• Pediatric Infection and Vaccine
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• v.2 no.2
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• pp.180-185
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• 1995

1. Purpose The accurate diagnosis and proper treatment of group A streptococcus should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. We would like to know the recover rate of beta-hemolytic streptococci by throat swab culture at the in-patient 2. Methods The throat swab cultures and filled up flow-sheets were undertaken on 619 children who had admitted to hospital, KyungHee university hospital from may 1994 to april 1995 prospectively. At the same time on admission, throat culture was performed. 3. Results The highest recover rate of BHS(Beta-Hemolytic Streptococci)and GAS(Group A Streptococci) were seen in above 10 years old, as 9.1% and 1.9%. BHS were obtained in 39 cases(6.3%) among 619 children while GAS was obtained in 3 cases (0.4%). Among 39 specimens of BHS, 33 specimens were classified as non-grouping streptococcus. 4. Conclusion The poor recovery rate of GAS inpatient compared with normal carrier rate is likely due to possible antibiotic abuse, errors in processing samples, and epidemiologic factors such as seasons and geographic areas. It is necessary to evaluate the clinical significance of non-A,B,C,G streptococcal infections and carriers.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.240-245
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• 1988

This study was prospectively planned to realize the reduction of calcium ion in serum along with the cardiopulmonary bypass[CPB], to find out the cause of the reduction, and to verify the justification of the classical methods of calcium replacement. Nine patients with various open heart surgeries by CPB in 1987 wee selected at random. Calcium chloride was added as follows:: For each unit of ACD blood transfusion, 600mg of calcium chloride was added. In case of massive transfusion, 600 mg of calcium chloride was injected every 2 or 3 units of transfusion. On occasions such as weaning from CPB, or following defibrillation, or hypotension, weak myocardial contractility of the heart, calcium chloride was needed in an amount of 10 mg / kg. In ICU, calcium chloride was limited to use in low serum level or in emergency use. Total calcium decreased early bypass and progressively increased above the preoperative value during late bypass and three hours thereafter, Ionized calcium increased during late bypass and three hours following. Total and ionized calcium depicted similar patterns of change during open heart surgery. Decrease of the calcium at the early bypass was thought from reduction of total protein and alkalosis during bypass. Meanwhile, increase of both calciums during the end of surgery was presumably attributable to addition of calcium chloride in priming solution, injections of calcium chloride in the process of termination of bypass. We conclude that enough calcium was replaced by the classical methods of calcium supplement.

• Journal of Chest Surgery
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• v.33 no.4
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• pp.306-309
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• 2000

Background: The purpose of this study was to evalute the diagnostic value of 2mm video thoracoscopy for primary spontaneous penumothorax. Material and Method: During the period of March to June 1999, we prospectively analyzed 33 consecutive patients suffering from primary spontaneous pneumothorax. 2mm video-assisted thoracoscopy was compared with the operative finding. We observed recurrence during the mean follow-up of 3months. Result: Blebs were present in 24 patient(73%: 24/33). These were treated by 10mm video-assised thoracoscopic stapling. Nine pateints with no bleb were treated with pleural drainage. There were no significant differences in the bleb finding. No recurrence occurred during the follow-up period. Conclusion: A 2mm video thoracoscopic examination for primary spontaneous pnumothorax is a useful alternative in deciding the operative indication.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.570-574
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• 2013

Background The elliptical excision is the standard method of removing benign skin lesions, such as congenital melanocytic nevi. This technique allows for primary closure, with little to no dog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scars which are unnecessarily long. This study was designed to compare the predicted results of elliptical excision with those resulting from our excision technique. Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. After an incision on one side of the nevus margin, subcutaneous undermining was performed in the appropriate direction. The skin flap was pulled up and approximated along several vectors to minimize the occurrence of dog-ear deformity. Results Overall, the final wound length was 21.1% shorter than that achieved by elliptical excision. Only 8.5% of the patients required dog-ear repair. There was no significant distortion of critical facial structures. All of the scars were deemed aesthetically acceptable based on their Patient and Observer Scar Assessment Scale scores. Conclusions When compared to elliptical excision, our technique appears to minimize dogear deformity and decrease the final wound length. This technique should be considered an alternative method for excision of facial nevi.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.669-673
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• 1991

