• Journal of Chest Surgery
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• 제29권6호
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• pp.672-674
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• 1996

유미흉은드물지만 심장수술,횡격막의 식도,대동맥 열공 부위의 수술합병증으로잘알려졌다. 특히 식도의 양성 또는 악성 종양에서 식도제거술이 필요한 영양 결핍상태의 환자에서 유미흥은호흘기능, 영양상태, 면역학적 인 면에서 치사율이 높은 위 험한 질병 이다. 본교실에서는 식도헙착 환자에서 식도열공을 통한 식도 제거술후 발생한 유미흥 1례를 경험하였다. 유미홍의 진단은 공장루를 통한 영양공급후 흥막 삼출액의 변화와 술후 5일째 흉막액의 Triglyceride 치의 증가로 진단하였다. 금식 상태에서도 하루 1500내지 2000cc의 유미삼출액이 배액되어 13일째 우 측 개흉술을 통해 횡격막 상부 흉관 결찰을 시 행하였으며, 좋은 결과를 얻을 수 있었다.

• The Korean Journal of Pain
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• 제2권2호
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• pp.194-197
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• 1989

Epidural morphine provides excellent analgesia for the management of postoperative pain, but nausea and vomiting are a commonly reported side effect. Scopolamine, a belladona alkaloid, is an effective antiemetic when nausea is induced by morphine. Transdermal scopolamine patches have the advantage of delivering a constant low dosage of the drug over a prolonged period. To evaluate the efficacy of prophylacitic transdermal scopolamine in reducing nausea or vomiting associated with postoperative epidural morphine analgesia, I studied 60 healthy adult patients. The patients were divided into 3 groups, each group consisting of 20 patients. Group 1; no scopolamine for control Group 2; transdermal scopolamine placebo patch Group 3; transdermal scopolamine patch All patients were anesthetized by epidural injection of 2% lidocaine 15 ml and 0.5% bupivacaine 10 ml with morphine 4 mg. A Comparison with the control group, the placebo group, and Group 3, indicated, that the transdermal scopolamine reduced the incidence of nausea or vomiting associated with postoperative epidural morphine analgesia (group 1; 35%, group 2; 25%, group 3; 10%). However there were no statistically significant differences between groups at a level of p>0.05.

• Journal of Chest Surgery
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• 제16권3호
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• pp.356-361
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• 1983

Pulmonary tuberculosis is still one of unsolved problems in Korea due to increased number of far-advanced and drug-resistant patients, who have poor pulmonary function. We have analyzed 1332 operated Gases during the period of 1958-1981. Annual incidence of the disease decreased from 110 [1960] to 21 [1980]. The ratio between male and female was 7:3 and the age of peak incidence was in the 3rd and 4th decades. Recently, patients below the age of 20 years were slightly decreased, but above 50 years were slightly increased. The patients consisted of far-advanced case in 60% and moderately-advanced in 39% in 1980, as compared with 40% and 59% correspondingly in 1965. Preoperative sputum positively decreased from 91% [1958-1963] to 43.8% [ 1974-1981 ]. Medically treated patients for more than 3 years increased from 16% [1958-1963] to 51% [1974-1981]. From the view of surgical indication, totally destroyed hung increased from 27% [1958-1963] to 4396 [1974-1981 ]. Therefore, pneumonectomy occupied 53.8% of total surgical management recently. Mode of surgical treatment showed that thoracoplasty [33%], resection [57%] in 1958-1963 and thoracoplasty [2%], resection [98%] in 1974-1981. As Semb`s thoracoplasty was the first choice of treatment until 1960, thereafter resection became the choice. Postoperative mortality increased from 1.6-2.096 to 396 recently as well as morbidity. It was mainly due to increased number of poor pulmonary function and postoperative spread of disease. On the basis of our experience, far-advanced and drug-resistant patients increased in number recently, whose pulmonary function was poor. So postoperative mortality and morbidity increased. Proper surgical intervention should be considered before the appearance of resistance for all chemotherapeutic drugs.

• Journal of Trauma and Injury
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• 제32권2호
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• pp.71-79
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• 2019

Purpose: Recent developments in minimally invasive techniques have the potential to reduce surgical morbidity, promote patient recovery, accelerate surgical procedures, and thus improve cost-effectiveness in case management. In this study, we compared the treatment efficacy and results of supraorbital keyhole approach (SOKA) with those of conventional unilateral frontal craniotomy (CUFC) for traumatic intracerebral hemorrhage (TICH) in the frontal lobe. Methods: We analyzed the data of 38 patients who underwent CUFC (n=30) and SOKA (n=8) and retrospectively reviewed their medical records and radiological findings. Furthermore, we tried to identify the best surgical method for such lesions by including patients who underwent burr hole aspiration and drainage (BHAD) (n=9) under local anesthesia due to various circumstances. Results: The difference in the initial Glasgow coma scale score, operative time, and length of hospitalization between the CUFC and SOKA were statistically significant. All radiological features between the two groups including associated skull fracture, amount of pre- and postoperative hematoma, percentage of complete hematoma removal, pre- and postoperative midline shifting of the hematoma, and development of postoperative delayed hematoma were not statistically significant. Our experience of 46 patients with TICH in the frontal lobe with any of the three different surgical methods including BHAD enabled us to obtain valuable findings. Conclusions: Although it is difficult to insist that one particular approach is more useful than the other, we are confident that SOKA will have more advantages over CUFC in carefully selected patients with frontal TICH depending on the surgical experience of a neurosurgeon.

