• 성인간호학회지
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• 제16권3호
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• pp.388-397
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• 2004

Purpose: The purpose of this study was to explore the effectiveness of informational intervention delivered by electronic patient information board in the OR waiting room for reduction of anxiety of mothers with child having operation. Method: Nonequivalent control group non-synchronized design was used in this study. The subjects was 52 mothers whose children underwent elective surgery in one Pediatric Hospital. Informational intervention in this study consisted of four critical stages. State anxiety by Spielberger, mean arterial pressure, and heart rates at preoperative and postoperative period were measured. The data were analyzed by using Chi-Square test and t-test with SPSS/PC 10.0 program. Results: 1) There was a significant difference in the state anxiety between the control and the experimental groups. 2) There was no significant difference in the mean arterial pressure between the two groups. 3) There was no significant difference in the heart rate between the two groups. Conclusion: The results of this study indicate that informational intervention delivered by electronic patient information board would be an effective intervention during the operation in reducing anxiety of mothers with child having operation.

• Journal of Chest Surgery
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• 제26권10호
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• pp.781-786
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• 1993

Effrctive analgesia after elective thoracotomy can be provided by continuous extrapleural intercostal nerve block.This study was designed to prove the effectiveness of continuous extrapleural intercostal nerve block. Twenty patients undergoing elective thoracotomy were randomized into two groups. Group I received lumbar epidural block[N=10] and group II received continuous extrapleural intercostal nerve block[N=10]. Postoperative pain relief was assessed on Numeric Rating Scale[NRS] and recovery of pulmonary function was assessed by coparison of preoperatrive and postoperative FVC[Forced Vital Capacity], FEV1[Forced expiratory Volume in 1 second], VC[Vital Capacity]. Arterial blood gas analysis[ABGA], vital signs and amount of additive analgesics were compared also. No significant difference was observed between the groups concerning these parameters mentioned above. Systemic complications, such as urinary retention[2/10] and weakness of lower extremity[2/10], occurred in group I but no complication occurred in group II. We conclude that continuous extrapleural intercostal nerve block is as effective as epidural block in pain relief and restoration of pulmonary mechanics with fewer comlications. Also because of it`s ease and safetiness, this must be considered as a substitute of epidural block in routine use for thoracotomy pain relief.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.245-252
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• 2016

Regional anesthesia in the maxillofacial region is safer and more efficient than general anesthesia when its indications are carefully considered. In addition, the majority of medical institutions in developing countries are not well equipped for proper anesthesia and elective surgery. In this review, we describe regional anesthesia and cutaneous nerve divisions in the maxillofacial region. In addition, we summarize detailed regional anesthetic techniques adapted for representative cleft lip cases in developing countries.

• 수면정신생리
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• 제4권2호
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• pp.172-180
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• 1997

본 연구는 수술전일 수면제 필요군의 특성을 파악하고 수면제의 필요성에 기여하는 변인들의 상대적인 중요성을 알아보고자 하였다. 연구자는 수술이 예정된 환자들의 병록지를 검토한 후 반구조적 면담을 시행하였다. 또한 환자에게는 불안, 우울, 통증의 정도를 측정하는 자가평가 질문지와 수면 전 후 설문지를 작성토록 하였다. 설문지에 성실히 응답한 167 명의 환자를 수술당일 기상 후 지난 밤 수면제의 복용이 필요했다고 판단하는 환자군(수면제 필요군)과 필요하지 않았다고 판단한 군(수면제 불필요군)으로 분류한 다음, 양군간에 인구통계학적 특성, 임상적 특성, 수면에 영향을 줄 수 있는 가능한 인자, 심리적 특성, 수술전 주간 상태와 야간 수면 등을 비교하였다. 양군간에 유의한 차이를 보인 변인들에 대해서는 수면제 필요군을 특징짓는 변인들의 예측기여도를 측정하기 위해 판별분석을 하였다. 연구결과는 수면제 필요군과 불필요군 간에 인구통계학적 특성 및 임상적 특성은 차이가 없었다. 그러나 병실환경에 대한 만족도는 수면제 필요군에서 불필요군에 비해 낮았다. 심리적 특성에서 불안의 정도는 양군간에 차이가 없는 반면에, 우울과 통증의 정도는 수면제 필요군이 불필요군에 비해 더 심하였다. 수술전일의 야간 수면에서도 수면제 필요군이 취침 전 수면에 대한 기대가 더 부정적이었고, 실제로 다음날 아침 전일의 수면을 더 불량하게 평가하였다. 판별분석의 결과, '수면에 대한 기대도'와 '통증'이 수면제 필요성을 판별하는 중요한변인이었다. 이상의 결과로 수술전일의 불면을 개선하기 위한 수면제나 진통제의 투여는 치료자의 판단이나 다른 객관적인 지표보다는 수면제의 필요성에 대한 환자 자신의 주관적인 의견이 더 중시되어야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.43-48
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• 2011

Objective: Classical markers of infection cannot differentiate reliably between inflammation and infection after neurosurgery. This study investigated the dynamics of serum procalcitonin (PCT) in patients who had elective spine surgeries without complications. Methods: Participants were 103 patients (47 women, 56 men) who underwent elective spinal surgery. Clinical variables relevant to the study included age, sex, medical history, body mass index (BMI), site and type of surgery, and surgery duration. Clinical and laboratory data were body temperature, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and PCT, all measured preoperatively and postoperatively on days 1, 3, and 5. Results: PCT concentrations remained at <0.25 ng/mL during the postoperative course except in 2 patients. PCT concentrations did not correlate with age, sex, DM, hypertension, BMI, operation time, operation site, or use of instrumentation. In contrast, CRP concentrations were significantly higher with older age, male, DM, hypertension, longer operation time, cervical operation, and use of instrumentation. Conclusion: PCT may be useful in the diagnosing neurosurgical patients with postoperative fever of unknown origin.

