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23 "Surgery"
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Original article
Postoperative effects of bariatric surgery on heart rate recovery and heart rate variability
Han Su Park, Kyungwon Seo, Hyeon Soo Kim, Sung il Im, Bong Joon Kim, Bu Kyung Kim, Jung Ho Heo
Kosin Med J. 2022;37(2):119-126.   Published online June 27, 2022
DOI: https://doi.org/10.7180/kmj.22.020
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  • 36 Download
Abstract PDFPubReader   ePub   
Background
Several studies have reported associations between obesity and autonomic dysfunction. However, little research has investigated the effect of bariatric surgery on heart rate recovery (HRR) in the treadmill test and heart rate variability (HRV) in 24-hour Holter monitoring. We investigated the effects of bariatric surgery on HRR and HRV, which are parameters related to autonomic dysfunction.
Methods
We retrospectively investigated patients who underwent bariatric surgery in 2019. The treadmill test, 24-hour Holter monitoring, and echocardiography were performed before and 6 months after surgery. We compared the changes in HRR in the treadmill test and HRV parameters such as the time domain and spectral domain in 24-hour Holter monitoring before and after surgery.
Results
Of the 40 patients who underwent bariatric surgery, 25 patients had the treadmill test or 24-hour Holter monitoring both before and after surgery. Body weight and body mass index significantly decreased after surgery (112.86±24.37 kg vs. 89.10±20.26 kg, p<0.001; 39.22±5.69 kg/m2 vs. 31.00±5.09 kg/m2, p<0.001, respectively). HRR significantly increased (n=23; 43.00±20.97 vs. 64.29±18.49, p=0.001). The time domain of HRV parameters increased (n=21; standard deviation of the N-N interval 123.57±28.05 vs. 152.57±39.49, p=0.002 and mean N-N interval 791.57±88.84 vs. 869.05±126.31, p=0.002).
Conclusions
Our data showed that HRR after exercise and HRV during 24-hour Holter monitoring improved after weight reduction with bariatric surgery through improved cardiac autonomic function.
Case report
A Case of unexpected Fatal Hemoperitoneum in Non-severe Acute Pancreatitis
Seong Jin Choi, Eileen L. Yoon, Jong Ho Lee, Kye Yeon Kim, Soo In Choi, Won-choong Choi
Kosin Med J. 2020;35(1):52-57.   Published online June 30, 2020
DOI: https://doi.org/10.7180/kmj.2020.35.1.52
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Abstract PDFPubReader   ePub   

Acute pancreatitis (AP) severity is determined by associated organ failure (OF). However, enzymatic erosion of peripancreatic vessels can lead to life-threatening hemoperitoneum in clinically non-severe AP without OF. We herein report a case of unexpected hemoperitoneum which developed in a patient with clinically resolving AP without OF. A 36-year-old woman with alcohol use disorder presented with resolving epigastric pain and sustained abdominal distension of 2 weeks’ duration. Ranson’s score on admission was 1 and Computed tomography (CT) revealed non-necrotic AP with peripancreatic fluid collection. She showed sudden hypotension with an abrupt decrease in serum hemoglobin within 24 hours after admission. She was suspected to have an acute hemoperitoneum associated with venous bleeding from AP based on repeated CT. Venous bleeding from the splenic branch was ligated during surgery. The possibility of bleeding at the pancreatic bed should be considered even if the pancreatitis is not severe.

Original articles
Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures
Jae Meen Lee, Beong Ik Hur, Chang Hwa Choi
Kosin Med J. 2019;34(1):30-37.   Published online June 30, 2019
DOI: https://doi.org/10.7180/kmj.2019.34.1.30
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Abstract PDFPubReader   ePub   
Objectives

Trigeminal neuralgia (TN) is undurable paroxysmal pain in the distribution of the fifth cranial nerve. Invasive treatment modalities for TN include microvascular decompression (MVD) and percutaneous procedures, such as, radiofrequency rhizotomy (RFR). Gamma Knife radiosurgery (GKRS) is a considerable option for patients with pain recurrence after an initial procedure. This study was undertaken to analyze the effects of gamma knife radiosurgery in recurrent TN after other procedures.

