Journal of Yeungnam Medical Science

Original articles

Anesthesiology and Pain Medicine
Effect of intraoperative music on quality of recovery after arthroscopic knee surgery: a prospective, double-blind, randomized controlled trial: Ji yong Yeom, Soomin Kim, Hyeon Seung Yi, Juhee Min, Eun Kyung Choi; J Yeungnam Med Sci. 2026;43:29. Published online April 9, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.29 [Epub ahead of print]

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Abstract PDF: Background
Various perioperative therapeutic strategies have been used to minimize postoperative complications and enhance recovery. Music intervention has attracted increasing attention as a safe, noninvasive, and cost-effective approach with potential benefits for patient-centered postoperative outcomes. Accordingly, this study investigated the effect of intraoperative music on postoperative recovery quality, as assessed using the Quality of Recovery-40 (QoR-40) questionnaire, as well as its potential analgesic and antiemetic effects in patients undergoing arthroscopic knee surgery.
Methods
Eighty-two patients were enrolled and allocated to either the music or control group. In the music group, patient-selected tracks were delivered intraoperatively via headphones. Postoperative recovery quality was assessed using the QoR-40 at 24 hours. Pain was evaluated 30 minutes, 2 hours, and 24 hours after arrival in the post-anesthesia care unit. The incidence of postoperative nausea and vomiting (PONV) was recorded at all time points.
Results
Although the total QoR-40 scores did not differ between the groups, the music group demonstrated significantly higher physical comfort scores (p=0.006). The incidence of PONV at 24 hours was lower in the music group (p=0.048), whereas the postoperative pain scores and rescue analgesic requirements showed no significant differences at any assessment point.
Conclusion
In patients undergoing arthroscopic surgery, intraoperative music was associated with improvements in physical comfort and PONV, despite no significant difference in the total QoR-40 score.

Anesthesiology and Pain Medicine
Quadratus lumborum block for postoperative pain management in patients undergoing ileostomy closure: a prospective, randomized controlled trial: Su Jin Kang, Soo Yeun Park, Jun Seok Park, Jinseok Yeo; J Yeungnam Med Sci. 2026;43:5. Published online December 19, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.5

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Abstract PDF: Background
Quadratus lumborum (QL) block is used for multimodal analgesia following abdominal surgery. We introduced an ultrasound-guided QL block to treat postoperative pain for ileostomy closure. This study aimed to investigate the analgesic efficacy of the QL block compared to placebo after ileostomy closure.
Methods
Fifty-seven patients undergoing elective ileostomy closure were randomized (1:1) to the placebo or QL block group in this double-blind randomized controlled trial. After general anesthesia, a unilateral QL block was performed under ultrasound guidance. Opioid consumption and numeric rating scale (NRS, 0–10) pain scores were recorded at 2, 6, 12, 24, 48, and 72 hours postoperatively. The primary outcome was the NRS pain score at rest at 6 hours. Secondary outcomes included pain scores, rescue analgesics over 72 hours, Quality of Recovery-15 scores in 24 hours, complications, and length of hospital stay.
Results
Baseline characteristics were similar among the 54 patients (27 per group) who completed the study, excluding three who dropped out. The QL block did not reduce NRS pain scores at rest at 6 hours (median [interquartile range], 5 [4–6] vs. 5 [3–6]; p=0.78). Over the 72-hour postoperative period, pain scores at rest remained comparable between the groups, while the QL group showed slightly lower movement-induced pain at certain time points. The QL group required fewer analgesics and antiemetics at certain intervals, but the total opioid use, length of hospital stay, and quality of recovery were not significantly different.
Conclusion
The QL block showed no meaningful advantage in postoperative analgesia compared to placebo for ileostomy closures.