• The Korean Journal of Pain
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• 제28권4호
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• pp.244-253
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• 2015

Background: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results: A total of 301 children with a mean age of $7.56{\pm}2.61$ years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.99-107
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• 2020

Objectives: We accessed the various clinico-histopathological factors, and their association with occult metastasis (OM) in oral tongue squamous cell carcinoma (OTSCC). Materials and Methods: One hundred-nine patients with OTSCC were divided into the elective neck dissection (END) group and the watchful waiting (WW) group. Age, sex, T-stage, depth of invasion and differentiation were evaluated to determine the correlation between clinico-histopathological factors and OM. For immunohistochemical analysis, paraffin-embedded blocks of 41 OTSCC specimens were examined with antibodies (VEGF-c, c-Met, and ROR1). Results: The group with tumor thickness of oral tongue cancer ≥3 mm had higher incidence of OM than those with a thickness of <3 mm. The depth of invasion was statistically correlated with OM (P=0.022). Immunohistochemical analysis showed that high expression of VEGF-c (P=0.043), c-Met (P=0.009), and ROR-1 (P=0.003) were statistically correlated with OM. Conclusion: The analysis of these clinico-histopathological and immunohistochemical factors can help to determine neck dissection in clinically negative (cN0) patients.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.176-180
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• 2019

The growing use of laparoscopy in elective surgery has led to its increase utilization in emergency surgery. However, the employment of laparoscopy in abdominal trauma is still unusual. Here in we report a case of a patient with blunt abdominal trauma that resulted in a combination of exceptional traumatic lesions, diaphragmatic and bladder lacerations. Both injuries were diagnosed and successfully resolved by laparoscopy. The report of this type of lesions and resolution is extremely rare, being this the second case described in the international literature. This article intends to show that laparoscopy may not only be used as a diagnostic tool, but also as a therapeutic instrument in selected cases of blunt abdominal trauma.

• Journal of Chest Surgery
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• 제56권2호
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• pp.140-142
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• 2023

The azygos vein sometimes merges abnormally across the right upper lobe of the lung and it hangs at the lower edge of a membranous septum, called the meso-azygos. The septum invaginates the lobe and makes a fissure. The smaller medial part of the right upper lobe is called an azygos lobe. A 16-year-old male patient was diagnosed with right-sided pneumothorax, and a closed thoracostomy was done in the emergency room. During elective wedge resection including the bulla, the meso-azygos, abnormal azygos vein, and azygos lobe were detected. We reviewed the computed tomography images and found that the azygos lobe had re-expanded laterally, not medially, to the meso-azygos after the closed thoracostomy in the emergency room. The patient had been diagnosed with left-sided pneumothorax a year ago, and no one noticed the azygos lobe at that time. We report the intraoperative findings and comparative images of a migratory azygos lobe.

• Journal of Gastric Cancer
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• 제8권3호
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• pp.154-159
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• 2008

목적: 위암 수술을 시행하는 임상의들은 광범위한 림프절 절제로 인한 수술 후 감염 가능성으로 인하여 대개 수술 후 3일 이상 예방적 항생제를 투여하고 있으나 투여기간의 결정은 임상의 개개인이나 기관에 따라 결정되고 있다. 본 연구는 위암 수술 후의 예방적 항생제의 투여 기간이 환자의 회복에 어떤 영향을 미치는지 알아보고자 시행하였다. 대상 및 방법: 2007년 1월 1일부터 2007년 12월 30일까지 가톨릭대학교 의과대학 성모병원 외과에서 위 선암으로 수술을 받은 환자 중 수술 전 감염이 없어 항생제의 선행투여가 없는 93명의 환자들을 대상으로 하였다. 수술 시기에 따라 31명의 환자들은 수술 후 24시간까지만 투여가 계획되었고(A군), 31명의 환자들은 3일간 투여가 계획되었으며(B군), 31명의 환자에겐 대조군으로 5일 이상 항생제 투여가 계획되었다(C군). 세 군 간 수술 후 7일 이내의 감염을 포함한 합병증과 체온, 중성구 개수 변화들을 비교하였다. 결과: 수술 후 감염률은 A군에서는 31명 중 4명(12.9%), B군은 31명 중 5명(16.1%), C군에서는 31명 중 6명(19.4%)로 세 군 간의 유의한 차이는 없었다(P=0.788). 수술 후 매일 가장 높이 조사된 체온들의 변화와 중성구 개수변화도 차이가 없었다(P=0.119, P=0.855). 결론: 위암 수술을 위한 위 절제 및 재건시의 예방적 항생제 투여는 수술 24시간 이내에만 시행하여도 환자 회복엔 영향이 없을 것으로 보인다.