초음파영상술을 이용한 절단된 경막외 카테터의 위치확인 및 수술적 제거

김성년(Sung Nyeun Kim),박철주(Cheol Joo Park),권오 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2

Continuous epidural blockade is a widely accepted, useful technique for providing anesthesia and analgesia. But there have been several anecdotal reports of complications such as: abnormal position, knotting, shearing of the catheter, etc. We experienced a case of shearing of the end of an epidural catheter which was difficult to remove from epidural space of a 39-year-old patient. Ultrasonogram proved to be very effective to confirm the presence and position of the retained catheter. We surgically removed the retained catheter as it could potentially lead to infection of the epidural space. We advocate ultrasorgram as an effective procedure to confirm and locate retained epidural ca- theter.

흰쥐에서 Capsaicin 대조( Cisterna Magna ) 내 주입 후 삼차신경 유해자극수용전달로에서의 Fos 단백의 발현

정성우(Sung Woo Chung),김영인(Yeong In Kim),김성년(Sung Nyeun Kim) 대한통증학회 2000 The Korean Journal of Pain Vol.13 No.2

N/A Background: Trigeminovascular system is implicated in the pathophysiology of the headache in migraine. This study was designed to evaluate the pattern of Fos protein expression in trigeminal nociceptive central pathway after meningeal stimulation of rats by capsaicin. Methods: The expression of Fos protein was examined by immunohistochemistry in thalamus, brainstem and upper cervical cord (at three levels corresponding to obex, 0.8 mm and 2 mm below obex) 2 hours after intracisternal injection of either diluted capsaicin solution (0.1 ml, 61μg/ml) or normal saline (0.1 ml) through a catheter placed in the cistema magna, or following epidural instillation of diluted capsaicin solution in urethane-anesthetized Sprague-Dawley rats. Results: Fos immunoreactivity was strongly expressed within lamina I, II of bilateral trigeminal nucleus caudalis (TNC) after cistemal capsaicin injection and magnitude of expression was greatest at level 2.0 mm below obex. Epidural capsaicin caused much less labelling than cistrnal capsaicin. Fos positive cells were also observed in area postrema, nucleus of the solitary tract, medullary reticular nucleus and midline nuclear groups of the thalamus with similar intensity between capsaicin and control group. Conclusions: These results indicate that the injection of capsaicin into the cisterna magna is an effective stimulus for the induction of Fos protein within TNC through activation of trigeminovascular afferents and this animal model can be useful for the evaluation of the pathophysiology and drug development in migraine and related headache.

불인성 미골통에 Caudal Epidural Steriod 이용 -증례보고-

안명자,서재현,김성년,Ahn, Myung-Ja,Suh, Jae-Hyun,Kim, Sung-Nyeun 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.1

Coccygodynia is a pain syndrome resulting from trauma, fractures, infection and tumor, and is usually amenable to conservative treatment. We present one case of coccygodynia that developed 2 days after percutaneous cordotomy done for pain control of cervix cancer unresponsive to conservative treatment which subsequently was treated with a caudal injection of lidocaine and triamcinolone. Caudal epidural steroid injection is less invasive and has less potential for complication than the neurosurgical interruption of the pain pathway.

기관내 실리콘 T-튜브를 통한 마취관리

김성년,이승균,서재현,차두갑 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.5

생쥐에서 수정 직후 아산화질소 노출이 배아의 성장에 미치는 영향

김성년,김장흡,이혜진,조원선 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.5

Background: Nitrous oxide exposure for long periods during gestation causes the increased fetal wastage, growth retardation, morphological abnormalities in rodents. Most studies have explained deleterious effects of nitrous oxide on postimplantation embryo development. The aim of this study was to evaluate the effects of nitrous oxide on embryo after the fertilization in superovulated BALB/c mice. Methods: Pregnant mice were exposed to 70% nitrous oxide in oxygen for 6, 12 and 24 hours on the day of gestation, and 2-cell stage embryos were cultured to blastocyst. Reproductive data were determined at cesarean section on 16th day of gestation based on embryonic developmental failure in vitro by 24 hours nitrous oxide. The protective effects of folinic acid or methionine against inhibition of 2-cell embryo development were also evaluated. Results: Blastocyst development was significantly lower in 12 and 24 hours nitrous oxide group than in the control and 6 hours nitrous oxide group. The pregnancy rate and the mean number of implantations were significantly lower in 24 hours nitrous oxide group than in the control. No significant differences in percentage of the living fetus, the dead fetus, the resorption per implantation, the mean fetal weight and the crown-rump length were observed between nitrous oxide group and control group. There was no significant difference between the nitrous oxide group and the nitrous exposed group receiving methionine and folinic acid. Conclusions: The exposure to high concentration of nitrous oxide for a long time after the fertilization in mice may be possibility of the early abortion of embryos, whereas there is not any influence on fetus after the implantation. (Korean J Anesthesiol 1997; 32: 701∼709)

일본의 Pain Clinic

김성년 대한마취과학회 1983 Korean Journal of Anesthesiology Vol.16 No.4

The status of pain clinic in Japan was presented. There are 98 pain clinics in Japan. The activity in the clinical field or research field is are very apparent. They are expanding the indications for pain clinics and trying to seek new therapeutic remedies for patients in dain, but there are also some problems in running pain clinic, for example, the shortage of man power, inade quote facilities and the uneven effects of drugs. Some information about pain clinics was presented.

