1.Separation of symphysis pubis during vaginal delivery - Report of 5 cases -.
Young Hwan SO ; Sung Geun PARK ; Chul Woo KAL ; Moon Jong KIM ; Jung Hyung LEE ; Yee Chul KIM
Korean Journal of Obstetrics and Gynecology 2000;43(12):2310-2314
No abstract available.
2.Intrathecal Phenol-Glycerine Block far Perianal Cancer Pain .
Hung Kun OH ; Yong Taek NAM ; Yee Chul LEE
Korean Journal of Anesthesiology 1979;12(4):398-406
Phenol-glycerine subarachnoid blocks were performed in 5 patients, who had intractable perianal pain from postoperative rectal cancer. An initial diagnostic subarachoid block with 0. 25 ml of 0.5% tetracaine in 10% glucose through L 5-S 1 was performed with the patient in a sitting position tilted about 15 degree to the affected side. After evaluation of the test block, the following day a therapeutic block was undertaken by injecting 0. 15-0. 2 ml of 10% phenol-glycerine. Excellent relief occurred in all cases and in one of them the repeated block for recurrent pain was done and 5 months after the first block. One case required of successive blocks 3 times during 8 days with the old phenol glycerine solution over 1 year. Life duration ranged from days to more than 12 months after the blocks. As to complication, dysuria developed temporarily in 3 cases. The one-sided saddle block with 10% phenol glycerine for perianal cancer pain is remarkably safe as well as effective and should be employed more frequently.
Dysuria
;
Glucose
;
Glycerol
;
Humans
;
Phenol
;
Rectal Neoplasms
;
Tetracaine
3.Balanced Anesthesia with Buprenouphine - N2O - O2 for Cesarean Section.
JIn Kyeung LEE ; Young Joo PARK ; Kyu Chang LEE ; Nam Sik WOO ; Yee Chul LEE
Korean Journal of Anesthesiology 1993;26(6):1183-1188
Balanced anesthesia with the potent opioid analgesics for cesarean section is preferential technique than N2O-O2 with single inhalation anesthetics due to avoid the decreased uterine muscle tone or vigorous postpartum blood loss. The 60 patients were randomly assigned to study the two group so that 30 patients were administered Buprenorphine(B group) or fentanyl(F group) anesthesia. The hemodynamic responses and recovery characteristics of the two groups were compared with each other. The patients who received the analgesics for postoperative pain control were observed. The results were as follows ; 1) The systolic and diastolic blood pressure at 10 min after injection of fentanyl was significantly lower than preinduction time. 2) The diastolic pressure at 10 minute after injection of buprenorphine was significantly lower than pre-induction. 3) There was no difference between the two patient groups in the blood pressure, the heart rate. 4) postoperative recall was 1 patients in the F group and 3 patients in B group. 5) The 24 patients were injected analgesics. Among them 10 patients(33.3%) were in the B group and 16 patients(53.3%) were in the F group. The authors conclude that balanced anesthesia with buprenorphine is a practical altemative technique to fentanyl for cesarean section patients.
Analgesics
;
Analgesics, Opioid
;
Anesthesia
;
Anesthetics, Inhalation
;
Animals
;
Balanced Anesthesia*
;
Blood Pressure
;
Buprenorphine
;
Cesarean Section*
;
Female
;
Fentanyl
;
Heart Rate
;
Hemodynamics
;
Humans
;
Mice
;
Myometrium
;
Pain, Postoperative
;
Postpartum Period
;
Pregnancy
4.Comparison of Propofol and Enflurane for General Anesthesia: Effect on Cortisol Level and Hemodynamic Response.
