1.A Catheter Fragment in External Iliac Artery Cutted during Femoral Artery Cannulation: A case report.
Jeong Han HWANG ; Sang Kyi LEE ; Seong Hoon KO ; Chan Uhng JOO
Korean Journal of Anesthesiology 1998;35(5):1007-1011
Arterial cannulation for constant monitoring of arterial pressure and blood gase analyses has become commonplace in the care of the critically ill patients. The radial artery is often regarded as causing a negligible complication risk because of extensive collateral arterial flow in the hand. One of other alternative sites for arterial cannulation is femoral artery. Femoral artery cannulation has a high degree of success in very small, critically ill children. It should be considered an acceptable alternative to small-vessel cannulation when the latter is not technically achievable, or in the unstable patient where rapid establishment of reliable artery access is necessary. Arterial cannulation may cause many complications: arterial catheters can directly injure the vessels, resulting in thrombosis, occlusion, distal embolization or ischemia. Local insertion site complications, such as hematoma, hemorrhage, and infection may occur. Arterial catheter may also be a source of systemic sepsis. We report an unusual case of unintentional release of a catheter fragment into the external iliac artery in a 7-month (7.8 kg) male patient with tetralogy of Fallot, which was inadvertently inserted during right femoral artery cannulation. The catheter fragment was successfully retrieved with the Amplatz Goose Neck microsnare under fluoroscopy without any problems.
Arterial Pressure
;
Arteries
;
Catheterization*
;
Catheters*
;
Child
;
Critical Illness
;
Femoral Artery*
;
Fluoroscopy
;
Hand
;
Hematoma
;
Hemorrhage
;
Humans
;
Iliac Artery*
;
Ischemia
;
Male
;
Neck
;
Radial Artery
;
Sepsis
;
Tetralogy of Fallot
;
Thrombosis
2.Ultrasonographic finding of hepatocellular carcinoma
Han Soo RYU ; Seong Ku WOO ; Jae Hoon LIM ; Young Tae KO ; Ho Kyun KIM ; Soon Yong KIM
Journal of the Korean Radiological Society 1983;19(4):753-761
With the development of gray scale ultrasonography, detection and evaluation of hepatic parenchymal diseaseincluding space occupying lesions are easitly performed and frequently used in the world. Thirty-five cases ofhistopathologically proven and ultrasonographically suggested hepatocellular carcinoma are retrospectivelystudied. The results were as follows; 1. Ultrasonographic findings of hepatocellular carcinoma show hyperechoicpattern in 22 cases (63%), hypoechoic pattern in 2 cases (6%), and mixed pattern in 11 cases (31%). 2. The marginof tumor is ill-defined in 19 cases (54%) and well defined in 16 cases (46%). 3. The size of tumor by sonographicmeasurement was larger than 5cm in diameter in 33 cases (94%). 4. The number of tumor is solitary in 19 cases andmultiple in 16 cases. The sites of involved lobe were right lobe in 22 cases (63%), left lobe in 2 cases (6%), andboth lobes in 11 cases (31%). 5. Associated sonographic findings were hepatomegaly with focal contour change in 25cases (71%), splenomegaly in 16 cases (46%), cirrhosis of liver in 15 cases (43%), ascites in 11 cases (31%) andtumoral thrombosis in portal vein in 8 cases (23%). 6. The sex ratio is 6:1 male predominence and the age rangesfrom 32 to 76 years with highest incidence in 5th and 6th decades.
Ascites
;
Carcinoma, Hepatocellular
;
Fibrosis
;
Hepatomegaly
;
Humans
;
Incidence
;
Liver
;
Male
;
Portal Vein
;
Sex Ratio
;
Splenomegaly
;
Thrombosis
;
Ultrasonography
3.The Effects of Female Hormones on Postoperative Nausea and Vomiting.
Jeong Woo LEE ; Seong Kyu KIM ; Dong Chan KIM ; Young Jin HAN ; Seong Hoon KO
Korean Journal of Anesthesiology 2008;54(1):58-62
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most common complaints following laparoscopic surgery, and being female is a risk factor for PONV. Therefore, we conducted this study to determine if the incidence of PONV is associated with variations in the blood concentration of female hormones that occur during different stages of the menstrual cycle. METHODS: We recruited 103 women who were undergoing gynecological laparoscopic surgery under general anesthesia and met all of the inclusion criteria for this study. A menstrual history was taken from each patient during the preoperative anesthetic visit and blood samples were collected from all patients to determine the concentration of female hormones (estradiol, progesterone). We then assessed the nausea rating scale (NRS) and the occurrence of retching and vomiting at 0-2 hours, 2-6 hours, and 6-24 hours postoperatively. RESULTS: The overall incidence of PONV was 60.2% within the first 24 hours following surgery. However, no significant differences in the incidence of PONV were observed in women in different menstrual phases (follicular phase, 63.5% vs. luteal phase, 56.9%). In addition, there was no significant difference observed in the female hormonal concentration of the blood of patients who experienced PONV and those that did not, and there was no correlation between the NRS and the blood concentration of female hormones. CONCLUSIONS: The results of this study suggest that female hormones (estradiol, progesterone) are not associated with the occurrence of PONV following gynecological laparoscopic surgery.
