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JYMS : Journal of Yeungnam Medical Science

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Dae Pal Park 16 Articles
Treatment of Atelectasis Dectected in the Recovery Room after General Anesthesia
Chang jae Hwang, Heung dae Kim, Dae pal Park, Il suk Seo, Sun ok Song, Sae yeon Kim, Dae lim Jee, Deok hee Lee
Yeungnam Univ J Med. 2007;24(2 Suppl):S696-701.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S696
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Atelectasis is a relatively common complication following surgery in anesthetized patient with respiratory symptoms, but rarely occur in normal healthy patient. Anesthesiologists must be wary to prevent atelectasis, because it may lead to hypoxia during and after the operation. This case reports a healthy patient without previous respiratory symptoms who developed left lower lobar atelectasis after general anesthesia. Vigorous chest physiotherapy including intended coughing, deep breathing, chest percussion and vibration under postural change was effective. Therefore, vigorous chest physiotherapy is essential part of early treatment modalities for atelectasis in postoperative recovery room.
Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet.
Gul Jung, Woo Mok Byun, Hyung Jun Lim, Jong Gyun Kim, Dong Min Kwak, Deok Hee Lee, Sae Yeon Kim, Sun Ok Song, Il Sook Seo, Dae Lim Jee, Heung Dae Kim, Dae Pal Park
Yeungnam Univ J Med. 2007;24(2):344-344.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.344
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Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack-Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.
Risk Factors of Acute Renal Failure after Colorectal Surgery.
Hae Mi Lee, Chang Jae Hwang, Jaehwang Kim, Heung Dae Kim, Dae Pal Park, Il Suk Seo, Sun Ok Song, Sae Yeon Kim, Deuk Hee Lee, Daelim Jee
Yeungnam Univ J Med. 2007;24(2):275-286.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.275
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BACKGROUND
Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. MATERIALS AND METHODS: Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. RESULTS: The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). CONCLUSION: Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.
Thiopental Prevents A Beta-Endorphin Response to Cardiopulmonary Bypass.
Sun Ok Song, Daniel B Carr, Dae Pal Park, Dae Lim Jee, Sae Yeon Kim
Yeungnam Univ J Med. 1997;14(2):350-358.   Published online December 31, 1997
DOI: https://doi.org/10.12701/yujm.1997.14.2.350
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AbstractAbstract PDF
No abstract available.
The effect of lidocaine dose and pretreated diazepam on cardiovascular system and plasma concentration of lidocaine in dogs ansthetized with halothane-nitrous oxide
Kyeong Sook Lee, Sae Yeon Kim, Dae Pal Park, Jin Mo Kim, Chung Gil Chung
Yeungnam Univ J Med. 1993;10(2):451-474.   Published online December 31, 1993
DOI: https://doi.org/10.12701/yujm.1993.10.2.451
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AbstractAbstract PDF
Lidocaine if frequently administered as a component of an anesthetic: for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrhythmic therapy. Diazepam decrease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the stimulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and increased pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was associated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and increased PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather increased than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when an infusion of large dose of lidocaine is given to dogs anesthetized with halothane and nitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impaired autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Effects of furosemide on perioperative serum osmolality and electrolytes during transurethral resection of the prostate
Sae Yune Kim, Un Seok Roh, Dae Pal Park
Yeungnam Univ J Med. 1992;9(1):110-120.   Published online June 30, 1992
DOI: https://doi.org/10.12701/yujm.1992.9.1.110
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The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate. 30 patients, who belonged to physical status II or III of ASA classification, were selected randomly and divided with two groups as follows: G1 (N=15): Not-administrated furosemide (control group) G2 (N=15): Administrated furosemide (Experimental group) All patients were premedicated with Hydroxyzine (1mg/kg, IM) and were performed continuous epidural anesthesia with 2% lidocaine (1-1.5mg/segment). For irrigating solution, 5% D-sorbitol was used and Hartman's solution were given for maintenance fluid and fixed the height of irrigating container to 60 cm from symphysis pubis. With the starting of operation, 20 mg furosemide was administrated to experimental group. The blood samples for the values of Na⁺, K⁺, Glucose and BUN were performed at the periods of preoperation, 10 min, 20 min, 30 min after the starting of operation and immediate postoperation. Based these date, serum osmolality and effective osmolality were calculated. The results were as follows: 1. The sodium concentration of control group was decreased statistically significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value (p<0.05). But that of experimental Group was not changed significantly. 2. The serum osmolality and effective osmolality were decreased statistically significantly at 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value (p<0.05). But those of experimental group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraoperatively. And so we recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.
Effect on the management of postherpetic neuralgia.
