• Archives of Plastic Surgery
• /
• 제41권4호
• /
• pp.312-316
• /
• 2014

This is a review article of the wide-awake approach to hand surgery. More than 95% of all hand surgery can now be performed without a tourniquet. Epinephrine is injected with lidocaine for hemostasis and anesthesia instead of a tourniquet and sedation. This is sedation-free surgery, much like a visit to a dental office. The myth of danger of using epinephrine in the finger is reviewed. The wide awake technique is greatly improving results in tendon repair, tenolysis, and tendon transfer. Here, we will explain its advantages.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제18권5호
• /
• pp.315-317
• /
• 2018

• Journal of Chest Surgery
• /
• 제50권3호
• /
• pp.211-214
• /
• 2017

Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery. Awake ECMO was also used to avoiding the complications of sedatives and mechanical ventilation. Here, we describe a successful operation using awake ECMO as a bridge to surgery.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제17권4호
• /
• pp.313-316
• /
• 2017

Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.

• Clinical and Experimental Pediatrics
• /
• 제51권8호
• /
• pp.861-867
• /
• 2008

목 적 : 소아청소년 간질 환자에서 뇌파 검사를 시행 할 때 수면-각성주기가 각성 뇌파에 비해 간질파의 발현에 미치는 영향과 이에 관련된 인자들을 알아보고자 본 연구를 시행하였다. 방 법 : 2005년 7월 1일부터 2006년 7월 31일까지 부산대학교병원에서 치료 중인 소아청소년 간질 환자에서 수면 뇌파(S)와 각성 뇌파(W)를 동시에 찍은 환아 178명을 대상으로 하였다. 전체 환자들에서 수면 뇌파와 각성 뇌파에서 간질파의 발현율(S1, W1)을 구하여 서로 비교 분석하였다. 또한 전체 환자들을 성별, 경련의 유형 및 원인, 첫 경련 시 나이, 뇌파 검사 당시 항경련제 복용 유무, 뇌파 검사 시 나이, 그리고 배경파의 이상 여부와 같은 인자들에 따라 환자군을 나누었고, 각 환자군에서의 수면 뇌파와 각성 뇌파에서 간질파의 발현율을 비교분석하였다. 결 과 : 전체 환자의 수면 뇌파에서 간질파의 발현율(45.5%)이 각성 뇌파에서 간질파의 발현율(28.7%)보다 의미 있게 높았다(P<0.001). 남아 군에서 S1 (45.7%), W1 (28.3%)로 수면 뇌파에서 간질파의 발현율이 높았으며(P<0.01), 여아 군에서도 S1 (45.3%), W1 (29.1%)로 수면 뇌파에서 간질파의 발현율이 각성 뇌파에서보다 의미 있게 높았다(P<0.05). 부분성 발작군에서는 S1 (67.9%)이 W1 (35.8%)보다 의미 있게 높았지만(P<0.001), 전신성 발작군에서는 S1 (25.6%), W1 (22.2%)로 나타났으나 통계학적인 의의는 없었다. 4) 특발성 발작군에서 S1 (41.8%)이 W1 (27.0%)보다 의미 있게 높았고(P<0.01) 증후성 발작군에서도 S1 (59.5%)이 W1 (35.1%)보다 의미 있게 높았다(P<0.05). 경련시 나이가 5세 이하 환자군에서 S1 (46.7%), W1 (30.4%)로 수면 뇌파 검사에서 간질파의 발현율이 더 높게 나타났으나 통계학적인 의의는 없었으며 5세 초과의 환자군에서는 S1 (44.2%), W1 (26.7%)로 수면 뇌파에서 간질파의 발현율이 각성 뇌파에서 간질파의 발현율보다 의미 있게 높았다(P<0.01). 뇌파 검사 당시 항경련제 복용 중인 환자군에서는 S1 (54.0%)이 W1 (31.0%)보다 의미 있게 높았지만(P<0.001) 항경련제를 복용하지 않고 있는 환자군에서는 S1 (30.8%), W1 (24.6%)로 통계학적인 의의는 없었다. 뇌파 검사 시 나이가 10세 이하인 군에서 S1 (44.3%), W1 (26.8%)로 수면 뇌파 검사에서 간질파의 발현율이 더 높게 나타났으나 통계학적인 의의는 없었으며 10세 초과인 환자군에서는 S1 (46.9%), W1 (30.9%)로 수면 뇌파에서의 간질파 발현율이 각성 뇌파에서보다 높게 나타났다(P<0.05). 정상 배경파를 보인 군에서 S1 (44.1%), W1 (27.0%)로 S1이 W1보다 유의하게 높았으나(P<0.001) 비정상 배경파를 보이는 군에서는 S1 (53.8%), W1 (38.5%)로 의미 있는 차이를 보이지 않았다. 결 론 : 소아청소년 간질 환자의 뇌파 검사 상 대부분의 환자군에서 수면 뇌파의 간질파 발현율이 각성 뇌파에서보다 유의하게 높았다. 이러한 결과를 고려할 때 간질이 의심되는 소아에서 간질의 진단을 위해서 뇌파 검사를 시행할 때에 반드시 수면 뇌파를 시행하는 것이 권장된다. 전신성 발작군, 첫 경련 시 나이가 5세 이하군, 뇌파 검사 당시 항경련제 비복용군, 뇌파 검사 시 나이가 10세 이하인 군, 그리고 배경파의 비정상소견이 보이는 뇌기능 저하 소견을 보이는 환자군에서는 각성 뇌파에서도 간질파의 발현이 비교적 높게 나타났다.