Review articles

Anesthesiology and Pain Medicine
Regional analgesia for postoperative pain control after thoracic surgery: a narrative review: Sang-Jin Park, Eun Kyung Choi; J Yeungnam Med Sci. 2025;42:80. Published online December 4, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.80

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Abstract PDF: Effective management of post-thoracotomy pain is essential to prevent pulmonary complications and reduce the risk of developing chronic pain syndrome. Although systemic opioids remain a common option, their use is limited by significant adverse effects, making regional analgesia the cornerstone of postoperative pain management. Thoracic epidural analgesia, historically regarded as the gold standard, provides potent postoperative pain relief but carries risks of hypotension and, in rare cases, severe neurological events. Thoracic paravertebral block (PVB) has emerged as the primary alternative, offering comparable analgesic efficacy and an improved safety profile, particularly in maintaining hemodynamic stability. However, PVB is technically demanding and associated with a higher failure rate and localized procedural complications such as pneumothorax. Fascial plane blocks have recently been developed to prioritize safety. The erector spinae plane block is technically simpler, using the transverse process as a “bony backstop” to minimize the risk of pleural injury; however, its analgesic potency may be lower than that of PVB. The intertransverse process block seeks to combine the efficacy of PVB with enhanced safety; however, supporting evidence remains limited. Alternative regional techniques, such as serratus anterior plane block, intercostal nerve block, and continuous wound instillation, typically provide insufficient analgesia for the comprehensive pain associated with open thoracotomy. No regional analgesic technique has demonstrated universal superiority. The optimal approach should be individualized, balancing the distinct risk–benefit profile of each block with patient comorbidities, surgical factors, and institutional expertise.

Physical therapy, Sports Therapy, and Rehabilitation
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review: Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden; J Yeungnam Med Sci. 2024;41(4):235-251. Published online August 22, 2024; DOI: https://doi.org/10.12701/jyms.2024.00521

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Abstract PDF

Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

Citations

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The Role of Pulmonary Rehabilitation in Lung Transplantation for Cystic Fibrosis
Esra Pehlivan
OBM Transplantation.2025; 09(01): 1. CrossRef
Early mobilization after lung transplantation: A scoping review protocol
Matthieu Reffienna, Adéla Foudhaïli, Colin Sidre, Damien Vitiello, Jonathan Messika
MethodsX.2025; 14: 103404. CrossRef
Seven-day rehabilitation services in hospital settings: benefits and drawbacks
Massimiliano Polastri, Luciana Scuotto
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Original articles

Nutrition and Dietetics
Impact of Controlling Nutritional Status score on short-term outcomes after carotid endarterectomy: a retrospective cohort study: Hee Won Son, Gyeongseok Yu, Seung Jun Lee, Jimi Oh; J Yeungnam Med Sci. 2023;40(3):259-267. Published online October 26, 2022; DOI: https://doi.org/10.12701/jyms.2022.00507

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Abstract PDF

Background
Malnutrition and impaired immune responses significantly affect the clinical outcomes of patients with atherosclerotic stenosis. The Controlling Nutritional Status (CONUT) score has recently been utilized to evaluate perioperative immunonutritional status. This study aimed to evaluate the relationship between immunonutritional status, indexed by CONUT score, and postoperative complications in patients undergoing carotid endarterectomy (CEA).
Methods
We retrospectively evaluated 188 patients who underwent elective CEA between January 2010 and December 2019. The preoperative CONUT score was calculated as the sum of the serum albumin concentration, total cholesterol level, and total lymphocyte count. The primary outcome was postoperative complications within 30 days after CEA, including major adverse cardiovascular events, pulmonary complications, stroke, renal failure, sepsis, wounds, and gastrointestinal complications. Cox proportional hazards regression analysis was used to estimate the factors associated with postoperative complications during the 30-day follow-up period.
Results
Twenty-five patients (13.3%) had at least one major complication. The incidence of postoperative complications was identified more frequently in the high CONUT group (12 of 27, 44.4% vs. 13 of 161, 8.1%; p<0.001). Multivariate analyses showed that a high preoperative CONUT score was independently associated with 30-day postoperative complications (hazard ratio, 5.98; 95% confidence interval, 2.56–13.97; p<0.001).
Conclusion
Our results showed that the CONUT score, a simple and readily available parameter using only objective laboratory values, is independently associated with early postoperative complications.