Methods

Eleven recurrent TN patients after other procedures underwent GKRS in our hospital from September 2004 to August 2016. Seven patients had previously undergone MVD alone, two underwent MVD with partial sensory rhizotomy (PSR), and two underwent RFR. Mean patient age was 60.5 years. We retrospectively analyzed patient's characteristics, clinical results, sites, and divisions of pain. Outcomes were evaluated using the Visual Analog Scales (VAS) score.

Results

Right sides were more prevalent than left sides (7:4). The most common distribution of pain was V1 + V2 division (n = 5) following V2 + V3 (n = 3), V2 (n = 2), and V1 + V2 + V3 (n = 1) division. Median GKRS dose was 80 Gy and the mean interval between the prior treatment and GKRS was 74.45 months. The final outcomes of subsequent GKRS were satisfactory in most cases, and at 12 months postoperatively ten patients (90.0%) had a VAS score of ≤ 3.

Conclusions

In this study, the clinical result of GKRS was satisfactory. Invasive procedures, such as, MVD, RFR are initially effective in TN patients, but GKRS provides a safe and satisfactory treatment modality for those who recurred after prior invasive treatments.

The effect of suture by absorbable material on corneal astigmatism after phacoemulsification
Jae Ho Yoo, Sang Joon Lee
Kosin Med J. 2018;33(3):318-327.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.3.318
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Abstract PDFPubReader   
Objectives

To investigate the effect of absorbable suture on surgically-induced corneal astigmatism in 3.0-mm sclera tunnel cataract surgeries.

Methods

Medical records of patients who underwent phacoemulsification cataract surgery using a 3.0-mm sclera tunnel incision made by a single surgeon were reviewed. Uncorrected distant visual acuity, corneal astigmatism and surgically-induced astigmatism were measured in 56 patients' eyes that underwent sclera tunnel cataract surgery with absorbable sutures (sutured group) and in 23 patients' eyes without sutures (unsutured group). Uncorrected visual acuity, intraocular pressure, slit lamp examination, and automated keratometry were evaluated preoperatively and at 3 days, 2 weeks, 4 weeks, and 8 weeks after cataract operation.

Results

There were no significant differences in preoperative average uncorrected distant visual acuity of the two groups (sutured group: 0.79 ± 0.64, unsutured group: 0.68 ± 0.72, P = 0.145). Corneal astigmatism measured using keratometry in the sutured and unsutured group at postoperative day 3 were 2.27 ± 2.12 D versus 0.83 ± 0.55 D at (P < 0.001), a difference which had disappeared after 4 weeks. Surgically induced astigmatism using the Holladay and Vector methods showed similar outcomes, suggesting that the sutured group exhibited higher astigmatism compared with the unsutured group until 2 weeks post-surgery.

Conclusions

TPatients undergoing scleral tunnel cataract surgery with absorbable sutures have greater surgically induced astigmatism, especially in the early postoperative period, compared with those without sutures. However, this surgically induced astigmatism due to absorbable sutures in scleral tunnel cataract surgery is temporary and disappears at 4 weeks post-surgery.

Usefulness of neutrophil gelatinase-associated lipocalin(NGAL) to confirm subclinical acute kidney injury and renal prognosis in patients following surgery
Se Jun Park, Hoseok Koo, Kyoung Jin Lee, Seo Hyun Kim, Seo Young Yun, Seunghyup Kim, Dong Hee Whang, Shin Young Joo, Byungmo Lee, HoJun Chin, Sihyung Park
Kosin Med J. 2017;32(2):212-220.   Published online January 19, 2017
DOI: https://doi.org/10.7180/kmj.2017.32.2.212
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Abstract PDFPubReader   ePub   
Objectives

The neutrophil gelatinase-associated lipocalin (NGAL) level following non cardiac surgery is useful for predicting acute kidney damage. However, there is insufficient conclusive evidence as to whether NGAL can be used to predict subclinical AKI following non-cardiac surgery.

