인어체 ( Sirenomelia ) 기형 1 례

나계환(KW Rha),차희양(HY Cha),호삼수(SS Hoh),박흠례(HR Park) 대한산부인과학회 1987 Obstetrics & Gynecology Science Vol.30 No.3

Sirenomelia is a rare congenital malformation and the fusion of the lower limbs give the infant the appearance of a mermaid This anomaly shows the most severe form of a variable spectrum of embryologic defects which may include genitourinary, gastrointestinal, skeletal, cardiovascular and pulmonary abnormalities We experienced a case of sirenomelia and presented with review of literature

産科痲醉의 最近動向(Ⅲ)

崔裕德,羅桂煥 최신의학사 1986 最新醫學 Vol.29 No.3

産科麻醉의 最近動向(Ⅱ)

崔裕德,羅桂煥 최신의학사 1986 最新醫學 Vol.29 No.2

다발성 선천성 기형을 동반한 단안아(單眼兒)

황병철,나계환,김영선,박지홍 대한산부인과학회 1984 대한산부인과학회 학술대회 Vol.54 No.-

복강경 불임시술후 발생한 자궁외임신에 관한 임상적 고찰

이남경,나계환,김영선,호삼수 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.11

Methoxyflurane 을 이용한 Pheechromocytoma 의 마취관리

박광원,최령,나계환,정순미,백상기 대한마취과학회 1978 Korean Journal of Anesthesiology Vol.11 No.2

Various aneathetic agents have been successfully used for patients undergoing surgery for pheochromocytoma removal. A review of the literature on the anesthetic management of pheochromocytoma discloses no general agreement regarding choioe of an anesthetic agent It would appear that the selection of the anesthetic agent is not as important as the proper management of the patient Previously the anesthetic experience of a case of pheochromocytoma removal managed under methoxyflurane anesthesia has been reporthd by us. Thereafter we have had another five cases of pheochromocytoma removal operation under general anesthesia, employing methoxyflurane as a primary anesthetic, with relatively satisfactory results.

교감신경차단에 의한 대장표진의 치료

김종래,오흥근,나계환 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.1

Since May 1976, 16 cases of herpes zoster were treated, mainly by repeated stellate ganglion or epidural block with 1% lidocaine. These cases were divided into two groups depending on the duration of herpes zoster, within 2 weeks (group 1) and 2 weeks to 2 months (group 2). The results were as follows: 1) No significant differences of sex and age distribution in the two groups were observed. The youngest case was 12 years old, the oldest 80 years and 87. 5% of cases were above the age of 50. 2) The left side was slightly more often involved. The highest incidence was observed in the thoracic region (62.5%) and in 1 or 2 segments (75%). 3) Blocks, repeated more than four times, were needed for the complete relief of pain in group 1. 4) The effect of repeated blocks was excellent in early cases. The above results indicate that repeated sympathetic blocks, more than 5 times, were effective for early cases of herpes zoster.

인공호흡기를 사용한 환자에 있어서 상기도 감염에 대한 임상고찰

김인세,이영애,나계환,김영숙,김종래,박광원 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.3

The control of infection in the intensive care unit is a very important problem in the treatment of critically ill patients. Moreover for the patient who is receiving artificial ventilation, possibity of cross-infection may impose an added risk when the general condition is poor. This study was undertaken to investigate the incidence of upper respiratory tract infection in patients requiring prolonged respiratory care who were admitted to the I.C.U. The total number of cases in this study was 48, and the patients were equally devided in two groups, group one consisting of 24 cases who had respiratory care with early tracheostomy (transtracheostomy intubation) and group two who had received respiraory care through oral or nasotracheal intubation without tracheostomy. Specimens for bacteriologic culture were taken especially from the regions of the upper respiratory tract, and the results were compared for the two groups. All patients had respiratory care through artificial ventilators using either the pressure preset or volume preset type. The results obtained from the bacteriologic culture were as follows: 1. The most frequently found organism was pseudomonas aeruginosa, and next was staphylococcus, followed by β-streptococcus and E. coli. 2. The greatest number of organisms in group one was seen on the third day, and in group two on the first day of respiratory care. 3. In group one, the kinds of organisms were more variable than in group two. From the data shown, the most frequently found organisms in the I.C.U. were pseudomonas aeruginosa, β-streptococcus, and E. coli. There was little difference in the aspects of upper respiratory infection between the patients with transtracheal intubation and the patients with translaryngeal intubation without tracheostomy.

