기관-식도루 환자의 마취 관리

백해정,이상귀 의과학연구소 1992 全北醫大論文集 Vol.16 No.1

Esophageal atresia with tracheoesophageal fistula was first reported by Thomas Gibson in 1697. Esophageal atresia is classified into six types by Gross. Esophageal atresia with tracheoesophageal fistula can be treated surgically under general anesthesia, however the mortality rate of surgery is very high because of pulmonary complications and combined anomaly(s) of heart, genitourinary tract, gastrointestinal tract and musculoskeletal system etc. The authors experienced a case of a successful general endotracheal anesthesia under appropriate monitoring techniques for a surgical treatment of a one-year old female(9.8kg) patient with tracheoesophageal fistula(Gross's classification type C) (Key words: Tracheoesophageal Fistula, Esophageal Atresia)

아동의 듣기·말하기 능력 향상을 위한 소리 내어 읽어주기 프로그램 개발

백해정(Baek, HaeJung),이성은(Lee, SungEun) 한국열린교육학회 2009 열린교육연구 Vol.17 No.3

본 연구는 아동의 듣기·말하기 능력 향상을 위한 소리 내어 읽어주기 프로그램을 개발한 후, 실제 적용하여 아동들의 듣기·말하기 능력 향상에 어떠한 영향을 미치는지 알아보는 데 그 목적이 있다. 이를 위하여 요구조사를 기초로 프로그램의 목표 및 내용을 선정하고 조직하여 수업모형과 평가방법을 개발하였다. 개발된 프로그램은 초등학교 3학년 한 학급 아동 33명에게 8주, 총 18차시 동안 적용하여 그 효과를 사전․사후 검사를 통해 알아보았다. 연구 결과, 아동의 듣 기·말하기 능력 향상을 위한 소리 내어 읽어주기 프로그램은 듣기 능력의 하위요소인 식별적 듣기, 분석적 듣기, 감상적 듣기에 긍정적인 영향을 나타내었고, 말하기 능력의 하위요소 중, 발음을 제외한 내용 생성, 내용 조직, 내용 표현 능력에도 긍정적인 영향을 나타내었다. 후속 연구로는 아동의 듣기·말하기 능력 향상을 위한 소리 내어 읽어주기 프로그램에 대한 좀 더 장기적인 연구와 연구 대상의 폭을 넓혀 그 효과를 검증해 보도록 하는 것이 지속적으로 이루어지도록 제언하였다. The purpose of this study is to develop of the reading aloud approach program for improving children′s listening and speaking ability. For this purpose, the survey was carried out on teachers and elementary students to understand their demands about advancement of listening and speaking ability , listening & speaking teaching-learning method and process of reading aloud approach. And a following step was analytical study of the contemporary public education curriculum. As a result, the primary purpose of program and the established the supplementary goals were suggested. This program was applied to 33 children, 3rd elementary students. Reading aloud approach was provided for the experimental group. In the concrete, this program was applied to 1 classes of 3rd graders in I elementary schools io-yang city, Gyeonggi province. Reading Aloud approach was provided for the experimental group from the 6th of March, 2009 to the 5th of May(8weeks) over, 18 periods. To verify the achievement of Program, pre-test and post-test was executed and the data from this was treated on SPSS/WIN 15.0 with T-test. As a result of the Reading Aloud Approach Program has a significant effect on listening and speaking ability of elementary middle students(especially 3rd elementary students). In listening ability, the achievement of the experimental group shows significant difference(p< .01). Literal listening, analytic listening and appreciational listening ware subcategories of listening ability. Among them, the most significant difference was found in analytic listening. In speaking ability, the achievement of the experimental group shows significant difference(p< .01). Pronunciation, contents formation, contents organization and contents expression ware subcategories of speaking ability. Among them, the most significant difference was found in contents expression. In the preliminary and afterward estimation of the application of the reading aloud approach, the results showed quite meaningful difference. The experimental group using this program improved listening and speaking ability after the treatment. It means that the program was primarily effective for development of childre n′listening and speaking ability. In conclusion, there are some limits to this research. This was fulfilled for 8 weeks, 18 periods. It needs longitudinal study. And it was not to apply the result to older students. So, following research is more needed.

상복부 수술후 진통을 위한 경막외 약물 주입에 있어서 Clonidine 첨가 효과에 관한 연구

이선숙,최훈,한영진,이준례,백해정 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.3

Epidural narcotics has been most widely used for the control of postoperative pain. However, patients have been treated insufficiently because of the fear of respiratory depression. Urinary retension, nausea and vomiting, pruritus are other complications of epidural narcotics. Epidural local anesthetics may be an alternative to epidural narcotics. But the duration of action is usually too short, although epinephrine can prolong the analgesic effect. Clonidine, an a2-adrenergic agonist has its own analgesic effect and can prolong the effects of epidurally administered drugs. Therefore epidural clonidine may be expected to lessen the requirement of epidural narcotics and hence reduce the complications of narcotics. 75 ug or 150ug of clonidine was added to 0.125% bupivacaine or 2 mg of morphine. 6ml of mixed solution was administered epidurally during and after operation for the control of pain following upper abdominal surgery. Clonidine caused increase in the analgesic duration of epidural bupivacaine and morphine. Clonidine also cause decrease in systolic pressure in dose-dependent manner, especially during anesthesia without significant alterations in heart rate. Clonidine may be an useful adjunct to epidural narcotics, provided the dosage is carefully titrated in the range of modest hemodynamic change.

개봉술후 Bupivacaine 에 의한 늑강차단술의 진통 효과에 대한 고찰

김동찬,송희선,이상귀,백해정 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.5

Postoperative pain may be associated with shallow breathing, inability to cough, and reduction in spirometric values which lead to restrictive pattern of ventiltion with hypoxemia and/or hypercapnea. Therfore postoperative pain should be maneged by using appropriate methods. To investigate the analgesic effect of interpleural block with 0.25% or 0.375% bupivacaine hydrochloride, 30 patients were randomly divided into one of three groups(saline group, 0.25% bupivacaine group and 0.375% bupivacaine group). In the saline group, 0.9% saline with 1: 200,000 epinephrine(0.5 ml/kg) was injected into the pleural cavity via the chest drainage tube, either 0.25% or 0.375% bupivacaine with 1: 200,000 epinephrine(0.5 ml/kg) was injected with the same manner of the saline group in the bupivacaine groups, respectively. Respiratory parameters(minute volume, tidal volume, respiratory rate, forced vital capacity, incentive spirometric volume, cough score, deep inspiratory score), numeric pain rating score and hemodynamic changes were measured before anesthetic induction, 10 minutes before the study drug injection, 30 and 60 minutes after the study drug administration, respectively. Postoperative respiratory parameters were decreased at l0 minutes before the drug injection compared to the preanesthetic values in all groups. There were no statistically significant differences of all parameters after the drug administration among three groups. There was a tendency of improvement in the respiratory parameters after the drug injection in saline and 0.25 % bupivacaine groups and a greater tendency of improvement of respiratory parameters and numeric pain rating score in 0.375% bupivacaine group than the other groups. Only one case of tachycardia was developed in the saline group. These results suggest that the postoperative pain after thoracotomy is not appropriately manged by using the interpleural block with 0.25% or 0.375% bupivacaine hydrochloride (0.5 ml/kg) administrated via the drainage tube of the chest