• Journal of Korean Neurosurgical Society
• /
• v.56 no.2
• /
• pp.103-107
• /
• 2014

Objective : This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods : We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results : The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions : Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

• Journal of Chest Surgery
• /
• v.17 no.3
• /
• pp.409-417
• /
• 1984

In the early days of open heart surgery, acute respiratory failure following extracorporeal circulation was a significant deterrent to an uncomplicated recovery. Although a marked improvement in prevention and treatment of postoperative respiratory failure has been achieved, the problem has not been completely eliminated and continues to be a causative factor in morbidity and mortality Fates following open heart surgery. We have attempted to evaluate postoperative respiratory failure in patients undergoing cardiac operation with the aid of extracorporeal circulation. Our series comprised 92 patients who underwent elective open heart surgery at the Department of Thoracic and Cariodvascular Surgery, School of Medicine, Kyungpook National University, from January, 1980 to December, 1982. In our study, the overall incidence of acute respiratory failure following open heart surgery was 18.8 percent. The duration of extracorporeal circulation in a series of 18 patients who developed postoperative respiratory failure [Group B] was longer in the mean value [120.3 minutes] than the uncomplicated 74 patients [Group A] [85.8 minutes]. The duration of artificial ventilation after open heart surgery in Group A averaged 13.4 hours as contrasted with 76.5 hours in Group B. In Group B, the inspired oxygen concentration [FiO2] in artificial ventilation was continued in the higher level than Group A until 18 hours after operation. Upon pulmonary function test performed pre-and postoperatively, residual volume[RV], RV/TLC and FEV 1.0/FVC were remained essentially unchanged following extracorporeal circulation, whereas forced vital capacity [FVC], FEV 1.0 and FEF 25-75% were significantly decreased in the early postoperative days. The incidence of acute respiratory failure was significantly higher in a series of patients who developed postoperative complications, such as re- exploration due to massive bleeding, low cardiac output, acute renal failure and arrhythmias. A total of 9 patients died, giving an overall mortality was 33.3 percent whereas the mortality was only 1.1 percent for patients without respiratory failure.

• Korean Journal of Adult Nursing
• /
• v.27 no.5
• /
• pp.481-492
• /
• 2015

Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

• Archives of Craniofacial Surgery
• /
• v.17 no.2
• /
• pp.63-67
• /
• 2016

Background: The subciliary approach is commonly used for reconstruction of orbital wall or zygomaticomaxillary fractures. However, this approach is associated with postoperative complications, especially lower eyelid malposition. We report the experience of managing postoperative lower eyelid malposition with triamcinolone acetonide. Methods: A retrospective review was performed for all traumatic facial fractures requiring surgery via the subciliary approach at Chosun University Hospital in 2014. For each patient meeting inclusion criteria, the medical chart was reviewed for demographic information and postoperative course, including the presence of postoperative eyelid malposition or scleral show. Results: The review identified 189 cases in which the subciliary approach was used, and postoperative lower eyelid malposition was found in 7 cases (3.7%). For these 7 patients, the mean therapeutic period (interval to correction of the malposition) was 10.5 weeks (range, 8 to 14 weeks). On average, patients received 3 injections of triamcinolone. In all cases, degrees of the malposition were improved, and none of the patients required an operative intervention to correct the malposition. Conclusion: Triamcinolone injection is an appropriate treatment modality for lower eyelid malposition after subciliary approach. Treatment duration is relatively short, requiring fewer than 4 outpatient clinic visits, with relatively earlier recovery compared to conservative "wait-and-see" management.

• Medical Lasers
• /
• v.9 no.1
• /
• pp.39-43
• /
• 2020

Background and Objectives Breast reconstruction has the advantage of reducing the loss of the body image of patients after mastectomy surgery, and also improving the quality of the social and sexual life of breast cancer patients. However, in surprising and unfortunate number of patients, acute postoperative pain persists beyond the normal course of postsurgical recovery. We set out to investigate the effect of local dynamical micro-massage (LDM) treatment for achieving pain relief and reducing other postoperative complications. Materials and Methods We performed a retrospective analysis on 58 patients who underwent LDM treatment for postoperative pain management at Soonchunhyang University Bucheon Hospital between February 2017 and June 2019. Those patients who complained of persistent postoperative pain, which was uncontrollable with medication, were treated with LDM. The degree of pain and discomfort with contracture were recorded using numerical rating scale (NRS) scoring system with numbers from 0 to 10 ('none' to 'worst'). Results The median NRS score of pain was reduced by 62.3% from the start to the end of LDM treatment (p<0.001). Further, the NRS score of discomfort with contracture was reduced 66.0% (p<0.001). There was no complication related to the LDM treatment. Conclusion Dual-frequency ultrasound LDM can be an effective therapeutic option for persisting pain after breast reconstruction surgery. It was also effective in improvement of discomfort with contracture and erythema of the surgical wound.

