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영남대학교 의과대학> Journal of Yeungnam Medical Science> Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

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Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

Donghwi Park , Min Cheol Chang
  • : 영남대학교 의과대학
  • : Journal of Yeungnam Medical Science 39권3호
  • : 연속간행물
  • : 2022년 07월
  • : 190-199(10pages)
Journal of Yeungnam Medical Science

DOI


목차

Introduction
Thoracic facet joint injection
Costotransverse joint injection
Thoracic paravertebral block
Intercostal nerve block
Erector spinae plane block
Pectoralis and serratus plane blocks
Conclusion
Notes
References

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초록 보기

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

UCI(KEPA)

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  • : 2384-0293
  • : 학술지
  • : 연속간행물
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KCI등재

1The blind spot and challenges in pain management

저자 : Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 179-180 (2 pages)

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2Pain in amyotrophic lateral sclerosis: a narrative review

저자 : Soyoung Kwak

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 181-189 (9 pages)

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Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

KCI등재

3Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

저자 : Donghwi Park , Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 190-199 (10 pages)

다운로드

(기관인증 필요)

초록보기

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

KCI등재

4The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

저자 : Donghwi Park , Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 200-205 (6 pages)

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(기관인증 필요)

초록보기

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

KCI등재

5The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review

저자 : Aung Chan Thu

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 206-215 (10 pages)

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(기관인증 필요)

초록보기

Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

KCI등재

6A comparative study of the psychological impacts of tasks related and unrelated to COVID-19 on nurses: a cross-sectional study

저자 : Hyun Ji Kim , Geon Ho Lee

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 216-222 (7 pages)

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Background: This study assessed the psychological impact of the outbreak of coronavirus disease 2019 (COVID-19) on university hospital nurses. It provides an assessment of mental health issues, including depression, anxiety, distress, and burnout of nurses dealing directly and indirectly with COVID-19.
Methods: In a web-based, cross-sectional study, 111 nurses from Daegu Catholic University Hospital in Korea were enrolled from August 4 to August 9, 2020. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, and Maslach Burnout Inventory were used to assess the psychological symptoms of depression, anxiety, psychological distress, and burnout among the study participants.
Results: Of 111 nurses, 35 (31.5%), nine (8.1%), 26 (23.4%), and 49 (44.1%) experienced depression, anxiety, distress, and burnout, respectively. Nurses who performed COVID-19-related tasks were more likely to have moderate depression (related vs. unrelated, 52.0% vs. 25.6%; p=0.037). There were no differences in anxiety, distress, and burnout between nurses with and without COVID-19-related tasks. More than 50% of the participants showed receptive and positive attitudes toward caring for COVID-19 patients.
Conclusion: Nurses who performed COVID-19-related tasks had a higher risk of depression. There were no significant differences in anxiety, distress, and burnout between the two groups. Since nurses who perform COVID-19-related tasks are more prone to psychological distress, continued psychiatric interventions are required for infectious disease outbreaks with a high mortality rate for healthcare workers who are emotionally vulnerable.

KCI등재

7Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study

저자 : Kyung-hwa Kwak , Jay Kyoung Kim , Ki Tae Kwon , Jinseok Yeo

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 223-229 (7 pages)

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Background: The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19-related surgical patients.
Methods: We reviewed the medical records of 118 COVID-19-related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19-related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results: One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of -11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19-related patients underwent emergent surgery in the negative-pressure room, including three COVID-19-confirmed patients and five COVID-19-exposed patients.
Conclusion: All surgeries of the COVID-19-related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

KCI등재

8Assessment of normal anal sphincter anatomy using transanal ultrasonography in healthy Korean volunteers: a retrospective observational study

저자 : Daeho Shon , Sohyun Kim , Sung Il Kang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 230-234 (5 pages)

