Acute and Critical Care

Jae Young Kwon

11 Articles

A Case of Hemoperitoneum due to Spontaneous Rupture of Visceral Artery Aneurysm after Ingestion of Puffer Fish: Do Won Lee, Hae Kyu Kim, Hyun Jung Lee, Jung Min Hong, Jae Young Kwon; Korean J Crit Care Med. 2013;28(3):210-213.; DOI: https://doi.org/10.4266/kjccm.2013.28.3.210

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Abstract PDF: Ingestion of puffer fish can cause intoxication, which produces a wide range of symptoms due to the presence of neurotoxins, such as tetrodotoxin, in puffer fish. Abdominal pain is just one of the symptoms that should be treated with symptomatic and supportive therapy. This study reports a case of a 56-year-old male patient with abdominal pain, who was admitted to the emergency room with a diagnosis of puffer fish poisoning. In this case, the abdominal pain did not improve, but rather, the symptoms worsened. Finally, the cause of the abdominal pain was found to be hemoperitoneum due to active bleeding at the greater omentum, as observed on abdominal computed tomography; the source of bleeding was the right colic artery branch. Embolization was performed successfully, and the post-intervention course was uneventful. The patient was discharged without any complications within 13 days after admission.

Ultrasound Guided Bronchoscopic Balloon Dilatation in the Management of Tracheal Stenosis: A Case Report: Jung Min Hong, Tae Kyun Kim, Ah Reum Cho, Do Won Lee, Yun Hee Han, Jae Young Kwon; Korean J Crit Care Med. 2012;27(2):139-142.; DOI: https://doi.org/10.4266/kjccm.2012.27.2.139

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Abstract PDF: We performed a balloon dilatation without a fluoroscopy monitoring by ultrasound. A 44 year old female patient was presented with subglottic stenosis, due to prolonged intubation. Although she had undergone tracheal resection and end-to-end anastomosis, the tracheal stenosis had recurred. She was scheduled for balloon dilatation. However, fluoroscopic guidance was not available, and thus, we used ultrasonographic monitoring as an alternative method. We performed a transverse scan, just cranial to the suprasternal notch, and we obtained a real time image of the trachea dilated by the balloon. We suggest that ultrasonographic monitoring is a useful adjunct to balloon dilatation in patients with tracheal stenosis.

Inflammation and Sepsis: Ji Young Yoon, Jae Young Kwon; Korean J Crit Care Med. 2010;25(1):1-8.; DOI: https://doi.org/10.4266/kjccm.2010.25.1.1

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Abstract PDF

Despite the development of modern intensive care and new antimicrobial agents, the mortality of the patients with severe sepsis and septic shock remains high. The poor outcome is considered to be a consequence of an overactive systemic inflammatory response. Sepsis is now defined as systemic inflammatory response syndrome (SIRS) in which there is an identifiable focus of infection. As a consequence of the overactive SIRS response, the function of various organ systems may be compromised, resulting in multiple organ dysfunction syndrome (MODS) and death. Systemic inflammation is a consequence of activation of the innate immune system. It is characterized by intravascular release of pro-inflammatory cytokines and other vasoactive mediators, and the concurrent activation of the innate immune cells. In addition to the pro-inflammatory reactions, the host's anti-inflammatory mechanisms are also activated and aimed at counteracting the inflammatory response. The balance between pro- and anti-inflammatory reactions is critical for the outcome of the patient. Understanding the mechanisms of acute inflammatory responses in critical ill patients is necessary for the development of urgently needed therapeutics. The aim of this review is to provide a description of the key components and mechanisms involved in the inflammatory response in patients with SIRS and sepsis.

