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Articles by J. S Kim
Total Records ( 6 ) for J. S Kim
  H. J Kwak , S. K Min , J. S Kim and J. Y. Kim
  Background

Pain from a propofol injection is a common side-effect in paediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combined pretreatment of alfentanil with lidocaine on the incidence and severity of propofol injection pain in children.

Methods

After obtaining parental consent, 120 paediatric patients were allocated randomly into one of the three groups (n=40, in each). The patients in the alfentanil group received alfentanil 15 µg kg–1 90 s before the propofol injection. The patients in the lidocaine group received propofol 3 mg kg–1 premixed with lidocaine 0.1% over a 15 s period. The patients in the combination group received both alfentanil and lidocaine.

Results

The incidence of propofol injection pain (severity 2 or more) in the combination group (2.6%) was significantly lower than that in the alfentanil and lidocaine groups (30% and 38.5%, respectively) (P=0.001 and <0.001, respectively). No patient in the combination group complained of moderate or severe pain from propofol injection.

Conclusions

Our study demonstrated that the combination treatment of two different analgesic modalities, alfentanil and lidocaine, could prevent the moderate and severe pain on propofol injection, and reduce the incidence of mild pain compared with each drug alone.

  H. J Kwak , J. Y Kim , S. K Min , J. S Kim and J. Y. Kim
  Background

The goals of this study were to determine the effective bolus dose of alfentanil required for successful tracheal intubation during inhalation induction using sevoflurane 5% without neuromuscular block in children, and whether nitrous oxide reduces these doses.

Methods

Fifty paediatric patients, aged 3–10 yr, were randomly assigned to one of the two groups. Subjects received either sevoflurane 5% in oxygen 100% (O2 group, n=25) or sevoflurane 5% in oxygen 40% and nitrous oxide 60% (N2O group, n=25) through a face mask. One minute after inhalation induction, a predetermined dose of alfentanil was injected over 15 s. The alfentanil dose was determined using Dixon's up-and-down method, starting from alfentanil 14 µg kg–1. The trachea was intubated 3 min after inducing anaesthesia.

Results

The ED50 [95% confidence interval (CI)] of alfentanil for successful tracheal intubation was 11.5 (9.9–13.1) and 8.6 (7.4–9.8) µg kg–1 in the O2 and N2O groups, respectively. The ED50 of the N2O group was significantly lower than that of the O2 group (P=0.0146). From isotonic regression, 50% effective dose (ED50) (95% CI) of alfentanil in the O2 and N2O groups was 11.4 (9.9–13.0) and 6.5 (5.0–8.1) µg kg–1, respectively.

Conclusions

The effective bolus dose of alfentanil for successful tracheal intubation was 11.5 µg kg–1 in 50% of children during inhalation induction using sevoflurane 5% without neuromuscular blocking agent. Addition of nitrous oxide 60% in oxygen reduced the effective alfentanil dose by 25%.

  M. W Suh , H. J Lee , J. S Kim , C. K Chung and S. H. Oh
 

Speechreading is a visual communicative skill for perceiving speech. In this study, we tested the effects of speech experience and deafness on the speechreading neural network in normal hearing controls and in two groups of deaf patients who became deaf either before (prelingual deafness) or after (postlingual deafness) auditory language acquisition. Magnetic signals from the cerebral cortex were recorded using a 306-channel magnetoencephalographic system. During magnetoencephalographic measurements, subjects were asked to perform a speechreading task from video clips of a female speaker either pronouncing syllables (speechreading condition) or showing closed-mouth movement. The sources of the evoked fields were modelled using equivalent current dipoles, the origins of which were fitted to the intracranial space based on magnetic resonance imaging findings. During the speechreading condition, the latency of auditory cortex activation was shorter in the postlingual deafness group than in the normal hearing control group. This parameter negatively correlated with speechreading scores measured clinically. Furthermore, as the duration of deafness increased, the latency of auditory cortex activation decreased exponentially. However, no such correlation was found in the prelingual deafness group which differed significantly from the two other groups in this respect. The latency of auditory cortex activation was significantly longer in the prelingual deafness group than in the two other groups. Thus, auditory experience may be crucial for the development of a normal neural network for speechreading. The pre-existing speechreading network in the postlingual deafness group is made more efficient by speeding up the neural response.

  B. K Koo , K Waseda , H. J Kang , H. S Kim , C. W Nam , S. H Hur , J. S Kim , D Choi , Y Jang , J. Y Hahn , H. C Gwon , M. H Yoon , S. J Tahk , W. Y Chung , Y. S Cho , D. J Choi , T Hasegawa , T Kataoka , S. J Oh , Y Honda , P. J Fitzgerald and W. F. Fearon
 

Background— We sought to investigate the mechanism of geometric changes after main branch (MB) stent implantation and to identify the predictors of functionally significant "jailed" side branch (SB) lesions.

