• Archives of Plastic Surgery
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• v.41 no.4
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• pp.312-316
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• 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
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• v.18 no.5
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• pp.315-317
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• 2018

• Journal of Chest Surgery
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• v.50 no.3
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• pp.211-214
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• 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
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• v.17 no.4
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• pp.313-316
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• 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
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• v.51 no.8
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• pp.861-867
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• 2008

Purpose : We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. Methods : This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. Results : Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. Conclusion : The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.

• 제어로봇시스템학회:학술대회논문집
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• 1996.10a
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• pp.19-23
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• 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.

• Korean Architects
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• s.640
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• pp.82-87
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• 2022

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.7
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• pp.2638-2647
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• 2010

X-MAC reduces transmission delay and energy consumption by using a short preamble instead of the existing long preamble. To solve the problem of X-MAC, this paper proposes a new MAC protocol called Express-MAC. The wireless sensor network is mainly used for the purpose of gathering event data or situation information. Especially, the transmission pattern of the sensor network with the purpose of event detection such as intrusion detection is very intermittent as well as successively occurring when a single event takes place in most cases. By reflecting sensor network's key transmission patterns as above, EX-MAC has used multi-hub path's path reservation system and awake section's transmission time reservation method in data transmission when the first event takes place. The awake time reservation in transmission path has improved successive data transmission's end-to-end delay, and it has also increased efficiency in terms of energy consumption by reducing the preamble length of data transmission and reception node.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.297-305
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• 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
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• v.27 no.1
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• pp.37-49
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• 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.