• Journal of the Ergonomics Society of Korea
• /
• v.24 no.2
• /
• pp.17-24
• /
• 2005

The objective of this study is to examine the prevalence of musculoskeletal disorders(MSDs) among nursing personnels. A self-reporting survey adapted from Nordic questionnaires was used as diagnostic tool, and conducted for 162 nurses working for a general hospital. The survey was performed five times every three months during a year. The MSDs were defined by using three criteria, depending upon the frequency, duration and pain intensity of the symptoms. The results showed that the 12-month prevalences of MSDs at any body site by criterion 1, 2, 3 were 56.8%, 53.7%, 45.7%, respectively, and that the shoulder was the most susceptible to MSDs, followed by knee/lower leg, lower back, hand/wrist, neck, ankle/feet, finger, etc. Only one statistically significant risk factor of departments or units was identified through the Chi-square test. The prevalence of MSDs was the highest in intensive care unit, second in surgical ward, while the prevalence was the lowest in emergency room. The MSDs prevalence of Korea at any body part or by body part was much lower than that of foreign countries such as Japan, USA, Sweden, etc. This implies that when considering poor working conditions and load in Korea, the incidence rate of MSDs may rapidly increase in Korea in the future.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.36 no.6
• /
• pp.303-307
• /
• 2014

Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma, occurs commonly in the soft tissues in adult, but is rare in the maxillofacial region. It consists of undifferentiated mesenchymal tumor cells resembling histiocytes and fibroblasts. The purpose of this article is to report a case of UPS in the mandible. A 44-year-old patient presented with a painful growing mass in the mandible of two months' duration. Computed tomography and positron emission tomography-computed tomography revealed an ill-defined heterogenous, hypermetabolic mass about 4 cm in size in the left mandible invading adjacent soft tissues. A left mandiblulectomy and reconstruction with a fibular free flap were performed. Immunohistochemical study gave a diagnosis of UPS. The patient was referred for adjuvant chemotherapy after surgical removal of the tumor.

• Archives of Craniofacial Surgery
• /
• v.11 no.2
• /
• pp.116-119
• /
• 2010

Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.1
• /
• pp.11-16
• /
• 2012

Background: The purpose of this study was to evaluate the safety and effectiveness of intravenous ketamine-midazolam sedation in uncooperative children and disabled people undergoing dental procedures. Methods: From September 2009 to January 2012, total 114 intravenous deep sedation were carried out using midazolam and ketamine at pediatric dentistry in Wonkwang University Daejeon Dental Hospital. Patients' dental charts and sedation records were retrospectively reviewed. Results: 103 cases were enrolled, divided into four groups. There were 22 children under five in group 1, 14 children over six years with severe anxiety in group 2, 34 disabled person in group 3 and 33 children over six years with surgical procedure in group 4. Carries treatment (56 cases) was the most common dental treatment. The highest ketamine usage was 4.15 mg/kg, the longest duration of dental treatment was 41.6 minutes in children under five group. Nausea and vomiting (16 cases) was the most common side effect. Conclusions: Intravenous ketamine-midazolam sedation appears safe and effective for uncooperative children and disabled person undergoing dental procedures. But, emesis is a common side effect of ketamine occurring with increasing age.

• Journal of Chest Surgery
• /
• v.23 no.1
• /
• pp.146-151
• /
• 1990

Myasthenia gravis is a disorder of neuromuscular transmission characterized by weakness and fatigue of voluntary muscles. It is now reasonably established to be due to an autoimmune attack directed against the postsynaptic nicotinic acetylcholine receptors of voluntary muscles. Thymectomy has become increasingly important in the treatment of this disease after the successful case of Blalock in 1939. From January 1984 to December 1988, we performed total thymectomy in 25 cases of myasthenia gravis except one, and get the results as follows. l. Among 25 cases, male to female was 10:15 and the age was ranged from 16 years to 65 years. 2. Thymectomy was done in 24 cases and 1 case of malignant thymoma was not resectable. 3. There were 2 deaths after thymectomy due to myasthenic crisis. 4. There were 19 cases [76 %] of improvement after thymectomy as follows; complete remission was 6 cases [24 %], marked improvement was 9 cases [36 %] and subjective improvement was 4 cases [16 %]. 5. The effect of age, and duration of disease on operative result was not statistically significant, but that of thymic pathology was significant.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.1
• /
• pp.30-37
• /
• 1995

The prognosis of parosteal osteosarcoma is better than any other malignant bone tumors, but there are many controversies in its treatment. We tried to evaluate the prognosis and the effectiveness of limb-salvage operation in the treatment of the parosteal osteosarcoma. We experienced 12 patients of conventional parosteal osteosarcoma(2 males and 10 females) from 1981 to 1991. The limb-salvage operations with wide resection margin were done in 8 patients(5 tumer prosthesis, 2 resection arthrodesis and 1 vascularized fibular transplantation), marginal en-bloc resection and amputation in 2 patients, respectively. The duration of mean follow up was 5 years and 9 months, ranging from 2 year-3 months to 11 years, except of the patient who died with metastasis 1 year 8 months after. The disease-free survival rate(DFSR) of all patients was 68% and that of the patients treated with limb-salvage operation was 88% at 7 years. The DFSR was 33% with marginal margin(3 cases) and 89% with wide margin(9 cases) at 7 years. The results were unsatisfactory in the conventional parosteal osteosarcoma treated with marginal resection. The limb-salvage operation with wide surgical margin was thought to be the treatment of choice.

