• Title/Summary/Keyword: CHIEF method

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Ketolytic Defects in Children and Adolescents (소아청소년기의 케톤분해이상질환군)

  • Choi, Joong Wan;Ahn, Seok Min;Kim, Young Han;Baek, Joon Woo;Ryu, Hye Won;Bae, Eun Joo;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.3
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    • pp.147-154
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    • 2015
  • Purpose: 3HB and AcAc are two ketone bodies that can be used as energy source in brain via succinyl-CoA:3-ketoacid CoA transferase (SCOT) and mitochondrial acetoacetyl-CoA thiolase (beta-ketothiolase, T2), called ketolysis. In case of malfunction of these enzymes, ketolysis cannot occur fluently causing various clinical manifestations. We want to know the numbers of patients and clinical manifestations of ketolytic defects in Korea. Material: For 67 patients of ketolytic defects out of 2794 patients that have done urine organic acid analysis, we analyzed clinical manifestations and age distribution. The study period was from January 2007 to September 2015. Method: To confirm persistency of ketonuria, repeated and loading organic acid analysis were done at least 1 week period interval. SPSS was used for statistical analysis. Result: Thirty patients in infantile period (2 M-2 Y), 31 patients in childhood period (2 Y-12 Y), 5 patients after adolescent period (>12 Y) and 1 in neonatal period were diagnosed during the study period. The most frequent chief complaint was seizure followed by seizure with developmental delay and developmental delay only. Conclusion: Ketolytic defects were not so rare in Korea. Major clinical manifestations are seizure and developmental delay or mental retardation.

Usefullness of Injection Laryngoplasty with Calcium Hydroxyapatite in Unilateral Vocal Cord Paralysis (일측 성대마비 환자에서 Calcium-Hydroxyapatite를 이용한 성대 주입술의 유용성)

  • Lee, Jae-Hoon;Kim, Sung-Won;Oh, Jung-Ho;Kim, Seung-Tae;Lee, Kang-Dae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.119-125
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    • 2011
  • Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

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'Study on Oui-Ga-Sil( 胃家實 )' (위가실(胃家實)에 관(關)한 연구(硏究))

  • Han, Gyu-Eon;Ryu, Bong-Ha;Park, Dong-Won;Ryu, Gi-Won;Jang, In-Gyu
    • The Journal of Internal Korean Medicine
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    • v.10 no.1
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    • pp.65-80
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    • 1989
  • About Oui-Ga-Sil(胃家實) in order to considerate the contents recorded in Nai-Gyung Sang-Han-Lon and latter literature, definition, etiopathology, syndrome, differential diagnosis, therapy, Prognosis and prevention were classified. And the results were as follows: 1. Oui-Ga(胃家)was a term which indicated the whole digestive system such as stomach, small intestine, large intestine, rectum and anus. Sil(實)could be defined as the peculiar concept pertaining to the acute and last stage which was invaded to inside bowels because of abundance with evil influence. 2. Eliology of Oui-Ga-Sil was abunt gastric fever originally, injured mucus because of mistreatment, the invasion to inside of outside evil influence through meridian. Pathology was the opening and shutting appearance of gastric abundance with intestinal emptiness, and intestinal abundance with gastric emptiness, Oui-Ga-Sil could be occurred because of gastric abundant dryness and splenic humidifying capacity decrease. 3. Symptom of Oui-Ga-Sil was classified as for the sunlight outside syndrome and the inside abundant syndrome. The sunlight outside syndrome was body fever, sweating, no chilling, on the contrary hatred of fever. The chief complaint of inside abundant syndrome was daily fever, talking in delirium, hand and foot sweating, abdominal distention, difficult defection and those could be pertained to sunlight bowel syndrome. 4. Diagnostic views of Oui-Ga-Sil were that pulse was descending abundant large strong and smooth quick, a coated tongue was yellow, deep yellow, old yellow, thick, scorching dry rough or gray black. On abdominal diagnosis, pressing by hand, patient was conscious of pain, excessive pain, rejection against press, impossible press or intermittent abdominal pain and bowel cutting pain without press. 5. Differential diagnosis was that the sunlight of Nai-Gyung-Fever-Theory was outside desease making meridian the prime object, Baik-Ho-Tang syndrome was making figureless abundant fever the pivotal point. And important differential standard of splenic shrink syndrome was that a daily fever, an irritation with fever were not occurred. 6. Theory of Oui-Ga-Sil was that Seng-Gi-Tang classes had been used in attacking downward or making balance, and moxibustion on Jung-Wan, honey boiling induction theory had been also used. Attacking downward therapy was invigorating method to preserve mucus, and if mucus had been exausted with complicating emptiness prognosis had been appeared badly. 7. Preventing from Oui-Ga-Sil diet by rule, fitness to cold and warmth may be needed to prevent outside evil influence attack and inside evil influence occurrence. Prudence with being very busy, fatigue, wine and woman may be also needed not to be an injury to splanic and gastric spirit.

