• 대한의생명과학회지
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• 제7권1호
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• pp.7-15
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• 2001

Although extracorporeal circulation (ECC) has been routinely used for cardiovascular surgery, hyperoxemia during ECC may produce oxygen toxicity and cellular injury. This study was performed to investigate the clinical influences of hyperoxemic ECC during cardiovascular operation. 40 adult patients scheduled for elective cardiovascular surgery were classified into normoxemic (arterial oxygen tension: 115 mmHg, n＝20) and hyperoxemic (arterial oxygen tension: 380 mmHg, n＝20) ECC. At preoperative and postoperative period, total leukocyte and neutrophil counts, platelet counts, iron, glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine in peripheral arterial blood, malondialdehyde (MDA) and troponin-T concentration (TnT) in coronary sinus blood, pulmonary vascular resistance (PVR), and postoperative blood loss volume (BLS) were measured and compared between groups. Hyperoxemic group had postoperatively higher total leukocyte and neutrophil counts, MDA, TnT, PVR total BLS, iron, glucose, AST, ALT, BUN, and creatinine than normoxemic group (p<0.05).0 conclusion, hyperoxemic ECC results in greater inflammatory response and oxidative damaging effects on the heart lung, liver and kidney, probably being adverse to postoperative patient recovery. For reducing these deleterious effects and improving postoperative outcomes, management lowering oxygen tension during ECC is recommended.

• Journal of Veterinary Science
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• 제21권1호
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• pp.8.1-8.11
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• 2020

This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10-70) vs. 19.63 (10-25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.

• Hip & pelvis
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• 제35권1호
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• pp.40-46
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• 2023

Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.

• 대한족부족관절학회지
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• 제3권1호
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• pp.5-11
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• 1999

We present our experience with the use of nerve block anesthesia in 212 of 484(43.8% ) surgical procedures of the foot and ankle between 1995 and 1997. Nerve block anesthesia was used for surgical procedures of the forefoot, midfoot, hindfoot, and ankle in the setting of elective surgery and trauma. From the viewpoint of the surgeon, nerve block anesthesia was completely successful in 99.5% of the procedures performed. We confirmed that 80% of patients were satisfied with the use of nerve block anesthesia for their operative procedure. There were only one(0.5%) miner complication being toxic neuritis of posterior tibial nerve. With increasing experience, the expanded indications and uses of nerve block anesthesia for foot and ankle surgery are proving to be simple, safe, reliable, and well tolerated by the patient.

• 한국임상수의학회지
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• 제41권2호
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• pp.112-116
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• 2024

Uterine rupture is uncommon in small animals and can be caused by trauma, infection, dead fetus, or inappropriate obstetric techniques. A 4-year-old, intact female mixed-breed dog weighing 3 kg presented for elective ovariohysterectomy with a history of a motor vehicle accident two months previously. The patient showed no clinical signs of uterine abnormalities or evidence of pregnancy during physical examination. Clinical examinations, radiography, and ultrasonography revealed no significant findings. During ovariohysterectomy, a completely transected left uterine horn and dome-shaped ends were identified. The uterine layers were everted such that the endometrium could be seen outside the uterine horn. The dog recovered without post-operative complications and was discharged the following day. This report describes a rare case of an asymptomatic uterine rupture caused by trauma in a non-gravid dog.

• Journal of Chest Surgery
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• 제10권2호
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• pp.274-280
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• 1977

As a major cause for postoperative hypoxia, the importance of increased physiological shunting is increasingly emphasized. This study is a review and analysis of postoperative physiological shunting following open heart surgery with the aid of extracorporeal circulation. Sixteen patients were selected from among 21 patients who underwent elective open heart surgery at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University, School of Medicine, from December, 1975 to September, 1977. The results were as follows: 1. The degree of postoperative physiological shunt was progressively increased from 18.8% mean value one hour after surgery to 22.7% mean value, reaching a peak on the second postoperative days. 2. For up to one week, large physiological shunt[15%] was persisted in one patient. 3. Comparing long[more than 90 minutes] with short[less than 90 minutes] perfusion time group using pump oxygenator, it was found that the physiological shunt increased about 3% in the long as compared with the short perfusion time group. 4. The mean blood pressure was 70-80 mmHg without a remarkable causal relationship between physiological shunt and mean blood pressure. 5. On elevated $PaO_2$[>200 torr], the physiological shunt was decreased less than 20% of cardiac output, but on diminished $PaO_2$[102 torr] after two days, it was 22.7% of cardiac output. From above results, a contrary causal relationship between $PaO_2$ and physiological shunt was obtained. Co Reviewing chest X-rays postperfusion, it was demonstrated that no remarkable causal relationship between roentgen-ray evidence and physiological shunt could be obtained.