• Journal of Chest Surgery
• /
• v.24 no.2
• /
• pp.182-189
• /
• 1991

Fourteen patients underwent surgical resection of bullae between February, 1987 and June, 1990 via median sternotomy. Twelve patients had spontaneous pneumothorax with previous history of pneumothorax on the contralateral side or visible bullae on chest X-ray films. Two patients had bullous emphysema. The duration of operation and admission, frequency and amount of analgesic administered for pain control, pulmonary function test [FEV1, FVC, MVV] and the amount of bleedings were compared with six cases of staged unilateral thoracotomy. The results were as follows: 1. All patients were male. 2. Mean follow up period was 13.5 month and no recurrence of pneumothorax are noted after the operation. 3. Median sternotomy showed shortened admission days than thoracotomy. [12.4$\pm$2.7, 15.6$\pm$3.1 days] 4. Significantly shortened anesthetic time in median sternotomy than thoracotomy [121$\pm$21, 184$\pm$33 minutes] 5. Median sternotomy required less injection of analgesics than thoracotomy. [6.5$\pm$2.7, 13.5$\pm$3.1 ampules] 6. Bleeding amount and PFT showed no differences. 7. Complications were prolonged air leakage for more than 7 days [2 patients], transient elevation of SGOT and SGPT[2 patients], and wound infection[1 patient]

• Journal of Korean Neurosurgical Society
• /
• v.57 no.2
• /
• pp.123-126
• /
• 2015

A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.6
• /
• pp.581-583
• /
• 2009

Abducens nerve palsy associated with spinal surgery is extremely rare. We report an extremely rare case of abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing, which resolved spontaneously and completely. A 61-year-old previous healthy man presented with chronic lower back pain of 6 weeks duration and 2 weeks history of bilateral leg pain. He was diagnosed as having isthmic spondylolisthesis at L4-5 and L5-S1, and posterior lumbar interbody fusion was conducted on L4-5 and L5-S1. During the operation, inadvertent dural tearing occurred, which was repaired with a watertight dural closure. The patient recovered uneventfully from general anesthesia and his visual analogue pain scores decreased from 9 pre-op to 3 immediately after his operation. However, on day 2 he developed headache and nausea, which were severe when he was upright, but alleviated when supine. This led us to consider the possibility of cerebrospinal fluid leakage, and thus, he was restricted to bed. After an interval of bed rest, the severe headache disappeared, but four days after surgery he experienced diplopia during right gaze, which was caused by right-side palsy of the abducens nerve. Under conservative treatment, the diplopia gradually disappeared and was completely resolved at 5 weeks post-op.

• Journal of Chest Surgery
• /
• v.15 no.3
• /
• pp.278-284
• /
• 1982

As of today, the frequency of primary lung cancer is one of the improved problems in modern medicine and is increasing rapidly year by year. This study dealed with 138 cases of primary lung cancer proved by histopathologic examination in Thoracic & Card iovascular Surgery Dept. of N.M.C. from Sept. 1966 through June 1981. The majority of patients belong to 5th and 6th decade. Ratio between male and female was 3.7: 1. Initial symptoms were cough, blood tinged sputum, hemoptysis, chest pain, dyspnea and duration of symptoms before admission was within 6 months [60%] and 12 months [78%]. Histopathologically, 64 cases [61%] of them were the squamous cell carcinoma, 21 cases [15%] were the adenocarcinoma, 20 cases [14.8%] were the anaplastic carcinoma. Fifty-six cases were resectable: 43 cases were subjected to pneumonectomy and 13 cases were to lobectomy. The remaining 82 cases were nonresectable, but exploratory thoracotomy was performed in 22 cases of them. Among 56 resected cases, 33 cases were radically operated and 17 cases were subjected to palliative operation and 6 cases were subjected to extended operation. [Concomitant pericardium resection in 1 case and concomitant chest wall resection in 5 cases]. Surgical mortality was 10.7% and causes of death were aspiration of contralateral lung, respiratory insufficiency, postop. empyema with B.P.F, cardiogenic failure. This study analysed the cancer stage between preop clinical T.N.M. stage and postop. T.N.M. stage in 78 cases; resectable 56 cases and non-resectable 22 cases.