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Background: To date, there have been no studies on the normal anatomic values of the anal sphincter in healthy Koreans. Therefore, this study aimed to determine the normal anatomic values of transanal ultrasonography (TAUS).
Methods: The thickness of the external anal sphincter (EAS) and internal anal sphincter (IAS) was measured by TAUS from healthy Korean volunteers between September 2019 and August 2021.
Results: Thirty-six volunteers with a median age of 37 years (range, 20-77 years) and a median body mass index (BMI) of 23.5 kg/㎡ (range, 17.2-31.2 kg/㎡) were examined. The median thickness of the EAS at 4 cm and 2 cm from the anal verge was 7.4 mm (range, 5.8-8.8 mm) and 6.5 mm (range, 5.6-8.0 mm), respectively. The median thickness of the IAS at 2 cm from the anal verge was 1.8 mm (range, 0.8-4.3 mm). There were no differences in sphincter muscle thickness between the sexes. However, the EAS tended to thicken as the BMI increased (EAS at 2 cm and 4 cm from the anal verge, Spearman rho=0.433, 0.363; p=0.008 and p=0.029, respectively).
Conclusion: In healthy Korean, the median thickness of the IAS at 2 cm from the anal verge was 1.8 mm and the median thickness of the EAS at 2 cm and 4 cm from the anal verge was 6.5 mm and 7.4 mm respectively. There were no differences in anal sphincter thickness between sexes, but BMI was related to EAS thickness.

KCI등재

9Preemptive pyloroplasty for iatrogenic vagus nerve injury in intrahepatic cholangiocarcinoma patients undergoing extensive left-sided lymph node dissection: a retrospective observational study

저자 : Shin Hwang , Dong-hwan Jung , Eun-kyoung Jwa , Yumi Kim

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 235-243 (9 pages)

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Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients.
Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed.
Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month.
Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.

KCI등재

10Effect of nonsurgical periodontal therapy and smoking status on hematological variables related to anemia of chronic disease in chronic periodontitis patient: a case-control study

저자 : Sangita Show , Somen Bagchi , Arka Kanti Dey , Ramanarayana Boyapati , Pritish Chandra Pal , Kanikanti Siva Tejaswi

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 244-249 (6 pages)

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Background: Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking.
Methods: Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation.
Results: The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively).
Conclusion: NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

12
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1The blind spot and challenges in pain management

저자 : Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 179-180 (2 pages)

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2Pain in amyotrophic lateral sclerosis: a narrative review

저자 : Soyoung Kwak

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 181-189 (9 pages)

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Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

KCI등재

3Ultrasound-guided interventions for controlling the thoracic spine and chest wall pain: a narrative review

저자 : Donghwi Park , Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 190-199 (10 pages)

다운로드

(기관인증 필요)

초록보기

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

KCI등재

4The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

저자 : Donghwi Park , Min Cheol Chang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 200-205 (6 pages)

다운로드

(기관인증 필요)

초록보기

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

KCI등재

5The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review

저자 : Aung Chan Thu

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 206-215 (10 pages)

다운로드

(기관인증 필요)

초록보기

Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

KCI등재

6A comparative study of the psychological impacts of tasks related and unrelated to COVID-19 on nurses: a cross-sectional study

저자 : Hyun Ji Kim , Geon Ho Lee

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 216-222 (7 pages)

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초록보기

Background: This study assessed the psychological impact of the outbreak of coronavirus disease 2019 (COVID-19) on university hospital nurses. It provides an assessment of mental health issues, including depression, anxiety, distress, and burnout of nurses dealing directly and indirectly with COVID-19.
Methods: In a web-based, cross-sectional study, 111 nurses from Daegu Catholic University Hospital in Korea were enrolled from August 4 to August 9, 2020. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, and Maslach Burnout Inventory were used to assess the psychological symptoms of depression, anxiety, psychological distress, and burnout among the study participants.
Results: Of 111 nurses, 35 (31.5%), nine (8.1%), 26 (23.4%), and 49 (44.1%) experienced depression, anxiety, distress, and burnout, respectively. Nurses who performed COVID-19-related tasks were more likely to have moderate depression (related vs. unrelated, 52.0% vs. 25.6%; p=0.037). There were no differences in anxiety, distress, and burnout between nurses with and without COVID-19-related tasks. More than 50% of the participants showed receptive and positive attitudes toward caring for COVID-19 patients.
Conclusion: Nurses who performed COVID-19-related tasks had a higher risk of depression. There were no significant differences in anxiety, distress, and burnout between the two groups. Since nurses who perform COVID-19-related tasks are more prone to psychological distress, continued psychiatric interventions are required for infectious disease outbreaks with a high mortality rate for healthcare workers who are emotionally vulnerable.

