요추 2번 선택적 신경근 차단 후 발생한 고환 통증과 쳐짐

조용현 ( Yong Hyun Cho ),신광일 ( Kwang Ii Shin ),신옥영 ( Ok Young Shin ),김선희 ( Sun Hee Kim ),장원 ( Won Jang ),이현석 ( Hyun Seok Lee ),고현철 ( Hyun Chul Go ),고우형 ( Woo Hyung Go ),권재현 ( Jae Hyun Kwon ) 경희대학교 경희의료원 2021 慶熙醫學 Vol.36 No.1

The L2 spinal nerve root block is an effective procedure for pain reduction in patients with discogenic low back pain, but relatively few cases have been published that address complication of testicular pain and ptosis associated with this intervention. We experienced a patient testicular pain and ptosis after L2 spinal nerve root block, and the patient was recovered after 2 weeks without any serious side effect In this report, the ways on how to deal with testicular pain and ptosis are discussed including brief review of the relevant literature.

중증근무력증-마취 2례보고

신광일,김광우,곽일용,정춘근 대한마취과학회 1970 Korean Journal of Anesthesiology Vol.3 No.1

Anesthetic experience with thymectomies for two patients with myasthenia gravis has been reported. Both of them talerated the surgical procedures under endotracheal nitrous oxide-oxygen-halothane anesthesia well, but one of tbem expired from cholinergic crisis on the 3rd postoperative day. Chemical diagnosis of myasthenia gravis and the salient clinical features including choice of preanesthetic medication, anesthetic agents, techniques and of neuromuscular blocking agents for myasthenic patients have been discussed. Paramount importance of rigid attention to ventilation, the maintenance of a patent airway and the removal of secretions by bronchoscopy or tracheostomy whenever necessary for the patient safety throughout operative and postoperative period has been stressed. Frequent determinations of pulmonary function and the use of edrophonium test in avoiding cholinergic crisis are advocated.

N2O-O2 Halothane 마취중 Reserpine 투여견에서 각종 Sympatomimetic Amines 의 혈압상승효과에 관한 실험적 연구

신광일,김광우,김용락,곽일용,최수홍 대한마취과학회 1972 Korean Journal of Anesthesiology Vol.5 No.2

Vasopressor effects of epinephrine, norepinephrine, ephedrine, phenylephrine, methoxamine and of mephentermine were compared in resrpinized dogs with or without nitrous oxide-oxygen-halothane anesthesia. The results are as follows: (1) Epinephrine and norepinephrine were shown to have the most potent pressor effect in reserpinized and nitrous oxide-oxygen-halothane-anesthetized dogs. Phenylephrine, methoxamine, mephen-termine and ephedrine were less potent in decreasing order. (2) Decrease in mean arterial pressure was less marked in dogs reserpinized and anesthetized with nitrous oxide-oxygen-halothane than in reserpinized but unanesthetized dogs. (3) It revealed that nitrous oxide-oxygen-halothane anesthesia potentiated the vasopressor effects of the sympathomimetic amines studied. Nitrous oxide-oxygen-halothane anesthesia is implicated to exert an sympathomimetic effect.

저장혈액수혈시 용혈에 관한 임상적 연구

신광일,김광우,김용락,곽일용 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

During massive transfusions especially under pressure, considerable hemolysis has been expected. It had been assumed that hernolysis would increae with increasing age of the bank blood, increasing pressure and ivith decreasing bore of the reedle. Moss and Stauntan, however, found that hemolysis actually increased when blood was forced through larger bore needles. The authors have studiecl the magnitude of hemolysis according to various needle sizes under ordinary clinical transfusion conditions, and concluded as follows: 1) Hemolysis was maximum when a 18G needle was used and minimum with use of a 22G. needle regardless of the age and temperature of the bank blood, 2) Hemolysis increased with incrcasing age of the bank blood. 3) When the needle size was ccnstant, hemolysis was not affected by warmining of the bank blood.

Hdroxyethyl Starch(HES)가 혈액응고에 미치는 영향

신광일,김광우,김용락,곽일용,최수홍,장호단 대한마취과학회 1973 Korean Journal of Anesthesiology Vol.6 No.1

To determine the effects of hydrcxyethyl starch upon liver, kidney, serm electrolytes and particularly upon blood coagulation, 500 ml of 6% HES in saline solution was administered intravenously to 15 patients during elective minor surgery. In all cases weighted blood loss was less than 600 ml without replacement. The following laboratory tests were performed immediately before infusion and again 1 hour, 24 hours, 48 hours, and 1 week after the infusion: RBC, WBC, hemoglobin, hematocrit, ESR, platelet, bleeding time, coagulation time, prothrombin time, total protein, albumin, total bilirubin, direct bilirubin, SGOT, SGPT, alkaline phosphatase, BUN, sodium, potassium, and chloride. The results are as follows: 1) No anaphylactic shock or bleeding tendency characteristic of colloids was encountered. 2) No functional disturbance of liver or kidney directly attributable to HES was identified. 3) All laboratory parameters except WBC and ESR decreased after infusion. The decrease was, however, within the normal range and believed secondary to dilational effect of infusion. WBC increased somewhat, but returned to the preinfusion level in a week. 4) Exceptionally erythrocyte sedimentation rate increased notably during the 24 hour period following infusion. As with dextran, this was interpreted not due to direct effect of HES, but due to increased adsorption of fibrinogen, α-β-γ-glcbulin to red cell surface with changes in electric charge between red cells. 5) Clinical applicability, metabolic aspect, degree of subtitution of hydroxyethyl group and safety with multiple infusion of HES must be carefully determined.

