• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.2 s.5
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• pp.98-102
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• 2003

Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically iii and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

• The Korean Journal of Physiology
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• v.28 no.2
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• pp.225-231
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• 1994

The present study was undertaken to investigate the role of endogenous nitric oxide in renin release under different physiological conditions. In the first series of experiments, renin release was either inhibited by acute volume-expansion (VE) or stimulated by clipping one renal artery in the rat. VE was induced by intravenous infusion of saline (0.9% NaCl) up to 5% of the body weight over 45 min under thiopental (50 mg/kg, IP) anesthesia. VE caused a decrease of plasma renin concentration (PRC). With $N^G-nitro-L-arginine$ methyl ester $(L-NAME,\;5\;{\mu}g/kg\;per\;min)$ superadded to VE, PRC decreased further. The magnitude of increase in plasma atrial natriuretic peptide levels following VE was not affected by the L-NAME. In two-kidney, one clip rats, L-NAME-supplementation resulted in a decrease, and L-arginine-supplementation an increase of PRC. Plasma atrial natriuretic peptide levels were significantly lower in the L-arginine group than in the control. Blood pressure did not differ among the L-NAME, L-arginine, and control groups. In another series of experiments, the renin response to a blockade of NO synthesis was examined using in vitro preparations from isolated renal cortex. L-NAME significantly increased basal renin release, although it was without effect on the isoproterenol-stimulated release. These findings suggest that endogenous nitric oxide significantly contributes to the renin release. Since many factors may affect the renin release in vivo, an interaction between NO and renin under various pathophysiological states is to be further defined.

• The Korean Journal of Physiology
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• v.28 no.2
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• pp.197-202
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• 1994

The present study was aimed to determine if endogenous L-arginine-nitric oxide (NO) pathway has central, rather than peripheral, mechanisms in blood pressure regulation. Arterial blood pressure and heart rate responses to acute inhibition of the t-arginine-NO pathway were examined in rats anesthetized with thiopental (50 mg/kg, IP). An intracerebroventricular (ICV) cannula was placed in the left lateral ventricle. The right femoral artery was cannulated to measure arterial blood pressure and the vein to serve as an infusion route. $N^G-nitro-L-arginine$ methyl ester (L-NAME) was infused either intracerebroventricularly or intravenously. ICV infusion $(1.25\;{\mu}L/min)$ of L-NAME $(20\;or\;100\;{\mu}g/kg)$ per minute for 60 min) increased the mean arterial pressure and heart rate. Plasma renin concentrations(PRC) were significantly lower in L-NAME-infused group than in the control. L-Arginine $(60\;{\mu}g/min,\;ICV)$ prevented the pressor response to ICV L-NAME. The pressor response was not affected by simultaneous intravenous infusion of saralasin, but was abolished by hexamethonium treatment. Intravenous infusion $(40\;{\mu}L/min,\;10{\sim}100\;{\mu}g/kg\;per\;minute\;for\;60\;min)$ also increased blood pressure, while it decreased heart rate. These results indicate that endogenous L-arginine-NO pathway has separate central and peripheral mechanisms in regulating the cardiovascular function. The central effect may not be mediated via activation of renin-angiotensin system, but via, at least in part, activation of the sympathetic outflow.

• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.2 s.3
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• BMB Reports
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• v.33 no.3
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• pp.221-227
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• 2000

The distribution of barbiturates in the model membranes of total lipids (SPMVTL) and total phospholipids (SPMVPL) extracted from synaptosomal plasma membrane vesicles was determined by employing a fluorescent probe technique. The two fluorescent probes 2-(9-anthroyl)stearic acid and 12-(9-anthroyl)stearic acid were utilized as probes for the surface and the hydrocarbon interior of the outer monolayer of the SPMVTL and SPMVPL, respectively. The Stern-Volmer equation of fluorescent quenching was modified to calculate the relative distribution. The analysis of preferential quenching of these probes by barbiturates indicates that pentobarbital, hexobarbital, amobarbital and phenobarbital are predominantly distributed on the surface area, while thiopental sodium has an accessibility to the hydrocarbon interior of the outer monolayer of the SPMVTL and SPMVPL. From these results, it is strongly suggested that the more effective penetration into the hydrocarbon interior of the outer monolayer of the membrane lipid bilayer could result in a higher general anesthetic activity.

• Korean Journal of Pharmacognosy
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• v.17 no.2
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• pp.113-122
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• 1986

In order to investigate the pharmacological activities of the combined preparation of crude drugs, Chunghyulgangki-Tang was studied. Chunghyulgangki-Tang has been widely used to cerebral apoploxy, hypertension and arteriosclerosis, etc. In this study, water extract of Chunghyulgangki-Tang was conducted in attempt to investigate for analgesic, sedative, antipyretic, isolated ileum and heart, blood vessels and blood pressure action in mice, frogs, rats, guinea-pigs and rabbits. The following results were obtained; Analgesic action by the acetic acid stimulating method in mice was recognized. Sedative activities by the wheel cage method and rotor rod method in mice were shown. Prolonged action against the hypnotic duration induced by thiopental-Na was significantly noted in mice. The effect of antipyretic in endotoxin febrile rats was significantly recognized. Spontaneous motility of the isolated ilem of mice was suppressed and contractions of the isolated ileum of mice and guinea-pigs induced by acetylcholine chloride, barium chloride and histamine were remarkably inhibited. Acceleration of isolated heart motility was shown in frogs. Vaso-dilating and hypotensive actions were recognized in rabbits. According to the above results, effects based on the oriental medicinal references were approximate to the actural experimental results.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.1-6
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• 2018

