• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.213-221
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• 1996

To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.65-69
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• 2017

Patients with severe gag reflex (SGR) have difficulty getting the treatment they require in local clinics, and many tend to postpone the start of their treatment. To address this problem, dentists have used behavioral techniques and/or pharmacological techniques for treatment. Among the pharmacological methods available, propofol IV sedation is preferred over general anesthesia because it is a simpler procedure. Propofol in combination with remifentanil is characterized by stable sedative effects and quick recovery, leading to a deep sedation. Remifentanil acts to reduce the pain caused by lipid-soluble propofol on injection. The synergistic effects of propofol-remifentanil include reduction in the total amount of drug required to achieve a desired sedation level and anti-emetic effects. In this case report, we outline how the use of propofol-remifentanil IV sedation enabled us to successfully complete a wide range of dental treatments in a patient with SGR.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.330-336
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• 1989

The patient was 47-year-old male who had suffered from aphasia and hemiplegia of the right side, but mental state was alert. On physical examination, BP was 130/80 mmHg in the right arm, but not checked in the left arm. The pulses of the left common carotid, brachial, and radial arteries were not palpable. The pulses of the right femoral, popliteal, and dorsalis pedis arteries were weakly palpable. Brain CT Scan revealed cerebral infarction of the left hemisphere. Aortogram showed occlusion of the left common carotid, and the right internal carotid and common iliac arteries. Subclavian steal phenomena were observed in the delayed aortogram. Double extra-anatomic bypasses; Axillo-Axillar bypass and Femora-Femoral bypass, were performed in the local anesthesia at two stages, because of risk of major operation under general anesthesia. Postoperatively, all pulses except for pulse of the left common carotid artery were equally palpable. On discharge, the hemiplegia of the right side was improved and able to walk with assistance.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.389-394
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• 1988

The patient was 22-year old male who had been suffered from labored breathing. Computerized tomography, tracheoscopy, tracheogram disclosed tracheal obstruction by external mass compression on Tl level, which ranged 4.Oem in the length and approximately 4mm in diameter on tracheogram. Under the local anesthesia, tracheostomy was done to prevent intraoperative airway obstruction. And general anesthesia, low collar incision 8z extended median sternotomy was made and nearly total thyroidectomy was performed. After the circumferential resection of the obstructed segment approximately 4cm in length[7 tracheal rings], direct end-to-end anastomosis of trachea was performed. Postoperatively, the patient`s neck was maintained in flexion state to reduce tension of anastomotic site. Postoperatively. medical therapy[Comthyroid k Calcium lactate] and radiotherapy were done. At present, 2-months after operation, he lives well.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.1
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• pp.52-54
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• 2017

Vocal polyps are benign laryngeal lesions which arise from the Reinke's space abd hoarseness is the most common symptom. However, airway compromised is rarely presented in the vocal polyp. A rare case of large subglottic polyp causing dyspnea is reported. Tracheostomy was performed under local anesthesia and then the mass was resected under general anesthesia using a laryngofissure approach. The dyspnea and hoarseness disappeared after surgery immediately. The histopathological findings indicated a diagnosis of vocal cord polyp with chronic inflammatiuon. We consider that tracheostomy is the safest and most useful procedure to guarantee the upper airway in cases of large vocal polyp showing dyspnea. We hereby report a case of huge subglottic polyp in which a tracheostomy and laryngofissure was required for removing the subglottic mass successfully.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.126-130
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• 2007

Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.270-274
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• 1993

Massive extradural spread, distinguished from subarachnoid injection that sometimes follows the introduction of small amounts of local anesthetics or narcotics during attempted epidural anesthesia or analgesia, has been attributed to subdural injection. A 64-year-old woman was admitted for partial radical hysterectomy under general anesthesia after insertion of lumbar epidural cathter by loss of resistance technique with 5 ml of air. In this case, we experienced severe respiratory depression and loss of consciousness after administration of 4 mg of morphine for postoperative pain control. We confirmed air shadows at right silvian and suprasella cisterna region by CT scanning. Patients was recovered without sequele after 2 days, As this case resembles a "massive epidural", it is suggested that subdural injection rather than epidural injection may explain the phenomenon.

• Journal of Biomedical Engineering Research
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• v.18 no.2
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• pp.127-132
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• 1997

Recently there has been increased interest in the use of iontophoresis for the transdermal delivery of drugs, both ionic and nonionic. The use of iontophoresis has been rare over the years due to the lack of domestic supplies of the instrument and the expensive iontophoresis instrument made by foreign country. The purpose of this study was to design a commercially available iontophoresis system (WIT- 1 ). The efficacy of WT- 1 system was well defined. In clinical trial, procaine iontophoresis produced local anesthesia of significantly longer duration than swabbing and placebo groups. The 4% procaine iontophoresis using WIT-1 significant difference in anesthetic duration between WIT- 1 system and IontopherTM PM system. The result of this study suggest that WIT-1 system can be used for the transdermal delivery of drugs in various clinical conditions.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.67-71
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• 2016

Eisenmenger syndrome (ES) is characterized by pulmonary arterial hypertension and right-to-left shunting. The signs and symptoms of ES include cyanosis, shortness of breath, fatigue, hemoptysis, and sudden death. In patients with ES, it is important that the systemic and pulmonary circulations be properly distributed and maintained. General dental treatment is not known to be particularly dangerous. To control pain and anxiety, local anesthetics without epinephrine are usually recommended. However, in cases of difficulty of cooperation, general anesthesia for dental treatment makes the condition worse. In the present case, intravenous deep sedation with propofol and remifentanil was administered for behavioral management during dental treatment successfully.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.76-78
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• 2018

With recent developments in medical technology and the introduction of various types of lasers, the role of fiberoptic laryngeal laser surgery (FLS) in laryngology has been significantly expanded. FLS are typically performed under local anesthesia, and patients may return to normal activities immediately after the procedure. This corresponds to the current trend of minimally invasive surgery and may limit unnecessary general anesthesia, reduce medical costs, and increase patient compliances. Main indications of FLS procedure were vocal polyp, recurrent respiratory papillomatosis, vocal fold granuloma and vocal fold dysplasia. In this review, we discuss practical tips and unique value of FLS.