1.Two Cases of Massive Ovarian Edema.
Young Gyu LEE ; Sam Bong KIM ; Heung Gon KIM ; Weon Cheol HAN ; Hyung Bae MOON
Korean Journal of Gynecologic Oncology and Colposcopy 1994;5(2):98-103
Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema*
;
Female
;
Ovary
2.Pulse Rate Changes after Increased Doses of Glycopyrrolate in Combination with Neostigmine.
Soon Gyu PARK ; Soon Yong HONG ; Kiu Sam KIM
Korean Journal of Anesthesiology 1987;20(6):751-755
Glycopyrrolate is frequently administered in combination with neostigmine to reverse a neuromus- cular blockade. The dosage was well established at 1/5 of neostigmine. But the authers have often observed a delayed manifestation of relative bradycardia after such a recommended dosage. This is not mentioned in the literature, but this may be due to an insufficient observation period. The authors monitored the change of pulse rate for 1 hour after the administration of the recom. mended dose. Further, the data wIns compared with that obtained after studies of lower and higher doses. The doses were 0.004, 0.008 and 0.012mg/kg of glycopyrrolate with 0.04mg/kg of neostigmine. 1) At all doses, bradycardia relative to the pre-reversal pulse rate was progressive until 30 minutes after injection. 2) As the glycopyrrate dose was increased the degree of bradycardia decreased (-24.7, -20.5, - 15.0 at 30 min.). 3) There was no difference in the immediate change in the pulse rate between the dcsages of 0.008 and 0.012 mg/kg. Change occured at 9 mins. 4) At dosages of 0.004 and 0.008 mg/kg, the pulse rates at 60 min were comparable to their ward pulses, but at a dosage of 0.012 mg/kg, the pulse rate was 8.5 beats/min higher.
Bradycardia
;
Glycopyrrolate*
;
Heart Rate*
;
Neostigmine*
3.Etoposide, adriamycin, cisplatin(EAP) combination chemotherapy for advanced gastric cancer.
Joon Sik KIM ; Jeong Hee KIM ; Own Gyu UH ; Si Young KIM ; Hwi Joong YOON ; Kyung Sam CHO
Journal of the Korean Cancer Association 1992;24(4):562-569
No abstract available.
Doxorubicin*
;
Drug Therapy, Combination*
;
Etoposide*
;
Stomach Neoplasms*
4.The Preoperative Factors for Conversion of Laparoscopic to Open Cholecystectomy for Treatment of Acute Cholecystitis.
Seok Gyu SONG ; Jong Myeong LEE ; Woo Young KIM ; Eul Sam CHUNG
Journal of the Korean Surgical Society 1999;57(2):255-259
BACKGROUND: Since its introduction in 1987, the laparoscopic cholecystectomy has become the treatment of choice for most patients with symptomatic cholelithiasis. However, about 20% of the patients requiring a cholecystectomy present with acute cholecystitis, and the safety of a laparoscopic cholecystectomy in these patients has been questioned. With increasing experience, many studies have reported that a laparoscopic cholecystectomy in patients with acute cholecystitis is safe and cost effective. This study was to review retrospectively the results of laparoscopic cholecystectomies in patients with acute inflamed gallbladders. METHODS: From July 1993 through Fabruary 1997, laparoscopic cholecystectomies were attempted in 250 patients with or without symptomatic gallbladder disease. Acute cholecystitis, confirmed by clinical, laboratory, operative, and histological findings, was present in 61 patients. The preoperative factors that may be useful in predicting conversion to an open operation were analyzed. RESULTS: The frequency of conversion to an open operation was 19.7% for acute inflammation and 3.2% for chronic inflammation. Patients who had a laparoscopic cholecystectomy done within 72 hours of the onset of symptoms had a lower rate of conversion to open procedures. Patients who had a laparoscopic cholecystectomy done and who had a white blood cell count over 15 10(9)/L, persistant high fever (>38.0degrees C) over 3 days, and managed diabetes mellitus for over 3 years had a high rate of conversion to open procedures. There were no bile-duct injuries and no mortalites. CONCLUSIONS: Laparoscopic intervention appears to be a safe and beneficial option in the management of patients with acute cholecystitis. Surgeons should have extensive experience with both routine laparoscopic cholecystectomy and conventional open biliary tract surgery. A greater number of patients with inflammation require conversion to an open operation compared with the number of patients with no obvious inflammation who require conversion. Conversion to an open operation was frequent for patients with empyema, with symptoms that had lasted for longer than 72 hours prior to the operation, with white blood cell counts over 15 10(9)/L, with persistant high fever (>38.0degrees C) over 3 days and with managed diabetes mellitus for over 3 years, suggesting that once this diagnosis of acute cholecystitis is made, excessive time should not be spent in a laparoscopic trial dissection before conversion to an open operation.