Fructose-l, 6-diphosphate as an additive to cold crystalloid cardioplegia [St. Thomas sol.] was studied prospectively in 60 patients undergoing open heart surgery from January 1, 1991, to June 30, 1991. Thirty patients received cardioplegia with FDP[group I ] and 30 patients received cardioplegia without FDP [group II ]. There were no differences between two groups pre-operatively with regard to age, heart disease, cross-clamp time, cardiac enzymes, or hemodynamic measurements [p>0.05]. Cardiopulmonary bypass was established using ascending aorta and vena cava cannulation employing moderate systemic hypothermia [30oC nasopharyngeal temperature] and hemodilution All patients received cardioplegia through the aortic root at aortic root pressure of 80mm Hg. The composition of the cardioplegic solution and its delivery were identical in both groups except for the addition of FDP[1.5 mg/mL] in group I. The cardioplegic infusate consisted of St. Thomas Hospital solution. The initial dose was infused through the aortic root. Topical myocardial cooling with saline slush was employed in all patients. Recorded operative data were cardiopulmonary bypass and cross-clamp times, amount of cardioplegic infusate. Blood samples for assessment of lactate dehydrogenase [LDH], creatine kinase [CK] and transaminases [GOT, GPT] were obtained before and at 1,2,3,7th postoperative period. Better myocardial protection effect was noted in group I than group II with respect to the % change of cardiac enzymes, although the differences were not significant. We conclude that FDP is a safe additive to crystalloid cardioplegia and may be beneficial in open heart surgery patients.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.23-27
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• 2014

Purpose: Laparoscopic hernia repair in children is still controversial. The aim of this study was to report our long-term results of the laparoscopic hernia technique, which is based on the same surgical principles as conventional open herniotomy. Methods: Five hundred fourteen pediatric patients with inguinal hernia were included in this study under informed consent. All patients underwent a laparoscopic technique of sac transection and intracorporeal ligation. The asymptomatic contralateral inguinal ring was routinely explored and repaired if a patient had patent processus vaginalis on the contralateral side. Patients were prospectively followed for 5 years. Those who were lost to follow-up were excluded from the study. Perioperative complications and recurrences were evaluated. Results: The mean follow-up period was 29 months. Mean operation time was 27.5 minutes. Forty one percent of the patients had contralateral patent processus vaginalis. Only one hernia recurred (0.19%). We had one case of contralateral metachronous hernia (0.21%) during follow-up period. Conclusion: The long-term follow-up results of our study revealed that laparoscopic hernia sac transection and ligation can be a safe and effective alternative for conventional herniorraphy.

• Journal of Acupuncture Research
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• v.21 no.6
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• pp.269-279
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• 2004

Meniere's disease is not a life-threatening but life-altering inner ear process characterized by episodic vertigo, fluctuating hearing loss, tinnitus, and ear fullness. The etiology and pathophysiology of the symptoms is still disputed. Thereby the treatment of Meniere's disease is empirical. As yet, no treatment has prospectively modified the clinical course of the condition and thereby prevented the progressive hearing loss. We experienced two cases of Meniere's disease treated with herbal medication and acupuncture. 62 year-old male and 64 year-old female patients had definite Meniere's disease. Banhabaeckchulchunma-tang was administered in both cases. After treatment Vertigo attacks were completely controlled in both, whereas Hearing level remained unchanged. Tinnitus was improved in one patient and unchanged in the other. Therefore, Banhabaeckchulchunma-tang and acupuncture could be a safe and simple therapeutic modality that is effective in controlling the vertigo ; however further studies must be done on hearing preservation and tinnitus.

• Journal of Korean Academy of Nursing
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• v.43 no.1
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• pp.20-29
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• 2013

Purpose: The purpose of this study was to propose and test a predictive model that could explain and predict nursing productivity. Methods: A survey using a structured questionnaire was conducted with 360 nurses in Korea. The data were analyzed using SPSS Windows 18.0 and AMOS 19.0 program. Results: Based on the constructed model, burnout and organizational commitment were found to have direct effects on nurses' turnover intention and nursing productivity. While nursing work environment was found to have indirect effects on nurses' turnover intention and nursing productivity. Conclusion: This structural equational model is a comprehensive theoretical model that explains the related factors and their relationship with nursing productivity. Comprehensive organizational interventions to improve nursing productivity should focus on improving the nursing work environment. Findings from this study can be used to design appropriate strategies to decrease nurse turnover in Korea. Further studies are needed to prospectively verify these causal relationships with larger samples.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.437-445
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• 1994

The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE III scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE III score rised (p<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. When the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. When we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (p<0.05).

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.133-136
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• 2010

Purpose: The aim of this study was to evaluate the effectiveness of our retraction method for achieving a good operative field for the adequate lymph node dissection during laparoscopic gastrectomy in view of short term surgical outcome. Materials and Methods: This study prospectively enrolled 19 patients who underwent laparoscopic gastrectomy for early gastric cancer. The procedure was simply performed by putting the laparoscopic sigle suture in the phrenoesophageal ligament, and then the string was pulling and tying over the sternum. Surgical outcomes of these patients were evaluated. Results: Under V-shaped liver retraction, the mean operating time and mean number of retrieved lymph nodes was 166.3 minute and 31.37, respectively. And the results were satisfactory compared to open or conventional laparoscopic gastric surgery. Conclusions: V-shaped liver retraction requires no extra port or assistant's hands, and prevents additional injury to any intra-abdominal organ. And this method can easily, efficiently and safely enable to achieve a good operative field for the lymph node dissection near the lesser curvature of the stomach.