• 간호행정학회지
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• 제17권2호
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• pp.189-197
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• 2011

Purpose: This study was an analysis of the relationship between perception for appraisal of staff nurses in operating rooms and performance and organizational commitment. Method: The survey was conducted with 176 staff nurses in operating rooms in 2 hospitals in Seoul. Data were analyzed using frequency, one-way ANOVA, Pearson correlation analysis, and stepwise multiple regression. Result: 1. Perception for appraisal including accuracy and justice was significantly related to organizational commitment (r=.496, P=.000). Perception for appraisal including accuracy and justice was slightly related to performance (r=.220, P=.003). 2. In order to determine the percentage of the variance of performance and organizational commitment that could be predicted by perception for appraisal, perception for appraisal was entered in the regression equation. Accuracy accounted for 25% of the variance in the organizational commitment. To determine the percentage of the variance of performance that could be predicted by perception for appraisal and organizational commitment, the perception for appraisal and organizational commitment were entered in the regression equation. Organizational commitment accounted for 21% of the variance in the performance. Consequently accuracy predicted organizational commitment. Organizational commitment predicted performance. Conclusions: Findings indicate the need to increase accuracy of performance appraisal to promote organizational commitment and performance in perioperative nurses.

• 가정간호학회지
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• 제21권2호
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• pp.120-126
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• 2014

Purpose: This study was carried out to investigate the effect of a decrease in indwelling catheter size and preoperative education on bladder discomfort and nursing needs. The study was conducted on patients in the recovery room after their surgery. Methods: This study is a randomized control trial. Data were collected from September 2011 to February 2012 at a university hospital in Bundang, Korea. The sample consisted of 75 patients, excluding one patient from the experimental group 2. From among the patients that were sent to the ICU, 24 were in experimental group 1, 24 were in experimental group 2, and 27 were in the control group. Data were collected and analyzed using a chi-square test, t-test, and one-way ANOVA. Results: There were significant differences between the bladder discomfort experienced by patients in experimental group 1 and the control group, and experimental group 2 and the control group. Then nursing needs of the control group were higher than those of the experimental groups 1 and 2. Conclusion: The decrease in indwelling catheter size and preoperative nursing education is an effective nursing intervention in perioperative care.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권6호
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• pp.289-291
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• 2013

Moyamoya disease is a rare neurovascular disorder that involves constriction of certain arteries in the brain. In patients with moyamoya disease, it is very important to prevent cerebral ischemic attacks and intracerebral bleeding caused by fluctuating blood pressure and increased respiration. A 40-year-old woman with moyamoya disease was scheduled for extraction of her right upper and lower impacted wisdom teeth. Her lower impacted wisdom tooth was situated close to the inferior alveolar nerve. We decided to continue her oral antiplatelet therapy and planned intravenous sedation with analgesic agents administered approximately five minutes prior to extraction of the root of the mandibular wisdom tooth. Oral analgesic medications were regularly administered postoperatively to alleviate pain and anxiety. During the perioperative period, no cerebrovascular event occurred, and the wisdom teeth were successfully extracted as per the planned procedure. It is thought that the perioperative risks of wisdom tooth extraction in patients with moyamoya disease can be minimized with the use of our protocols.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.516-519
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• 2007

Purpose: Hemophilia is one of the most common bleeding disorder, and circulating levels of factor VIII or IX are closely related to the severity and frequency of the bleeding. The severity of hemophilia is classified to be severe, moderate, and mild when the factor level is less than 1%, between 1% and 5%, and between 5% and 25%, respectively. Hemophilic pseudotumor is a rare complication occurring in 1 - 2% of patients with factor VIII or IX deficiency. If the treatment is delayed, it would cause disabling and life threatening results. Methods: We experienced hemophilic pseudotumor developed at the fracture site of the proximal phalanx of the hand in a hemophilic B patient. Hemophilic pseudotumor was successfully treated with perioperative factor replacement and surgical intervention included excision and autologous bone graft. Results: Hemophilic pseudotumor was healed with complete regression, and no specific complication was developed. Conclusion: When we accounter hematoma like lesion after surgery unpredictably, we must consider hemophilic pseudotumor and make a accurate diagnosis with preoperative hematologic screening and various imaging study. Subsequently, adequate perioperative supplement of concentrate and surgical intervention brings to the satisfactory result without recurrence.

• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.374-380
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• 2021

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.

