1.Anesthetic Management for Thoraco-Xiphopagus Conjoined Twins: A case report.
Sang Do HAN ; Seong Hyun YANG ; Sung Su CHUNG ; Chang Young JEONG ; Chan Jin PARK
Korean Journal of Anesthesiology 1997;33(1):172-177
The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia
;
Growth and Development
;
Hand
;
Heart Defects, Congenital
;
Humans
;
Incidence
;
Infant, Newborn
;
Ketamine
;
Korea
;
Neuromuscular Blockade
;
Respiration
;
Twins, Conjoined*
;
Ventilation
2.Inhibition of L-type calcium currents by magnesium sulfate on the rat basilar artery smooth muscle cells
Naveen Sharma ; Janardhan Prasad Bhattarai ; Pyoung Han Hwang ; Seong Kyu Han ; Yun Su Yang
Neurology Asia 2014;19(3):301-307
Objective: Vasospasm remains the leading cause of cerebral damage after aneurysmal subarachnoid
hemorrhage. Although magnesium regulates the calcium influx in vascular smooth muscle and
endothelial cells, it has not been reported whether L-type calcium channels are involved in magnesiuminduced
vascular relaxation in rat basilar artery. So, the effect of magnesium sulfate on L-type calcium
currents in freshly isolated smooth muscle cells from rat basilar artery was investigated. Methods:
The smooth muscle cells were isolated from rabbit basilar artery by enzyme treatment. L-type Ca2+
currents were identified using cesium chloride, a potassium channel blocker and Bay K8644, an
activator of L-type Ca2+ channel. Currents were recorded under step pulse whole cell patch clamp
technique. Results: In the presence of cesium chloride (in pipette solution), inward currents were
observed by depolarizing step pulses. The inward currents were significantly reduced by nimodipine
(n=4, p<0.05), an L-type Ca2+ channel blocker and increased by Bay K8644 (n=5, p<0.05), an L-type
Ca2+ channel activator. The L-type calcium currents (156±17.0 pA, n=12) were significantly reduced
by the application of 5 mM magnesium sulfate (53.8±7.0 pA, n=12, p<0.01).
Conclusion: These results suggest that magnesium may relax cerebral vessel of rat basilar artery
through decreasing intracellular Ca2+ ion by inhibition of L-type Ca2+ channels.
3.A Case of Intramural Pregancy.
Seong Kweon SON ; Hae Su SHIN ; Young Min YANG ; Won Sik SHIN
Korean Journal of Obstetrics and Gynecology 2000;43(7):1294-1297
Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis
;
Early Diagnosis
;
Fallopian Tubes
;
Female
;
Fertilization
;
Hemoperitoneum
;
Humans
;
Laparoscopy
;
Pregnancy
;
Pregnancy, Ectopic
;
Uterine Rupture
;
Round Ligaments
4.A Clinical Review of the HELLP Syndrome.
Sang Tae AHN ; Haeng Soo KIM ; Jeong In YANG ; Joon Hwan OH ; Ki Su HAN ; Seong Cheon YANG ; Kie Suk OH
Korean Journal of Perinatology 2001;12(2):122-130
No abstract available.
Female
;
HELLP Syndrome*
;
Pregnancy
5.Retrospective Study of Sandblasted, Large-grit and Acid-etched Implant
Ji Ho JO ; Su Gwan KIM ; Seong Yong MOON ; Ji Su OH ; Jin Ju PARK ; Jong Won JUNG ; Dae Woong YOON ; Seong Su YANG ; Mi Ae JEONG
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 2011;33(4):352-358
Dental Implants
;
Female
;
Follow-Up Studies
;
Gingivitis
;
Humans
;
Male
;
Membranes
;
Prognosis
;
Prosthodontics
;
Retrospective Studies
;
Sinusitis
;
Survival Rate
;
Tooth
;
Transplants
6.Evaluation of Relapse according to Set-back Degree of the Mandible at Bilateral Sagittal Split Ramus Osteotomy in Mandibular Prognathism Patients
Kyung Hwan YOO ; Su Gwan KIM ; Seong Yong MOON ; Ji Su OH ; Saeng Gon KIM ; Jin Ju PARK ; Jong Won JUNG ; Dae Woong YOON ; Seong Su YANG
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 2011;33(4):319-322
7.Usefulness of Deep Seating Technique for Transradial Coronary Intervention.
Hae Jong CHOI ; Moo Hyun KIM ; Chang Ho YANG ; Kwang Soo CHA ; Seong Geun KIM ; Su Hun LEE ; Sang Gon KIM ; Young Dae KIM ; Jong Seong KIM
Korean Circulation Journal 2000;30(8):921-926
BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.
Arteries
;
Bradycardia
;
Catheters
;
Coronary Vessels
;
Humans
;
Hypotension
;
Stents
8.Usefulness of Deep Seating Technique for Transradial Coronary Intervention.
Hae Jong CHOI ; Moo Hyun KIM ; Chang Ho YANG ; Kwang Soo CHA ; Seong Geun KIM ; Su Hun LEE ; Sang Gon KIM ; Young Dae KIM ; Jong Seong KIM
Korean Circulation Journal 2000;30(8):921-926
BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.
Arteries
;
Bradycardia
;
Catheters
;
Coronary Vessels
;
Humans
;
Hypotension
;
Stents
9.The Prognostic Factors of Pneumonia with Septic Shock in Patients Presenting to the Emergency Department.
Jong Won KIM ; Jin Joo KIM ; Hyuk Jun YANG ; Yong Su LIM ; Jin Seong CHO ; In Cheol HWANG ; Sang Hyun HAN
Korean Journal of Critical Care Medicine 2015;30(4):258-264
BACKGROUND: Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department. METHODS: From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined. RESULTS: Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35-4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01-1.08), leukopenia (OR, 3.63; 95% CI, 1.48-8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41-4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30-6.38). CONCLUSIONS: A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.
Anoxia
;
APACHE
;
Cause of Death
;
Communicable Diseases
;
Emergencies*
;
Emergency Service, Hospital*
;
Humans
;
Korea
;
Leukopenia
;
Mortality
;
Pneumonia*
;
Prognosis
;
Retrospective Studies
;
Shock, Septic*
10.Acute Physiologic and Chronic Health Examination II and Sequential Organ Failure Assessment Scores for Predicting Outcomes of Out-of-Hospital Cardiac Arrest Patients Treated with Therapeutic Hypothermia.
Sung Joon KIM ; Yong Su LIM ; Jin Seong CHO ; Jin Joo KIM ; Won Bin PARK ; Hyuk Jun YANG
Korean Journal of Critical Care Medicine 2014;29(4):288-296
BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE
;
Area Under Curve
;
Cardiopulmonary Resuscitation
;
Hospital Mortality
;
Humans
;
Hypothermia*
;
Hypothermia, Induced
;
Intensive Care Units
;
Logistic Models
;
Odds Ratio
;
Organ Dysfunction Scores*
;
Out-of-Hospital Cardiac Arrest*
;
Outcome Assessment (Health Care)
;
Retrospective Studies
;
Survivors