• Korean Journal of Radiology
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• v.22 no.2
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• pp.189-197
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• 2021

Objective: Muscle depletion in patients undergoing liver transplantation affects the recipients' prognosis and therefore cannot be overlooked. We aimed to evaluate whether changes in muscle and fat mass during the preoperative period are associated with prognosis after deceased donor liver transplantation (DDLT). Materials and Methods: This study included 72 patients who underwent DDLT and serial computed tomography (CT) scans. Skeletal muscle index (SMI) and fat mass index (FMI) were calculated using the muscle and fat area in CT performed 1 year prior to surgery (1 yr Pre-LT), just before surgery (Pre-LT), and after transplantation (Post-LT). Simple aspects of serial changes in muscle and fat mass were analyzed during three measurement time points. The rate of preoperative changes in body composition parameters were calculated (preoperative ΔSMI [%] = [SMI at Pre-LT - SMI at 1 yr Pre-LT] / SMI at Pre-LT x 100; preoperative ΔFMI [%] = [FMI at Pre-LT - FMI at 1 yr Pre-LT] / FMI at Pre-LT x 100) and assessed for correlation with patient survival. Results: SMI significantly decreased during the preoperative period (mean preoperative ΔSMI, -13.04%, p < 0.001). In the multivariable analysis, preoperative ΔSMI (p = 0.016) and model for end-stage liver disease score (p = 0.011) were independent prognostic factors for overall survival. The mean survival time for patients with a threshold decrease in the preoperative ΔSMI (≤ -30%) was significantly shorter than for other patients (p = 0.007). Preoperative ΔFMI was not a prognostic factor but FMI increased during the postoperative period (p = 0.009) in all patients. Conclusion: A large reduction in preoperative SMI was significantly associated with reduced survival after DDLT. Therefore, changes in muscle mass during the preoperative period can be considered as a prognostic factor for survival after DDLT.

• Journal of Korean Academy of Nursing
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• v.14 no.2
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• pp.38-46
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• 1984

The purpose of this study was to test the effect of the structured preoperative teaching on post-operative recovery and to observe the effects of an structured preoperative teaching on the adult surgical patient's ventilatory function ability, the length of hospital stay, the number of analgesics within a 72 hour postoperative period, the length of early ambulation. The research question investigated in this study was: What would be the effects of a structured preoperative teaching upon the adult surgical patients postoperative recovery? This study was based on a sample of 40 patients who were scheduled for abdominal surgery. They were asssigned alternately to experimental and control group. Among 40 subjects, 20 were placed in the experimental group and 20 in the control group. Preoperative ventilation function testing of control and experimental subjects was done the evening before surgery and before the patient received the structured preoperative teaching. A structured preoperative teaching was given to the subjects in the exporimental group only by writer. Postoperative testing was done the 5th postoperative day. The data were collected over a period of two months, from Aug. 8 to Oct. 31, 1983. For the analysis of the data and test for the hypotheses, the t-test with mean difference was used. The results of this study regarding the four-hypotheses were as follows: 1. Experimental group which received structured preoperative eaching will have more increase to-cough and deep breathe as measured byhis forced vital capacity(FVC), forced expiratory volume 1 (FEV1), maximal voluntary volume 15 (MVV 15) than control group without structured preoperative teaching. The ventilation function ability was more increase in experimental group than in control group, the mean difference was statistically significant at 0.01 level. Hypotheses 1 was supported. 2. Experimental group with structured preoperative teaching will have more reduced the length of hospital stay than control group without structured preoperative teaching. The length of hospital stay of the experimental group and control group were 11.90 days and 16.05 days respectively. However, the difference was. not statistically significant at .05 level. Therefore the hypothese 2 was not supported. 3. Experimental group with structured preoperative teaching will have more reduce the number of analgesics within a 72 hour postoperative period than control group. The number of analgesics within a 72 hour' postoperative period of experimental group and control group were 1.65 times and 2.4 times. The difference was not statically significant at .05 level. Therefore, the hypotheses 3 was not supported. 4. Experimental group with structured preoperative. teaching will have more reduce the length of early ambulation than control group without structured preoperative teaching. The length of early ambulation of experimental group and control group were 2.2 days and 3.5 days respectively The difference was statistically signficant at 0.05 level. Thus the hypothess 4 was supported.

