• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.14 no.5
• /
• pp.2322-2328
• /
• 2013

The aim of this study was to quantify the sedative effects of high spinal anesthesia, according to patient age, by also evaluating respiratory and hemodynamic changes. A prospective study was performed in 60 patients who were electively scheduled for lower limb or lower abdominal surgery. They were allocated into one of 2 groups according to their age: older age (51-80 years) and young age (20-50 years). In all groups, the lowest intraoperative bispectral index (BIS) values significantly lower than preoperative values. Patients in the older age group had significantly lower intraoperative BIS values than younger patients. The sedative effect of high spinal anesthesia is greater in older patients than in young patients, with an increase in respiratory instability. Our study showed a negative correlation between age and lowest BIS value; the lowest BIS value was reduced in older patients.

• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.730-734
• /
• 1998

Background: It is important to know the location, number, size and shape of bullae before thoracotomy or VATS bullectomy. Chest X-ray and chest CT may be used but with some limitation. The purpose of this study was to compare the diagnostic value of thoracography with that of chest X-ray in preoperative detection of bullae. Meterial and Method: Thoracography was performed by injection of non-ionic water-soluble dye into pleural space in 22 primary spontaneous pneumothoraces, which underwent thoracotomy or VATS bullectomy. Chest X-ray and thoracography were compared through operative finding. Results: Sensitivity and accuracy of thoracography(75% and 72.7%) were higher than those of chest X-ray(30% and 36.4%). However, specificity of thoracography(50%) was lower than that of chest X-ray (100%). There were no complications during or after thoracography. Conclusion: Thoracography is a safer and more useful method for preoperative detection of bullae when compared with chest X-ray.

• Journal of Yeungnam Medical Science
• /
• v.7 no.2
• /
• pp.173-179
• /
• 1990

Nonsurgical management of four cases of the parasagittal epidural hematoma were experienced. Patients were mildly symptomatic or minimal neurological disturbances on admission. Patients were treated conservatively because of stable neurologic sign. All patients had who diastatic fracture and/or suture have become a complete neurological recovery with satisfactory absorption of EDH over a period of 5 to 12 weeks.

• Journal of Life Science
• /
• v.18 no.11
• /
• pp.1532-1537
• /
• 2008

The purpose of this study was to investigate the effect of different arthroplasty designs on knee kinematic and lower limb muscular activation for up-stair and down-stair movement. 3-D video analysis of whole body and joint kinematics and EMG analysis of quadriceps and hamstrings were conducted. One-way ANOVAs were used for statistical analyses (p=0.05). The single-radius group exhibited more arthroplasty limb quadriceps EMG and hamstring coactivation EMG than the multi-radius group. Single-radius demonstrated more abduction angular displacement and reached peak abduction earlier than the multi-radius arthroplasty limb. The single- radius the percent body fat showed similar values in the Elderly, Single and Multi-radius group among the periods, however Control group was Lowered among the periods. Single-radius group limb also increased the quadriceps muscle activation level to produce more knee extension moment to compensate for the short quadriceps moment arm. Resting metabolic rate was significantly increased in control group in the period of LI. Energy expenditure was extremely increased in all groups except control group among the periods. We can say this is the exercise effects.

• Clinical and Experimental Pediatrics
• /
• v.50 no.11
• /
• pp.1125-1128
• /
• 2007

Epidural hematoma is relatively rare in newborn infants and frequently associated with instrumental deliveries or other complications during labor and delivery. Although surgical evacuation has been the most common therapy, many other procedures have been described. Although many epidural hematomas require surgical evacuation rather than nonsurgical management, conservative or aspiration of hematoma have been attempted. In the case of EDH associated with cephalhematoma, aspiration of cephalhematoma could be attempted because frequent features of these combination were communication between these hematoma. We report a case of successful nonsurgical management of epidural hematoma through the aspiration of accompanying cephalhematoma in a 5-day-old newborn infant.

• Journal of Chest Surgery
• /
• v.34 no.1
• /
• pp.41-44
• /
• 2001

배경: 최근 들어 최소 절개술의 도입의 장점으로 입원간의 단축이 거론되고 있다. 이에 본 연구에서는 최소 흉골 절개술(mini-sternotomy)하에 시행된 개심술 환자에 대하여 전향적으로 수술 후 문제가 없는 환아에 대하여 5일 이내에 퇴원을 시도하고 그 안전성, 경제성 등을 평가하였다. 대상 및 방법: 1998년 11월부터 1999년 7월까지 최소 흉골 절개술하에 개심술을 시행한 환자 중 5일 이내에 퇴원한 환자 29명과 1997년 1월부터 5월까지 전통적인 흉골 절개술로 개심술을 시행한 29명의 환아들을 각각 실험군(제1군)과 대조군(제2군)으로 하였다. 환자는 동일한 수술자로부터 수술을 받았고 질병군은 유사하였다. 결과: 제1군과 제2군의 수술 후 재원일수, 총 병원비, 합병증, 수술 후 소견 등에 차이가 있는지 비교하였다. 평균 수술 후 재원일수는 4.5$\pm$0.6일 및 9.1$\pm$2.4일이었다(p<0.05). 두 환자군에서 수술 후 합병증으로 인한 재입원은 없었고 수술 후 시행한 심초음파에서도 심장수술과 관련된 병변은 관찰되지 않았다. 제1군의 총 입원비의 평균은 7,333,184$\pm$113원이었고, 환자부담액은 3,464,383$\pm$80원이었다. 반면 제2군에서의 총 입원비의 평균은 7,486,136$\pm$140원, 환자부담액은 3,660,194$\pm$92원이었다(p>0.05). 결론: 본 연구를 통해 단기 퇴원 지침하에 환자를 치료함으로써 수술 후 재원일수를 단축시키는 시도가 합병증이나 잔존 병변을 남기지 않고 안정적으로 시행될 수 있다는 사실을 확인하였다. 하지만 경제적 이점은 통계적인 유의성을 찾을 수 없었다. 향후 환자군의 크기와 질병군의 난이도 등을 조절한 비교 평가가 필요하다고 생각된다.

