Duk-Kyung Kim

Samsung Medical Center, Sŏul, Seoul, South Korea

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Publications (187)510.61 Total impact

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    ABSTRACT: To identify the incidence and the risk factors of emergence agitation in adults undergoing general anesthesia for nasal surgery. We retrospectively examined 792 patients aged ≥18 years who underwent general anesthesia for elective nasal surgery between July 2012 and August 2013. Patients in the postanesthesia care unit with a Richmond Agitation Sedation Scale≥+1 at any time were considered to have emergence agitation. The overall incidence of emergence agitation is 22.2%. From multivariate regression analysis, the following six variables were found to be significantly associated with emergence agitation (P<0.05): younger age, recent smoking, sevoflurane anesthesia, postoperative pain on the numerical rating scale (NRS)≥5, presence of a tracheal tube, and presence of a urinary catheter. Presence of a tracheal tube was the greatest risk factor, increasing the risk of developing emergence agitation by approximately fivefold (odds ratio, 5.448; 95% confidence interval, 2.973 to 9.982). Younger age was also a strong risk factor (odds ratio, 0.975 for each 1-year increase; 95% confidence interval, 0.964 to 0.987). Current smoking, sevoflurane anesthesia, postoperative pain of NRS≥5, and the presence of a urinary catheter nearly doubled the risk of emergence agitation. Emergence agitation following general anesthesia is a common complication in adult nasal surgery patients. To reduce the occurrence and consequences of agitation episodes, elimination of the associated risk factors is necessary, especially in at-risk patients.
    Clinical and Experimental Otorhinolaryngology 03/2015; 8(1):46. DOI:10.3342/ceo.2015.8.1.46 · 0.84 Impact Factor
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    ABSTRACT: Using the Korean Society of Anesthesiologists database of anesthesia-related medical disputes (July 2009-June 2014), causative mechanisms and injury patterns were analyzed. In total, 105 cases were analyzed. Most patients were aged < 60 yr (82.9%) and were classified as American Society of Anesthesiologists physical status ≤ II (90.5%). In 42.9% of all cases, the injuries were determined to be 'avoidable' if the appropriate standard of care had been applied. Sedation was the sec most common type of anesthesia (37.1% of all cases), following by general anesthesia. Most sedation cases (27/39, 69.2%) showed a common lack of vigilance: no pre-procedural testing (82.1%), absence of anesthesia record (89.7%), and non-use of intra-procedural monitoring (15.4%). Most sedation (92.3%) was provided simultaneously by the non-anesthesiologists who performed the procedures. After the resulting injuries were grouped into four categories (temporary, permanent/minor, permanent/major, and death), their causative mechanisms were analyzed in cases with permanent injuries (n=20) and death (n=82). A 'respiratory events' was the leading causative mechanism (56/102, 54.9%). Of these, the most common specific mechanism was hypoxia secondary to airway obstruction or respiratory depression (n=31). The sec most common damaging event was a 'cardiovascular events' (26/102, 25.5%), in which myocardial infarction was the most common specific mechanism (n=12). Our database analysis demonstrated several typical injury profiles (a lack of vigilance in seemingly safe procedures or sedation, non-compliance with the airway management guidelines, and the prevalence of myocardial infarction) and can be helpful to improve patient safety.
