수술중 수혈 및 수액의 새로운 경향에 관한 고찰

유지섭,임문규,전세웅 대한마취과학회 1970 Korean Journal of Anesthesiology Vol.3 No.1

Transfusion therapy has changed in the past several years, largely as a result of improved knowledge of the physIology of hypovolemia, development of plasma expcnders and plastic blood-collection equipment, the possibility of blood mediated infection and also shortage of whole blood Supply. In Korea, the difficulty of getting blood is remarkably increasing recently. According to recent studies, the patient seems can undergo rapid loss of 1000 to 2000mL, or up to 40 percent of their blood volume without developing irreversible shock, and that blood pressure can be maintained by the administration of saline fluids, lactated Ringer solution being presently most in vogue. If there is further blood loss, it may be necessary to augument the bodys circulating hemoglobin, but this can be done by the administration of packed cells. During 1968 and 1970 at St. Mary's Hospital took place 6904 general anesthesia. Blood transfusion or these cases were analysed. In the past several years, we have tried to reduce the whole blood transfusion during surgery and to use lactated Ringer's solution and plasma expanders like hemaccel and macrodex, etc. In this review there was significant change in intraoperative blood and fluid replacement and the trend of decreasing blood transfusion and increasing lactated Ringers solution and plasma expander was noticed.Supply of packed cell is required to improve the transfusion technique in future.

악하선 절제술 후 발생한 역설적 아랫 입술 경련

유지섭(Ji Seob Yoo),홍용태(Yong Tae Hong) 대한두경부종양학회 2021 대한두경부 종양학회지 Vol.37 No.1

Benign submandibular gland tumor is a common disease in the head and neck region and can be completely removed by transcervical approach. Typical submandibular gland resection can lead to neurological complications. The most common complications are damage to the marginal mandibular branch of the facial nerve and weakening of the lower lip. We report a case of ipsilateral lower lip twitching occurring 3 months after surgery. There was no difficulty during the operation, and there were no neurologic complications immediate after surgery. However, in the present case, the patient experienced lower lip twitching paradoxically after surgery which has not been reported in the literature yet. Therefore, we reported this case with a review of relevant literature.

화상환자의 혈청 Potassium 변화 : Succinylcholine iodide 정수시

전세웅,유지섭 대한마취과학회 1974 Korean Journal of Anesthesiology Vol.7 No.1

Transient hyperkalemia is well known to occur in man following intravenous administration of succinylcholine chloride (Anectine). Furthermore, massive hyperkalemia following succinylcholine chloride administration is a recognized danger in patients with severe burns, massive trauma, muscle dystrophy, and peripheral nerve injury or lesions on central nervous system with skeletal muscle paralysis. Increased serum potassium may lead to severe cardiac arrhythmia or cardiac arrest. Reported mary literatures, this was shown for succinylcholine chloride but not for succinylcholine iodide. The authors studied succinylcholine iodide intravenous administration for burned patient as to whether serum potassium changes or not. Effects of intravenous succinylcholine iodide on serum potassium, ECG and fasciculation were studied in fifteen burned patients. For serum potassium change, venous blood sample was drawn at preoperative period and at 10 minutes after succinylcholine iodide administration. Results were as follows; 1. Serum potassium was increased at 10 minutes after succinylcholine administration (4.47±0.65 mEq/L) than the preoperative value (4.17±0.51 mEq/L). Mean increase was 0.30 mEq/L. 2. In ECG change, only one patient showed transient premature ventricular contraction during induction of anesthesia. In this case serum potassium was increased 0.8 mEq/L (△K). Occurance of this arrhythmia, it was not confirmed whetner it was due to increased serum potassium(△K=0.8 mEq/L) or other factors. 3. Surprisingly, fasciculation was minimal level in all cases. 4. Significance in statistical analysis did not correspond with clinical signs. 5. Succinylcholine iodide intravenous administration was not contraindicated for intubation in. burned patient.

노인마취례 보고 : 과거 10 년간 past 10 years

전세웅,유지섭 대한마취과학회 1975 Korean Journal of Anesthesiology Vol.8 No.2

It is a fallacy on the part of the anesthesiologist and surgeon to think that the same prin- ciples of anesthesia and surgery apply in the younger patient as in the aged who have a mul- tiplicity of preoperative pathologic and physiologic states which may affect them during sur- gery and postoperatively and which must be considered in their preoperative preparation. Ch anges of importance are related to diminished cardiac, pulmonary, renal and hepatic reserves. With this steady increase of candidates for geriatric anesthesia, it is necessary that periodic reviews be presented so that the problems associated with the management of this enlarging group of patients may be elucidated. In this paper presented 1, 208 cases of geriatric anesthesia during 1964~1973 (10 years) at St. Mary's hospital and were analysed. Results were as follows; 1. Number of the total operative cases were 24, 970, among them over 60 years of age were 1,208 cases. Incidence was 4.9%. 2. Among the 1,208 cases, 967 cases were over 60~69 years of age (80%), 210 cases were over 70~79 years of age (17.4%) and 31 casese were over 80 years of age (2.6%). 3. Emergency versus elective surgical cases re 29.1% versus 78.9% 4. Among the 1,208 cases, 726 cases were general surgery(60.1%), sach of 138 cases were orthopedics and urological ones(11.4%). 5. Inhalation anesthesia was performed 1,127 cases(90.4%) and spinal anesthesia was 29 cases(2.3%). 6. Halothane and methoxyflurane anesthesia irere markedly increased after 1970 inatead of diethyl ether anesthesia. 7. ECG was checked 42.2% of the cases preoperatively. 8. Post-anesthetic related death was not evaluated because of the insufficient record.