• Journal of Korean Clinical Nursing Research
• /
• v.24 no.1
• /
• pp.85-93
• /
• 2018

Purpose: This study aim to determine the effect of chewing gum on the reduction of postoperative ileus and recovery after surgery. Methods: The study was conducted as a randomized controlled trial among 82 patients who underwent spine surgery between May 2015 and October 2015. Patients in experimental group chewed sugarless gum 3 times daily for 30 minutes each time until POD 5. Abdominal discomfort, the first defecation, and CAS score (Constipation Assessment Scale) were monitored. Results: After the experiment, abdominal discomfort was significantly decreased in the experimental group compared to that of the control group (F=2.46, p=.044). However, the first defecation occurred on postoperative hour 69.6 in the chewing gum group and on hour 60.2 in the control group (t=-1.63, p=.107). CAS was significantly decreased in the experimental group compared to that of the control group (F=3.51, p=.012). Conclusion: Chewing gum is expected to help patient recover after surgery as safe nurse intervention which can reduce abdominal discomfort and constipation during early postoperative days after spine surgery.

• Journal of Korean Medicine Rehabilitation
• /
• v.27 no.3
• /
• pp.33-45
• /
• 2017

Objectives The objective of this study is to report the evidence that continuous passive motion (CPM) therapy combined with Korean Medicine is effective for knee injuries. Methods We searched 2 Korean medical electronic databases, and 2 Chinese electronic databases to find randomized controlled clinical trials (RCTs) that treat knee injuries with Korean Medicine combined with CPM therapy. We selected studies by screening. We extracted data from selected RCTs, and analyzed RCTs by using Cochrane's Risk of bias criteria. Results 386 studies are searched, and 7 RCTs are selected. According to the study, several kinds of Korean Medicine such as hydrotherapy, decoction, acupuncture, moxibustion, and manual therapy are used with CPM therapy for the knee joint postoperative rehabilitation. We found the encouraging evidence that Korean Medicine and CPM combined therapy is more effective than single CPM therapy by alleviating pain, increasing range of motion, and improving knee function, etc. However, the risk of bias in most RCTs was judged to be uncertain. Conclusions Combination of Korean Medicine and CPM therapy can compensate the defect of single CPM therapy, and promotes the recovery of knee joint function.

• Archives of Plastic Surgery
• /
• v.41 no.1
• /
• pp.71-76
• /
• 2014

Background Numerous methods exist for simultaneous correction of mild blepharoptosis during double eyelid surgery. These methods are generally categorized into either incisional (open) or non-incisional (suture) methods. The incisional method is commonly used for the creation of the double eyelid crease in patients with excessive or thick skin. However, concurrent open ptosis correction is often marred by the lengthy period of intraoperative adjustment, causing more swelling, a longer recovery time, and an increased risk of postoperative complications. Methods The authors have devised a new, minimally invasive technique to alleviate mild ptosis during incisional double eyelid surgery. The anterior lamella is approached through the incisional technique for the creation of a double eyelid while the posterior lamella, including Muller's and levator muscles, is approached with the suture method for Muller's plication and ptosis correction. Results The procedure described was utilized in 28 patients from June 2012 to August 2012. Postoperative asymmetry was noted in one patient who had severe preoperative conjunctival scarring. Otherwise, ptosis was corrected as planned in the rest of the cases and all of the patients were satisfied with their postoperative appearance and experienced no complications. Conclusions Our hybrid technique combines the benefits of both the incisional and suture methods, allowing for a predictable and easily reproducible correction of blepharoptosis with an aesthetically pleasing double eyelid.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.260-263
• /
• 1996

High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.

• Journal of Chest Surgery
• /
• v.5 no.1
• /
• pp.29-34
• /
• 1972

Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.