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Journal of Korean Academy of Community Health Nursing.2018; 29(3): 290. CrossRef
The Anti-Inflammatory Effect of Arginine-Vasopressin on Lipopolysaccharide-Induced IκBα/Nuclear Factor-κB Cascade
Jisoo Park, Eun Young Eo, Kyoung-Hee Lee, Jong Sun Park, Jae-Ho Lee, Chul-Gyu Yoo, Choon-Taek Lee, Young-Jae Cho
The Korean Journal of Critical Care Medicine.2015; 30(3): 151. CrossRef
Splenic Hemorrhage with Hemoperitoneum Caused by a Snakebite
Ji Young Yhi, Yoomi Yeo, Ji Yeoun Kim, Il Hwan Oh, Soon Woo Hwang, Sang Ki Lee, Dong Shin Kwak, Ji-Yoon Choi, Jeong Eun Kim, Joon-Sung Park
Korean Journal of Critical Care Medicine.2013; 28(4): 336. CrossRef
A Case of Systemic Inflammatory Response Syndrome Secondary to an Acute Polyarticular Gout
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Journal of the Korean Geriatrics Society.2012; 16(3): 158. CrossRef

Effects of Sevoflurane and Ischemic Preconditioning on Neurologic Injury and Bcl-2 Family Protein mRNA Expression after Transient Spinal Ischemia in the Rats: Soon Hwan Kang, Eun Soo Kim, Seung Hoon Baek, Jae Young Kwon; Korean J Crit Care Med. 2004;19(1):20-31.

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Abstract PDF: BACKGROUND
Spinal cord injury occurring as the result of surgical repair of thoracic and thoracoabdominal aortic disease remains a devastating complication. Anesthetic and ischemic preconditioning have been known to prevent ischemic injury. The purpose of this study was to elucidate the effects of sevoflurane and ischemic preconditioning (IPC) on neurologic outcome, DNA fragmentation and Bcl-2 protein gene expression in transient spinal ischemia. METHODS: Rats were anesthetized with enflurane or sevoflurane, divided by 5 groups: Sevoflurane group and enflurane group (13 minutes of ischemia), Control group, Rapid group, Delayed group (15 minutes of ischemia). Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. Neurologic scores were assessed at the time of recovery and 1, 2, 3, 24 hours after transient spinal ischemia. After 24 hours, rats were euthenized and spinal cords were removed for the assay of DNA fragmentation. Other groups of rats received 5 minutes of ischemia, and after 1, 6, 24, 48 and 72 hours, spinal cords were removed for the assay of Bcl-2 family protein mRNA and DNA fragmentation. RESULTS: The neurologic injury and DNA fragmentation of sevoflurane group were significantly lesser than enflurane group. 5 minutes of IPC caused increase in Bcl-xl protein mRNA transcription at 48 and 72 hours reperfusion. There were no significant changes in neurologic injury, Bcl-2 family mRNA transcription and DNA fragmentation between control group, rapid group, and delayed group. CONCLUSIONS: Sevoflurane was effective in preventing neurologic injury after 13 minutes of transient spinal ischemia. However, rapid and delayed ischemic preconditioning did not potentiated neuroprotective action of sevoflurane during 15 minutes of spinal ischemia.

The Effects of Moderate Hypothermia on the Formation of Apoptosis in Transient F degrees Cal Cerebral Ischemia Model in Rats: Tae Jung Woo, Seong Wan Baik, Kyoo Sub Chung, Inn Se Kim, Hae Kyu Kim, Jae Young Kwon; Korean J Crit Care Med. 2002;17(1):12-18.

