• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.189-193
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• 2018

A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.126-132
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• 2017

Background: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. Methods: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%-75%, Group C: 25%-50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. Results: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). Conclusions: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.

• Journal of Korean society of Dental Hygiene
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• v.15 no.2
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• pp.319-324
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• 2015

Objectives: The purpose of this study was to verify the oral environmental change in using the natural oral cleaner containing propolis and prevention effect of oral disease. Methods: The subjects were 60 university students in Gangwon province. The groups consisted of 30 students of experimental group and 30 students of control group. The subjects were those who did not take the antipsychotic, diuretic, antihistamine, and anesthetic. The students rinsed their mouth with propolis mixture of oral cleanser for 4 weeks after receiving informed consent from October 1 to November 2, 2012. Collected saliva was measured for amount, salivary consistency, pH, plague index, gingival index, and halitosis. Results: The amount of salivary in propolis mixture of oral cleansing group remarkably increased (t=2.16, p<0.05). pH was alkaline in the group with oral cleaner containing the propolis (t=2.80, p<0.01). The bad breath remarkably decreased in the group with oral cleaner containing the propolis (t=-5.77, p<0.001). Conclusions: The use of the oral cleaner containing the propolis increased the amount of salivary and pH. The use of oral cleaner containing the propolis reduces halitosis and maintains good quality of oral hygiene.

• The Korean Journal of Physiology and Pharmacology
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• v.2 no.3
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• pp.307-312
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• 1998

This study was performed to investigate the mechanism of central analgesic effects of antidepressants. Thirty four male rats were anesthetized with pentobarbital sodium (40 mg/kg, ip). A stainless steel guide cannula and a PE tube (PE10) were implanted into the lateral ventricle and cisterna magna area. Stimulating and recording electrodes were implanted into the incisor pulp and anterior digastric muscle. Electrodes were led subcutaneously to the miniature cranial connector sealed on the top of the skull with acrylic resin. The jaw opening reflex was used in freely moving rats, and antidepressants were administered intracisternally in order to eliminate the effects of anesthetic agents on the pain assessment and evaluate the importance of the central action site of antidepressants. After 48 hours of recovery from surgery, digastric electromyogram (dEMG) of freely moving rats was recorded. Electrical shocks (200 ${\mu}sec$ duration, 0.5-2 mA intensity) were delivered at 0.5 Hz to the dental pulp every 2 minute. Intracisternal administration of $15\;{\mu}g$ imipramine suppressed dEMG elicited by noxious electrical stimulation in the tooth pulp to $76{\pm}6%$ control. Intracisternal administration of $30\;{\mu}g$ desipramine, nortriptyline, or imipramine suppressed dEMG remarkably to $48{\pm}2,\;27{\pm}8,\;or\;25{\pm}5%$ of the control, respectively. Naloxone, methysergide, and phentolamine blocked the suppression of dEMG produced by intracisternal antidepressants from $23{\pm}2\;to\;69{\pm}4%,\;from\;32{\pm}5\;to\;80{\pm}9%,\;and\;from\;24{\pm}6\;to\;77{\pm}5%$ of the control, respectively. These results indicate that antidepressants produce antinociception through central mechanisms in the orofacial area. Antinociception of intracisternal antidepressants seems to be mediated by an augmentation of descending pain inhibitory influences on nociceptive pathways.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.1
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• pp.25-31
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• 2000

ATP-sensitive potassium channels ($K_{ATP}$ channels) play an important role in insulin secretion from pancreatic beta cells. We have investigated the effect of propofol on $K_{ATP}$ channels in cultured single pancreatic beta cells of rats. Channel activity was recorded from membrane patches using the patch-clamp technique. In the inside-out configuration bath-applied propofol inhibited the $K_{ATP}$ channel activities in a dose-dependent manner. The half-maximal inhibition dose (ED50) was $48.6{\pm}8.4\;{\mu}M$ and the Hill coefficient was $0.73{\pm}0.11.$ Single channel conductance calculated from the slope of the relationship between single channel current and pipette potential $(+20{\sim}+100\;mV)$ was not significantly altered by propofol $(control:\;60.0{\pm}2.7\;pS,\;0.1\;mM\;propofol:\;58.7{\pm}3.5\;pS).$ However, mean closed time was surely increased. Above results indicate that propofol blocks the $K_{ATP}$ channels in the pancreatic beta cells in the range of its blood concentrations during anesthesia, suggesting a possible effect on insulin secretion and blood glucose level.