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Studies on the Rapid Plasma Reagin(RPR) Card Test for the Diagnosis of Syphilis (매독진단(梅毒診斷)을 위(爲)한 신속(迅速)한 혈장항체검사법(血漿抗體檢査法)에 관(關)한 연구(硏究))

  • Kim, Joo-Deuk;Lew, Joon;Kim, Hyun-Joo
    • The Journal of the Korean Society for Microbiology
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    • v.3 no.1
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    • pp.15-23
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    • 1968
  • For the effective control of Syphilis, many investigators have developed a more rapid, simple and economical screening serological test which is adequately sensitive and specific. To fulfill the requirements of a more rapid serologic test for syphlis, a substitute for the conventional serum specimen was needed since considerable time and labor are involved in the processing of blood to serum. Burdon suggested the use of plasma in the serologic tests for syphilis as a substitute for serum. He noticed that plasma was more sensitive than serum in the Kline and Kahn tests, and attributed this to the presence of more antibody-like substance, "reagin" in plasma than in serum. However, to make plasma sufficiently sensitive, it was necessary to inactivate plasma by heating at a temperature of $56^{\circ}C$ for about 30 minutes. Heating of plasma resulted in the precipitation of fibrinogen which made centrifugation necessary to obtain dear plasma. Since the chief disadvantage to the use of unheated plasma(or serum) was a reduction in sensitivity of results-which probably was due to a labile factor such as complement-Portnoy et al began to consider rapid chemical methods of inactivation of plasma(or serum). They experienced that choline chloirde was shown to be anticomplementary which suggested its use as an inactivating agent for unheated plasma(or serum). In 1959 Portnoy et al reported the Rapid Plasma Reagin(RPR) Test for syphilis which is a more rapid, economical and simple. But still this test has many disadvantages as a rapid performing, field and office procedure, because it requires the usual laboratory equipments such as centrifuge, rotating machine, microscope etc. To substitute these disadvantages of the RPR test, in 1962, Portnoy et al developed the Rapid Plasma Reagin(RPR) card test for syphilis, which has the following advantages: a) Simplicity and rapidity of performance, b) Requires no laboratory equipments, c) Stable antigen suspension, d) Adequate sensitivity and specificity. This RPR card test can be used as a rapidly performing and screening test in field investigation, outpatient clinics, small laboratories and hospitals doing limited syphilis serology, and predonor in blood bank. Private clinic which has limited laboratory equipment and technic for syphilis serology can also use this RPR card test as a tool in the rapid diagnosis of syphilis. It was thought that this RPR card test is a useful tool in Korea for private physician and mass survey for syphilis diagnosis. But Portnoy patented the reagents needed for the performing the RPR card test. Therefore authors developed newly the reagents and according to Portnoy's method evaluated the newly developed. RPR card test compared with the VDRL, Kolmer CF, and RPCF tests. The RPR card and VDRL tests were performed plasma and serum from the total 1,132 cases. Among these 1,131 cases, 521 were syphilis suspected laboratory specimens, and 611 were syphilis unsuspected healthy young men. After screening with these two tests, the RPR card and VDRL tests, reactive specimens to the above one or both tests were retested by the Kolmer CF and RPCF tests.

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"Conlplex Pneuwlonectonly" in Lung Cancer (폐암의 "Conlplex Pneuwlonectonly")