• 대한두개안면성형외과학회지
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• 제20권3호
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• pp.212-216
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• 2019

Zygomaticomaxillary complex (ZMC) fractures account for a substantial proportion of trauma cases. The most frequent complications of maxillofacial fracture treatment are infections and soft tissue flap dehiscence. Postoperative infections nearly always resolve in response to oral antibiotics and local wound care. However, a significant infection can cause a permanent fistula. A 52-year-old man visited our clinic to treat an oroantral fistula (OAF), which was a late complication of a ZMC fracture. Postoperatively, the oral suture site dehisced, exposing the absorbable plate. However, he did not seek treatment. After 5 years, an OAF formed with a $2.0{\times}2.0cm$ bony defect on the left maxilla. We completely excised the OAF, harvested a piece of corticocancellous bone from the iliac crest, inserted the harvested bone into the defect, and covered the soft tissue defect with a buccal mucosal transposition flap. Although it is necessary to excise OAFs, the failure rate is higher for large OAFs (> 5 mm in diameter) because of the extensive defect in the underlying bone that supports the overlying flap. Inappropriate management of postoperative wounds after a ZMC fracture can lead to disastrous outcomes, as in this case. Therefore, proper postoperative treatment and follow-up are essential.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.141-146
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• 2021

Objective: This study was at investigated the effects of manual lymphatic drainage (MLD) on stress and pain in patients with postoperative breast cancer. Design: A randomized controlled trial. Methods: A total of twenty-two patients with postoperative breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD groups (n=12) and rest groups (n=12). The intervention was conducted in each group for twenty minutes a day, five times a week, for four weeks. Before and after the intervention, the participants measured sympathetic nerve, parasympathetic nerve, and pain by using a sphygmograph and short-form McGill pain questionnaire.An independent t-test was used to analyze pretest and posttest changes between the groups, a paired t-test was used to analyze pre-posttests within each group. Results: After analyzing, the MLD group has been shown a significant decrease in the sympathetic nervous system (p<0.05), a significant increase in the parasympathetic nervous system (p<0.05), and a significant increase in pain (p<0.05). However, the rest group was no significant difference between pre and post. Conclusions: The results of this study confirmed that MLD techniques are an effective method in reducing stress and pain in patients with postoperativebreast cancer. And it is thought that can be used as basic data and to develop programs on stress and pain management reduction for patients with breast cancer.

• Clinical Pain
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• 제20권2호
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• pp.145-149
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• 2021

Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.

• 동서간호학연구지
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• 제16권1호
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• pp.44-52
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• 2010

Purpose: The study examined the effects of preoperative patient controlled analgesia (PCA) education on postoperative pain, knowledge of PCA, and attitude toward pain medication. Methods: The participants were patients who underwent surgery in H University Hospital,and were assigned to PCA group (experiment group, n=30) or the control group (n=30). Results: Knowledge of PCA and positive attitude toward pain medication were higher in the experiment group than in the control group. Postoperative pain scores in the experiment group were significantly lower than those in the control group at 48 and 72 hr after surgery, but there was no significant difference at 24 hr after surgery. The experiment group had more positive attitudes on the medication than the control group. Conclusions: Preoperative PCA education could be an effective nursing intervention for pain management of patients after surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권5호
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• pp.270-277
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• 2023

Objectives: Concha cartilage is recommended for correction of cleft nasal deformities. Morbidities at the donor site have been reported in esthetic rhinoplasty cases. Reports on cleft patients are limited, so we investigated the complications of concha cartilage harvesting using the retroauricular approach in cleft rhinoplasty and their management. Materials and Methods: This was a retrospective review of the charts of 63 patients with cleft deformities who underwent septorhinoplasty with concha cartilage. All cases were harvested using a retroauricular approach. Data on patient demographics, surgery type, amount of cartilage harvested, and complications were gathered. Results: Sixty-three patients were enrolled (21 males and 42 females). The mean age of patients was 20.2±5.9 years. Complications were observed in 6 cases (9.5%) and included delayed wound healing (4.8%), prolonged postoperative pain (1.6%), postoperative paresthesia (1.6%), and prominauris (1.6%). Conclusion: The rate of complications associated with concha cartilage harvesting using a retroauricular approach is low. The use of meticulous surgical techniques, especially hemostasis control and adequate wound dressing, is key to minimizing postoperative complications.

• Archives of Plastic Surgery
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• 제45권6호
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• pp.525-533
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• 2018

Background Patients with ectropion experience devastating symptoms. Therefore, the prevention and management of this condition are of utmost importance. To treat ectropion, it is important to perform medial and lateral canthopexy in an effective way. In this study, we propose a comprehensive algorithm for the prevention and management of ectropion based on a new classification of ectropion according to its signs and causes. Methods Canthopexy was performed in 68 cases according to the proposed algorithm, which starts with a categorization of the types of ectropion and ends with the recommended operative technique. To assess the results, we reviewed clinical preoperative and postoperative photographs. To evaluate improvements in patients' symptoms, we conducted a survey with responses scored on a Likert scale. Results None of the patients had scleral show postoperatively. The average patient satisfaction score was satisfied or higher for all symptoms, and the most improved symptom was aesthetic appearance. No major complications were reported. Conclusions For the comprehensive management of ectropion, it is crucial to consider both treatment and prevention. Through the simple surgical algorithm proposed in this study, both medically acceptable results and high levels of patient satisfaction were achieved without significant postoperative complications. We recommend using this algorithm for the comprehensive management of ectropion.