1.Use of Nicardipine and Esmolol in the Anesthetic Management for Bilateral Pheochromocytoma: A case report.
Pil Jae LIM ; Hyun Jeong KWAK ; Ho Sung KWAK
Korean Journal of Anesthesiology 2003;44(1):128-131
Pheochromocytoma stems from the chromaffin cell and mostly is located in the adrenal medulla. It is an important cause of secondary hypertension due to correction of hypertension by a resection of the tumor. Because it produces and secretes catecholamine, it bothers anesthesiologists with excessive hypertension, tachycardia and arrhythmia during the anesthetic period. Therefore, anesthetic management is directed to avoid these conditions. We report a case of bilateral pheochromocytoma successfully managed intraoperatively with an infusion of nicardipine and an intermittent esmolol injection.
Adrenal Medulla
;
Arrhythmias, Cardiac
;
Chromaffin Cells
;
Hypertension
;
Nicardipine*
;
Pheochromocytoma*
;
Tachycardia
2.Effects of Preinduction Atropine on the Hemodynamic Response to Induction with Fentanyl and Vecuronium for Coronary Artery Bypass Grafting.
Hyun Jeong KWAK ; Woo Kyung LEE ; Geun Mo PARK ; Young Lan KWAK
Korean Journal of Anesthesiology 2003;44(5):626-632
BACKGROUND: Induction of anesthesia with a high dose of fentanyl and vecuronium decreases the heart rate and blood pressure. This study was designed to evaluate the effect of preinduction atropine on these hemodynamic changes in patients undergoing coronary artery bypass graft surgery (CABG). METHODS: Forty-one patients who underwent CABG were randomly divided into two groups. After insertion of a radial artery cannula and a Swan-Ganz catheter, normal saline 1 ml (control group, n = 20) or atropine 0.5 mg (atropine group, n = 21) was injected intravenously 1 min before the induction of anesthesia. Anesthesia was induced with a first dose of fentanyl (5-8 microgram/kg) and vecuronium (0.12 mg/kg) and a second dose of fentanyl (5-10 microgram/kg). The patient was then intubated. Hemodynamic variables were measured before the induction of anesthesia, 1 min after the administration of each drug during the induction of anesthesia and 5, 10, and 30 min after the intubation. RESULTS: There was no significant differences between the two groups in terms of demographic data except that the number of patients with diabetes mellitus was greater in the control group than in the atropine group. The number of patients treated for hypotension or bradycardia during the induction of anesthesia was greater in the control group than in the atropine group, but this was not statistically significant. Heart rates significantly decreased in the control group but were maintained in the atropine group without any significant tachycardia. Blood pressure significantly decreased in both groups. CONCLUSIONS: Intravenous injection of atropine before anesthetic induction in patients undergoing CABG attenuates the decrease in heart rate resulting from anesthetic induction with high dose fentanyl and vecuronium. However, it didn't prevent the decrease in blood pressure nor did it reduce the incidence of treatment for hypotension.
Anesthesia
;
Atropine*
;
Blood Pressure
;
Bradycardia
;
Catheters
;
Coronary Artery Bypass*
;
Coronary Vessels*
;
Diabetes Mellitus
;
Fentanyl*
;
Heart Rate
;
Hemodynamics*
;
Humans
;
Hypotension
;
Incidence
;
Injections, Intravenous
;
Intubation
;
Radial Artery
;
Tachycardia
;
Transplants
;
Vecuronium Bromide*
3.Effects of Hand Massage and Hand Holding on the Anxiety in Patients with Local Infiltration Anesthesia.
Hyun Jung OH ; Jeong Sook PARK
Journal of Korean Academy of Nursing 2004;34(6):924-933
PURPOSE: This study was to examine the effects of hand massage and hand holding as nursing interventions on the anxiety in patients with local infiltration anesthesia. METHOD: The design of this study was a nonequivalent, control group, non- synchronized design. The subjects of this study consisted of 15 patients for the hand group, 15 patients for the hand holding group and 17 patients for the control group awaiting surgery in the operation room of a general hospitalin Daegu. As an experimental treatment, hand massage was carried out by the Hand Massage Protocol developed by Snyder(1995) and interpreted by Cho(1998) and hand holding developed by Cho(1998). The data were analyzed by SPSS/WIN, T-test, ANOVA, Cronbach's alpha, and the Scheffe test. RESULTS: The hand massage group and hand holding group were more effective than the control group in reducing anxiety, VAS score, systolic blood pressure and pulse rate. CONCLUSION: Hand massage and hand holding are effective nursing interventions that alleviates the psychological and physiological anxiety of patients with local infiltration anesthesia. In particular, the simple contact of hand holding is regarded as an effective and easily accessible nursing intervention in the operating room.
Adolescent
;
Adult
;
Aged
;
Anesthesia, Local/*nursing
;
Anxiety/*nursing
;
Blood Pressure
;
Female
;
*Hand
;
Heart Rate
;
Humans
;
Male
;
*Massage
;
Middle Aged
4.Localized Pseudopolyposis of the Ascending Colon Associated with Granulomatous Colitis: A case report.