• Journal of Chest Surgery
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• 제14권3호
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• pp.187-194
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• 1981

Cardiac surgery is generally followed by a period of routine ventilator support. When the patient seems hemodynamically stable and relatively alert following surgery, respiratory adequacy is tested by the weaning trial. In this study, physiological and clinical prediction of postoperative respiratory adequacy, including values of pulmonary function tests, were examined in an attempt to identity those few variables which predicted the outcome of the ventilator weaning trial following surgery. Our series comprised 27 patients who underwent elective open intracardiac operations at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from October 1979 to July, 1980. The pulmonary function tests performed on all patients included the following; forced vital capacity [FVC], forced expiratory volume [FEV1.0], forced expiratory flow [FEF 25--75~], residual volume [RV], and functional residual capacity [FRC], measured with a helium dilution technique. Of our 27 patients, 8 were successfully weaned within 20 hours of operation. All patients with cyanotic heart diseases or acquired heart diseases were unsuccessfully weaned. The bypass time in the successful weaning group was shorter in the mean value [82.8 minutes]than in the unsuccessful weaning group [120.5 minutes]. There was a relatively significant difference in the mean values for the two groups in arterial pressure, bleeding amounts and FiO2 among the postoperative monitoring variables, and in forced vital capacity [FVC]. The postoperative clinical assessments appeared vague but corresponded reasonably well to appraisal of success in weaning, especially in variables of cough and self-respiration efforts.

• Journal of Chest Surgery
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• 제9권1호
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• pp.55-62
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• 1976

This is a report of 8 cases cardiac arrest developed in the operating room at Jeonbug university Hospital from January 1973 to October, 1975. Four patients of cardiac arrest developed during the elective operation, 3 during the emergency operation and the remaining one, bronchoscopy for foreign body removal under the general anesthesia. Immediate closed chest cardiac massage was performed in the 7 patients and the remaining one underwent open chest cardiac massage. Five of 7 patients with the closed chest cardiac massage regained consciousness and restored respiration, but 3 patients of these survived to be discharged. Two patients who underwent pneumonectomy for multiple lung abscess and open drainage for liver abscess, were resuscitated but did survived. The Latter died from bleeding due to rupture of the liver that developed during the closed chest cardiac massage. One patient who had open chest cardiac massage survived to be discharged without any sequele. Unsuccessful resuscitation was observed in two patients, one had a complication of malignant hyperthermia with muscle rigidity during gastrectomy for ulcer perforation and another had not firm support on the back during massage.

• Journal of Chest Surgery
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• 제28권11호
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• pp.977-982
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• 1995

Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1048-1054
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• 1992

With use of a simple, inexpensive and nonpharmacological program for blood conservation, 24 consecutive patients underwent elective or urgent coronary artery bypass grafting without need of homologous red cell transfusions and /or fresh frozen plasma transfusions in 16 patients[66.7%]. Left internal mammary artery graftings were done in 18 patients[75%], with supplemental saphenous vein grafts in all. Intraoperatively, autologous heparinized blood was removed before bypass and retransfused at the conclusion of ext-racorporeal circulation. The volume remaining in the oxygenator and tubing set was returned without cell processing or hemofiltration. Using the hard-shell cardiotomy reservoir from the oxygenator, autotransfusion of the shed mediastinal blood was continued hourly by the next early;norning. The mean postoperative mediastinal blood loss was 364$\pm$234ml, whereas 553$\pm$383ml was autotransfused. 4 patients [16.7%] received homologous blood and an additional 4 patients[16.7%] fresh frozen plasma. Thus, in total, 16 patients[66.7%] were not exposed to any homologous blood products during the hospital stay. At discharge, the mean hemoglobin concentration was 10.3$\pm$1.6g /dl. Postoperative complications were few and there was no hospital death.