• 제어로봇시스템학회:학술대회논문집
• /
• 제어로봇시스템학회 1996년도 Proceedings of the Korea Automatic Control Conference, 11th (KACC); Pohang, Korea; 24-26 Oct. 1996
• /
• pp.19-23
• /
• 1996

A full automatic interpretation of awake electroencephalogram (EEG) had been developed by the authors and presented at the past KACCs in series. The automatic EEG interpretation consists of four main parts: quantitative EEG interpretation, EEG report making, preprocessing of EEG data and adaptable EEG interpretation. The automatic EEG interpretation reveals essentially the same findings as the electroencephalographer's (EEG's), and then would be applicable in clinical use as an assistant tool for EEGer. The method had been developed through collaboration works between the engineering field (Saga University) and the medical field (Kyoto University). This work can be understood as an artificial realization of human expert skill. The procedure for the artificial realization was summarized in a methodology for artificial realization of human skill which will be applicable in other fields of systems control.

• 건축사
• /
• 통권640호
• /
• pp.82-87
• /
• 2022

• 한국산학기술학회논문지
• /
• 제11권7호
• /
• pp.2638-2647
• /
• 2010

긴 preamble을 사용하는 비동기식 MAC 프로토콜의 문제점을 개선하기 위해 나온 프로토콜이 X-MAC 이다. 본 논문에서는 X-MAC의 문제점을 해결하기 위하여 Express-MAC이라는 새로운 MAC프로토콜을 제안하였다. 무선센서 네트워크는 주로 이벤트 데이터나 상황정보를 인지하는 목적에 많이 사용된다. 특히 침입감지 같은 이벤트 감지를 목적으로 하는 센서네트워크의 전송 패턴은 매우 간헐적이면서도 한 번의 이벤트 발생 시 연속적으로 일어나는 것이 대부분이다. EX-MAC은 위와 같은 센서 네트워크의 주요 전송 패턴을 반영하여 첫 이벤트 발생 시 데이터 전송에서 멀티 홉 경로의 채널 예약 및 awake 구간의 전송 시간 예약 방식을 사용하였다. 전송 경로상의 awake 시간 예약은 연속적인 데이터 전송의 단대단 지연 성능을 향상시켰으며 데이터 송수신 노드의 preamble 길이를 줄임으로써 에너지 소비 측면에서도 효율성을 증대시켰다.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제17권4호
• /
• pp.297-305
• /
• 2017

Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation. If the general method of intubation was expected to be difficult, awake intubation was performed. The degree of nasal bleeding during intubation was also evaluated. Results: The mean age of the operators (11 men, 7 women) was 27.8 years. FNI was performed in a total of 716 patients. The success rate was 88.3% for the first attempt and 94.6% for the second attempt. The failure rate of intubation in anesthetized patients was 4.9%, and 13.6% in awake patients. When intubation was performed in anesthetized patients, the failure rate from the first to fifth trial was 9.6%, which decreased to 0.7% when the number of trials increased to > 30 times. In terms of awake intubation, there was no failed attempt when the resident had performed the FNI > 30 times. The number of FNIs performed and nasal bleeding were important factors influencing the failure rate. Conclusion: The success rate of FNI increased as the number of FNI performed by residents increased despite the nasal bleeding.

• The Korean Journal of Physiology
• /
• 제27권1호
• /
• pp.37-49
• /
• 1993

Ventilatory responses to inhaled $CO_2$ were measured during continuous negative pressure breathing (CNPB) in awake dogs. End expiratory lung volume (EELV) decreased linearly with pressure level during CNPB (correlation coefficient= 0.81, p<0.005) during air breathing. When CNPB was applied during 5% $CO_2$ inhalation, the decrease in EELV was not significantly different (p<0.5) from that during air breathing. As a result of a lowered EELV, tidal volume ($V_T$) significantly decreased by 22% and breathing frequency ($f_B$) increased by 68% in the steady state during air breathing (p<0.0001). These responses were similar during 5% $CO_2$ inhalation, thus the $CO_2$ response curve measured during CNPB shifted upward without a change in sensitivity (p>0.05). These results indicate additive effects of CNPB and $CO_2$ inhalation. The degree of hyperventilation during CNPB at eupnea was estimated to be 63% of that during control ventilation and was significantly greater than zero (p<0.0001), which suggests an alveolar hyperventilation due to CNPB. These results suggest that the mechanical alterations associated with n decrease in lung volume could play an important role in ventilatory control independently of chemical regulation of breathing. Thus, exercise hyperpnea, which is associated with a lowered functional residual capacity (FRC), may in part be explained by this mechanical stimulation of breathing.