• Journal of Yeungnam Medical Science
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• 제39권3호
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• pp.223-229
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• 2022

Background: The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19-related surgical patients. Methods: We reviewed the medical records of 118 COVID-19-related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19-related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak. Results: One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of -11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19-related patients underwent emergent surgery in the negative-pressure room, including three COVID-19-confirmed patients and five COVID-19-exposed patients. Conclusion: All surgeries of the COVID-19-related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

• The Korean Journal of Pain
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• 제35권4호
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• pp.391-402
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• 2022

Background: The mechanism of peripheral axon transport in neuropathic pain is still unclear. Chemokine ligand 13 (CXCL13) and its receptor (C-X-C chemokine receptor type 5, CXCR5) as well as GABA transporter 1 (GAT-1) play an important role in the development of pain. The aim of this study was to explore the axonal transport of CXCL13/CXCR5 and GAT-1 with the aid of the analgesic effect of botulinum toxin type A (BTX-A) in rats. Methods: Chronic constriction injury (CCI) rat models were established. BTX-A was administered to rats through subcutaneous injection in the hind paw. The pain behaviors in CCI rats were measured by paw withdrawal threshold and paw withdrawal latencies. The levels of CXCL13/CXCR5 and GAT-1 were measured by western blots. Results: The subcutaneous injection of BTX-A relieved the mechanical allodynia and heat hyperalgesia induced by CCI surgery and reversed the overexpression of CXCL13/CXCR5 and GAT-1 in the spinal cord, dorsal root ganglia (DRG), sciatic nerve, and plantar skin in CCI rats. After 10 mmol/L colchicine blocked the axon transport of sciatic nerve, the inhibitory effect of BTX-A disappeared, and the levels of CXCL13/CXCR5 and GAT-1 in the spinal cord and DRG were reduced in CCI rats. Conclusions: BTX-A regulated the levels of CXCL13/CXCR5 and GAT-1 in the spine and DRG through axonal transport. Chemokines (such as CXCL13) may be transported from the injury site to the spine or DRG through axonal transport. Axon molecular transport may be a target to enhance pain management in neuropathic pain.

• 근관절건강학회지
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• 제20권3호
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• pp.247-257
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• 2013

Purpose: The purpose of this descriptive study was to investigate the knowledge of radiation protection and the recognition and performance of radiation protection behaviors among perioperative nurses. This study was intended to yield basic data for the development of nursing interventions aimed at improving the nurses' radiation protection behaviors. Methods: One hundred and thirty-seven nurses working in the operating room participated in a survey from September 1 to 30, 2011. The data was analyzed using t-test, ANOVA, and Pearson's correlation with the SPSS/WIN 19.0 program. Results: The average score of radiation protection knowledge was $7.57{\pm}3.45$ out of 16. The average score for the recognition and performance of radiation protection behaviors was $4.32{\pm}0.23$. The knowledge of radiation protection was significantly correlated with the recognition and performance of radiation protection behaviors. Conclusion: Expanding the knowledge of radiation protection could lead to the increase of the recognition and performance of radiation protection behaviors. Therefore, promoting the performance of radiation protection behaviors by improving perioperative nurses' knowledge of radiation protection through reinforcing radiation-related education hereafter could be an important part of nursing.

• 대한간호학회지
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• 제35권1호
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• pp.125-134
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• 2005

Purpose: The purpose of this study was to identify the influencing factors on the development of pressure ulcers in patients undergoing surgery which lasted more than two hours. Method: One hundred nineteen surgical adult patients were included in the study. Data was measured on each participant from December 2003 to February 2004. It was collected using a structured researcher-administered sheet and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The prevalence of a perioperative pressure ulcer was 26.1%. The level of moisture, friction and shear, length of surgery, and perioperative irrigation were significantly higher in the pressure ulcer group than those in the non-pressure ulcer group. The level of activity and level of consciousness were significantly lower in the pressure ulcer group than those in the non-pressure ulcer group. Significant influencing factors on the development of pressure ulcer were 'moisture' and 'irrigation' and those variables explained 23.1% of varience in the development of a pressure ulcer during surgery. Conclusion: It is necessary to develop a strategy to prevent pressure ulcer by taking 'moisture' and 'irrigation' into account during the preoperative, perioperative and postoperative period.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• 성인간호학회지
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• 제24권5호
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• pp.489-498
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• 2012

Purpose: The purpose of the study was to identify reports of workplace violence, stress and turnover intention among perioperative nurses. Methods: The data were collected using questionnaire from 162 perioperative. Results: All of the nurses in the study reported incidents of violence within six months of the study. Doctors and specifically operating surgeons were cited as perpetrating workplace violence. The stated source of the violence was failure or shortage of surgical equipment or instrument and fall out of surgeon's preference. Subjects reported (87.7%) workplace abuse from nurses and most often from senior nurses. Nurse abuse was in the form of verbal abuse. Fatigue and stress stemming from heavy workload were cited as the source of the workplace violence. The subjects reported stress levels of 7.39 out of a possible ten points from workplace violence. A little more than thirty five percent of the subjects reported having intentions to leave because of workplace violence. These nurses reported higher level of stress and experienced more workplace violence from nurses and doctors as compared to those nurses who reported no turnover intention. Conclusion: The results of this study indicate that a third of the employed nurses reported wanting to leave their positions due to workplace violence. Workplace violence is a serious problem for nurses whether it is from physicians or from other nurses.