• Advances in pediatric surgery
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• v.7 no.1
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• pp.21-25
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• 2001

Congenital diaphragmatic hernia (CDH) in the past was considered a surgical emergency requiring immediate operation. Several groups now advocate preoperative stabilization and delayed surgery. The treatment strategy for CDH in this institution is delayed surgery after preoperative stabilization. The aim of this study was to evaluate the results of delayed surgery. A retrospective review of 16 neonates with CDH was performed. Surfactant. conventional mechanical ventilation. high frequency oscillation. and nitric oxide were utilized for preoperative stabilization as necessary. The difference in outcome between two groups differentiated by the duration of the preoperative stabilization periods with mechanical ventilation (${\leq}$ 8 hours and > 8 hours) was determined. Chi-square test was used to analyze the data. There were 7 right-sided hernias and 9 left. The average duration of stabilization was 32.4 hours. Hepatic herniation through the defect was found in 6 cases and all died. The most common postoperative complication was pneumothorax. The mortality rate of the right side hernia was higher than the left (85.7% vs. 33.3%. p=0.036). Mortality rate of the group (N=8) whose preoperative stabilization period was 8 hours or less was better than that (N=6) whose preoperative stabilization period was more than 8 hours (25.0% vs. 83.3%. p=0.031). The overall mortality rate was 56.3%. The better prognosis was noticed in left side hernia. no liver herniation, or shorter preoperative stabilization period.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.421-427
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• 1991

Atrial fibrillation[Af] is closely related to thrombus in left atrium, systemic embolism, and loss of the contribution of atrial contraction to cardiac output. Therefore maintenance of sinus rhythm[SR] is undoubtedly hemodynamically superior to Af in the clinical course of mitral valvular disease especially in the unstable period immediately after surgery. In this article, the conversion rate and the factors influencing the conversion of Af to SR after surgery were studied. Ninety-three patients with mitral valvular replacement at Chungnam National University Hospital were analysed with electrocardiography before and after surgery during the period from June 1985 to June 1990. Eighty patients presented Af before surgery. Twenty-four[30Yo] of the patients were converted to SR[A group] and fifty six presented continuous Af after surgery[B group]. The duration of preoperative Af, preoperative left atrial dimension[LAD], preoperative functional status[NYHA classification] and cardiothoracic[CT] ratio were factors influencing the conversion of Af to SR after surgery. The mean preoperative duration of Af was 3.5$\pm$2.6yr in group A and 7.6$\pm$4.9yr in group B. The mean preoperative LAD was 53. 7$\pm$9.4mm in group A and 62.5$\pm$11.2mm in group B. Before surgery, eleven patients[46%] were belong to NYHA class I, II in group A and eight[14%] in group B. The preoperative CT ratio was 62$\pm$6% in group A and 69$\pm$8% in group B.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.654-665
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• 2000

The purpose of this study was to elucidate the effects of music therapy on the preoperative anxiety of surgerial patients. The research design was a nonequivalent control, group non-synch-ronized design. The data were collected during the period from January 4 to March 17, 1999 at C-University hospital in Seoul. The subjects were sixty patients who had surgery under general anesthesia and had undergone laparotomy. They were assigned to two groups, thirty to the experimental group and thirty to the control group. They also did not have any complication, were alert enough to be interviewed and agreed willingly to participate in this study. The tool of Trait Anxiety Inventory was used to measure trait-anxiety on all patients and the Visual Analogue Scale(VAS) was used to measure state-anxiety on all patients. And systolic and diastolic blood pressure, pulse rate, and blood sugar levels were collected a the day before surgery and the preoperative period. The experimental group received music therapy with self-selected music tapes after choosing from a Music Preference Questionnaire, while the control group didn't receive music therapy. Data were analyzed by ${\chi}^2$-test, t-test, paired t-test. The results of this study are summarized as follows: 1. The preoperative state anxiety of the experimental group was re-markably lower than that of the control group. 2. Decreasing rate in the vital signs of the experimental group was remarkably lower than that of the control group. 3. The preoperative blood sugar of the experimental group was remarkably lower than that of the control group. According to these results, Music Therapy can be regarded as an effective nursing intervention that relieves preoperative anxiety of surgical patients and helper stabilize vital signs. From this study, the following recommendations can be made: 1. In order to decrease surgical patient's preoperative anxiety, I suggest the nursing intervention should go side by side with music therapy.

