• The Korean Journal of Pain
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• v.29 no.2
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• pp.110-118
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• 2016

Background: Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug. The concomitant use of opioids and nefopam is believed to have many advantages over the administration of opioids alone for postoperative pain management. We conducted a randomized, double-blind study to determine the fentanyl-sparing effect of co-administration of nefopam with fentanyl for postoperative pain management via patient controlled analgesia (PCA). Methods: Ninety female patients who underwent laparoscopic total hysterectomy under general anesthesia were randomized into 3 groups, Group A, fentanyl $1,000{\mu}g$; Group B, fentanyl $500{\mu}g$ + nefopam 200 mg; and Group C, fentanyl $500{\mu}g$ + nefopam 400 mg, in a total volume of 100 ml PCA to be administered over the first 48 h postoperatively without basal infusion. The primary outcome was total fentanyl consumption during 48 h; secondary outcomes included pain scores and incidence of side effects. Results: Eighty-one patients were included in the analysis. The overall fentanyl-sparing effects of PCA with concomitant administration of nefopam during the first 48 h postoperatively were 54.5% in Group B and 48.9% group C. Fentanyl use was not significantly different between Groups B and C despite the difference in the nefopam dose. There were no differences among the three groups in terms of PCA-related side effects, although the overall sedation score of Group B was significantly lower than that of Group A. Conclusions: The concomitant administration of nefopam with fentanyl for postoperative pain management may allow reduction of fentanyl dose, thereby reducing the risk of opioid-related adverse effects.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.148-152
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• 2013

We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.

• Development and Reproduction
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• v.6 no.1
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• pp.17-23
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• 2002

In oocyte retrieval, a vein anesthetic drug is commonly used for induction and maintenance of general anesthesia. Propofol and Thiopental sodium are frequently used for ultrasound-guided transvaginal oocyte retrieval. The present study aimed to assess the effects of Propofol and Thiopental on in vitro fertilization(IVF). Immature porcine oocytes were exposed to various concentrations ot Propofo1 and Thiopental sodium. The rates of oocyte maturation, fertilization and development were observed. The parthenogenetic effects of the anesthetics were also evaluated. The rate of oocyte maturation after exposure to high concentrations of the anesthetics for long time was significantly higher than that of the control. But the rate of fertilization after long-time exposure to the high concentration of the anesthetic drugs was significantly lower than that of the control. The results support that Propofo1 serves like other anesthetics described, as a parthenogenetic activator. Oocytes exposed to Thiopental sodium showed decreased rates of maturation and fertilization. These results suggest that usage of optimum concentration of anesthetic drug is important in increasing the rates of oocyte maturation, fertilization and development in IVF.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.374-380
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• 2010

Treacher Collins syndrome(TCS) is a rare, incurable condition occurring in approximately 1 of 25,000 to 50,000 births. It may occur as a spontaneous mutation out of genetically normal parents or it may be manifested as an autosomal dominant pattern. TCS is characterized by facial deformities such as, underdevelopment of the maxilla, mandible and zygoma, malocclusion, bilateral deformities of auricles, antimongoloid slant of the palpebral fissures. The syndrome is often associated with cleft lip and palate, ear malformations and hearing loss, short stature, and anomalies of the heart and skeleton. Respiratory difficulty associated with air way obstruction may also be observed, and there is considerable difficulty in airway management during general anesthesia. It is necessary that dentists provide safe dental treatments and guidelines to TCS patients by providing adequate understanding about the characteristics of the syndrome and proper ways of managements. The purpose of this study is to report the dental and medical characteristics of the patient who visited the Department of Pediatric Dentistry, Yonsei University for multiple dental caries treatment and to review the literatures of TCS.

• Korean Journal of Cleft Lip And Palate
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• v.9 no.2
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• pp.93-100
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• 2006

Although the delayed type of rhinoplasty is currently acceptable in the correction of cleft lip and nasal deformity, Delaire tried to achieve the simultaneous nasolabial reconstruction and muscular rearrangement that affect the subsequent skeletal growth of the face. the anatomic muscular reconstruction can be achieved by making the anchorage of the nasolabial muscles of the cleft side to the nasal septum and muscles on the non-cleft side. Two cleft lip patients of 6 and 7 year-old without any previous operation history were treated with the functional cheilorhinoplasty. One patient with incomplete cleft lip underwent a cheiloplasty along with the rearrangement of orbicularis oris muscle. The other patient had a complete cleft lip and palate with accompanying nasal deformity, who underwent the functional cheilorhinoplasty with the reconstruction of anterior nasal base. All the operation was done under the general anesthesia and patients healed without any significant complications. In the incomplete case, the shapes of Cupid's bow was restored, and the length of columella was regained comparable to the non-affected side. In the complete cleft lip and palate case, the depressed nostril was reconstructed with acceptable symmetry by complete releasing of deformed alar cartilage undermined with a dissecting scissors. In summary, the functional repair of cleft lip and nose could be possible at the same time by using Delaire method. This method is effective to correct the primary nasolabial deformity, which results in the restoring favorable anatomy and its function.