Anesthesia, General
;
Estradiol
;
Female
;
Humans
;
Incidence
;
Laparoscopy
;
Luteal Phase
;
Menstrual Cycle
;
Nausea
;
Postoperative Nausea and Vomiting
;
Progesterone
;
Risk Factors
;
Vomiting
4.Subependymal Giant Cell Astrocytoma in the tuberous Sclerosis.
Jin Han PARK ; Seong Ho KIM ; Dong Ro HAN ; Jang Ho BAE ; Sam Kyu KO ; Oh Lyong KIM ; Byung Yon CHOI ; Soo Ho CHO
Yeungnam University Journal of Medicine 1994;11(2):221-229
Tuberous sclerosis is reported rarely and is associated with systemic lesions including central nervous system, skin, heart, eye and kidney. Approximately 5-15% of individuals with tuberous sclerosis will develop brain neoplasia, almost invariably subependymal giant-cell astrocytoma (SGCA). We experienced a case of SGCA with tuberous sclerosis operated by the transcallosal approach and report with literature review.
Astrocytoma*
;
Brain
;
Central Nervous System
;
Heart
;
Kidney
;
Skin
;
Tuberous Sclerosis*
5.Clinical efficacy on the use of colpotomy in laparoscopic myomectomy.
Dae Yong KO ; Seong Hee KIM ; Jung Han LEE ; Seung Ryong KIM
Korean Journal of Obstetrics and Gynecology 2008;51(4):458-463
OBJECTIVE: Recently, laparoscopic operations are widely used for the resection of uterine myomas and the method for extraction of resected tissue leiomyoma is chiefly used with the morcellator or minilaparotomy. We investigated the feasiblity of colpotomy for the extraction of myoma tissue in the laparoscopic myomectomy. METHODS: A retrospective study was performed from May 2004 to July 2007 after a review of the medical records of 75 patients who have undergone myomectomy utilizing colpotomy. The patients profiles characteristics included myoma size, operation time, amount of blood loss, and complications in the Hanyang University Guri Hospital. RESULTS: Seventy-five patients were involved. The mean age of the patients was 40.5 (27-53) years, multiparity was found in 55 (73%) patients, the mean weight of the myomas was 204.3 (30-890) gm, the mean operation time was 2.47 (1.1-5.8) hours, the mean decrement of hemoglobin was 2.98 (0.2-5.9) gm/dL, the number of patients that needed transfusion was 8 (10.6%) and the number of the cases experiencing complications was one (0.01%). CONCLUSIONS: We concluded that colpotomy for the extraction of myoma tissue in laparoscopic myomectomy is a safe procedure in aspects of risk and cosmetic outcome and on an individual basis, can be used as an alternative to the usage of morcellator or minilaparotomy.
Colpotomy
;
Cosmetics
;
Female
;
Hemoglobins
;
Humans
;
Laparoscopy
;
Laparotomy
;
Leiomyoma
;
Medical Records
;
Myoma
;
Parity
;
Retrospective Studies
6.The Effects of the Rate of Increase in Inhaled Isoflurane Concentration on the Circulatory Responses.
Sang Kyi LEE ; Seong Hoon KO ; Dong Chan KIM ; Jeong Han HWANG ; He Sun SONG
Korean Journal of Anesthesiology 1999;36(4):577-583
BACKGROUND: A rapid increase in isoflurane concentration induces tachycardia and hypertension and increases plasma catecholamine concentration. The current study examined the effects of the rate of increase in inhaled isoflurane concentration on the circulatory responses. METHODS: Unpremedicated sixty three ASA physical status 1 patients, aged 20-40 years, scheduled for elective surgery under general anesthesia were randomly allocated into one of three groups. In each group, the inspired concentration of isoflurane via mask was increased up to 5 vol% at the rate different from other groups. The inspired concentration of isoflurane via mask was increased to 5.0 vol% abruptly (group 1), for 100 seconds (group 2), or 200 seconds (group 3). The target was to produce an end-tidal concentration of isoflurane (ETisof) of 2.6 vol% which was maintained until the end of the study by adjusting the vaporizer setting, when necessary. Heart rate (HR), mean arterial pressure (MAP), ETisof, end-tidal concentration of carbon dioxide, and peripheral oxygen saturation were measured at baseline and every 30 seconds for 5 minutes after inhalation of isoflurane and for 2 minutes after intubation. RESULTS: HR and MAP were significantly increased in all three groups compared with baseline, but significant differences in maximum values were not observed in three groups. There were significant differences among the groups in time from the onset of isoflurane inhalation to the maximal effect on HR and MAP. However, there were no significant differences among the groups of the ETisof at the maximal HR and MAP were seen. CONCLUSIONS: The high concentration of isoflurane transiently increase HR and MAP during inhaled anesthesia induction. However, the rate of increase in inhaled isoflurane concentration does not affect the circulatory responses.