Methods

We measured serum NGAL and creatinine levels in 41 patients following non-cardiac surgery, and the increase of these variables was used to predict acute decreases in kidney function.

Results

The study included a total of 41 patients. The mean age was 64.65 ± 17.09 years. The serum creatinine concentration was increased 12 hours after surgery. The mean SD serum NGAL decreased after 4hours after surgery and continued to decrease after 12 hours after surgery. The incidence of subclinical AKI determined by the 4 hour serum NGAL level was 10(24.4%), and the incidence of serum creatinine elevation was 0(0.0%). The incidence of subclinical AKI determined by the 12 hour serum NGAL level was 4(9.8%), and the incidence of subclinical AKI determined by serum creatinine was 4(9.8%). The elevation of NGAL was more rapid than the serum creatinine 4 hours after surgery

Conclusions

We verified the usefulness of the serum NGAL level as a predictive factor for subclinical AKI after non-cardiac surgery.

Comparison of survival outcomes between modified radical mastectomy and breast conserving surgery in early breast cancer patients
Yoon Seok Kim, Dong Won Ryu, Chung Han Lee
Kosin Med J. 2016;31(1):19-29.   Published online February 4, 2016
DOI: https://doi.org/10.7180/kmj.2016.31.1.19
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  • 1 Citations
Abstract PDFPubReader   ePub   
Abstract Objectives

Breast conserving surgery (BCS) for early breast cancer is now an accepted treatment, but there are controversies about its comparability with mastectomy. Thus, we investigated the survival outcomes who underwent BCS and modified radical mastectomy (MRM).

Methods

In this retrospective review, we analyzed the survival outcomes of 618 patients with early breast cancer who underwent two different surgery from January 2002 to December 2009. Postoperative pathologic difference, disease free survival period, overall survival period, recurrence pattern, recurrent rate and site were compared. In addition, preoperative patients data are also collected.

Results

Disease free survival period of MRM and BCS was 108.46 months and 80.82 months, respectively (P< 0.01). However, there was no significant correlation between overall survival period and operative methods (P= 0.67). In addition, recurrence pattern (P= 0.21), recurrent rate (P= 0.36) and site (P= 0.45, P= 0.09) were not associated with operative method.

Conclusions

In this study, we can suggest that early breast cancer patients could improve their disease free survival if they underwent MRM. So, when we operate high risk breast cancer patients, MRM could be considered for their disease free life. Further studies may be required to establish appropriate strategy of surgery for early breast cancer.

Citations

Citations to this article as recorded by  
  • Application of Raman spectroscopy in breast cancer surgery
    Yikeun Kim, Sung Ui Jung, Jinhyuk Choi
    Kosin Medical Journal.2023; 38(3): 176.     CrossRef
Simultaneous Laparoscopy-Assisted Resection for Synchronous Colorectal and Gastric Cancer
Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek
Kosin Med J. 2015;30(2):115-121.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.2.115
  • 989 View
  • 2 Download
  • 3 Citations
Abstract PDFPubReader   ePub   
Abstract Objectives

The purpose of this study is to evaluate feasibility and safety of simultaneous laparoscopy-assisted resection for synchronous colorectal and gastric cancer.

Methods

From January 2001 to December 2013, a total of 29 patients underwent simultaneous resection for synchronous colorectal and gastric cancers. Medical records were reviewed, retrospectively.

