• Journal of Gastric Cancer
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• v.11 no.2
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• pp.101-108
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• 2011

Purpose: Despite the compelling scientific and clinical data supporting the use of early oral nutrition after major gastrointestinal surgery, traditional bowel rest and intravenous nutrition for several postoperative days is still being used widely after gastric cancer surgery. Materials and Methods: A phase II study was carried out to evaluate the feasibility and safety of postoperative early oral intake (water intake on postoperative days (POD) 1-2, and soft diet on POD 3) after a gastrectomy. The primary outcome was morbidity within 30 postoperative days, which was targeted at <25% based on pilot study data. Results: The study subjects were 90 males and 42 females with a mean age 61.5 years. One hundred and four (79%) and 28 (21%) patients underwent a distal and total gastrectomy, respectively. The postoperative morbidity rate was within the targeted range (15.2%, 95% CI, 10.0~22.3%), and there was no hospital mortality. Of the 132 patients, 117 (89%) successfully completed a postoperative early oral intake regimen without deviation; deviation in 10 (8%) due to gastrointestinal symptoms and in five (4%) due to the management of postoperative complications. The mean times to water intake and a soft diet were $1.0{\pm}0.2$ and $3.2{\pm}0.7$ days, respectively, and the mean hospital stay was $10.0{\pm}6.1$ days. Conclusions: Postoperative early oral intake after a gastrectomy is feasible and safe, and can be adopted as a standard perioperative care after a gastrectomy. Nevertheless, further clinical trials will be needed to evaluate the benefits of early oral nutrition after upper gastrointestinal surgery.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.86-94
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• 2022

Purpose: Patients experiencing chemotherapy-induced peripheral neuropathy (CIPN) apply various palliative care as well as drugs in their daily life to alleviate symptoms. There is a need to identify the influence of these efforts and patients' psychosocial status on the relief of CIPN symptoms. This short-term prospective study investigated how prescription drugs, non-pharmacological behaviors (exercise, massage, and heat therapy), and psychological states (social support, depression, and anxiety) affected CIPN symptoms. Methods: Participants scheduled to receive postoperative platinum or taxane-based chemotherapy were enrolled consecutively. CIPN was measured with the Neurotoxicity-12 subscale of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity-12 instrument. Data were collected three times during the 4 or 5 cycles of chemotherapy. Results: At the end of the 2nd chemotherapy cycle, 93.1% of participants reported CIPN symptoms. Multiple regression analyses showed that a heat therapy (β= -.34, p< .001), massage (β= -.21, p= .012), and walking 5 times or more per week (β= -.26, p= .021) provided relieve for CIPN symptoms. Depression (β= .19, p= .027) significantly exacerbated CIPN symptoms. Conclusion: These results suggested that a comprehensive management program that includes walking, heat therapy, massage, and mood therapy should be encouraged. Moreover, patients should be educated at chemotherapy initiation to understand appropriate interventions that can relieve CIPN symptoms.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.521-526
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• 2014

The authors report a case of symptomatic epidural gas accumulation 2 weeks after the multi-level lumbar surgery, causing postoperative recurrent radiculopathy. The accumulation of epidural gas compressing the dural sac and nerve root was demonstrated by CT and MRI at the distant two levels, L3-4 and L5-S1, where vacuum in disc space was observed preoperatively and both laminectomy and discectomy had been done. However, postoperative air was not identified at L4-5 level where only laminectomy had been done in same surgical field, which suggested the relationship between postoperative epidural gas and the manipulation of disc structure. Conservative treatment and needle aspiration was performed, but not effective to relieve patient's symptoms. The patient underwent revision surgery to remove the gaseous cyst. Her leg pain was improved after the second operation.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.709-714
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• 1984

The Takayasus arteritis is the obstructive disease in the principal branches arising from the aortic arch, and it can cause circulatory disturbances in the head or arms. We have experienced a case of complete obstruction of the left subclavian artery, the patient was undergone surgical repair with Knitted-Dacron patch graft between the left common carotid artery and the left subclavian artery. After operation, there were no symptoms except hypertension, and also no postoperative complications were seen. In the postoperative aortogram, the patency of the graft was good. The postoperative course was eventful and he has been in good conditions up to now so far.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.2
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• pp.88-93
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• 1998