Thalamonal, Ketamine 점적, N2O 및 근이완제에 의한 기관내마취

정원철,오흥근,정화성,나계환 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.3

The dangers of explosion hazards and operation theater contamination by inhalation anesthetics have led to a renewed interest in intravenous anesthesia. without intubation. We have reported clinical studies of Thalamonal-ketamine anesthesia under room air breathing in non-abdominal surgery in a previous paper that discussed advantages, disadvantages and usefulness. Now, we report Thalamonal-N₂O-Ketamine anesthesia with a microdrip technique and intubation in 63 patients undergoing various operations. These patients were divided into three groups by operation site: Group 1-upper abdominal, Group 2-lower abdominal and Group 3-non-aMominal surgery. These groups were subdivided, by muscle relaxants used, into pancuronium, d-tubocurarine and no relaxant groups. To minimize potential cardiovascular stimulation and postoperative sequelae, ThalamonaI was used at the beginning of anesthesia. The results were as follows: 1) The average duration of anesthesia was 153.9 minutes. The duration of anesthesia was 217.9 minues in Group I, 121.9 minutes in Group 2 and 152.1 minutes in Group 3. 2) The average dose of ketamine-during induction was 1mg/kg/19 minutes. The average maintenance dose of ketamine was 1.8mg/kg/hr, 2.3mg/kg/hr in Group 1, 1.6mg/kg/hr in Group 2 and 1.8mg/kg/hr in Group 3. 3) The order of frequency of administration and total dose of pancuronium and d-tubocurarine was Group 1, Group 2 and Group 3. 4) The changes in vital signs after intubation and during anesthesia were insignificant clinically. 5) The average duration required from the end of operation to extubation was 10 minutes. 6) Arterial blood gas study performed preoperatively, during operation and in the recovery room in 11 patients revealed no significant changes. 7) The postanesthetic complications were pleasant dreams 18% (11), unpleasant dreams 6% (4), emergence delirium 3% (2), vomiting 6% (4) and shivering 3% (2).

Halothane 마취 및 수술침습이 뇌하수체 성선자극홀몬 분비에 미치는 영향

김종래,김원준,박광원,유경자,나계환,정인석 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.1

The neuroendocrine responses to surgical stress in man include release of ACTH, GH and prolactin in the serum (Cooper and Nelson, 1962; Ney et al., 1963; Rpse et a;. 1966; Schlach. 1967; Gordon et al., 1972; Jeffrey et al., 1977). Data on serum LH and FSH during operation under general anesthesia have been conflicting. Ecidence has also been accumulated that serum LH levels are increased significantly in male patients during operation under general anesthesia in comparison to preasnesthesia levels(Nakashima et al., 1975). However, the intraoperative response of serum LH in males might be different from that in postmenopausal females with a very high basal level of LH and from menstrating females. Effects of surgical stress under general anesthesia with halothane-N2_O on serum LH and FSH levels were stuidied in 12 menstruating female patients, 8 postmenopausal female patients, and in 8 male patients with no endocrine disorders, liver or kidney function impairment as judged by routine tests. Control serum samples were taken immediately before anesthesia and subsequent samples were obtained from the patients 30 minutes, 1 hour and 5~6 hours after the onset of anesthesia and on the second and seventh postoperative day. The concentrations of serum LH and FSH were measured by a specific and sensitive radioimmunoassay method. The results are as follows; 1) Preanesthetic levels of serum LH and FSH served as controlds and were within range of normal values for male and female subjects in our laboratory. 2) In male patients, serum LH levels, 1 hour after onset of anesthesia increased significantly over those of preanesthesia, while no significant intraoperative increase in LH levels was found in female patients. 3) No signifiant change in serum LH levels was demonstrated on the second and seventh postoperative day except female patients, who showed significant decrease in the serum LH level on the second postoperative day. 4) No significant intraoperative and postoperative changes in serum FSH levels were observed in male or female patients. From the above results, it may be concluded that significant intraoperative increase in serum LH levels occurs in male patients but not in female patients.