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Biomedical subjects

S M Baek

Publications and source records attributed to S M Baek.

At least 37 records · Page 2Linked to original sources
PubMed1980

Percutaneous identification of the temporal branch of the facial nerve.

A technique is presented for percutaneous localization of the temporal branches of the facial nerve based on their relation to the fixed bony landmarks of the lateral orbital wall and the superior border of the zygomatic arch. Anthropometric measurements of the lateral orbital walltragion distance in cadavers and live volunteers were made to correlate this with the position of the temporal branch as it crosses the superior border of the zygomatic arch.

Anthropometry↗
PubMed1980

The lower trapezius island myocutaneous flap.

The lower trapezius myocutaneous island flap is described. The reliability and uniform thickness of this flap make it ideal for reconstruction of facial skin defects or for subcutaneous augmentation of the face.

Aged↗
PubMed1980

The gluteus maximus myocutaneous flap in the management of pressure sores.

The gluteus maximus myocutaneous flap is modified to obviate the necessity of a skin graft to the donor defect. This is a sufficiently large flap which, in the event of a recurrence, can be rerotated. The design and surgical technique of this flap for ischial and sacral pressure sores are described. This flap was used for 36 pressure sore without loss of any portion of the flap.

Buttocks↗
PubMed1975

Cardiorespiratory response to a new isoquinoline derivative in critically III patients.

NC 7197, a new N-substituted tetrahydroisoquinoline derivative, was given in doses of 0.2 mg/kg body weight on 26 occasions to a series of 23 critically ill postoperative and posttraumatic patients who had been in moderate or severe degrees of shock. This agent was observed to improve pressure-flow and oxygen-transport variables, including increases in cardiac index, mean arterial pressure, central venous pressure, both left and right ventricular stroke work, central blood volume, systemic vascular resistance, oxygen availability, arteriovenous oxygen content difference, and oxygen consumption, and decreases in mean transit time and pulmonary vascular resistance. Previous studies on critically ill patients have suggested that these are the most commonly desired therapeutic actions for this type of patient. The agent has pronounced inotropic effect with minimal chronotropic effects, but with higher doses, chronotropic effects as well as alpha blocking effects may occur. The optimal effects may be obtained by adjusting the dose to an appropriate therapeutic range. It is concluded that, in the dose used, this agent produced both alpha and beta adrenergic actions in critically ill patients.

Adult↗
PubMed1975

Plasma expansion in surgical patients with high central venous pressure (CVP); the relationship of blood volume to hematocrit, CVP, pulmonary wedge pressure, and cardiorespiratory changes.

There was no correlation of blood volume measurements with central venous pressure (CVP) or hematocrit determinations and only minimal suggestive trends with wedge pressure in a large series of postoperative patients; the lack of correlations emphasize the unreliability of venous pressure and hematocrit determinations to predict blood volume alterations. To evaluate the physiological problems, to define optimal therapeutic goals, and to measure therapeutic effectiveness of volume loading with an oncotically active agent, we measured the hemodynamic and oxygen transport responses to 500 ml. of 5 percent albumin given over 1 hour in 22 patients with CVP greater than 15 cm. H2O. The patients were separated into two groups according to the CVP response to volume therapy. The CVP decreased in 14 (64 percent) of these patients (Group 1), but it increased slightly but not significantly in eight (36 percent) patients (Group 2). In Group 1 patients, there was increased flow, improvement of tissue perfusion as reflected by increased oxygen consumption, and augmentation of the ventricular function. In Group 2 there were slight increases in mean flow, mean pulmonary arterial pressure, and mean transit time and slightly decreased pulmonary vascular resistance; there was appreciable improvement in left ventricular function without significant deterioration of right ventricular function. The high initial central venous pressure is not a reliable index of either hypervolemia or cardiac failure in critically ill patients. It is concluded that a trial of volume loading with an oncotically active agent with frequent auscultation of the chest and careful observation of the CVP trends will give the maximum diagnostic as well as therapeutic information.

Adult↗
PubMed1975

Free-water clearance patterns as predictors and therapeutic guides in acute renal failure.