Methods and Results— Seventy-seven patients with bifurcation lesions were prospectively enrolled from 8 centers. MB intravascular ultrasound was performed before and after MB stent implantation, and fractional flow reserve was measured in the jailed SB. The vessel volume index of both the proximal and distal MB was increased after stent implantation. The plaque volume index decreased in the proximal MB (9.1±3.0 to 8.4±2.4 mm3/mm, P=0.001), implicating plaque shift, but not in the distal MB (5.4±1.8 to 5.3±1.7 mm3/mm, P=0.227), implicating carina shifting to account for the change in vessel size (N=56). The mean SB fractional flow reserve was 0.71±0.20 (N=68) and 43% of the lesions were functionally significant. Binary logistic-regression analysis revealed that preintervention % diameter stenosis of the SB (odds ratio=1.05; 95% CI, 1.01 to 1.09) and the MB minimum lumen diameter located distal to the SB ostium (odds ratio=3.86; 95% CI, 1.03 to 14.43) were independent predictors of functionally significant SB jailing. In patients with ≥75% stenosis and Thrombolysis In Myocardial Infarction grade 3 flow in the SB, no difference in poststent angiographic and intravascular ultrasound parameters was found between SB lesions with and without functional significance.

Conclusions— Both plaque shift from the MB and carina shift contribute to the creation/aggravation of an SB ostial lesion after MB stent implantation. Anatomic evaluation does not reliably predict the functional significance of a jailed SB stenosis.

Clinical Trial Registration: http://www.clinicaltrials.gov. Unique Identifier: NCT00553670.

  H Zheng , J. H Nam , B Pang , D. H Shin , J. S Kim , Y. S Chun , J. W Park , H Bang , W. K Kim , Y. E Earm and S. J. Kim
 

Mouse B cells and their cell line (WEHI-231) express large-conductance background K+ channels (LKbg) that are activated by arachidonic acids, characteristics similar to TREK-2. However, there is no evidence to identify the molecular nature of LKbg; some properties of LKbg were partly different from the reported results of TREK type channels. In this study, we compared the properties of cloned TREK-2 and LKbg in terms of their sensitivities to ATP, phosphatidylinositol 4,5-bisphosphate (PIP2), intracellular pH (pHi), and membrane stretch. Similar to the previous findings of LKbg, TREK-2 showed spontaneous activation after membrane excision (i-o patch) and were inhibited by MgATP or by PIP2. The inhibition by MgATP was prevented by wortmannin, suggesting membrane-delimited regulation of TREKs by phosphoinositide (PI) kinase. The same was observed with the property of LKbg; the activation of TREK-2 by membrane stretch was suppressed by U73122 (PLC inhibitor). As with the known properties of TREK-2, LKbg were activated by acidic pHi and inhibited by PKC activator. Finally, we confirmed the expression of TREK-2 in WEHI-231 by using RT-PCR and immunoblot analyses. The amplitude of background K+ current and the TREK-2 expression in WEHI-231 were commonly decreased by genetic knockdown of TREK-2 using small interfering RNA. The downregulation of TREK-2 attenuated Ca2+-influx induced by arachidonic acid in WEHI-231. As a whole, these results strongly indicate that TREK-2 encodes LKbg in mouse B cells. We also newly suggest that the low activity of TREK-2 in intact cells is due to the inhibition by intrinsic PIP2.

  D. S Jeong , K. H Kim , J. S Kim and H. Ahn
  Background

Cardiac involvement in Behçet's disease is a rare but severe complication and presents challenges to cardiac surgeons as a result of late valve detachment or pseudoaneurysms of the aortic root after valve surgery. Few reports have been published on this topic. In this article, clinical data and surgical outcomes in patients with aortic regurgitation attributable to Behçet's disease were analyzed.

Methods

Nineteen patients with aortic regurgitation attributable to Behçet's disease were surgically treated between March 1986 and June 2008. There were 15 men and 4 women with ages ranging from 24 to 55 years (mean, 39 ± 7 years). Mean follow-up duration from index operations was 77.4 ± 68.1 months (range, 9 to 271 months).

Results

Overall mortality was 47.3% (9 of 19 patients), but no early deaths occurred at index operations. All deaths occurred after second operations, and the causes of death were low cardiac output (n = 6) and sudden aggravation of aortic regurgitation (n = 3). Erythrocyte sedimentation rates and C-reactive protein concentrations were negatively correlated with event-free period. Event-free survival at 13 years was 39.2% ± 14.1% in patients who underwent aortic root replacement, but this was 4% ± 3.9% in patients who underwent valve replacement (p = 0.001). Event-free survival at 13 years in patients who were administered immunosuppressive therapies was 33.7% ± 11.0% and 0% in patients not administered immunosuppressive therapy (p = 0.001).

Conclusions

The mortality in this condition was very high and was found to depend on levels of postoperative inflammatory markers. Aortic root replacement and postoperative immunosuppressive therapy may be helpful.

 
 
 
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