• Journal of Korean Neurosurgical Society
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• v.52 no.1
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• pp.14-20
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• 2012

Objective : Intracranial meningiomas are primarily benign tumors with a good prognosis. Although WHO grade II meningiomas are rare (2-10%), WHO grade II meningiomas have higher recurrence and mortality rates than benign. We evaluated the patient recurrence rate and investigated the prognostic factors of WHO grade II meningiomas. Methods : Between 1993 and 2005, 55 patients were diagnosed with WHO grade II meningiomas in our hospital. WHO grade II meningiomas (n=55) were compared with other WHO grades meningiomas (I, n=373; and III, n=20). The patients had a median age of 48.4 years (range, 14-17 years), a male-to-female ratio of 26 : 29, and a mean follow-up time of 45 months (range, 3-175 months). Results : In WHO grade II meningiomas, only the extent of resection was a significant prognostic factor. Post-operative radiotherapy had no significant influence on tumor recurrence (p=0.053). The relative risk of recurrence was significantly higher in WHO grade II meningiomas with incomplete resection (10/27, RR=37%) than in WHO grade II meningiomas with complete resection (4/28, RR=14%) regardless of post-operative radiotherapy. In the incomplete resection group, Simpson grade III or IV had a significantly high risk of recurrence regardless of post-operative RT (n=3, RR=100%) However, if the degree of resection was Simpson grade II, the recurrence rate was similar to the complete resection group even though post-operative RT was not performed. Conclusion : Complete resection was the most powerful independent predictive factor of the recurrence rate in WHO grade II meningiomas. Post-operative adjuvant RT was not a significant factor in this study.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.90-104
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• 2000

Background : This study was designed to assess the effects of information on the satisfaction of parents and families whose children underwent elective surgery in the Pediatric Operating Room. Methods : We measured parent and family satisfaction with information given before and after offering informational interventions. The data were collected from 510 patients parents and families whose children had undergone elective surgery in the Pediatric Operating Room of Seoul National University Hospital in Seoul. South Korea. The data collection ran from May 3. 1999 to May 30. 1999 and from September 6, 1999 to September 30, 1999. The research instrument consisted of four categories (pre-operative period, intra-operative period, post-operative period, others) and 24 questionnaires. SPSS was used to analyze the data. Results : The major findings of this study are summarized as follows: 1. Before surgery, the satisfaction with the following was increased: the explanations of the necessary preparation for the surgery (6.0%), the time the patient would enter the operating room (20.6%), the operative procedure (2.0%), and the use of the waiting room (10.0%). 2. During the operation, the satisfaction with the situation board (15.1%), public announcements in the waiting room (8.4%), and the answering of the families questions (12.2%) was increased. however, the satisfaction with the surgeons explanations of the surgical outcomes decreased by 8.3%, even though the frequency of these explanations increased by 5%. 3. After surgery, the satisfaction with the following was increased: the explanations of patient's status of recovery(10.3%) the time the patient would be moved from the recovery room (17.6%), how the patient would be transferred to the ward (19.2%), and post-operative care (6.3%). Conclusion : Based upon the above findings, we concluded that pre-, intra-, and post-operative informational interventions were effective in increasing the satisfaction of the parents and families of children undergoing elective surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5427-5431
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• 2014

