1.Effects of Unilateral Hypoxic Ventilation upon Pulmonary Hemodynamics and Intrapulmonary Shunt in Dogs.
Korean Journal of Anesthesiology 1983;16(4):284-294
The effects of unilateral hypoxic ventilation on pulmonary hemodynamics, alveolar-arterial oxygen tension difference (A-aDO2) and intrapulmonary shunt in 10 dogs were studied under unilateral hypoxic ventilation using nitrogen. Hear rate, mean arterial pressure, central venous pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac output, blood gases and hemoglobin were measured during controlled ventilation with 100% oxygen and unilateral hypoxic ventilation. Using the above steps pulmonary hemodynamics, (A-a)DO2 and intrapulmonary shunt were calculated and the following results were obtained. 1) Mean pulmonry arterial pressure significantly increased (20%) from 20.6+/-2.60mmHg to 24.8+/-2.46mmHg(p<0.005) and pulmonary vascular resistance also significantly increased(43%) from 434+/-68.4 dynee. sec/cm(2) to 605+/-81.0 dynes. sec/cm(2)(p<0.005), whereas the cardiac output decreased (8%) from 1.92+/-0.23 l/min to 1.76+/-0.21 l/min(p<0.05) after unilateral hypoxic ventilation. 2) Alveolar-arterial oxygen tension difference significantly increased from 180+/-23.2mmHg to 470+/-31.9mmHg(p<0.005) after unilateral hypoxic ventilation. 3) Intrapulmonary shunt significantly increased from 9.5+/-1.40% to 24.8+/-2.02%(p<0.005) after unilateral hypoxic ventilation, but it was much lower than the mathematically expected value(40% over). The above findings suggest the operation of a protective mechanism, which causes hypoxic pulmonary vasoconstriction in the unilateral hypoxic lung, and diverts blood flow from the hypoxic to the non-hypoxic lung and so minimizes the hypoxic effect on the arterial blood.
Animals
;
Arterial Pressure
;
Cardiac Output
;
Central Venous Pressure
;
Dogs*
;
Gases
;
Hemodynamics*
;
Lung
;
Nitrogen
;
Oxygen
;
Pulmonary Wedge Pressure
;
Vascular Resistance
;
Vasoconstriction
;
Ventilation*
2.A case of Guillain Barre Syndrome showing pupillary paralysis.
Seong Hye CHOI ; Jong Moo PARK ; Kwang Woo LEE
Journal of the Korean Neurological Association 1998;16(3):413-415
It has been reported that pupillary paralysis is rare findings in typical Guillain-Barre syndrome(GBS). We experienced a 56-year-old male with fulminant GBS who pupillary paralysis. He showed quadriplegia, total paresis of motor cranial nerves including bilateral ptosis and complete opthalmoplegia. Pupils were dilated up to 8mm and fixed. After a one year follow up, his pupil slowly constricted to light. The instillation of 0.1% pilocarpin caused both pupillary constriction. These results pointed to postganglionic involvement of pupillary parasympathetic nerves.
Constriction
;
Cranial Nerves
;
Follow-Up Studies
;
Guillain-Barre Syndrome*
;
Humans
;
Male
;
Middle Aged
;
Paresis
;
Pilocarpine
;
Pupil
;
Pupil Disorders*
;
Quadriplegia
3.Polymer formation and altered biodistribution of IgG labelled with Tc and cyclic DTPA.
Sang Moo LIM ; Kwang Sun WOO ; Wee Sup CHUNG ; Ok Doo AWH
Korean Journal of Nuclear Medicine 1993;27(2):270-276
No abstract available.
Immunoglobulin G*
;
Pentetic Acid*
;
Polymers*
4.Seizures after Spontaneous Intracerebral Hemorrhage.
Kwang Moo WOO ; Seung Yeob YANG ; Keun Tae CHO
Journal of Korean Neurosurgical Society 2012;52(4):312-319
OBJECTIVE: In patients with spontaneous intracerebral hemorrhage (ICH), the risk factors for seizure and the effect of prophylactic anticonvulsants are not well known. This study aimed to determine the risk factor for seizures and the role for prophylactic anticonvulsants after spontaneous ICH. METHODS: Between 2005 and 2010, 263 consecutive patients with spontaneous ICH were retrospectively assessed with a mean follow-up of 19.5 months using medical records, updated clinical information and, when necessary, direct patient contact. The seizures were classified as early (within 1 week of ICH) or late (more than 1 week after ICH). The outcomes were measured with the Glasgow Outcome Scale at discharge and the modified Rankin Scale (mRS) at both 2 weeks and discharge. RESULTS: Twenty-two patients (8.4%; 9 patients with early seizures and 13 patients with late seizures) developed seizures after spontaneous ICH. Out of 263 patients, prophylactic anticonvulsants were administered in 216 patients. The prophylactic anticonvulsants were not associated with a reduced risk of early (p=0.094) or late seizures (p=0.326). Instead, the factors associated with early seizure were cortical involvement (p<0.001) and younger age (60 years or less) (p=0.046). The risk of late seizure was increased by cortical involvement (p<0.001) and communicating hydrocephalus (p=0.004). The prophylactic anticonvulsants were associated with a worse mRS at 2 weeks (p=0.024) and at last follow-up (p=0.034). CONCLUSION: Cortical involvement may be a factor for provoked seizures. Although the incidence of early seizures tended to decrease in patients prescribed prophylactic anticonvulsants, no statistical difference was found.
