PubMed Health⌕ Search

Biomedical subjects

S H Ko

Publications and source records attributed to S H Ko.

33 records · Page 2Linked to original sources
PubMed1998

Small-dose fentanyl: optimal time of injection for blunting the circulatory responses to tracheal intubation.

UNLABELLED: This study was designed to examine the optimal time of injection of a small dose of fentanyl during anesthetic induction to attenuate circulatory responses to laryngoscopy and tracheal intubation. One hundred seventy patients were randomly assigned to one of five groups. In Groups II, III, IV, and V, patients received fentanyl (2 microg/kg) 1, 3, 5, or 10 min before tracheal intubation, respectively. Group I patients did not receive fentanyl and served as the control group. In Groups III and IV, blood pressures were not increased, except diastolic pressure in Group III, significantly postintubation compared with preinduction values; but Groups I, II, and V showed a significant increase (P < 0.05). The 1-min postintubation values of systolic, diastolic, and mean arterial pressure in Groups III and IV were less than those in the control group (P < 0.05). Increases of heart rate in Group IV were less (P < 0.05) than those in the control group, but significant differences were not observed in Groups II, III, and V. The number of patients with tachycardia and dysrhythmia was significantly smaller in Group IV than in the control group (P < 0.05). We conclude that the most effective time to administer fentanyl to protect circulatory responses to laryngoscopy and tracheal intubation is 5 min before tracheal intubation. IMPLICATIONS: Fentanyl is often used to reduce the hemodynamic response to tracheal intubation. However, large doses may cause unwanted side effects. Administration of fentanyl at the optimal time reduces the dose required. Our results indicate that optimal injection time of fentanyl for intubation is 5 min before intubation.

Adult↗
PubMed1998

Epidural verapamil reduces analgesic consumption after lower abdominal surgery.

UNLABELLED: In this double-blind study, we administered lumbar epidural bupivacaine or bupivacaine plus verapamil to investigate the possible role of the calcium channel blocker, verapamil, in postoperative pain. One hundred patients (ASA physical class I or II) scheduled for lower abdominal surgery were randomly assigned to one of four groups. Group 1 received 10 mL of 0.5% epidural bupivacaine injected 15 min before incision, followed by 10 mL of epidural normal saline 30 min after incision. Group 2 received 10 mL of epidural normal saline injected before incision, followed by 10 mL of 0.5% epidural bupivacaine 30 min after incision. Group 3 received 10 mL of 0.5% epidural bupivacaine plus 5 mg of verapamil injected before incision, followed by 10 mL of epidural normal saline 30 min after incision. Group 4 received the same drugs as Group 3, in the reverse order. Pain and mood numeric rating scores, sedation scores, Prince Henry scores, patient-controlled cumulative postoperative analgesic consumption, and the incidence of side effects were assessed 2, 6, 12, 24, and 48 h after the operation in each group. Cumulative postoperative analgesic consumption in Groups 3 and 4 was significantly lower (P < 0.05) than that in Groups 1 and 2 24 and 48 h after surgery. There were no differences in the pain, mood, and sedation scores and the incidence of side effects among the four groups. We conclude that epidural verapamil decreases postoperative pain, possibly by interfering with normal sensory processing and by preventing the establishment of central sensitization. IMPLICATIONS: Calcium plays an important role in pain physiology at the spinal cord level. We examined the effect of bupivacaine plus verapamil (calcium channel blocker) and of bupivacaine alone. We demonstrated that the combination, administered epidurally, resulted in less postoperative analgesic consumption than bupivacaine alone.

Abdomen↗
PubMed1998

Identification of Tyrophagus putrescentiae allergens and evaluation of cross-reactivity with Dermatophagoides pteronyssinus.

House dust mites are the most common cause of allergic sensitization in respiratory allergic patients in the world. Tyrophagus putrescentiae (TP), which was followed by Dermatophagoides farinae (DF) and Dermatophagoides pteronyssinus (DP), has been reported as the third most common house mite in Korea. We previously reported that many respiratory allergic patients had become concomitantly sensitized to DP, DF and TP. The aims of this study were to identify the allergic components of TP and to evaluate the cross-reactivity between TP and DP. The allergenic components of TP and DP extracts were determined with SDS-PAGE and IgE immunoblotting analysis. The cross-reactivity as evaluated by ELISA inhibition and inhibitory immunoblotting experiments. According the SDS-PAGE, the protein components of the two extracts were somewhat different, although a few components displayed identical molecular weights. The 18 kD protein of TP was the most prevalent allergen in the sera of patients sensitized to TP and DP. Both of the maximum inhibition percentages of optic densities of TP-specific IgE in ELISA with TP and DP extract were 100%, respectively and the 50% inhibitory dose (ID50) of TP extract and DP extract were 0.01 micrograms/ml and 0.02 micrograms/ml, respectively. Maximum inhibition of optic densities of DP-specific IgE in ELISA with TP and DP extracts were 29% and 100%, respectively and the ID50 of DP extract was 0.007 micrograms/ml. On inhibitory immunoblotting of DP specific IgE, 5 micrograms/ml of TP extract completely inhibited 16 kD without inhibiting the other allergic component. Whereas, on inhibitory immunoblotting of TP-specific IgE, 5 micrograms/ml of DP extract completely inhibited all the IgE binding components of TP. These results suggested that the major allergen of TP may be the 18 kD component and we also concluded that TP allergens have a strong cross-reactivity with DP extracts, but that DP allergens only have partial cross-reactivity with TP extracts.