Citations

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The relationship between controlling nutritional status (CONUT) and cerebrovascular stenosis: a retrospective study with implications for ischemic stroke prevention
Ning Wang, Kun Guo, Bo Zhu, Yuanzhi Zhang, Xiaotao Jia, Zhiqin Liu, Zhengli Di, Naibing Gu, Ting Li
PeerJ.2026; 14: e20968. CrossRef

Anesthesiology and Pain Medicine
Comparison of the efficacy of erector spinae plane block according to the difference in bupivacaine concentrations for analgesia after laparoscopic cholecystectomy: a retrospective study: Yoo Jung Park, Sujung Chu, Eunju Yu, Jin Deok Joo; J Yeungnam Med Sci. 2023;40(2):172-178. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00500

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Abstract PDF

Background
Laparoscopic cholecystectomy (LC) is a noninvasive surgery, but postoperative pain is a major problem. Studies have indicated that erector spinae plane block (ESPB) has an analgesic effect after LC. We aimed to compare the efficacy of different ESPB anesthetic concentrations in pain control in patients with LC.
Methods
This retrospective study included patients aged 20 to 75 years scheduled for LC with the American Society of Anesthesiologists physical status classification I or II. ESPB was administered using 0.375% bupivacaine in group 1 and 0.25% in group 2. Both groups received general anesthesia. Postoperative tramadol consumption and pain scores were compared and intraoperative and postoperative fentanyl requirements in the postanesthesia care unit (PACU) were measured.
Results
Eighty-five patients were included in this analysis. Tramadol consumption in the first 12 hours, second 12 hours, and total 24 hours was similar between groups (p>0.05). The differences between postoperative numeric rating scale (NRS) scores at rest did not differ significantly. The postoperative NRS scores upon bodily movement were not statistically different between the two groups, except at 12 hours. The mean intraoperative and postoperative fentanyl requirements in the PACU were similar. The difference in the requirement for rescue analgesics was not statistically significant (p=0.788).
Conclusion
Ultrasound-guided ESPB performed with different bupivacaine concentrations was effective in both groups for LC analgesia, with similar opioid consumption. A lower concentration of local anesthetic can be helpful for the safety of regional anesthesia and is recommended for the analgesic effect of ESPB in LC.

Citations

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Comparison of erector spinae plane block and rhomboid intercostal block for postoperative pain management in patients undergoing unilateral breast surgery
Gülnihal Avcı, Sevim Cesur Okan, Hadi Ufuk Yörükoğlu, Can Aksu, Alparslan Kuş
BMC Anesthesiology.2026;[Epub] CrossRef
Overview of ultrasound-guided plane blocks performed within the scope of multimodal anesthesia applications in lower and upper abdominal surgeries
Mert Yetgin, Hülya Sungurtekin, Hale Yetgin
Pamukkale Medical Journal.2025; 18(4): 21. CrossRef
Surgeon-Delivered Bupivacaine Achieves Analgesic Efficacy Comparable to ESP and TAP Blocks in Laparoscopic Cholecystectomy: A Randomized Controlled Trial
Melih Can Gül, Ramazan Koray Akbudak
Surgeries.2025; 6(4): 90. CrossRef
Bilateral erector spinae plane block on opioid-sparing effect in upper abdominal surgery: study protocol for a bi-center prospective randomized controlled trial
Changzhen Geng, Li Wang, Yaping Shi, Xinnan Shi, Hanyi Zhao, Ya Huang, Qiufang Ji, Yuanqiang Dai, Tao Xu
Trials.2024;[Epub] CrossRef
Erector Spinae Plane Block with 0.375% Bupivacaine vs 0.25% Bupivacaine in Laparoscopic Cholecystectomy Patients: Effect on Postoperative Analgesia, Shoulder Tip Pain, and Postoperative Stress Markers
Mohammad Mohsin, Asna Jamal, Ali Saloda, Kharat M Batt, Shantnu Bhanwala
Research & Innovation in Anesthesia.2024; 9(1): 1. CrossRef

Surgery
Patient outcomes and prognostic factors associated with colonic perforation surgery: a retrospective study: Do-bin Lee, Seonhui Shin, Chun-Seok Yang; J Yeungnam Med Sci. 2022;39(2):133-140. Published online October 29, 2021; DOI: https://doi.org/10.12701/yujm.2021.01445

