• Journal of Gastric Cancer
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• v.9 no.1
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• pp.18-25
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• 2009

Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.222-228
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• 2020

As the elderly population increases, the incidence of lumbar fusion is increasing, and there has been increasing interest in rapid rehabilitation and functional recovery after surgery. Enhanced recovery after surgery program and multimodal pain control methods can reduce the complications and allow rapid recovery. Various methods have been used to increase the fusion.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.103-116
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• 2020

The incidence of rotator cuff tear is increasing rapidly due to the aging of the population and the advancement of radiological diagnosis, and so on. Recently, arthroscopic rotator cuff repair is common way of surgery, and the surgical outcome is comparable to open rotator cuff repair. Arthroscopic repair is one of the minimally invasive procedures itself and may have additional benefits of postoperative pain reduction and early functional recovery. Recently, there has been increasing interest in various methods for improving the functional recovery of patients after arthroscopic shoulder surgery. Various protocols of functional recovery after arthroscopic shoulder surgery are classified by the postoperative period, and they are being studied actively and improved at each stage. On the other hand, there are a range of methods according to the postoperative period, rehabilitation stage, characteristics of individual patients, degree of rotator cuff tear, and underlying disease. Therefore, for functional recovery after arthroscopic rotator cuff repair, it is essential to establish proper regimens for functional recovery.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2003.11a
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• pp.84-90
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• 2003

최근 견관절 질환 치료의 발전에 힘입어 술 후의 유병율을 줄이고, 보다 견고한 조직 복원이 가능해 짐으로써 운동사슬(kinetic chain)의 생리적이고 생 역학적인 복원을 위한 재활치료를 조기에 시행할 수 있게 되었다. 이러한 조기재활 치료는 술 전 적절한 준비, 해부학적인 수술적 치료, 술 중 적절한 운동범위의 회복, 술 후 조기 보조 및 능동 보조운동, closed chain-axial loading rehabilitation protocol, 재활치료 중 기능적 관절위치 유지 및 기능회복에 따른 생리적 호전 등의 원칙을 통해 견관절의 여러 질환의 재활치료에 적용할 수 있다. 견관절의 조기 재활치료 시 통증은 근육의 조화운동을 저해하게 되며 관절의 안정적인 운동과 기능을 방해하게 된다. 따라서 시각 측정표를 이용한 4이하의 통증범위에서, 관절의 위치와 팔 및 몸의 운동 그리고 근육의 작용을 잘 관찰하는 가운데 운동을 함으로써 통증으로 인한 근억제 효과를 줄이며, 보다 조기에 안전하게 일상생활 및 운동복귀를 할 수 있다.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.57-64
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• 2016

Clinical therapy that combines full-mouth rehabilitation with immediate implantation and orthognathic surgery poses a challenge to prosthodontists. This clinical report describes a multidisciplinary approach to the diagnosis and treatment of a patient presenting with skeletal discrepancy and rampant caries. The results thus achieved indicate that full-mouth rehabilitation by fixed immediate and early loading implantation accompanied by orthognathic surgery can be a predictable and effective treatment procedure.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.223-231
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• 2002

Purpose : We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction. Methods : We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl-triglycerine scan and the degree of hydronephrosis by renal ultrasonography. Results : In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement. Conclusion : We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.

• Journal of Korean Academy of Nursing
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• v.51 no.6
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• pp.732-745
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• 2021

Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

• Journal of Oral Medicine and Pain
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• v.32 no.3
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• pp.263-272
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• 2007

The purpose of this study was to analyze the nerve damage after tooth extraction and implant surgery, and to establish a predictive model for assessment and management of dysesthesia. In this questionnaire study, the subjects chosen for this study were 276 dentists who answered the questionnaire about dysesthesia after tooth extraction and implant surgery. The analysis of the results consist of the sex and age distribution, affected site, associated symptoms, rate and duration of the recovery. The results are summarized as follows. : 1. There were no significant difference between the sex and the dysesthesia. 2. The most common affected site was the mandibular region. In the group of the implant surgery, 100% affected the mandibular site. The tooth extraction group was 93.2% affected. 3. Pain was one of the most associated symptom with dysesthesia-46.5% of the tooth extraction and 44.8% of the implant surgery. 4. The recovery ratio was 72.3% in the tooth extraction, 71.8% in the implant surgery. Most of them, they recovered in $1{\sim}6$ months. In conclusion, most of dysesthesia may be recovered within 1 year. However, the possibility of persistent dysesthesia should not be neglected. Therefore, practitioners must discuss the possibility of nerve injury with their patients, and include this possibility in the consent forms. Various methods of monitoring recovery of sensation should be considered for objective assessment of prognosis. In addition, immediate referral to orofacial pain specialists can offer the patients an opportunity for more effective and noninvasive treatments.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.170-175
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• 2014

The growth disorder influences craniofacial development and early loss of permanent teeth. This case reports the importance of computerized tomography (CT) and surgical guide to identify horizontal bone loss, adjacent teeth and to guide drills when placing implants in a short stature patient. The patient has idiopathic short stature and the 3rd grade of intellectual disability. To recover posterior mandibular teeth, implant treatment was planned. CT images showed that the adjacent teeth were located markedly to the buccal side. A CT-based surgical guide was fabricated and implants was placed using flapless surgery. Bone dehiscence and fenestration may happen when the surgical guide was fabricated just based on adjacent clinical crowns. Thus, it is essential to analysis bone and teeth and to make surgical guide through CT, especially in atrophied bone on grow disorder patients. Furthermore, systematic researches are recommended to elucidate the relationship between growth disorder and tooth malposition.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.329-334
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• 2003

Backgound: Cryoablation and radiofrequency ablation have been used to treat the atrial fibrillation. Some reports insisted that the microwave ablation Is a better method for a deep and extensive lesion. Material and Method: From December 2001 to July 2002, we peformed 8 microwave ablations in patients who needed mitral valve surgery (7 MVR, 1 MVR+AVR). There were 3 men and 5 women, and their mean age was 43.4$\pm$8.3 years and mean follow up period was 5.6$\pm$2.4 months respectively. The microwave was applied on endocardium or epicardium by Lynx (Afx, inc.) using a power of 45 watts for 25 seconds. We studied the left atrial dimension, the left atrial function and the sinus conversion with echocardiography and electro-cardiography at three times; 1) before the operation, 2) immediately after the operation, and 3) 6 months after the operation. Result: There was no complication and no mortality. The mean aortic clamping time was 104.6$\pm$25.0 minutes, and the mean total bypass time was 130.5$\pm$28.7 minutes. The rate of sinus conversion was 75%, A wave across the mitral valve was a mean of 77.0$\pm$24.8 cm/sec, and the AVE was a mean of 0.46$\pm$0.17 at 5.6 months postoperatively Conclusion: There was no difference in the early result of microwave ablation compared to other methods. The microwave ablation was an acceptable method due to its convenient application especially in beating heart.