Biliary Tract
;
Cholecystectomy*
;
Cholecystectomy, Laparoscopic
;
Cholecystitis, Acute*
;
Cholelithiasis
;
Diabetes Mellitus
;
Diagnosis
;
Empyema
;
Fever
;
Gallbladder
;
Gallbladder Diseases
;
Humans
;
Inflammation
;
Leukocyte Count
;
Retrospective Studies
5.detection of BCR-ABL gene rearrangement by use of the polymerase chain reaction in chronic myeloid leukemia.
Joon Sik KIM ; Jeong Hee KIM ; Wan Gyu UH ; Sun Hee KIM ; Si Young KIM ; Hwi Joong YOON ; Kyng Sam CHO
Korean Journal of Hematology 1993;28(1):71-80
No abstract available.
Gene Rearrangement*
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
;
Polymerase Chain Reaction*
6.Balanced Anesthesia with Thalamonal for Thymectomy in Myasthenia Gravis.
Jong Han HAN ; Jae Bong SHIM ; Hyun Soo KIM ; Gyu Sam KIM ; Kwang Min KIM
Korean Journal of Anesthesiology 1987;20(3):401-405
Anesthesiologists have a particular interest in myasthenia gravis, since they may need to provide anesthesia for thymectomy or other surgery, or they may have to be involved in the treatment of respiratory failure which mar complicate this disease. We report a case of balanced anesthesia, using thalamonal-N2O-O2 for thymectomy in myasthenia gravis, which posed no postoperative respiratory problem.
Anesthesia
;
Balanced Anesthesia*
;
Myasthenia Gravis*
;
Respiratory Insufficiency
;
Thymectomy*
7.A Case of Ovarian Mullerian Mucinous Papillary Cystadenoma of Borderline Malignancy.
Jae Gyu LEE ; Sam Hyun CHO ; Seung Ryong KIM ; Jung Bae YOO ; Kyung Tai KIM ; Hyung MOON ; Youn Yeoung HWANG ; Seung Sam PAIK ; Eun Kyung HONG
Journal of the Korean Cancer Association 1997;29(3):522-527
Ovarian mucinous cystadenoma of borderline malignancy was consisted of intestinal mucinous cystadenomas of borderline malignancy and Mullerian mucinous papillary borderline tumors. Mullerian mucinous papillary tumors was lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors. These tumors have clinical and pathologic differences from those of intestinal mucinous cystadenomas of borderline malignancy.We report a case of ovarian Mullerian mucinous papillary cystadenomas of borderline malignancy with review of literature.
Cystadenoma, Mucinous
;
Cystadenoma, Papillary*
;
Epithelium
;
Female
;
Mucins*
;
Ovary
8.Three cases of double primary lung cancer.
Yeong Sung KIM ; Jong Kon LEE ; Ok Sik SHIN ; Gyu Chang SHIN ; Byung Sam LEE ; Yong Ku OH ; Se Kil KEE ; In Mook CHO ; Byeong Hun KIM
Tuberculosis and Respiratory Diseases 1991;38(2):186-193
No abstract available.
Lung Neoplasms*
;
Lung*
9.Sudden cardiovascular collapse after platelet transfusion during liver transplantation: flat-line thromboelastometry and inferred pulmonary thromboembolism: A case report.
