• Journal of Chest Surgery
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• v.26 no.11
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• pp.856-860
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• 1993

We performed serial pulmonary function test and arterial blood gas analysis at preoperative period and postoperative 1st week in 337 patients who underwent pulmonary resection from May 1988 to April 1992 at Dept. of Thoracic and Cardiovascular Surgery, Seoul adventist hospital. Follow-up study for PFT and ABGA were possible in 30 % of the patients at postoperative 3rd or 4th month. In patient who underwent pneumonectomy, VC was decreased from 57.7% to 46.1%, FVC was decreased from 53.5 % to 41.2 % and MBC also decreased from 68.1% to 49.6 % at postoperative 1st week. But ABGA revealed that POa-, was increased from 87.2 mmHg to 92.7 mmHg, and PCO2 was decreased from 43.2 mmHg to 35.9 mmHg at postoperative 1st week. In patients who underwent lobectomy, VC was decreased from 78.1% to 68.30 %, FVC was decreased from 72.5% to 55.3% and MBC was decreased from 73.5% to 68% at postoperative 1st week.But, ABGA revealed that PO2 was increased from 95.2 mmHg to 97.9 mmHg and PCO2 was decreased from 42.3 mmHg to 39.0 mmHg at postoperative 1st week. The pulmonary function recovered at postoperative 3rd or 4th month and its ratio to preoperative value was 90% in lobectomy cases, but in pneumonectomy cases VC and MBC were recovered 20% and 15 % above the preoperative values. We concluded that resection of atelectasis, destructed lung, open negative and open positive cavity in the pulmonary tuberculosis were beni~t to improve ventilation-perfusion ratio,and pulmonary function was recovered nearly to preoperative level at postoperative 3rd or 4th month.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.36-42
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• 2005

Purpose: To evaluate the clinical results of anterior subcutaneous ulnar nerve transposition operation and the factors that influence the results for cubital tunnel syndrome. Materials and Methods: Seventeen cases of cubital tunnel syndrome were treated by anterior subcutaneous transposition between March 2001 and December 2003. The mean age was 56 years and mean follow up period was 20.4 months. All patients were reviewed retrospectively. The preoperative evaluation was done by Dellon's classification and the clinical results were evaluated by Messina’s classification. We analyzed the effect of the operation and the relations between the results and the preoperative factors, for example, duration of symptom, age, cause of illness, present of association with diabetes mellitus or preoperative flexion contracture of the elbow were analyzed. Results: The results according to Messina's classification were 4 cases of excellent, 9 cases of good, 3 cases of fair, and 1 case of poor. The preoperative factors like duration of symptom, age, cause of illness and flexion contracture of the elbow didn't show any statistical difference in the result of operation, but the cases which have diabetes mellitus were unsatisfactory with statistical difference (p=0.018). Conclusion: Anterior subcutaneous ulnar nerve transposition is relatively easy and good operative method in cubital tunnel syndrome.

• The Korean Journal of Health Service Management
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• v.8 no.1
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• pp.151-164
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• 2014

This study was conducted to investigate the effect of timing of surgery on outcomes of spine operated patients for lumbar herniated intervertebral disc. The research design was cohort study and based on the data of claims for the medical expenses of health insurance. 21,475 cases who had primary spine surgery between January 1, and December 31, 2003, observed to conservative treatment period in the past two years from preoperative primary diagnosis to timing of primary surgery. According to one and five year follow up monitoring, the probability of occurrence of reoperation was not statistically significant with preoperative duration of symptom. Also one year follow up, the probability of occurrence of complication, was not statistically significant with preoperative duration of symptom. But five year follow up, groups who had one to two month preoperative duration of symptom decreased complication rate than less than a month(95%CI:0.594-0.927). Thus, from the onset of symptoms of back pain before primary surgery with enough and adequate time observation is required. Also, medical consumers or providers to choose surgery in determining prudence is required.

• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.1-6
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• 2010

Objective: On the basis of preoperative computed tomography (CT) scans, we studied the change of the size of anterior primary division (APD) of the L5 spinal root in the presence of foraminal/extraforaminal entrapment of the L5 spinal root. Methods: Two independent radiologists retrospectively reviewed the preoperative CT scans of 27 patients treated surgically and compared the sizes of the APDs on bilateral L5 spinal roots. If one side APO size was larger than the other side APD size, it was described as left or right "dominancy" and regarded this as "consensus (C)" in case that there was a consensus between the larger APD and the location of sciatica, and regarded as "non-consensus (NC)" in case that there was not a consensus. Oswestry Disability Index (ODI) scores were used for preoperative and postoperative evaluation. Results: On CT scans, twenty-one (77%) of 27 patients were the consensus group (APD swelling) and 6 (22%) were a non-consensus group (APD no swelling). In 9 patients with acute foraminal disc herniations, asymmetric enlargement of the APD on L5 spinal root was detected in all cases (100%) and detected in 11 (64%) of 17 patients with stenosis. Preoperative ODI score was 75-93 (mean 83) and postoperative 001 scores were improved to 13-36 (mean 21). The mean follow-up period was 6 months (range, 3-11 months). Conclusion: An asymmetric enlargement of the APD on L5 spinal root on CT scans is meaningfully associated with a foraminal or extraforaminal entrapment of the L5 spinal root on the lumbosacral junction.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.337-343
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• 2016

Background: Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes. Methods: We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA. Results: Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality. Conclusion: In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair.

