• Advances in pediatric surgery
• /
• v.15 no.1
• /
• pp.58-63
• /
• 2009

환아는 4개월부터 직장 탈출증과 심한 변비를 보였으며, 9개월에 질로부터 대변이 배출되는 증상을 나타냈으나 검사상 우측 이상 형성 콩팥 및 이소성 요관 이외 특이 소견이 없어 경과 관찰을 시행하였다. 16개월에 전신 마취하에 이학적 검사를 시행하여 누공을 확인하였고 이를 통한 대장 조영술에서 직장 중복증을 진단하여 수술을 시행하였다. 수술 시야에서 직장부터 횡행 결장에 이르는 관형의 뒤창자 중복을 확인하고, 직장-질 누공을 분리하고 결장 및 직장에는 중격절개술을 시행하였으며, 동반된 기형인 이소성 요관과 무기능 우측 신장은 절제하였다. 환아는 수술 후 3년간 잘 지내고 있다. 직장-질 누공을 동반한 관형의 뒤창자 중복은 매우 드문 선천성 기형으로 저자들의 경험을 문헌 고찰과 함께 보고하는 바이다.

• Korean Journal of Veterinary Research
• /
• v.2 no.1
• /
• pp.37-50
• /
• 1962

Ten calves were subjected to general anesthesia with ten percent chlooral hydrate solution. The drug was administered by the method of slow intravenous injection so as to have a better control over the dosage and time until deep anesthesia was attained. Although one of ten calves failed to produce anesthesia, the remainder of nine responded satisfactorily with deep anesthesia. The dosage required averaged as great as 17.5gm per calf, and the time 23 minutes. In view of these advantages indicated in the results, further studies on the use of intravenous chloral hydrate for deep anesthesia in bovine species are to be justifiable.

• Korean Journal of Veterinary Research
• /
• v.34 no.1
• /
• pp.213-218
• /
• 1994

복강장기의 유착을 방지하기 위하여 토끼의 공장에 인공창상을 일으키고 sodium carboxymethylcellulose (SCMC)와 dextran 70을 단일 혹은 합제로 사용하여 이들의 유착방지 효능을 조사하였고, 아울러 체중의 변화를 조사함으로써 이들을 사용하였을 때 일어날 수 있는 부작용을 검토하였다. 인공창상에 의한 유착형성 유발빈도와 정도를 알아보기 위하여 토끼를 전신마취시킨 다음 개복수술을 시행하여 공장의 장막에 2cm 폭으로 3곳에 abrasion또는 electrocautery를 실시하였던 바, 이러한 인공창상들이 유의성있는 높은 유착형성율(abrasion, 70%; electrocatuery, 72.7%)과 심한 유착정도를 일으켰으며(abrasion, 1.80; electrocatuery, 2.44), 체중의 감소를 가져왔다(abrasion, -2.5%; electrocautery; 9.9%). Abrasion보다는 electrocatuery에 의한 자극이 더욱 심한 유착정도 및 체중감소를 보였으며 심할 경우 폐사를 일으키기도 하였다. 이러한 유착을 효과적으로 방지하기 위하여 1, 2, 3%의 SCMC 및 6, 10%의 dextran 70 용액을 단일 또는 합제를 만들어 abrasion방법으로 공장에 인공창상을 일으킨 토끼의 복강내에 주입하고 수술 4주후에 복강을 열어 유착형성율을 조사하였던 바, 1% SCMC와 10% dextran 70의 합제(Synthetic soln)에서 가장 낮은 유착형성율(0%)을 보여 유착방지 효과가 가장 뚜렸하였다. 아울러 수술 4주일후 체중의 변화도 유의하게 일으키지 아니 하였다. 그러므로 유착방지제로서 synthetic solution을 사용하는 것이 가장 효과적이라고 사려된다.

• Journal of Chest Surgery
• /
• v.30 no.8
• /
• pp.827-832
• /
• 1997

Lung volume reduction surgery(LVRS) has recently been advocated as an alternative or a bridge to lung transplantation for patients with evere dibbling emphysema. This procedure is a palliative treatment performed to alleviate the dyspnea of patients with emphysema and improve performance in the activities of daily living. The rationale of lung volume reduction for generalized emphysema is that the removing of the diseased and functionless lung may improve the function of remaining, less diseased lung. The factors critical to the success of LVRS are careful patient selection, accurate localization of target areas, meticulous anesthetic and operative technique, and intensive postoperative support. We have experienced a case of severe emphysema in a 59-year-old male patient. After selection process and pulmonary rehabilitation, the patient was treated with video-assisted thoracoscopic LVRS and the post-operative course was uneventful.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.14 no.1
• /
• pp.11-15
• /
• 2014

Background: It is imperative that adequate sedation level should be maintained for safe and effective dental sedation. Cerebral state index (CSI) is a empirically derived parameter calculated from the processed electroencephalography (EEG). We investigated whether CSI can be used as a sedation depth indicator. Methods: We continuously recorded CSI and bispectral index (BIS) values from 10 healthy children aged 3.6 yr undergoing dental sedation. We also evaluated sedation level using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S). The correlation between CSI and BIS, or CSI and sedation score were sought a regression analysis. Results: There were good linearity between CSI values and sedation score. (r = 0.916, P < 0.001) The paired CSI and BIS values showed a significant correlation between the two values. (r = 0.895, P < 0.001) The difference between CSI and BIS values was not statistically significant at deep and conscious sedative levels. Conclusions: The CSI monitor can be easy to monitor sedation depth during dental sedation for children.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.2
• /
• pp.104-107
• /
• 2017

