• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.2
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• pp.125-130
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• 2009

For many years, intermaxillary fixation using arch bar has been operated in treatment of mandibular fracture patients. But it has many complications including injury of operators and assistants cause by wire, inflammation of periodontium. For that reasons alternatives are required; osteosynthesis technique using mini plate, intermaxillary fixation using IMF screws have been available. Treatment by arch bar fixation, however, is still valuable to treat craniomaxillary fracture patients. The purpose of this study is to know effect arch bar on periodontium and influence gingival gel on periodontium applied by arch bar. 40 mandibular fracture patients are monitored. 30 patients were applied by arch bar, 10 patients were not. And the former were classified by 3 categories; Nano vitamin and Mastic gel were applied to 10 patients respectively and any gingival gel was not used to 10 patients. Clinical attachment level, bleeding on probing and periodontal depth of each group were measured and compared before operation and on 2 weeks and 6 weeks after operation. Mann-Whitney U test was used to analyze result which leads to this conclusion. 1. Whether arch bar is applied or not, treatment of mandlbular fracture gave rise to gingivitis, but 6 weeks after operation, gingivitis is restored to the same level as the state before operation. 2. More severe gingivitis appeared when arch bar is applied to mandibular fracture than when it is not. 3. Both gingival gel used in this study can reduce gingivitis which can be caused by arch bar. 4. In this study, Mastic gel is more effective for prevent gingival inflammation cause by arch bar than nano vitamin. In regard to this result, gingivitis is considered to be available because it is reversible and does not induce periodontal disease. Gingival gel is regarded to be helpful for patients applied by arch bar to feel less discomfort.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.263-269
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• 1997

From April 1987 to May 1996, 13 infants underwent a Norwood operation for complex congenital heart diseases including hypoplastic left heart syndrome (n : 7), mitral stenosis with small VSD and subaortic stenosis (n : 1), mitral atresia with ventricular septal defect, coarctation of aorta, and subaortic stenosis (n = 1), interrupted aortic arch with ventricular septal defect and subaortic stenosis (n : 1), tricuspid atresia with transposition of the great arteries (n = 1), and complex double-inlet left ventricle (n : 2). All patients without hypoplastic left heart syndrome were associated wit hypoplasia of ascending aorta and arch. Age at operation ranged from 3 days to 8.7 months (mean 60.6 $\pm$ 71.6 days, median 39 days). The operative mortality( < 30 days) was 46% (6 patients). Late mortality was 15% (2 patients). All operative deaths occured during the Erst 24 hours after the operation as a result of cardiopulmonary bypass weaning failure (5 patients) and sudden hemodynamic instability postoperatively (1 patient). Late death was due to aspiration pneumonia in two cases. There are 5 long-term survivals (39%). Three of them have undergone a two-stage repair with a modified Fontan operation in two and total cavopulmonary shunt in one at 12, 17, 4.5 months after Norwood procedure with no mortality. Two patients have entered a three-stage repair strategy by undergoing a bidirectional cavopulmonary shunt at 3 and 5.5 months after initial operation with 1 operative death. The actuarial survival rate for all patients at the first-stage operation, including hospital deaths and ate death was 30.8% at 1 year. In conclusion, the operative mortality of Norwood operation was relatively high compared to other operation for major cardiac anomalies, continuing experience will lead to an improvement in result.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.340-344
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• 2018

Background In performing extended latissimus dorsi (ELD) flap procedures, a skin paddle design on the bra line helps reduce visible scarring. This improves the patient's satisfaction with the outcome. However, such a design leads to a longer operation time and increased fatigue of the surgeon due to the narrow operative field. In this study, the authors propose a method that elongates the axillary incision line posteriorly by 1.5 cm from the lateral border of the latissimus dorsi muscle. We examined whether this method could shorten the operation time and compared the incidence of complications between patients who underwent this novel procedure and patients who underwent the traditional procedure. Methods In this study of patients who underwent ELD flap procedures for immediate breast reconstruction, 89 underwent surgery with the elongated axillary incision and 45 underwent surgery without the elongated incision. The total operation time and complications were retrospectively examined based on the patients' medical records, and we examined whether there was any statistically significant difference in the total operation time. Results In the experimental group with the elongated axillary incision, the operation time ranged from 125 to 255 minutes (median, 175 minutes). In contrast, in the control group without the elongated axillary incision, the operation time ranged from 142 and 340 minutes (median, 205 minutes). The operation time was statistically significantly different between the two groups, and no significant complications were observed in the experimental group. Conclusions Elongation of the axillary incision alone may shorten the operation time of the ELD flap procedure without causing additional complications.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.843-850
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• 2007