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    ABSTRACT: Singleton-Merten syndrome (SMS) is an autosomal-dominant multi-system disorder characterized by dental dysplasia, aortic calcification, skeletal abnormalities, glaucoma, psoriasis, and other conditions. Despite an apparent autosomal-dominant pattern of inheritance, the genetic background of SMS and information about its phenotypic heterogeneity remain unknown. Recently, we found a family affected by glaucoma, aortic calcification, and skeletal abnormalities. Unlike subjects with classic SMS, affected individuals showed normal dentition, suggesting atypical SMS. To identify genetic causes of the disease, we performed exome sequencing in this family and identified a variant (c.1118A>C [p.Glu373Ala]) of DDX58, whose protein product is also known as RIG-I. Further analysis of DDX58 in 100 individuals with congenital glaucoma identified another variant (c.803G>T [p.Cys268Phe]) in a family who harbored neither dental anomalies nor aortic calcification but who suffered from glaucoma and skeletal abnormalities. Cys268 and Glu373 residues of DDX58 belong to ATP-binding motifs I and II, respectively, and these residues are predicted to be located closer to the ADP and RNA molecules than other nonpathogenic missense variants by protein structure analysis. Functional assays revealed that DDX58 alterations confer constitutive activation and thus lead to increased interferon (IFN) activity and IFN-stimulated gene expression. In addition, when we transduced primary human trabecular meshwork cells with c.803G>T (p.Cys268Phe) and c.1118A>C (p.Glu373Ala) mutants, cytopathic effects and a significant decrease in cell number were observed. Taken together, our results demonstrate that DDX58 mutations cause atypical SMS manifesting with variable expression of glaucoma, aortic calcification, and skeletal abnormalities without dental anomalies. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
    The American Journal of Human Genetics 01/2015; 96(2). DOI:10.1016/j.ajhg.2014.11.019 · 10.99 Impact Factor
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    ABSTRACT: Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHTN) are complications of portal hypertension and cirrhosis. Their pathophysiological mechanisms clearly differ. HPS is characterized by a defect in arterial oxygenation induced by pulmonary vascular dilatation. In contrast, PPHTN is predominantly due to excessive pulmonary vasoconstriction and vascular remodeling, but is rarely associated with hypoxia. We report a case of a patient who had both HPS and PPHTN at the time of presentation. HPS was aggravated after sildenafil administration for the treatment of PPHTN. We demonstrated increased amount of intrapulmonay shunt after sildenafil challenge by using agitated saline contrast transthoracic echocardiography.
    Korean Circulation Journal 01/2015; 45(1):77-80. DOI:10.4070/kcj.2015.45.1.77
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    ABSTRACT: Purpose The aim of this study is to investigate the association between short sleep hour and body mass index (BMI) obesity after adjustment for socioeconomic position and health behavior factors in the general representative population in Korea in 2007-2009. Methods The fourth Korea National Health and Nutrition Examination Survey was conducted by the Korea Institute for Health and Social Affairs for the Korean Ministry of Health and Welfare in 2007-2009. The sample included 6,424 Korean Young adults aged 20-44 years (male 3,400 and female 3,017). Sleep duration was grouped by hours slept but was also classified into two categories: short sleepers (<6 h/night) and normal sleepers (6–9 h/night). Results The distribution of short sleepers and normal sleepers was 9.5% and 90.5%, respectively. The distribution of obesity was 27.8%. The adjusted odds ratio (OR) for obesity was 1.39 (95% Confidence Interval (CI) 1.09-1.77) after adjustment for confounding factors. In male, the adjusted OR for obesity was not significant difference, however, in female, the adjusted OR for obesity was 1.66 (95% CI 1.14-2.40) Conclusions This community-based random sample drawn from the entire Korean young adults population showed that short sleep hour was significantly associated with obesity, especially, female.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Purpose The aim of this study is to examine the prevalence of chronic kidney disease (CKD) in metabolic syndrome (MetS) and to investigate the association between metabolic syndrome (MetS)and chronic kidney disease (CKD) after adjustment for socioeconomic position and health behavior factors in the general representative population in Korea in 1998 through 2009. Methods The first, second, third and fourth Korea National Health and Nutrition Examination Survey (KNHANES I, II, III, and IV) was conducted by the Korea Institute for Health and Social Affairs for the Korean Ministry of Health and Welfare in 1998, 2001, 2005 and 2007-2009. The sample included 11,289 Korean men and women aged 45-64 years. Subjects were classified into two groups based on their baseline glomerular filtration rate (GFR) using the Chronic Kidney Disease Epidemiology Collaboration equation: 1) greater than or equal to 60 mL/min/1.73 m2 (non-CKD group; normal and mild renal dysfunction), and 2) less than 60 mL/min/1.73 m2 (CKD group; moderate, severe renal dysfunction, and renal failure). The MS was determined using National Cholesterol Education Program Adult Treatment Panel III criteria and the Asia-Pacific criteria for obesity based on waist circumference. Results The distribution of CKD was 1.8%, 6.8%, 3.6% and 2.9% in 1998, 2001, 2005, and 2007-2009, respectively. The distribution of MetS was 41.4%, 41.9%, 39.7% and 34.3%, respectively. The adjusted odds ratio for MS was 6.26 (95% Confidence Interval (CI) 1.78-21.9), 2.96 (95% CI 1.02-8.54), 2.55 (95% CI 0.50-13.0), and 1.89 (95% CI 1.19-3.02) after adjustment for confounding factors, respectively. Conclusions This community-based random sample drawn from the entire Korean middle aged population showed that MS was significantly associated with CKD.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Hereditary protein S deficiency is one of the natural anticoagulant deficiency causing thrombophilia. Protein S deficiency is caused by a mutation in the PROS1 gene on 3q11.2 and is typically inherited in an autosomal dominant manner. We herein describe a Korean man with protein S deficiency from a novel nonsense mutation of PROS1. The patient was a 47-year-old man with deep-vein thrombosis. No relevant family history was documented. Coagulation test results included a significantly decreased protein S activity at 30%. Molecular genetic analysis targeting PROS1 on suspicion of hereditary protein S deficiency revealed that he was heterozygous for a novel transversion mutation, c.903C>G, in the exon 9 of PROS1. The mutation was predicted to result in premature termination at the codon 301 in the laminin G-type domain (p.Tyr301) of the protein (nonsense mutation). According to a review of the literature and database, the mutation described herein is the first substitution mutation affecting the codon 301 of PROS1.
    Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 09/2014; 26(2). DOI:10.1097/MBC.0000000000000217 · 1.38 Impact Factor
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    ABSTRACT: Purpose Compared to open gastrectomy (OG), laparoscopic gastrectomy (LG) has improved short-term outcomes and equivalent oncological outcomes. In this study, a potential short-term advantage of LG over OG, reduced risk of emergence agitation, was evaluated. Methods This retrospective study compared LG versus OG with respect to emergence agitation in 400 adult patients who underwent sevoflurane anesthesia. In all cases, a serial Richmond Agitation-Sedation Scale (RASS) assessment was performed in the postanesthesia care unit (PACU). Patients with a RASS score ≥+1 at any time were considered to have emergence agitation. Severe agitation was defined as a RASS score of +3 or +4. Results This study included 214 OG group subjects and 186 LG group subjects in the analysis. The overall incidence of emergence agitation was significantly lower in the LG group than the OG group (23.7 vs. 43.5 %, p p = 0.035). Multivariate logistic regression analysis demonstrated that the type of surgery (OG vs. LG), as well as current smoking, total dose of rescue opioids used in the PACU, and maximum pain score in the PACU, were independent risk factors for emergence agitation (odds ratio, 1.984; 95 % confidence interval, 1.249-3.153; p = 0.004). Patients with emergence agitation had significantly increased PACU stays (p = 0.024). Conclusions Compared to an open approach, a laparoscopic gastrectomy approach can provide the short-term benefit of decreased emergence agitation.
    Journal of Anesthesia 08/2014; 29(2). DOI:10.1007/s00540-014-1905-8 · 1.12 Impact Factor
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    ABSTRACT: Hereditary protein S deficiency from a mutation in the PROS1 gene causes a genetic predisposition to develop venous thromboembolic disorders in humans. Recently, the acknowledgment of the clinical significance of large copy number mutations in protein S deficiency has increased. In this study, the authors investigated the genomic architecture of PROS1 in order to understand the microscopic sequence environment leading to large intragenic copy number mutations in the gene. The study subjects were 3 unrelated male patients with hereditary protein S deficiency from a tandem duplication mutation involving exons 5-10 of PROS1. Breakpoint analyses revealed 10-bp microhomology sequences in the intervening sequence (IVS)-4 and IVS-10 at the duplication junction without additional sequence changes, suggesting a single replication-based event as the potential molecular mechanism of rearrangement and founder effect in the mutant alleles. Further analyses on nucleotide sequences flanking the microhomology sequence revealed the presence of a repeat element (LTR-ERV1) and quadruplex-forming G-rich sequences in IVS-4. The results from genotyping multi-allelic short tandem repeats supported founder effect in the identical mutations in the 3 unrelated patients. In conclusion, we identified unique genomic architectures in the intervening sequences of PROS1 that underlie a large intragenic tandem duplication mutation leading to inherited thrombophilia.
    Gene 06/2014; DOI:10.1016/j.gene.2014.06.067 · 2.08 Impact Factor
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    ABSTRACT: The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (±2.27) m/sec (13.1±1.85 in men, 12.1±2.51 in women; P=0.019) and 8.70 (±1.99) m/sec (9.34±2.13 in men, 8.15±1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.