• Korean Journal of Adult Nursing
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• v.18 no.5
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• pp.709-717
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• 2006

Purpose: The Purpose of this study was to elucidate the effects of aromatherapy massage on the preoperative anxiety of stomach cancer patients. Method: The research design was a nonequivalent control group non synchronized design. The data were collected during the period of October 2 to December 30, 2005 at H Hospital in Seoul. The subjects were 40 patients who were operated under general anesthesia for stomach cancer. State anxiety, systolic and diastolic blood pressure, pulse rate were measured on the day before surgery and the preoperative period. Data were analyzed by ${\chi}^2$ test, independent t-test, paired t-test. Results: Hypothesis 1 that the level of preoperative state anxiety of the experimental group who received aromatherapy massage is lower than that of the control group who did not received aromatherapy was supported(p=.004). Hypothesis 2 the physiological index of the preoperative anxiety of the experimental group who received aromatherapy is lower than that of the control group who did not received aromatherapy. Conclusion: According to these results, aromatherapy hand massage can be regarded as a partially effective nursing intervention that relives anxiety of surgical patients and decreases the blood pressure level.

• Korean Journal of Adult Nursing
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• v.16 no.1
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• pp.146-155
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• 2004

Purpose: The Purpose of this study was to explain the effects of aromatherapy massage on the preoperative anxiety of hemorrhoidectomy patients, and to provide the effective and holistic nursing care to them. Method: The research design was a nonequivalent control group non-synchronized design. The data were collected during the period from November 1 to November 30, 2003 at K-Hospital in Seoul. The subjects were fifty patients who were to have a hemorrhoidectomy under general anesthesia. They were assigned to two groups, 25 subjects to the experimental group and 25 subjects to the control group. The State Anxiety Inventory tool was used to measure state-anxiety on all patients the day before surgery. Systolic and diastolic blood pressure, and pulse rate were measured on the day before surgery and the preoperative period. The experimental group received aromatherapy massage on the hand with lavender oil. Data were analyzed by $x^2$ test, independent t-test, paired t-test. Result: 1. Hypothesis 1, that the level of preoperative state-anxiety of the experimental group who received aromatherapy massage would be lower than that of the control group who did not received aromatherapy was supported(p=.047). 2. Hypothesis 2was that the Physiological index of the preoperative anxiety of the experimental group who received aromatherapy would be lower than that of the control group who did not received aromatherapy. The 1st subhypothesis that "the level of the preoperative systolic and diastolic blood pressure of the experimental group would be less than that of the control group" was not supported. Conclusion: Aromatherapy massage can be regarded as a partially effective nursing intervention that relives the preoperative anxiety of surgical patients and stabilizes vital signs.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.34-39
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• 1997

Between May, 1994 and December, 1995, 122 adult cardiac surgical procedures requiring cardiopulmonary bypa s were performed at Kang Dong Sacred Heart Hospital, including 18 cases(14.8%) that were associated with preoperative(n:9), intraoperative(n=7), postoperative(n:2) use of an IABP (intra-aortic balloon pump). The reasons for IABP were low cardiac output and PTCA(percutaneous transluminal coronary angioplasty) failure in preoperative period, CPB(cardiopulmonary bypass) weaning difficulty in intraoperative period, and intractable arrhythmia in postoperative period. The mean age of the IABP patients was 61.8 $\pm$ 6.9 years(range, 39 to 75years). The overall hospital mortalities in patients with preoperative and intraoperative IABP insertion were 3 and 42.9% respectively. Two patients with postoperative IABP insertion are alive. The rate of IABP weaning is 66.7% for preoperative group, 85.7% for intraoperative group and 100% for postoperative group . In conclusion, if there were no irreversible myocardial damages, IABP could be used safely and emergently at any perioperative period for hemo ynamic stability, CPB weaning, and to overcome low cardiac output syndrome.

