行動的 니힐리즘의 試圖 : Andre Malraux의 征服者에서

宋貞子 이화여자대학교 문리대학 한국어문학회 1965 韓國語文學硏究 Vol.6 No.-

영·유아보육사업과 보육사업발전방향

송정자 경영행정대학원 1997 최고경영자과정 논문집 Vol.7 No.-

甲申政變의 改革思想에 관한 考察

宋政子 청주대학교 행정대학원 1994 수료논문집 Vol.1 No.1

근치 위절제술 환자에서 Pentaspan의 혈장 증량효과

송정자,이준례,최훈 최신의학사 1993 最新醫學 Vol.36 No.5

대상포진후 신경통 치료중에 발생한 흉막 삼출액

송정자(Jung Ja Song),한영진(Young Jin Han),최 훈(H 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.2

We experienced a case of pleural effusion while treating postherpetic neuralgia in a 70 year old male patient. The patient had scar and color change on the skin along the course of the right Th4-5 intercostal nerve, characteristics of healed herpes zoster. The patient also com- plained of severe pain along the lesion site which made sleeping difficult. He had been treated with; epidural blocks with or without catheterization, epidural or regional corticosteroids; mul- tiple intraspinal and intercostal blocks with local anesthetic;- or neurolytic, alcohol, transcutaneous electrical nerve stimulation, etc., for about six months by the time of pleural effusion development. We came to the conclusion that the effusion was due to pleural irrita- tion by multiple intercostal nerve blocks, because it was bloody and developed on the affected right side, although the patient had a history of a certain hepatic pathology and pulmonary tu- berculosis which may be a predisposing factor to the effusion.

Pheochromocytoma 적출술의 Isoflurane 마취 1예

김동찬,송정자,송희선 의과학연구소 1993 全北醫大論文集 Vol.17 No.1

A 32 year-old female underwent resection of a pheochromocytoma under general anesthesia. The patient was treated with prazosin 3mg/day for 10 days preoperatively. The night before surgery, 5mg of diazepam was given orally. One hour before induction, 10mg of diazepam was injected intramuscularly. Following intravenous injection of 100ug of fentanyl, 150mg of thiopental sodium and 6m9 of vecuronium, maskinduction was started with N_2O-O_2-Isoflurane(50% -50% , 1-2vol% ). After blood pressure and heart rate werestabilized, endotracheal intubation was peformed. Anesthesia was maintained with NrO,02, isoflurane and vecuro-nium. During manipulation of tumor mass A tolerable blood pressure and heart rate were maintained by inh3venous phentolamine and labetalol. No arrhyomia was noted throughout the procedure without mild tachycardia. After removal of tumor masa blood pressure was maintained by rapid iDusion of fluid and dopamine dripping. (Key words: Pheochromocytoma, Isoflurane, Labetalol)

수술중 Bupivacaine 으로 늑간신경차단후 갑자기 발생한 저혈압

송희선,이상귀,송정자,구자홍 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.5

Postoperative pain may be associated with shallow breathing, inability to cough, and reduction in spirometric values which lead to restrictive pattern of ventilation with hypoxemia and/or hypercarbia. Therefore, postoperative pain should be managed with appropriate methods. The authors have usually performed intraoperative intercostal nerve block with 0.25% bupivacaine hydrochloride to alleviate postoperative thoracotomy pain. A 21 years old male patient developed sudden hypotension and severe bradycardia 1 minute following the intraoperative 4th, 5th, 6th intercostal nerve block with a total of 10 ml of 0.25% bupivacaine hydrochloride, who was treated by ephedrine with success. The authors discuss the possible causes of sudden hypotension and severe bradycardia in detail.

대퇴골 골절 수술 후 발생한 폐색전증

송희선,이상귀,송정자,고성훈,유춘원 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.4

Pulmonary embolism is a common and lethal, which accounts for substantial morbidity and mortality. Clinical manifestations of pulmonary embolism are nonspecific during general anesthesia. A 60 years old female received elective operation for left femur fracture under general anesthesia. At the end of operation, she suddenly became hypotensive and developed cyanosis. Immediate cardiopulmonary resuscitation(CPR) was performed without definitive diagnosis. Pulmonary embolism was suspected by clinical signs and echocardiography. So, patient was transferred to intensive care unit and with intensive care and aggressive treatment, patient's vital signs and ventilatory status were progressively improved. However, the endotracheal tube was accidentally extubated by the patient at the second postopetative day, and then cardiac arrest was developed and the patient expired. The primary goal of therapy for pulmonary embolization is to prevent reembolization. In the pulmonary thromboembolization, early diagnosis and intensive care improve outcome.

