Comparison of the effect of dexmedetomidine and midazolam under spinal anesthesia for cesarean delivery: a randomized controlled trial, single center study in South Korea

Kang Hyoseok,Lim Taeha,Lee Hyun jeong,Kim Tae Wan,Kim Wan,Chang Hae Wone 대한마취통증의학회 2023 Anesthesia and pain medicine Vol.18 No.2

Background: Cesarean section under spinal anesthesia may cause anxiety and hypotension. Administration of sedative drugs after delivery can diminish these side-effects, but may increase hemodynamic instability. We evaluated the effect of the administration of 0.7 μg/kg dexmedetomidine and compared it with that of 0.03 mg/kg midazolam for usefulness of sedation of the parturient after delivery during cesarean section.Methods: After obtaining written consent and the ethics board approval, 60 parturients aged 20–43 years who underwent elective cesarean delivery under spinal anesthesia were recruited. A total of 0.5% hyperbaric bupivacaine (8–10 mg) and intrathecal fentanyl (10 μg) was given to induce anesthesia. Parturients were then randomly allocated to receive either midazolam (0.03 mg/kg; group M) or dexmedetomidine 0.7 (μg/kg; group D) after delivery. The primary outcome measure was patient satisfaction score. Secondary outcomes included vital signs; vasopressor dosage; incidence of shivering, nausea, and vomiting; incidence of bradycardia; time to sensory and motor recovery; postoperative nausea and vomiting score; and postoperative pain visual analog scale at 6, 24, and 48 h.Results: Satisfaction scores for sedation were similar between the two groups. The systolic blood pressure, heart rate, oximetry saturation, and tympanic temperature were comparable between the two groups. The predicted mean systolic blood pressure of group D was 106.3 mmHg and that of group M was 107.5 mmHg. Both groups showed comparable adverse intraoperative and postoperative outcomes.Conclusions: Dexmedetomidine and midazolam showed similar hemodynamic effects and patient satisfaction in parturients under spinal anesthesia.

경로개척형 추격 전략을 가능케 하는 조건에 관한 연구

강효석(Hyoseok Kang),송재용(Jaeyong Song),이근(Keun Lee) 한국전략경영학회 2012 전략경영연구 Vol.15 No.3

본 연구에서는 렌즈교환식 카메라 산업에 대한 사례 연구를 통하여 어떠한 조건 하에서 후발기업이 경로개척형 추격 전략을 채택하고 이에 성공할 수 있는지에 관한 두 가지 명제를 검증하였다. 첫째, 외부 요인으로서 선후발자 간의 시장 점유율 격차가 클수록 선발기업은 기술적으로 경직되고 후발기업은 경로개척형 전략을 채택할 유인이 증가한다. DSLR 시장의 선발기업이었던 캐논과 니콘은 지난 60여 년간 시장 지배적 지위를 유지하며 DSLR 기술에 천착하였다. 이에 올림푸스, 삼성전자,소니 등의 후발기업은 기술 경로를 개척할 유인을 갖게 되었고, DSLR 카메라의 핵심 부품인 미러박스와 펜타프리즘을 제거한 미러리스(mirrorless) 카메라를 개발하여 추격에 성공하였다. 둘째, 내부적으로 후발기업이 일정 수준의 기존 지식 기반과 재조합 역량을 갖추고 있어야 경로개척형 추격에 성공할 수 있다. 미러리스 카메라 시장에 진출한 기업은, 과거 축적한 카메라 관련 지식과 기술을 재구성하고 재조합함으로써 새로운 기술과 제품을 개발할 수 있었다. 본 연구를 통하여 큰 시장 격차가 오히려 선발기업의 경로의존성을 강화하고 후발기업의 기술경로 개척을 촉진함으로써 기술 추격의 가능성을 높인다는 점, 새로운 기술경로 상에서도 기존 지식 기반과 이를 재조합하는 역량, 즉 추격 역량이 요구된다는 점을 확인하였다. 본 연구 결과는 추격 역량이라는 내부 조건과 시장 격차라는 외부 조건에 따라 기업이 어떠한 추격 전략을 택하여 기술 추격에 성공할 수 있을지에 관한 지침을 제공한다. 나아가 기존 선발기업이나 이미 추격을 달성한 후발기업에게도 유용한 시사점을 제공할 것으로 기대된다. This study examines the question of under what conditions a latecomer"s path-creating catch-up can be successful. By scrutinizing the interchangeable-lens camera industry, in which barriers to entry are significantly high, we verify the two propositions, namely the external and internal pre-conditions, for the successful path-creating catch-up. First, a large gap in market share between the latecomer and the forerunner motivates the former"s path-creation, whereas such difference makes the latter rigid or complacent in the existing technology. Market dominant positions made the 50-year ironclad market leaders, Canon and Nikon, adhere to the DSLR camera technology. On the other hand, due to its small market share, a chain of latecomers had sufficient incentives to explore the brand-new mirrorless camera technology. Second, in order to succeed in path-creating catch-up, latecomers need to have a certain degree of prior knowledge or experience in the related knowledge areas and recombinative capability, namely “catch-up capability”. Firms which pioneered in the mirrorless camera market had conducted the DSLR camera or related business before and had abundant experience in recombining different fields of knowledge and technology.