Young Joo PARK ; Nam Sik WOO ; Yee Chul LEE ; Young Sook CHOI ; Hee Goo LEE
Korean Journal of Anesthesiology 1994;27(7):723-731
Surgety is a potent stimulus for the neurohormonal axis and it is important to know the influence of specific anesthetic procedures on those host responses. The purpose of this study was to compare the effect of total intravenous anesthesia of propofol with those of inhalation anesthesia on circulating cortisol concentration and hemodynamic responses during pre-induction (Tl), bolus injection of induction doses (T2), post-intubation (T3), skin incision (T4), after 30 minutes skin incision (T5) and in the recovery room after reversal of anesthesia and extubation (T6). Sixty patients of ASA class 1 or 2 schedule to undergo general anesthesia were allocated randomly to two groups. Group E was induced with pentotal sodium (5 mg/kg) and maintained with O2/N2O and 1.5-2 Vol/% enflurane, group P was induced with propofol (2 mg/kg) and maintained with O2/N2O and continuous infusion of propofol (initial rate is 10 mg/kg/hr for 10 minutes and then 8 mg/kg/hr). The results were as follows; 1) The changes of the plasma cortisol level, there were statistically difference between the E group and the P group in the skin incision and 30min. after (P<0.06). 2) The plasma cortisol level in the propofol group was significantly increased than eontrol value only 30 min. after reversal and extubation. 3) The plasma cortisol level in the enflurane group was continuously increased from post- intubation until the end of the experiment. 4) There were no significant difference in hemodynamic changes between the enflurane group and the propofol group.In condusion, total intravenous anesthesia of propofol have no suppressive cortisol production during sutgical stress.
Anesthesia
;
Anesthesia, General*
;
Anesthesia, Inhalation
;
Anesthesia, Intravenous
;
Appointments and Schedules
;
Axis, Cervical Vertebra
;
Enflurane*
;
Hemodynamics*
;
Humans
;
Hydrocortisone*
;
Intubation
;
Plasma
;
Propofol*
;
Recovery Room
;
Skin
;
Sodium
5.Comparison of Propofol and Enflurane for General Anesthesia: Effect on Cortisol Level and Hemodynamic Response.
Young Joo PARK ; Nam Sik WOO ; Yee Chul LEE ; Young Sook CHOI ; Hee Goo LEE
Korean Journal of Anesthesiology 1994;27(7):723-731
Surgety is a potent stimulus for the neurohormonal axis and it is important to know the influence of specific anesthetic procedures on those host responses. The purpose of this study was to compare the effect of total intravenous anesthesia of propofol with those of inhalation anesthesia on circulating cortisol concentration and hemodynamic responses during pre-induction (Tl), bolus injection of induction doses (T2), post-intubation (T3), skin incision (T4), after 30 minutes skin incision (T5) and in the recovery room after reversal of anesthesia and extubation (T6). Sixty patients of ASA class 1 or 2 schedule to undergo general anesthesia were allocated randomly to two groups. Group E was induced with pentotal sodium (5 mg/kg) and maintained with O2/N2O and 1.5-2 Vol/% enflurane, group P was induced with propofol (2 mg/kg) and maintained with O2/N2O and continuous infusion of propofol (initial rate is 10 mg/kg/hr for 10 minutes and then 8 mg/kg/hr). The results were as follows; 1) The changes of the plasma cortisol level, there were statistically difference between the E group and the P group in the skin incision and 30min. after (P<0.06). 2) The plasma cortisol level in the propofol group was significantly increased than eontrol value only 30 min. after reversal and extubation. 3) The plasma cortisol level in the enflurane group was continuously increased from post- intubation until the end of the experiment. 4) There were no significant difference in hemodynamic changes between the enflurane group and the propofol group.In condusion, total intravenous anesthesia of propofol have no suppressive cortisol production during sutgical stress.
Anesthesia
;
Anesthesia, General*
;
Anesthesia, Inhalation
;
Anesthesia, Intravenous
;
Appointments and Schedules
;
Axis, Cervical Vertebra
;
Enflurane*
;
Hemodynamics*
;
Humans
;
Hydrocortisone*
;
Intubation
;
Plasma
;
Propofol*
;
Recovery Room
;
Skin
;
Sodium
6.The Effect of an Intraperitoneal Injection of Ketamine and Ketorolac on Mechanical Allodynia in Rats with Spinal Nerve Ligation.