• 성인간호학회지
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• 제28권6호
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• pp.680-690
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• 2016

Purpose: This study was designed to identify knowledge, attitude, environment, and self-efficacy among perioperative nurses in terms of radiation protection and to describe those factors affecting radiation protection behaviors. Methods: The sample was comprised of 128 perioperative nurses who agreed to participate in this descriptive study. Data were collected from a self-administered questionnaire and were analyzed using the t-test, analysis of variance, Mann-whitney U test, Kruskal-Wallis test, Pearson's correlation, and multiple regression analyses. Results: Radiation protection behaviors were significantly different by participant's gender, length of career as a perioperative nurse, educational level and prior experience with radiation protection education. Radiation protection behaviors were significantly correlated with radiation protection environment and self-efficacy in terms of radiation protection behaviors. In the multiple linear regression models, radiation protection environment and self-efficacy on radiation protection behaviors were statistically significant predictors of radiation protection behaviors, which accounted for 50.3% of variance in dependent variable. Conclusion: This study concluded that radiation protective environment in operating room is important to promote radiation protective behaviors and radiation safety management program to enhance self-efficacy is highly recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권6호
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• pp.392-396
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• 2003

Purpose : The purpose of this study was to find the predictors for successful arthrocentesis for anterior disc displacement without reduction(ADD without Reduction) of the temporomandibular joint (TMJ). Patients and Methods : Arthrocentesis and lavage was carried out in 25TMJs of 22patients whose MRI findings were all anterior disc displacement without reduction. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of postoperative pain score. Predectors which was analyzed were age, duration of painful locking, MMO, the degree of pain, perioperative clicking and the amounts of irrigation fluid. Results: 18cases (72%) was included to criteria for success. There were no significant differences in age, duration of locking, MMO and the degree of pain statistically. But In 15cases(83%) of successful cases, amouts of irrigated solution recovered to normal MMO were less than 150ml. And In 8cases (44%) of successful cases, perioperative clicking was appeared. Conclusion : Amounts of irrigated solution recovered to normal MMO and the appeareance of perioperative clkicking may be predictors of the successful results of arthrocenetesis of ADD without reduction of TMJ.

• Journal of Gastric Cancer
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• 제15권1호
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• pp.10-18
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• 2015

The purpose of this study was to determine if international guidelines differ in their recommendations concerning additive therapy for advanced, but potentially curable, gastric cancer. A systematic search of the English and German literature was conducted in the databases Medline, Cochrane Database, Embase, and PubMed. The search terms used were 'guidelines gastric cancer,' 'guidelines stomach cancer,' and 'Leitlinien Magenkarzinom.' Six different guidelines published after January 1, 2010, in which the tumors were classified according to the seventh edition of the TNM system (2010), were identified. Although the examined guidelines were based on the same study results, their recommendations concerning accompanying therapy for gastric cancer differ considerably. While perioperative chemotherapy is recommended in Germany, Great Britain, and large parts of Europe, postoperative adjuvant radiochemotherapy or perioperative chemotherapy is recommended in the USA and Canada. In Japan, postoperative adjuvant chemotherapy is recommended. The results of identical studies were interpreted differently in different countries. Since considerable effort is required for each country to separately test relevant studies for their validity and suitability, an international cooperation could simplify the creation of a common basis for guidelines and contribute to improved comparability of international guidelines.

• 기본간호학회지
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• 제25권4호
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• pp.240-249
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• 2018

Purpose: The study was done to explore whether the duration of perioperative prophylactic antibiotics therapy influenced uncertainty of recovery in patients with elective laparoscopic uterine myomectomy. Methods: A prospective study was conducted using self-report questionnaires and electrical medical records for patients with uterine myomectomy. According to the length of the perioperative prophylactic antibiotics therapy, the patients were divided into three groups: single-dose antibiotic treatment group, short-term antibiotic treatment group, and long-term antibiotic treatment group. Data were collected from December 20, 2016 to July 31, 2017 from 161 patients who underwent laparoscopic myomectomy at a metropolitan city general hospital. Results: Level of uncertainty of recovery was $2.98{\pm}0.22$. The uncertainty was highest in the long-term antibiotic treatment group, followed by the short-term antibiotic treatment group and the single-dose antibiotic treatment group (F=89.40, p<.001). In the regression analysis, factors influencing uncertainty of recovery among uterine myomectomy patients were duration of perioperative prophylactic antibiotic therapy (${\beta}=.70$, p<.001) and duration of NPO (${\beta}=-.11$, p=.047) which explained 51.5% of the variance (F=83.75, p<.001). Conclusion: Based on these results, information including the administration of antibiotics before surgery should be provided to the patients to help reduce the uncertainty of postoperative recovery.