• Archives of Plastic Surgery
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• 제37권6호
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• pp.795-800
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• 2010

Purpose: According to various medical publications, it is believed that epinephrine should not be injected in fingers. However numerous articles show the successful use of local anesthetic with epinephrine in the digits. Epinephrine-mixed lidocaine solution enables to maintain a bloodless field for operation and provides long duration of local anesthesia when patient was wide awake. Methods: From May 2009 to December 2009, ten patients underwent flexor tendon reconstruction with local anesthesia using epinephrine. No tourniquet was necessary. Before operation, all patients were injected with local anesthetics using 1% lidocaine 20 mL and 0.1% epinephrine 0.1 mL. Results: There was no case of digital necrosis nor gangrene in the epinephrine injection. All 10 patients actively could move the finger through a full range of motion. All procedures were performed without sedation nor tourniquet and we could obtain a good vision of operative field and patients were comfortable. The patient make his or her fingers move through a full range of active motion before the skin is closed. Phentolamine was not required to reverse the vasoconstriction in any patients. Conclusion: The assertation that epinephrine should not be injected into the fingers is clearly no longer valid. The epinephrine injection allowed the authors to adjust flexor tendon surgery without risks associated with general anesthesia. It also enables to ensure longer anesthetic duration and bloodless operative field, and prevent post operative complications. In case of flexor tendon surgery, the use of epinephrine injection is recommended because of the advantages of local anesthesia.

• 한국컴퓨터산업학회논문지
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• 제6권3호
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• pp.465-476
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• 2005

무선 센서 네트워크는 물리적인 제약을 가진 수많은 센서 노드들로 구성되어 있다. 각 센서 노드는 주변의 상태를 감지하고, 감지된 정보를 싱크(Sink)로 보내는 역할을 한다. <중략> 본 논문에서는 교량과 같은 인공구조물에 적합한 비 계층적 무선 센서 네트워크 구조를 제시하였다. 또한, 센서 노드들의 휴면(Sleep)과 활동(Awake) 상태를 이용한 효율적인 보안 라우팅 프로토콜과 센서 노드의 키와 위치 정보를 사전에 노드에 분배하는 사전 키 분배 방식 및 2계층 인증 기법을 제안하였다. 제안하는 방식은 대체 경로 수의 증가로 인한 데이터 전송률의 증가와 에너지 소모율의 감소 효과를 보였다.

• Archives of Plastic Surgery
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• 제49권4호
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• pp.531-537
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• 2022

Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.

• 대한후두음성언어의학회지
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• 제14권2호
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• pp.83-87
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• 2003

Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

• Transactions on Control, Automation and Systems Engineering
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• 제4권3호
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• pp.239-243
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• 2002

Multi-valued decision making for transitional stochastic events was newly derived based on conditional probability of knowledge database which included experts'knowledge and experience. The proposed multi-valued decision making was successfully adopted to the determination of the five levels of the vigilance of a subject during the EEG (electroencephalogram) recording; awake stage (stage W), and sleep stages (stage REM (rapid eye movement), stage 1, stage 2, stage $\sfrac{3}{4}$). Innovative feature of the proposed method is that the algorithm of decision making can be constructed only by use of the knowledge database, inspected by experts. The proposed multi-valued decision making with a mathematical background of the probability can also be applicable widely, in industries and in other medical fields for purposes of the multi-valued decision making.

• 산업기술연구
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• 제25권B호
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• pp.211-220
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• 2005

The wireless sensor network consists of a number of sensor nodes which have physical constraints. Each sensor node senses surrounding environments and sends the sensed information to Sink. The inherent vulnerability in security of the sensor nodes has promoted the needs for the lightweight security protocol. In this paper, we propose a non-hierarchical sensor network and a security protocol that is suitable for monitoring the man-made objects such as bridges. Furthermore, we present the efficient way of setting the routing path by storing IDs, MAC(message authentication code) and the location information of the nodes, and taking advantage of the two node states, Sleep and Awake. This also will result in the reduced energy consuming rate.

• 대한임상독성학회지
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• 제6권1호
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• pp.45-48
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• 2008

A 57-year-old man was transferred to our emergency department with decreased mental status after organophosphate intoxication. He had a four year history of benzodiazepine and hypnotic medication use for chronic insomnia and a depressive mood disorder. He had no previous history of seizures, diabetes mellitus, and hypertension. By hospital day 5, the patient was noted to be awake and to have repetitive jerking movements involving the left upper extremity, and appeared apathetic, depressed and less responsive to external stimuli. A benzodiazepine withdrawal syndrome was subsequently apparent when he developed several generalized tonic clonic seizures and status epilepticus. Using a continuous midazolam intravenous infusion, we successfully controlled the refractory seizure without complications. We present a rare case of status epilepticus from a benzodiazepine withdrawal that developed during the treatment for organophosphate intoxication.

• 대한치과마취과학회지
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• 제13권2호
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• pp.51-54
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• 2013

A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and we successfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

• 한국조리학회지
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• 제6권3호
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• pp.343-355
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• 2000

Caffeine is widely consumed ingredient and it belongs to alkaloids. Many foods that we intake contain caffeine ; coffee, tea cocoa, chocolate, and coke. And it is also added to many commercial remedies ; cold tablets, headache tablets, etc. Effect of caffeine that is known to us so far is as follows; 1. Remaining awake for long hours 2. Increasing concentration and decreasing fatigue 3. Increasing basal metabolic rate 4. decomposing glycogen and body fat and providing energy 5. Stimulating gastric acid 6. Increasing urinary excretion. Caffeine containing beverages(especially, coffee)are also favorite food in adult. In case of children and youth, chocolate and coke are favorite food. So, to intake caffeine containing foods moderately can be a vitality of life. But, a long-term intake or overdose of caffeine can result in many side effects. For example, headache, irritability, restlessness, hypertension, fetal abnormality, etc. Therefore, it is desirable that caffeine intake is under 300-400mg per day. To decrease intake of caffeine, 1. Use decaffeinated coffee 2. Product of decaffeinated coffee bean through gene transformation 3. Indicate content and function of caffeine on caffeine-food container 4. Provide an information of caffeine to public.

• 한국정보과학회:학술대회논문집
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• 한국정보과학회 2004년도 가을 학술발표논문집 Vol.31 No.2 (3)
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• pp.25-27
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• 2004

Power Saving는 Portable 무선 기기 전반에 걸쳐 중요한 연구 과제로서, 에너지 절감을 위해 많은 protocol들이 제안되고 있다. 한편 에너지의 절감은 송수신 성능의 감소라는 문제점을 갖기 때문에 PS(Power Saving) protocol 설계상의 주요 과제는 이 trade-off에 대하여 송수신성능의 희생을 최소화 하면서 에너지 절감율을 대폭 향상 시키는 데에 있다. 본 논문에서는 저자들이 [1]에서 이미 제안한 바 있는 SPFAI(Synchronized Periodically-Fully-Awake-Interval ) Protocol을 개선하여 한층 더 효율적인 PS protocol을 제시하고 기존 SPFAI과의 성능비교를 위하여 대표적인 공개 network simulator인 NS2[2]를 이용하여 제안된 protocol의 성능을 검증한다.