    Journal of Korean Medical Science 06/2014; 29(6):798-804. DOI:10.3346/jkms.2014.29.6.798 · 1.25 Impact Factor
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    ABSTRACT: Malperfusion syndrome caused by acute type A aortic dissection is associated with high mortality. However, the impact of subclinical malperfusion is not clear. We reviewed surgical outcomes in acute type A dissection for the presence of clinical and subclinical malperfusion. From 1998 to 2012 at Samsung Medical Center, 268 consecutive patients had an emergency operation for acute type A dissection. We divided patients into three groups: clinical, subclinical, and no malperfusion. Clinical malperfusion was identified by signs or symptoms of organ dysfunction (n = 36). Subclinical malperfusion was defined as laboratory evidence of organ hypoperfusion or imaging findings without signs or symptoms (n = 40). Patients with no evidence of malperfusion were defined as having no malperfusion (n = 192). The mean patient age was 57.3 ± 13.8 years, and 141 patients (53%) were women. Antegrade selective cerebral perfusion was used in 213 patients (79%). Total arch replacement was performed in 53 patients (20%). The average cardiopulmonary bypass time was 218.31 ± 72.17 minutes. Early mortality was 8% in all patients, 5% in the no-malperfusion group, 8% in the subclinical malperfusion group, and 25% in the clinical malperfusion group. Overall survival in the clinical malperfusion group was worse than in the subclinical (p = 0.026) and no-malperfusion (p < 0.001) groups. Survival rates in the subclinical and no-malperfusion groups were not different (p = 0.482). On multivariate Cox regression analysis, older age, longer cardiopulmonary bypass time, and clinical malperfusion syndrome were predictors of mortality. Mortality was not increased in asymptomatic patients with malperfusion by laboratory or imaging findings. Immediate operation before progression of organ malperfusion is still a valid option for patients with acute type A dissection.
    The Annals of thoracic surgery 05/2014; 98(1). DOI:10.1016/j.athoracsur.2014.03.026 · 3.65 Impact Factor
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    ABSTRACT: Background and ObjectivesVascular surgery carries high operative risk. Recently developed cardiac computed tomography (CT) provides excellent imaging of coronary artery disease (CAD), as well as myocardial perfusions. We investigated the role of stress perfusion CT with coronary computed tomography angiography (CCTA) using 128-slice dual source CT (DSCT) in preoperative cardiac risk evaluation.Subjects and MethodsPatients scheduled for vascular surgery were admitted and underwent the adenosine stress perfusion CT with CCTA using DSCT. Patients who presented with unstable angina, recent myocardial infarction, decompensated heart failure, or renal failure were excluded. Stress perfusion CT was first acquired using sequential mode during adenosine infusion, after which, scanning for CT angiography was followed by helical mode. Perioperative events were followed up for 1 month.ResultsNinety-one patients completed the study. Most patients (94.5%) had coronary atherosclerosis, with 36 (39.6%) patients had more than 50% coronary artery stenosis. Perfusion defects with significant stenosis were found in 12 cases (13.2%). Revascularization after DSCT was rarely performed. Four patients (4.4%) experienced cardiac events in the perioperative period: two experienced heart failure and two had non-fatal myocardial infarction.ConclusionWe cannot conclude that the stress perfusion CT, with CCTA using DSCT, plays a significant role in preoperative risk evaluation from this study. However, the coronary atherosclerosis and the significant CAD were commonly found. The perfusion defects with significant lesions were found in only small fraction of the patients, and did not contribute to perioperative myocardial infarction or heart failure.
    Korean Circulation Journal 05/2014; 44(3):170-6. DOI:10.4070/kcj.2014.44.3.170
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    ABSTRACT: The aim of this study is to assess the changes in the causes of valvular heart disease between 2006 and 2011 in Korea. Data were collected from the Korean National Health Insurance Service from 2006 through 2011. These data consisted of primary diagnoses related to valvular heart disease regardless of other conditions. Valvular heart disease included non-rheumatic mitral valve disorders, non-rheumatic aortic valve disorders, rheumatic mitral valve disorders, and rheumatic aortic valve disorders. Overall, the age-standardized cumulative prevalence of non-rheumatic valvular heart disease was 70.6 per 100,000 persons in 2006 and 110.3 in 2011. This represented an increase from 42.2 to 65.2 in women and from 28.4 to 45.1 in men. In particular, there was a greater increase in prevalence in patients aged 65years or older compared with groups aged 20-44years or 45-64years for both genders. The age-standardized cumulative prevalence of rheumatic valve disease did not change dramatically between 2006 and 2011. The overall age-standardized cumulative prevalence of non-rheumatic valvular heart diseases increased between 2006 and 2011, especially in individuals older than 65years. These changes should be considered in future designs of cardiovascular healthcare services in countries with a rapidly aging population.