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Abstract PDF

Background
Despite advances in surgery and intensive perioperative care, fecal peritonitis secondary to colonic perforation is associated with high rates of morbidity and mortality. This study was performed to review the outcomes of patients who underwent colonic perforation surgery and to evaluate the prognostic factors associated with mortality.
Methods
A retrospective analysis was performed on 224 consecutive patients who underwent emergency colonic perforation surgery between January 2008 and May 2019. We divided the patients into survivor and non-survivor groups and compared their surgical outcomes.
Results
The most common cause of colon perforation was malignancy in 54 patients (24.1%), followed by iatrogenic perforation in 41 (18.3%), stercoral perforation in 39 (17.4%), and diverticulitis in 37 (16.5%). The sigmoid colon (n=124, 55.4%) was the most common location of perforation, followed by the ascending colon, rectum, and cecum. Forty-five patients (20.1%) died within 1 month after surgery. Comparing the 179 survivors with the 45 non-survivors, the patient characteristics associated with mortality were advanced age, low systolic blood pressure, tachycardia, organ failure, high C-reactive protein, high creatinine, prolonged prothrombin time, and high lactate level. The presence of free or feculent fluid, diffuse peritonitis, and right-sided perforation were associated with mortality. In multivariate analysis, advanced age, organ failure, right-sided perforation, and diffuse peritonitis independently predicted mortality within 1 month after surgery.
Conclusion
Age and organ failure were prognostic factors for mortality associated with colon perforation. Furthermore, right-sided perforation and diffuse peritonitis demonstrated a significant association with patient mortality.

Citations

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Risk factor analysis and nomogram model construction for mortality in patients following colonic perforation surgery
Xiu-Juan Xu, Hou-Dao Zhang, Chu-Ji Cheng, Ya-Ming Zhang, Qi Zhang
World Journal of Gastrointestinal Surgery.2026;[Epub] CrossRef
Cecal Perforation Presenting as Apparent Peritoneal Carcinomatosis: Distinguishing Acute Peritonitis From Malignant Mimicry
Newton Rahming, Norah Daghestani, Shinelle De Almeida, Imad N Farhat, Mhadhumithaa Naresh, Frederick Tiesenga
Cureus.2026;[Epub] CrossRef
Retroperitoneal Abscess Revealing Ascending Colon Adenocarcinoma: A Case Report
Evangelia Dimitrakopoulou, Paraskevas Stamopoulos, Grigorios Mitsopoulos, Ourania Batsi, Ioannis Kaklamanos
Cureus.2025;[Epub] CrossRef
Stercoral perforation of the colon: a report of two cases with different anatomic locations and prognostic outcomes
Melike Zeynep Can Sahin, Cisil Bayir, Aysenur Yildiz, Muhammer Ergenc
Journal of Trends in Medical Investigation.2025; 1(1): 24. CrossRef
A sharp plant stem causing terminal ileal perforation with clinical presentation resembling acute appendicitis: a case report
Pirada Yincharoen, Weeratian Tawanwongsri
Frontiers in Medicine.2025;[Epub] CrossRef
Colorectal Oncologic Emergencies
Joshua Sullivan, Alec Donohue, Shaun Brown
Surgical Clinics of North America.2024; 104(3): 631. CrossRef
Risk Factors for Postoperative Major Morbidity, Anastomotic Leakage, Re-Surgery and Mortality in Patients with Colonic Perforation
Maximilian Brunner, Lara Gärtner, Andreas Weiß, Klaus Weber, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann
Journal of Clinical Medicine.2024; 13(17): 5220. CrossRef
Evaluation of Morbidity and Mortality in Iatrogenic Colonic Perforation During Colonoscopy: A Comprehensive Systematic Review and Meta-Analysis
Ajibola A Adebisi, Daniel E Onobun, Adeola Adediran, Reginald N Ononye, Ethel O Ojo, Adedayo Oluyi, Ayotunde Ojo, Stephen Oputa
Cureus.2024;[Epub] CrossRef
One Year of Experience Managing Peritonitis Secondary to Gastrointestinal Perforation at a Tertiary Care Hospital: A Retrospective Analysis
Muhammad Hasaan Shahid, Faisal I Khan, Zain Askri, Arslan Asad, M. Azhar Alam, Danish Ali, Rabia Saeed, Aun Jamal, Tauseef Fatima, M. Farooq Afzal
Cureus.2022;[Epub] CrossRef
Risk factors for urgent complications of colorectal cancer
S. N. Shchaeva
Surgery and Oncology.2022; 12(2): 28. CrossRef