• Korean Journal of Ophthalmology
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• v.32 no.6
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• pp.488-496
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• 2018

Purpose: This study aimed to analyze the factors influencing visual field recovery after transsphenoidal approach-tumor resection (TSA-TR) in pituitary adenoma patients with visual field defects (VFDs). Methods: We retrospectively evaluated 102 eyes of 102 patients with VFDs induced by pituitary adenomas who underwent TSA-TR between January 2010 and December 2015. All patients had been observed for more than one year. The severity of the VFD in each patient was evaluated using the mean deviation (MD) and pattern standard deviation in the most-affected eye. Clinical and demographic data such as preoperative visual acuity and visual field, age, sex, tumor volume, neurological symptoms at diagnosis, duration of symptoms, patterns of the preoperative VFD, and preoperative central VFD were investigated and analyzed for association with recovery of the visual field. Results: Recovery from VFDs occurred in 71 (69.6%) eyes after a mean period of $18.36{\pm}5.21$ months. The recovery group was younger (p = 0.003), had higher preoperative MD values (p = 0.016), and had better preoperative visual acuity (p = 0.03), compared with the non-recovery group. Preoperative central VFD (p = 0.006) and preoperative bilateral VFD (p = 0.016) were significantly less frequent in the recovery group. Multivariate logistic regression revealed that age at diagnosis (odds ratio [OR], 0.962; p = 0.022), preoperative MD (OR, 1.069; p = 0.046), preoperative central VFD (OR, 0.212; p = 0.039), and preoperative bilateral VFD (OR, 0.212; p = 0.035) were associated with visual field recovery after TSA-TR. Conclusions: Younger age, higher preoperative MD, and the preoperative abscence of central VFD or bilateral VFD were favorable factors influencing visual field recovery after TSA-TR in patients with pituitary adenomas. An understanding of the associated clinical factors may help predict visual outcomes after TSA-TR in pituitary adenoma patients with VFDs.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.18-26
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• 2002

The purpose of this study was to elucidate the effects of inhalation method using essential oils on the preoperative anxiety of hystrectomy patients, and to provide effective and holistic nursing care to them. The research design was a nonequivalent control group non synchronized design. The data were collected from February 1 to March 31, 2002 at D Medical Center in Busan. The subjects were forty one patients that were operated on under general anesthesia for hystrectomy. They were assigned to two groups, twenty one subjects in the experimental group and twenty subjects in the control group. The tool of the Visual Analogue Scale(VAS) was used to anxiety on all patients the day before surgery and the preoperative period. Then systolic and diastolic blood pressure, pulse rate levels were measured the day before surgery and the preoperative period. The experimental group received two treatments of inhalation method using essential oils of with lavender, ylang ylang, and bergamot oil. The data were analyzed by the $X^2$ test and the independent t-test. The results of this study were summarized as follows: 1. Hypothesis 1: It has been supported that the experimental group received inhalation method using essential oils might cause lower level of the preoperative VAS anxiety than that of the control group(t=-2.93, p=.006). 2. Hypothesis 2: It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative systolic blood pressure than the control group(t=-.120, p=.905). It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative diastolic blood pressure than the control group.(t=1.766, p=.085). 3. Hypothesis 3: It has been supported that the experimental group received inhalation method using essential oils might cause lower level in preoperative pulse rate than the control group(t=5.853, p=.000). According to these results, inhalation method using essential oils can be considered an effective nursing intervention that relieves the preoperative anxiety of hysterectomy patients and stabilizes vital sign partially.