture method in the esophageal anastomotic procedures. But the disadvantages of the stapler suture method is that there is not reachable site with anastomotic stapler the thoracic inlet region and the cost is expensive. We have treated 44 cases of the surgical complications after esophageal reconstructive procedure with conservative and surgical treatment for 10 years from January, 1980 to December, 1989. The anastomotic site stenoses were 8 cases in the hand-suture methods and 4 cases in the stapler-suture methods. The anastomotic leaks were 8 cases in hand-suture methods and 5 cases in stapler-suture methods. There were one death in the surgical repair of four post-operative anastomotic stenoses and two deaths in the surgical repair of three post-operative anastomotic leakages. Ever though we consider that there is more anastomotic leakage than stenoses after the hand-suture methods in esophageal reconstructive procedures. the cost with long stay in the intensive care unit to treat anastomotic leakage after the hand-suture, would be more expensive than-the cost of the treatment of the anastomotic stenoses after auto-suture.