Allergens↗
PubMed1997

Epidural morphine plus ketamine for upper abdominal surgery: improved analgesia from preincisional versus postincisional administration.

Increased postoperative pain may be caused by central nervous system plasticity, which may be related to actions of N-methyl-D-aspartic acid (NMDA) receptors on neurons in the dorsal horn of the spinal cord. Opioids act mainly on presynaptic receptors and reduce neurotransmitter release, while ketamine antagonizes NMDA receptors and prevents wind-up and long-term potentiation. Thus, we postulated that central nervous system sensitization would be prevented more effectively by the preoperative use of these two drugs simultaneously, and the effect of preemptive analgesia would be demonstrated. Ketamine, 60 mg, and morphine, 2 mg, were injected epidurally through an indwelling catheter that was inserted at the T7-8 interspace in 60 ASA physical status class 1-2 patients. The drugs were injected before induction of anesthesia (Group 1; n = 30) or immediately after removal of a surgical specimen (Group 2; n = 30). An additional 2 mg of morphine was injected when the patients complained of resting pain. The analgesic effect was assessed by the time from first analgesic injection to second dose and the number of patients who needed supplemental injections. Complications were also noted. The duration of analgesia was longer (P < 0.01) in Group 1 (31.1 +/- 16.0 h) than in Group 2 (21.1 +/- 12.0 h), and the proportion of patients who needed supplemental injections was decreased (P < 0.05) in Group 1 (56.7%) compared with Group 2 (90.0%). The incidence of adverse effects was not different between the two groups. In conclusion, preoperative administration of morphine and ketamine is more effective in reducing postoperative pain than it is when given during the operation.

Abdominal Pain↗
PubMed1997

Propofol attenuates ischemia-reperfusion injury in the isolated rat heart.

UNLABELLED: The purpose of this study was to examine the direct effects of propofol on ischemia-reperfusion injury using an isolated Langendorff rat heart preparation. Hearts were perfused with Krebs-Henseleit (K-H) solution (control); intralipid; or 10, 30, and 100 microM propofol. Hearts were rendered globally ischemic for 25 min, then reperfusion was begun with K-H solution for 30 min. Treatment with 100 microM propofol delayed the onset of contracture during ischemia compared with control or intralipid treatments (6.4 +/- 2.1 vs 4.4 +/- 1.4 or 4.1 +/- 0.7 min, respectively; P < 0.05). During reperfusion, 100 microM propofol increased coronary flow and reduced lactate dehydrogenase release compared with control or intralipid treatments. After 30 min of reperfusion, left ventricular developed pressure (LVDP) returned to 55 and 76 mm Hg in the 30 and 100 microM propofol-treated groups, respectively, whereas LVDP was 39 mm Hg in the control group. The hearts treated with 100 microM propofol showed significantly lower left ventricular end-diastolic pressure compared with the control or intralipid groups 30 min after reperfusion (29 +/- 13 vs 48 +/- 5 or 48 +/- 11 mm Hg, respectively; P < 0.05). In histological evaluation, control and intralipid hearts had increased injury severity scores compared with hearts treated with 100 microM propofol (1.8 +/- 0.9 and 1.7 +/- 0.8 vs 1.0 +/- 0.7, respectively; P < 0.05). In conclusion, we suggest that propofol administered before and during global myocardial ischemia has cardioprotective effects on ischemia-reperfusion injury. IMPLICATIONS: It is important to protect the heart from injury by ischemia and reperfusion. The current study demonstrates that in the isolated rat heart, propofol attenuates mechanical, biochemical, and histological changes causes by ischemia and reperfusion.

Anesthetics, Intravenous↗
PubMed1997

Blockade of myocardial ATP-sensitive potassium channels by ketamine.