Anesthesia
;
Anesthesia, General
;
Arterial Pressure
;
Carbon Dioxide
;
Heart Rate
;
Humans
;
Hypertension
;
Inhalation
;
Intubation
;
Isoflurane*
;
Masks
;
Nebulizers and Vaporizers
;
Oxygen
;
Plasma
;
Tachycardia
7.Changes in Cardiopulmonary Variables during Cemented Hip Arthroplasty in the Elderly Patients.
Seong Hoon KO ; Dong Chan KIM ; Sang Kyi LEE ; Young Jin HAN ; Hunh CHOE ; He Sun SONG
Korean Journal of Anesthesiology 1998;34(5):1002-1008
BACKGROUND: Bone cement implantation syndrome is characterized by hypotension, hypoxemia, cardiac arrhythmia, cardiac arrest, or any combination of these complications. The purpose of this study was to examine the effects of methylmethacrylate bone cement on cardiopulmonary variables during cemented hip arthroplasty in the elderly patients. METHODS: Twenty patients, aged over 65, undergoing cemented hip arthroplasty under general anesthesia were evaluated. Various cardiopulmonary variables with pulmonary and radial artery catheter, analysis of arterial blood gases, and capnography were measured at pre- and post-prosthetic insertion. RESULTS: The application of methylmethacrylate bone cement and femoral prosthesis resulted in an increase in pulmonary artery pressure and pulmonary vascular resistance, but there were no significant changes in blood pressure, heart rate, cardiac output, and systemic vascular resistance. Cemented hip arthroplasty was also associated with increased PaCO2 and dead space ventilation. Decreased PaO2 (1 atient) and hypotension (2 patients) were noted just after implatation of bone cement and prosthesis. CONCLUSIONS: In conclusion, hip arthroplasty with methylmethacrylate bone cement is associated with substantial risk in the elderly patients. We make recommendations of measures for the prevention and the management against hypotension and hypoxemia during cemented hip arthroplasty in the elderly patients.
Aged*
;
Anesthesia, General
;
Anoxia
;
Arrhythmias, Cardiac
;
Arthroplasty*
;
Blood Pressure
;
Capnography
;
Cardiac Output
;
Catheters
;
Gases
;
Heart Arrest
;
Heart Rate
;
Hip*
;
Humans
;
Hypotension
;
Methylmethacrylate
;
Prostheses and Implants
;
Pulmonary Artery
;
Radial Artery
;
Vascular Resistance
;
Ventilation
8.A Study on Method for Screening of Hypercalciuria in Children.
Kee Hwan YOO ; Byung Min CHOI ; Young Sook HONG ; Joo Won LEE ; Soon Kyum KIM ; Jeong Hoon CHOI ; Han Seong KO
Journal of the Korean Society of Pediatric Nephrology 2000;4(1):11-16
A 33-year-old woman who was diagnosed as medullary carcinoma by fine needle aspiration of thyroid mass is presented. The smear revealed dispersed pattern and small clusters of cells without follicular or papillary structures. The nuclei were round, oval or spindle shaped and eccentrically located. The cytoplasm was abundant and showed red-stained cytoplasmic granulation and tail-like projection with indistinct border. Clumps of amorphous, light-green material were intermingled with tumor cells.
Adult
;
Biopsy, Fine-Needle
;
Carcinoma, Medullary
;
Child*
;
Cytoplasm
;
Female
;
Granular Cell Tumor
;
Humans
;
Hypercalciuria*
;
Mass Screening*
;
Thigh
;
Thyroid Gland
9.How Long Should a Patient Stay in Lateral Position for Unilateral Spinal Anesthesia with Hyperbaric Bupivacaine?.