Results

Eight patients (5 male) underwent laparoscopy-assisted resection (LAP group) and twenty one patients (17 male) underwent open surgery (Open group). In the both group, the mean age (65.2 vs. 63.7 years, p =0.481), body mass index (22.6 vs. 22.3, p = 0.896) was comparable, respectively. In LAP group, laparoscopy-assisted distal gastrectomy was performed for all eight patients. In Open group, subtotal gastrectomy with billroth I gastroduodenostomy was most common procedure (66.7%). The operation time, blood loss volume was similar between the two groups. Gas out was earlier (3.0 vs. 4.6 days p = 0.106), postoperative hospital stay was shorter (12.0 vs. 18.3 days, p = 0.245) in LAP group. The postoperative complications were an ileus, a wound seroma and a bile leakage in LAP group, pneumonia (10.0%), wound bleeding (5.0%) and leakage (5.0%) in Open group.

Conclusions

The simultaneous laparoscopy-assisted resection for synchronous colorectal cancer and gastric cancer is a feasible and safe procedure.

Citations

Citations to this article as recorded by  
  • Minimally invasive treatment of multiple primary tumors of the gastrointestinal tract. Clinical observation
    J. M. Madyarov, A. A. Filatov, A. E. Kulikov, Z. R. Rasulov, L. A. Shestakova, D. A. Chekini, I. N. Iurichev, V. V. Vereshchak, E. N. Puchkova, A. O. Rasulov, R. A. Rasulov
    MD-Onco.2023; 3(3): 29.     CrossRef
  • Simultaneous Treatment of Multifocal Gastric and Sigmoid Colon Carcinoma from Laparoscopic Access: A Case Report
    Oleg V. Zaytsev, Ivan S. Ignatov, Aleksandr Yu. Ogorel'tsev, Sergey V. Bizyayev, Mariya A. Evsyukova, Yuliya B. Li, Maksim A. Yudin, Svetlana V. Snegur, Irina Yu. Bragina, Elena G. Korobova
    I.P. Pavlov Russian Medical Biological Herald.2022;[Epub]     CrossRef
  • Simultaneous Totally Laparoscopic Distal Gastrectomy and Anterior Resection for Synchronous Gastric and Colon Cancer
    Beslen Goksoy
    Cureus.2021;[Epub]     CrossRef
Case report
Simultaneous Laparoscopy-Assisted Resection for Colorectal Cancer and Metastases
Seung Hyun Lee, Joong Jae Yoo, Sung Dal Park, Byung Kwon Ahn, Sung Uhn Baek
Kosin Med J. 2015;30(1):73-79.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.73
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Abstract PDFPubReader   ePub   
Abstract

With advancement of minimal invasive surgery, a simultaneous laparoscopy-assisted resection for colorectal cancer and metastasis has become feasible. Hence, we report three cases of simultaneous laparoscopic surgery for colorectal cancer with liver or lung metastasis. In the first case, laparoscopic right hemicolectomy and left lateral segmentectomy of liver was performed for ascending colon cancer and liver metastasis. In the second case, laparoscopic right hemicolectomy and wedge resection of right lower lung was performed for cecal cancer and lung metastasis. In the third case, laparoscopic right hemicolectomy and wedge resection of left lower lung was performed for ascending colon cancer and lung metastasis. In the first two cases, patients quickly returned to normal activity. In the third case, postoperative bleeding was observed, but spontaneously stopped. There was no postoperative mortality. Simultaneous laparoscopic surgery represents a feasible option for colorectal cancer with metastases on the other organs.

Original articles
Therapeutic comparison of Surgery combined with chemotherapy and chemotherapy alone for Primary Gastrointestinal Lymphoma: A single center study
Je Hun Kim, Ho Sup Lee, Jun Seop Lee, Jin Young Lee, Su Young Kim, Cheol Su Kim, Joung Wook Yang, Ga In You
Kosin Med J. 2015;30(1):29-39.   Published online January 20, 2015
DOI: https://doi.org/10.7180/kmj.2015.30.1.29
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  • 2 Download
Abstract PDFPubReader   ePub   
Abstract Objectives

There is still no consensus on the optimal treatment for primary gastrointestinal lymphoma (PGIL). The aim of this study was to compare surgery combined with chemotherapy and chemotherapy alone in PGIL.