• Journal of Chest Surgery
• /
• v.36 no.8
• /
• pp.595-601
• /
• 2003

Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.

• Journal of Chest Surgery
• /
• v.34 no.6
• /
• pp.465-471
• /
• 2001

Background: Hypothermia protects the brain by suppressing the cerebral metabolism and it is performed well enough before the total circulatory arrest(TCA) in the operation of aortic disease. Generally, TCA has been performed depending on the rectal or nasopharyngeal temperatures; however, there is no definite range of optimal temperature for TCA or an objective indicator determining the temperature for safe TCA. In this study, we tried to determine the optimal range of temperature for safe hypothermic circulatory arrest by using the intraoperative electroencephalogram(EEG), and studied the role of EEG as an indicator of optimal hypothermia. Material and Method: Between March, 1999 and August 31, 2000, 27 patients underwent graft replacement of the part of thoracic aorta using hypothermia and TCA with intraoperative EEG. The rectal and nasopharyngeal temperatures were monitored continuously from the time of anesthetic induction and the EEG was recorded with a ten-channel portable electroencephalography from the time of anesthetic induction to electrocerebral silence(ECS). Result: On ECS, the rectal and nasopharyngeal temperatures were not consistent but variable(rectal 11$^{\circ}C$ -$25^{\circ}C$, nasopharynx 7.7$^{\circ}C$ -23$^{\circ}C$). The correlation between two temperatures was not significant(p=0.171). The cooling time from the start of cardiopulmonary bypass to ECS was also variable(25-127min), but correlated with the body surface area(p=0.027). Conclusion: We have found that ECS appeared at various body temperatures, and thus, the use of rectal or nasopharyngeal temperature were not useful in identifying ECS. Conclusively, we can not fully assure cerebral protection during hypothermic circulatory arrest in regards to the body temperatures, and therefore, the intraoperative EEG is one of the necessary methods for determining the range of optimal hypothermia for safe circulatory arrest. :

• Radiation Oncology Journal
• /
• v.9 no.1
• /
• pp.17-25
• /
• 1991

This study was undertaken to find the effect of radiation therapy on the healing ability of surgical wounds and on this basis, to find the proper time interval between the radiation therapy and surgery. Two hundred and fifty-two mice were used and a single dose of 2000 cGy was given in each instances to the hind limb of mice. Incisional wounds were produced after varying intervals in the previously irradiated areas and then they were followed up at regular intervals by the measurement of tensile strength. The wounds which received surgery immediately, 1 or 2 weeks after irradiation revealed marked delay and the wounds which received surgery 12, 16 or 20 weeks after irradiation demonstrated slight delay in wound healing in terms of tensile strength measurement. But the wounds which received irradiation 4 or 8 weeks before surgery did not differ much in the wound healing process from that of the control group. Histopathologic studies of the wounds demonstrated epithelization in most instances as quickly as in the control wounds. The appearance of fibroblasts and collagen fibers has delayed momently and appeared to have close correlation with the tensile strength healing curves.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.747-752
• /
• 1996

Video-assisted thoracic surgery(VATS) has been widely used in the treatment of spontaneous pneumothorax in spite of the absence of definitive data regarding the relative safety and long term results of this procedure. We reviewed 34 patients (group I) who underwent )8 video-assisted surgical procedures for spontaneous pneumothorax from June 1994 to December 1995 and compared the results of these patients with the results of another 14 patients (group ll) who underwent bullectomy through axillary Oho- racotomy during the same period. Average age, sex distribution, site and extent of pneumothorax, surgical indications, and complication rate showed no differences between the two groups. In group ll patients, th number and sites of bullae tend to be multiple compared to patients in group 1. The mean number of ends-GIA used for stapling of bullae was 2. 6 per patient with the range from 2 to 4 in group 1. The mean duration of chest tube drainage was not different between the two groups ().7 days and 3.9 days), but the mean time to discharge was significantly shorter in group I (5.6 days) than in group ll (8.9 days). Mean follow-up time was 12 and 11 months in each groups and ranged from 2 to 21 months. Pneumothorax recurred after three of 38 procedures in group I (7.9 %) with no recurrence in group ll. These data suggest that video-assisted thoracic surgery is a viable alternative to thoracotomy for the treatment of spontaneous pneumothorax with low morbidity and shorter hospital stay. However, it should be applied cautiously to patients with spontaneous pneumothorax because of the relatively high incidence of recurrence compared to axillary thoracotomy.