• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권3호
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• pp.267-272
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• 2009

Bone grafting the alveolar cleft allows for stability and continuity of the dental arch, provides bone for eruption of permanent teeth or placement of dental implants, and gives support to the lateral ala of the nose. Closure of residual oronasal fistula can occur simultaneously. Repair of alveolar clefts can occur at a variety of stages defined as primary, early secondary, secondary, and late. Most centers perform this surgery as secondary bone grafting. Autogenous bone provides osteogenesis, osteoinduction and conduction and is recommended for grafting to the cleft alveolus and several donor sites are available. The surgeon should select the best flap design considering the amount of mucosa available, blood supply and tension-free closure, and the extent of the oronasal communication. The authors provide a comprehensive understanding of alveolar clefts and their repair by reviewing the historical perspective, objectives for treatment, timing, source of graft, presurgical orthodontics, surgical techniques, postoperative care, and complications.

• 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.

• 대한간호학회지
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• 제38권1호
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• pp.83-91
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• 2008

Purpose: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. Method: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. Result: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). Conclusion: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.151-154
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• 2016

Purpose: To evaluate the association between time to surgery and injury severity score (ISS). Methods: Medical charts and records were reviewed for polytrauma patients who underwent trauma surgery from November 2014 to March 2016. The patients were divided into two groups based on the ISS. Results: Among the 217 operated patients, 22 patients underwent first and second surgery. The patients with an ISS over 17 (mean 13.0 days) had a longer interval between surgeries than patients with an ISS of 17 or less (mean 7.5 days) (p=0.031). One hundred and twenty-one patients only underwent elective surgery and there is a positive correlation between ISS and time to elective surgery (p<0.028, Pearson's correlation coefficient=0.224). Seventy-four patients underwent emergent surgery only. Among these, the patients with an ISS of 17 or less underwent general surgery (86%) but the patients with an ISS more than 17 underwent neurological surgery (47%). Conclusion: Patients with high ISS need critical care during the preoperative and postoperative period.

• 성인간호학회지
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• 제16권4호
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• pp.566-574
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• 2004

Purpose: To find the effects of semi-Fowler's position on the post-operative recovery for patients with laparoscopic abdominal surgery in recovery room. Method: The research was performed by nonequivalent control group non-synchronized quasi-experimental design. The subjects are forty patients who had laparoscopic abdominal surgery in a hospital from Aug. thru Nov. of 2003. Post-recovery scores and $O_2$saturation degree were measured. The experimental group was place in semi fowler's position while the control group was placed in supine position. The homogeneity between the control group and experimental group was analyzed using the Chi-square, and the hypothesis were tested using t-test. Result: 1. The patients in the experimental group placed in semi fowler's position showed significant higher post-recovery scores than those in the control group who were in a supine position. 2. The patients in the experimental group who were in semi Fowler's position showed no significant higher $O_2$ saturation degree than those in the control group who were in supine position. Conclusion: Based on the results described above, it is considered that the semi-Fowler's position might be effective in enhancing the post-operative recovery score of the patients with laparoscopic abdominal surgery in recovery room.

• 대한치과의사협회지
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• 제37권1호통권356호
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• pp.62-68
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• 1999

Patients who present with severe maxillary bone loss Secondary to trauma or resorption provide a unique diagnosis and difficulty in implant installation. To solve this problem, various bone grafting methods and graft materials can be used in these compromised cases. But for the patients required wide reconstruction, autogenous iliac bone has been used widely because of easy harvesting of much corticocancellous bone. Usually, implant installations are performed 6-12 months later after grafting. but this method necessary long treatment period and additional surgery. To avoid this disadvantages, bone grafting with immediate implant installations are frequently used. But special care is necessary to prevent postoperative complication in this method. We present three cases of veneer grafting with immediate implant installation. These patients had a knife-edge shaped alveolar bone due to labial alveolar bone loss. We reconstructed this alveolar bone with veneer grafting with iliac bone and performed immediate implant installation. There was no complications during healing periods in these three cases. Six months later, we found good survival of grafting bone and osseointegration of these implants, so we could perform prosthetic treatment successfully.

• Journal of Chest Surgery
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• 제23권1호
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• pp.16-21
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• 1990

From November 1978 through June 1989, 33 patients aged 3 months to 27 years [mean 9.7 years] underwent repair of intracardiac defects associated with corrected transposition. Five patients had had previous palliative surgery. Operation were performed in 31 for ventricular septal defect, 22 for pulmonary outflow tract obstruction, 16 for atrial septal defect, and 5 for anatomical tricuspid valve regurgitation. Pulmonary outflow tract obstruction was relieved by pulmonary valvotomy in 9, Rastelli procedure in 5, modified Fontan procedure in 3, and by REV procedure in 5 patients recently. Early mortality was 21.2%[7/33] and no late mortality during follow up period. Two had residual pulmonary outflow tract obstruction and one residual VSD. In eight patients, transient arrhythmia was found but soon returned to sinus rhythm. Five patients developed complete heart block and 2 were given permanent pacemaker insertion. There were 8 RBBB, 1 LBBB and one second degree atrioventricular block patients, but all showed no clinical significance. This report suggests that surgical repair of intracardiac defects associated with corrected transposition can be achieved with acceptable low risk. Though the mortality is still high, we can improved the result by advancing surgical technique, knowledge of the special conduction system, and by improving postoperative care.

• Journal of Chest Surgery
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• 제24권2호
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• pp.115-122
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• 1991

From April 1986 to December 1989, 25 infants under the age of 12 months with tetralogy of Fallot were operated on. Age ranged from 3 to 12 months[mean 8.9$\pm$4.9 months] and mean body weight was 7.8$\pm$ 2.6kg. All the patients were deeply cyanotic, 12 of them experienced anoxic spell. Transannular patch was laid down in 19 patients, in 7 of them monocuspid patch was utilized. Postrepair P RV/LV was measured at operation room in 17 patients[mean 0.48$\pm$0. 14]. Hospital mortality was 20Yo. Causes of deaths include right ventricular failure and low cardiac output. The mortality was closely related with patient`s age and body surface area at operation. Also higher mortality was noticed in patients having major associated anomaly or previous palliative operation, preoperative management with propranolol and transannular repair. 18 patients were followed up for 12 to 50 months with a mean follow-up time of 24 months after operation. There were no late deaths and late ventricular arrhythmia or congestive heart failure was not detected as yet. Redo operation was performed in one case because of residual pulmonic stenosis. Considering several advantages of early primary repair, primary repair of symptomatic infants with tetralogy of Fallot should be encouraged despite somewhat high mortality rate as yet and better results could be anticipated along with improvement of myocardial protection method and postoperative care.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.192-195
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• 2009

We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

• Journal of Chest Surgery
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• 제51권4호
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• pp.280-282
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• 2018

Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that may present with various symptoms, depending on the nature and severity of other cardiovascular anomalies. Furthermore, contralateral lung surgery in patients with UAPA is extremely rare, and clinical experience is limited. This report describes a case of surgical treatment of contralateral primary lung cancer in a patient with isolated UAPA. A 56-year-old man was diagnosed with primary lung cancer accompanied by isolated UAPA on the contralateral side. He underwent meticulous cardiorespiratory function tests preoperatively. We performed a right lower lobectomy. Although in the immediate postoperative period, the patient suffered from a mild decline in his respiratory function, he recovered uneventfully. The present case shows that preoperative awareness of UAPA and meticulous perioperative management enable contralateral lung surgery to be performed safely.