정형외과 수술환자의 Thalamonal-N2O-O2 마취

정구영,유지섭 대한마취과학회 1978 Korean Journal of Anesthesiology Vol.11 No.3

Orthopedic surgery was perfonned under Thalamonal-N2O-O2 anesthesia by an intravenous injection of a small dose of Thalamonal and N2O inhalation. Respiratory rate was compared before and after intravenous administration of nalorphine at the end of operation. From 22 cases, the following results were obtained: 1) Average dose of Thalamonal during induction of anesthesia was 1.67ml/10kg. During induction, rigidity of chest wall developed in 5 cases, 2) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at. each 43. 8 min. interval, and average dose of Thalamonal was 0. 013 ml/kg/30min. 3) After injection of nalorphine, average rate of respiration per minute increased from 15. 1 to 21. 1(39. 9%) 4) 21 cases among 22 cases recovered promptly after discontinuation of N2O, and recovery was delayed in 1 case. Self extubation was seen in 3 cases.

대량 수혈에 의한 급성 뇌수종 : 비인두섬유성혈관종 증례 a Case of Nasopharyngeal Angiofibroma

전세웅,유지섭 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

Acute pulmonary edema was experienced during the mass excision of a nasopharyngeal angiofibroma clue to massive transfusion (8,000ml of blood withih 3 hours). High FIoz with maaual PEEP, diuretics, steroid agd digitalis were given immediately. Full recovery was observed after 18 hours of ICU care.

抗痙攣性 藥物(Dilantin Sodium)이 齒?組織에 미치는 影響에 對한 臨床的 觀察

崔翔默,李種昕,柳枝燮,孫性熙 現代醫學社 1969 現代醫學 Vol.10 No.2

The purpose of this study was evaluated the oral condition of 173 hospitalized epileptic patients at 3rd Army Hospital Psychiatry Department, with particular attention to the influences of the anticonvulsant drugs upon the gingiva. The result are as follows: 1) In total of 173 patients, patients whn are suggested Dilantin Hyperplasia were 65 patients only (37.57%). The Hyperplasia degrees was classified as Normal 108 (62.43%) Minimal 52 (30.05%) Moderate 10 (5.77%) Marked 2 (1.15%) Very severe 1 (0.57%) 2) Patients receving Phenobarbital without Dilantin have some prevalence of Hyperplasia (12.5%). Patients receving Dilantin have a higher prevalence (40%) than those patients receving Phenobarbital. 3) Patients receving Dilantin and Phenobarbital combination developed hyperplasia more frequently than those receving Phenobarbital and Dilantin only (44.79%). 4) It seems to be some relationship among Dilantin, Poor oral Hygine and Hyperplasia. It may be involve the influences of inflammation, irritation or some other factors. 5) The,minimum length of time limit of Hperplasia under Dilantin treatment has been suggested at least two months. 6) It seems to e1 higher prevarence in the anterior than posterior regions and upper than lower regions.

가토에서 Succinylcholine Chloride 정주에 의한 " Train of Four " 반응

전세웅,한영문,유지섭 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.2

The history of muscle relaxants is fascinating, and their use for clinical applications has been accepted. Depolarizing drugs can prodee a non-depolarizing type of neuromuscular block. Decamethonium produces a nondepolarizing block in the isolated rabbit lumbrical muscle. Electromyographic studies of the hand muscles in man have demonstrated that a dual block will be produced with doses of succinylcholine varying from 500 to 1,500 mg (initially a delpolarizing block and subsequently a non-depolarizing block exists). The common peroneal nerve in the rabbit knee was stimulated by a $quot;train of four$quot; method (Ali et al) repeated intermittently. The muscle response with the $quot;train of four$quot; method to intravenous succinylcholine chloride (1 mg/kg) in the rabbit was recorded and analysed after a single injection and repeated intravenous injections of succinylcholine chloride 1 mg/kg. Result were as follows: 1) Time after the $quot;train of four$quot; to depression of muscle twiteh of 25, 50, 75 & 100% was 128. 2, 135. 3, 142. 8 and 159 seconds respectively. 2) Recovery index of a single intravenous injection of succinylcholine chloride 1 mg/kg was observed as 3 minutes and 14 seconds. 3) A depolarizing form of $quot;train of four$quot; response to the first succinylcholine chloride injection 1 mg/kg was observed and, a non-depolarizing form of $quot;train of four$quot; response to the second dose of succinylcholine chloride 1 mg/kg was observed definitely.

