• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.129-137
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• 2006

The treatment plan for orthognathic surgery must be based on accurate predictions, and this can be produced the most esthetic, functional and stable results. The purpose of this study was aimed to evaluate the amount and interrelationship of the gonial angle and the mandibular width change after the mandibular setback surgery in the mandibular prognathic patients. Twenty patients were selected who received orthognathic surgery after presurgical orthodontic treatment. The patients with skeletal and dental Class III malocclusion were operated upon with bilateral sagittal split ramus osteotomy and mandibular setback. The lateral and posteroanterior cephalometric radiographs were taken preoperatively, postoperative 1 day and 12 months later after the orthognathic surgery, and then the gonial angle and mandibular width were measured. The computerized statistical analysis was carried out with SPSS/PC program. The gonial angle at postoperative 1 day was decreased about $5.3^{\circ}$ than preoperative value and the gonial angle at postoperative 12 months was increased about $1.4^{\circ}$ than postoperative 1 day. So the gonial angle at postoperative 12 months was decreased about $3.9^{\circ}$ than preoperative value. The mean preoperative gonial angle was $125.35^{\circ}{\pm}7.36$, showing significantly high value than normal and mean gonial angle at postoperative 12 months was $121.45^{\circ}{\pm}6.81$, showing value near to normal. The mandibular width at postoperative 1 day was decreased about 1.1 mm than preoperative value and the mandibular width at postoperative 12 months was more decreased about 1.7 mm than postoperative 1 day. So the mandibular width at postoperative 12 months was decreased about 2.8 mm than preoperative value. These results indicate that sagittal split ramus osteotomy in mandibular prognathic patients with high gonial angle is effective to improvement of gonial angle. It is considered to be helpful for maintenance of postoperative stable gonial angle area that detailed postoperative care and follow-up.

• Child Health Nursing Research
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• v.13 no.3
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• pp.273-281
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• 2007

Purpose: This study was done to verify the effects of information using photographs on preoperative anxiety of children and their parents. Methods: Participants were 48 hospitalized children and their parents (48 pairs). In the experiment group (18 pairs) photographs were used with the children and parents to provide information before the child underwent an operation. Children and parents in control group (30 pairs) received regular care. Anxiety of children and their parents was measured using both a self-report and physiologic responses (heart rate and blood pressure). The data were analyzed using the SAS program. Results: Compared with the control group, self-reports of the experimental group indicated a significant difference in subjective anxiety. However, there was no decrease in physiologic anxiety as shown by heart rate and blood pressure in those in the experimental group as compared to the control group. Conclusions: Preoperative information using photographs were shown to be an effective method to reduce anxiety of children and their parents.

• Biomedical Science Letters
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• v.11 no.3
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• pp.407-416
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• 2005

Cardiopulmonary bypass (CPB) for cardiac surgery induces the production and release of numerous chemotactic substances and cytokines, ensuing systemic inflammatory response that causes postoperative major organ dysfunctions. We performed a randomized, prospective study to investigate clinical effects of preoperative treated-methylprednisolone for preventing inflammation in pediatric cardiac surgery with CPB. Thirty pediatric patients scheduled for elective cardiac surgery were randomized to either control(n=15) or steroid group (n=15, 10 mg/kg of methylprednisolone). Arterial blood samples were taken before and after the operations for measuring total leukocyte (T-WBC) and differential counts, platelet counts, interleukin-6 (IL-6), myeloperoxidase (MPO), neuron specific enolase (NSE), troponin-I (TNI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine levels. Postoperative parameters such as pulmonary index (PI, $PaO_2/FiO_2$), 24 hrs and total bleeding volumes, mechanical ventilating (MVP) and intensive care unit (ICU)-staying periods, and hospitalization were assessed. T-WBC, neutrophil fraction, IL-6, MPO, NSE, TNI, AST and creatinine levels, bleeding volumes, PI, and MVP at the postoperative periods were lower or shorter in steroid group than in control group (P<0.05). These findings indicated that preoperative administration of methylprednisolone attenuated CPB-induced inflammatory reactions, contributing to postoperative recovery of patients underwent cardiac surgery.

• Journal of Korean Clinical Nursing Research
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• v.17 no.3
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• pp.443-454
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• 2011

Purpose: The purpose of this study was to investigate the predictors of delirium in patients after orthopedic surgery. Methods: Participants were 121 orthopedic surgery patients from one university affiliated hospital located in Seoul. The instrument of Delirium Observation Screening Scale (DOS) developed by Schuurmans et al. (2003) was utilized. Data were collected from September 1st, 2010 to March 31st, 2011 and analyzed using SPSS 12.0 with descriptive statistics, t-test, chi-square test and logistic regression. Results: The delirium in patients after orthopedic surgery was occurred in 9 (7.4%) out of 121 patients. Several factors were associated with the delirium occurrence age, admission route, preadmission Activity of Daily Living (ADL), preadmission hearing aid use, preadmission walking degree, diagnosis, type of surgery, Intensive Care Unit (ICU) stay after surgery, restraint, drainage tube, time of admission to surgery, preoperative albumin and preoperative sodium. Preadmission ADL, preoperative sodium and time of admission to surgery were the significant predictors of the delirium occurrence. Conclusion: Study results may help nurses predicting and detecting delirium early and providing preventive measures to the patients with high risk of delirium after orthopedic surgery.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.324-327
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• 1994

Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.146-151
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• 2005

