Journal of Yeungnam Medical Science

Sae Yeon Kim

12 Articles

Anesthesia for Cesarean Section in a Parturient with Dilated Cardiomyopathy: A Case Report.: Sae Yeon Kim, Su Jeong Heo, Sun Ok Song; Yeungnam Univ J Med. 2010;27(1):52-56. Published online June 30, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.1.52

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Abstract PDF: Idiopathic peripartum cardiomyopathy is an uncommon malady disease. Making the diagnosis is often difficult and it is always necessary to exclude other prior heart disease and other causes of left ventricular dysfunction in pregnant women. Heart failure in these women ensues when the cardiovascular demands of normal pregnancy are further amplified when the common complications of pregnancy complications superimposed upon these underlying conditions that cause compensated ventricular hypertrophy. This may be aggravated by making a late diagnosis and providing inappropriate treatment. We experienced a 38-year-primigravida who has diagnosed with idiopathic peripartum cardiomyopathy and underwent elective cesarean section with general anesthesia.

Anesthetic Experience for Trans-Sphenoidal Surgery of Pituitary Adenoma on a Patient with Brugada Syndrome: A Case Report.: Min Jung Heo, Sae Yeon Kim; Yeungnam Univ J Med. 2009;26(2):148-155. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.148

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Abstract PDF: Brugada syndrome is characterized by an ECG pattern of right bundle branch block and ST segment elevation in the right precordial leads (V(1)-V(3)) without structural heart disease. It is also characterized by sudden cardiac death that's caused by ventricular fibrillation. This is a familial syndrome with an autosomal dominant inheritance pattern and it may be considerably more common in Southeast Asia. Many factors during anesthesia can precipitate malignant dysrrhythmia in these patients, so careful choice of anesthetics is required. We experienced a case of Brugada syndrome in a 59-year-old male patient who was under general anesthesia for trans-sphenoidal surgery to treat a pituitary adenoma, and the patient was diagnosed as having Brugada syndrome without any untoward cardiovascular events.

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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Abstract PDF: 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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Abstract PDF: 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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Abstract PDF: 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.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia.: Ji Yoon Kim, Dong Won Lee, Il Sook Seo, Sae Yeon Kim; Yeungnam Univ J Med. 2007;24(2):206-215. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.206

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Abstract PDF

BACKGROUND
The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. MATERIALS AND METHODS:Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by NICO(R). We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. RESULTS: In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. CONCLUSION: The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions
Ji Young Moon, Bo Hwan Kim
Journal of Korean Biological Nursing Science.2015; 17(2): 114. CrossRef

Changes of Blood Gases, Plasma Catecholamine Concentrations and Hemodynamic Data in Anesthetized Dogs during Graded Hypoxia Induced by Nitrous Oxide.: Sae Yeon Kim, Sun Ok Song, Jung In Bae, Jae Kyu Cheun, Jae Hoon Bae; Yeungnam Univ J Med. 1998;15(1):97-113. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.97

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Abstract PDF: The sympathoadrenal system plays an important role in homeostasis in widely varing external environments. Conflicting findings, however, have been reported on its response to hypoxia. We investigated the effect of hypoxia an the sympathoadrenal system in dogs under halothane anesthesia by measuring levels of circulating catecholamines in response to graded hypoxia. Ten healthy mongreal dogs were mechanically ventilated with different hypoxic gas mixtures. Graded hypoxia and reoxygenation were induced by progressively decreasing the oxygen fraction in the inhalation gas mixture from 21%(control) to 15%, 10% and 5% at every 5 minutes, and then reoxygenated with 60% oxygen. Mean arterial pressure, central venous pressure and mean pulmonary arterial pressure were measured directly using pressure transducers. Cardiac output was measured by the thermodilutional method. For analysis of blood gas, saturation and content, arterial and mixed venous blood were sampled via the femoral and pulmonary artery at the end of each hypoxic condition. The concentration of plasma catecholamines was determined by radioenzymatic assay. According to the exposure of graded hypoxia, not only did arterial and mixed venous oxygen tension decreased markedly at 10% and 5% oxygen, but also arterial and mixed venous oxygen saturation decreased significantly. An increased trend of the oxygen extraction ratio was seen during graded hypoxia. Cardiac output, mean arterial pressure and systemic vascular resistance were unchanged or increased slightly. Pulmonary arterial pressure(PAP) and pulmonary vascular resistance(PVR) were increased by 55%, 76% in 10% oxygen and by 82%, 95% in 5% oxygen, respectively(p<0.01). The concentrations of plasma norepinephrine, epinephrine and dopamine increased by 75%, 29%, 24% in 15% oxygen and by 382%, 350%, 49% in 5% oxygen. These data suggest that the sympathetic nervous system was activated to maintain homeostasis by modifying blood flow distribution to improve oxygen delivery to tissues by hypoxia, but hemodynamic changes might be blunted by high concentration of nitrous oxide except PAP and PVR. It would be suggested that hemodynamic changes might not be sensitive index during hypoxia induced by high concentration of nitrous oxide exposure.

