• Journal of Chest Surgery
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• v.17 no.1
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• pp.144-149
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• 1984

Diaphragmatic eventration is a rare condition in primary diaphragmatic diseases and is found rarely in clinical experience. Diaphragmatic eventration means abnormally high position of diaphragm, which is caused acquired, paralytic or congenital, nonparalytic etiologic origins. This report is presented a symptomatic diaphragmatic eventration of 50 years old woman, who had complained coughing and left chest pain since I year ago prior to admission in Kosin Medical College, Gospel Hospital. A patient who had established accurate diagnosis at pre-operative period. There had been post-operative course uneventfully.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.47-53
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• 2017

Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.154-158
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• 2011

Background: Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis. Materials and Methods: From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence. Results: There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002). Conclusion: R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.32-36
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• 2007

Background and Objective：A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods：From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$；OPMI $pico^{(R)}$；Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results：There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion：Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.3
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• pp.157-162
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• 2003

Background : The surgical removal of impacted mandibular third molar can result in considerable pain, swelling, and dysfunction that patient are incapable of work for several days. Factors contributing to post operative swelling, trismus and pain are complex. There is no question but that the procedure of surgically removing an impacted mandibular third molar is inherently a traumatic one and that some sequelae related to the inflammation response are expected. Meticulous surgical technique will minimize the sequelae of inflammation but will not prevent them. In an effort to minimize these sequelae the use of steroid was instituted. Patients and Methods : Present study was to investigate the effect of one preoperative steroid injection in the masseter muscle to the patients(male 9, female 11) who needed prophylactic removal of bilateral, symmetrical, impacted wisdom teeth in the mandible on the complaint like swelling, trismus and pain. through Double-Blind test. Results : 1. After 24 hours investigation, preoperative steroid injection had significantly reduced swelling with 39% and trismus with 57.5%. 2. $7^{th}$ post operative day investigation, reduced swelling and trismus had shown, however, not significant. 3. There wasn't major difference from the group who took preve-ntive steroid in the visual analogue scale, the first analgesic intake time and the pain period. 4. There wasn't any adverse reaction of steroid for 20 patient From the above result, If the patients are not contraindication to steroid and pronounced post operative reaction can be expected the use of steroid to the surgical removal of impacted mandibular third molar is recommended.

• 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.19 no.1
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• pp.108-115
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• 1986

During 12 years period from 1974 to 1985, 76 valve replacement procedures were performed at Seoul National University Hospital in 67 pediatric patients aging up to 15 years [mean 12.3 years] and it was 7.3% of total valve replacement procedures in same period. Sixty seven patients were composed of 44 males and 23 females. Of the 67 patients, 43 patients had acquired valve lesions and 24 patients congenital valve lesions. Sixty cases received single valve replacement, 7 cases double or triple valve replacement and 9 cases redo-valve replacement. Sixty seven patients received 84 valves [65 bioprosthetic valves and 19 prosthetic valves by] 76 operations, Sixty three of 65 bioprosthetic valves had been replaced before 1983 and 15 of 19 prosthetic valves in recent 2 years. Eleven patients [14.6%] died within one month post-operatively and 8 patients [10.5%] during the follow-up period with the overall mortality rate of 25.1%. There were early post-operative complication of 23 cases [30.3%] and late post-operative complication of 27 cases [35.3%] with the total complication rate of 65.8%. In 58 patients received bioprosthetic valves, there were 14 cases of restenosis of replaced valves. Of the 14 cases of bioprosthetic valve restenosis, 8 cases received redo-valve replacement procedures without mortality in 1 5/12-5 years after initial operation but 4 cases died without reoperation and 2 cases lost during follow-up. The overall mortality and complication rate were still high but they markedly decreased during recent 2 years. So, in spite of its containing many problems, valve replacement in children is becoming safe and useful procedure in whom valve reconstructive procedures are impossible.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.395-402
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• 1993

For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumor, and to provide the guidelines of surgical management of mediastinal tumor,238 patients with mediastinal tumors treated during the period from January 1983 to December 1991 were reviewed at Seoul National University Hospital. There were 106 males & 132 females, and their ages ranged from 3 months to 73 years, with average 33.6 years. The most frequently encountered tumor site was anterosuperior mediastinum followed by posterior, and middle mediastinum. In the pathological viewpoint, thymoma was the most frequent type followed by neurogenic tumor. 81% of the tumor were benign and 19% were malignant. Half of the malignant tumors were neurogenic tumors. Malignancy rate was high in pediatric patients compared to adults as 40% and 19% respectively. 65% of patients were asymptomatic at diagnosis.There was no operative mortality. Post operative complications were occurred in 35 cases. Most frequent complications were adjacent peripheral nerve injuries. But other usual operative complications, such as bleeding, chylothorax, infection, were relatively rare.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.345-352
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• 1994

We have performed left lung transplantation followed by ligation of right pulmonary artery in 14 dogs at the Chest Disease Research Institute, Yonsei University College of Medicine from May 1992 to February 1994. Excised left lung was perfused with 1500cc of 4$^{\circ}$C cold Euro-Collin`s[E-C] solution at a pressure of 30cmH2O through main pulmonary artery and preserved in 4$^{\circ}$C cold E-C solution for one hour. Left lung transplantation were proceeded in order of left atrium, left main bronchus, left pulmonary artery and right pulmonary artery ligation as usual method. The femoral artery and pulmonary artery pressures were monitored for more than 5 hours after the transplantations in 14 dogs. Six recipient dogs had elevated mean pulmonary artery pressure to greater than 30mmHg after the left lung transplantation and ligation of right pulmonary artery. The cause of elevated mean pulmonary artery pressure was due to inadequate preservation resulting in ischemic damage to donor lungs in 3 cases, and inadequate surgical techniques in 3 cases. Two recipient dogs without surgical complications died immediate post-operatively due to hemorrhagic shock. The bleeding focuses were LA anastomotic site in one case and femoral artery puncture site in another case. The remaining 6 recipient dogs showed mean pulmonary arterial pressure less than 30mmHg. However, one dog had spontaneous pneumothorax in post-operative 4 days, and another dog had rejection phenomenon in post-operative 5 days which was confirmed by pathologic findings of extracted transplanted lung. One dog succumbed of severe hemoptysis which was due to lung abscess with pin point stenosis of bronchial anastomosis in post-operative 38 days. In conclusion, elevated mean pulmonary arterial pressure greater than 30mmHg in immediate postoperative period can be due to inadequate preservation of extracted lung or poor surgical techniques. And the two dogs succumbed of hemorrhagic shock even though the mean pulmonary arterial pressure was less than 30mmHg. It is thought that careful preservation of the extracted donor lung in 4oC E-C solution and complete surgical techniques are the most important factors early and late complications.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1237-1247
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• 2019

Post-stroke oculomotor nerve palsy occurs more frequently than previously reported, but only a few studies of traditional Korean medicine treatments have been reported. The symptoms are severe and difficult to treat, and current treatments are high-cost, short-lasting, insufficient for shortening the therapeutic period and promoting better recovery, or involve the risk of post-operative over-correction or under-correction. Traditional Korean medicine treatments may be comparatively effective at lower cost and less harmful. Thus, we report three cases of post-stroke oculomotor nerve palsy treated with traditional Korean medicine.