• Journal of the korean academy of Pediatric Dentistry
• /
• v.49 no.2
• /
• pp.228-233
• /
• 2022

Arteriovenous malformations (AVMs) are rare congenital anomalies characterized by direct communication between arteries and veins that bypass the capillary bed. AVMs may not manifest clinically until late infancy or childhood. In particular, facial AVMs can cause urgent life-threatening dental events. A 5-year-old girl without a medical history visited the hospital because of spontaneous gingival bleeding around the posterior gingival area of the lower left 2nd primary molar. Angiography through the femoral approach under general anesthesia was performed for differential diagnosis and therapeutic option. The blood flow was effectively reduced after arterial embolization alone, and there was no evidence of recurrence at the 5-month follow-up. The present study reports that embolization of the affected vessels can be a more effective and safe method than surgical resection for the treatment of AVM during the growth period.

• The Korean Journal of Pharmacology
• /
• v.29 no.2
• /
• pp.213-223
• /
• 1993

To investigate the endothelium dependent vascular reactivity of the systemic arterial and the pulmonary arterial system in acute renal hypertensive rats of 2-kidney, 1-ligation type (RHRs), acetylcholine (ACh)-induced vasodilation and depressor effects were evaluated in isolated arteries and in vivo, respectively, in the presence and absence of functional endothelium. ACh $(10^{-5}\;M)$ relaxed the intact thoracic aortas from RHRs and normotensive rats (NRs), but the effect was significantly smaller for those from RHRs (34 and 86%, respectively, p<0.01). ACh-induced vasodilation was completely abolished after removal of endothelial cell or pretreatment with EDRF inhibitors, L-NAME and MB, indicative of its dependence on intact endothelial or EDRF function. ACh also induced vasorelaxation of the intact pulmonary arteries from RHRs and NRs; however, unlike the effects on the thorcic aorta, no significant difference in amplitude was noted between two groups. ACh $(0.1{\sim}10\;{\mu}g/kg,\;i.v.)$ reduced mean systemic arterial pressure in anesthetized RHRs and in NRs to the similar magnitude (% change: 39 and 46% at $10\;{\mu}g/kg$, respectively) and these hypotensive effects were significantly decreased after pretreatment with L-NAME (30 mg/kg, i.v.). Deprssor effects of ACh on mean pulmonary arterial pressure were similar in RHRs and NRs with and without pretreatment of L-NAME. However, in both NRs and RHRs, the depressor effects of ACh on mean pulmonary arterial pressure were significantly reduced compared with those for mean systemic arterial pressure, and the increment of mean pulmonary arterial pressure noted after L-NAME $(0.1{\mu}100\;mg/kg,\;i.v.)$ was significantly smaller than that for mean systemic arterial pressure. These results indicate that in RHRs the endothelial cell function was impaired, at least in part, in systemic arterial system, but not in pulmonary arterial system, and both ACh-evoked and basal release of EDRF was less in the pulmonary arterial system than in systemic arterial system of both NRs and RHRs.

• Journal of Yeungnam Medical Science
• /
• v.5 no.1
• /
• pp.23-32
• /
• 1988

Finger injuries are becoming more common with the increasing use of mechanical industrial and household appliances. Among the hand injuries, amputation is the serious disaster to the patient. Recently, application of microsurgical technique to the reattachment of ampuatated digits has been common clinical procedures. We performed microsurgical replantation to the 75 patients with 102 digits from march in 1986 to february in 1988. The following results were obtained. 1. The most common age distribution was third decade and male to female ratio was about 5:1. 2. The ratio of right to left hand was about 1:1 but the dominant to non-dominant hand was about 2:1. 3. The index finger was most commonly injured and the next was middle finger. 4. The most common type of the injuries was the crushing injury and the most common vector was a kind of pressor. 5. The anesthesia was performed in equal ratio between the general and regional anesthesia. 6. The survival rate of microreplantation to the injuries of the zone II was 77.8% and zone III was 80%. 7. The functional result after replantation at zone II was better than zone III. 8. Microreplantation was performed in any case of the type of the injury, the severity of crushing and the ischemic time, and the patients requirement was an important factor.

