• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.1 s.4
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• pp.19-27
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• 2003

Background: Conscious sedation is a minimally depressed level of consciousness that retains the patient's ability to maintain the airway continuously and to respond appropriately to physical stimulation and verbal command at any time, produced by a pharmacologic or nonpharmacologic method or a combination thereof. In dental anesthesia, a state of sedation in which the conscious patient is rendered free of fear, apprehension, and anxiety through the use of pharmacologic agents. Midazolam is a useful drug of benzodiazepine on minor operation of dentistry. The purpose of this study is to estimate the appropriate dosage protocol of midazolam to the patient receiving intravenous sedation at the department of oral and maxillofacial surgery. Methods: Total subject was fifty-one patients and fifteen patients of this subject were decided to control group (Group I) that they were not received intravenous sedation. The experimental group was randomly subdivided into two groups and each of those groups was administrated to 0.05 mg/kg (Group II) and 0.08 mg/kg (Group III) each other. All patients of the subject were surveyed with postoperative one day questionaire to evaluate the level of sedation. Results: In view of antegrade amnesia, 1. Group II and III were statistically different compared to Group 1, respectively. 2. Group II and III were not statistically different. Conclusions: Apparent antegrade amnesia was found in both groups 0.05 mg/kg and 0.08 mg/kg intravenously administered. So we present the protocol of the department of oval and maxillofacial surgery, Kangnung National University Dental Hospital. But further studies concerning patient's age, body weight, and general condition will be carried out.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.163-166
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• 2014

A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.291-295
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• 2012

Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient. A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery. We detected the ureteral injury early and took a definitive action within 24 hours. In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.

• Journal of Chest Surgery
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• v.33 no.9
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• pp.729-733
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• 2000

Background: Recent trends suggest that minimally invasive cardiac surgery reduces postoperative morbidity and offers a cosmetic benefit. This study was performed to evaluate the CPB time, ACC time, OP time, ICU stay and postoperative hospital stay following a lower partial sternotomy and those of the median sternotomy. Material and Method: A group of 26 adult patients who underwent cardiac surgery through lower partial sternotomy from August 1997 to July 1999(A group) were compared to 45 adult patients who underwent cardiac surgery through median sternotomy from January 1996 to July 1997(B group). The mean ages(46.4$\pm$14.6 years, A group and 46.8$\pm$13.2 years, B group) were similar. Operations were performed with central cannula and antegrade/retrograde blood cardioplegia. Result: There was no death in each group. No differences were found in CPB time, ACC time, OP time, ICU stay and postoperative hospital stay. Postoperative complications were sternal splitting in a patient in group A and a patient with bleeding that required reoperation and a patient with delayed wound closure in group B. Conclusion: The lower partial sternotomy offered a cosmetic benefit, but does not significantly reduced the length of operative time and hospital stay. Minimally invasive cardiac surgery will be applied increasing because of the suggested advantage and choosing a proper operative technique will be helpful.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.28-34
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• 2018

Purpose : The purpose of this study was to compare the effect of recirculation rate according to cannulation direction and interval among hemodialysis patients with arteriovenous fistula (AVF). Method : The research used repeated measures design. This study was conducted among thirty patients who received hemodialysis three times a week for longer than a year through AVF at the I University hospital. Three different types of interventions were administered to the participants each week for three weeks. Needles were placed at a different distance and in a different direction each week: 7 cm apart from each other in antegrade direction during the first week, 5 cm apart in retrograde direction in the following week, and 7 cm apart in retrograde direction in the third week. Results : No significant differences in the recirculation rate were found due to any of the three tested methods (p = 1.00). Conclusion : This finding suggests that, if the patients have well-functioned AVF, we can choose an appropriate intervention from among the three methods in consideration of the patient's diverse needs.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.402-408
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• 1998

A 56-year old female underwent total aortic arch replacement March 1995, because of an expanding chronic Debakey type I aortic dissection. This aortic dissection had an intimal tear at the origin of the right carotid artery. Retrograde and antegrade propagation of dissection resulted in aortic arch blood flow separation and expanding pseudolumen to the abdominal aorta. Sudden anuria(ARF) developed 3 hours later postoperatively and renal doppler ultrasonography and aortography showed diminished blood flow of renal arteries. We performed balloon aortic dilatation but failed. She could be restored good renal flow after intimal flap fenestration resection and thrombectomy of the abdominal aorta. This patient could be discharged in a state of mild CRF after 2 months of ICU care for respiratory and renal failure.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.20 no.4
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• pp.235-240
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• 2018