• Journal of Chest Surgery
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• v.25 no.5
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• pp.469-479
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• 1992

Searching for the clinical effects of colloid solutions that used to increasing the oncotic pressure of priming solutions at the cardiopulmonary bypass, 29 patients [who were diagnosised as simple VSD around 10kg of body weight and scheduled to be operated from June 1990 to December 1990 at Sejong General Hospital] were divided randomly and prospectively to the two groups: A group [15] was received 4gm% albumin as addition to the priming solutions and B Group [14] the same amount of Ringer`s lactated solution. 34 clinical parameters [Body weight, sex, age, body surface area, Qp/Qs, pulmonary arterial pressure, cardiopulmonary bypass time, anesthetic time, intraoperatively infused crystalloid and colloid amount, hemoglobin, hematocrit, serum sodium concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum concentration, serum osmolarity, urine osmolarity, urine specific gravity, serum protein, serum albumin concentration, urine output, central venous pressure, postoperatively infused colloid amount, immedediate post-operative peak inspiratory pressure, cardiac index, blood pressure and pump flow during cardiopulmonary bypass, inotro-pic assist, diuretics, extubation period, total drain amount, duration of ICU] were measured and compaired between the two groups. There were no differences of preoperative and operative clinical parameters. And postoper-atively, practically there were no nearly differences at the clinical outcomes between the two groups, but some parameters [cardiac index, PIP, BP and pumpflow during CPB, etc] contributed to being preferable to the Group A at certain times [P<0.05]. Conclusively, it might be thought that the priming solution of cardiopulmonary bypass added by colloid solution had some beneficial effects on the patients, especially younger and associated with complex anomaly to be expected taken longer time of cardiopulmonary bypass, and more studies about the neonatal and complex anomaly cases were needed in that points.

• Journal of Chest Surgery
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• v.3 no.2
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• pp.91-106
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• 1970

Two groups of left pulmonary-subclavian artery anastomosis were done in 26 adult mongorel dogs. For the first group. the distal end of the subclnvian artery was nnastomosed to the side of the left pulmonary artery, and for the second group, the subclavian end wns anastomosed to the proximal end of the left lower lobe pulmonary artery. Among them, 6 died of bleeding or anesthetic failure during the day of operation, 10 survived 1 to 106 days and the other 10 were sacrificed at various interval. To investigate the relationship between hemodynamic stress and temporal evolution of the pulmonary vascular lesions. the pulmona try and femoral artery pressures, arteriogram and pathohistological specimens were obtained. The following results were obtained. 1. The postoperative pulmonary artery pressures were within normal limits except 2 dogs in the first group, but in nil 12 dogs of the second group, they were in moderate to maked pulmonary hypertension level. 2 After subclavian pulmonary anastomosis, both groups dogs showed increased femond artery pulse pressure. 3. The pulmonary vascular changes were more severe and appeared earlier in the second group dogs compared with the first group.4. The earliest vascular changes appeared in the media of the small muscular arteries and arterioles. 5. Various vascular chaDges were produced in 2 or 3 months. Thereafter, the changes were stationary. 6. Among the first group, two long-term servivors (No. 705 & 713) which had normal pulmonary artery pressure under the anesthesia, also showed various vascular changes as other pulmonary hypertensive dogs. 7. In the early stage medial hypertrophy. interruptio~l of elastic lamellae were found in the small muscular arteries and arterioles, which were followed by intimal proliferation and thrombosis. These findings may suggest some evidences of trauma to the vessels. 8. Pulmonary arteriograms showed irregularity of the intima of the large and medium sized arteries, abrupt ending of some of the small arteries and narrowing of the anastomosis.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.684-688
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• 1995