Aim: To evaluate the outcome of stapled versus sutured colo-rectal anastomosis after low anterior resection of mid-rectal carcinoma. Patients and Methods: A prospective study of fifty patients who underwent colo-rectal anastomosis following low anterior resection (LAR) of T2 mid-rectal cancers at the Egyptian National Cancer Institute during the time period from June 2010 to June 2013 was conducted. Classification was into two groups; a stapled anastomosis group I (25 patients) and a hand-sewn anastomosis group II (25 patients). All operations are evaluated regarding intra-operative complications such as anastomotic line bleeding, visceral injuries or major blood loss. The anastomotic time and operative time are documented for each operation. All patients are evaluated post-operatively for anastomotic leakage (AL), wound infection and ileus. Results: The distance of the tumor from the anal verge was $9.6{\pm}2.0cm$ in group I and $9.9{pm}2.4cm$ in group II. The mean operative time was $191.5{\pm}16.2min$ in the stapled group and $208{\pm}18.6min$ in the sutured group (p=0.002). The mean anastomotic times were $9.0{\pm}1.9min$ and $19.7{pm}12.2min$ (p=0.001). Anastomotic leakage developed in three (12.0%) patients in the stapled group and in four (16.0%) patients in the sutured group (p=1.000). Post-operative ileus was observed in 3 patients in group I and one patient in group II. Wound infection developed in three (12.0%) patients in the stapled group and four (16.0%) patients in the sutured group (p=1.000). Conclusion: Colo-rectal anastomosis after low anterior resection for mid rectal carcinoma can be conducted safely either by stapling or hand-sewn techniques; however the stapling technique showed shorter anastomotic and operative times with no significant advantages regarding intra- or post-operative complications or hospital stay.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.297-305
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• 1979

Occlusive coronary artery disease presents a potential threat to a significant population in the United States. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. Operative vascular procedures have increased steadily in number over the past 20 years in the United States. There have been many isolated case reports about coronary artery surgery, but these had little clinical impact. Nowadays, major three coronary bypass surgery has developed principally at three cardiac centers in the United States since 1967. Among three coronary bypass operation, the aorta-coronary artery saphenous vein bypass graft was first demonstrated by Favolaro and Effler at the Cleveland Clinic in 1967. We experienced one case of coronary artery disease, which was treated successfully by aorta-coronary saphenous vein graft with mild hypothermia under extracorporeal circulation in May, 1977. Saphenous vein was removed from above the knee and was 2.5 mm in diameter. The left ventricle was not vented for the left ventricle was not overdistended. Temporary artificial pace-maker-Medtronic-was implanted for the prevention and treatment of post-operative arrhythmia and heart block in post-operative first day. He is a 57 year old male businessman who had been suffered from hypertension [200 mmHg in systolic pressure] since 4 years ago, who had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain with choking sensation for 50 days. This symptom was aggravated exposing cold weather, or cold water, but was respond to rest. Pre-operative ECG revealed no any other ischemic sign except sinus bradycardia. Significant S-T segment depression was noted at lead II, AVF after double 5 minutes exercise, indicating positive Master`s test. Serum cholesterol was slight elevated to 253 mg/dl. Final pre-operative diagnosis was made by coronary arteriogram, which showed about 1.0-cm segmental 90 % occlusive atherosclerotic lesion in the proximal part of right coronary artery above the origin of acute marginal artery. Left coronary artery revealed good patency and there was no collateral circulation between right and left coronary artery .Hospital course was not eventful. He was discharged with good result on the post-operative day. He has been free from chest pain for longer than 2 years. And also the arterial flow in the coronary bypass graft is auscultated with the pocket-sized ultrasonic velocity detector, which shows the patency of the coronary bypass graft good.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.479-487
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• 1988

Valve replacements in 82 children, aging up to 15 years[mean 11.67 years] were done at Seoul National University Hospital during 13 years period from 1974 to 1986. The patients were composed of 5] males and 31 females and 50 patients had acquired heart disease and 32 patients congenital heart disease. 75 patients received single valve replacements, 6 patients double valve replacements, 1 patient triple valve replacement, and among all of them, 11 patients redo-replacements. The bioprosthetic valves have been applied to 58 patients and prosthetic valve to 24 patients and the latter was the main artificial valve since 1984. Among the 69 patients who had definite post-operative records, the overall mortality was 27.5%[20.3% was early mortality and 7.2% late mortality] and the overall mortality was lowered to 4.3% since 1984. There were early post-operative complication rate of 26.1% and late complication rate 34.8%, and among the latter, the valve failure rate was 11.4% patient-year, and the thrombo-embolism rate 1.76%/patient-year. 55 patients among the survivals after post-operative 1 month, were received follow-up with various anticoagulating medication for total 2046 patient-months[mini-mum 1 month to maximum 90 month, mean 37.2*25.44 months] and actuarial survival rate was 82*8% at 5 years and valve failure free and thrombo-embolic free survival rate were 61*8% and 90*3% respectively. And among them, valve failure free survival `rate of tissue valve were 91*6% at post-operative 2 years, 78*3% at 3 years, 59*9% at 4 years, 54*10% at 5 years, 53*15% at 6 years, so markedly decreased at 3-5 years post-operatively. These results suggest that cardiac valve replacement in children have been effective therapeutic method though various problems are still remained, and the choice of valve should be prosthetic valve mainly due to its durability at the present.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.190-194
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• 1977