Methods

We retrospectively reviewed and analyzed the treatment outcomes of 107 patients with primary gastrointestinal lymphoma diagnosed between March 1999 and December 2009 at Kosin University Gospel Hospital. Patients were divided into two groups: 35 patients who underwent surgery combined with chemotherapy (group A) and 72 patients who were treated with chemotherapy alone (group B). And we analyzed prognostic factors associated with short survival.

Results

The 5-year progression free survival rates (PFS) of group A and B were 86.7% and 66.1%, respectively (P = 0.037), while the 5-year overall survival rates (OS) were 86.8% and 68.4%, respectively (P = 0.129). In multivariate analysis, Both PFS and OS were not changed by treatment strategies (surgery combined with chemotherapy or chemotherapy only). The international prognostic index (IPI) was the only independent predictive factor for PFS.

Conclusions

In our study, surgery combined with chemotherapy and chemotherapy only make no difference of survival rate. And further randomized prospective studies are needed to confirm a treatment strategies at improving survival outcomes in PGIL patients.

The Safety of Elective Colorectal Surgery without Mechanical Bower Preparation
Chul-Min Lee, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek
Kosin Med J. 2012;27(2):105-110.   Published online December 27, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.2.105
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Abstract PDFPubReader   ePub   
Objectives

To reduce the risk of postoperative infectious complications and anastomotic leakage in colorectal surgery, preoperative mechanical bowel preparation (MBP) is performed routinely. The aim of this study was to evaluate the safety of primary anastomosis in elective colorectal surgery without MBP.

Methods

From Jan. 2005 to Dec. 2006, three hundred and seventy-nine patients of elective colorectal surgery with primary anastomosis were performed with MBP in 352 cases (Prep group) and without MBP in 24 cases (Non-prep group). For preoperative MBP, 4 liters of polyethylene glycol solution was administered. Postoperative infectious complications and other morbidity were reviewed with medical records and prospectively collected data.

Results

Demographic, clinical and treatment characteristics did not differ significantly between the two groups. The overall rate of abdominal infectious complications (wound infection, anastomotic leak) was 2.9 % in the Prep group and 9 % in the Non-prep group (P > 0.05). Anastomotic leak occurred in nine patients (2.6%) in the Prep group and one (4.5%) in the Non-prep group.

Conclusions

The incidence of infectious complications after elective colorectal surgery without MBP did not differ significantly compare to that with MBP. However, prospective, randomized clinical trial is needed to assess the safety of primary anastomosis in elective colorectal surgery without MBP.

Review article
Laparoscopic Hepato-biliary Pancreas Surgery: Current Status
Dong Hoon Shin
Kosin Med J. 2009;24(2):1-7.   Published online December 31, 2009
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Case reports
A Case of Bariatric Surgery during Gastric Cancer Operation
Kyung Hyun Choi, Ki Young Yoon, Hyung Whan Moon, Yeon Myung Shin, Kyung Won Seo, Su Mi Ahn, Yun Mi Song, Jung Hee Seok, Kung Yeon Jeong, Eun Ha Lee
Kosin Med J. 2008;23(3):99-101.   Published online September 30, 2008
  • 195 View
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Treatment of Acute Myocardial Infarction in a Patient with Deformed Chest Wall After Radiation Therapy
Kang Joo Choi
Kosin Med J. 2008;23(3):111-113.   Published online September 30, 2008
  • 255 View
  • 0 Download
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Original article
The preliminary experience of the third generation cryosurgical ablation of the prostate with androgen deprivation therapy
Byung Ju Sung, Jae Min Chung, Seong Choi
Kosin Med J. 2007;22(1):114-119.   Published online June 30, 2007
  • 215 View
  • 0 Download
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Case report
Comparative Analysis in Surgical Treatment of Spondylolisthesis
Jae Do Kim, Jeong Hyun Jo, Dong Seung Lee
The Journal of Kosin Medical College. 1990;6(1):47-63.
  • 221 View
  • 0 Download
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KMJ : Kosin Medical Journal