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증례보고 : Beckwith-Wiedemann Syndrome 환아 두 명의 마취 관리
김현주 ( Hyun Joo Kim ),김진태 ( Jin Tae Kim ),김현정 ( Hyun Jung Kim ),김희수 ( Hee Soo Kim ),김종성 ( Chong Sung Kim ),김성덕 ( Seong Deok Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
Beckwith-Wiedemann syndrome consists of various abnormalities, including macroglossia, visceromegaly, omphalocele, and neonatal hypoglycemia. These abnormalities frequently require operative correction and careful anesthetic management. Principal problems associated with anesthetic management in this syndrome are congenital heart disease, hypoglycemia, and difficult airway combined with macroglossia. We report two cases of general anesthetic management in children with Beckwith-Wiedemann syndrome. (Korean J Anesthesiol 2009;56:583~6)
김지은 ( Ji Eun Kim ),염명걸 ( Myung Kul Yum ),김희수 ( Hee Soo Kim ),김진태 ( Jin Tae Kim ),김종성 ( Chong Sung Kim ),김성덕 ( Seong Deok Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
Background: Heart rate is tightly controlled by brain. If activity of brain and electroencephalograph (EEG) are changed by anesthetics, electrocardiograph (ECG) might be changed. We investigated whether there is a correlation between EEG and ECG, ECG could replace EEG as a monitor for depth of anesthesia. Methods: We recruited 50 patients, aged 2-8 years. Inspired and expired end-tidal sevoflurane concentrations were held constant at 1.0 or 2.5 vol%, after which ECG and EEG were obtained for 15 minutes. Total power (TP), low-frequency power (LFP), high-frequency power (HFP), approximate entropy (ApEn), and Hurst exponent (H) were calculated from the ECG. The relationship between EEG and ECG indices at the two sevoflurane concentrations was measured by Pearson`s correlation coefficient. Results: As anesthesia deepened, ApEn, H of ECG and beta wave decreased and those of delta and theta increased in 4 channels. In FP2, changes of beta and theta wave were negatively correlated with ApEn and H of ECG (P<0.05), and changes of delta wave was positively correlated with ApEn (P<0.05) and H (P<0.01). In F8, changes of beta and theta wave were negatively correlated with ApEn (P<0.05) and only theta wave was negatively correlated with H (P<0.05). In C4, change of delta wave was positively correlated with ApEn (P<0.001) and H (P<0.05). Conclusions: EEG and ECG indices are correlated during sevoflurane anesthesia in children, and ECG-derived indices could possibly be used to monitor depth of anesthesia. (Korean J Anesthesiol 2009; 57: 56~61)
임상연구 : 사시수술을 받는 소아에서 Propofol과 Nalbuphine이 Sevoflurane 마취 후에 발생하는 각성흥분에 미치는 영향
김현정 ( Hyun Jung Kim ),김희수 ( Hee Soo Kim ),김성덕 ( Seong Deok Kim ),김종성 ( Chong Sung Kim ),김진태 ( Jin Tae Kim ),이강준 ( Kang Joon Lee ),박성주 ( Seong Joo Park ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.5
Background: Emergence agitation in children is frequently associated with sevoflurane general anesthesia. We measured the effects of propofol and nalbuphine on emergence agitation after sevoflurane anesthesia in children for strabismus surgery. Methods: Ninety pediatric patients receiving sevoflurane anesthesia for elective strabismus surgery were enrolled. They were randomized to receive either saline (Group S), propofol 1 mg/kg (Group P), or nalbuphine 0.1 mg/kg (Group N) at the end of surgery. We evaluated the incidence of emergence agitation and recovery in the postanesthesia care unit. Results: The time to recovery was similar between the three study groups. The incidence of agitation was significantly lower in Group N compared with Group S, but the incidence of agitation between Group S and Group P was not different. Conclusions: Nalbuphine 0.1 mg/kg at the end of strabismus surgery under sevoflurane anesthesia effectively reduced emergence agitation in children without delaying recovery, but propofol did not. (Korean J Anesthesiol 2008;55:575~8)
증례보고 : 어린이에서 ProSeal 후두마스크 삽입 후 발생한 혀주름띠 열상
