• Archives of Plastic Surgery
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• 제32권4호
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• pp.421-427
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• 2005

Although the incidence of mediastinal wound infection in patient undergoing median sternotomy for cardiovascular surgery is relatively low(less than 1%), it is not only a devastating and potentially life-threatening complication but also associated morbidity, mortality and cost are unacceptably high. During the past few decades various methods had been applied for the treatment of postoperative mediastinitis. Currently, chest wall reconstruction by using muscle flaps-especially pectoralis major muscle and rectus abdominis muscle are commonly selected for the reconstruction after wide debridement has become widely accepted. We performed bilateral pectoralis major-rectus abdominis muscles in-continuity bipedicle flap to overcome the limit of each flap for reconstruction of sternal defects in 17 patients. We analyzed the results of the surgery. Recurrent infection developed in 17.6% of cases and abdominal herniation was observed in one patient. There was no postoperative hematoma or death. We conclude that this flap is very valuable in reconstruction of the anterior chest wall defect caused by post-sternotomy infection because it provides sufficient volume to fill the entire mediastinum, and the complication rate compares favorably to that of other methods.

• 대한족부족관절학회지
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• 제6권1호
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• pp.73-79
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• 2002

Purpose: To evaluate the effectiveness of callotasis using the external fixator for the treatment of brachymetatarsia. Materials and Methods: Eleven patients(15 cases) who underwent callotasis were available. Follow-up averaged 23 months(15-38 months). Both the patients' postoperative satisfaction and the postoperative radiographic results were retrospectively evaluated. Results: The duration from applying the external fixator to remove averaged 15 weeks (8-21 weeks). We did osteotomy again in two cases because of early consolidation at the osteotomy site during distraction period. All cases were evaluated mild claw toe deformity and motional pain in metatarsophalangeal joint, but all patients satisfied the postoperative results except one complained motional pain and stiffness in metatarsophalangeal joint. The metatarsal shortening averaged 13mm(9-18mm) before operation. The amount of distraction for shortened metatarsals averaged 15mm(5-22mm). We found the 6 cases of narrowing of the metatarsophalangeal joint, 2 cases of subluxation of the metatarsophalangeal joint. Conclusion: We think that callotasis with external fixator is good operative method for the brachymetatarsia.

• 여성건강간호학회지
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• 제16권1호
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• pp.60-68
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• 2010

Purpose: This study determined the effect of head and neck massage on anxiety, pain, and discomfort for hysterectomy patients. Methods: Subjects consisted of 48 hysterectomy patients at K hospital. Experimental group (n=23) received head and neck massage at 8 minutes per massage for five times: (at admission, before sleeping on preoperative day, at 4 hours after operation, before sleeping on operation day, before sleeping on the first postoperative day). Control group (n=25) received conventional treatment. As an effectiveness of this intervention, state of anxiety and BP was measured before sleeping on preoperative day. Pain and discomfort were measured before sleeping on the day of surgery and then on the first postoperative day. Data was analyzed descriptive statistics using $x^2$ test, Fisher's exact test, paired t-test, unpaired t-test, repeated measures ANOVA and Bonferroni multiple comparison. Results: 1. State of anxiety score and BP at post-treatment decreased significantly in the experimental group. 2. Pain score in experimental group was lower than that in control group, with no significant difference; whereas, 3. Discomfort level decreased significantly in the experimental group. Conclusion: Results indicate that head and neck massage could be an effective intervention for reducing preoperative anxiety and postoperative discomfort in hysterectomy patients.

• The Korean Journal of Pain
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• 제10권2호
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• pp.208-213
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• 1997

Background: Pruritus is the most frequent undesirable symptom associated with epidural morphine. It is unpleasant and often difficult to treat. Naloxone is presently the drug of first choice for treating this symptom. Naloxone however decrease the pain threshold in some cases. Recently it was reported subhypnotic doses of propofol were efficient in relieving epidural-morphine-induced pruritus(EMIP). In a prospective. randomized, double-blinded clinical trial, we compared the efficacy of propofol and naloxone for treatment of EMIP. Methods: Forty patients with EMIP were allocated to receive either 20 mg propofol, or 1.5 ${\mu}g/kg$ naloxone intravenously. Pruritus and level of postoperative pain were assessed after 5 min, using pruritus rating scale and visual analogue scale. Results: The overall success rate in treating pruritus was similar in both groups (propofol 70% vs naloxone 65%). Twenty-five percent of the patients in the naloxone group had an increase in the level of postoperative pain versus none in the propofol group(P=0.018). Conclusions: These results suggest propofol and naloxone are equally effective in treating EMIP. However, the level of postoperative pain is significantly reduced when treated with propofol.

• 대한한방부인과학회지
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• 제31권4호
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• pp.188-196
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• 2018

Objectives: This study is to report the clinical effectiveness of the complex Korean medicine therapy on a postoperative endometriosis patient's hypoestrogenic side effects who is treated with GnRH-agonist injection. Methods: The patient in this case was diagnosed with endometriosis and has been treated with GnRH-a injection after laparoscopic operation. The patient complained hot flash and sweating mainly after GnRH-a treatment. The patient received complex Korean medicine therapy during 10 days admission period. The clinical effects were evaluated through KI (Kupperman's Index) and SF-36 (36 item Short Form Health Survey). Results: After the complex Korean medicine therapy, the various clinical symptoms including hot flash and sweating were improved. Also, the quality of life was enhanced. Conclusions: This case report shows that the complex Korean medicine therapy was effective for treating hypoestrogenic side effects occurred after GnRH-a treatment in postoperative endometriosis patient.

