• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.2
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• pp.79-85
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• 2005

The symptoms in patello-femoral joint can be occurred from various causes. Most of patients complained chronic discomfort and it is rare to have a characteristic acute pain. Initial management should be started conservatively and if it has no effect to relieve symptoms, surgical treatment would be considered. The selection of operative treatment should be decided in the consideration of patients age, activity and ability of performing rehabilitation. Before surgery, accurate diagnosis is essential and causative factors should be removed or corrected with surgery. Arthroscopic surgery is effective for the most of disease in the patello-femoral joint disorder with low morbidity and early rehabilitation. At arthroscopy, superomedial or superolateral portal can be used for the evaluation and treatment of articular surface in the patella. The structure of normal variants should be saved if it does not have pathological changes for prevention of post operative morbidity. If the arthroscopic surgery has difficulties during the procedure or no effect in removal of lesion, open surgery should be considered.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.128-130
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• 2007

Purpose: Pnumosinus dilatans is a rare disease that one or more of the paranasal sinuses are dilatated without functional alteration. The most frequently involved sites are frontal and sphenoid sinus. Facial asymmetric contour is the most common signs and nasal obstruction and pain may be combined. The purpose of reconstruction of pneumosinus dilatans is two-fold, to re-establish a permanent pressure equilibrium of sinus and to correct the possible facial deformities. Methods: We present a case of a 24-year-old female with a 7-year history of protrusion of right malar region. Plane radiography and computed tomography detailed an abnormal expansion of the right maxillary sinus without thinning of bony wall, leading to diagnosis of maxillary pneumosinus dilatans. Surgical decompression and maxilloplasty were achieved by ostectomy of anterior wall of maxillary sinus and repositioning of removed bony fragment with miniplate. Results: Post operative course was uneventful without complication and malar height became symmetric by physical and radiologic examination. Conclusion: We corrected successfully pneumosinus dilatans of maxillary sinus by surgical decompression and maxilloplasty. For this case, we reviewed literature related to this topic.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.247-253
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• 2001

Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.598-604
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• 2008

Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.2
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• pp.212-222
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• 2014

Purpose: The purpose of this study was to evaluate the nursing students' clinical judgment skills in simulation using Tanner's Clinical Judgment Model. Method: Forty-five teams of a total 93 nursing students participated in a post-operative patient care scenario using human patient simulator. Data were collected from students' responses in scenario and guided reflective journaling according to the framework of Tanner's model which comprised noticing, interpreting, responding, and reflecting on response. Data were analyzed using descriptive statistics. Results: The students' responses of the situation were in accordance with the goals of scenario, i.e. relieving patient' pain and preventing pulmonary complications. However, most of students needed clinical cues and focused on a given clue to solve the issues. They were lack of ability to collect additional information as well as connect the relevant clues in simulated clinical situation. Conclusion: The nursing students have difficulty in what they notice, how they interpret finding, and respond appropriately to the situation. The simulation training using Tanner's model could provide faculty and nursing students with an effective teaching and learning strategy to develop the clinical judgment skills.

• Korean Journal of Adult Nursing
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• v.23 no.1
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• pp.87-99
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• 2011

Purpose: The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room. Methods: The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program. Results: The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (${\beta}$=.226) and then shivering (${\beta}$=.222). Conclusion: The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.83-86
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• 2000

A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.70-73
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• 2004

The incidence of endometriosis in post-operative abdominal scars is rare. We describe two cases of abdominal endometriosis diagnosed by fine needle aspiration (FNA). Both patients presented with subcutaneous masses at previous cesarean section scars with cyclic symptoms of pain. The cytologic smears were cellular and comprised two distinct cell populations consisting of epithelial and stromal components. An epithelial component consisted of flat sheets of polygonal cells and the second stromal component showed crowded clusters of spindle cells or isolated single cells. Hemosiderin-laden macrophages were found in the background. FNA offers a safe and effective tool for diagnosis of abdominal wall endometriosis.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.82-89
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• 1977

A rupture of a dissecting aneurysm of the aorta is life threatening disease and calls for emergency surgical treatment. The author recently experienced one case of ruptured dissecting aneurysm of the descending thoracic aorta complicated with left hemothorax who was recovered after emergency operation of Aug. 11, 1976. The patient was a 43 years old farmer with known hypertension [260/120] for 20 years but without any venereal disease and had experienced sudden throbbing chest pain. Chest film and aortogram revealed this case ruptured aneurysm of descending thoracic aorta complicated with left hemothorax. In this case, large dissecting aneurysm extend from proximal part of left subclavian artery below diaphragm and involved with 3.0 and 4.0cm sized elliptical rupture in proximal part of descending thoracic aorta. And so, neither fenestration procedure nor replacement of dacron artificial vessel was suitable for this case. Finally, only the rupture site of aneurysm was treated by covering with fibrous pleura and teflon patch. The post-operative management of this case was planned to control hypertension with antihypertensive drugs. The follow-up was possible up to date about 2months. The patient has been doing well with ordinary activities except mild chest discomfort.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.64-67
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• 2009

Splenic cystic lesion is uncommon in children, and cystic lymphangioma of the spleen has not been reported in Korean pediatric patients. Here we report a case of cystic lymphangioma arising from the spleen in a 16 year-old male. The patient presented with left flank pain for 5 days after blunt trauma to the same site. On physical examination, left abdominal tenderness and a palpable spleen were noted. Abdominal ultrasound and MRI revealed multiple septated macro-cystic mass abutting to the spleen medially, suggestive of cystic lymphangioma of the spleen. Laparotomy revealed a 20 cm sized cyst in the spleen, and 2,000mL of dark-brownish fluid was aspirated from the cyst. Splenectomy was performed. Pathological examination revealed the cystic lymphangioma. Post-operative recovery was uneventful, and the patient was discharged at 7 days after surgery.