  • Baek, Hyo-Chae;Bae, Gi-Man;Lee, Du-Yeon
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.614-620
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    • 1996
  • The method of treatment in lung cancer patients with invasion to parietal pleura, diaphragm, peri- cardium or vertebra is controversial, and resection of these invasion together with pneumonectomy is called "complex pneumonectomy" From March 1990 to February 1994 we performed 18 cases of "complex pneumonectomy". Seven patients had resection of chest wall, 10 patients had pericardial re- section, and one patient had resection of diaphragm Right pneumonectomy was done in 8 cases and left pneumonectomy was done in 10 cases. The age of patients were from 40 to 70 years(mean 58 years) with male to female ratio of 17 to 1. The chief complaints of the patients on admission were cough (13), dyspnea on exertion (11), chest pain (10), weight loss (9), general fatigue (9), and sputum production (4 . Postoperative pathology were 13 squamous cell carcinoma, 3 adenocarcinoma, and one case each of adenosquamous carcinoma and small cell carcinoma. The postoperative pathologic stages were 2 T3NO MO, 4 TIWIMO, 6 T3N2MO, 5 T4N2MO, and 1 TIWIMO. There was one operative mortality(5.5%). Excluding one follow up loss, 14 patients expired during the follow-up and the mean survival was 9.07 $\pm$ 4.82 months. One patient with stage TINOMO who had chest wall resection is alive at 35 months follow-up and a patient with T3N2MO who had diaphragm resection is alive at 36 months follow-up. Therefore, selection of patients for "complex pneumonec- tomy" is very important, and a long term survival is possible.ong term survival is possible.

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A Study of Huh-Im(許任)'s ChimGuKyungHumBang(『鍼灸經驗方』) (허임(許任) 『鍼灸經驗方』 연구(硏究))

  • Park, Mun-Hyun
    • The Journal of Korean Medical History
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    • v.15 no.1
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    • pp.63-146
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    • 2002
  • Huh-Im(許任, 1570~1647) was an acupuncture doctor of Chosun(朝鮮) era through the late 16th century and early 17th century. Even though he was a person of low birth, he participated in the loyal medication through three loyal generations, Sunjo(宣祖), Kwanghaegun(光海君) and Injo(仁祖). He was recognized of his services and became an official, 'Dangsanggwan'(堂上官) and Kyunggi(京畿) district official several times. In the early Chosun era, acupuncture medicine was focused. During the late 16th century, Imjin(壬辰) war aroused more needs about acupuncture medicine, and acupuncture doctors showed remarkable work. Under these circumstances, Huh-Im(許任)'s fame spread throughout the country. Huh-Im(許任) wrote ChimGuKyungHumBang("鍼灸經驗方") in 1644 based on his lifetime clinical acupuncture & moxibustion experience. It was the first specialized book of acupuncture in Chosun era. This event took place 30 years after DongEuiBoGam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") was published. But it was not influenced much by DongEuiBoGam - Acupuncture Chapter("東醫寶 鑑-鍼灸篇") in the form or contents. ChimGuKyungHumBang("鍼灸經驗方") and Huh-Jun(許浚)'s DongEuiBo- Gam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") were the fruits of the middle Chosun, and they are complementary to each other in theory and practice. The chief distinctions of ChimGuKyungHumBang("鍼灸經驗方") are in it's compact and practical edition and a lot of his clinical acupuncture prescriptions mentioned in the book. Huh-Im(許任) not only accepted the existing books such as NaeKyung("內經"), DongInSuHyulChimGuDoKyung and Shin- Eung Kyung("神應經") with his point of view and clinical experience, but also showed creative operation of studies. Indicating incorrect acupuncture points(訛穴), acupuncture remedy based on the visceral pathogenesis(臟腑病機) and the channel pathogenesis, research on new acupuncture points, sorting out plenty of outer meridian acupuncture points(經外奇穴), creating supplementary and purging acupuncture method(鍼補瀉法) which is a change of hand treatment of KiHyoYangBang("奇效良方"), operating variety of acupuncture and moxibustion treatments, and application of acupuncture treatments on surgery field such as intumescences and emergency cases are the examples. Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") influenced on the folk remedy books(民間經驗方書) in the late Chosun era. Compact and practical characteristics of the book let acupuncture treatment be freindly to the people. It can be confirmed in JeungBoSanRimKyungJe-Emergency Chapter("增補山林經濟-救急篇") or the formation of SaAmChimBob(舍巖鍼法). ChimGuKyungHumBang("鍼灸經驗方") was introduced to Japan in 18th century and published twice. ChimGuJibSung("鍼灸集成"), known as an acupuncture medical book of late Qing dynasty(淸末, 1874), is confirmed to be an plagiarization of DongEuiBoGam-Acupuncture Chapter("東醫寶鑑-鍼灸篇") and ChimGuKyungHum- Bang("鍼灸經驗方") of 17th century Chosun. Confusions and errors arouse from mistaken editional trend of ChimGuJIbSung("鍼灸集成") which had not disclosed it's original author and the title of the book must be reformed. In this way, fruits of acupuncture of the middle Chosun era including Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") will take a right place in acupuncture medicine history.

