• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.155-156
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• 1998

Screw loosening and subsequent pullout can be attributed to the reduction in bone mineral density in the vertebrae manifested by osteoporosis in which the decrease in fixation strength between the cancellous bone and screw threads are accelerated by repeated loads exerted by patients own weight and activities following the surgery. In this study, the change in pullout strength of the pedicle screws was investigated before and after repeated loads were imparted. For this purpose. Diapason pedicle screws $(6.7\times40mm)$ were inserted onto fresh porcine spine specimens (T1-L5) after bone mineral density was measured using a DEXA. With an MTS, an axial load was applied at a loading rate of 0.33mm/sec until failure to measure the maximum pullout strength. Flexion moment of 7.5N-m was then imparted at 0.5Hz for 2000 cycles. It was found that the maximum pullout strength was exponentially related to BMD regardless of load types ($107.71\;\times\;\exp^{(1.43{\times}BMD)}r^2=0.93$, P<0.0001 without repeated load; ($107.71\;\times\;\exp^{(2.19{\times}BMD)}r^2=0.78$, P<0.0001 with repeated load). The results suggest that the reduction in pullout strength for pedicle screws is far more prominent in osteoporotic spine than in normal spine especially as number of repeated load was increased. More importantly, it was demonstrated that the level of bone mineral density and the activity level of the patient should be evaluated in more detail for successful implementation of pedicle screw systems in spinal surgery.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.551-556
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• 2018

Cases of repeated acute gastric dilatations after binge eating in one patient are rarely reported. We report here a case of repeated acute gastric dilatations in a 22-year-old woman with bulimia nervosa. Her repeated acute gastric dilatations seem to have been related to superior mesenteric artery syndrome. On her last visit due to acute gastric dilatation, she underwent emergency gastric decompression surgery because of abdominal compartment syndrome; however, she eventually died because of ischemia reperfusion injury. Emergency physicians should be aware of the need to manage acute gastric dilatation in patients with eating disorder and should pay attention to the signs and distinctive clinical features of abdominal compartment syndrome.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.146-150
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• 2015

Arterial thoracic outlet syndrome (TOS) causes ischemic symptoms; it is the rarest type, occurring in 5% of all TOS cases. This paper is a case report of a 38-year-old male patient diagnosed with arterial TOS, displaying symptoms of acute critical limb ischemia caused by thromboembolism. Brachial artery of the patient has been diffusely damaged by repeated occurrence of thromboembolism. It was thought to be not enough only decompression of subclavian artery to relieve the symptoms of hand ischemia; therefore, bypass surgery using reversed great saphenous vein was performed.

• Advances in pediatric surgery
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• v.10 no.1
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• pp.43-46
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• 2004

Two cases of trichobezoar with unusual presentation in female children are described. The first case is a 7-year-old female with a 3-day history of abdominal pain, obstipation, and emesis. She developed intestinal obstruction and showed double bezoars in the stomach and intestine respectively. She had been in a habit of biting or sucking hairs before sleeping from infancy until 5 years of age. The other patient is a 6-year-old girl referred for an epigastric mass, emotional disturbance and trichotillomania. In spite of the psychological treatment, 4 laparotomies were necessary due to repeated recurrences.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.196-200
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• 2014

Budd-Chiari syndrome is an uncommon condition characterized by hepatic outflow obstruction. Direct suture of the injured Inferior vena cava in a patient with blunt hepatic trauma also may cause an equivalent condition. However, early diagnosis is possible with common symptoms and radiologic evaluation. Moreover, a transluminal approach with balloon angioplasty could prevent long-term complications of Budd-Chiari syndrome without repeated abdominal surgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.7-12
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• 2020

Recurrent respiratory papillomatosis (RRP) is characterized by repeated recurrence in the respiratory system, such as the pharynx, larynx, and trachea, caused by the human papilloma virus. The main treatment is surgical removal of the papilloma. However repeated recurrence of RRP in multiple areas is burdened for the surgeon. In addition to the surgery, various adjuvant therapies have been studied to reduce the recurrence. Literature review was conducted with a focus on the adjuvant treatments for RRP.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.175-180
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• 2001