Nephrology
Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery: Yoo Jin Lee, Bong Soo Park, Sihyung Park, Jin Han Park, Il Hwan Kim, Junghae Ko, Yang Wook Kim; Yeungnam Univ J Med. 2021;38(2):136-141. Published online October 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00542

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Abstract PDF

Background
Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery.
Methods
This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016.
Results
AKI occurred in 13 (3.7%) of the 351 patients. The patients’ preoperative estimated glomerular filtration rate (eGFR) was 66.66±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02–0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61–0.89; p=0.002).
Conclusion
Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

Citations

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The sustained benefits of gram-negative antimicrobial prophylaxis in total hip arthroplasty: a 10-year retrospective analysis
Itay Ashkenazi, Weston Buehring, Armin Arshi, Vinay K Aggarwal, Joseph A Bosco, Ran Schwarzkopf
HIP International.2026; 36(1): 18. CrossRef
Osteoarthritis is a risk factor for renal function injury based on the National Health and Nutrition Examination Survey and Mendelian Randomized study
Liang Pang, Kai Wu, Yibo Zhu, Qianwei Wang, Zhihui Zheng, Cunxian Lv, Zhancheng Bao
Scientific Reports.2025;[Epub] CrossRef
Supplemental oxygen is associated with increased complications and readmission following total shoulder arthroplasty
Nikhil Vallabhaneni, Alexander S. Guareschi, Josef K. Eichinger, Richard J. Friedman
Seminars in Arthroplasty: JSES.2023; 33(3): 512. CrossRef
Acute kidney injury after primary total hip replacement
M. L. Lebed, M. G. Kirpichenko, E. V. Novikova, T. G. Lebed, A. V. Mankov
Acta Biomedica Scientifica.2023; 8(5): 125. CrossRef

Review article

Urology
Frailty and elderly in urology: implications for postoperative complications: Phil Hyun Song; Yeungnam Univ J Med. 2020;37(4):296-301. Published online October 8, 2020; DOI: https://doi.org/10.12701/yujm.2020.00752

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Abstract PDF

The geriatric population is at a greater risk of postoperative complications than young adults. This risk is associated with the physiologic decline seen in this population known as frailty. Unlike fitter patients, frail patients who undergo operative treatment have a greater likelihood of developing postoperative complications and endure prolonged hospital stays. This circumstance is comparable to the urological status. Therefore, tolerable measurement of frailty as a domain of preoperative health status has been suggested to ascertain vulnerability in elderly patients. In this review, we will elaborate on the concept of frailty and examine its importance with respect to surgical complications, focusing on the urological status.

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Frailty and surgical outcomes in genitourinary prosthetic procedures: an ACS-NSQIP comparative analysis of risk indices
Umar Ghaffar, Behzad Abbasi, Nizar Hakam, Adrian Fernandez, Marvin N. Carlisle, Robert Pearce, Hiren V. Patel, Kevin D. Li, Nikit Venishetty, Benjamin N. Breyer
International Urology and Nephrology.2025; 57(9): 2885. CrossRef

Case report

Anesthesiology and Pain Medicine
Diplopia developed by cervical traction after cervical spine surgery: Ji-Yoon Kim, Hyuna Kim, So Jeong Kang, Hyunjee Kim, Young-Seok Lee; Yeungnam Univ J Med. 2021;38(2):152-156. Published online July 29, 2020; DOI: https://doi.org/10.12701/yujm.2020.00241

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Abstract PDF

Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1–C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient’s symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient’s fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

Citations

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Transient internuclear ophthalmoplegia following anterior cervical discectomy and fusion
Kevin N. Cordeiro, Garret P. Greeneway, Paul S. Page, Nathaniel P. Brooks
Surgical Neurology International.2022; 13: 527. CrossRef