• Journal of East-West Nursing Research
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• v.27 no.1
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• pp.1-13
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• 2021

Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.49-54
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• 2023

Purpose: The present study examined the effectiveness of the preoperative ischemia-modified albumin (IMA) levels in predicting the healing period of amputation wounds in patients with diabetes mellitus following a non-traumatic below-knee amputation (BKA). Materials and Methods: This study enrolled 41 diabetic foot ulcer patients who underwent BKA at the authors' hospital diabetic foot center from April 2016 to April 2022. Among the 41 patients, 29 (70.7%) were male and 12 (29.3%) were female. Their mean age was 64.54±11.38 years (41~81 years). The mean follow-up period was 19.48±5.56 weeks (14~48 weeks) after BKA. The patients were divided into two groups (high IMA group and normal IMA group), which evaluated the healing period, wound dehiscence, and revision operation rate using a Fisher's exact test and Mann-Whitney U test. Three orthopedic surgeons performed stump wound evaluation, and they were evaluated as healing when all sutures were fused without oozing. Results: Thirty patients (73.2%) (group A) showed a high level of IMA (median: 91.2 U/mL), and 11 (26.8%) patients (group B) showed a normal range of IMA (median: 82.7 U/mL). In group A, the median period for wound healing took 1.4 weeks longer, which was significant (p=0.001). No statistical relationship was observed between wound dehiscence, revision operation rate, and IMA value. There was no correlation between the other risk factors (estimated glomerular filtration rate, HbA1c) and the wound healing period. Conclusion: Although there was a limitation in using IMA as the sole factor to predict the healing period of amputation wounds in patients after BKA, this study revealed a significant positive correlation between IMA and the period of stump healing after BKA. Therefore, the preoperative IMA levels may help predict the period of stump healing after BKA.

• Biomedical Science Letters
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• v.16 no.4
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• pp.247-258
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• 2010

The objective of this research was to evaluate the relationships of preoperative (Pre-OP) levels of hematological and biochemical indices to perioperative variables in patients that underwent coronary artery bypass graft surgery (CABG). Pre-OP levels of hematological factors [total white blood cells (T-WBC), erythrocytes, hemoglobin, hematocrit, glycohemoglobin A1c (HbA1c), or platelet] were negatively or positively related with biochemical indices [alanine aminotransferase (ALT), bilirubin, glucose, fructosamine, triglyceride, and high density lipoprotein cholesterol (HDL)]. Pre-OP levels of hematological factors and biochemical indices were negatively or positively correlated with echocardiographic variables. Pre-OP level of HbA1c had a relationship with C-reactive protein. Pre-OP levels of aspartate aminotransferase (AST), ALT, HDL, glucose, fructosamine, or blood urea nitrogen (BUN) were positively or negatively associated with Pre-OP levels of cardiac markers (brain natriuretic peptide, troponin-I, creatine kinase isoenzyme 2, or CRP). Pre-OP levels of hematological factors (excepting T-WBC) related with operation time (OPT), postoperative mechanical ventilation time (POMVT), intensive care unit-period (ICU-period) or hospitalization. Pre-OP levels of AST, ALT, bilirubin, triglyceride, HDL, low dwensity lipoprotein, fructosamine, or BUN were positively or negatively correlated with OPT, graft numbers, POMVT, ICU-period or hospitalization. Retrospective this study reveals that Pre-OP levels of hematological and biochemical markers are associated with echocardiographic variables, several cardiac markers and postoperative outcomes, suggesting that Pre-OP levels of hematological and biochemical markers may be useful predictors for the diagnosis and prognosis of coronary artery disease.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.649-655
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• 1988

One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.111-116
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• 2023

We provided general anesthesia management to a patient with advanced atrioventricular block, which was discovered in the remote period after open-heart surgery. A 21-year-old man with Noonan syndrome was scheduled to undergo excision of a median intramandibular tumor. At 2 months of age, the patient underwent endocardial repair for congenital heart disease. During our preoperative examination, an atrioventricular block was detected, which had not been previously noted. Emergency drugs were administered, and a transcutaneous pacemaker was placed. During anesthesia induction, mask ventilation was easy, and intubation was performed smoothly using a video laryngoscope. The transcutaneous pacemaker was activated in demand mode at a pacing rate of 50 cycles/min approximately throughout the anesthesia time, and the hemodynamic status remained stable. The effect of intraoperatively administered atropine was brief, lasting only a few seconds. Although body movements due to thoracoabdominal muscle spasm were observed during pacemaker activation, they did not interfere with surgery. In postoperative patients with congenital heart disease, an atrioventricular block may be identified in the remote period, and preoperative evaluation should be based on this possibility. In addition, during anesthesia management, it is important to prepare multiple measures to maintain hemodynamic status.