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만성 신부전 환자의 상완 동-정맥루 형성술식을 위한 경추 경막외마취
유승화(Seung Hwa Ryoo),김태준(Tae Joon Kim),옥시영(Si Young Ok),김상호(Sang Ho Kim),박욱(Wook Park),송단(Dan Song),문철(Chul Moon) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6
Purpose: Cervical epidural analgesia is used for pain control in head and neck or upper arm. But it is not commonly used for the purpose of pure regional anesthesia for upper arm surgery. Therefore, we investigated the usefulness of cervical epidural anesthesia (CEA) as a method of regional anesthesia for arteriovenous bridge graft (AVBG) for hemodialysis at upper arm and evaluated the effects of CEA on hemodynamics and respiration. Methods: One hundred-fifty chronic renal failure patients scheduled for AVBG were randomly assigned. In the sitting position, an epidural catheter was inserted at C6-7 or C7-T1 and 15 ml of 0.375% ropivacaine with fentanyl 20㎍ was injected. Analgesic level, blood pressure and heart rate were measured at 5-minute intervals after injection of the drug. Arterial blood sampling was taken for aBGA before and twenty minutes after CEA. Results: Average anesthetic dermatomalsensory levels were C3.4±1.2∼T5.7±2.8. During surgery, hypotension was noted in 49% of patients. It was treated with ephedrine or phenylephrine i.v. Baseline PaCO₂ changed from 42.4±2.9 ㎜Hg to 44.6±3.6 ㎜Hg. Conclusion: The above results suggest that CEA is suitable for AVBG at upper arm as a regional anesthesia.
Rhee, Seung-Hyun,Park, Sang-Hun,Ha, Sung-Ho,Ryoo, Seung-Hwa,Karm, Myong-Hwan,Kim, Hyun Jeong,Seo, Kwang-Suk The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.5
Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.
Lipid emulsion therapy of local anesthetic systemic toxicity due to dental anesthesia
Rhee, Seung-Hyun,Park, Sang-Hun,Ryoo, Seung-Hwa,Karm, Myong-Hwan The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.4
Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.
정부 조직구조에 따른 책임은폐와 문제해결의 동학(動學): 국내 가습기 살균제 사건과 일본의 약해간염 사고의 비교
현승효 ( Seung Hyo Hyeon ),이민규 ( Min Kyu Lee ),류화신 ( Hwa Shin Ryoo ) 한국보건행정학회 2020 보건행정학회지 Vol.30 No.4
Background: In this study, we compared the incidents of humidifier disinfectants and incidents of mild hepatitis in Japan to highlight the differences in government response in the health care field in terms of “chain of responsibility”. Methods: We examined whether the three mechanisms of action and the chain of responsibility hypothesis were applied to compare the cases of Korea and Japan. The incident of Japan occurred in 1987 in Misawa city, Aomori prefecture. In the 1990s, the safety of blood products increased dramatically. However, relief for infected victims was neglected. Green Cross did not notify the parties. In Korea, in the spring of 2011, a number of lung disease patients were accidentally admitted to a hospital in Seoul, and a female patient with respiratory failure symptoms expired. The Korea Centers for Disease Control and Prevention conducted animal tests and the Ministry of Health and Welfare issued an order for forced collection of humidifier disinfectants. Results: In the case of Japan, the Ministry of Health and Welfare had to take responsibility for follow-up measures such as the investigation of the cause, so it was tied to a “chain of responsibility”. However, in the case of Korea, the Ministry of Health and Welfare was free from the chain. Conclusion: Through the comparison between the cases of Japan and Korea, we confirmed that whether or not a government organization chooses to conceal responsibility depends on its past behavior, which is whether it is free from the chain of responsibility or not. Therefore, it was reaffirmed that an organization (ministry or department) free from the chain of responsibility must exist within the government.
〈논문 or 기술논문 택일〉 리트랙터용 웨빙 센서 장치 거동의 해석적 연구
명승일(Myeong Seung-il),유원화(Ryoo Won-Hwa),강신유(Kang Shin-you),김석현(Kim Seock-Hyun) 대한기계학회 2009 대한기계학회 춘추학술대회 Vol.2009 No.11
Most retractor are equipped with a function to decide on whether webbing can be withdrawn by webbing withdrawal acceleration or not. This function is performed by the webbing withdrawal sensor which is a component of retractor. As webbing withdrawal acceleration is related with chest acceleration, webbing withdrawal sensor is important for injury prevention. In this study is to analyze in theory behavior of webbing withdrawal sensor, and it is to verify fitness with bases by the results through Finite Element Method. These process will be help to shorten development time and to simplify development process when newly develop this device or revise former thing.