Jeong Ja KWAK ; Kye Hyun KWON ; So Young JIN ; Dong Wha LEE
Korean Journal of Pathology 1994;28(1):82-85
Pseudopolyps represent discrete areas of mucosal inflammation and regeneration that are seen in a variety of inflammatory bowel disease including ulcerative colitis and Crohn's disease. These polyps are typically short, measuring less than 1.5 cm in height. Rarely, localized giant pseudopolyposis can occur, i.e., a collection of larger inflammatory pseudopolyps giving rise to a mass lesion within the colon. The most serious problem concerned with pseudopolyposis is a confusion with carcinoma. We experienced a case of localized giant pseudopolyposis causing partial large bowel obstruction. Right hemicolectomy was done for a preoperative diagnosis of ascending colon carcinoma. The resected specimen contained a circumferential lesion, which was composed of numerous interconnecting cylindrical villi, measuring 12 cm in length and 3 cm in height. Microscopically, these polypoid lesions were inflammatory pseudopolyps. Several deep fissure-like ulcerations were noted with multifocal microabscess, lymphoid hyperplasia and an area of noncaseating granuloma.
5.Atypical manifestation of solid and papillary epithelial neoplasm of the pancrease: case report.
Jeong Ho KWAK ; Dong Chan LEE ; Hyung Mo KIM ; Sang Hyun BYUN ; Kyung Ho KIM
Journal of the Korean Radiological Society 1993;29(2):279-282
We report a rescently experienced case with atypical radiologic manifestation of solid and papillary epithelial neoplasm of the pancreas in a 37 years old female patient. The tumor had heavy calcification on its capsule wall and septa. Instead of the usual encapsulated lesion with partly solid and partly cystic-hemorrhagic components, the lesion consisted of numerous fine cavitations containing air without fluid component except focal abscess fluid.
Abscess
;
Female
;
Humans
;
Neoplasms, Glandular and Epithelial*
;
Pancreas*
;
Pancrelipase*
6.The Effect of Daunorubicin on Experimental Proliferative Vitreoretinopathy.
Jae Hyun LEE ; Hyung Woo KWAK ; Woo Jeong CHOI
Journal of the Korean Ophthalmological Society 1996;37(10):1656-1662
Proliferative vitreoretinopathy (PVR) is a main cause of failure in retinal reattachment surgery. There have been many studies about the inhibition of proliferative vitreoretinophthy with several drugs. Authors investigated the inhibitory effect of proliferative vitreoretinopathy and retinal toxicity with various concentration of daunorubicin after intravitreal injection into the eyes of the pigmented rabbit. 7 pigment rabbit (11eyes) were used as subjects. After lensectomy and vitrectomy, control group was injected dermal fibroblast and F-BSS, and treatment group was injected dermal fibroblast and 5, 10, 15, 30 nmol Daunorubicin. At two weeks after intravitreal injection, both group were enucleated and examined with gross finding, light--microscopy, and electronmicroscopy. In all control group, proliferative vitreoretinopathy was found, but only preretinal membrane formation was found in 5, 10 nmol Daunorubicin injected group. In 15 nmol Daunorubicin injected group, the retina structure was preserved normally. In 30 nmol Daunorubicin injected group, the retinal outer segment was degenerated in microscopic finding. These results show that Daunorubicin has a potent effect on proliferative vitreoretinopathy, especially in 15 nmol, but retinal toxicity is suspected in marethan 30 nmol.
Daunorubicin*
;
Fibroblasts
;
Intravitreal Injections
;
Membranes
;
Retina
;
Retinal Photoreceptor Cell Outer Segment
;
Retinaldehyde
;
Vitrectomy
;
Vitreoretinopathy, Proliferative*
7.Ovarian Mucinous Adenocarcinoma Associated with Mucinous Adenocarcinoma of the Uterine Cervix.
Kye Hyun KWON ; Jeong Ja KWAK ; So Young JIN ; Dong Wha LEE
Korean Journal of Pathology 1995;29(2):244-247
When coexistence of carcinoma with similar histologic type is present in female genital tract, it is difficult to differentiate independent primary tumor from metastasis. Most of them are endometrial and ovarian tumors, but coexistence of uterine cervical and ovarian tumor with similar histologic type is rare. We experienced an independent primary tumor of ovarian mucinous cystadenocarcinoma associated with mucinous adenocarcinoma of uterine cervix. The patient was a 50-year-old woman. She had a lower abdominal mass which was detected as a huge cyst on ultrasonography. Although the ovarian lesions were bilateral, features that preferred to consider independent primary tumor are listed as; absence of lymphatic or vascular invasion, absence of ovarian surface implant, superficial invasion of cervical tumor, absence of tumor in abdominal cavity, and disease free follow-up after removal of the tumor.
Female
;
Humans
;
Cysts
;
Adenocarcinoma
8.Fine needle aspiration cytology of Ki-1 positive large cell lymphoma-a case report-.
Kye Hyun KWON ; Jeong Ja KWAK ; So Young JIN ; Dong Wha LEE
Korean Journal of Cytopathology 1993;4(2):127-132
No abstract available.
Biopsy, Fine-Needle*
9.The Effect of Venous Extension on the prognosis of Renal Cell Carcinoma.
Seong Jin JEONG ; Jeong Hyun KIM ; Cheol KWAK ; Eun Chan PARK ; Hae Won LEE ; Sang Eun LEE
Korean Journal of Urology 2000;41(6):731-740
No abstract available.
Carcinoma, Renal Cell*
;
Prognosis*
10.The Effect of Venous Extension on the prognosis of Renal Cell Carcinoma.
Seong Jin JEONG ; Jeong Hyun KIM ; Cheol KWAK ; Eun Chan PARK ; Hae Won LEE ; Sang Eun LEE
Korean Journal of Urology 2000;41(6):731-740
No abstract available.
Carcinoma, Renal Cell*
;
Prognosis*