Background: The Ivor-Lewis operation has been widely applied for treating thoracic esophageal cancer, but more acceptable results from three-field lymph node dissection have recently been reported. In this study the efficacy of the Ivor-Lewis operation was evaluated. Material and Method: Among the 273 patients, who underwent operation for esophageal cancer between September 1994 and August 2004, we retrospectively studied 172 patients with esophageal squamous cell carcinoma and who had no other primary cancer and who underwent complete resection with an Ivor-Lewis operation. The postoperative complications, the short and long-term survival and the recurrence patterns were analyzed. Result: The postoperative staging was as follows: stage I in 40 cases, IIA in 48 cases, IIB in 18 cases, III in 55 cases, IVA in 5 cases and IVB in 6 cases. The operative mortality rate was 4% (7 of 172 pts). Postoperative complication occurred in 32 patients (18%) and tumor recurred in 55 patients (32%). The overall 5-year survival rate was 48%; it was 85.6% in stage I patients, 47.6% in IIA patients, 65% in IIB patients, 22.8% in III patients and 0% for those in IV (p<0.05). The 5-year survival rate according to the location of esophageal cancer was 26.5% for patients with tumor in the upper 1/3 of the esophagus and 52.4% for patients with tumor in the mid and lower 1/3 (p>0.05). Conclusion: The Ivor-Lewis operation is an acceptable surgical procedure for thoracic esophageal squamous cell carcinoma. Yet it is necessary to consider other surgical procedures, and especially three-field lymph node dissection for treating upper 1/3 esophageal cancer.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.398-405
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• 1992

Twenty nine adult patients underwent surgical esohpagectomy and one, bypass procedure for documented carcinoma of esophagus and cadiac portion of stomach at Chonnam National University Hospital from Jan 1986 to April 1991. There were several kinds of esophagectomies including through transhiatal, left thoracotomy only, laparotomy and thoracotomy, and laparotomy and right thoracotomy and cervical incision. Twenty five and squamous cell carcinoma and 5, adenocarcinoma. The tumor locations were the upper third in 3, middle third in 12, lower third in 10 and cardiac portion of stomach in 5. After operation, 8[27%] patients were classified in Stage IIa, 6[20%] patients in Stage IIb, 15 patients[50%] in Stage III and one patient in Stage IV. Major postoperative complications included anastomotic narrowing in 3, limited suture line leak in 2, wound infection in 2, hoarseness in 2, pseudomembraneous enterocolitis in 1 and herpes zoster in 1. There was no death within 30 days of operation. Ten months survival was 100% for patients with Stage lIa, 67% for patients with Stage IIb, 50% for patients with Stage III. Furthermore, 20 months survival was 75% in IIIa, 33% in IIb, and 40% in III. But there were no significant differences in survivals among the stage. The actuarial survival is 58% at one year and 41% at two years, The periods of average survival is 589 days after operation.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.856-862
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• 1988