The safety and feasibility of simple coil embolization and stent deployment for the treatment of posterior inferior cerebellar artery (PICA) aneurysms, as well as their radiologic and clinical results, have not been adequately understood. Especially, if dissecting aneurysm of proximal PICA is associated with small caliber PICA and stenosis of ipsilateral vertebral artery orifice (VAO), endovascular coiling with saving of PICA is not always easy. This 64-year-old man presented with subarachnoid hemorrhage due to a ruptured dissecting aneurysm of left proximal PICA. The aneurysm was irregularly fusiform in nature with a shallow PICA orifice (1.4 mm) and narrow caliber (0.9-1.5 mm). Moreover, the ipsilateral VAO showed severe stenosis (1.8 mm). We performed bifemoral puncture and chose additional route from right vertebral artery to left vertebrobasilar junction for retrograde approach and deployment of LVIS Jr. intraluminal support at proximal PICA. And then, the antegrade approach and coiling of aneurysm was done. Despite of transient thrombus of PICA, the aneurysm was successfully secured with preservation of whole PICA course. For preservation of narrow PICA with ipsilateral VAO stenosis, the contralateral approach and deployment of LVIS Jr. intraluminal support may be considered.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.169-174
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• 2009

Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.473-477
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• 2020

Superficial inferior epigastric artery (SIEA) flaps represent a useful option in autologous breast reconstruction. However, the short-fixed pedicle can limit flap inset options. We present a challenging flap inset successfully addressed by de-epithelialization, turnover, and counterintuitive rotation. A 47-year-old woman underwent left tertiary breast reconstruction with stacked free flaps using right deep inferior epigastric perforator and left SIEA vessels. Antegrade and retrograde anastomoses to the internal mammary (IM) vessels were preferred; additionally, the thoracodorsal vessels were unavailable due to previous latissimus dorsi breast reconstruction. Optimal shaping required repositioning of the lateral ends of the flaps superiorly, which would position the ipsilateral SIEA hemi-flap pedicle lateral to and out of reach of the IM vessels. This problem was overcome by turning the SIEA flap on its long axis, allowing the pedicle to sit medially with the lateral end of the flap positioned superiorly. The de-epithelialized SIEA flap dermis was in direct contact with the chest wall, enabling its fixation. This method of flap inset provides a valuable solution for medializing the SIEA pedicle while maintaining an aesthetically satisfactory orientation. This technique could be used in ipsilateral SIEA flap breast reconstructions that do not require a skin paddle, as with stacked flaps or following nipple-sparing mastectomy.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.6
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• pp.533-542
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• 2015

Little human tissue data are available for slow waves and migrating motor complexes, which are the main components of small bowel motility. We investigated the electrophysiological and mechanical characteristics of human ileal motility, in vitro. Ileum was obtained from patients undergoing bowel resection. Electrophysiological microelectrode recordings for membrane potential changes and mechanical tension recordings for contraction from smooth muscle strips and ileal segments were performed. Drugs affecting the enteric nervous system were applied to measure the changes in activity. Slow waves were detected with a frequency of 9~10/min. There were no cross-sectional differences in resting membrane potential (RMP), amplitude or frequency between outer and inner circular muscle (CM), suggesting that electrical activities could be effectively transmitted from outer to inner CM. The presence of the interstitial cell of Cajal (ICC) at the linia septa was verified by immunohistochemistry. Contractions of strips and segments occurred at a frequency of 3~4/min and 1~2/min, respectively. The frequency, amplitude and area under the curve were similar between CM and LM. In segments, contractions of CM were associated with LM, but propagation varied with antegrade and retrograde directions. Atropine, $N^W$-oxide-L-arginine, and sodium nitroprusside exhibited different effects on RMP and contractions. There were no cross-sectional differences with regard to the characteristics of slow waves in CM. The frequency of contractions in smooth muscle strips and ileal segments was lower than slow waves. The directions of propagation were diverse, indicating both mixing and transport functions of the ileum.