• 간호행정학회지
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• 제21권3호
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• pp.233-242
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• 2015

Purpose: This was a correlational study to identify effects of perception of clinical ladder system on job satisfaction and intention to leave in perioperative nurses. Methods: Participants were 154 of perioperative nurses from larger general hospitals in Seoul. Data were collected from April, 16 to 22, 2013 using self-report questionnaires which included items on perception of clinical ladder system, job satisfaction, and intention to leave. Data were analyzed using frequency, t-test, ANOVA, $Scheff{{\acute{e}}$ test, Pearson correlation coefficients, and multiple stepwise regression. Results: The average mean score for perception of clinical ladder system was midline at 2.69 point out of 4 point. Perception of clinical ladder system correlated positively with job satisfaction (r=.38, p<.01) and negatively with intention to leave (r=-.88, p<.01). Perception of clinical ladder system was the factor which most influenced job satisfaction explaining 17.1% of the variance, also perception of clinical ladder system was the factor which most influenced intention to leave, explaining 12.7% of the variance. Conclusion: Results of this study suggest that there is a need to enhance the perception of the clinical ladder system and to find ways to fulfill the expected effects for improving perioperative nurses' job satisfaction and reducing the intention to leave.

• The Korean Journal of Pain
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• 제19권2호
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• pp.218-222
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• 2006

Complex regional pain syndrome (CRPS) is a syndrome of pain and sudomotor or vasomotor instabilities. The perioperative pain management in CRPS patients is very important, as surgery can aggravate preexisting symptoms, especially when performed around the lesion site. Despite the increasing interest in CRPS research, little is known about the optimal perioperative treatment strategy for CRPS patients. Herein, the case of a female CRPS patient, who underwent elective surgery at the lesion site, is reported. As a preemptive analgesia, the patient was satisfactorily managed with two weeks of patient-controlled epidural analgesia, initiated 2 days prior to surgery. The techniques for the prevention of perioperative pain, including preemptive analgesia, as well as its importance, are discussed.

• Journal of Chest Surgery
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• 제31권1호
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• pp.7-12
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• 1998

1994년 1월부터 1996년 7월까지 관상동맥 우회로 이식술을 받았던 87명을 대상으로 수술후 심근경색의 진단에 있어서 심전도 검사의 가치를 평가해 보았고 심전도에 의해 진단된 심근경색의 위험인자에 대해 조사하였다. CK-MB 최고치의 평균과 LDH1/LDH2의 비가 1이상인 경우의 빈도는 new Q파군, ST변화군 및 심전도상 변화가 없는군 간에 유의한 차이가 있었다. 심전도상 new Q파 또는 48시간이상 지속되는 ST절 변화가 있을 때 심근경색으로 진단하였다. 병원 사망률은 3.3%이며, 술후 심근경색 발생률은 17.2%였다. 술후 심근경색의 중요한 위험인자들은 1) 관상동맥 내막절제술, 2) 좌심실 박출계수의 저하(ejection fraction 40%이하), 3) 대동맥 차단시간의 연장이었고, 좌주관상동맥 질환, 3혈관 질환, 이식혈관이 3개이상인 경우, 불안정형협심증 및 고혈압 등은 술후 심근경색 발생과 연관성이 없었다. 이상에서 관상동맥 우회로 이식술후에 발생하는 심근경색의 진단에 심전도 검사는 유용한 방법이 될 수 있다고 생각된다.

• 동서간호학연구지
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• 제27권1호
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• pp.1-13
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• 2021

Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

• Journal of Gastric Cancer
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• 제19권1호
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• pp.72-82
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• 2019

Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

• Molecules and Cells
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• 제46권9호
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• pp.527-534
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• 2023

Liver ischemia-reperfusion injury (IRI) is the main cause of organ dysfunction and failure after liver surgeries including organ transplantation. The mechanism of liver IRI is complex and numerous signals are involved but cellular metabolic disturbances, oxidative stress, and inflammation are considered the major contributors to liver IRI. In addition, the activation of inflammatory signals exacerbates liver IRI by recruiting macrophages, dendritic cells, and neutrophils, and activating NK cells, NKT cells, and cytotoxic T cells. Technological advances enable us to understand the role of specific immune cells during liver IRI. Accordingly, therapeutic strategies to prevent or treat liver IRI have been proposed but no definitive and effective therapies exist yet. This review summarizes the current update on the immune cell functions and discusses therapeutic potentials in liver IRI. A better understanding of this complex and highly dynamic process may allow for the development of innovative therapeutic approaches and optimize patient outcomes.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.260-266
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• 2023