The survival rate after resectional operation for carcinoma of the esophagus is still very low and many factors contribute to these poor results. We analyze the clinical results of 56 operated patients among 62 esophageal cancer patients between March, 1974 and July, 1988. Among the 62 patients, 52 patients were squamous cell carcinoma and 8 were adenocarcinoma, one was leiomyosarcoma and one was adenosquamous cell carcinoma. The classification of esophageal cancer was based on TNM classification of American Joint Committee on cancer". Among the operated patients, stage I was 5[9.6%], stage II was 13[25%], stage III was 26[50%], stage IV was 8[15.4%]. And its one year survival rate was 80%, 69%, 11.5%, 0% for each stages. The rate of resectability was 30.3% and resection of esophagus with esophagogastrostomy and extended lymph node dissection was performed on 17 patients without distant metastasis or adjacent organ invasion. Substernal esophago-colono-gastrostomy, Celestine tube insertion and feeding gastrostomy was performed on remained 39 patients. The analysis of postoperative survival duration revealed the superiority of esophagectomy with extended lymph node dissection over other palliative operation. [1 year survival rate: 79% versus 21%] We concluded that the survival rate of esophageal resection with lymph node dissection group was superior to nonresective palliative operation group. And transthoracic approach was superior to extrathoracic approach in involved lymph node dissection and esophageal resection in locally invaded cases.ases.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.116-120
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• 2005

Objective : The aim of this study is to analyze the clinical symptoms, radiological changes, interval from first operation to symptom recurrence and to propose the proper treatment method for re-operated patients following chronic subdural hematoma surgery. Methods : Between January 1992 and April 2003, 18 of 138patients of chronic subdural hematoma repeatedly underwent surgical treatment. The symptoms, mental status by Bender grade, radiological hematoma size and midline shifting, interval from symptom onset to diagnosis, surgical method and prognosis by Glasgow outcome scale[GOS] between the first attack and the recurrence were compared. Results : The symptoms at the time of recurrence were nearly the same as with the first attack, but two patients[2/18, 11.1%] showed a more declined mentality. In addition, the recurred hematoma sizes were the same or large than those previously found. Many patients were recurred within two weeks[13/18, 72.2%]. Most patients were operated on using the previous burr hole, with the exception of one patient who recurred at a different site. All patients had a good prognosis more than GOS 4 [GOS 4:4, GOS 5:12], but two died due to extracranial complication and infection. Conclusion : These results suggest that the early diagnosis and treatment are important, mostly recurred same symptoms within two weeks. Re-operation using the previous burr hole site is a good method.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.1
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• pp.113-120
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• 2005

Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.25-31
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• 1989

Forty-five patients, aged 16 months to 15.5 years mean 69 months, with a wide variety of cardiac malformations underwent the modified Fontan operation between Sep. 1986 to Aug. 1988. Nineteen patients had previously undergone palliative operations mainly modified B-T shunt. Twenty patients had a mean pulmonary artery pressure greater than 15 mmHg, with nine operative deaths. Thirteen patients had anomalies of systemic venous connection and seven patients had anomalies of pulmonary venous connection. There were eighteen patients under the age 4 years and fifteen of them survived [83.3%]. Eighteen patients had a pulmonary vascular resistance [PVR] more than 2.5U/m, and nine died [50%] whereas two of twenty-three with a PVR less than 2.5U/m died[8.6%]. PVR and anomalies of pulmonary venous connection had a significant influence on survival, but age and anomalies of systemic venous connection did not. Amount of pleural effusion drained postoperatively and PVR had positive linear correlation. Pulmonary artery pressure was not an independent predictor of outcome and pulmonary artery pressure alone should not contraindicate a Fontan procedure if PVR is low. In general, the Fontan operation should be done at a younger age less than 4 year to avoid ventricular dysfunction due to long-standing exposure to hypoxia.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.2
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• pp.173-180
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• 2007

Purpose: The present study was done to examine the effect of music therapy on anxiety and pain in patients for whom a ureteral stent was inserted under local anesthesia. Method: The participants in this study were 22 patients who received a ureteral stent at the Day Surgery Center of C University Hospital during the period from May to October in 2006. The patients were divided into a control group (n=11) and an experimental group (n=11). For the experimental group, music was played according to their musical preference using headphones. The music was provided from the point when the patient took the posture for the operation and was covered with a sterilized drape to the point when the cystoscope was removed after finishing the operation. The control group was only provided with ordinary nursing services. Results: The results show that the provision of music therapy to these patients is effective in reducing the patients' salivary cortisol and Vas-anxiety score and stabilizing their systolic blood pressure. Conclusion: We conclude that music therapy can be actively used as a nursing intervention for reducing anxiety in patients who receive operations under local anesthesia.