Purpose: We have preoperatively and postoperatively investigated the characteristics of anemia in patients with gastric cancer in order to provide optimal medical care for the patients. Materials and Methods: Preoperative hemoglobin, serum iron, serum ferritin, serum vitamin $B_{12}$, and serum folic acid were measured for 321 patients with gastric cancer. These were measured again for 287 patients 6 months postoperatively. Results: Ninety-four patients (29.3%) had preoperative anemia. Preoperative hemoglobin, serum iron, and serum vitamin $B_{12}$ levels were higher in the patients with early gastric cancer than in patients with advanced gastric cancer. Preoperative hemoglobin, serum iron, and serum ferritin levels were higher in male patients than in female patients. The patients who had preoperative anemia showed a high probability of having postoperative anemia (P<0.001), and the patients who had low serum ferritin levels preoperatively showed a high probability of having low serum ferritin levels and iron deficiency anemia postoperatively (P<0.004). Conclusion: Preoperative ferritin deficiency should be improved by iron supplement, even though the patient may not be anemic at that time. Periodic postoperative measurements of the hemoglobin, serum iron, serum ferritin, serum vitamin $B_{12}$, and serum folic acid levels are highly recommended because postgastrectomy anemia is not rare. Finally, if any low hemoglobin, serum iron, serum ferritin, serum vitamin $B_{12}$, or serum folic acid levels are found, they should be treated in an appropriate way.

• The Journal of the Convergence on Culture Technology
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• v.4 no.2
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• pp.171-178
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• 2018

The study was done to analyze the effects of aroma inhalation method on preoperative anxiety of upper and lower surgical patients. The research design was a nonequivalent control group non-synchronized design. The subjects were a total 60 patients of each group 30 patients that were operated on under general anesthesia for upper and lower limbs surgery. The tool of the Amsterdam preoperative anxiety information scale(APAIS), systolic and diastolic blood pressure, and pulse rate levels was measured the day before surgery. The data were analyzed by the $x^2$ test Fisher's exact test, paird t-test, and the independent t-test using SPSS 20.0. Study result indicated that Lavender aroma therapy had the effect on reduction of anxiety before surgery and reduction of blood pressure, and pulse rate levels. Therefore, the study result could be used as a scientifical data that can be applied to the nursing interventions that use the aroma inhalation method and contributing to development of the holistic nursing care.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.324-331
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• 2017

Background Lipedema is a condition consisting of painful bilateral increases in subcutaneous fat and interstitial fluid in the limbs with secondary lymphedema and fibrosis during later stages. Combined decongestive therapy (CDT) is the standard of care in most countries. Since the introduction of tumescent technique, liposuction has been used as a surgical treatment option. The aim of this study was to determine the outcome of liposuction used as treatment for lipedema. Methods Twenty-five patients who received 72 liposuction procedures for the treatment of lipedema completed a standardized questionnaire. Lipedema-associated complaints and the need for CDT were assessed for the preoperative period and during 2 separate postoperative follow-ups using a visual analog scale and a composite CDT score. The mean follow-up times for the first postoperative follow-up and the second postoperative follow-up were 16 months and 37 months, respectively. Results Patients showed significant reductions in spontaneous pain, sensitivity to pressure, feeling of tension, bruising, cosmetic impairment, and general impairment to quality of life from the preoperative period to the first postoperative follow-up, and these results remained consistent until the second postoperative follow-up. A comparison of the preoperative period to the last postoperative follow-up, after 4 patients without full preoperative CDT were excluded from the analysis, indicated that the need for CDT was reduced significantly. An analysis of the different stages of the disease also indicated that better and more sustainable results could be achieved if patients were treated in earlier stages. Conclusions Liposuction is effective in the treatment of lipedema and leads to an improvement in quality of life and a decrease in the need for conservative therapy.

• Tuberculosis and Respiratory Diseases
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• v.80 no.4
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• pp.368-376
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• 2017

Background: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. Methods: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. Results: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). Conclusion: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.827-833
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• 2020

Objective : Spine surgery is associated with higher morbidity and mortality rates in elderly patients. The modified Frailty Index (mFI) is an evaluation tool to determine the frailty of an individual and how preoperative status may impact postoperative survival and outcomes. This study aimed to determine the usefulness of mFI in predicting postoperative complications in patients aged ≥75 years undergoing surgery with instrumentation. Methods : We retrospectively reviewed the perioperative course of 137 patients who underwent thoracolumbar-instrumentation spine surgery between 2011 and 2016. The preoperative risk factors were the 11 variables of the mFI, as well as body mass index (kg/㎠), preoperative hemoglobin, platelet, albumin, creatinine, anesthesia time, operation time, estimated blood loss, and transfusion amount. The 60-day occurrences of complication rates were used for outcome assessment. Results : Major complications after spinal instrumentation surgery occurred in 34 of 138 patients (24.6%). The mean mFI score was 0.18±0.12. When we divided patients into a pre-frail group (mFI, 0.09-0.18; n=94) and a frail group (mFI ≥0.27; n=44), only the rate of sepsis was statistically higher in the frail group than in the pre-frail group. There were significantly more major complications in patients with low albumin levels or in patients with infection or who had experienced trauma. The mFI was a more useful predictor of postoperative complications than the American Society of Anesthesiologists physical status score. Conclusion : The mFI can successfully predict postoperative morbidity and mortality in patients aged ≥75 years undergoing spine surgery. The mFI improves perioperative risk stratification that provides important information to assist in the preoperative counselling of patients and their families.