• Journal of Chest Surgery
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• v.37 no.1
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• pp.11-18
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• 2004

Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.121-128
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• 2015

Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.

• The Korean Journal of Physiology and Pharmacology
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• v.3 no.5
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• pp.481-490
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• 1999

To investigate the changes in the responses of vestibular neurons with time during vestibular compensation, the resting activity and dynamic responses of type I and II neurons in the medial vestibular nuclei to sinusoidal angular acceleration were recorded following unilateral labyrinthectomy (ULX) in Sprague-Dawley rats. The unitary extracellular neuronal activity was recorded from the bilateral medial vestibular nuclei with stainless steel microelectrodes of $3{\sim}5\;M{\Omega}$ before ULX, and 6, 24, 48, 72 hours, and 1 week after ULX under pentobarbital sodium anesthesia (30 mg/kg, i.p.). Gain (spikes/s/deg/s) and phase (in degrees) were determined from the neuronal activity induced by sinusoidal head rotation with 0.05, 0.1, 0.2, and 0.4 Hz. The mean resting activity before ULX was $16.7{\pm}8.6$ spikes/s in type I neurons $(n=67,\;M{\pm}SD)$ and $14.5{\pm}8.4$ spikes/s in type II neurons (n=43). The activities of ipsilateral type I and contralateral type II neurons to the lesion side decreased markedly till 24 hr post-op, and a significant difference between ipsilateral and contralateral type I neurons sustained till 24 hr post-op. The gain at 4 different frequencies of sinusoidal rotation was depressed in all neurons till 6 or 24 hr post-op and then increased with time. The rate of decrease in gain was more prominent in ipsilateral type I and contralateral type II neurons immediately after ULX. Although the gain of those neurons increased gradually after 24 hours, it remained below normal levels. The phase was significantly advanced in all neurons following ULX. These results suggest that a depression of activities in ipsilateral type I and contralateral type II neurons is closely related with the occurrence of vestibular symptoms and restoration of activities in those neurons ameliorates the vestibular symptoms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.3
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• pp.111-115
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• 2014

Purpose: This study evaluated powdered burn wound dressing materials from wild silkworm fibroin in an animal model. Methods: Fifteen rats were used in this experiment. Full-thickness $2{\times}2cm$ burn wounds were created on the back of rats under anesthesia. In the two experimental groups, the wounds were treated with two different dressing materials made from silkworm fibroin. In the Control Group, natural healing without any dressing material was set as control. The wound surface area was measured at five days, seven days and 14 days. Wound healing was evaluated by histologic analysis. Results: By gross observation, there were no infections or severe inflammations through 14 days post-injury. The differences among groups were statistically significant at seven days and 14 days, postoperatively (P<0.037 and 0.001, respectively). By post hoc test, the defect size was significantly smaller in experimental Group 1 compared with the Control Group and experimental Group 2 at seven days postoperatively (P=0.022 and 0.029, respectively). The difference between Group 1 and Group 2 was statistically significant at 14 days postoperatively (P<0.001). Group 1 and control also differed significantly (P=0.002). Group 1 showed a smaller residual scar than the Control Group and Group 2 at 14 days post-injury. Histologic analysis showed more re-epithelization in Groups 1 and 2 than in the Control Groups. Conclusion: Burn wound healing was accelerated with silk fibroin spun by wild silkworm Antheraea pernyi. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials can be used for treatment of burn wound.

• Journal of Veterinary Clinics
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• v.26 no.3
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• pp.205-211
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• 2009

Perioperative pain relief is essential in veterinary practice. However, the cat is one of the most poorly understood species regarding pain control management. Ovariohysterectomy(OHE) produces considerable postoperative pain in cats. Practitioners are often reluctant to administer analgesics due to lack of familiarity with available drugs, concern about side effects, or frustration with the need for record keeping of controlled substances. The purpose of this study was to determine if intraperitoneal administration of bupivacaine can provide relief of pain following OHE in cats. Twelve healthy female cats were randomly divided into two groups. OHE was performed under general inhalation anesthesia. Just prior to complete closure of the linea alba, 6 cats in SAL group received 0.88 ml/kg 0.9% saline, 6 cats in BUP group received 4.4 mg/kg 0.75% bupivacaine diluted to an equivalent volume with saline in the intraperitoneal space. Cats were scored at 0, 1, 2, 4, 8, 12 and 24 hours post-extubation by one observer. Cats were evaluated using a visual analogue scale(VAS) and composite pain scale(CPS) that included physiologic variables. There were no significant differences in body weight, anesthesia time, surgery time, and incision length between the two groups. Cats in the BUP group had significantly(p<0.05) lower VAS-pain scores than cats in the SAL group at 4, 8, 12 hours after surgery. Cats in the BUP group had significantly lower CPS scores than cats in the SAL group at 8, 12 hours after surgery. No adverse side effects were observed. These results support that the intraperitoneal administration of bupivacaine following OHE can be used for the prevention of postoperative pain and pain-induced behavioral changes in cats.