Kabuki syndrome is characterized by typical facial features (elongated palpebral fissures with eversion of the lateral third of the lower eyelid; arched and broad eyebrows; short columella with depressed nasal tip; large, prominent, or cupped ears), minor skeletal anomalies, persistence of fetal fingertip pads, mild to moderate intellectual disability, and postnatal growth deficiency. A 6-year-old male with kabuki syndrome was referred from the local dental clinic for left facial swelling and dental caries on all primary molars. He was treated for acute periapical abscess with incision and drainage under physical restraint, and left maxillary second primary molar was extracted. Other caries treatment was performed under general anesthesia. As the syndrome involves many different medical problems, special cares should be considered. Dental treatment should be carried out in comprehensive consultation system.

• Journal of fish pathology
• /
• v.25 no.1
• /
• pp.47-58
• /
• 2012

Behavioral and physiological responses of juvenile red seabream (Pagrus major) to different concentrations of ethanol were investigated. No swimming and no reaction to touching by a wooden stick was observed at 0.6% ethanol group in behavioral response, and survival rate was 100% after 5 hours of treatment. Red blood cell count, hematocrit and hemoglobin levels in plasma were not significantly different among all groups. AST activities in plasma significantly decreased as ethanol concentration increased. On the contrary, ALT activities in plasma significantly increased as ethanol concentration increased. Cortisol level in plasma was the lowest in 0.6% ethanol group. Glucose levels in plasma increased significantly when ethanol concentration increased more than 0.4%. Oxygen consumption of fish in 0.6% ethanol seawater was constantly lower than that of fish in control seawater from 2 hours after the exposure to ethanol seawater until the end of experiment.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.2
• /
• pp.105-109
• /
• 2012

The gag reflex is a physiological reaction, but, an exaggerated gag reflex can be a severe limitation not only to treat dental caries but also to do oral exam. Procedures such as surface anesthesia of the palate and pharyngeral area, sedation, or general anesthesia can be options as behavioral management. But, there are no golden rule for the sever gag reflex patients. We present a case report of propofol intravenous sedation using TCI pump for simple dental treatment. A 44-year-old man, who had past history of general anesthesia for dental treatment because of severe gag reflex, was scheduled intravenous sedation for simple dental treatment. After 8 hour fasting he entered the clinic for persons with disabilities. We explained about intravenous deep sedation and got informed consent. First, we kept intravenous catheter (22G) in the arm and started monitoring ECG, non-invasive blood pressure, pulse oximetry and end-tidal $CO_2$ through nasal cannula. We started propofol infusion with TCI pump at the target concentration of 3 mcg/ml. The patient became sedated, but he showed involuntary movement during dental treatment, so we increased the target concentration to 4 mcg/ml. We finished the dental treatment without complications during 30 min. And after 40 min recovery room stay he was discharged without any complications.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.13 no.1
• /
• pp.47-51
• /
• 2017

Haddad syndrome, the association of Congenital Central Hypoventilation Syndrome (CCHS) and Hirschsprung's disease (HD), is a disease caused by mutation of PHOX2B gene. This disease, which occurs very rarely worldwide, is characterized by adequate ventilation during wakefulness and hypoventilation during sleep due to decreased ventilatory sensitivity. In this case report, we report a case of dental treatment under general anesthesia in a child with Haddad syndrome. A 3-year-old child with Haddad syndrome visited Seoul National University Dental Hospital for dental treatment. Dental treatment was planned under general anesthesia because of his medical condition. Treatment was successfully done without any postoperative complications. This case suggests that general anesthesia may be advantageous for dental treatment due to the risk of respiratory depression in a child with Haddad syndrome.

• Journal of Korean Academy of Nursing Administration
• /
• v.19 no.2
• /
• pp.239-253
• /
• 2013

Purpose: This study was done to identify job tasks and task elements of Korean nurse anesthetists according to type of medical institution. Methods: A job task scale which consisted of 9 job tasks and 40 task elements was developed. Data were collected from December, 2009 to February, 2010 from 182 nurse anesthetists who were working in medical institutions (response rate: 75.8%). Results: Forty-eight percent of nurse anesthetists were independent from anesthesiologists in anesthetic practice. Preanesthetic nursing assessment was much more frequent in small hospitals than in general hospitals (p<.05), and anesthetic nursing intervention, administering the anesthetics, monitoring the patient's status during anesthesia, and provision of safety and compliance with anesthetic ethics were much more frequent in general hospitals than medical centers (p<.001). There were no differences among the medical institutions for job tasks in post-anesthetic nursing interventions (p=.229), administering anesthetics (p=.354) and monitoring patients' status during anesthesia (p=.099), providing safe anesthetic environment (p=.896), and management of ancillary personnel/equipment (p=.617). Conclusion: Results indicate that nurse anesthetists contribute significantly to anesthetic practice in small hospitals and general hospitals. Therefore, it recommended that nursing leaders make efforts to enact legal nurse anesthetist-related policies for safe and high quality anesthetic nursing care.