Tae Kwan KIM ; Yee Suk KIM ; Jun Ro YOON ; In Soo HAN ; Jin Seo KIM ; Chul Woo LEE
Korean Journal of Anesthesiology 2004;46(6):719-723
BACKGROUND: It is difficult to manage the symptoms of neuropathic pain, especially alloynia. The mechanism of the induction and maintenance of mechanical allodynia has been extensively researched for several decades. N-methyl-D-aspartate (NMDA) receptor antagonists are known to reduce mechanical allodynia. Recently, the role of prostaglandins in spinal nociceptive processing has been the focus of attention. Therefore, the present study was designed to investigate the effect of a combination of ketamine, a non-competitive NMDA antagonist, and of ketorolac, non-selective cyclooxygenase (COX) inhibitor on mechanical allodynia. METHODS: Male SD rats were prepared by tightly ligating the left L5 and L6 spinal nerves. All rats developed mechanical allodynia 7 days after surgery. N group (control, n = 6) received 5 ml of 0.9% normal saline intraperitoneally. K group (n = 6) received ketamine 1 mg/kg. T group received ketorolac 30 mg/kg, and KT group received ketamine 1 mg/kg and ketorolac 30 mg/kg simultaneously. Paw withdrawal thresholds to von Frey hairs were measured before and at 15 min, 30 min, 60 min and 120 min after drug administration. RESULTS: Normal saline and ketamine 1 mg/kg did not increase the paw withdrawal threshold from baseline. Ketorolac 30 mg/kg increased the paw withdrawal threshold only at 120 min after intraperitoneal injection. However, the co-administration of ketamine 1 mg/kg and ketorolac 30 mg/kg increased the paw withdrawal threshold significantly from baseline for 120 min. CONCLUSIONS: Intraperitoneal injection of ketamine and ketorolac attenuated the mechanical allodynia developed by spinal nerve ligation. Therefore, we suggest that combination of ketamine and ketorolac might be useful for the management of neuropathic pain.
Animals
;
Hair
;
Humans
;
Hyperalgesia*
;
Injections, Intraperitoneal*
;
Ketamine*
;
Ketorolac*
;
Ligation*
;
Male
;
N-Methylaspartate
;
Neuralgia
;
Prostaglandin-Endoperoxide Synthases
;
Prostaglandins
;
Rats*
;
Spinal Nerves*
7.Risk Factor Assessment Using Surface Electromyography and Electrogoniometer among Automobile Part Manufacturers.
Dongmug KANG ; Cheol Ho YEE ; Yong Chul SHIN ; Eun A KIM ; Ji Hoon WOO ; Byung Mann CHO ; Su Ill LEE
Korean Journal of Occupational and Environmental Medicine 2005;17(4):267-277
OBJECTIVES: As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer. METHODS: Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively. RESULTS: After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76 degrees, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively. CONCLUSIONS: Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.
Automobiles*
;
Body Mass Index
;
Elbow
;
Electromyography*
;
Forearm
;
Heart
;
Humans
;
Joints
;
Male
;
Muscle Tonus
;
Muscles
;
Odds Ratio
;
Posture
;
Risk Factors*
;
Skin
;
Wrist
8.Transvginal Sonography in the Prediction of Preterm Labor.
Soo Pyung KIM ; Jong Chul SHIN ; Chang Yee KIM ; Jin Hee RYU ; Young LEE ; Eun Ah CHOI ; Hee Bong MOON ; Ki Bum KIM ; Jung NAM ; Soon Man KWON
Korean Journal of Perinatology 1998;9(3):245-251
OBJECTIVE: Preterm labor and delivery is probably the largest problem in modern perinatology. The early diagnosis of preterm labor is crucial for prevention of preterm birth. To predict the onset of preterm labor, we examined the diagnostic performance of serial cervical assessment by transvaginal sonography. METHODS: In this prospective study, we performed transvaginal sonography at approximately 30 and 34 weeks of gestation in women with singleton pregnancies. Cervical parameters evaluated included endocervical length, the presence of funneling, funnel length and funnel width. We then assessed the relation between cervical parameters and the risk of spontaneous preterm labor. RESULTS: We examined 258 women at approximately 30 weeks of gestation and 247 of these women again at approximately 34 weeks. Spontaneous preterm labor occurred in 9 of women examined at 30 weeks(Group 1) and in 13 at 34 weeks(Group 2). The endocervical length was normally distributed at 30 and 34 weeks(mean +/-SD, 38.26+/-6.82mm and 35.63+/-7.35mm, respectively). The endocervical length decreased significantly from 30weeks to 34 weeks(p=0.0001). Both groups showed significantly shorter endocervical length(p <0.05) and groupl more presence of funneling than group of term pregnancy(p<0.05). Receiver-operator characteristic curve and multiple logistic regression analyses indicated that endocervical length <-30mm at 30 weeks and <-25mm at 34 showed highest diagnostic index in predicting the onset of preterm labor(p=0.0001). Conclusions: Serial transvaginal ultrasound assessment of endocervical length during early third trimester is a useful predictor of preterm labor and delivery in low-risk patients.