Original article

Orthopedics and Sports Medicine
Correlation between anterior thigh pain and morphometric mismatch of femoral stem: Haksun Chung, So Hak Chung; Yeungnam Univ J Med. 2020;37(1):40-46. Published online September 16, 2019; DOI: https://doi.org/10.12701/yujm.2019.00325

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Abstract PDF

Background
Postoperative pain occurring after hip arthroplasty has become common since the expanded use of cementless femoral stems. The characteristic pain develop in the anterolateral thigh area. This study aimed to predict anterior thigh pain based on the measurements of postoperative anteroposterior (AP) and lateral (Lat) radiographs of the hip joint.
Methods
The present study included 26 patients (29 hips) who underwent total hip replacement or bipolar hemiarthroplasty between March 2010 and May 2016, whose complete clinical information was available. AP and Lat radiographs of the affected hip were taken on the day of surgery and 1 and 6 months postoperatively. Patients with improper radiographs were excluded. The distance from the femoral stem to the nearest cortical bone in the distal region of the stem was measured. The patient group with a visual analog scale (VAS) score of ≥6 points was designated as patients with anterior thigh pain.
Results
Sex, age, weight, height, body mass index, and bone mineral density in the lumbar spine and femur did not have a significant effect on postoperative VAS scores (p>0.05). Presence of contact between the femoral stem and cortical bone was associated with postoperative anterior thigh pain.
Conclusion
Hip AP and Lat radiographs are usually taken to confirm fixation and alignment of the femoral stem after hip arthroplasty. The measurement method introduced in this study can be utilized for predicting anterior thigh pain after hip arthroplasty.

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Hydroxyapatite ceramic-coated femoral components in younger patients followed up for 27 to 32 years
Piyush K. Upadhyay, Nirav Shah, Vishal Kumar, Saqeb B. Mirza
Bone & Joint Open.2024; 5(4): 286. CrossRef
Mid-Term Outcomes of a Short Modular Neck-Preserving Cementless Hip Stem: A Retrospective Study With a 6-Year Minimum Follow-Up
Michele Carnovale, Daniele De Meo, Giovanni Guarascio, Paolo Martini, Gianluca Cera, Pietro Persiani, Vittorio Candela, Stefano Gumina, Ciro Villani
Arthroplasty Today.2024; 27: 101387. CrossRef

Original Articles

Urology
Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length: Geon Woo Lim, Young Dong Yu, Kyung Hwa Choi, Seung Ryeol Rhee, Dong Soo Park, Young Kwon Hong; Yeungnam Univ J Med. 2018;35(2):179-186. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.179

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Abstract PDF

Background
To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.
Methods
A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation.
Results
The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis.
Conclusion
Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

Citations

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Mechanical characteristics of the ureter and clinical implications
Sorcha O’Meara, Eoghan M. Cunnane, Stefanie M. Croghan, Connor V. Cunnane, Michael T. Walsh, Fergal J. O’Brien, Niall F. Davis
Nature Reviews Urology.2024; 21(4): 197. CrossRef
Analysis of the Efficacy and Risk Factors for Failure of Balloon Dilation for Benign Ureteral Stricture
Bing Wang, Wenzhi Gao, Kunlin Yang, Honglei Liu, Yangjun Han, Mingxin Diao, Chao Zuo, Minghua Zhang, Yingzhi Diao, Zhihua Li, Xinfei Li, Gang Wang, Peng Zhang, Chunji Wang, Chunjuan Xiao, Chen Huang, Yaming Gu, Xuesong Li
Journal of Clinical Medicine.2023; 12(4): 1655. CrossRef
Left-sided flap transposition of the appendix for urethroplasty in oncourology
A. K. Nosov, D. I. Rumyantseva, E. M. Mamizhev, P. A. Lushina, N. A. Shchekuteev, M. V. Berkut
Cancer Urology.2022; 18(1): 127. CrossRef

Anesthesiology and Pain Medicine
Effect of preoperative pregabalin on postoperative pain after gastrectomy: Chan Yoon Park, Sol Hee Park, Dong Gun Lim, Eun Kyung Choi; Yeungnam Univ J Med. 2018;35(1):40-44. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.40

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Abstract PDF

Background
Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain.
Methods
Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period.
Results
The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth.
Conclusion
A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