• Journal of Veterinary Clinics
• /
• v.29 no.5
• /
• pp.384-390
• /
• 2012

Echocardiographic measurements of cardiac output, including the modified Simpson's method, Automated Contour Tracking(ACT) method, and left ventricular outflow method are well described methods of evaluating cardiac function due to its reliability and the benefits of its non-invasive technique in human medicine. The purpose of this study was to evaluate the accuracy of an echocardiography estimate of cardiac output in isoflurane-anesthetized beagle dogs and was to compare the ACT method to the other methods used in measurement of cardiac output. In healthy beagle dogs, cardiac output results by echocardiography estimate methods showed an excellent correlations with those by the thermodilution method (The modified Simpson's method : r = 0.815, $r^2=0.665$, y = 0.434x + 0.311 ; ACT method : r = 0.86, $r^2=0.748$, y = 0.391x + 0.242 ; ventricular outflow method : r = 0.691, $r^2=0.478$, y = 0.593x + 0.242). Among the results obtained, the ACT method showed the highest correlation coefficient. In conclusion, our study demonstrated that echocardiography estimate methods did not prove to be suitable in accurately measuring absolute cardiac output values but showed an excellent correlation with thermodilution method. Therefore, by using the measurement of cardiac output as supplemental data, echocardiography estimate methods can be used for detection and correction of hemodynamic disturbances during emergency and anesthesia in veterinary practice.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.8 no.1
• /
• pp.22-28
• /
• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Veterinary Clinics
• /
• v.28 no.5
• /
• pp.473-478
• /
• 2011

The study evaluated the antioxidant effects of ascorbic acid (AA) against oxidative stress during laparotomy in dogs under general anesthesia using isoflurane. Twelve dogs were randomly assigned to either the ascorbic acid group (AAG) or the sham group (SG). AAG received intravenous dosage of 100 mg/animal of standard AA 10 minutes before anesthesia. Plasma levels of cortisol, glucose, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were measured. Cortisol level increased significantly with time in both groups (p < 0.05). The change of glucose levels was not significantly different between both groups. TOS and OSI increased significantly with time in the SG (p < 0.05), whereas it did not significantly change with time in the AAG. The TOS and OSI of the AAG were significantly lower than in the SG (p < 0.05). However, TAS did not significantly change between both groups. The results suggest that the decrease of TOS in the AAG might be related to the conversion of antioxidants to oxidants. The decrease of OSI indicates that the decrease of reactive oxygen species (i.e., oxidative stress) produced at the site of injury is able to decrease surgical side effects of abnormal blood circulation, organ failure, and inflammation. Therefore, AA can be used to protect a surgical patient from oxidative stress in canine laparotomy.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.4
• /
• pp.310-316
• /
• 2021

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm³ (32,400-203,904/mm³), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.6 no.2
• /
• pp.77-83
• /
• 2010

This article discusses the issues of benefit and risk associated with outpatient general anesthesia and deep sedation for the special need dental patients. The purpose of administering anesthesia for patients with special needs is to provide effect dental treatment. But there are many complications such as sore throat, nausea and vomiting, airway trauma, airway obstruction and hypoxic brain damages, etc. In order to decrease incidence of complication, before general anesthesia meticulous patient evaluation is much important. But, there are a number of factors that make it difficult to accurately assess the anesthetic risk for many people with special needs. These include limited medical workups, uncooperative behavior, and difficulties in postoperative cares, etc. But Judging from several years experience of many contries, it appears that the incidence of mortalities for people with special needs in dental setting is minimal and the incidence of morbidity is limited. In the long run, the delivery of general anesthesia and deep sedation for people with special needs can be considered a very safe and successful procedure.

• Korean Journal of Adult Nursing
• /
• v.23 no.1
• /
• pp.87-99
• /
• 2011

Purpose: The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room. Methods: The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program. Results: The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (${\beta}$=.226) and then shivering (${\beta}$=.222). Conclusion: The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.2
• /
• pp.73-79
• /
• 2017

The purpose of this study was to analyze the dental treatment of patients with disabilities, especially according to the frequency of general anesthesia, and to propose the improvements in oral care. The subjects of the present study were 85 patients including age, sex, medical condition, dental treatment and the number of general anesthesia. The patients were divided into regular and irregular check groups according to their follow-up patterns. These two groups were compared for the frequency of general anesthesia and the type of repeated treatment. The results showed that restorative treatment was superior in numbers under first visit of general anesthesia. And more general anesthesia was performed in the irregular recall check group compared with the regular recall check group. This survey suggest that easy access to a dental clinic and the convenience of treatment is needed. On the other hand, there is a time limit on the dental care for disabilities by the dentist. Therefore oral care training program should be simultaneously provided for parents to improve the efficiency of dental care at home. In conclusion, efforts should be made for more comprehensive and effective dental care including regular recall check and preventive home care for disabilities.