Anticonvulsants
;
Cerebral Hemorrhage
;
Follow-Up Studies
;
Glasgow Outcome Scale
;
Humans
;
Hydrocephalus
;
Incidence
;
Medical Records
;
Retrospective Studies
;
Risk Factors
;
Seizures
5.Distribution of 123I, 99mTc-human polyclonal nonspecific IgG and 67Ga-citrate in abscess bearing mice.
Sang Moo LIM ; Kwang Sun WOO ; Wee Sup CHUNG ; Ok Doo AWH ; Yong Sup SEO ; Jong Doo LEE
Korean Journal of Nuclear Medicine 1992;26(1):116-123
No abstract available.
Abscess*
;
Animals
;
Immunoglobulin G*
;
Mice*
6.Comparison of Direct-labeling Method of Antibody with 99mTc and 188Re.
Chang Woon CHOI ; Sang Moo LIM ; Kwang Sun WOO ; Wee Sup CHUNG ; Tae Hyun CHOI ; Soo Jeong LIM
Korean Journal of Nuclear Medicine 1999;33(1):84-93
PURPOSE: We investigated the direct labeling method of antibody with 99mTc and 188Re and examined the stability and function of these labeled compounds in in vitro and in vivo. MATERIALS AND METHODS: Disulfide bond of nonspecific human IgG was reduced to -SH group by 2-mercaptoethanol. Stannous ion was used to reduce 99mTc and 188Re. The stability of 99mTc-IgG and 188Re-IgG was estimated upto 24 hrs. Biodistribution was evaluated in abscess bearing rats at 4 and 24 hr post-injection of 99mTc or 188Re labeled IgG. RESULTS: The number of -SH group per reduced IgG molecule was 2.34. The labeling yield of 99mTc-IgG and 188Re-IgG were 90% and 95%, respectively. The stability of 99mTc-IgG at 1, 4, 6 and 24 hr was 91%, 83%, 78%, 7% and that of 188Re-IgG, high uptake was found on kidney, blood, stomach and abscess (9.42+/-0.68, 1.43+/-0.24, 0.86+/-0.18, 0.72+/-0.10 %ID/g, respectively). The uptakes at 24 hr were kidney, abscess, stomach, and blood in descending order. In case of 188Re-IgG, high uptake at 4 hr post injection appeared on kidney, blood, abscess and stomach (3.92+/-0.62, 1.32+/-0.08, 0.88+/-0.01, 0.26+/-0.06, respectively). The upatkes at 24 hr were kidney, abscess, blood abd stomach in descending order. The abscess to blood uptake ratio of 99mTc-IgG was 0.5 at 4 hr and 2.02 at 24 hr and that of 188Re-IgG was 0.67 and 1.29. CONCLUSION: 99mTc-IgG and 188Re-IgG and 188Re-IgG canbe labeled efficiently with direct labeling method. However, 99mTc-IgG and 188Re-IgG, labeled with direct method, was unstable. Further study in needed to enhance the stability of the antibody labeling.
Abscess
;
Animals
;
Humans
;
Immunoglobulin G
;
Kidney
;
Mercaptoethanol
;
Rats
;
Stomach
7.In Vivo Image and Biodistribution of 123I-15-(p-iodophenyl)-3-R , S - methylpentadecanoic acid ( BMIPP ) in Liposarcoma Bearing Nude Mice.
Chang Woon CHOI ; Sang Moo LIM ; Tae Sup LEE ; Yong Sup SUH ; Kwang Sun WOO ; Wee Sup CHUNG ; Soo Jung LIM ; Ok Doo AWH
Korean Journal of Nuclear Medicine 2001;35(5):324-333
No abstract available.
Animals
;
Liposarcoma*
;
Mice
;
Mice, Nude*
8.Clinical and Pathological Characteristics of Micropapillary Transitional Cell Carcinoma of the Bladder.