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Settlement Characteristics of Large Drilled Shafts Embedded in Bed Rocks (암반에 근입된 대구경 현장타설말뚝의 침하특성)

  • Hong Won-Pyo;Yea Geu-Guwen;Nam Jung-Man;Lee Jae-Ho
    • Journal of the Korean Geotechnical Society
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    • v.21 no.5
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    • pp.111-122
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    • 2005
  • The data on the pile load tests performed on 35 large drilled shafts are analyzed to investigate the load-settlement characteristics of large drilled shafts embedded in bed rocks. Generally, the settlement of large drilled shafts embedded in bed rocks is too small to determine the ultimated load with application of the regulation in design code for either the total settlement or the residual settlement. Therefore, to determine the yield load of large drilled shafts embedded in bed rocks, p(load)-logS (settlement) curve method, which has been proposed originally for the driven pile, was applied to the investigation on the data of the pile load tests. This technique shows that the yield load can be determined accurately and easily rather than other conventional techniques such as P-S, logp-logS, S-logt, and P-S curve methods. An empirical equation is proposed to represent the relationship between pile load and settlement before the yield loading condition. And the settlement of piles was related with the depth embedded in rock as well as rock properties. Based on the investigation on the data of pile load tests, the resonable regulations f3r both the total settlement and the residual settlement are proposed to determine the yield load of large drilled shafts embedded in bed rocks.

CLINICAL STUDY OF AMELOBLASTOMA ON THE JAW (악골에 발생한 법랑아세포종의 임상적 연구)

  • Kim, Hyun-Syeob;Ryu, Jae-Young;Yu, Min-Gi;Seo, Il-Young;Shet, Uttom Kumar;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Choi, Hong-Ran;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.535-542
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    • 2007
  • Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

Comparative Study of Conventional Phlebectomy and Transiliuminated Powered Phlebectomy in Varicose Veins (하지 정맥류의 고식적 수술 방법과 광투시 전동형 정맥제거술의 비교연구)

  • Lee Choong Won;Chung sung Woon
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.415-420
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    • 2005
  • Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). Material and Method: From March 200f to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. Result: Operative time was significantly shorter in the TIPP group than CP group (for one leg $108.4\pm27.6\;min\;vs\;83_4\pm24.4\;min,\;for\;both\;legs\;184.7\pm28.4\;min\;vs\; 137.8\pm24.4\;min)$. There was signifcant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group $(5.9\pm2.2\;vs\;4.2\pm1.6)$. Mean duration of hospitalization was Significantly shorter in the TIPP group than CP group $(4.4\pm1.0\;days\;vs\;5.8\pm1.9\;days)$. Complications were pain $(15.9\%)$, remnant lesion $(9.5\%)$, and ecchymosis $(4.8\%)$ in the CP group and ecchymosis $(19.6\%),\;pain\;(7.8\%),\;and\;remnant\;lesion\;(7.8\%)$ in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. Conclusion: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

Deep Sedation with Sevoflurane in Patients with Double Outlet of Right Ventricle (양대혈관 우심실 기시 환아의 Sevoflurane을 이용한 깊은 진정 하 치과치료)

  • Hyun, Hong-Keun;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Hyun-Jeong;Seo, Kwang-Suk;Lee, Jung-Man;Shin, Soonyoung
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.2
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    • pp.115-119
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    • 2012
  • Double outlet of right ventricle (DORV) refers to a congenital heart disease in which pulmonary and systemic circulation originates from the right ventricle. In the patient with DORV, it is important to maintain the balance between pulmonary and systemic circulation in anesthetic management. A 4-year-old boy with DORV, who underwent a Blalock-Taussig shunt operation, was transferred to the clinic with a chief complaint of multiple caries. Due to poor cooperability, it was impossible to treat the caries without sedation or general anesthesia. We planned to sedate him with consideration with detrimental effects associated with positive pressure ventilation for dental treatment. After a prophylactic administration of antibiotics, sevoflurane was administered through T-cannula site. Throughout the treatment, His blood remained stable around 80/40 mmHg, oxygen saturation remained around 91%. After 3 hour of sedation with sevoflurane (end-tidal sevoflurane con 1-1.8 vol%), he fully regained consciousness, and discharged from hospital without complications. In case of DORV patient, deep sedation with sevoflurane may be used as effective method of behavioral management during dental treatment.