Early Diagnosis
;
Female
;
Humans
;
Logistic Models
;
Obstetric Labor, Premature*
;
Perinatology
;
Pregnancy
;
Pregnancy Trimester, Third
;
Premature Birth
;
Prospective Studies
;
Ultrasonography
9.Early Effect of Endotoxin on Cerebral Autoregulation.
Ho Kyung SONG ; Yee Suk KIM ; Byung Hoon SONG ; Chul Woo LEE ; Tae Kwan KIM
Korean Journal of Anesthesiology 2003;45(6):774-778
BACKGROUND: Under normal conditions, cerebral blood flow is regulated as cerebral perfusion pressure changes (autoregulation). Inflammatory conditions like bacterial meiningitis result in a loss of cerebral autoregulation several hours after exposure to bacterial endotoxin. Endotoxin appears to produce effects via the production of reactive oxygen species, such as the superoxide anion. METHODS: Cerebral blood flow (CBF) was measured by hydrogen clearance in anesthetized rats 30 minutes after intravenous endotoxin 5 mg/kg or normal saline (control). Mean arterial pressure was reduced from 100 mmHg to 80 mmHg and 60 mmHg by hemorragic hypotension, and cerebral blood flow was measured at each pressure. RESULTS: In the control group, CBF did not change when arterial pressure was reduced to 80 mmHg (113.9 ml vs 111.9 ml), but declined significantly at 60 mmHg (113.9 ml vs 88.4 ml). In the group treated with endotoxin, both a reduction of mean arterial pressure to 80 mmHg (129.8 ml vs 101.8 ml) and 60 mmHg (129.8 ml vs 78.4 ml) caused a significant reduction in CBF, indicating that autoregualtion had been abolished. CONCLUSIONS: The results of this study indicate that within minutes of endotoxin exposure, CBF markedly increased, and that the autoregualtion of CBF was inhibited.
Animals
;
Arterial Pressure
;
Homeostasis*
;
Hydrogen
;
Hypotension
;
Meningitis
;
Perfusion
;
Rats
;
Reactive Oxygen Species
;
Superoxides
10.Allogeneic Bone Marrow Transplantation in Shwachman-Diamond Syndrome with Malignant Myeloid Transformation: A Case Report.
So Young PARK ; Min Byoung CHAE ; Yee Gyung KWACK ; Moon Hee LEE ; In Ho KIM ; Young Soo KIM ; Chul Soo KIM
The Korean Journal of Internal Medicine 2002;17(3):204-206
Shwachman-Diamond syndrome (SDS) is a rare genetic disorder of unknown pathogenesis involving exocrine pancreatic insufficiency and hematological and skeletal abnormalities. About 25% of patients develop hematopoietic malignancies. We report on a case of acute myeloid leukemia (M2) in a 21-year-old woman affected by SDS. She was treated with conventional chemotherapy (idarubicin plus cytarabine) and reached complete remission of leukemia. After induction chemotherapy, she underwent allogeneic bone marrow transplantation (BMT). The BMT preparative regimen consisted of total body irradation (TBI) followed by cyclophosphamide. Cyclosporin A and short term methotrexate were used for graft-versus-host disease prophylaxis. After a follow-up of 12 months, she is alive leukemia free off any immunosuppressive agent. Although experience in this field is scarce, we speculate that bone marrow failure in SDS is an indication for BMT which is the only curative trentment option.
Adult
;
*Bone Marrow Transplantation
;
Case Report
;
*Cell Transformation, Neoplastic
;
Female
;
Human
;
Leukemia, Myelocytic, Acute/*pathology/*therapy
;
Myelodysplastic Syndromes/*complications/*therapy
;
Pancreatic Insufficiency/complications/therapy
;
Syndrome
;
Transplantation, Homologous