Background: Knowledge of the base rate of signal changes consistent with distal biceps tendinopathy on magnetic resonance imaging (MRI) has the potential to influence strategies for diagnosis and treatment of people that present with elbow pain. The aim of this study is to measure the prevalence of distal biceps tendon signal changes on MRIs of the elbow by indication for imaging. Methods: MRI data for 1,306 elbows were retrospectively reviewed for mention of signal change in distal biceps tendon. The reports were sorted by indication. Results: Signal changes consistent with distal biceps tendinopathy were noted in 197 of 1,306 (15%) patients, including 34% of patients with biceps pain, 14% of patients with unspecified pain, and 8% of patients with a specific non-biceps indication. Distal biceps tendon changes noted on radiology reports were associated with older age, male sex, and radiologists with musculoskeletal fellowship training. Conclusions: The finding that distal biceps MRI signal changes consistent with tendinopathy are common even in asymptomatic elbows reduces the probability that symptoms correlate with pathology on imaging. The accumulation of signal changes with age, also independent of symptoms, suggests that tendon pathology persists after symptoms resolve, that some degree of distal biceps tendinopathy is common in a human lifetime, and that tendinopathy may often be accommodated without seeking care. Level of evidence: IV.

• 대한간호학회지
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• 제34권6호
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• pp.945-953
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• 2004

Purpose: This study was to explore the experiences of perioperative patients with cancer. The purpose of this inquiry was to describe the essence of such experiences, and to understand them from the patients' point of view. Method: Participants in this study were 9 cancer patients with ages ranging from 31 to 70 years old, living in B city, who experienced cancer operations. Data collection consisted of in-depth interviews and an observation method done from October to December in 2003. In analysing data, Colaizzi's(1978) phenomenological research method was adopted. Results: Five categories emerged from ten theme clusters. The five categories were: 'shock', 'expectations & wishes', 'despair', 'feelings of burden', 'continual pain'. Conclusion: The results of this study showthat oncology nurses need to pay more attention to the psychosocial aspect of nursing to empathize and support the cancer patients who suffer and its treatment, and operations.

• Journal of Gastric Cancer
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• 제18권1호
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• pp.69-81
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• 2018

Purpose: It has been reported that the survival of patients with locally advanced gastric cancer (LAGC) is better in East Asia countries than in developed western countries; however, the prognosis of LAGC remains poor. This study aimed to evaluate the effects of perioperative chemotherapy on the long-term survival of East Asia patients with LAGC. Materials and Methods: From October 2006 through August 2008, 43 patients with LAGC received perioperative S-1 combined with weekly docetaxel in a phase II study (neoadjuvant group). These patients were matched using propensity scores to patients who underwent surgery without neoadjuvant chemotherapy during the same period (surgery group). The surgical outcomes and long-term survivals were compared between the 2 groups. Results: After matching, 43 and 86 patients were included in the neoadjuvant and surgery groups, respectively, and there was no significant difference in their baseline characteristics. Although the operating time was longer in the neoadjuvant group, there was no significant difference in postoperative complications between the 2 groups. The neoadjuvant group had a significantly higher 5-year overall survival (OS) rate (73.3% vs. 51.1%, P=0.005) and a trend towards higher 5-year progression-free survival (PFS) (62.8% vs. 49.9%, P=0.145). In the multivariate analysis, perioperative chemotherapy was an independent factor for OS, with a hazard ratio of 0.4 (P=0.005) and a marginal effect on the PFS (P=0.054). Conclusions: Perioperative chemotherapy was associated with better long-term survival without increasing postoperative complications in the setting of D2 surgery for patients with LAGC, suggesting that perioperative chemotherapy can be a therapeutic option in East Asia countries.

• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.412-418
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• 2010

Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.