Hyperhidrosis, one of the abnormalities in autonomic nervous system, has been treated with dermatologic principles or thoracic sympathectomy via conventional axillary thoracotomy or dorsal spinal approach. But these techniques were rather ineffective or invasive. Recently, VATS is widely applied in thoracic surgical area, and hyperhidrosis is not the exception of these cases.From May 1993 to August 1994, 30 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic [T2, T3 sympathectomy with thoracoscopic surgery at Seoul National University Hospital. There were 20 men and 10 women and the mean age was 23.0 years.Mean operating time was 115 min and there was no thoracotomy conversion. Operative complications were anesthetic overdose in 1, Horner`s syndrome in 1, and small amount of residual pneumothorax in 6. Mean postoperative hospital stay was 2.3 days [range from 1 to 4 days and postoperative analgesics were required in 17 cases with a single dose.Sweating amount was measured in 12 patients, showing significantly decreased amount from 284.5 mg preoperatively to 18.9 mg postoperatively in 5 minutes [p=0.004 . There was no recurrence during mean 6 months follow up. Twenty two patients [73.3 % complained moderate compensatory hyperhidrosis on the trunk.In conclusion, all patients were greatly satisfied with those results including no more palmar sweating, less pain, better cosmetics, short hospital stay. In addition, recent use of sweating amount measurement and intraoperative temperature monitoring could make this technique more accurate, so we easily applied thoracoscopic sympathectomy with minimal risk.

• Restorative Dentistry and Endodontics
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• v.21 no.2
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• pp.677-687
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• 1996

This study was conducted to evaluate the tissue responses histologically to three root canal cements : Sealapex, AH-26, and zinc oxide-eugenol cement. Twelve white female Sprague-Dawley rats, weighing between 350 and 400 gm, were anesthetized with an intraperitoneal injection of Ketamine hydrochloride(0.4 ml). After shaving the sites selected(left and right scapular areas, left and right pelvic areas), the animal's backs were scrubed with soap and water, and sterilized with absolute alcohol. Each material was mixed to a thin consistency to flow out easily through a 24-guage needle, and loaded into a sterile, disposable plastic 1-ml syringe. All of the rats were injected subcutaneously with 0.1 ml of the three test sealers. Normal saline was used as a control. Animals were sacrificed after 48hr, 1, 4, and 12 weeks by overanesthetization using jars containing anesthetic ether. The tested sites were surgically removed with the surrounding tissue and fixed with 10% formalin. After 48 hours specimens were embedded in paraffin, sectioned to an average thickness of $6{\mu}m$ thick, stained with hematoxylin-eosin. The slides were examined under the light microscope. The results were obtained as follows 1. All material except the control showed various degree of inflammation on 48 hr. 2. Sealapex : In early stage, severe inflammatory cell infiltration was observed. At the 4th weeks observation, graunlomatous tissue with macrophage and foreing body giant cells containing many dark particles in their cytoplasm was observed. 3. AH-26 : Mild inflammatoy reaction was observed with AH-26 throughout the experimental period. 4. Zinc oxide-eugenol cement : Severe inflammatory cell infiltration, necrosis along the material, edema could be seen in early stage. Zinc oxide-eugenol cement maintained a moderate/severe reaction throughout the experimental period.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.2
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• pp.95-100
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• 2014

Background: About 60% of patients with epilepsy showed a variety of complications after returning home. The purpose of this study is to get further information and to help in the anesthetic management of the disable patients with epilepsy. Methods: After searching the outpatient anesthesia list of Seoul National University Dental Hospital clinic of the disabled from September 2010 to March 2012, we found total 83 patient cases who were taking antiepileptic drugs. A nurse of anethesiology department called to the patient's home after general anesthesia and got surveys with questionnaires form filled with complications at home. We enrolled total of 51 patients who agreed to participate this survey. And we also reviewed pre-anesthesia evaluation sheet, anesthesia record, and recovery and discharge record. Results: 11 of 51 (21.6%) patients had seizure convulsion at home within 1 weeks. 33.4% of patients who had at least once seizure attack per week had a seizure attack within 3 days. And 50% of once a month frequency patients had a seizure attack within 1 week. 33% of 1 - 3 seizure attacks per year patient group had a convulsion within 1 week. But there was no seizure attack within 1 week in whom had no seizure attack history during more than 1 year. Conclusions: After dental treatment, patient taking anticonvulsant have so many complications-especially seizure, more than we respected. We need more research about handle these problems.