Sequential changes in renal function were studied in a series of 114 postoperative patients who developed acute renal failure. The loss of concentrating ability, manifest by a change from strongly negative free-water clearances to values near zero, occurred 24 to 48 hours before the onset of blood urea nitrogen (BUN) and creatinine elevations. In 15 patients a transient period of positive free-water clearance was documented just before these values approached zero. Criteria were proposed for early diagnosis of acute renal failure (ARF) based upon description of the temporal pattern of free-water clearance values. The loss of concentration ability occurred with decreased urinary Na+ concentration unless patients were given large amounts of saline solution prior to the development of ARF. This was followed by gradually increasing urinary Na+ concentrations. Changes in K+ concentrations were not significant until the late stage of renal failure. Recovery patterns in 46 of these patients who survived demonstrated an early return of negative free-water clearance followed by gradually decreasing BUN and serum creatinine values. During this period recovery of the ability of Na reabsorption and excretion of K+ was indicated by decreased urinary Na+ concentrations and increased urinary K+ concentrations.

Acute Kidney Injury↗
PubMed1975

Clinical determinants of survival from postoperative renal failure.

In a series of 114 consecutive patients with acute renal failure, the over-all mortality rate was 60 per cent; 62 per cent of the patients had a documented episode of hypotension just prior to the development of acute renal failure. In 11 patients, a second episode of renal failure developed following recovery from the initial episode of acute renal failure; all of these patients died. The urine output rate during the course of acute renal failure was inversely related to the mortality rate in the series as a whole. The mean duration of acute renal failure in survivors of the present series was 11.0 plus or minus 1.4 days. Complications of renal failure in the order of their frequency included hemorrhagic hypotension, sepsis, sepsis with hypotension and consumption coagulopathies; only 12 per cent had no complications. Only six of 51 patients whose clinical course was complicated by sepsis with or without an episode of hypotension survived. By contrast, 30 of 53 patients who had hemorrhagic hypotension without sepsis survived. The date suggest that although acute renal failure has a high mortality rate, it is a benign disease that is potentially reversible. Regardless of age and sex, renal functional recovery will take place if the patient is maintained in good physiologic condition long enough without a continued stress, such as sepsis, hypotension or hypovolemia, all of which prolong renal ischemia. During the course of renal failure, extreme care is essential to maintain adequate circulating volume without extracellular fluid overload; a second hemodynamic insult may result in serious damage to the regenerating renal tubules. We conclude that early recognition of acute renal failure, aggressive management of sepsis, careful titration of fluid and electrolyte therapy, meticulous monitoring, maintenance of the circulation and judicious utilization of dialysis will aid in reduction of mortality in these critically ill patients.

Acute Kidney Injury↗
PubMed1975

The influence of parenteral nutrition on the course of acute renal failure.

The influence of hypertonic glucose with and without added amino acids was studied in 129 consecutive postoperative patients with acute renal failure. The addition of amino acids was associated with lower mortality and morbidity rates in the patients who received dialysis as well as in those who did not. There was no significant differences in the blood urea nitrogen levels of the two groups. The incidence of hyperkalemia and the rise in plasma osmolality were less in the group given adequate calories and amino acids.

Acute Kidney Injury↗
PubMedDate not supplied

A new clamp for end-to-side microvascular anastomosis.

A new clamp for use in microvascular end-to-side anastomosis is described. The advantages of the clamp are that the end of the donor vessel is placed precisely over the opening of the recipient vessel without tension, good exposure of the posterior wall is provided, and the tension on the stay sutures is easily adjusted.

Arteries↗
PubMedDate not supplied

Ten-digit and nine-digit replantation (4 cases).

Ten or nine-digit amputation is a very rare injury. From March, 1987 to June, 1988, we replanted two cases of ten-digit complete amputation and two cases of nine-digit complete amputation with success. The maximum ischaemic time was 39 h and the operation time was between 25 and 31 h. All digits survived completely except for partial necrosis of one finger. The follow-up has been 13-20 months, and all the patients have a pair of good, functional and aesthetically acceptable hands.

Adolescent↗