Seong Hoon KO ; Seung Gwan KANG ; Sang Kyi LEE ; Young Jin HAN ; Huhn CHOE ; He Sun SONG
Korean Journal of Anesthesiology 2000;38(1):35-41
BACKGROUND: In searching for a differential spinal block between dependent and nondependent sides, we evaluated the influence of the duration of lateral decubitus on the spread of hyperbaric bupivacaine during spinal anesthesia. METHODS: Spinal anesthesia with 1.2 ml of hyperbaric 0.5% bupivacaine (6 mg) was administered with a 25-gauge Whitacre unidirectional needle to 50 ASA 1 patients undergoing unilateral knee arthroscopy. The patients were allocated randomly to three groups according to the duration of lateral decubitus after spinal injection in the lateral position operation side dependent: Group 1, 10 min in lateral decubitus then supine; Group 2, 20 min in lateral decubitus then supine; Group 3, 30 min in lateral decubitus then supine. Sensory and motor block (pinprick/modified Bromage scale) as well as skin temperature were compared between the dependent and nondependent sides. Circulatory variables were recorded for 10 min after being turned supine. RESULTS: The sensory block between dependent and nondependent sides were significantly different in Group 3. In Group 1, the level of maximum sensory block was higher than Group 3 on nondependent side. There was no difference in the number of patients having achieved Grade 3 and 0 motor block among three groups on dependent and nondependent sides. The skin temperature in lateral decubitus was significantly higher on the dependent side than nondependent side in three groups. In Groups 1 and 2, the skin temperatures of nondependent side were increased after turned supine, but that was maintained during supine position in Group 3. The circulatory variables were stable in all 50 patients. CONCLUSIONS: We conclude that when a small dose of 0.5% hyperbaric bupivacaine is injected into patients in the lateral position, complete unilateral spinal anesthesia is achieved when the patients arekeep in a lateral position for more than 30 min after spinal injection.
Anesthesia, Spinal*
;
Arthroscopy
;
Bupivacaine*
;
Humans
;
Injections, Spinal
;
Knee
;
Needles
;
Skin Temperature
;
Supine Position
10.A Clinical Study of Congenital Urinary Tract Anomalies in Children.
Mi Young HAN ; Seong Ho CHA ; Byong Soo CHO ; Jin Il KIM ; Yung Tae KO
Journal of the Korean Pediatric Society 1997;40(3):375-384
PURPOSE: A study was done to assess the incidence, clinical characteristics of urinary tract anomalies for decreasing urinary tract morbidity. METHODS: We review 98 cases of anomaly of urinary tract who were admitted Kyung Hee University Hospital between 1986 and 1995. We analyzed incidence and associated anomalies, associated diseases and treatment modalities. RESULTS: 1) It was composed of 45 cases (45%) of renal anomalies, 37 cases (37.7%) of ureteral anomalies, 7 cases (7.1%) of urethral anomalies, 3 cases Prune-belly syndrome, 3 cases of urachal remnants, 2 cases of bladder exstrophy, 1 cases of VATER syndrome. 2) Anomalies of the kidney were composed of 14 cases of renal agenesis, 11 cases of multicystic dysplastic kidney, 10 cases of hydronephrosis 3 cases of hypoplasia, 3 cases of polycystic kidney, 2 cases of ectopia, 1 case of malrotation and 1 case of horseshoe kidney, 20 cases (44.4%) were diagnosed before 1 month of life. 20 cases were male and 25 casses were female. Bilateral involvement were in 7 cases and 38 cases of unilateral involvement were composed of 23 cases of right side and 15 cases of left side. Operative treatment were performed in 15 cases (30%) of renal anomalies. The common chief complaint of renal anomalies were abnormal finding on urinalysis (24.4%), abnormal finding on fetal ultrasonogram (20%), gastrointestinal tract symptom (15.6%), and fever (9%). 3) Anomalies of the ureter were composed of 26 cases of ureteral duplication, 9 cases of UPJ obstruction, 2 cases of megaureter. Ureteric duplications included 8 cases of male and 18 cases of female and 19 cases were unilateral and 7 cases were bilateral. 19 cases were diagnosed before 5 years old. 19 cases (73.1%) had symptoms associated with urinary tract infection. 11 cases had abnormal finding of ipsilateral kidney on DMSA scan or IVP. Associated abnormalities were hydronephrosis, ureterocele and VUR. UPJ obstruction were mostly diagnosed before 1 month of life, 6 cases were male and 3 cases were female. 2 cases were bilateral and 3 cases were right side involvement and 4 cases were left side. CONCLUSIONS: It seems to be reasonable that we should recommend the patients with the symptoms of urinary tract diseases to do evaluate the possibility of congenital urinary tract anomalies.
Bladder Exstrophy
;
Child*
;
Child, Preschool
;
Female
;
Fever
;
Gastrointestinal Tract
;
Humans
;
Hydronephrosis
;
Incidence
;
Kidney
;
Male
;
Multicystic Dysplastic Kidney
;
Polycystic Kidney Diseases
;
Prune Belly Syndrome
;
Succimer
;
Ultrasonography
;
Ureter
;
Ureterocele
;
Urinalysis
;
Urinary Tract Infections
;
Urinary Tract*
;
Urologic Diseases