• 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.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.85-89
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• 2024

Postoperative atlantoaxial rotatory subluxation (AARS) is a rare complication that develops almost exclusively in children following oropharyngeal and otologic surgeries, proposing that oropharyngeal inflammatory responses and excessive head rotation are responsible factors. However, there have been no reports of AARS after excision of a nevus on the head and neck. Here, we present two cases of AARS following limited head rotation during simple nevus excision. Patient 1, a 9-year-old girl, complained of neck pain and limited range of motion after excision of the nevus on the neck. After 2 months, computed tomography and magnetic resonance imaging finally revealed AARS with a ruptured transverse atlantal ligament. A month of halo traction was required for the treatment. Patient 2, an 11-year-old girl, presented with immediate pain and limited neck extension after tissue expander insertion under the upper chest and excision of the nevus on her left cheek. The diagnosis was promptly made using cervical spine radiography. A cervical collar was applied for 1 month. Both patients recovered without any complications after treatment. This report highlights the importance of suspicion for AARS after surgery regardless of surgical duration or amount of head rotation.

• Clinics in Shoulder and Elbow
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• 제18권4호
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• pp.221-228
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• 2015

Background: The The purpose of this study was to make a comparative analysis of the clinical outcomes after the operative treatment of refractory medial epicondylitis between the suture anchor group and the non-suture anchor group. Methods: We enrolled 20 patients (7 men and 13 women) with recalcitrant medial epicondylitis who were able to receive operative treatment in a minimum of an 18-month follow-up. The mean age was 48.6 years (range, 36-59 years). The patients were allocated into either the suture anchor group (7 patients) or the non-suture anchor group (13 patients). We evaluated clinical outcomes using the visual analog scale (VAS), the pain grading system of Nirschl and Pettrone, and postoperative grip strength. Results: The VAS score decreased from 8.8 to 2.0 for the suture anchor group and from 8.6 to 1.3 for the non-suture anchor group (p=0.16). The postoperative grip strength was 95%, 93% of the non-treated arm in both groups (p=0.32). The postoperative satisfaction level was good in 5 patients and fair in 2 for the suture anchor group and excellent in 5 patients, good, in 4, and fair, in 4 for the non-suture anchor group (p=0.43). The clinical outcomes did not show a statistically significant difference between the two groups. Conclusions: We found that patients with recalcitrant medial epicondylitis were treated reliably with satisfactory clinical outcomes whether or not suture anchors were used. We believe the use of suture anchors when more than 50% of the tendon origin is affected provides an effective and favorable treatment modality.

• 대한두경부종양학회지
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• 제22권2호
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• pp.137-141
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• 2006

Purpose : It has been generally accepted that lobectomy is a standard surgical procedure in treatment of benign thyroid nodules. However lobectomy may cause postoperative hypothyroidism. Most of surgeons believe that nodulectomy has its limitation in treatment of thyroid nodules due to recurrence of nodules and presence of cancer. The current study attempts to determine whether nodulectomy is justified in aspects of preservation of thyroid function, risk of recurrence and complications. Methods: Data was collected retrospectively on 74 patients undergoing thyroidectomy(single nodulectomy, n=43;bilateral nodulectomies, n=9;lobectomy with nodulectomy, n=22) for benign thyroid nodules from 1999 to 2004. All patients were evaluated for complication, postoperative thyroid function, and recurrence of benign nodule and cancer were followed by regular ultrasonographic examination for 2-6 years. Results : The pathologic results of 74 patients were nodular hyperplasia(55 patients), Hashimoto's thyroiditis(8 patients), follicular adenoma(7 patients) and papillary carcinoma(4 patients). Average operation time was 30 minutes from skin incision to specimen out. In postoperative follow-up of 70 patients, six cases(8.5%) became mild hypothyroid, and ultrasonographically detected micronodule was also six cases(8.5%). There were no other complications. Conclusion : Thyroid nodulectomy appears to have advantages of relatively few complication and simple procedure with no access to laryngeal nerves. Therefore, it may be one of treatment options in selected cases of benign thyroid nodules.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.706-710
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• 2006

Purpose: Keloid is a clinical term characterized by elevation and extension of scar tissue beyond wound margin. Currently, there is no known treatment that shows consistent effect in all patients. Postoperative radiation therapy is known to prevent recurrence of keloid. Methods: We reviewed data of patients who had undergone operation or operation followed by radiation therapy at our institute for the last 12 years. Follow up was possible in 39 patients(21 patients treated only by operation and 18 treated by operation and radiation therapy) We then investigated recurrence in both groups by VAS score. By mail, patients were asked to score their current condition on the bar in 4 aspects(itching, pain, mass lesion(by patients and other persons)). Two criteria were used for defining successful treatment. One is the case which total VAS score was 0, and the other is sum of VAS score of mass lesion was 0 to 5. Results: In the former, recurrence rate is 90.5% in operations-only group but 66.7% in operations plus radiation therapy group(p < 0.05). In the latter, recurrence rate is 66.7% in operation-only group but 22.2% in operations plus radiation therapy group(p < 0.05). Conclusion: These results shows postoperative radiation therapy is effective method in keloid treatment.