Potentials of Smart dynamometer use for clinical and self-management of rehabilitation in breast cancer survivors: a feasibility study

Seungjin Kang,Sooyoung Yoo,Hyunyoung Baek,Junheon Lee,Younggeun Choi,Hyangjung Kim,Hyoseok Yi,Eun Joo Yang 대한의용생체공학회 2019 Biomedical Engineering Letters (BMEL) Vol.9 No.2

The aim of this study was to examine the feasibility of the Smart dynamometer as a rehabilitation exercise device in a dailycare by comparing with the existing medical devices. We used and analyzed clinical and measurement data of breast cancersurvivors who have used Smart dynamometer during their rehabilitation after breast cancer surgery. The Smart dynamometerwas compared with the two existing devices of Takei dynamometer and surface electromyography (sEMG) that were usedin routine care, respectively. Three key components of the rehabilitation exercise devices were analyzed to validate the feasibilityof the Smart dynamometer: grip strength, reaction time, and grip endurance time. Pearson’s correlation analysis wasperformed to compare the statistical signifi cance between the devices. The data of 12 and 15 female breast cancer patientswere analyzed for comparing the Smart dynamometer with Takei dynamometer and sEMG, respectively. There was a veryweak correlation between the maximum values from the Takei and the Smart dynamometers in the aff ected and non-aff ectedarms of breast cancer patients (r = 0.5321, 0.4733). Comparisons of 3 features between the Smart dynamometer and sEMGshowed that there were strong positive correlations for both reaction time and endurance time in the aff ected and non-aff ectedarms (r > 0.9). The feasibility of the Smart dynamometer for the possible use in a daily rehabilitation exercise was partiallyverifi ed. Moreover, since the Smart dynamometer was highly correlated with time-related variables, it was important andsignifi cant to measure both grip strength and time-related information.

중환자 마취 중 시행된 지속적 신대체요법

( Jae Woo Lee ),( Hyoseok Kang ),( Yong Soo Lee ),( So Jin Shin ) 경희대학교 경희의료원 2017 慶熙醫學 Vol.32 No.1

A 48 yrs old woman with high fever, untreated diabetes and liver cirrhosis underwent emergency nephrectomy following rapid deterioration of hemodynamic state due to acute emphysematous pyelonephritis with abscess in right kidney, complicated with septic shock. To correct metabolic acidosis and electrolyte imbalance, to prevent renal failure, and to remove of toxic material from blood, CRRT (continuous renal replacement therapy) was applied during surgery and continued in intensive care unit after surgery. CRRT usually have been used in the intensive care unit for treatment of postoperative acute renal failure in the anesthesia. Other uses of CRRT include correcting metabolic acidosis and electrolyte imbalance and removing toxins in sepsis.

환기보조를 받는 근위축성 측색 경화증 환자에서 시행한 지속적 경막외 마취

( Young-seob Lim ),( Hyoung-gyun Kim ),( Hyoseok Kang ) 경희대학교 경희의료원 2019 慶熙醫學 Vol.34 No.1

Background: Amyotrophic lateral sclerosis (ALS) is chronic progressive motor neuron disorder, not affecting sensory and autonomic function. As the disease progresses, a respiratory depression appears. Anesthesia and postoperative pain control in patient with ALS is challenging problems. Case Report: 56 years old man was scheduled for open reduction and internal fixation on the left distal femur. He was diagnosed with Lou Gehrig’s Disease 10 years ago, and had tracheostomy 4 years ago. He used home ventilator and was unable to move by himself below the neck and. We chose epidural anesthesia with catheter to control the pain during the surgery and postoperative period. His home ventilator was to be used during surgery. Blocked sensory level was T12 by 0.75% hyperbaric ropivacaine 10 mL and he was stable during surgery. After 48 hours epidural catheter removed, no aggravation of neurologic and respiratory signs or symptoms were noted until he discharged. Discussion: ALS is characterized as neurodegenerative disease. Patient is progressively paralyzed while remaining fully alert. Respiratory failure is the main cause of death of ALS. General anesthesia can cause the increase in weakness of the respiratory function. Spinal and epidural anesthesia are not contraindication in ALS, and there is no data that spinal epidural anesthesia deteriorates neurologic function in patients with degenerative disease. Conclusion: ALS patient receiving ventilatory support successfully underwent the operation on the left distal femur under continuous epidural anesthesia without neurologic and respiratory aggravation.

Comparison of ramosetron’s and ondansetron’s preventive anti-emetic effects in highly susceptible patients undergoing abdominal hysterectomy

Jae-Woo Lee,HyeJin Park,Juyoun Choi,So Jin Park,Hyoseok Kang,Eu-Gene Kim 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.6

Background: This study compared the preventive effects of ramosetron and ondansetron on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing abdominal hysterectomy. Methods: In a prospective, randomized, double-blinded study, a total of 120 highly susceptible women (nonsmokers,those receiving opioid-based IV patient-controlled analgesia [PCA]) undergoing abdominal hysterectomy were included in the study. Patients were divided into 2 groups and each group received either 0.3 mg of ramosetron or 4 mg of ondansetron, IV. All patients received fentanyl-based IV PCA during the 48 h postoperative periods. The incidences of PONV and side effects of 5-HT3 antagonists (headache and dizziness) were assessed at 3 intervals (<2 h,2-24 h and 24-48 h) postoperatively. Results: Patients in the ramosetron group showed a significantly higher ratio of complete response and lower incidence of nausea during the 24-48 h interval after surgery compared with those the ondansetron group. Conclusions: Ramosetron (0.3 mg) is more effective in preventing delayed PONV in highly susceptible women undergoing abdominal hysterectomy compared with ondansetron (4 mg).

Real‐Time Light‐Guided Vocal Fold Injection: Ex Vivo Feasibility Study in a Canine Model

Cha, Wonjae,Ro, Jung Hoon,Yang, Sun Choel,Choi, Chang Jun,Yang, Inchul,Kang, Hochul,Cho, Il‐,Young,Jo, Min‐,gyu,Seo, Hyoseok Wiley (John WileySons) 2019 The Laryngoscope Vol.129 No.4