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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Abstract PDF: No abstract available.

Effect of Intracarotid Cold Saline Infusion during Cerebral ischemia on Brain Edema in the Rabbit: Sae Yeon Kim, Kyu Taek Choi; Yeungnam Univ J Med. 1995;12(2):260-268. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.260

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Abstract PDF: Ischemia results when the decrease in tissue perfusion exceeds the tissues ability to increase an oxygen extraction from the blood. Brain edema has been defined as an abnormal accumulation of fluid within brain parenchyma associated with a volumetric enlargement of the brain tissue. In most instances, the labelling of edema as vasogenic or cytotoxic is only relative. For cerebral protection, there were many possible techniques which could increase or maintain cerebral perfusion and reduce cerebral metabolic demand for oxygen. This study was carried out the effect of mild Brain hypothermia which was induced by infusion with cold saline into the carotid artery, during brief episodes of transient global ischemia on postischemic brain edema in rabbit. Eight rabbits were anesthetized with halothane and mechanically ventilated with oxygen. For isolated cerebral perfusion, polyethylene catheter was inserted left carotid artery for infusion of cold saline, external carotid artery was ligated, vertebral arteries were cauterized, right carotid artery was snared for ischemia and femoral artery and vein were also cannulated for monitoring and drug treatment. At 3 hours after transient global ischemia, specific gravity of cerebral cortex and hippocampus was compared with no-perfusion group, perfusion with cold saline group and normal group. There was no significant differences in physiologic variables among the groups before transient global ischemia. But during transient global ischemia, brain temperature of perfusion group was decreased when compared to no perfusion group. Specific gravity of cerebral cortex and hippocampus of no-perfusion group and perfusion group was statistically significant when compared to normal group (p<0.01). The results of this study suggested that mild brain hypothermia with intracarotid cold saline infusion during brief episodes of transient global ischemia had decreased postischemic brain edema in rabbit.

The Role of Jugular Venous Oxyhemoglobin Saturation Monitoring During Cardic Surgery.: Sae Yeon Kim, Dae Lim Jee; Yeungnam Univ J Med. 1994;11(1):49-54. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.49

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Abstract PDF: Postoperative brain damage is one of most serious complications of cardiopulmonary bypass (CPB). To prevent brain damage during CPB, adequate cerebral perfusion for cerebral oxygen demand should be maintained. This study monitored jugular venous oxyhemoglobin saturation (SjO₂), which reflects the overall balance of cerebral oxygen supply and demand, intermittently in 10 patients undergoing cardiac surgery. At the initiation of CPB, in spite of a significant decrease in mean arterial pressure, SjO₂ did not change, and it was stable during the hypothermic period of CPB. But a significan reduction in SjO₂ was observed during the rewarming period, and SjO₂ had an inverse linear correlation with esophageal temperature. Furthermore, the percent decrease of SjO₂ was related to rewarming speed. Therefore, therapeutic approaches for SjO₂ desaturation include slower rewarming, increasing cerebral blood flow, decreasing the cerebral metabolic rate for oxygen, increasing oxygen content, and increasing perfusion flow rate.

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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Abstract 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.

Postoperative analgesic effect of intraarticular bupivacaine or morphine after arthroscopic knee surgery.: Sae Yeon Kim; Yeungnam Univ J Med. 1993;10(2):445-450. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.445

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Abstract PDF: Recent studies have shown that opiods can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. This study sougt to compare the effects of morphine with those of-bupivacaine administered intraarticularly upon pain after arthroscopic knee surgery. In a ramdomized manner, 60 healthy patients received either morphine(3 mg in 20 ml NaCl : n=20), bupivacaine(20 ml, 0.25% : n=20) intraarticularly at the completion of surgery, and others were not administered (n = 20) under general anesthesia after 1, 2, 4, 6, 12 and 24h of postoperative day, pain was assessed by a visual analogue pain scalps, time to first analgesic use were recorded. Pain scores were signicantly greater in the morphine group than two groups at 11. From 4th until the end of the study period, pain scores were significantly greater in the bupivaca.ne group than in the other two group. Anagesic requirements were significantly greater in the morphine group than two groups at 1h but were significantly greater in the bupivacaine group than in the other groups throughout the remainder of the study period. The results suggest that intraarticular morphine produces an analgesic effect of delayed onset but of remarkably long duration.

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