    International journal of cardiology 04/2014; 174(2). DOI:10.1016/j.ijcard.2014.04.112 · 6.18 Impact Factor
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    ABSTRACT: Cardiac arrest caused by acute pulmonary embolism is associated with high patient mortality. We reviewed patients who had cardiac arrest by acute pulmonary embolism. Between January 2001 and September 2013 we identified 20 patients at our institution with a confirmative diagnosis of acute pulmonary thromboembolism and cardiac arrest. Percutaneous cardiopulmonary support (PCPS) and surgical embolectomy is the standard course of care for patients in shock or cardiac arrest due to pulmonary thromboembolism at our institution. Patients were divided into two groups (PCPS group, No PCPS group). PCPS was used in 60%. Surgical embolectomy was performed for 85%. Overall in-hospital and surgical mortalities were 35% and 29%, respectively. Based on multivariate analysis, both cardiopulmonary resuscitation > 15 minutes and absence of PCPS were significant risk factors affecting survival (p = 0.001 and 0.049, respectively). When the duration of cardiac arrest is short, surgical embolectomy is a viable option after cardiac arrest due to pulmonary thromboembolism. PCPS may be a useful tool for both patient stabilization and providing a bridge when deciding upon further management options.
    ASAIO journal (American Society for Artificial Internal Organs: 1992) 03/2014; 60(3). DOI:10.1097/MAT.0000000000000063 · 1.39 Impact Factor
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    ABSTRACT: Left-sided portal hypertension and consequent gastric varices can occur in patients with isolated splenic vein thrombosis. It is a rare but clinically significant and curable cause of gastrointestinal hemorrhage. Our patient, a 20-year-old woman, with left flank pain was diagnosed with having idiopathic splenic vein thrombosis with resultant splenic infarction. Thorough workups for the possible etiologies of splenic vein thrombosis were all negative. After six months of anticoagulation, follow-up computed tomography revealed formation of gastric varices; one month following the discovery, she developed gastrointestinal bleeding. Splenectomy was performed, resulting in the resolution of gastric varices.
    01/2014; 3(2):111. DOI:10.12997/jla.2014.3.2.111
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    ABSTRACT: Fibrosclerosing periaortitis is a rare condition that refers to a spectrum of idiopathic diseases characterized by a fibroinflammatory reaction that extends from the adventitia of the aorta into the surrounding structures. It can be present in either IgG4-related or non-IgG4-related fibrosclerosing periaortitis. IgG4-related fibrosclerosing periaortitis could be associated with concomitant multi-organ involvement. However, non-IgG4-related fibrosclerosing periaortitis has rarely been associated with systemic manifestations. Here, we report a 76-year-old female with non-IgG4-related fibrosclerosing periaortitis, who developed pancytopenia, pleural effusion and ascites, which improved after high dose steroid treatment.
    01/2014; 86(6):749. DOI:10.3904/kjm.2014.86.6.749
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    ABSTRACT: Atrioventricular conduction disturbance is a rare clinical manifestation of Behçet disease. We describe a case in which a 48-year-old man complaining of dyspnea on exertion presented with complete atrioventricular block with junctional escape rhythm caused by Behçet disease. He also had moderate aortic regurgitation and mitral regurgitation. MRI and PET scan revealed inflammatory changes involving the ventricular septum and the ascending aorta. Recovery of atrioventricular conduction and improvement of valvular regurgitation were achieved with immunotherapy. Timely diagnosis and treatment of cardiac Behçet disease can prevent unnecessary pacemaker implantation.
