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Kyoung Sub Yoon 2 Articles
Advantages of Using Ultrasound in Regional Anesthesia for a Super-Super Obese Patient
Woo Jae Yim, Kyoung Sub Yoon, Jeong In Hong, Sang Yoong Park, So Ron Choi, Jong Hwan Lee
Kosin Med J. 2019;34(1):52-56.   Published online June 30, 2019
DOI: https://doi.org/10.7180/kmj.2019.34.1.52
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

In this case report, we describe the use of ultrasound in the administration regional anesthesia for a super-super obese patient. A 23-year-old female patient (height 167.2 cm, weight 191.5 kg, body mass index 68.6 kg/m2) was admitted to the hospital for surgical repair of an anterior talofibular ligament rupture. We used ultrasound to help facilitate the administration of regional anesthesia. In the sagittal view of the lumbar spine, (with the patient in a sitting position) we were able to identify the border between the sacrum and the lumbar vertebral; in the transverse view, we were able to identify the transverse process, posterior dura, vertebral body, and the distance from the skin to the posterior dura. After skin marking, regional anesthesia was successfully performed. Based on this case study, we suggest that ultrasound can be very useful in regional anesthesia for severely obese patients.

A double-knotted pulmonary artery catheter with large loop in the right internal jugular vein: A case report
Kyoung Sub Yoon, Jung A Kim, Jeong In Hong, Jeong Ho Kim, Sang Yoong Park, So Ron Choi
Kosin Med J. 2018;33(2):240-244.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.2.240
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.


KMJ : Kosin Medical Journal