• Journal of Chest Surgery
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• 제54권6호
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• pp.543-546
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• 2021

A 55-year-old woman who had received an implantable left ventricular assist device 3 months earlier presented with dyspnea and a low-flow alarm of the device. Computed tomography and log-file analysis of the device system suggested inflow cannula obstruction. Since the patient had cardiogenic shock due to pump failure, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. With ECMO, surgical exchange of the pump was considered. However, the obstruction spontaneously resolved without surgical intervention. It turned out that an obstructive thrombus was washed out by rebooting the pump. Moreover, the thrombus was embolized in the patient's left subclavian artery. The patient underwent heart transplantation 4 months after the pump obstruction accident and continued to do well.

• 한국임상수의학회지
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• 제39권6호
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• pp.405-410
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• 2022

An 11-year-old thoroughbred post-partum broodmare presented with the symptoms of colic. The physical and clinical examinations indicated a large colon displacement or volvulus. Immediate surgical intervention was performed, and a strangulating large colon volvulus (LCV) was defined as a volvulus of >540° in the counterclockwise direction. After correcting and assessing the gut viability, approximately 80% of the entire large colon was resected and anastomosed using an end-to-end technique. With supportive care after surgery, the horse regained its appetite and vitality without significant clinical complications and was discharged on postoperative day 9. This report presents the first surgical correction using a large colon resection and anastomosis (LCRA) and the critical care for a strangulating LCV in a horse in Korea. This case enhances the current knowledge of clinical LCV and the related considerations for treatment.

• 대한두개안면성형외과학회지
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• 제24권3호
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• pp.133-138
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• 2023

White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.

• 한국전문물리치료학회지
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• 제31권2호
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• pp.167-173
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• 2024

Background: Stress urinary incontinence (SUI) impacts the social, physical, and psychological well-being and quality of life of the patient. Several techniques exist for its management, including transcutaneous electrical stimulation (TES). Objects: We aimed to demonstrate the effects of TES on ultrasonographic variables and quality of life in women with SUI. Methods: This prospective study recruited 21 women who had been diagnosed with grade 1 or 2 SUI between July 2018 and March 2019. The exclusion criteria were pregnancy and a history of urogenital surgery. All participants were assessed at baseline and 8 weeks after intervention initiation. The bladder neck position (BNP), length of the urethra (LU), funneling index (FI), and rhabdosphincter thickness (RT) were measured. The Incontinence-Quality of Life (I-QOL) was used to assess incontinence-specific quality of life. Statistical significance level was set at p < 0.05. Results: Twenty-one patients with SUI used TES for 8 weeks. BNP and FI significantly decreased after intervention (p < 0.05). LU, anterior and posterior RT (indicators of external sphincter hypertrophy) significantly increased post-intervention (p < 0.05). The total I-QOL score increased from 64.81 to 71.86 after the intervention (p < 0.05). Conclusion: This intervention improved BNP, LU, FI, RT, and subjective indicators such as quality of life in women with SUI. Therefore, TES can be an effective non-surgical treatment method for improving SUI symptoms and quality of life in these patients.

• 여성건강간호학회지
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• 제24권2호
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• pp.163-173
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• 2018

Purpose: To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. Methods: With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. Results: The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were $1.57{\pm}0.51$, $0.37{\pm}0.64$, $3.62{\pm}0.67$, and $4.00{\pm}0.45$, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. Conclusion: In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

• 한국임상수의학회지
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• 제35권5호
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• pp.200-205
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• 2018

This retrospective study is designed to compare the clinical results of tibial tuberosity transposition (TTT) and anti-rotation suture (ARS) treatments for medial patellar luxation (MPL). Medical records of 133 dogs were reviewed that had undergone surgical correction of MPL between January 2013 and May 2017. MPL correction was performed on 182 stifles, with TTT and ARS being performed on 101 stifles and 81 stifles. The common dog breeds receiving surgical treatment for MPL were Maltese, Pomeranian, Chihuahua and Poodle. Mean age of dogs with MPL was 32.6 months, and their mean body weight was 4.26 kg. Seventy dogs (52.6%) were male and 63 (47.4%) were female. Of the 182 stifles with MPL, grade II, III and IV were 18.7%, 72.0% and 9.3%. Total complications after TTT and ARS were recorded in 16.8% and 29.6%. Major complications after TTT and ARS were recorded in 5.9% and 12.3%, minor complications after TTT and ARS were recorded in 10.9% and 17.3%. The risk of complication and reluxation rate after TTT were significantly lower than that for ARS (p < 0.05). However, the rate of reluxation among dogs treated by ARS (1.2%) for grade II MPL was significantly lower than that for dogs treated by ARS (8.6%) for grade III MPL (p < 0.05). The TTT group had a shorter recovery period after surgical intervention than that in the ARS group (p < 0.001). In conclusion, TTT had a significantly lower incidence of complication and a shorter recovery period than ARS. However, ARS for grade II MPL appears to be a good surgical option for reducing the rate of reluxation after surgery. These results of this study could be used to provide therapeutic guidelines for surgical MPL correction in small-breed dogs.