    01/2014; 86(1):65. DOI:10.3904/kjm.2014.86.1.65
  • Jin-Kyoung Kim, Duk-Kyung Kim, Myeong-Jin Lee
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    ABSTRACT: To determine bispectral index (BIS) values produced by equipotent concentrations of commonly used volatile anaesthetics. Female patients undergoing thyroidectomy were randomly assigned to receive isoflurane, sevoflurane or desflurane anaesthesia. After induction, anaesthesia was maintained by the volatile agent at 1 minimum alveolar concentration and supplemented with remifentanil infusion. BIS values were recorded during 1 h surgical anaesthesia after a 15 min equilibrium phase. Time-averaged BIS value during the study period was significantly lower in the desflurane group (n = 29) than the sevoflurane group (n = 27) (37.0 ± 4.9 vs 41.5 ± 5.9). Duration of deep hypnosis (BIS < 40) was significantly longer in the desflurane group than the sevoflurane group (40.2 ± 20.7 vs 24.3 ± 22.5 min). There were no significant differences in any parameter between the isoflurane group (n = 27) and any other group. Desflurane produces a greater hypnotic effect than sevoflurane during equipotent anaesthesia. Management of volatile anaesthesia using predetermined minimum alveolar concentration targets can lead to an unnecessarily long duration of deep hypnosis.
    The Journal of international medical research 12/2013; 42(1). DOI:10.1177/0300060513505525 · 1.10 Impact Factor
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    ABSTRACT: To determine the role of endothelial progenitor cells (EPCs) in the pathogenesis of thromboangiitis obliterans (TAO), EPC numbers and colony-forming units, migratory function and tubular structure formation in vitro were compared between 13 young male TAO patients and two age-matched healthy control groups: 11 smokers and 12 non-smokers. TAO patients had significantly lower numbers of EPCs and EPC colonies compared to both non-smokers [190 (97.0-229) vs 528 (380-556), p < 0.001 for EPCs and 0.80 (0.53-1.00) vs 2.80 (2.08-4.00) per mm(2), p = 0.001 for EPC colonies] and smokers [190 (97.0-229) vs 272 (229-326), p = 0.012 for EPCs and 0.80 (0.53-1.00) vs 2.80 (1.80-3.93) per mm(2), p = 0.001 for EPC colonies]. However, there were no significant differences in migratory function or tube formation between the three groups. These results suggest that TAO patients have an intrinsic decrease in EPCs not entirely associated with smoking, which may be the cause of endothelial dysfunction seen in TAO patients leading to the development of this disease at early ages.
    Vascular Medicine 12/2013; 18(6):331-9. DOI:10.1177/1358863X13513935 · 1.73 Impact Factor
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    ABSTRACT: The cardiovascular system may be one of the target organs of both immunoglobulin G4 related and non-related systemic multifocal fibrosclerosis. We present a case of IgG4 non-related systemic multifocal fibrosclerosis mimicking mitral stenosis on echocardiography. For a more detailed differential diagnosis, we used multimodal imaging techniques. After surgical biopsy around the abdominal aortic area in the retroperitoneum, histological examination revealed IgG4 non-related systemic multifocal fibrosclerosis. We describe the multimodal imaging used to diagnose IgG4 non-related systemic multifocal fibrosclerosis and a positive response to steroid treatment. There have been no previous case reports of IgG4 non-related systemic multifocal fibrosclerosis with intracardiac involvement. Here, we report a case of IgG4 non-related systemic multifocal fibrosclerosis mimicking mitral stenosis.
    Journal of Korean medical science 12/2013; 28(12):1830-4. DOI:10.3346/jkms.2013.28.12.1830 · 1.25 Impact Factor

Publication Stats

1k Citations
510.61 Total Impact Points

Institutions

  • 2002–2015
    • Samsung Medical Center
      • • Department of Anesthesiology and Pain Medicine
      • • Department of Cardiology
      • • Department of Radiology
      Sŏul, Seoul, South Korea
  • 1999–2015
    • Sungkyunkwan University
      • • School of Medicine
      • • Samsung Medical Center
      • • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2008–2012
    • Konkuk University Medical Center
      • Department of Anesthesiology and Pain Medicine
      Changnyeong, South Gyeongsang, South Korea
  • 2010
    • Seoul Medical Center
      Sŏul, Seoul, South Korea
  • 2009–2010
    • Konkuk University
      • Department of Anesthesiology and Pain Medicine
      Sŏul, Seoul, South Korea
  • 2005–2007
    • MEDIPOST Biomedical Research Institute
      Sŏul, Seoul, South Korea