Succinylcholine chloride 의 정맥주사시 경골골절 가토의 혈청 Potassium 의 변화

김성년,정운혁 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.1

The use of the succinylcholine chloride for endotracheal intubation is a widely accepted technic during induction of inhalational anesthesia, Currently transient hyperkalemia is well known to occur in man following intravenous administratian of succinylcholine chloride. Furthermore, the massive hyperkalemia following succinylcholine chloride administration is a recognized danger in patients with severe burns, massive trauma, muscle dystrophy and skeletal muscle paralysis caused by peripheral nerve injury or lesions of the central nervous system. Increased serum potassium may lead to severe cardiac arrhythmia or cardiac arrest. We studied the eifect of intravenously administered succinylcholine chloride on the serum potassium level and electrocardiographic changes in nontraumatized and traumatized (fract- ured tibia) rabbits. The following results were obtained: 1. Serum potassium was slightly increased in the non-traumatized group and slightly decreased in the traumatized group before succinylcholine chloride injection, after 5 minutes of succinyl choline chloride injection and after 10 minutes of succinylcholine chloride injection but no statistical significance was noticed in either group. 2. Serum calcium was significantly decreased in the traumatized group after intravenous succinylcholine chloride. (p$lt;0. 05) 3. Hemoglobin and hematocrit were decreased in both non-traumatized and traumatized groups due to blood loss during the studies. 4. In the non-traumatized group, the incidence of arrhythmia was increased from 25 to 40% and incidence of arrhythmia in the traumatized group was the same, 53. 3% before and after succinylcholine chloride injection.

소아 상기도폐새 치료에서의 경비기관내삽관과 기관절개술의 비교

김성년,정운혁,박호상 대한마취과학회 1978 Korean Journal of Anesthesiology Vol.11 No.3

Acute obstruction of the upper airway in children demands prompt diagnosis and treatment. The management is complex and therefore demands serious, detalled and expert attention. An artificial airway is often required to alleviate the obstruction and due consideration should then be given to the relative merits of the passage of an endotracheal tube and tracheostomy. These are measures which should be carried out early in the illness and must not be postponed until the child is in a critical condition when emergency intervention is often associated with a high incidence of morbidity and mortality. Tracheostomy has heen the procedure of choice to relieve airway obstruction; however, in recent years several investigators have reported the encouraging results of nasotracheal intubation as an alternate procedure in the management of upper airway obstruction in children. The purpose of this report is to evaluate tbe relative effectiveness of two procedures; nasotracheal intubation ami tracheostomy, Nasotracheal intubation or tracheostomy were employed in the management of 27 cases, and it would aypear that the two methods of handling airway obstractiorr wer.e equally satisfactory. It was suggested that nasotracheal intubation was superior to tracheostomy in terms of the duration of hospitalization (13,0 days vs. 21. 3 days) and intubation (108. 4 hours vs 167. 2 hours). All patieots tolerated well the nasotracheal tube without accidental extubation.

신경변증성 통증모델 흰쥐의 뇌에서 Fos 의 발현

김경현,박종민,문동언,김성년,민진혜,정창우 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.2

Fos Expression in the Brain of Neuropathic Pain Rats Jin Hye Min, M.D.^*, Chong Min par, M.D., Dong Eon Moon, M.D. Sung Nyeun KIm, M.D., Chang Woo Chung, M.D.^*, and Kyung Hyun Kim, M.D.^* Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul and ??Kwandong University, Gangneung, Korea background: There have been some investigations regarding expression of c-fos, as a marker of altered neuronal expression in the spinal cord of neuropathic rats. However, the expression of c-fos in the brain of a neuropathic pain model has not yet been investigated. The purpose of this study was to evaluate the time course of c-fos expression in the brain of neuropathic pain rats. Methods: The experimental rats were divided into two group; neuropathic pain (n = 16) and control (n = 16) groups. The left L_5-L_6 spinal nerves of the neuropathic pain group were ligated but those of the control group not ligated (sham operation). Two hours, 1st day, 3rd day and 7th day after the operation, we examined the expression of Fos in the cerebral cortex, the amygdala, the thalamus and the hypothalamus of the coronary sectioned brains of the rats. Results: C-fos expressions in the cerebral cortex and the amygdala of the neuropathic pain group were greater at 2 hours, the 3rd and the 7th day than the control group, but those of the thalamus and hypothalamus of the neuropathic pain group were greater on the 3rd and 7th day than the control group (P < 0.05). In the neuropathic pain group, c-fos expressions of four brain regions were greater on the 3rd and 7th day than those at 2 hours and day 1, but there was no difference between the 3rd and 7th day's (P < 0.05). Conclusions: There were sgnificant expressions of Fos protein in the brain of the neuropathic pain group at 2 hours, the 3rd day and 7th day of the operation, but the meaning of each expression was different. The expression of Fos at postoperative 2 hours resulted from acute pain but that at the 3rd and 7th day of the operation resulted from neuropathic pain. (Korean J Anesthesiol 2001; 41: 229~237)

중증 근무력증 환자에서 Atracurium 의 근육이완반응

김경희,김성년,이승균,서재현 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.6

Special considerations are required in the anesthetic management of the myasthenic patient undergoing surgery under general anesthesia. The myasthenic patient is generally highly sensitive to non-depolarizing agents and resistant to depolarizing agents. It is advisable to avoid the non-depolarizing agents or use only small dose during anesthesia, if neccessary. Atractrium is an intermediate acting bisquatenary ammonium compound and it's effects are well dissipated by Hofmann elimination and ester hydrolysis. We have had myasthenic patient undergo thymectomy. Muscle relaxation was obtained by using a small dose of atracurium during anestnesia. Patient's perianesthetic course was net remarkable except slow spontaneous recovery, but it was well reversed by anticholinesterase.