신장이식환자의 마취 24 례

김갑성,정태호,전세웅,김성년,정운혁,유지섭 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.1

This is a report of anesthesia done for 24 cases of renal transplantation performed at St. Mary's Hospital, Catholic Medical college, Seoul, Korea, between 25 March 1969 and 19 August 1976. The recipient of renal transplantation show many critical conditions which require special considerations in performing anesthesia. The patients preoperative condition should be evaluated more carefully than most other kinds of surgical patients and anesthesia technic also must be selected specially. All kidney grafts were obtained from living donors. The family linkage of 24 donors was: 7 cases(29.1%) were from parents, 3 cases(12.5%) from children, 9 cases (37.5%) from siblings, 3 cases(12. 5%) from other relatives and 2 cases (8. 3%) were from nonrelated prsons. In the sex distribution of the donors, each sex was equally distributed.: All donors were anesthetized by means of endotra,cheal anesthesia using halothane, nitrous oxide and oxygen. As to complications during the nephrectomy of donors, a case of hiccup and two cases of pleural tear were encountered. The removed kidney was perfused with Hartmanns solution before transplantation and the choice of anesthetic agents caused no problems in the function of transplanted kidneys. The recipients had histories of chronic glomerulozephritis or pyelonephritis from 6 months to 32 years and showed uremic conditions. Their mean age was 38 years, ranging from 18 years to 59 years. The most frequent age group of the recipients was the 30 and 40 year group. Most recipients were males; among 24 cases, only 3 were females. Most of the recipients had decreased function of heart and lungs, severe anemia difficult to correct by blood transfusion(Hb, 7. 3 gm%, Hct. 24, 2%), increased BUN(70. 36±31. 34 mg/dl), hyperkalemia (4. 67±0. 63 mEq/L), poor and fragile veins, bleeding tendency and decreased kidney function(serum creatinine 10. 48 edmea, ±2. 99 mg/dl). Prolonged medication to the recipient was another hazard to anesthesia. To lessen the risk during the anesthesia maintenance, preoative preperation of the recipient The Journal of The Korean Society of Anesthesiologists Vol. 10, No. 1, 1977 Premedication of the recipients was perfor med by valium(515 mg) and atropine(0. 4 0. 5 mg) one hour before anestl esia. For tlie anesthetic technic, endotracheal anesthesia was applied to aI1 cases. Induction was done with intravenous pentothal soium, l00~ 200 mg or Epontol 250~500mg. As to the muscle relaxant to facilitate intubation, succinylchline for ll cases of the initial period of the transplantation, later gallamine for one case and pancuronium for the recent 12 cases. All anesthesia was maintained with halothane, nitrous oxide and oxygen. Muscle relaxants were used in al) cases during the surgery: succinylcholine drip for the initial 7 cases, d-Tubocurarine for 2 cases, gallamine for 2 cases and pancuronium for the recent 12 cases. Galllamine seems to be not contraindicated, as far as the active diuresis could be anticipated after the transplantation. Amount of blood transfused during operation was 2, 041 ml in average, ranging from 800 ml to 5000 ml and fluid infused was 1, 242 m] of Hartmann's sol. and/or other solutions. Respiration was controlled manually or mechanicaIly. During the anesthesia, 16 cases of hypertension, 7 cases of arterial hypotension, 3 cases of arrhythmia, one cas of tight chest and one case of tachycardia, were encountered. Emergence of anesthesia was within 15 minutes. After the transplantation, diuresis started in 33 minutes on the average and most patients showed marked diuresis in which urine volume of 24 hours was 10, 164 ml on the average. The total surgical procedure lasted 4 hours and 50 minutes on the average, ranging from 3 hours 50 minutes to 7 hours. The ischemic tine of the removed kidney was 32 minutes in average. Followup of the patients showed that 10 cases died out of 24 cases between 4 months and 4 years.after the surgery Patients surviving more than 1 year were 11 cases out of 15 cases(73. 3%), two cases out of 8 cases(25%) survived more than 2 years and two cases out of 8 cases(25%) more than 3 years. One case had the longest survival of 7 lt3 Xears.

ATmega128을 이용한 태양광 자동차 제어

박형규(Hyung-kyu Park),송재영(Jae-yeong Song),유지섭(Ji-sub Yu),이성용(Seoung-Yong Lee),한새론(Sae-Ron Han),최관순(Kwan-Sun Choi) 한국정보기술학회 2012 Proceedings of KIIT Conference Vol.2012 No.11

차세대 에너지 중 하나인 태양광과 마이크로콘트롤러를 결합한 RC 자동차를 제작하였다. 제작된 RC카의 뒷바퀴는 DC 모터, 앞바퀴는 서보모터를 사용하였으며 블루투스 통신을 사용하여 속도와 방향을 제어할 수 있도록 하였다. We implemented a RC car with microcontroller and solar plower. It is composed of front wheel driver with servo motor and rear wheel driver with DC motor. we can control a speed and direction of RC car using Bluetooth communication.