Seborrheic dermatitis treatment with stellate ganglion block -a case report-

송장호,김건우,문기호,송정윤,김병건,정종권,이춘수,차영덕 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.2

Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials.

심장수술 시 농축적혈구, 자가수혈기 혈액, 체외 순환기 혈액에서의 유리 혈색소 농도 비교

송장호,구승우,백종화,정용보,이정순,최인철 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: Intraoperative autotransfusion or residual blood in a cardiopulmonaty bypass (CPB) circuit has been used to reduce the need for an homologous blood transfutsion during cardiac surgery. However, it may contain some free hemoglobin released from damaged cells. The load of blood containing free hemoglobin may cause renal dysfunction. We measured the amount of free hemoglobin in backed blood, cell saver blood and CPB blood to evaluate what is the least hemolytic blood transfused in cardiac surgery. Methods: This study was performed in 20 patients undergoing cardiac surgery. In each patient, the banked blood, intraoperative salvaged blood with a cell saver and CPB residual blood were sampled at the end of the operation. The concentration of free hemoglobin, hemoglobin and platelet counts were measured in these blood samples and percent of hemolysis was calculated (%hemolysis = [free hemoglobin] / .free hemogloben + hemoglobin]) Results: In salvaged blood with a cell saver, CPB residual blood and banked blood, hemoglobin concentrations were 20.1 ± 2.7 g/dl, 8.0 ± 1.1 g/dl, and 22.2 ± 2.7 g/dl, respectively. Free hemoglobin concentrations were 336.6 ± 239.5 mg/dl, 49.2 ± 26.8 mg/dl, and 279.5 ± 167.5 mg/dl respectively. Platelet counts were 26.1 ± 22.2 × 10^3/mm^3, 116.8 ± 56.5 × 10^3/mm^3, and 94.9 ± 43.6 × 10^3/mm^3 respectively. % Hemolysis were 1.6 ± 1.1%, 0.6 ± 0.4%, and 1.2 ± 0.7% respectively. In the comparison between the salvaged blood with a cell saver and CPB residual blood, free hemoglobin concentration, % hemolysis, and platelet counts had positive correlations (r = 0.8, 0.7, and 0.6). Conclusions: In twenty cardiac surgeries, CPB residual blood had a lower free hemoglobin level than the other two blood groups. The platelet counts in CPB residual blood were higher than those in cell saver blood but did not differ from those in banked blood. Therefore, CPB residual blood was the least hemolytic blood among the three blood groups when a transfusion was performed in cardiac surgery. (Korean J Acesthesiol 2002; 43: 588~593)

소아의 진단적 검사 또는 치료적 시술을 위한 진정요법

송장호,이재민 대한의사협회 2013 대한의사협회지 Vol.56 No.4

As various diagnostic and treatment technologies evolve, the performance of diagnostic and therapeutic procedures on pediatric patients outside operating rooms is rapidly becoming more common. Procedural sedation and analgesia refers to the use of sedatives and analgesics to provide anxiolysis, analgesia, and immobilization during the procedure. There is a need for a common guideline that may be used by different health professionals, including anesthesiologists,pediatricians, emergency medicine physicians, dentists, radiologists, and others that are involved in these settings. Furthermore, during the entire process an anesthesiologist should be responsible for the training of those involved. Procedural sedation and analgesia is a branch of clinical medicine that includes informed consent, fasting before sedation, patient evaluation, medication administration, patient monitoring, recovery and discharge, and cardiopulmonary resuscitation. Complications associated with procedural sedation and analgesia may occur due to a drug overdose or side effects, inadequate patient monitoring, physicianʼs errors, and/or insufficient recovery. Although the most common complications are airway obstruction or respiratory depression,these may be prevented by careful patient monitoring and appropriate emergency response. Further progress in procedural sedation and analgesia will require research, an assessment of newer sedatives, and improvements in the reporting system for adverse events.

Bernard Malamud와 그의 작품 The Fixer

송장호 金烏工科大學校 1995 論文集 Vol.16 No.-

The Fixer is Malamud's finest achievement because the central metaphor of imprisonment is derived from the social facts of Czarist Russia and the actual details of the career of Mendel Beiliss. In the novel, Malamud dramatized the responsibilties of peoplehood most intenseely and sustainedly. The novel tells the story of Yakov Bok, the fictional correlative of the Russian martyr Mendel beiliss Yakov Bok attempts to evade the resposibilties of his identity. Therefore, he decides to escape from shtetl. He drops his bag of prayer articles in the Dnieper River, going to Kiev and taking the Russian name. The novel is filled with the anguish of his imprisonment and trial with his terrible disappointments and the dishonest machinations of anti-Semitic officals. Yakov is doomed to dia because he is a Jew, but he rejects the God of his people. However, he insists on humanistic morality beyond all religious and social problems. At the first, Yakov had selfish mind, complaining his situations. But he gradually comes to change his attitudes into social morality. Yakov's changes of mind seem to be Malamud's intention for readers.

