• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.7
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• pp.200-206
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• 2018

The aim of this study was to evaluate the effect of Ropivacaine on pain following laparoscopic surgery. Between March 2015 and June 2017, all 97 patients with renal mass who elected to receive laparoscopic nephrectomy were reviewed, retrospectively. Normal saline (0.9%) was used as a control in 45 patients while Ropivacaine was used for local anesthesia in the instillation group (n=52). Pain score (visual analog scale) of the shoulder and upper abdominal area between the two groups was significantly different between recovery time and 24 h (p<0.05), with no significant differences between 48 and 72 h (both p>0.05). In the instillation group, pain score of shoulder and abdominal pain in the two groups according to the amount of CO2 used was not significantly different between recovery time and 24, 48, and 72 h (all p>0.05). Ropivacaine reduced shoulder and upper abdominal pain that occurred within 24 h after surgery. Effective pain control with Ropivacaine is needed in the early postoperative period when a large amount of CO2 is used in laparoscopic surgery.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.38-42
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• 1996

Intraabdominal complications after cardiac surgery are infrequent, but often fatal. From 1985 to 1993, a total of 1241 cardiovascular operations requiring cardiopulmonary by pass were performed at Pusan Paik Hospital. A total of 16 intraabdominal complications occurred, represe ting a 1.3% incidence. Complications included enterocolitis in six, hepatitis in three, gastric bleeding in two, erosive gastritis in one, cholecystitis in one, spleen rupture in one, epididymitis in one, inguinal hernia in one patient. The overall mortality rate was 12.5% (2 of 16). Three of the 16 patients underwent surgical intervention, and one died. We concluded that intraabdominal complications after cardiac surgery are associated with a high mortality rate, so when evidence of an acute abdominal symptom is observed or conservativi medical treatment fails to improve symptoms, prompt early surgical intervention should be performed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.301-314
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• 2003

The purposes of this retrospective study were to assess the change of serum parameters in oral and maxillofacial surgery patients after operation and to determine what laboratory parameters on treatment periods were associated with the recovery of systemic condition. For purposes of assessing systemic nutritional status, several serum parameters were chosen. The sample patients were randomsubjects extracted from three category patient groups- oral cancer, odontogenic abscess, facial bone fracture based on treated patients at department of oral and maxillofacial surgery in Pusan National University Hospital from September 1, 1998, to September 1, 2002. Each groups were consisted with 10 patients. Each patient chart was examined and blood sample parameters were reviewed with clinical signs, symptoms and vital sign at preoperative day, postoperative 1 day, postoperative 1 week. Several parameters were analyzed statistically for extraction of mean values and differences between the periods groups. The findings of serum parameters of cancer, abscess and fracture groups were as follows: 1. In cancer patients, Hb, MCV, albumin, cholesterol, LDH, AST, ALT, neutrophil, platelet, leukocyte, Na, K, Cl, BUN, creatinine were analyzed. Values of Hb, albumin, AST, neutrophil, leukocyte, Cl showed significantly differences according to periods. 2. In abscess patients, CRP, ESR, leukocyte, body temperature, neutrophil were analyzed. Values of CRP, leukocyte, body temperature, neutrophil showed significanlty differences according to periods. 3. In fracture patients, same parameters with cancer patient's were chosen. Values of platelet, Cl only showed significantly differences according to periods. 4. In cancer patients, data regarding correlation was analyzed statistically as Pearson's value. A positive correlation was found between Hb and albumin, K, Na(P<0.05). A positive correlation was also found between neutrophil and leukocyte(P<0.05). Positive correlations were found between cholesterol and ALT, LDH and platelet, creatinine both, Platelet and BUN, Na and K(P<0.01). 5. In abscess patients, Peason's correlation values were analyzed on parameters. A positive correlation was found only between CRP and neutrophil(P<0.05). 6. In fracture patients, The correlations of parameters also were statistically analyzed. Positive correlations were found between MCV and K, albumin and LDH, AST and three parameters of creatinine, Na, Cl, K and neutrophil, neutrophil and three parameters of leukocyte, BUN, K(P<0.05). Positive correlations were found between LDH and AST, ALT and AST, creatinine both(P<0.01). This retrospective clinical study showed the CRP levels only on abscess patients may be useful in determination of clinical infected status, but the levels of other parameters on cancer, fracture patients did not showed significant values as diagnostic aids for clinical status.

• Journal of Chest Surgery
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• v.37 no.6
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• pp.524-529
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• 2004

Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.59-65
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• 2012

Purpose: Multidisciplinary approaches of surgical resection and chemotherapy have been widely used for the treatment of non-metastatic osteosarcomas. We aimed to assess the effect of neoadjuvant chemotherapy for metastasis and disease-specific survival. Materials and Methods: Authors retrospectively reviewed 225 young (<30 years old) and non-metastatic osteosarcoma patients who underwent surgical resection and postoperative chemotherapy between February 1984 and July 2010. Mean age was 14.4 years old (ranged: 4-29 years old) and average follow-up period was 9.1 years (2-28 years). The patients were divided into two groups according to the application of preoperative chemotherapy. Both groups were compared with clinical characteristics, metastasis-free survival and disease-specific survival. Results: All of 225 patients, 32 patients were treated with postoperative chemotherapy and 193 patients were performed preoperative and postoperative chemotherapy. Postoperative chemotherapy group showed significantly high rate of amputation (p<0.001). Metastasis was occurred in 101 patients. Postoperative chemotherapy group indicated significant higher rate of metastasis (69% vs 41%, p=0.004) and early development of metastasis (mean: 11.5 vs 20.3 months, p=0.045) than pre-and postoperative chemotherapy group. Fifty-seven patients were died of osteosarcoma. Postoperative chemotherapy group revealed significant lower rate of 5-year disease-specific survival than pre-and postoperative chemotherapy group (51% vs 84%, p=0.001). Adult (>15 years) and large sized tumor (>8 cm) were meaningful risk factors of metastasis and disease-specific survival. Although, local recurrences were occurred in 13 patients, there was no significant difference. Conclusion: Neoadjuvant chemotherapy offers better disease-specific survival and metastasis-free survival.