• Applied Microscopy
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• v.23 no.2
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• pp.11-26
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• 1993

This experiment was performed to study the morphological responses of the pigment epithelial cell and the Bruch's membrane of the retina of rat following X-ray irradiation. Male rats were divided into normal and experimental groups. The heads of the rats, under sodium thiopental anesthesia, were exposed to 3,000 rads or 6,000 rads of radiation in a single dose, respectively. The source was a Mitsubishi Linear Accelerator ML-4MV. The target to skin distance was 80cm, and the. dose rate was 200 rads/min. The experimental groups were sacrificed on the 6th hour, 2nd and 6th day after X-ray irradiation. Under anesthesia, 1% glutaraldehyde-1% paraformaldehyde solution(0.1M Millonig's phosphate buffer, pH 7.3) was perfused through the left ventricle and ascending aorta. Pieces of the tissue taken from the posterior region of the retina were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde(0.1M Millonig's phosphate buffer, pH 7.3) and 1% osmium tetroxide(0.1M Millonig's phosphate buffer, pH7.3), and embedded in araldite mixture. The ultrathin sections contrasted with uranyl acetate and lead citrate were observed with JEM 100 CX-II electron microscope. The results were as follow; 1. The morphological changes of the pigment epithelial cells were not pronounced after exposure to 3,000 rads of X-ray. But on the 6th hour after exposure to 6,000 rads of X-ray, bulging nuclear membrane protruding into the cytoplasm and nuclear chromatin clumped into numerous masses along the nuclear membrane were observed. At the 2nd and 6th day post-irradiation, partial cytolysis or necrosis were seen. 2. The thickness of the Bruch's membrane of the experimental groups were increased in the time and dose range covered by this study, and splitting or diffusing basal laminae of the choriocapillary layer were observed frequently in the experimental group. Above results suggest that large amount(6,000 rads) of head irradiation induce direct hazardous effects on the pigment epitherial cells and Bruch's membrane of the retina of the rat, but pigment epithelial cells are more radioresistant than Bruch's membrane.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3400-3411
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• 2013

The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

• Journal of Korean Academy of Nursing
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• v.38 no.5
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• pp.720-729
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• 2008

Purpose: This study investigated the preemptive analgesic effects of Morphine and Ketorolac on postoperative pain, cortisol, $O_2$ saturation and heart rate for the first 24 hr after abdominal surgery. Methods: Data collection was performed from April 1 to September 30, 2006. Forty patients undergoing a gastrectomy under general anesthesia were randomly allocated to the experimental or control group. The experimental group (20 patients) was administered Morphine and Ketorolac approximately 1 hr prior to skin incision, but the control group (20 patients) was administered Morphine and Ketorolac at peritoneum closure through a patient-controlled analgesia (PCA) pump. Postoperative pain, blood pressure, heart rate, cortisol, $O_2$ saturation, frequency of the PCA button pressed and doses of additional analgesics were observed through post operative 24 hr. Collected data was analyzed using t-test, $X^2$ test, repeated measures ANOVA, and Bonferroni methods. Results: Postoperative pain, cortisol, the frequency of PCA button pressed, and dose of additional analgesics of the experimental group were significantly lower than the control group. There were no statistical differences in blood pressure, heart rate and $O_2$ saturation between the experimental group and control group. Conclusions: We concluded that administration of morphine and ketorolac at 1 hr prior to skin incision resulted in decreasing postoperative pain, but it didn't affect blood pressure, heart rate or $O_2$ saturation for 24 hr after abdominal surgery.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.369-378
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• 2019

Background: Behavior guidance is a technique used to subdue inappropriate behavior by establishing communication that meets the needs of a child. This study aimed to measure the effectiveness of a mobile app (Little Lovely Dentist) compared to the tell-show-do (TSD) technique in managing anxious children during their first dental visit. Methods: Fifty children (30 boys and 20 girls) without any past dental experience, aged from 7 to 11 years, were randomly allocated into either the dental app group or the TSD group. The pre- and post-operative anxiety of children who underwent prophylactic cleaning was assessed both physiologically and subjectively using a heart rate measurement and the RMS pictorial scale, respectively. Results: The intragroup comparison of heart rate and RMS scores for children allocated to the dental app group was statistically significant (P value ≤ 0.001). However, a significant reduction only occurred in the RMS scores, but not the heart rate measurements, in the TSD group. Conversely, there was an increase in heart rates in the TSD group. Conclusion: Educating the child prior to a dental procedure using a smartphone application such as Little Lovely Dentist can significantly alleviate the anticipatory anxiety and engage children in dental treatment during their first visit.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.