General anesthesia is an effective behavior management method for disabled patients or uncooperative children who have difficulty in cooperation. The objective of this study was to assess and analyze dental treatment under general anesthesia in department of pediatric dentistry at Pusan National University Dental Hospital for 5 years. One hundred and nine cases of general anesthesia from June 2013 to May 2018 were surveyed for this study. Patients' distribution, reasons for general anesthesia, treatment pattern, agents for general anesthesia, duration of treatment, and visiting route were assessed. The proportion of male was higher than female and age group of 5 to 9 was highest. Reasons for general anesthesia were handicapped situations with or without systemic disease(52%), operative treatment needs(13.2%), uncooperative(15%) and others(29.8%). Most used agents for general anesthesia were thiopental sodium and sevoflurane. Dental treatment under general anesthesia for handicapped and uncooperative children has been increasing. Therefore, it is important to improve the system and efficiency of general anesthesia to provide satisfactory treatment.

• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.1 s.2
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• pp.21-26
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• 2002

연구배경: 장애인의 치과치료는 일반인의 치과치료와는 달리 많은 문제점들을 가지고 있다. 이러한 장애인 환자의 치과치료를 위하여 서울대학교 치과병원에서는 치과마취과를 중심으로 임상 각과가 협진하여 외래마취 기반 하에 1999년부터 장애인 진료실을 운영하고 있다. 이번 연구에서는 서울대학교 치과병원 장애인 진료실의 치료방법을 소개하고 그 동안 치료받은 장애인 환자들의 자료를 바탕으로 마취과적인 특징을 분석하였다. 방법: 2001년 1월부터 2002년 5월까지 치료받은 총 54명의 장애인 환자들의 치료기록지와 마취, 그리고 회복실 기록지를 검토하였다. 환자의 성별, 나이, 전신질환, 수술 전 시행된 검사, 치료에 참여한 협진과, 마취 유도제와 유지제, 총 마취시간과 회복실 체류시간, 그리고 회복실에서 관찰된 합병증을 조사하였다. 결과: 총 54명의 환자들을 대상으로 58건 치과치료가 시행되었다. 한 건의 의식진정 법을 제외하고는 모두 전신마취 하에서 치과치료가 시행되었다. 마취유도제는 thiopental sodium, 근이완제는 vecuronium과 succinylcholine가 가장 많이 사용되었으며 마취 유지를 위해서는 enflurane과 isoflurane의 흡입마취제를 이용하거나 TCI를 이용한 propofol 지속정주를 이용하였다. 총 마취지속시간은 $160.2{\pm}55.5$분이었으며 회복실에서의 체류시간은 $132.8{\pm}50.1$분, 그리고 완전한 회복을 확인하기 위해 병동에 단기 입원시킨 소아환자에서는 $58.7{\pm}16.8$분이었다. 회복실에서 심각한 합병증은 발생하지 않았다. 지속적인 감시를 위하여 4명의 환자가 입원을 권유받았으나 특별한 합병증 없이 다음 날 퇴원하였다. 결론: 서울대학교 치과병원 장애인 진료실은 외래마취에 대한 기존의 연구들보다 긴 마취시간과 회복실 체류시간을 보였다. 그러나 별다른 합병증 없이 일회 방문으로 장애인 환자들에게 필요한 치과치료를 모두 제공할 수 있었다.

• Biomolecules & Therapeutics
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• v.14 no.2
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• pp.83-89
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• 2006

The main aim of this study was to characterize the pharmacological profile of flavonoids utilizing behavioral tests and to investigate how the psychopharmacological activities of wogonin, baicalein and oroxylin A are different. Wogonin, baicalein and oroxylin A were intraperitoneally injected as dosages of 2.5, 5, 10 and 20 mg/kg. In the locomotor activity, Rota-rod test, and elevated plus-maze tests, the behavioral parameters were analyzed by automatic systems. Thiopental induced sleeping time was measured. Water extract of S. baicalensis didn't exhibit sedative effect. Wogonin and bacalein exhibited anxiolytic activity although it was less potent than buspirone. Wogonin and baicalein decreased locomotor activity at a dose of 10 mg/kg. Wogonin also shortened significantly running time on the rota-rod at doses of 5 and 10 mg/kg. Wogonin and baicalein enhanced sleeping at doses of 5 and 10 mg/kg. These results indicate that wogonin produce anxiolysis with sedation and so did bacalein with mild sedation. On the contrary, oroxylin A enhanced running activity on the rotarod and did't depress locomotor activity. Oroxylin A significantly hindered sleeping rather than helped it at doses of 5 and 10 mg/kg. Oroxylin A didn't produce anxiolysis and instead, produce awakening effect. This study demonstrates that wogonin and bacalein exhibited anxiolytic activity with mild sedation, but oroxylin A didn't produce anxiolysis and instead, produce awakening effect. This result indicates that anxiolytic effect without sedation induced by Scutellaria baicalensis is produced by combination of flavonoids.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.81-86
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• 1999

Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.