박미정 ( Mi Jung Park ),김희수 ( Hee Soo Kim ),김진태 ( Jin Tae Kim ),김종성 ( Chong Sung Kim ),김성덕 ( Sung Deok Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5
The laryngeal mask airway (LMA) is widely used as an adjunctive airway device composed of a tube with a cuffed mask-like projection on the distal end. The LMA is simple to use and less invasive to pharynx and larynx than endotracheal tube. The LMA is inserted blindly into the hypopharynx, forms a low pressure seal around the laryngeal inlet. It is minimally stimulating the airway. Microscopic mucosal injuries are common during laryngeal mask airway (LMA) insertion but macroscopic injuries are rare and few have been reported with the ProSeal LMA. This report describes a case of the tearing of the lingual frenulum incidentally caused by insertion of the ProSeal LMA in a child. (Korean J Anesthesiol 2009;57:644∼6)
주영 ( Young Joo ),김현정 ( Hyun Jung Kim ),김진태 ( Jin Tae Kim ),김희수 ( Hee Soo Kim ),이상철 ( Sang Chul Lee ),김종성 ( Chong Sung Kim ),김성덕 ( Seong Deok Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.2
Background: Hypothermia is considered one of the reasons for intraoperative shivering. The purpose of this study is to assess whether active warming can prevent hypothermia and shivering in young adults under spinal anesthesia. Methods: Fifty male patients scheduled for an elective operation on lower extremity under spinal anesthesia were randomly assigned into the warming group (n=25) and the control group (n=25). The active warming was performed using a forced air-warming device, a warmed blanket and warmed fluid. Axillary and tympanic temperatures, shivering degree, thermal discomfort, and anesthetic level were checked every 10 minutes after intrathecal injection of local anesthetics. Results: Patients` characteristics and anesthetic levels were comparable between the groups. Axillary and tympanic temperatures were maintained higher in the warming group than the control group 10 minutes and 20 minutes after intrathecal injection respectively. The lowest temperature in operating room was higher in the warming group (36.3±0.5℃) compared with the control group (35.7±0.5℃) (P<0.05). Incidences of intraoperative shivering and thermal discomfort were lower in the warming group. Conclusions: We conclude that intraoperative active warming can prevent hypothermia and shivering during spinal anesthesia. (Korean J Anesthesiol 2009;57:176∼80)
폴리에테르 유도체 사용에 따른 콘크리트의 공학적 특성에 관한 연구
김성덕(Kim, Seong-Deok),손인석(Son, In-Suk),박병근(Park, Byung-Keun),정상진(Jung, Sang-Jin) 대한건축학회 2013 大韓建築學會論文集 : 構造系 Vol.29 No.4
The basic properties and length change characteristic of the polyether derivative, which is a shrinkage reducer, were analyzed to reduce the drying shrinkage and cracks of general concrete, and the basic properties and drying shrinkage characteristic of the concrete were analyzed according to the addition of industrial byproducts (FA and BS), which are used to support eco-friendly policies and to ensure economic feasibility. The results showed that the concrete mixture of 100% normal Portland cement had a lower fluidity and compressive strength when the added polyether admixture volume was greater. The drying shrinkage also decreased. The addition of BS and FA improved the fluidity of the concrete, in both cases with and without the addition of the polyether admixture The strength was low in the early stage because of the substitution of BS and FA, and increased with the lapse of time. The length of the concrete specimen decreased according to the addition of the admixture alone, and the addition of FA resulted in a lower length change rate than the addition of BS when the polyether admixture addition rate was 0% and 4%. In conclusion, the use of the polyether derivative for the general concrete (normal Portland cement) reduced the compressive strength, but improved the drying shrinkage reduction. The results with the normal Portland cement showed that even the addition of BS and FA alone had a shrinkage reduction effect, although it was small.