1.Anesthetic Experience of Dynamic Cardiomyoplasty: A case report.
Jin Hyung KWON ; Do Hyun KWON ; Young Rae CHO
Korean Journal of Anesthesiology 1997;33(1):162-166
Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult
;
Anesthesia
;
Cardiomyoplasty*
;
Cardiopulmonary Bypass
;
Exercise Tolerance
;
Fentanyl
;
Heart
;
Heart Failure
;
Hemodynamics
;
Humans
;
Intensive Care Units
;
Isoflurane
;
Male
;
Midazolam
;
Muscle, Skeletal
2.Safety of intravenous thrombolysis in embolic stroke by infective endocarditis
Jin-Man Jung ; Moon Ho Park ; Do-Young Kwon
Neurology Asia 2013;18(2):209-211
Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue
plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has
been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert
consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous
t-PA, who was later diagnosed with infective endocarditis.
3.A case of intracranial aneurysm and subarachnoid hemorrhage with tuberculous meningitis
Jee-Hoon Roh ; Do Young Kwon ; Moon Ho Park
Neurology Asia 2011;16(2):157-161
A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis,
treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular
complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because
of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid
hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman
who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant
tuberculous meningitis. She remained well with medical management.
4.Follow-up of herniated neucleus pulposus by MRI: report of three cases with lumbar radiculopathy.
Do Youn KWON ; Yong Hyun NAM ; In Young SEONG
Journal of the Korean Academy of Rehabilitation Medicine 1993;17(2):274-279
No abstract available.
Follow-Up Studies*
;
Magnetic Resonance Imaging*
;
Radiculopathy*
5.A Comparison of Inhalation Anesthesia with Enflurane and Intravenous Anesthesia with Ketamine Hydrochloride in Lung Surgery of Patients with Decreased Pulmonary Function.
Do Hyun KWON ; Hee Kwon PARK ; Keun Seok MO ; Kyung Cheon LEE ; Young Rae CHO
Korean Journal of Anesthesiology 1997;33(3):447-452
BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia
;
Anesthesia, Inhalation*
;
Anesthesia, Intravenous*
;
Blood Gas Analysis
;
Blood Pressure
;
Enflurane*
;
Heart Rate
;
Humans
;
Inhalation*
;
Intraoperative Period
;
Ketamine*
;
Lung*
;
Mortality
;
Perioperative Period
;
Preoperative Period
;
Recovery Room
6.Anesthesia for Heart Transplantation in a Jehovah,s Witness: A case report.
Jin Hyung KWON ; Do Hyun KWON ; Young Rae CHO
Korean Journal of Anesthesiology 1997;32(6):1023-1027
Jehovah,s Witnesses who require operation represent a challenge to the physician because of the patient,s refusal to accept blood transfusion. An orthotopic heart transplantation was succesfully performed in a 40-year old Jehovah,s Witness without use of any blood product. During the operation, cell saver was used for shed blood and aprotinin was administered intravenously. The use of blood conserving methods, meticulous operative technique and brisk postoperative diuresis has added to the efficacy of heart transplantation in this patient. Total postoperative drainage was 860 ml and the lowest hemoglobin level was 11.8 g%. The patient recovered uneventfully and discharged on the 60th postoperative day.
Adult
;
Anesthesia*
;
Aprotinin
;
Blood Transfusion
;
Disulfiram
;
Diuresis
;
Drainage
;
Heart Transplantation*
;
Heart*
;
Humans
;
Transplantation
7.The effects of prestaglandin Ea o the synthesis of type I collagenase mRNA of cultured fibroblasts from hypertrophic scar and keloid.