KCI등재

7Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study

저자 : Kyung-hwa Kwak , Jay Kyoung Kim , Ki Tae Kwon , Jinseok Yeo

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 223-229 (7 pages)

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Background: The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19-related surgical patients.
Methods: We reviewed the medical records of 118 COVID-19-related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19-related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results: One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of -11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19-related patients underwent emergent surgery in the negative-pressure room, including three COVID-19-confirmed patients and five COVID-19-exposed patients.
Conclusion: All surgeries of the COVID-19-related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

KCI등재

8Assessment of normal anal sphincter anatomy using transanal ultrasonography in healthy Korean volunteers: a retrospective observational study

저자 : Daeho Shon , Sohyun Kim , Sung Il Kang

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 230-234 (5 pages)

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Background: To date, there have been no studies on the normal anatomic values of the anal sphincter in healthy Koreans. Therefore, this study aimed to determine the normal anatomic values of transanal ultrasonography (TAUS).
Methods: The thickness of the external anal sphincter (EAS) and internal anal sphincter (IAS) was measured by TAUS from healthy Korean volunteers between September 2019 and August 2021.
Results: Thirty-six volunteers with a median age of 37 years (range, 20-77 years) and a median body mass index (BMI) of 23.5 kg/㎡ (range, 17.2-31.2 kg/㎡) were examined. The median thickness of the EAS at 4 cm and 2 cm from the anal verge was 7.4 mm (range, 5.8-8.8 mm) and 6.5 mm (range, 5.6-8.0 mm), respectively. The median thickness of the IAS at 2 cm from the anal verge was 1.8 mm (range, 0.8-4.3 mm). There were no differences in sphincter muscle thickness between the sexes. However, the EAS tended to thicken as the BMI increased (EAS at 2 cm and 4 cm from the anal verge, Spearman rho=0.433, 0.363; p=0.008 and p=0.029, respectively).
Conclusion: In healthy Korean, the median thickness of the IAS at 2 cm from the anal verge was 1.8 mm and the median thickness of the EAS at 2 cm and 4 cm from the anal verge was 6.5 mm and 7.4 mm respectively. There were no differences in anal sphincter thickness between sexes, but BMI was related to EAS thickness.

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9Preemptive pyloroplasty for iatrogenic vagus nerve injury in intrahepatic cholangiocarcinoma patients undergoing extensive left-sided lymph node dissection: a retrospective observational study

저자 : Shin Hwang , Dong-hwan Jung , Eun-kyoung Jwa , Yumi Kim

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 235-243 (9 pages)

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Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients.
Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed.
Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month.
Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.

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10Effect of nonsurgical periodontal therapy and smoking status on hematological variables related to anemia of chronic disease in chronic periodontitis patient: a case-control study

저자 : Sangita Show , Somen Bagchi , Arka Kanti Dey , Ramanarayana Boyapati , Pritish Chandra Pal , Kanikanti Siva Tejaswi

발행기관 : 영남대학교 의과대학 간행물 : Journal of Yeungnam Medical Science 39권 3호 발행 연도 : 2022 페이지 : pp. 244-249 (6 pages)

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Background: Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking.
Methods: Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation.
Results: The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively).
Conclusion: NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

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