• The Korean Journal of Pain
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• 제26권4호
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• pp.361-367
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• 2013

Background: Nefopam is a centrally acting analgesic that is used to control pain. The aim of this study was to find an appropriate dose of nefopam that demonstrates an analgesic effect when administered in continuous infusion with fentanyl at the end of laparoscopic cholecystectomy. Methods: Ninety patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive analgesia with fentanyl alone (50 ${\mu}g$, Group 1, n = 30), or with fentanyl in combination with nefopam 20 mg (Group 2, n = 30) or in combination with nefopam 40 mg (Group 3, n = 30) at the end of surgery. Pain and side effects were evaluated at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours, and 12 hours after arrival in the post-anesthesia care unit (PACU). Results: Pain was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes, 2 hours, and 6 hours after arrival in the PACU. Nausea was statistically significantly lower in Group 2 than in Groups 1 and 3 at 10 minutes after arrival in the PACU. Shivering was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes after arrival in the PACU. Conclusions: Nefopam is a drug that can be safely used as an analgesic after surgery, and its side effects can be reduced when fentanyl 50 ${\mu}g$ is injected with nefopam 20 mg.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권2호
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• pp.115-120
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• 2015

Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent cholecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by comparing a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group. Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was $21.7kg/m^2$, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of overweight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy. Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.295-297
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• 2023

Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

• 대한간호학회지
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• 제40권5호
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• pp.714-723
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• 2010

Purpose: The purpose of this study was to examine the effects of using gauze frozen with normal saline or ice on thirstrelief and oral condition of laparoscopic cholecystectomy patients. Methods: A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=53) received either gauze frozen with normal saline (n=17), ice (n=18) or wet gauze (n=18) for thirst-relief. The subjective thirst level and oral condition of the participants were assessed before the intervention, 15 min after the first intervention and 15 min after the second intervention. Results: After oral care was provided twice, there were significant differences in thirst level among the groups. When oral care was provided twice, the oral condition of tongue, saliva, mucosal membrane, and gingiva was improved in patients receiving gauze frozen with normal saline or ice. Conclusion: Gauze frozen with normal saline and ice can be effective for oral care in reducing the thirst level and improving the condition of the oral cavity.

• 기본간호학회지
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• 제22권3호
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• pp.287-296
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• 2015

Purpose: The purpose of this study was to examine the effects of forced air warming on intraoperative and postoperative body temperature, postoperative shivering and pain in patients undergoing laparoscopic cholecystectomy. Methods: A quasi-experimental design with nonequivalent control group was utilized. Fifty eight patients scheduled for laparoscopic cholecystectomy were recruited and assigned to the experimental group (n=29) or control group (n=29). For the experimental group, forced air warming was applied from right after induction and up to one hour after surgery. Body temperature, shivering score and pain score were measured in both groups at 15 minute intervals. Data were collected from September, 2013 to April, 2014. Data were analyzed using t-test, Bonferroni test and repeated measures ANOVA. Results: The experimental group showed higher body temperature than the control group during surgery. After surgery the experimental group showed higher body temperature, lower shivering and less pain compared to the control group. Conclusion: Results show that forced air warming is effective in enhancing body temperature and reducing shivering and pain. Therefore, forced air warming is recommended as an operative nursing intervention.

• 한국임상수의학회지
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• 제29권4호
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• pp.297-300
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• 2012

본 연구에서는 개에서 일반 개복술을 통한 담낭절제술과 복강경을 이용한 담낭절제술에서 생체 내 산화-항산화 상태에 미치는 영향을 비교 연구하였다. 10 마리의 비글견을 사용하였고 일반 개복술을 통한 담낭절제술군 (group 1, n = 5)과 복강경을 이용한 담낭절제술군 (group 2, n = 5)으로 분류하였다. 심박수, 혈압, 호기말 이산화탄소 분압, 말초 산소포화도, 호흡수를 측정하였다. 산화 스트레스 평가를 위한 총 산화 상태 (total oxidant status, TOS) 및 총 항산화 상태 (total antioxidant status, TAS) 수준이 측정되었다. TAS에 대한 TOS의 비율로 산화 스트레스 지수 (OSI)를 평가하였다. 수술 후에 두 군 모두 TOS, OSI, TAS의 유의성 있는 변화가 관찰되었으나 군 간의 유의성은 없었다. 본 실험을 통해 개에서 일반 개복술을 통한 담낭절제술과 복강경을 이용한 담낭절제술에서 생체 내 산화스트레스 상태에 미치는 영향은 비슷하게 나타났다.

• 대한핵의학회지
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• 제28권1호
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• pp.141-144
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• 1994

내시경 담낭절제술은 개복수술보다 여러가지 장점이 있어서 점차 보편화되는 경향이지만 이에 수반하는 합병증도 여러가지가 발표되고 있으며, 그 가운데 담도손상으로 인한 담즙유출은 재수술을 요한다. 저자들은 43세의 남자와 54세의 여자에서 내시경 담낭절제술후에 발생한 복강내 담즙유출을 $^{99m}Tc$-DISIDA 간담도 스캔으로 확진하고 이의 유용성을 증례와 함께 보고하는 바이다.

• The Korean Journal of Pain
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• 제36권4호
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• pp.476-477
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• 2023

• 대한이식학회지
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• 제28권3호
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• pp.160-164
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• 2014

Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.245-251
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• 2018

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.