• Journal of Gastric Cancer
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• 제11권2호
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• pp.116-121
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• 2011

Purpose: Gastric cancer surgery is a common operation in East Asia, such as Korea and Japan, and there has been a significant increase in the need for this procedure due to the aging population. As a result, surgery for the treatment of gastric cancer for elderly patients is expected to increase. This study examined the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients. Materials and Methods: From November 2008 to August 2010, 590 patients, who underwent a curative resection for gastric cancers, were enrolled. Patients who underwent palliative or emergency surgery were excluded. A retrospective analysis of the correlation between surgical outcomes and age was performed. The elderly were defined as patients who were over the age of 65 years. Results: The mean age of all patients was 58.3 years, and complications occurred in 87 cases (14.7%). The most common complication was wound infection and severe complications requiring surgical, endoscopic, or radiologic intervention developed in 52 cases (8.8%). The rate of complications increased with increasing age of the patients. Univariate analysis revealed age, comorbidity, extent of resection, operation time, and combined resection to be associated with surgical complications. In particular, age over 75 years old, operation time, and comorbidity were predictive factors in multivariate analysis. In the elderly, only comorbidity was associated with surgical complications Conclusions: The patients' age is the most important factor for predicting surgical complications. Surgeons should pay an attention to the performance of gastric cancer surgery on elderly patients. In particular, it must be performed carefully for elderly patients with a comorbidity.

• Advances in pediatric surgery
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• 제12권2호
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• pp.137-146
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• 2006

Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods: from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7:1 to 2.1:1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.414-420
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• 2019

Background Congenital muscular torticollis (CMT) is characterized by persistent head tilt toward the affected side. No consensus exists regarding the cause of this disorder. In this study, we analyzed various clinical factors in patients with CMT who were treated with surgical release. This analysis enabled us to identify potential causative factors of CMT and to establish a basis for surgical interventions. Methods In total, 584 patients who underwent surgical intervention for CMT from October 2007 to December 2016 were included in this study. Their demographic characteristics, birthrelated factors, and clinical features were analyzed. Results Data from 525 patients were analyzed in this study after exclusion of those with insufficient information. Before birth, 31 patients (5.9%) were diagnosed with oligohydramnios, and 87 (16.6%) had a breech presentation. Seven (1.3%) cases of clavicle fracture and two (0.4%) cases of cephalohematoma were noted at birth. Before surgery, 397 patients (75.6%) underwent physiotherapy and 128 patients (24.4%) did not. The duration of physiotherapy ranged from 1 to 50 months (average, 6 months). Conclusions Our study shows that 16.6% of the CMT patients presented in the breech position, which is a much higher rate than that observed in the general population (3%-4%). We hypothesize that being in the breech position as a fetus appears to exert a significant influence on shortening and fibrosis of the sternocleidomastoid muscle.

• Journal of Chest Surgery
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• 제57권2호
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• pp.120-125
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• 2024

Background: This study aimed to assess the outcomes of patients with complex rib fractures undergoing operative or nonoperative management at our major trauma center. Methods: A retrospective review of all patients who were considered for surgical stabilization of rib fractures (SSRF) at a single major trauma center from May 2016 to September 2022 was performed. Results: In total, 352 patients with complex rib fractures were identified. Thirty-seven patients (11%) fulfilled the criteria for surgical management and underwent SSRF. The SSRF group had a significantly higher proportion of patients with flail chest (32 [86%] vs. 94 [27%], p<0.001) or Injury Severity Score (ISS) >15 (37 [100%] vs. 129 [41%], p<0.001). No significant differences were seen between groups for 1-year mortality. Patients who underwent SSRF within 72 hours were 6 times less likely to develop pneumonia than those in whom SSRF was delayed for over 72 hours (2 [18%] vs. 15 [58%]; odds ratio, 0.163; 95% confidence interval, 0.029-0.909; p=0.036). Prompt SSRF showed non-significant associations with shorter intensive care unit length of stay (6 days vs. 10 days, p=0.140) and duration of mechanical ventilation (5 days vs. 8 days, p=0.177). SSRF was associated with a longer hospital length of stay compared to nonoperative patients with flail chest and/or ISS >15 (19 days vs. 13 days, p=0.012), whilst SSRF within 72 hours was not. Conclusion: Surgical fixation of complex rib fractures improves outcomes in selected patient groups. Delayed surgical fixation was associated with increased rates of pneumonia and a longer hospital length of stay.