• Journal of Gastric Cancer
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• 제19권2호
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• pp.148-156
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• 2019

Esophagogastric junction (EGJ) cancer is a solid tumor entity with rapidly increasing incidence in the Western countries. Given the high proportion of advanced cancers in the West, treatment strategies routinely employed include surgery and chemotherapy perioperatively, and chemoradiation in neoadjuvant settings. Neoadjuvant chemoradiation and perioperative chemotherapy are mostly performed in esophageal cancer that extends to the EGJ and gastric as well as EGJ cancers, respectively. Recent trials have tried to combine both strategies in a perioperative context, which might have beneficial outcomes, especially in patients with EGJ cancer. However, it is difficult to recruit patients for trials, exclusively for EGJ cancers; therefore, the results have to be carefully reviewed before establishing a standard protocol. Trastuzumab was the first drug for targeted therapy that was positively evaluated for this tumor entity, and there are several ongoing trials investigating more targeted drugs in order to customize effective therapies based on tissue characteristics. The current study reviews the multimodal treatment concept for EGJ cancers in the West and summarizes the latest reports.

• Journal of Chest Surgery
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• 제54권6호
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• pp.494-499
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• 2021

Background: A recent increase in the incidental detection of ground glass nodules (GGNs) has created a need for improved diagnostic accuracy in screening for malignancies. However, surgical diagnosis remains challenging, especially via video-assisted thoracoscopic surgery (VATS). Herein, we present the efficacy of a novel electrical navigation system for perioperative percutaneous transthoracic nodule localization. Methods: Eighteen patients with GGNs who underwent electromagnetic navigated percutaneous transthoracic needle localization (ETTNL), followed by 1-stage diagnostic wedge resections via VATS between January and December 2020, were included in the analysis. Data on patient characteristics, nodules, procedures, and pathological diagnoses were collected and retrospectively reviewed. Results: Of the 18 nodules, 17 were successfully localized. Nine nodules were pure GGNs, and the remaining 9 were part-solid GGNs. The median nodule size was 9.0 mm (range, 4.0-20.0 mm); and the median depth from the visceral pleura was 5.2 mm (range, 0.0-14.4 mm). The median procedure time was 10 minutes (range, 7-20 minutes). The final pathologic results showed benign lesions in 3 cases and malignant lesions in 15 cases. Conclusion: Perioperative ETTNL appears to be an effective method for the localization of GGNs, providing guidance for a 1-stage VATS procedure.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.440-443
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• 2022

Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.255-260
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• 2022

Purpose: To determine the incidence and risk factors of postoperative infection after cranioplasty in patients with traumatic brain injury (TBI). Methods: Data of 289 adult patients who underwent cranioplasty after TBI at a single regional trauma center between year 2018 and 2021 were reviewed retrospectively. Patient characteristics and various procedural variables, such as interval between craniectomy and cranioplasty, estimated blood loss, laterality and materials of the bone flap, and duration and classification of perioperative antibiotics usage were analyzed. Results: Postoperative infection occurred in 17 patients (5.9%). Onset time of infectious symptom ranged from 9 days to 174 days (median, 24 days) after cranioplasty. The most common cultured organism was Staphylococcus aureus (47.1%), followed by Klebsiella pneumoniae (17.6%) and Enterococcus faecalis (17.6%). Patients with postoperative infection were more likely to have diabetes (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.92-25.21; P=0.003), lower body mass index (OR, 0.81; 95% CI, 0.66-0.98; P=0.029), and shorter duration of perioperative antibiotics (OR, 0.83; 95% CI, 0.71-0.98; P=0.026). Conclusions: For TBI patients with diabetes, poor nutritional status should be managed cautiously for increased risk of infection after cranioplasty. Further studies and discussions are needed to determine an appropriate antibiotics protocol in cranioplasty.

• Journal of Chest Surgery
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• 제56권2호
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• pp.67-74
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• 2023

Perioperative treatment with conventional cytotoxic chemotherapy for resectable non-small cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune checkpoint blockade (ICB) has now become an essential component of treatment, even as neoadjuvant or adjuvant therapy in patients with operable NSCLC. Both pre- and post-surgery ICB applications have proven clinical efficacy in preventing disease recurrence. In addition, neoadjuvant ICB combined with cytotoxic chemotherapy has shown a significantly higher rate of pathologic regression of viable tumors compared with cytotoxic chemotherapy alone. To confirm this, an early signal of OS benefit has been shown in a selected population, with programmed death ligand 1 expression ≥50%. Furthermore, applying ICB both pre- and post-surgery enhances its clinical benefits, as is currently under evaluation in ongoing phase III trials. Simultaneously, as the number of available perioperative treatment options increases, the variables to be considered for making treatment decisions become more complex. Thus, the role of a multidisciplinary team-based treatment approach has not been fully emphasized. This review presents up-to-date pivotal data that lead to practical changes in managing resectable NSCLC. From the medical oncologist's perspective, it is time to dance with surgeons to decide on the sequence of systemic treatment, particularly the ICB-based approach, accompanying surgery for operable NSCLC.