Bon Up Koo, Dae Pal Park
Yeungnam Univ J Med. 1991;8(1):136-141.   Published online June 30, 1991
DOI: https://doi.org/10.12701/yujm.1991.8.1.136
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Fifteen patients was analyzed on effect of the management of postherpetic neuralgia by local anesthesia on the special region at pain clinic in Youngnam University Hospital. The results were on follows: 1) The frequency of occurrence of sex and the lesion side were similar in all patients. 2) The age of incidence was between 50 and 70 years old. 3) The most frequent site of lestons was the neck. 4) There was no relationship between age and treatment time. 5) Whole patients was done average 7-10 time local injection.
Caudal Anesthesia for pediatric Inguinal Region Surgery.
Kyeung Sook Lee, Dae Pal Park
Yeungnam Univ J Med. 1990;7(1):127-131.   Published online June 30, 1990
DOI: https://doi.org/10.12701/yujm.1990.7.1.127
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AbstractAbstract PDF
Pediatric caudal anesthesia was done in 50 infants and children under 10 years of age, who were to undergo surgery of inguinal region. All cases were given 10mg/kg body weigh t of 1% lidocaine solution with epinephrine 1:200,000. The results were as follows: 1) Pediatric caudal anesthesia was simple, easy and reliable in technique. 2) Additional intravenous administration of Ketamine or pentothal sodium was needed. i.e., to provide a more cooperative state. 3) Anesthetic effect was judged very Excellent. 4) Cardiovascular and respiratory changes were minimal. Author's came to conclusion that caudal anesthesia for pediatric inguinal region surgery in reliable, simple in technique, favorable to surgeon, and is considered to be a good technique for pediatric anesthesia.
The Effect of Enflurane Anesthesia on The Liver in patient with positive HBsAg and increased SGOT, SGPT.
Ill Sook Suh, Dae Pal Park
Yeungnam Univ J Med. 1990;7(1):121-126.   Published online June 30, 1990
DOI: https://doi.org/10.12701/yujm.1990.7.1.121
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Halothane is usually a safe and effective inhalation anesthetic agent but it rarely has damaged liver. The authors selected 11 patients who had HBsAg positive and increased SGOT, SGPT at Yeungnam university hospital. Their physical status was ASA class 1 and 2. They had no previous history of operation or liver disease. The liver function tests were performed before surgery, and on 3rd, 7th and 10th postoperative days. The result were as follows: 1) The values of SGOT and SGPT were gradually increased on 3rd postoperative day and markedly increased on the 7th and 10th postoperative day. 2) Alkaline phosphatase, total protein, albumin, total bilirubin and direct bilirubin were not significantly changed.
Analgesic Effects of Epidural Clonidine.
Ill Sook Suh, Dae Pal Park
Yeungnam Univ J Med. 1989;6(2):57-62.   Published online December 31, 1989
DOI: https://doi.org/10.12701/yujm.1989.6.2.57
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Clonidine, α2-adrenergic agonist, applied spinally or epidurally has been shown to be effective in blocking noxious stimuli in human applications. The purpose of this study is to evaluate the analgesic effect of epidurally administered clonidine. In 40 patients undergoing hemorrhoidectomy or anal fistulectomy, 1.33% lidocaine 15ml (Group I) or 1.33% lidocaine mixed with 75µg clonidine (Group II) administered epidurally through sacral hiatus. Intraoperative changes of vital signs and duration of postoperative analgesic effects were observed. The results were as follows: 1) In the group I, average analgesic duration was 2.42 hours. 2) In the group II, average analgesic duration was 7.32 hours. 3) After epidural clonidine injection, the decrease in heart rate and blood pressure was not significant without sedation. 4) Postoperatively, any complaints related clonidine were not reported. In conclusion, postoperative pain control with epidural clonidine was effective.
Anesthetic Management of Corrective Operation of Tracheal Stenosis.
Dae Pal Park
Yeungnam Univ J Med. 1987;4(2):155-157.   Published online December 31, 1987
DOI: https://doi.org/10.12701/yujm.1987.4.2.155
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A 25 years old male patient was experienced Trough method operation to correct of Tracheal stenosis following Tracheostomy. After admission, a No.3 Magill plastic portex tube had been placed in the previous tracheostomy opening. Stenotic narrowing portion was noted low trachea (about 3.5 cm above carina) Despite of narrowing of the lesion, anesthetic course was uneventful with oxygen, halothane and non depolarized muscle relaxant by controlled respiration. Postoperative course were also favorable with adequate respiratory cares and blood gas analyzed.
Statistic Evaluation of Changing Pattern of Blood Pressure and Pulse Rate During Enflurane Anesthesia.
