Kyung Woo Kim

Prevalence of dietary supplement use in Korean children and adolescents: insights from Korea National Health and Nutrition Examination Survey 2007-2009.

The purpose of this study was to estimate the prevalence of dietary supplement (DS) use in Korean children and adolescents and to examine the related factors associated with DS use from the 4th Korea National Health and Nutrition Examination Survey. Total 6,131 participants aged between 2 and 18 yr were included in the analysis. We estimated the prevalence of DS use mainly from the DS questionnaire data of the Nutrition Survey. Reported supplements were classified according to the Health Functional Food Code. We also assessed the relationship between DS use and anthropometry, socioeconomic factors, health behaviors, and chronic diseases. Approximately 34% of Korean children and adolescent was taking DS. Younger age (P = 0.003), higher household income (P < 0.001), presence of chronic diseases (P = 0.05), regular meal consumption (P = 0.002), frequent snack consumption (P = 0.001), and normal body mass index rather than overweight (P = 0.10) or obesity (P = 0.03) were associated with the DS use after adjustment for related factors. Vitamin/mineral supplements (343.5/103 persons) were the most commonly taken DS in Korean children and adolescents, followed by Omega-3 (28.8), ginseng (18.3), colostrums (14.1) and chlorella/spirulina (10.0). In conclusion, DS use is common as much as in 34% of Korean children and adolescents and is associated with age, household income level, chronic diseases, meal regularity, and obesity status.

Anticholinergic premedication to prevent bradycardia in combined spinal anesthesia and dexmedetomidine sedation: a randomized, double-blind, placebo-controlled study

OBJECTIVE When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on patients undergoing spinal anesthesia with sedation by dexmedetomidine. DESIGN Randomized, double-blind, placebo-controlled study. SETTING Operating room. PATIENTS One hundred fourteen patients (age range, 2-65 years; American Society of Anesthesiology class I-II) participated in this study, willing to be sedated and to undergo spinal anesthesia. INTERVENTION The patients were divided into 2 groups: group A and group C. After performing spinal anesthesia, dexmedetomidine was infused at a loading dose of 0.6 μg/kg for 10 minutes, followed by an infusion at 0.25 μg/(kg h). Simultaneously with the loading dose of dexmedetomidine, patients in group A received an intravenous bolus of 0.5 mg atropine, whereas patients in group C received an intravenous normal saline bolus. MEASUREMENT Data on administration of atropine and ephedrine were collected. Hemodynamic data including heart rate, systolic blood pressure, diastolic blood pressure (DBP), and mean blood pressure (MBP) were also recorded. MAIN RESULTS The incidence of bradycardia requiring atropine treatment was significantly higher in group C than group A (P=.035). However, the incidence of hypotension needing ephedrine treatment showed no significant difference between the 2 groups (P=.7). Systolic blood pressure and heart rate showed no significant differences between the 2 groups (P=.138 and .464, respectively). However, group A showed significant increases in DBP and MBP, and group C did not (P=.014 and .008, respectively). CONCLUSION Prophylactic atropine reduces the incidence of bradycardia in patients undergoing spinal anesthesia with dexmedetomidine sedation. However, DBP and MBP showed significant increases in patients when prophylactic atropine was administrated. Therefore, atropine premedication should be administered cautiously.

Aorta-right atrial tunnel

Aorta-right atrial tunnel (ARAT), first reported in 1980 by Coto, is a rare congenital vascular anomaly. A 36-year-old female was admitted with chest discomfort, dyspnoea, palpitations, and general weakness. She had been treated for rheumatic fever at the age of 10, with no sequelae. Physical exam was normal except a grade 3/6 continuous murmur at the right sternal border. Transthoracic echocardiography (TTE) showed a tunnel-like shape …

Left atrial wall dissection after mitral valve replacement.

Left atrial dissection does occur, though rarely, after mitral valve surgery. A 68-year-old Korean female presented with moderate mitral stenosis, mild mitral regurgitation, moderate tricuspid regurgitation and mild aortic regurgitation. She was scheduled for mitral valve replacement and tricuspid annuloplasty. We experienced a left atrial dissection after weaning from cardiopulmonary bypass and decided not to repair it. The patient recovered uneventfully. We suggest that a specific type of left atrial dissection can be treated conservatively.

Anticholinergic premedication-induced fever in paediatric ambulatory ketamine anaesthesia.

Objective A randomized, double-blind, prospective study to evaluate the effect of anticholinergic drugs on thermoregulation in paediatric patients undergoing ambulatory anaesthesia with ketamine. Methods Patients were randomized to receive either 0.005 mg/kg glycopyrrolate or the equivalent volume of normal saline (placebo) at 30 min before ketamine anaesthesia. Body temperature was measured tympanically at baseline and at 0, 30, 60 and 90 min postoperatively. The quantity of saliva prodiced during surgery and incidence of fever were recorded. Results Body temperature was significantly higher in the glycopyrrolate group (n = 42) than the placebo group (n = 42) at 30, 60 and 90 min after surgery, and higher than baseline at 0, 30, 60 and 90 min after surgery. In the placebo group, body temperature was significantly higher than baseline at 0 and 30 min after surgery. Saliva secretion was significantly lower in the glycopyrrolate group than the placebo group. Conclusion Routine premedication with adjunctive anticholinergics should not be considered in paediatric patients receiving ketamine sedation due to the increased risk of fever. Trial registration number, Clinicaltrials.gov: NCT02430272

Suspected coronary ostium calcification identified as a protruding stent by epiaortic echography.

A 76‐year‐old male patient was admitted for mitral valvuloplasty. He had suffered a myocardial infarction 7 months earlier, and two stents had been inserted in the left main coronary artery and left circumflex artery. Intraoperative transesophageal echocardiography revealed a 10 × 8 mm echogenic mass at the ostium of the left main coronary artery. We initially suspected severe atheromatous calcification at the coronary ostium, which might require aortotomy and removal, but we decided to perform an epiaortic ultrasonographic scan first to obtain better images and reevaluate. Epiaortic scanning with a linear sonographic probe identified the mass as a protruding coronary stent.

Interruption of bispectral index monitoring by nerve integrity monitoring during tympanoplasty -A case report-.

We report that intraoperative NIM-2 monitoring devices can interfere with bispectral index monitoring. A 45-year-old male with chronic otits media underwent tympanolasty under general anesthesia with NIM-2 monitoring and bispectral index monitoring at our institution. And then, bispectral index monitoring was severely interrupted by facial nerve monitoring.

Use of light wand as an adjunct during intubation of patient with large epiglottic cyst.

Epiglottic cysts sometimes compromise a patients airway, and may make airway management difficult. We report a novel method of intubating a patient with a large epiglottic cyst, using direct laryngoscopy and a light wand. A 53-year-old man with hoarseness was admitted to the hospital. He complained of a mild cough and sore throat for 2 days, without dyspnea. General anesthesia for microscopic laser surgery was planned. Neck computed tomography revealed a nearly non-enhancing cyst, 2.7 × 1.8 × 3.3 cm, located on the right prelingual surface of the epiglottis (Figs. 1A and 1B). Fig. 1 Neck computed tomography (CT) revealed a nearly non-enhancing cyst in the right pre-epiglottic space with concomitant mild airway obstruction ([A] Transverse and [B] Sagittal views)