선택수술시 마취과에 자문을 구하였던 환자들의 분석

송희선,한영진,송정자,오경학 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.10

Many surgical procedures are delayed or cancelled due to inadequate preoperative assess- ment and preparation. To improve patient care and minimize operative delays and cancella- tions, preoperative evaluation and preparation of medically compromised patients is neces- sary. We analyzed 174 cases of written interdepartmental consultations submitted to our department from January 1991 to December 1992. Thus we expected more systemized and improved preoperative consultstion from reviewing the past consultations. The analysis were as follows: 1. The overall consultation rate was 1.38%. 2. Age distribution : 21.8% of total consulted cases were in the fifties and 39.7% were over 60 years old. 3. Sex distribution: Male : Female = 58%: 42%. 4. Departmental distribution of consultation : orthopedic surgery 41.4%, general surgery 16.7 %, neurosurgery 12.6%, urology 12.6%. 5. Interdepartmental consultation rate: orthopedic surgery 4.4%, urology 3.1%, neurosurgery 1.9%, cardiothoracic surgery 1.1%. 6. The primary reasons for consultation were related to the cardiovascular system (28.8% of cases), gastrointestinal system including hepatic disease(24%), respiratory system(23%) and the endocrine system(15%). Among the cardiovascular problems, 58% were associated with hypertension and 33% were associated with EKG abnormalities. The most frequently consulted problem was hepatic disease ineluding elevated transaminases(50 cases, 21.5%) followed by hypertension(39 cases, 16.7%), diabetes mellitus(26 cases, 11.2%) and EKG abnormalities(22 cases, 9.4%). 7. Results of consultation: 1) Frequency of consultation : 166 eases (95.4%) were once and the rest were twice. 2) Contents of problems : 129 cases(74.1%) had single problem, 35 cases(20.1%) had two problems, 8 cases(4.6%) had three problems. 3) Operation was done in 115 cases (66.1% of the consulted cases), delayed in 42 cases(24.1%) and cancelled in 17 cases(9.8%). Major causes of delay of elective surgery were elevated transaminases(26.4%) followed by hypertenaion(20.4%), diabetea. mellitua(15.1 %), others were tuberculosis and abnormal PFT. Major causes of cancellation were similar to that of delayed surgery, i.e., elevated transaminases(35.3%), decreased pulmonary function (14.8% ), liver cirrhosis (14.8%). Above results suggested thst the more systemized protocol may be needed to minimize the delay and cancellation of elective surgery.

제왕절개술을 위한 경막외 마취시 국소마취제 용량과 혈중농도의 비교

송희선,한영진,이준례,송정자 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.7

Epidural anesthesia for cesarean section requires sensory blockade up to T4 level. 18 to 20 ml of 0.5% bupivacaine, 1.5 to 2.0% lidocaine, or 3.0% chloropmcaine usually produces an adequate sensory blockade to T4 level. However, when we used that amount of local anesthetics, most of the patients often complained of mild to moderate pain or discomfort during delivery of baby, manipulation of peritoneum or the uterus. So we feeled the need of increase in dosage of local anesthetics and we used 26 ml of local anesthetics or local anesthetic-fentanyl mixture. This study was undertaken to measure plasma concentration of lidocaine and observe the possible systemic toxicity of local anesthetics with the total dosage of beyond maximum recom-mended dose. Epidural anesthesia were performed with a 17 gauge Tuohy needle and local anesthetics were injected as follows. Group 1 (n;17): 0.5% bupivacaine 100 mg+2% lidocaine 80 mg+fentanyl 100 ㎍ (50 ㎍/ml) Group 2 (n; 15): 2% lidocaine 520 mg without epinephrine Group 3 (n; ll): 2% lidocaine 480 mg + fentanyl 100 ㎍ All groups were received 26 ml of local anesthetics or local anesthetic-fentanyl mixture. We checked the level of anesthesia, length of spinal column, cardiovascular changes, plasma concen- tration of lidocaine, toxic systemic reactions and patient's complaints. The plasma concentration of lidocaine were measured by immunofluorescence assay at 2, 5, 7, 10, 12 and 15 minutes after injection of local anesthetics. The results were as follows; 1) The peak plasma concentration of lidocaine were measured 12 minutes after administration of local anesthetics in the group 2 and 3. 2) Sensory blockade up to T4 level could be accomplished within 10 minutes after epidural anesthesia in the group l. 3) In the group 2 and 3, onset of action was more rapid. These groups had a tendency to fall in blood pressure than the group 1, but recovered soon with small dose of ephedrine. 4) In one patient, maximum peak plasma concentration of hdocaine was 6.8 ug/ml, but no adversereaction was observed. Above results suggested that 26 ml of local anesthetics in all groups could be used for appropriate anesthesia for cesarean section with minimal camplications and patient's satisfaction.