In Young HUH ; Sun Kee KIM ; Ha Jung KIM ; Hyung Joo CHUNG ; Gyu Sam HWANG
Anesthesia and Pain Medicine 2015;10(4):295-300
Despite the well-known bleeding diathesis in patients with end-stage liver disease, inappropriate hypercoagulation is also emerging as a major concern. Pulmonary thromboembolism (PTE) is a major cause of perioperative morbidity and mortality during liver transplantation (LT). Flat-line thromboelastography is reported to predict PTE during LT. In this case, a 52-year-old woman with hepatocellular carcinoma underwent living-related LT. During the pre-anhepatic phase, one unit of apheresis platelets was transfused because of thrombocytopenia (32,000 /ml). After 20 minutes, blood pressure became unstable and circulatory collapse suddenly developed. In the middle of cardiopulmonary resuscitation, transesophageal echocardiography was immediately conducted, which revealed flail thrombi in the right atrium. Rotational thromboelastometry (ROTEM) conducted at that time was surprisingly flat in 4 channels, contradictory to the finding of hypercoagulation. This finding lead to a management dilemma during LT. Flattening in ROTEM requires caution in interpretation of severe hypocoagulation or ongoing PTE.
Blood Component Removal
;
Blood Platelets*
;
Blood Pressure
;
Carcinoma, Hepatocellular
;
Cardiopulmonary Resuscitation
;
Disease Susceptibility
;
Echocardiography, Transesophageal
;
Female
;
Heart Atria
;
Hemorrhage
;
Humans
;
Liver Diseases
;
Liver Transplantation*
;
Liver*
;
Middle Aged
;
Mortality
;
Platelet Transfusion*
;
Pulmonary Embolism*
;
Shock
;
Thrombelastography*
;
Thrombocytopenia
10.Appropriate Thresholds of Systolic Blood Pressure and R-R Interval for Assessment of Baroreflex Sensitivity by the Sequence Method during Sevoflurane Anesthesia.
Young Kug KIM ; So Ra KIM ; Gyu Sam HWANG
Korean Journal of Anesthesiology 2007;52(6):S1-S8
BACKGROUND: The sequence method of determining baroreflex sensitivity (BRSSEQ) has been reported to correlate poorly with the phenylephrine method of determining BRS in individuals with attenuated BRS. Inhalation anesthetics are also known to decrease BRS. We therefore assessed the effect of varying the systolic blood pressure (SBP) and R-R interval (RRI) thresholds on BRSSEQ values and compared these results with the BRS obtained by the modified Oxford technique (BRSMODOX). METHODS: The average number of valid sequences and BRSSEQ values were derived by varying the SBP threshold from 0.5 to 2.5 mmHg and the RRI threshold from 1 to 6 ms, and the relation of BRSSEQ values to BRSMODOX values using sequential administration of nitroprusside and phenylephrine was assessed in 40 healthy individuals during sevoflurane anesthesia. RESULTS: Increasing either the SBP thresholds or RRI thresholds resulted in a decrease in the number of valid sequences. As the SBP thresholds were decreased and the RRI thresholds were increased, BRSSEQ values increased. When the SBP threshold exceeded 1 mmHg, no significant correlations were observed between BRSSEQ and BRSMODOX values. Significant correlations between the two methods were observed for an SBP threshold of 0.5 mmHg and RRI thresholds of 1, 2, 3 and 4 ms. Biases between the two methods were 2.1, 2.1, 0.4, and 0.4 ms/mmHg for 0.5 mmHg and 1, 2, 3 and 4 ms. CONCLUSIONS: These findings suggest that adjusting the SBP threshold to 0.5 mmHg and the RRI threshold to 3 or 4 ms may improve BRSSEQ validity during sevoflurane anesthesia, when compared to BRSMODOX.
Anesthesia*
;
Anesthetics, Inhalation
;
Baroreflex*
;
Bias (Epidemiology)
;
Blood Pressure*
;
Nitroprusside
;
Phenylephrine