Hyun Hwan SUNG ; Kwang Jae WOO ; Ghee Young KWON ; Han Yong CHOI ; Hyun Moo LEE
Korean Journal of Urology 2007;48(9):910-914
PURPOSE: Micropapillary bladder carcinoma is a rare variant of urothelial cancer. The clinical course is more aggressive than that of conventional urothelial cancer, but the optimal treatment for this malady has not been confirmed. There are few studies about micropapillary bladder cancer. So, we performed a clinico-pathololic review on 10 cases with micropapillary bladder cancer. MATERIALS AND METHODS: Between December 1994 and May 2003, of the 1,170 cases that had undergone transurethral resection of bladder tumor (TURB), we reviewed the pathology of 440 patients who had stage T1 or T2 disease. Of these, we identified 10 patients(2.3%) with micropapillary bladder cancer, and then the medical records of these 10 patients were reviewed retrospectively. RESULTS: At the initial diagnosis, the average age was 66 years old(range: 48-79) and the male-to-female ratio was 4:1. After initially performing TURB, the pathological stages were T1G2(1 case), T1G3(5 cases) and T2G3(4 cases), and the clinical stages were T1N0M0(5 cases), T2N0M0(2 cases), T3N0M0(1 case), T2N2M0(1 case) and T2N0M1(1 case). Before the initial diagnosis, 75.0%(6/8 cases) of the urine cytology revealed malignancy. There were 4 cases of carcinoma-in-situ(CIS, 40%) and 5 cases of lympho-vascular invasion(50%). p53 gene mutation was reported in 66.7% (4/6 cases). Three quarters of the patients(6/8 cases) needed more aggressive treatments such as radical cystectomy or chemotherapy, with the exception of 2 patients who were lost to follow-up. CONCLUSIONS: At the initial diagnosis, the patients with micropapillary bladder cancer had a high stage and grade. These patients were highly associated with poor prognostic factors such as CIS, lympho-vascular invasion and p53 gene mutation. Three quarters of the patients needed more aggressive treatments, so they need to undergo active surveillance and treatment before progression.
Carcinoma, Transitional Cell*
;
Cystectomy
;
Diagnosis
;
Drug Therapy
;
Genes, p53
;
Humans
;
Lost to Follow-Up
;
Medical Records
;
Pathology
;
Retrospective Studies
;
Urinary Bladder Neoplasms
;
Urinary Bladder*
9.Grade Concordance between Transitional Cell Carcinoma of the Bladder and the Upper Urinary Tract.
Kwang Jae WOO ; Kyung Won KWAK ; Han Yong CHOI ; Hyun Moo LEE
Korean Journal of Urology 2008;49(1):7-11
PURPOSE: Transitional cell carcinoma(TCC) is thought to involve the entire urothelium as a multifocal field change. The tumor grade is a major prognostic factor in TCC and predicting the grade of TCC may be of clinical significance. The objective of this study is to clarify the grade concordance between upper tract TCC and bladder TCC. MATERIALS AND METHODS: From 1994 to 2006, a total of 241 patients underwent nephroureterectomy for upper tract TCC. Seventy-four of the 241 patients who had a history of previous bladder cancer and/or synchronous or metachronous bladder TCC were included in this study. The grade was recorded for each tumor. Fisher's exact test of concordance was used for statistical analysis. RESULTS: For the 74 patients who were analyzed, 42 patients(56.8%) developed bladder TCC during their follow up after nephroureterectomy, 14 patients(18.9%) had a history of bladder TCC prior to nephroureterectomy and 18 patients(24.3%) had a synchronous bladder tumor. In the case of developing bladder TCC during their follow up after nephroureterectomy, the grade concordance is highest between upper tract TCC and bladder TCC in 81.0% of the cases(p=0.005). Overall, the concordance rate between the upper tract TCC grade and the bladder TCC grade was 77.0%(p<0.001). CONCLUSIONS: Concordance of the TCC in the upper urinary tract and bladder was present in 77.0% of the cases. The patients who developed bladder tumor during their follow up after nephroureterectomy had the highest grade concordance between upper tract TCC and bladder TCC in 81.0% of the cases. This knowledge can have a significant impact on the therapeutic and follow up plans for transitional cell carcinoma.
Carcinoma, Transitional Cell
;
Follow-Up Studies
;
Humans
;
Urinary Bladder
;
Urinary Bladder Neoplasms
;
Urinary Tract
;
Urothelium
10.A Report of Unusual Anesthetic Managements of Pheochromocytoma.
Moo II KWON ; Ho Jo CHANG ; Woong Chul LIM ; Kwang Woo KIM ; II Young KWAK
Korean Journal of Anesthesiology 1974;7(1):59-65
It has been emphasized that continuous monitorings of arterial pressure, central venous pressure, electrocardiogram, blood gas analysis, serum electrolytes, body temperature, hematacrit and urinary output are mandatory for the anesthetic management of pheochromocytoma. In addition, it is necessary for the anesthetists to understand pharmacologic effects of drugs which influence the peripheral vascular tone and cardiac excitability. We experienced recently anesthetic management of two cases of pheochromocytoma; one raised problems of ventricular arrhythmias and hypertension that aggravated nature of arrhythrmias by increasing blood pressure and responded favorably to treatment with propranolol and trimetaphan. Tumor of this case originated from abdominal aortic wall. The other was managed by injection of d-tubocurarine which induced narrowing of pulse pressure by depletion of increasing systolic pressure and accompanied tachycardia without cardiac decompensation. We have reported proper anesthetic managements of two cases of pheochromocytoma with N2O O2-halothane anesthesia and reviewed literatures in discussion.
Anesthesia
;
Arrhythmias, Cardiac
;
Arterial Pressure
;
Blood Gas Analysis
;
Blood Pressure
;
Body Temperature
;
Central Venous Pressure
;
Electrocardiography
;
Electrolytes
;
Hypertension
;
Pheochromocytoma*
;
Propranolol
;
Tachycardia
;
Trimethaphan
;
Tubocurarine