• Journal of Life Science
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• v.20 no.9
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• pp.1299-1305
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• 2010

Cardiac troponin-I (cTnI), creatine kinase-MB (CK-MB), and C-reactive protein (CRP) are routine cardiac markers for the diagnosis of cardiovascular disease. Recently, brain natriuretic peptide (BNP) has garnered attention as a marker of heart failure. This study was retrospectively designed to investigate the relationships between preoperative BNP, other cardiac markers levels and perioperative parameters in seventy-four adult patients that underwent off-pump coronary artery bypass grafting (OPCAB) and to assess its usefulness for predicting postoperative outcomes. Preoperative levels of BNP, cTnI, CK-MB, and CRP had significantly positive or negative correlations with echocadiographic parameters. There were significantly positive relationships between BNP, cTnI, CK-MB, and CRP concentration. Postoperative mechanical ventilation time had a positive correlation to preoperative levels of cTnI, CK-MB, and CRP, while ICU-staying period had a positive correlation with BNP, cTnI and CK-MB. These results reveal that a preoperative level of BNP is a good predictor and that its combination with cTnI, CK-MB, and CRP might be useful for diagnosis and comprehensive risk stratification of patients with coronary heart diseases, as well as prognosis of perioperative outcomes in OPCAB patients.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.3
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• pp.262-268
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• 2016

Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

• Journal of Life Science
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• v.17 no.11
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• pp.1539-1546
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• 2007

We have investigated whether the supplement of magnesium to cold blood cardioplegia improves myocardial protection. Sixty patients scheduled for elective valvular heart surgery were randomly assigned to a control group (n=30) which received conventional cold blood cardioplegia and an Mg group (n=30) which received cold blood cardioplegia supplemented with 2 g of magnesium sulfate. Electrolytes levels including $Mg^{++}$, hematological and biochemical variables, cytokines, myocardial marker levels, and postoperative outcomes were compared between two groups before, during or idler operation. $Mg^{++}\;and\;Ca^{++}$ levels in the Mg group were higher than those of the control group after surgery. The total WBC counts, CK-MB, troponin-I and Interleukin-6 levels in the Mg group were lower than those of the control group after surgery. Postoperative incidence of atrial fibrillation was lower in the Mg group compared with the control group. These results showed that $Mg^{++}$ attenuated inflammatory reaction, myocardial damage, and hypomagnesemia during valvular surgery and reduced postoperative arrhythmia incidence without side effects.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1010-1016
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• 1996

Thymectomy is an accepted therapeutic modality for patients with myasthenia gravis. The selection of patients for operation, the timing of operation and the surgical approach are still controversial. We reviewed 82 patientsraged 13 to 66 years; mean age, 37.7 years treated with transsternal thymectomy between January 1983 and December 1994. Patients were symptomatically staged according to the modified Osserman's classification. There was one hospital death and postoperative follow-up was obtained on 75 patients. During a mean follow up of 56.9 months, 64 patients (85.3%) benefited from the operation with complete remis ion achieved in 28(37.3%). The thyroid disease was present in 8 patients, of whom 7(87. 5%) achieved complete remission in contrast to 21 (31.3%) of the 67 patients without thyroid disease. The disease duration less than 2 years in 32 patients was associated with complete remission in 16 (50%) in contrast to remission in 12(27.4%) of the 43 patients whose disease duration was more than 2 years. In conclusion, the complete remission rate after transsternal thymectomy was affected by the presence of thyroid disease and disease duration. Myasthenia gravis with late onset(>40 years), thymoma pathology, old age and male gender appear to decrease the complete remission rate after transsternal thymectomy, although it was not statistically significant. There was no difference of complete'remission rate between normal and hyperplasia of thymus. Transsternal thymectomy was found to be beneficial in most patients with myasthenia gravis, but the majority of patients with ocular disease did not b nefit from the operation.

• Journal of Gastric Cancer
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• v.10 no.1
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• pp.26-33
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• 2010

Purpose: We wanted to evaluate the technical feasibility and safety of totally laparoscopic total gastrectomy (TLTG) for treating early gastric cancer. Materials and Methods: The medical records of 11 consecutive patients who underwent TLTG after being diagnosed with early gastric cancer at Incheon St. Mary's Hospital, The Catholic University of Korea from February 2005 to September 2009 were retrospectively reviewed and their clinicopathologic characteristics and the surgical results wereinvestigated. Results: The mean operation time was $385.6{\pm}94.1$ minutes, the mean time for creating an intracorporeal anastomosis was $97.5{\pm}60.0$ minutes and the mean number of the harvested lymph nodes was $46.6{\pm}15.4$ The mean number of days after operation until starting a liquid diet was the $6.1{\pm}7.6^{th}$ postoperative day and the mean hospital stay after surgery was $14.2{\pm}11.9$ days. There was no case of open conversion, but there were 2 cases of intraoperative complication and 3 cases of postoperative complication. There was one case of postoperative mortality. The patient suffered from thrombocytopenia of an unknown cause, which was refractory to platelet transfusion, on $4^{th}$ postoperative day and the patient died of intraabdominal bleeding on the $6^{th}$ postoperative day. Conclusion: TLTG was a technically feasible and relatively safe procedure. However, a long time for creating the intracoproeal anastomosis and a long operation time are still problems to be solved.