• Journal of Chest Surgery
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• v.13 no.3
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• pp.274-279
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• 1980

A 21 years old male student was admitted because of mediastinal mass that was noticed in routine physical examination. He complained progressive hoarseness, mild dysphagia, and anterior chest pain on deep respiration. This mediastinal mass was diagnosed as aortic aneurysm involving ascending, transverse, and descending thoracic aorta with aid of aortogram. Total prosthetic replacement of aneurysm was performed successfully using extracorporeal circulation and hypothermia. For myocardial protection during aortic cross clamping, cardioplegic solution was used and topical myocardial cooling was also adapted For simplicity of cardiopulmonary bypass, Y-shaped connectors took cerebral perfusion catheters to the main perfusion line beyond the arterial pump. Total bypass time was 219 minutes, and aortic cross clamp time was 104 minutes. Recovery was uneventful except respiratory insufficiency for first 4 days. Isotope aortogram checked on post operative 30th day showed normal aortic configuration. He was discharged on post operative 35th day. A follow-up chest X-ray study 5 months later showed nearly normal anatomy.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.800-805
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• 1989

The roentgenologic appearance of carcinoma of the lung may vary considerably from case to case. And when it forms cavitary lesion, it is frequently confused with benign lesions and treated conservatively. Twenty-seven patients with cavitary bronchogenic carcinoma were treated in our St. Marys Hospital during the period 1984-1989. There were 24 males and 3 females. They ranged in age from 43 to 76 years. Symptoms of cough, blood-streaked sputum or pleuritic chest pain were present in all patients one month to 6 months before hospital admission and 7 patients among them were delayed in recognition of the malignancy from z month to 3 months. Of 27 malignancies with cavity, 22[81.5 %] were squamous cell ca., 3[11.1%] were large cell ca., and 2[7.4%] were adenoca. And of 22 squamous cell carcinomas, 5 were well differentiated, 13 were moderately and 4 were poorly. All lobes except Rt. middle lobe were involved [RUL 2 cases, RLL 13 cases, LUL 3 cases and LLL 9 cases]. We explored 16 patients and performed 7 lobectomy, 4 bi-lobectomy, 2 pneumonectomy and 3 08zC. Post-operative follow-up examination of the resected 13 patients indicated one and two year survival rates of 69.1 %[9/13 cases] and 37.5%[3/8 cases] respectively, and now 6 survivors whose post-operative periods were from 4 months to 37 months.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.105-107
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• 2010

The scanty literature on distal tibiofibular synostosis includes descriptions of relatively few specific complaints. Here we report a case of a 24-year-old young soldier who sustained a left ankle lateral malleolar fracture about 6 months ago and was initially treated by the open reduction and internal fixation with plate & screw. But 6 months later, he suffered from an vague ankle pain, each time the symptoms occurred right after an active ambulation, ankle dorsiflexion, especially when he had exercised aggressively. The radiographs revealed that there was a mature distal tibiofibular synostosis. We treated the patient with surgical excision of synostosis. Post-operative condition was satisfied to all concern and the result was found to be excellent during one-year follow-up.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.253-263
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• 2017

Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.

• Journal of Korean Academy of Nursing
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• v.39 no.1
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• pp.44-52
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• 2009

Purpose: The purpose of this study was to compare the effects of ondansetron combined with dexamethasone on Post-Operative Nausea and Vomiting (PONV) and pain with ondansetron alone in patients with laparoscopy assisted vaginal hysterectomy under general anesthesia. Methods: Data were collected from April 1 through September 30, 2005 using a double blind method. Ondansetron 4 mg and dexamethasone 10 mg were administered to the experimental group (25 patients), and ondansetron 4 mg only to the control group (25 patients). The medications were administered through an intravenous line at the beginning peritoneum suture. PONV by Index of Nausea Vomiting and Retching (INVR), nausea by Visual Analogue Scale (VAS), and pain (VAS) were assessed at postoperative 1 hr, 3 hr, 6 hr, 24 hr, and 48 hr. Data were analyzed using repeated measures ANOVA, and Bonferroni methods. Results: The experimental group that received ondansetron combined with dexamethasone had less PONV (p=.048), and nausea (p=.012) than control group that received ondansetron alone. However, there was no difference in pain (p=.557) between the patients in the two groups. Conclusion: We conclude that the administration of ondansetron combined with dexamethasone is more effective than the administration of ondansetron alone to reduce PONV in patients with laparoscopic hysterectomy.

• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.467-475
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• 2019

Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

• Journal of Oral Medicine and Pain
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• v.47 no.1
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• pp.52-61
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• 2022

Purpose: Most cases of oral and maxillofacial infections are usually easily treated by proper diagnosis, elimination of causative factors, and antibiotic therapy. However, the emergence and the increase of multidrug-resistant bacteria make treatment challenging. "ESKAPE" pathogens are the most common opportunistic organisms in nosocomial infections and have resistant to commonly used antibiotics. There are many medical reviews of ESKAPE pathogens, but few in dentistry. This study focuses on oral and maxillofacial infection especially with ESKAPE pathogens. The purpose of this study is to prepare feasible data about tracing and treatment of infection related to pathogens that may be beneficial to clinicians. Methods: A total of 154 patients with oral and maxillofacial infections were reviewed by analyzing retrospectively hospitalized data in the Department of Oral and Maxillofacial surgery, Chosun University Hospital, Korea, past 5 years from January 2014 to December 2018. Based on the medical records and microbiological tests, the results were divided into two groups: infections with ESKAPE pathogens and other bacteria. Results: A total of 22 species were isolated from 154 patients. The proportion of ESKAPE pathogens among all bacterial isolates collected from infected patients was 39.6%. Causative factors, especially in post-operative infection, showed a statistically significant correlation to ESKAPE infections (29 cases). And average of treatment period in ESKAPE group was longer than non-ESKAPE groups. Overall, Klebsiella pneumoniae (60.7%) was the most frequently isolated ESKAPE pathogen. And high antibiotic resistance rates had been detected in the ESKAPE during the five-year period. Conclusions: Infections with ESKAPE pathogens are now a problem that can no longer be overlooked in Dentistry. Based on results of this study, ESKAPE pathogens were highly associated with post-operative or opportunistic infections. Clinicians should be careful about these antibiotic resistant pathogens and use appropriate antibiotics to patients while having dental treatments.

• Child Health Nursing Research
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• v.9 no.2
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• pp.140-148
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• 2003

Purpose: The purpose of this study was to examine the nurses' knowledge and attitude to pain management in children and explore the status of pain management in clinical practice. Method: The subjects were 131 nurses enrolled in 3 university affiliated hospitals. Questionnaire method was utilized for data collection. Data was analyzed by SPSS statistical program. Result: The result was as follows: 1. The overall mean score of the pain knowledge was 16.88 (58.2％). The percentages of correct response in test subsections were pain assessment 45.5, choice of medication and drug action 48.7, and pain statement 79.6 respectively. 2. 70.3％ of the nurses agreed or strongly agreed that the procedural pain should always be eliminated. And, 44.3％ of the nurses agreed or strongly agreed that post-operative treatment of pain in children should always aim at eliminating the pain completely. 3. There was a significant relationship between pain attitude and knowledge related facts about pain(r=.217, p<.01). 4. When asked to identify the point of self-reported pain on a 0-10 scale at which the nurse would give medication, point 7 was mostly identified (29％). 5. Only 19.8％ of the nurses utilized pain rating scale to assess children's pain. 6. The nonpharmacologic interventions nurses used most were position change, emotional support, and massage. 7. 68.7％ of the nurses indicated that they learned about pain management from their current working environment. Also, Mostly helpful resource identified in increasing their pain management knowledge and skills was the continuing education program. Conclusion: The findings showed that there was a need to develop educational program for adequate pain management for children. Further research study is recommended to examine the effectiveness of the intervention methods for children's pain.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.118-125
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• 2001

The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution. Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative(n=26) and non-operative(n=36) groups. The prevalent age was between 11 and 15 years(28 cases; 45.2 %), and the most common previous operation was appendectomy(28 cases; 45.2 %). The most common operative procedures were adhesiolysis(17 cases; 65.4 %). The interval between admission and operation was 1 day in 11 cases(42.3 %). The most common site of adhesion was the ileum in 13 cases(50.0 %) and band constriction was the most frequent pattern(8 cases; 30.8 %). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation(fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film(p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.

• The Korean Journal of Pain
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• v.29 no.4
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• pp.239-248
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• 2016

Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.