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Abstract PDF: BACKGROUND
Delayed neuronal injury after cerebral ischemia came major neurologic complication after stroke or cardiac arrest. Apoptosis formation after ischemia may be one of a mechanism of delayed neuronal injury. This study was conducted to evaluate the effect of moderate hypothermia on apoptosis formation after one hour of middle cerebral artery degrees Cclusion in rats.
METHODS
Ten Sprague-Dawley rats (300 g) were freely fed till just before operation. Anesthesia was induced with 4 vol% isoflurane in oxygen and then maintained with 2 vol% isoflurane in oxygen. Middle cerebral artery degrees Cclusion (MCAO) was induced by intraluminal monofilament nylon with blunted tip. All rats were divided randomly into two groups. In group 1 (n=5), rectal temperature was maintained at 38 degrees C. In group 2 (n=5), rectal temperature was maintained at 32 degrees C. Rectal temperature was monitored during experiment. After 60 minutes of MCAO, intraluminal monofilament was removed and all rats were returned to cages. Brain were quickly removed and cerebral hemispheres were separated after 23 hours reperfusion. Apoptosis formation were counted with TUNEL stain.
RESULTS
In group 1, after 60 minutes of MCAO and 23 hours reperfusion, 51 3.6% of hipp degrees Campal neurons were TUNEL-positive stained apoptotic cells. In group 2, TUNEL-positve neurons were 26.1 6.5% and significantly less than those of group 1 (p<0.05).
CONCLUSIONS
Sixty minutes of MCAO and 23 hours reperfusion induce hipp degrees Campal neuronal apoptosis. Moderate hypothermia of 32 degrees C reduces apoptosis of hipp degrees Campal neurons after 60 minutes of MCAO and 23 hours reperfusion.

Servo Controlled Modes of Ventilation: Chul Hong Kim, Jae Young Kwon; Korean J Crit Care Med. 2002;17(1):1-4.

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Abstract PDF: No abstract available.

Neuromuscular Dysfunction in Patients Using Neuromuscular Blocking Agents: Jae Young Kwon; Korean J Crit Care Med. 2001;16(2):96-99.

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Abstract PDF: No abstract available.

The Use of Thiopental Sodium with BIS Monitoring in Hypoxic Brain Damage: Jae Young Kwon, Sul Ki Song, Kyung Hoon Kim, Sang Wook Shin, Seong Wan Baik; Korean J Crit Care Med. 2000;15(1):52-55.

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Abstract PDF: Hypoxemia is a common and potentially serious postoperative complication. Hypoxic encephalopahty may occur in prolonged hypoxemia. This condition needs brain protection. There are many brain protective methods. The primary cental nervous system protective mechanism of the barbiturates is attributed to their ability to decrease the cerebral metabolic rate, thus improving the ratio of oxygen (O2) supply to O2 demand. The electroencephalogram-derived bispectral index system (BIS) is a promising new method to predict probability of recovery of consciousness. We experienced two cases of hypoxic brain damage in recovery room. The patients were treated with thiopental and monitored with BIS. The use of thiopental as brain protection during complete global ischemia after cardiac arrest was not effective.

Suturing of a Pulmonary Artery Catheter during Open Heart Surgery: Kyoo Sub Chung, Seong Wan Baik, Jae Young Kwon, Jae Woo Kim, Jin Ho Song; Korean J Crit Care Med. 1998;13(1):109-112.

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Abstract PDF: Insertion of a pulmonary artery catheter for the measurement of pulmonary artery pressures and cardiac output has been widely used for the management of patients undergoing open heart surgery. Complications of pulmonary artery catheter insertion include cardiac arrhythmia, thromboembolism, tricuspid valve injury, intracardiac knotting, pulmonary artery rupture. We experienced a case of catheter-related complication which was caused by suturing pulmonary artery catheter during right atrial bleeding control during open heart surgery. The catheter was attached to the right atrial wall by nylon suture and successfully removed by operation without significant complication.

The experimental study on the effects of Ringer's lactate andpentastarch infusion in hemorrhagic dogs: Woog Seong Kim, Jae Young Kwon, Hae Kyu Kim, Inn Se Kim, Kyoo Sub Jung; Korean J Crit Care Med. 1992;7(2):105-112.

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Abstract PDF: No abstract available.

The change of brain temperature during forebrain ischemia in rat: Yoon Seob Na, Jae Young Kwon, Hae Kyu Kim, Soung Wan Baik, Inn Se Kim, Kyoo Sub Chung; Korean J Crit Care Med. 1992;7(1):35-40.

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Abstract PDF: No abstract available.

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