BACKGROUND: The adenosine triphosphate (ATP)-sensitive potassium (KATP) channel underlies the increase in potassium permeability during hypoxia and ischemia. The increased outward potassium current during ischemia may be an endogenous cardioprotective mechanism. This study was designed to determine the effects of ketamine on KATP channel in rat hearts. METHODS: Inside-out and cell-attached configurations of patch-clamp techniques and 3 M potassium chloride-filled conventional microelectrodes were used to investigate the effect of ketamine on KATP channel currents in single rat ventricular myocytes and on the action potential duration of rat papillary muscles, respectively. RESULTS: Ketamine inhibited KATP channel activity in rat ventricular myocytes in a concentration-dependent manner. In the inside-out patches, the concentration of ketamine for half-maximal inhibition and the Hill coefficient were 62.9 microM and 0.54, respectively. In a concentration-dependent manner, ketamine inhibited pinacidil- and 2,4-dinitrophenol-activated KATP channels in cell-attached patches. The application of ketamine to the intracellular side of membrane patches did not affect the conduction of single-channel currents of KATP channels. Ketamine increased the action potential duration, which was then shortened by pinacidil in a concentration-dependent manner. CONCLUSIONS: Ketamine inhibited KATP channel activity in a concentration-dependent manner. These results suggest that ketamine may attenuate the cardioprotective effects of the KATP channel during ischemia and reperfusion in the rat myocardium.

Adenosine Triphosphate↗
PubMed1990

[Study on folk caring in Korea for cultural nursing].

Care is a central concept of nursing. Nursing would not exist without caring. Care and quality of life are closely related. Human behavior is a manifestation of culture. We can say that caring and nursing care are expression of culture. The nurse must understand the relationship of culture with care for ensure quality nursing care. But knowledge of cultural factors in nursing is not well developed. Time and in-depth study are needed to find meaningful relationships between culture and care. Nurses recognized the importance of culturally appropriate nursing. There are two care systems in culturally based nursing. The folk care system and the professional nursing care system. The folk care system existed long before the professional nursing care system was introduced into this culture. If the discrepancy between these two care systems is great, the client may receive inappropriate nursing care. Culture and subcultures are diverse and dynamic in nature. Nurses need to know the caring behaviors, patterns, and their meaning in their own culture. In Korea we have taken some first step to study cultural nursing phenomena. It is not our intent necessarily to return to the past and develop a nationalistic of nursing, but to identify the core of traditional caring and relate that to professional nursing care. Our Assumptions are as follows: 1) Care is essential for human growth, well being and survival. 2) There are diverse and universal forma, expressions, patterns, and processes of human care that exist transculturally. 3) The behaviors and functions of caring differ according to the social structure of each culture. 4) Cultures have folk and professional care values, beliefs, and practices. To promote the quality of nursing care we must understand the folk care value, beliefs, and practices. We undertook this study to understand caring in our traditional culture. The Goals of this study were as follows: 1) To identify patterns in caring behavior, 2) To identify the structural components of caring, and 3) To understand the meaning and some principles of caring. We faced several questions in this study. Who is the care-giver? Who is the care-recipient? Was the woman the major care-giver at any time? What are the patterns in caring behavior? What art the principles underlying the caring process? We used an interdisciplinary team approach, composed of representatives from nursing and anthropology, to contribute in-depth understanding of caring through a sociocultural perspective. A Field study was conducted in Ro-Bong, a small agricultural kinship village.(ABSTRACT TRUNCATED AT 400 WORDS)

Culture↗
PubMed1989

[Theoretical models of causative factors in depression: a review of the literature for nursing].

This literature review was undertaken to explore theoretical models of depression for their potential usefulness in nursing research and practice. Depression has been accounted for by numerous theories or models of causation: 11 theories selected from psychology, medicine and psychoanalysis and supported by empirical or experimental research were reviewed. These theories identify a variety of precipitating and predisposing factors that may affect the individual's depression. Aggression-turned-inward theory, object loss theory, ego functioning theory, personality organization theory, behavioral theory, learned helplessness theory, cognitive theory, genetic factors, and biological theories conceptualize predisposing factors. Only life stressors theory identifies precipitating factors. Each of these theories contributes to an understanding of depression, but many of them use overlapping and interrelated factors. It is also evident from recent research that there are multiple causes for depression involving an interactive effect among predisposing and precipitating factors that are both biological and psychological in origin. That is, a single theory is not useful, but perhaps a unified theory could be developed that would be helpful to nursing. This review points to the need for continuing development and testing of theories that would integrate the multiple conceptualizations of depression.

Depression↗
PubMedDate not supplied

[Testing the criterion-related validity of a mental health assessment tool in Korean adults].

This study was conducted to testing the criterion-related validity of a mental health assessment tool which developed based on a Korean culture. Criteria scale for this tool were MMPI and CMI(M-R). The study subject were 100 male and female aged 20 or more with quota sampling. The data was collected from August 16. to August 26, 1989. The data obtained from 85 subjects were analysed using S.P.S.S. (Statistical Package for the Social Science). As a result, there are no significant correlation between Mental Health Assessment Tool and MMPI and CMI except Mf (Masculinity-Femininity) Subscale of MMPI. This result means the MMPI and CMI was not related to tool which developed based on medical model from ethic perspectives, although the tool which had been developed in American Modified to Korean situation. So I dare to say that only the absence of mental illness does not means mental health and the diagnosis of mental illness is not the only criteria of a mental health.

Adult↗