An analysis of 503 pulmonary resection is presented, with the following points of interest; 1] By using a stapling device, the operation time is shortened, more lung tissue can be saved, and post-operative complications are fewer. 2] By comparison with a previous series, postoperative drainage from the chest is decreased when the stapling device is used. In the present series 82% of patients has less than 500 cc of drainage post-operatively. Average required whole blood replacement was less than 800 cc in this series of patients. 3] Only 13 patients, or 2.6% developed a bronchopleural fistula, and only 8 patients, or 1.5% developed post-operative empyema when the stapling device was used. 4] Because of the decreased air leaks when the stapling device is used, the anterior and posterior tubes can be removed sooner. 5] With careful preservation of lung tissue and paralysis of the phrenic nerve, post operative `dead space" is not a problem after the pulmonary lobectomy. Thus thoracoplasty is not necessary to eliminate "dead space".

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.2
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• pp.220-230
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• 2010

Purpose: This study was done to identify differences in three groups of operative patients (Forced Air Warming, Electrical Blanketrol, Control) for discomfort and pattern of body temperature during surgery and post operatively. Methods: The sample consisted of 3 randomized 3 groups of abdominal surgery patients admitted to an university hospital in D-city : The Bair Hugger and upper body blanket were used with the first group, electrical blanketrol with PVC Film with the second, and the third group was the control. ANOVA was used with the WIN SPSS 17.0 program to analyze the data. Results: Significant differences were found among the three groups for tympanic and esophageal body temperature at 1 hour after starting surgery. There was significant difference in tympanic body temperature during the 15 minute stay in the post anesthetic room. There were no significant differences in thermal discomfort while in the post anesthetic room. or There among the three groups for serum cortisol during surgery. Conclusion: According to the results of this study, application of a Bair Hugger or electrical blanketrol improves maintenance of body temperature of operative patients as well as body temperature of post operative patients, and is a clinically significant warming method providing a more consistent body temperature.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.456-459
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• 2004

A 16 month old male infant was found with slip down state in a bath room without evidence of trauma to whole body. The infant was treated with several thoracentesis and closed drainage due to persistent right pleural effusion at other hospital and transferred to our hospital for further evaluation and treatment at July 2003. The pleural effusion was confirmed as chylothorax by chemical analysis. He was treated with parenteral feeding for 21 days. Because the amount of chest tube drainage was about 110∼210 cc/day, and could not be decreased with conservative treatment. patients underwent ligation of thoracic duct. Post-operative course was uneventful except post-op. empyema thoracis, The open drainage tube was removed at post operative 30 days, The patient was in very good condition with complete cure until post-operative 3 months.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.236-240
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• 1993

Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.192-200
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• 2008

To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Methods: Total fifty six (M:F = 33:24, age $6.7{\pm}3.2$ years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was $33{\pm}21$ months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. Results: In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal lobe of the hemispheres with EDAS and frontal EGS, the post-operative CVRI, and ${\Delta}CVRI$ showed a significant difference between patients with a good and poor clinical outcome (p<0.05). In a multivariate logistic regression analysis, the ${\Delta}CVRI$ and the post-operative CVRI of medial frontal gyrus on the hemispheres where EDAS with frontal EGS was performed were the significant predictive factors for the clinical outcome (p =0.002, p =0.015), Conclusion: With probabilistic map, we could objectively evaluate pre/post-operative hemodynamic changes of pediatric patients with moyamoya disease. Specifically the post-operative CVRI and the post-operative CVRI of medial frontal gyrus where EDAS with frontal EGS was done were the significant predictive factors for further clinical outcomes.