Purpose: The advantages of air reduction are the ease of performing the procedure, reduced radiation time and lower morbidity rate if perforation occurs. But, patients who fail air reduction undergo a laparotomy at which 10% have spontaneously reduced. The first enema decreases the edema and venous congestion of bowel wall, thus repeated reduction may succeed. The aim of this study is to evaluate the efficacy of delayed repeated pneumatic reduction of intussusception in patients with failure of an initial attempt. Methods: Between January 1998 and December 1999, 21 patients with proven intussusception received repeated delayed reduction 1 to 3 hours following the first failed attempt. These patients were in stable condition and did not have peritonitis, shock or toxic sign. Results: Before reduction, the patients had symptoms and signs for 6 to 48 hours (median 24 hr). The interval from the first reduction to the repeated was 1 to 3 hours (median 2.2 hr). The success rate of repeated reductions was 76.2% (16 of 21 patients), and 23.8% (5 of 21 patients) required surgery. Four of 5 patients requiring surgery were manually reduced and 1 spontaneously reduced in the operating room. Conclusion: We recommended a repeated reduction in patients with intussusception who are in stable clinical condition after an unsuccessful initial reduction attempt.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.18-23
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• 1995

We analyzed the results of ethanol sclerotherapy in 47 patients with cystic thyroid lesion. Cytologic study showed all of the lesions to be benign. The patients were followed clinically and ultrasonically I month and 3 or more months after ethanol sclerotherapy. If the cystic lesions recurred, repeated treatment was offered. In 4 patients with pure cystic lesion, all of the patents had almost total resolution of the cystic lesions. In 43 patients with mixed cystic lesion, 16(37.2%) patients had almost total resolution of the cystic lesions, 10(23.3%) patients showed a decrease' in the cystic lesion of <50%, but 11(25.6%) patients it did not change in size. Overall, in 30(63.8%) patients the cystic lesion decreased in size. Eleven patients who were not effective by sclerotherapy or follicular proliferation by cytology were converted to surgery. Although no severe complication were observed, there were complication of severe pain in I patient and a drunken feeling in I patient. If the malignancy must be excluded by repeated cytologic examination of aspirated fluid, we consider instillation of ethanol into the cystic lesions of the thyroid to be a simple, safe, economical and effective treatment.

• Journal of Gastric Cancer
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• v.2 no.1
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• pp.20-25
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• 2002

Purpose: Chylous ascites is an accumulation of lymphatic fluid within the peritoneal cavity due to trauma or to an obstruction on the lymphatic system. Postoperative chylous ascites is a rare complication of abdominal surgery. It is frequently reported after retroperitoneal dissections and results in high morbidity and mortality. However, there have been few report of such a complication following a radical gastrectomy. Therefore, we review the clinical analysis and treatment of chylous ascites based on our experience. Materials and Methods: From July 1992 to June 2001, we treated 13 cases of chylous ascites after operations for gastric cancer. We reviewed medical charts of those patients retrospectively. Results: The incidence of chylous ascites after operations for gastric cancer was $0.83\%$ (13/1552). The mean time from ingestion of a meal after the operation to the development of symptoms was 2 days (range: $1\∼6$ days). Conservative treatment by fasting, total parenteral nutrition (TPN), and repeated paracentesis was successful in all patients. The mean time from diagnosis to complete resolution was 25 days (range: $2\∼105$ days). Conclusion: Chylous ascites should be considered in any patient with a typical milky color of drainage who has recently undergone radical gastrectomy. Treatment with fasting, TPN, and repeated paracentesis usually is successful.

• Journal of the Korea Convergence Society
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• v.9 no.2
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• pp.371-380
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• 2018

The purpose of this study was to investigate the effects of patient controlled analgesia(PCA) convergence education on postoperative pain management in spinal surgery patients. Sixty spinal surgery patients were included. For the experimental group(n=30), PCA education using video, booklet, and a PCA model practice was provided before surgery. The data were collected using questionnaire and were analyzed using descriptive statistics, ${\chi}^2-test$, Fisher's exact test, t-test and repeated measures ANOVA. PCA knowledge-attitude, PCA satisfaction and pain control satisfaction were higher in the experimental group than the control group(p<.001; p=.001; p<.001). Postoperative pain and frequency of additional analgesia use of the experimental group were significantly lower than those of the control group(p<.001; p=.001). This findings showed that the convergence PCA education of audiovisual aids with PCA practice training could be effective pain management intervention in patients undergoing spinal surgery. These apply to development of convergence nursing interventions in clinical practice.