Ill Sock Suh, Dae Pal Park
Yeungnam Univ J Med. 1986;3(1):81-85.   Published online December 31, 1986
DOI: https://doi.org/10.12701/yujm.1986.3.1.81
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Observation of changing pattern of blood pressure and pulse rate of enflurane anesthesia for 200 cases operations, performed during the past 4 years (1983~1986) in Yeungnam University Hospital have been evaluated clinically. In order to observe the influence of enflurane upon the blood pressure and pulse rate during general anesthesia, the authors prepared a formula, expressing changing of blood pressure and pulse rate by time series and analyzed the types and distribution pattern in the experiment. The results obtained were as follows: 1. Blood pressure and pulse rate were increased at the time of intubation. 2. Generally, blood pressure and pulse rate were increased at the time of intubation and then stabilized within 20 minutes. 3. Most common patterns were identified. ADEE type was 73~74%, which is most common type and AEEE type was about 40%.
Clinical Evaluation of Cesarian Section Anerohesia.
Dae Pal Park
Yeungnam Univ J Med. 1986;3(1):63-66.   Published online December 31, 1986
DOI: https://doi.org/10.12701/yujm.1986.3.1.63
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Maternal and fetal effects of anesthesia for 423 cesarian section, performed during the past three and quarter years period in this hospital, have been evaluated. It is emphasized that the selection of anesthetic agent and method should depend upon the physical status of the patients and the ability of both obstetrician and anesthesiologists. Author results were as follows: 1. The incidence of c-section was 13.9% of total deliveries. 2. More than about three fourths of total cases were emergency cases. 3. Almost all cases were operated under general anesthesia. 4. The good physical states of patients resulted in better Apgar score of infants. 5. The shorter the interval from induction of anesthesia to delivery, the better was the Apgar score of infants.
A Clinical Study of Succinylcholine-Atracurium for Cesarian Section.
Dae Pal Park
Yeungnam Univ J Med. 1986;3(1):49-51.   Published online December 31, 1986
DOI: https://doi.org/10.12701/yujm.1986.3.1.49
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Atracurium was used in 10 parturients undergoing elective cesarian section under general Anesthesia. An initial bolus of 0.4 mg/kg of the atracurium was injected after recovery from succinylcholine block. Complete neuromuscular block resulted in all cases. Muscular relaxation was maintained by incremental dose of 0.2mg/kg of atracurium. Administration of atracurium did not cause significant change in blood pressure, pulse rate and infants Apgar score. The residual neuromuscular block could be antagonized at the end of the procedure by mixture of 0.005 mg/kg glycopyrrolate and 0.03 mg/kg of neostigmine. In all parturients, antagonism was adequate as evidenced by respiratory response and head lift test. Atracurium may be advantageous in parturients undergoing cesarian section under general anesthesia cause it maintained cardiovascular stability, is non-cumulative, is readily antagonized by neostigmine and has no deleterious effect on the newborn.
Anesthetic Experiences of Myasthenia Gravis: Report of Two Cases.
Dae Pal Park, Kyung Chul Lee
Yeungnam Univ J Med. 1985;2(1):287-292.   Published online December 31, 1985
DOI: https://doi.org/10.12701/yujm.1985.2.1.287
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Myasthenia gravis is usually defined as a state of abnormal fatigability. The cause of myasthenia gravis is not known. Several disorders tend to occur more frequently in patients with myasthenia gravis, such as hyperthyroidism or other thyroidal disorder. Anesthetic experiences with thymectomies for two patients with myasthenia gravis has been reported. Both of them tolerated the surgical procedures under endoteracheal Nitrous oxide-Oxygen-Halothane anesthesia well. Diagnosis and clinical features including choice of preanesthetic medication, anesthetic agents, techniques and of neuromuscular blocking agents for myasthenic patients have been discussed. Paramount importance of rigid attention to ventilation, the maintenance of a patent airway and the removal of secretions whenever necessary for the patient safety throughout operative and postoperative period has been stressed.
Effects of Starvation and Perioperative Fluid Therapy on the Blood Glucose Concentrations during Anesthesia in Children.
Ill Sook Suh, Sun Ok Song, Dae Pal Park
Yeungnam Univ J Med. 1984;1(1):89-93.   Published online December 31, 1984
DOI: https://doi.org/10.12701/yujm.1984.1.1.89
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This study included 38 children patients of less than 4 years old and 18 kg body weight. After 8 hours of starvation, the children were divided into 2 groups: Group I received Hartmann's solution and Group II received Hartmann's dextrose solution. In both groups, the rates of infusion were 10 ml/kg/hr before and during operation and blood samples were collected just before and 1 hr after induction of anesthesia, respectively. The results were as follows; 1) In the Group I, blood glucose concentration just before induction was decreased than control values that was checked at ward, and 1 hr value after induction was significantly increased then control values. 2) In the Group II, blood glucose concentration was increased just before and 1hr after induction than control values significantly respectively. 3) In the blood glucose concentration 1 hr after induction, difference between Group I and Group II was not significant. 4) In children, duration of starvation about 8 hrs did not significant influence on blood glucose concentration although dextrose was not administered.

JYMS : Journal of Yeungnam Medical Science