Optimization of double cycling in container ports

송장호,곽규석 한국항해항만학회 2009 한국항해항만학회지 Vol.33 No.2

If the research on double cycle is revitalized, crane productivity will be rapidly improved because double cycle is an operational technique that can maximize equipments efficiency (Quay crane, RMG/RTG, Yard tractor). Unfortunately, it is very difficult for terminal operators to find out the starting point of double cycle because the loading & unloading pattern and conditions are various. Therefore, terminal operators are apt to fail to find out the optimal starting point of double cycle to maximize its frequency. Experiencing the same mistakes in the process we made efforts to find out the optimal starting point, finally we found out the formula for it. And we verified its precision is perfect through a lot of testing. This paper on double cycling focused on making the formula to find out optimal starting point of double cycle to maximize its frequency. And it can be applied to various ships’ stowages in common. If the research on double cycle is revitalized, crane productivity will be rapidly improved because double cycle is an operational technique that can maximize equipments efficiency (Quay crane, RMG/RTG, Yard tractor). Unfortunately, it is very difficult for terminal operators to find out the starting point of double cycle because the loading & unloading pattern and conditions are various. Therefore, terminal operators are apt to fail to find out the optimal starting point of double cycle to maximize its frequency. Experiencing the same mistakes in the process we made efforts to find out the optimal starting point, finally we found out the formula for it. And we verified its precision is perfect through a lot of testing. This paper on double cycling focused on making the formula to find out optimal starting point of double cycle to maximize its frequency. And it can be applied to various ships’ stowages in common.

심장폐우회술 없이 시행한 간구역절제술과 하대정맥 및 우심방 혈전제거술의 마취 경험 - 증례 보고 -

송장호,이홍식,한정욱,정종권,김현주,신혜란 대한마취통증의학회 2007 Anesthesia and pain medicine Vol.2 No.4

The tumor thrombus of hepatocellular carcinoma extending into the right atrium (RA) via the inferior vena cava (IVC) may cause fatal complications such as heart failure and pulmonary embolism. Surgery for removal of thrombus in the RA usually needs aid of cardiopulmonary bypass (CPB). We report a case of successful anesthetic management for simultaneous liver segmentectomy and IVC and RA thrombectomy without CPB.

Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block

송장호,심희용,이동주,정종권,차영덕,이두익,김건우,한정욱 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.66 No.4

Background: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block. Methods: Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 μg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 μg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index. Results: In group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E. Conclusions: Perineural 1 μg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 μg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine.

증례보고 : 소아 환자에서 Sevoflurane 마취 후 발생한 급성 간 손상

송장호 ( Jang Ho Song ),임현경 ( Hyun Kyoung Lim ),이춘수 ( Choon Soo Lee ),백완기 ( Wan Ki Baek ),윤정원 ( Jung Won Yoon ),신혜란 ( Helen Ki Shinn ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6

Postoperative hepatotoxicity may develop from many causes. One of them is direct injury to the liver cell due to anesthetic agents. Each agent has different hepatotoxic risk. Sevoflurane is known to have a very low potential for hepatotoxicity. We report a case of severe hepatic dysfunction after anesthesia with sevoflurane in a pediatric patient who underwent cardiopulmonary bypass surgery. (Korean J Anesthesiol 2007; 53: 781∼4)

임상연구 : 소아에서 술 전 미추차단은 적절한 마취 심도 유지를 위한 Sevoflurane의 요구량을 감소시킨다

송장호 ( Jang Ho Song ),이홍식 ( Hong Sik Lee ),김병건 ( Byung Gun Kim ),임현경 ( Hyun Kyoung Lim ),신혜란 ( Helen Ki Shinn ),정성미 ( Sung Mee Jung ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1

Background: It is generally known that neuraxial anesthesia for adults reduces the demand for hypnotics needed for adequate sedation. Therefore, this study examined the effect of a preoperative caudal block on the general anesthetic requirements for an adequate depth of anesthesia in children. Methods: Twenty children aged 3-5 years, who were set to undergo inguinal herniorraphy, were divided into 2 groups of 10 children each, normal saline and lidocaine groups. Tracheal intubation was performed. After setting up the bispectral index (BIS) monitor, a caudal block was administered to both groups differently, normal saline 0.7 ml/kg was administered to the normal saline group and 1.5% lidocaine 0.7 ml/kg was administered to lidocaine group. The end-tidal concentration of sevoflurane was maintained at 1.5 vol% for 10 minutes in the first patient in both groups, and the BIS value, was measured 6 times every 10 seconds, and averaged. When the BIS was ≥ 50, the end-tidal concentration of sevoflurane was increased by 0.2 vol% in the subsequent patient. When the BIS was less than or equal to 50, the end-tidal concentration of sevoflurane was decreased by 0.2 vol% in the subsequent patient. The MACBIS50 in both groups was calculated using probit analysis. Relative median potency analysis was used to compare the results in both groups. Results: The MACBIS50 of sevoflurane was significantly lower with a 1.5% lidocaine caudal block (1.40 vol% [95% CI, 1.25- 1.55 vol%]) compared with the normal saline group (1.77 vol% [95% CI, 1.61-2.00 vol%]). Conclusions: A preoperative caudal block reduces the demand for sevoflurane required for an adequate depth of anesthesia, as measured by the BIS in children. (Korean J Anesthesiol 2007; 52: 29~33)

Newly Developed Urinary Retention and Motor Weakness of Lower Extremities in a Postherpetic Neuralgia Patient

이미현,송장호,이두익,안현수,박지웅,차영덕 대한통증학회 2013 The Korean Journal of Pain Vol.26 No.1

During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.