Neurilemoma usually discovered incidentally, is a benign nerve-sheath tumor which has been described as a painless mass. In most cases, the size of the mass was smaller than 5cm. However, it was reported that there were masses, sometimes associated with local tenderness and pain, whose size was over 6cm. Then, we have found there is a relationship between mass size and neurologic symptoms, as well as with, postoperative complications. It is important to diagnose early and to treat it. Twenty neurilemoma patients, who were treated at Keimyung University Dongsan Medical Center were analyzed using their clinical symptoms, pathologic findings, radiologic findings and complications. There was no sexual difference in tumor incidence. The anatomical locations of tumors were as follows. ; upper extremities in 15 cases(69%), axilla in 1 case(4%) and lower extremities in 6 cases(27%). Symptoms were palpable mass in 22 cases, local tenderness in 8 cases(36%), radiating pain in 6 cases(27%) and paresthesia in 6 cases(27%), Median nerve was involved most frequently(33%). There were 2 patients(10%) with multiple symptoms. Tumor enucleation was done in all cases. The size of tumors in longest axis was smaller than 2cm in 2 cases, between 2 and 4cm in 11 cases and more than 5cm in 9 cases. There was no case of malignant transformation or recurrence. In conclusion, incidence of clinical symptom and postoperative complications are increased with the size of the tumor especially over the 5cm. Preoperative MRI finding was the most accurate method of diagnosis and most helpful in determining surgical resection margin.

• Journal of Sasang Constitutional Medicine
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• v.34 no.4
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• pp.49-56
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• 2022

Objectives The purpose of this study is to compare the changes before and after constitutional acupuncture treatment in soyangin who received embedding therapy for wrinkle improvement. Methods A retrospective study reviewing medical records was conducted. The patient was classified as a Soyangin by a specialist based on K-PRISM, personality, appearance, voice and usual symptoms. Records on the degree of wrinkles, postoperative symptoms, and patient satisfaction were reviewed. Results The patient's wrinkles were improved after the embedding therapy. After therapy symptoms were fever, flushing, and burning sensation. After acupuncture, these symptoms were reduced. Patient satisfaction increased after constitutional acupuncture treatment. Conclusion As a result of embedding treatment in Soyangin patients, there was an effect of wrinkle improvement. As a result of constitutional acupuncture treatment, anxiety and stress were reduced before the procedure, and symptoms of heat, burning, and flushing were reduced after the procedure.

• Asian Spine Journal
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• v.12 no.6
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• pp.1100-1105
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• 2018

Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p<0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.448-452
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• 2017

Background: Proper monitoring of cerebral perfusion during carotid artery surgery is crucial for determining if a shunt is needed. We compared the safety and reliability of near-infrared spectroscopy (NIRS) w ith transcranial Doppler (TCD) for cerebral monitoring. Methods: This single-center, retrospective review was conducted on patients who underwent carotid endarterectomy (CEA) using selective shunt-based TCD or NIRS at Daegu Catholic University Medical Center from November 2009 to June 2016. Postoperative complications were the primary outcome, and the distribution of risk factors between the 2 groups was compared. Results: The medical records of 74 patients (45 TCD, 29 NIRS) were reviewed. The demographic characteristics were similar between the 2 groups. One TCD patient died within the 30-day postoperative period. Postoperative stroke (n=4, p=0.15) and neurologic complications (n=10, p=0.005) were only reported in the TCD group. Shunt usage was 44.4% and 10.3% in the TCD and NIRS groups, respectively (p=0.002). Conclusion: NIRS-based selective shunting during CEA seems to be safe and reliable for monitoring cerebral perfusion in terms of postoperative stroke and neurologic symptoms. It also reduces unnecessary shunt usage.

• The Korean Journal of Pain
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• v.26 no.3
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• pp.277-285
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• 2013

Background: Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. Methods: OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and laparoscopic subtotal gastrectomies. Patients were classified as having OI if they experienced dizziness, nausea/vomiting, blurred vision, headache, somnolence and syncope. Factors contributing to OI were assessed with logistic regression analysis. Results: Out of 175 patients, 61 (52.6%) male and 44 (74.6%) female patients experienced OI at the time of first ambulation. The frequency of OI related symptoms were dizziness (97, 55.4%), nausea (46, 26.3%), headache (9, 5.1%), blurred vision (3, 1.7%) and vomiting (2, 1.1%). Significant risk factors for OI were gender (P=0.002) and total amount of opioids administered (P=0.033). Conclusions: The incidence of OI is significantly higher in male than in female patients and is influenced by the opioid dose.

• Journal of Yeungnam Medical Science
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• v.21 no.1
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• pp.114-119
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• 2004

This report concerns an unusual case of acute postoperative pulmonary edema without any apparent causes in a 45-year-old man. The patient was subjected to the removal of a previously placed device on the left tibia, and the excision of a benign mass on the right forearm. Unexpected acute bilateral pulmonary edema occurred immediately after the completion of the procedures. The etiologies were reviewed in relation to the patient's condition and clinical manifestations. Fluid overloading was excluded as a cause in view of the patient's perioperative state and postoperative chest X-ray results. We could not find any symptoms of upper airway obstruction during emergence from general anesthesia. We had doubts about tourniquet or fentanyl-induced pulmonary edema, but these factors were not sufficient to bring about pulmonary edema in this case. To our knowledge, the cause of acute pulmonary edema in this case is indeterminate.