• Journal of Veterinary Clinics
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• v.25 no.1
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• pp.31-36
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• 2008

One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.130-133
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• 2012

The purpose of this study is to assess the relationship between glomerular filtration rate (GFR) and age by using dynamic computed tomography (CT) and Patlak plot analysis in dogs. Fifteen dogs were used in this study. CT-GFR study was performed under general anesthesia using propofol and isoflurane. 1 ml/kg dosage of 300 mgI/ml iohexol was administered at a rate of 3 ml/s during GFR measurement. CT-GFR was determined with a single-slice dynamic acquisition and Patlak plot analysis. The individual and global GFR values were calculated to plasma clearance per body weight (ml/min/kg). Bodyweight ($mean{\pm}SD$) ranged from 2.0 to 5.7 kg ($3.31{\pm}1.13$ kg). Age ranged from 3 years to 13 years old ($7.14{\pm}3.30$). $Mean{\pm}SD$ creatinine ($0.53{\pm}0.34 $mg/dl), phosphorus ($4.1{\pm}1.2$ mg/dL), and albumin ($3.3{\pm}0.3$ mg/dL) concentrations and urine protein-to-creatinine ratios (all ratios were < 0.5) were within reference ranges. Abdominal ultrasonography revealed small-sized renal calculi, mineralization, or renal cyst at eight dogs. The global CT-GFR ranges shown in this study was 2.57 to 6.60 ml/min/kg. In this study, there was no trend toward weight-adjusted CT-GFR with increasing age. We found no relationships between age-related kidney dysfunction in fifteen dogs. Small-sized renal calculi or cysts did not affect renal function in this study. However, it is thought that a large sample size may have been required to document an age effect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.384-390
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• 2012

Purpose: The purpose of this study is to examine in vivo osteogenesis of cultured human periosteal-derived cells and polydioxanone/pluronic F127 scaffold. Methods: Two one-year-old miniature pigs were used in this study. $2{\times}10^6$ periosteal-derived cells in 1 mL medium were seeded by dropping the cell suspension into the polydioxanone/pluronic F127 scaffold. These cell-scaffold constructs were cultured in osteogenic Dulbecco's modified Eagle's medium for 7 days. Under general anesthesia with azaperone and tiletamine-zolazepam, the mandibular body and ramus of the pigs were exposed. Three bony defects were created. Polydioxanone/pluronic F127 scaffold with periosteal-derived cells and the scaffold only were implanted into each defect. Another defect was left empty. Twelve weeks after implantation, the animals were sacrificed. Results: New bone formation was clearly observed in the polydioxanone/pluronic F127 scaffold with periosteal-derived cells. Newly generated bone was also observed in the scaffold without periosteal-derived osteoblasts and empty defect, but was mostly limited to the periphery. Conclusion: These results suggest that cultured human periosteal-derived cells have good osteogenic capacity in a polydioxanone/pluronic F127 scaffold, which provides a proper environment for the osteoblastic differentiation of these cells.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.473-479
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• 2012

Warthintumor (WT), also known as adenolymphoma or papillary cystadenoma lymphomatosum, was described in 1895 for the first time. It is a common benign tumor of the parotid glands and the second most common neoplasm of the salivary gland, accounting for 5% to 14% of all parotid neoplasm. A 63-year-old man visited our clinic with the complaint of swelling on the right parotid gland. Physical examination showed a 3 cm, firm, well-circumscribed, painless mass on the right mandibular angle. Computed tomography imaging showed a $3.5{\times}2.0{\times}1.6$ cm well-defined cystic mass. WT is histologically characterized by bilayered, oncocystic cell, lymphoid stroma, and cystic space. With these typical cytomorphologic characteristics, the fine-needle aspiration cytology was performed as diagnostic tool before the surgery. The lymphocytes and oncocystic cell were not observed. The lesion was completely excised under general anesthesia. We diagnosed the case as WT, from the surgically excised specimen. We report on the case with a review of the literatures.

• The korean journal of orthodontics
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• v.20 no.3 s.32
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• pp.447-462
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• 1990

The objective of this experiment is to observe structural differences in the othodontic movement of vital (control group) and devitalized (experimental group) teeth in the mongrel dogs. The 5 utilized dogs in this experiment were approximately 1 year of age and their average weight was about 12 Kg. Endodontic therapy was performed on the 2nd premolars in upper & lower jaws of each animal under the general anesthesia by intravascular injection of 25mg/kg of pentobarbital sodium. The canals of the teeth were obturated by using gutta percha in conjunction with root canal sealer (AH26 Densply). One of the roots in the 2nd premolars was hemisected to make an extraction space for the devitalized teeth to be moved. The edgewise technique was employed for the movement of the teeth. Orthodontic models and intraoral roentgenograms were taken before and after orthodontic tooth movement. The open coil springs (.010 x .040) were used at interbraket space in order to provide equal forces (75gm) between the teeth in each arch wire. After 13 weeks of active orthodontic tooth movement, dogs were sacrified and the experimental results w ere examined through the intraoral radiography, microscopic examination and scanning electromicroscopic examination at the root sulfate. From the results of the study, the following conclusions may be drawn: The root resolution and cemental deposition were observed within the pressure and tension site in both group. 2. The root resorbed lacunae were observed in the cementum and/or into the dentin in both group. 3. The prominent osteoblastic activities were observed on the alveolar margin in the tension site in both group. 4. A few of blood vessels were observed in the pressure site, but also lots of blood vessels were observed in the tension site especially in the periphery of the alveolar bone in both group. 5. In the pressure site, resorbed lacunae were formed with deep and narrow cavity in the control group; the shallow and wide cavity in the experimental group. 6. In the pressure site, the repaired cementum or cementoid tissue was lined on cementum in the experimental group, but not in the control group. 7. There was no significant difference between external root resolution of endodontically and vital teeth when both were subjected to orthodontic forces.