Gil Hwan JO ; Do Myung CHANG ; Sang Hoon CHUNG ; Paik Kwon LEE ; Young Jin KIM
Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(6):1119-1124
To investigate the effects of prostaglandin E1(PGX1) in prevention of proliferative scar formation, we cultured fibroblasts of normal skin (NS), hypertrophic scar (HS) and keloid (KL) tissues obtained from patients. We have compared type I collagenase production of cultured fibroblasts from normal skin, hypertrophic scar, and keloid tissues under various concentrations of PGE1. Our results demonstrate that type I collagenase production was significantly increased after addition of PGE1 in HS and KL, but not NS. Type I collagenase production of HS and KL fibroblasts were increased similarly in 10M and 10M of PGE1 and maximally increased in the concentration of 10M. This promotive effects of PGE1 on the production of type I collagenase was larger in KL than in HS. These results also suggest that PGE1 may play the promotive effects on type I collagenase production in dose-dependent manner. PGE1 may have a role in the prevention of hypertrophic scar and keloid by enhancing the production of type I collagenase of HS and KL fibroblasts. The promotive effects of PGE1 on type I collagenase production was variable depending on its concentration, and its effects was maximum in certain optimal condition. The maximally effective concentration of PGE1 in the prevention of proliferative scar formation should be searched in further investigations for clinical use.
Alprostadil
;
Cicatrix
;
Cicatrix, Hypertrophic*
;
Collagenases*
;
Fibroblasts*
;
Humans
;
Keloid*
;
RNA, Messenger*
;
Skin
8.Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis.
Journal of Movement Disorders 2016;9(2):63-70
Post-stroke movement disorders are uncommon, but comprise an important part of secondary movement disorders. These exert variable and heterogeneous clinical courses according to the stroke lesion and its temporal relationships. Moreover, the predominant stroke symptoms hinder a proper diagnosis in clinical practice. This article describes the etiology, treatment options and prognosis of post-stroke movement disorders.
Diagnosis
;
Movement Disorders*
;
Prognosis*
;
Stroke
9.A New Animal Model of Proliferative Scarring.
Young Jin KIM ; Gil Hwan JO ; Do Myung CHANG ; Paik Kwon LEE ; Poong LIM
Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(4):671-676
Proliferative scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the biology and effective therapy of these entities. Consequently we created an accurate reproductive animal model to systematically study them. Human proliferative scars were explanted into flaps based on isolated vascular pedicles in congenitally rats. We compared the procollagen type III peptide levels of proliferative scar tissue before and after explanting. The procollagen type III peptide levels of explanted proliferative scar tissue remained increased as before explanting. Histological analysis of the explanted proliferative scar tissue revealed that all explants retained their original histotypic character even after 1 year. We could also retain the volume of implanted proliferative scar for 1 year and studied in vitro cellular proliferation. Fibroblast cultures from explanted scars demonstrated less aggressive growth characteristic than those from original surgical specimens. The advantages of this animal model are as follows: 1. The explants retain their histotypical character for a long period. 2. Placement of the explants outside the dorsum of a nude rat makes serial observation and measurement easier. 3. Agents under test can be injected into the explants through a catheter inserted into a single pedicle of island flap without the possibility of spreading systematically.
Animals*
;
Biology
;
Catheters
;
Cell Proliferation
;
Cicatrix*
;
Cicatrix, Hypertrophic
;
Collagen Type III
;
Fibroblasts
;
Humans
;
Keloid
;
Models, Animal*
;
Rats
;
Rats, Nude
10.A Case of Resection of Pulmonary Metastatic Choriocarcinoma in Drug-Resistant Patient.
Ji Min LEE ; Chi Heum CHO ; Soon Do CHA ; Sang Min CHO ; Kun Young KWON
Korean Journal of Obstetrics and Gynecology 2000;43(6):1096-1099
Pulmonary metastasis occurs frequently in patients with gestational choriocarcinoma and most of these patients achieve remission with chemotherapy alone. Thus, the indications for surgical intervention are limited, but in appropriately selected patients, resection of a chemotherapy-resistant lung lesion can be curative. We have experienced that pulmonary metastatic choriocarcinoma in a drug-resistant patient was cured by pulmonary resection. So we report this case with a brief review of literatures.
Choriocarcinoma*
;
Drug Therapy
;
Female
;
Humans
;
Lung
;
Neoplasm Metastasis
;
Pregnancy