1.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
2.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
3.Estimation of Trachea Size for an Emergency Tracheostomy
Hokyun NOH ; Sungwoo JANG ; Younghwan KIM ; Howon LEE ; Seok Hwa YOUN
Journal of Acute Care Surgery 2024;14(3):88-93
Purpose:
Tracheostomy is a procedure which requires careful selection of tracheostomy tube size, because it can significantly impact patient outcomes. However, in situations where radiological imaging is unavailable for measuring the tracheal inner diameter (ID), it can be estimated using the patient's height, weight, and sex. This study aimed to develop a method for estimating tracheal ID.
Methods:
A retrospective study was conducted on 468 adult patients who underwent chest computed tomography and chest X-ray at the National Medical Center from 2019 to 2021. Tracheal ID at the level of the jugular notch was measured and cross-checked. The correlation of the patient's body size and sex was then checked with tracheal ID and a regression equation was obtained to estimate tracheal ID.
Results:
Height showed the greatest correlation with tracheal ID, followed by either ideal body weight (IBW) or adjusted body weight (ABW). The regression equation to estimate tracheal ID was as follows: “Expected ID of the trachea (mm)” = [11.0781 + (1.9682 for Male or 1 for Female)] + [7.3767 × height (cm)] - {0.8022 × [√ IBW (kg) for healthy weight or ABW (kg) for obese]}. The equation was applied to determine appropriate tracheostomy tube sizes.
Conclusion
Tracheal ID can be estimated using patient sex, height, and either IBW or ABW. By providing a practical method for estimating tracheal ID, the derived regression equation can serve as a valuable tool for healthcare professionals in emergency situations, which may reduce tracheostomy complication rates and deliver better patient outcomes.
4.Effect of Modafinil and Methylphenidate on Sleep-Wake Architecture and EEG Power Spectra in Rats.
Jeong A PARK ; Hwan Soo JANG ; Sung Hoon JEONG ; Jeoung Hee HA ; Howon LEE ; Maan Gee LEE
Korean Journal of Psychopharmacology 2009;20(4):181-193
OBJECTIVE : Modafinil, methylphenidate, and caffeine are wakefulness-promoting substances. Previously, it was reported that caffeine-induced wakefulness differs from natural wakefulness in terms of the EEG spectral profiles. In order to evaluate whether wakefulness induced by other psychostimulants differs from both caffeine-induced and natural wakefulness, we examined the effects of the psychostimulants on sleep-wake architecture and EEG spectral profiles. METHODS : Eighteen Sprague-Dawley male rats underwent an EEG/EMG recording session from 10 : 30 to 17 : 30. They received caffeine (7.5, 15, 30 mg/kg i.p.), methylphenidate (1, 2, 5, 10 mg/kg i.p.) or modafinil (5, 10, 25, 50, 100 mg/kg i.p.) at 13 : 30. The number, total duration, and average duration of sleepwake states were obtained. EEG band powers were calculated by spectral analysis. Frequency bands were divided into the following ranges : D1, 1-2.5 Hz ; D2, 2.5-4.5 Hz ; T1, 4.5-7 Hz ; T2, 7-10 Hz ; SI, 10-14 Hz ; B1, 14-22 Hz ; B2, 22-34 Hz ; GA, 34-50 Hz. RESULTS : All three psychostimulants significantly and dose-dependently increased active wake duration and decreased slow-wave sleep. Equipotent doses of caffeine, methylphenidate, and modafinil for increasing active wake and decreasing slow-wave sleep were 7.5 mg/kg, 10 mg/kg, and 100 mg/kg, respectively. In equipotent doses, an increase of active wake duration by caffeine and methylphenidate was attributed to increases of both frequency and average duration of active wake state, whereas increase of active wake duration by modafinil was attributed to increase of average duration of active wake state only. In equipotent doses, caffeine and methylphenidate decreased the power of lower frequency bands (1-22 Hz), whereas modafinil did not. During slow-wave sleep, modafinil and methylphenidate increased the power of lower frequency bands, but caffeine did not. All the psychostimulants increased the power of the GA band, which was more prominent in the frontal cortex than the parietal cortex. CONCLUSION : These results suggest that moda-nil-induced wakefulness differs from caffeine- or methylphenidate-induced wakefulness in terms of EEG spectral profiles and sleep-wake architecture.
Animals
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Benzhydryl Compounds
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Caffeine
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Electroencephalography
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Humans
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Male
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Methylphenidate
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Rats
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Wakefulness
5.Strategy of Patient-Specific Therapeutics in Cardiovascular Disease Through Single-Cell RNA Sequencing
Yunseo JUNG ; Juyeong KIM ; Howon JANG ; Gwanhyeon KIM ; Yoo-Wook KWON
Korean Circulation Journal 2023;53(1):1-16
Recently, single cell RNA sequencing (scRNA-seq) technology has enabled the discovery of novel or rare subtypes of cells and their characteristics. This technique has advanced unprecedented biomedical research by enabling the profiling and analysis of the transcriptomes of single cells at high resolution and throughput. Thus, scRNA-seq has contributed to recent advances in cardiovascular research by the generation of cell atlases of heart and blood vessels and the elucidation of mechanisms involved in cardiovascular development and diseases. This review summarizes the overall workflow of the scRNA-seq technique itself and key findings in the cardiovascular development and diseases based on the previous studies. In particular, we focused on how the single-cell sequencing technology can be utilized in clinical field and precision medicine to treat specific diseases.
6.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
7.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
8.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
9.Effect of remimazolam on postoperative delirium and cognitive function in adults undergoing general anesthesia or procedural sedation: a meta-analysis of randomized controlled trials
Ji-In PARK ; Hyo-Seok NA ; Ji-Na KIM ; Jung-Hee RYU ; Howon JANG ; Hyun-Jung SHIN
Korean Journal of Anesthesiology 2025;78(2):118-128
Background:
Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures.
Methods:
We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model.
Results:
In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol.
Conclusions
Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.
10.Longitudinal Intravital Imaging of Tumor-Infiltrating Lymphocyte Motility in Breast Cancer Models
Inwon PARK ; Sujung HONG ; Joon SEOK ; Stephani Edwina LUCIA ; Eunjoo SONG ; Mingyo KIM ; Eunji KONG ; Howon SEO ; Yoonha HWANG ; Soyeon AHN ; Seonghye KIM ; Dong-Hyun JANG ; Jae Hyuk LEE ; Su-Hyung PARK ; Pilhan KIM ; You Hwan JO
Journal of Breast Cancer 2021;24(5):463-473
Immunoreactive dynamics of tumor-infiltrating lymphocytes (TILs) within the tumor microenvironment in breast cancer are not well understood. This study aimed to investigate the spatiotemporal cellular dynamics of TILs in breast cancer models. Breast cancer cells were implanted into the dorsal skinfold chamber of BALB/c nude mice, and T lymphocytes were adoptively transferred. Longitudinal intravital imaging was performed, and the spatiotemporal dynamics of TILs were assessed. In the 4T1 model, TILs progressively exhibited increased motility, and their motility inside the tumor was significantly higher than that outside the tumor. In the MDA-MB-231 model, the motility of TILs progressively decreased after an initial increase. TIL motility in the MDA-MB-231 and MCF-7 models differed significantly, suggesting an association between programmed death-ligand 1 expression levels and TIL motility, which warrants further investigation. Furthermore, intravital imaging of TILs can be a useful method for addressing dynamic interactions between TILs and breast cancer cells.