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Treatment of acute postoperative pain in patients undergoing open abdominal aortic repair (current state of the problem)
Anzhelika V. Kozhanova, Georgy P. Plotnikov
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Comparison of premedication with 75 mg and 150 mg pregabalin for postoperative analgesia in total hysterectomy patients - A randomised control trial
Ajish Varghese Cheruvathur, Dilshad Thondi Parambil, Saurabh Vig, Salman Mohammed Kutty Chenath, Priyadharshini Nagaraj, Krupa Mulgaonkar, S Jeevithan
Indian Journal of Clinical Anaesthesia.2022; 9(4): 467. CrossRef

Surgery
The Comparison of Survival Rates of Postoperative Adjuvant Chemotherapies in The Stage III Gastric Cancer Patients.: Eun Mi Kim, Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2006;23(2):193-204. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.193

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Abstract PDF: PURPOSE: Various postoperative adjuvant chemotherapy regimens have been proposed for the patients with advanced gastric cancer. The majority of clinical trials have shown no significant difference in the survival benefit. The aim of this study was to compare the survival rates of postoperative adjuvant chemotherapies used in stage III gastric cancer patients who received curative gastrectomy. MATERIALS AND METHODS: Between 1990 and 1999, a survival analysis was performed in 260 patients who received curative gastric resection and postoperative adjuvant chemotherapy. The patients were divided into four groups according to the chemotherapeutic regimens received. The groups were: the F group: furtulon alone, FM group: furtulon and mitomycin, FAM group: 5-FU, adriamycin and mitomycin, FLEP group: 5-FU, leucovorin, etoposide and cisplatin. The survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: There were no differences among the groups of patients with regard to tumor characteristics except for lymph node metastasis and the ratio of metastasis to lymph nodes. In the FLEP group, the ratio of metastasis to lymph nodes was higher than in the other groups. The five and ten year survival rates of F, FM, FAM and FLEP were 51.9%, 28.9%, 59.5%, 49.8%, 66.1%, 57.4% and 30.0%, 27.5%, respectively. The univariate analysis showed that age, Borrmann type, lymph node metastasis, ratio of metastasis to lymph nodes, postoperative adjuvant chemotherapy and recurrence were significant factors for survival. For the multivariate analysis, recurrence, age, Borrmann type, ratio of lymph node metastasis and lymph node dissection were independent prognostic factors; however, the postoperative adjuvant chemotherapy was not an independent prognostic factor. CONCLUSION: The FAM regimen was the most beneficial postoperative adjuvant chemotherapy for improved survival rates; the FM regimen was the second and the FLEP regimen was the last. In order to determine the effectiveness of postoperative adjuvant chemotherapy in stage III gastric cancer, well designed prospective studies including a surgery only group will be needed.

Case Report

Anesthesiology and Pain Medicine
Acute Postoperative Pulmonary Edema without Reasonable Causes: A Case Report.: Ji Hoon Jeong, Hyung Jun Lim, Sung Min Lee, Dae Lim Jee; Yeungnam Univ J Med. 2004;21(1):114-119. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.114

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Abstract PDF: This report concerns an unusual case of acute postoperative pulmonary edema without any apparent causes in a 45-year-old man. The patient was subjected to the removal of a previously placed device on the left tibia, and the excision of a benign mass on the right forearm. Unexpected acute bilateral pulmonary edema occurred immediately after the completion of the procedures. The etiologies were reviewed in relation to the patient's condition and clinical manifestations. Fluid overloading was excluded as a cause in view of the patient's perioperative state and postoperative chest X-ray results. We could not find any symptoms of upper airway obstruction during emergence from general anesthesia. We had doubts about tourniquet or fentanyl-induced pulmonary edema, but these factors were not sufficient to bring about pulmonary edema in this case. To our knowledge, the cause of acute pulmonary edema in this case is indeterminate.

Original Article

Radiation Oncology
A study of dose distribution in postoperative radiotherapy in uterine cervical cancer.: Sei One Shin, Sung Kyu Kim, Myung Se Kim; Yeungnam Univ J Med. 1991;8(1):166-177. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.166

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Abstract PDF: Uterine cervical cancer is the most common malignancy in Korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications cannot be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analyzed to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that out treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.

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