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Publications (4)4.54 Total impact

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    ABSTRACT: Cardiac comorbidities in patients undergoing amputation due to diabetic foot ulcer are associated with high mortality rates. The authors investigated whether preanesthetic echocardiographic and laboratory values can predict inhospital mortality in type II diabetes patients undergoing major lower limb amputation under spinal anesthesia. The archived medical records of 215 patients were retrospectively reviewed. Demographic data and preoperative laboratory and transthoracic echocardiographic values were analyzed by multivariate logistic regression for factors independently associated with inhospital mortality. Of the 215 patients, 12 died in hospital after amputation. Preoperative hemoglobin level (hazard ratio, 0.082; 95% confidence interval, 0.013-0.509; P = .007) and left ventricular ejection fraction (hazard ratio, 0.874; 95% confidence interval, 0.779- 0.981; P = .023) were found to be significant predictors of inhospital mortality. Preoperative hemoglobin level and left ventricular ejection fraction are highly correlated with inhospital mortality in type II diabetes patients undergoing major lower extremity amputation under spinal anesthesia. Copyright © 2015. Published by Elsevier Inc.
    Journal of Critical Care 05/2015; DOI:10.1016/j.jcrc.2015.04.122 · 2.19 Impact Factor
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    ABSTRACT: A 23-year-old woman with pulmonary arteriovenous malformation was scheduled for open reduction and internal fixation due to her mandible fracture. Total intravenous anesthesia using propofol and remifentanil was selected as the anesthetic method in order to avoid the inhibition of hypoxic pulmonary vasoconstriction and the exacerbation of intrapulmonary shunting. After the standard monitoring devices were applied, anesthesia was then induced and maintained with a target controlled infusion of propofol and remifentanil in the range of 2.5-3.0 µg/ml and 2-3 ng/ml, respectively. Anesthesia was performed uneventfully and the patient was discharged without complication.
    Korean journal of anesthesiology 01/2009; 56(6). DOI:10.4097/kjae.2009.56.6.713
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    ABSTRACT: There is both in vitro and clinical evidence that high-dose propofol can inhibit mitochondrial respiration, resulting in metabolic acidosis. The purpose of this study was to evaluate the effects of propofol anesthesia on the acid-base status in neurosurgical patients with large amount of normal saline administration. Thirty patients undergoing clipping of cerebral aneurysm were randomly assigned to receive propofol (n=15) or isoflurane (n=15). Propofol dose (mean+/-standard error) infused for maintenance was 5.7+/-0.2 mg/kg/h in propofol group. Acid-base parameters such as PaCO2, pH, serum bicarbonate concentration, standard base excess, serum electrolyte concentration, total protein, albumin, lactate, and phosphate were measured before and 4 hours after the induction of anesthesia, and after surgery. The apparent strong ion difference (SIDa), the effective SID (SIDe), and the amount of weak plasma acid were calculated using the Stewart equation. There were no significant differences in pH, PaCO2, bicarbonate, and lactate between 2 groups throughout the whole investigation period. After surgery, standard base excess significantly decreased in both groups without intergroup difference. SIDa and SIDe significantly decreased in both groups, and lactate and strong ion gap significantly increased after surgery in propofol group, but there were no significant differences between 2 groups. Both propofol and isoflurane were associated with hyperchloremic metabolic acidosis in neurosurgical patients with large amount of normal saline administration. The acid-base balance between the 2 anesthetics was similar using Stewart's physicochemical approach.
    Journal of Neurosurgical Anesthesiology 02/2008; 20(1):1-7. DOI:10.1097/ANA.0b013e3181483ddd · 2.35 Impact Factor
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    ABSTRACT: Among various measures to prevent deep venous thrombosis (DVT) in surgical patients, intermittent pneumatic compression of the legs is known to be effective without increasing the risk of bleeding. In this study, the coagulation/ fibrinolysis profile in patients undergoing gastrectomy with SCD Response Compression System, which detects individual venous refill time, was compared to that with elastic stocking using thromboelastography (TEG).
    Korean Journal of Anesthesiology 01/2007; 53(6). DOI:10.4097/kjae.2007.53.6.S1