홍창화(Chang-Hwa Hong),유승만(Seung-Mann Ryoo) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.1
모소낭은 청소년기에서 청년기에 주로 남성에서 호발하는 천미부의 감염성과 재발성이 많은 질환으로 알려져 있다. 이 질환은 대부분 단순 농양이나 피지낭종으로 오인되어 여려 번의 수술을 받는 경우가 흔하다. 수많은 치료법이 보고되고 있으나 치료의 원칙은 모소낭의 광범위 절제가 원칙이다. 이에 저자들은 청ㆍ장년에서 천미부에 발생한 농양의 진단 및 치료에 있어서 단순농양으로 오진 하고 단순 배농 및 절제를 계획하였다가 모소낭으로 지연 진단되어 광범위 절제술로 치료를 시행한 2예를 경험하여 문헌고찰과 함께 보고하는 바이다. A pilonidal cyst is known to be a recurrent infectious disease in the sacrococcygeal region and it usually affects adolescents and adults. It is often misdiagnosed as a simple abscess or a sebaceous cyst, so there are many patients with pilonidal cysts who have gone through several operations. Although many treatments for this malady have been reported, the principle treatment for pilonidal cysts is radical excision. We report here on two cases of pilonidal cyst and the patients were misdiagnosed as having a simple abscess. We planned to perform incision and drainage, but the lesions were finally diagnosed as pilonidal cysts and so we performed radical excision for the treatment. We also review the medical literature on abscesses that occur in the sacrococcygeal region in early adulthood.
A novel technique of submandibular intubation with a camera cable drape: a case report
Yun, Hye Joo,Rhee, Seung-Hyun,Park, Joo-Young,Chae, Yeon Su,Han, Jin-Hee,Ryoo, Seung-Hwa,Seo, Kwang-Suk,Kim, Hyun Jeong,Karm, Myong-Hwan The Korean Dental Society of Anesthsiology 2020 Journal of Dental Anesthesia and Pain Medicine Vol.20 No.3
Submental or submandibular intubation has been reported to cause fewer complications than tracheostomy. However, the risk of infection is always inherent because oral wounds are exposed to microbial flora and bacteria in the oral cavity. A novel technique of submandibular intubation was devised to reduce infection and injury to the soft tissues. We would like to report a novel safe technique that can be performed in patients requiring submental or submandibular intubation. This is the first report of submandibular intubation using a sterile disposable camera cable drape. This novel technique of submandibular intubation is safer, more sterile, easier, and less invasive than conventional submandibular intubation.
( Ji Young Kang ),( Jung Hur ),( Jiwon Ryoo ),( Hyungjoon Cho ),( Jongmin Lee ),( Hwa Young Lee ),( Chin Kook Rhee ),( Seung Joon Kim ),( Seok Chan Kim ),( Sook Young Lee ),( Soon Seog Kwon ),( Young 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0
Purpose As obesity is a crucial risk factor in asthma, diet control such as fasting could be beneficial effect in the disease control. Recently innate lymphoid cells (ILCs) are known early pivotal player in asthma pathogenesis and obesity. We investigate to the effect of intermittent fasting and the role of ILCs as its mechanism in an obese allergic asthma model. Methods In 3-week- old C57BL/6, obese asthma was induced by high-fat diet (HFD) for 8 weeks with subsequent ovalbumin (OVA) administration for 8 weeks. Intermittent fasting (IF) group skipped a meal for 24 hours from 12 weeks to 16 weeks. Typical parameters of asthma were measured. Adipokines such as leptin/adiponectin and ILCs profiles were examined. Results In the HFD-OVA group, pathognomic findings of asthma including AHR, airway inflammation, submucosal gland hyperplasia, and collagen deposition were observed prominently. Leptin level in serum increased whereas adiponectin decreased. Expression of ILC2 and ILC3 in the lung tissue were elevated. In the HFD-OVA-IF group, AHR decreased significantly and pathologic findings in asthma by PAS stain and hydroxyproline assay ameliorated. After IF, the concentration of leptin diminished, but that of adiponectin did not change remarkably. Notably, airway inflammation and type 1/2 cytokines increased without any statistical significance. The infiltration of ILC2 and ILC3 in the lung reduced in the HFD-OVA-IF group Conclusion This study reveals that intermittent fasting attenuates AHR and pathologic features such as submucosal gland hyperplasia and collagen deposition, not airway inflammation in an obese asthma model via a modulation of leptin and ILCs.
Choi, Yong-suk,Kim, Hyungseok,Rhee, Seung-Hyun,Ryoo, Seung-Hwa,Karm, Myong-Hwan,Seo, Kwang-Suk,Kim, Hyun Jeong The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.4
The effectiveness of dental implants in patients with disability, who are non-compliant during treatment, is controversial because of their poor oral health. Thus, oral health-care and management in such patients is concerning. Moreover, limited information is available on prognosis after implant placement. Herein, we describe a patient with schizophrenia who underwent dental implantation under multiple inductions of general anesthesia (5 times) and required conservative treatment and tooth extraction for multiple dental caries and retained roots because of inadequate oral health-care. Postoperatively, fracture of the prosthodontics and progression of dental caries were observed, and with 3 additional inductions of general anesthesia, conservative treatment, implant surgery, and prosthesis implantation were conducted. Postoperative 12-month follow-up since the last prosthesis implantation showed successful results. For patients with schizophrenia, multiple implantation can reduce horizontal bone loss and achieve aesthetic results compared to treatment with removable prosthodontics and could serve as an alternative treatment modality.