아데노신의 동방결절 박동수 감소작용에 대한 Aminophylline 의 영향

강화자,신광일 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.1

Since the first report by Drury and Szent-Gyorgyi in 1929, the inhibitory influences of adenosine on the heart have repeatedly been described by many investigators. A lot of investigations on the working mechanisms of adenosine have been focused mainly on the effects on the coronary blood flow. However, the cellular mechanisms underlyiag the inhibitory action of adenosine on the SA node are not well understood yet. Furthe-rmore, the physiological role of adenosine in the regulation of the heart beat remains still to be explored. Thus, this study was undertaken to examine the behavior of the rabbit SA node ander the influence of adenosine, and the interactions between adenosine and aminophylline on the SA node, and then to compare these results with those of acetylcholine. At the same dosage range, adenosine suppressed the sinus rate and atrial contractility even in the reserpinized preparation. The spontaneous firing rate of the SA node at 35℃ (mean±SEM, n=16) was 154±3.3 beats/min. The parameters of actiootential were: maximum diastolic potential(MDP), -73±1,7 mV; overshoot(OS), 9±1.4 mV; slope of pacemaker potential(SPP), 94±3.0 mV/sec. Adenosine suppressed the firing rate of the SA node in a dose-dependent manner. This inhibitory effect appeared at the concentration of 10^(-⁴)M and was potentiated in parallel with the increase in adenosine concentration. Changes in the action potential by adenosine were dose-dependent as show by the increase of MDP and the decrease of SPP until 10^(-⁴)M. Above this concentration, however, the amplitude of the action potential decreased markedly due to the simultaneous decrease of both MDP and OS. Dipyridamole, which is known to block the adenosine transport aross the cell membrane, definately potentiated the action of adenosine. The effects of adenosine on the SA node were inhibited by aminophylline. However, the similar effects of acetylcholine to those of adenosine were not reversed by aminophylline. These results suggest that adenosine suppressed the pacemaker activity ng dire-ctly on the membrane of the SA node, and the effects of adenosine on SA node are sele-ctively inhibited by aminophylline.

선천성완전흉부심 탈출증 마취 1례보고

염광원,신광일,김광우,곽일용 대한마취과학회 1971 Korean Journal of Anesthesiology Vol.4 No.1

A six-hour-old female infant with a complete, thoracic ectopic heart underwent left antero-lateraE thoracotomy, division of left superior vena cava, left lower lobectomy, and reduction of heart into the lobectomied space under endotracheal fluothane-oxygen anesthesia employing infant circle absorber. Despite all supporting measures available, her condition progressively deteriorated with increasing severity in bradycardia and cyanosis resulting in cardiac arrest three hours after the completion of surgery. Anesthetic management and cause of death have beee discussed together with the case report.

쇽 상태에서 Naloxone-HCI 에 의한 혈역학적 변화와 혈장 Beta-Endorphin 변화에 관한 실험적 연구

이두익,신광일 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.4

It is known that the cardiovascular system is extremely sensitive to the effect of both exogenous and endogenous opiates. In rabbits, less than 1% of the usual morphine dose necessary to produce antinociception results in significant hypotension and bradycardiz. The endogenous oplate, B-endorphin, is stored along with pituitary adrenocorticotrophin (ACTH), and the action of stressors seems to result in the release of both peptides. Therefore it seems likely that B-endorphin is released during stress such as shock and that it might contribute to the hypotension. In order to prove this hypothesis, hypovolemic and endotoxin shock model were produced in rabbits. If these hemorrhage and endotoxin induced hypotension were mediated through the B-endorphin release, the blockade of B0endorphin should reverse such hypotension. Using the sepcific opiate antagonist, Naloxone-HCI, these hypotensions could be reversed and prevented as following results show, 1) As compared with the saline control, the hypovolemic shock experiment had a 36.49±14.44% increase in mean arterial pressure(MAP) within 2 to 3 minutes and the endotoxin shock had a 52.43±23.66% increase in MAP within 5 to 6 minutes after naloxone treatment (0.4 mg/kg). 2) As compared with the saline control, in both hypovolemic and endotoxin shock naloxone pretreatment (0.4 mg/kg) could prevent the decrease of MAP significantly. 3) No significant difference were seem in heart rate between the control and both experimental groups. And plasma B-endorphia was measured by radioimmunoassay (RIA), using B-Endorphin kit (Immunonucler Corportion, Stillwater, Minnesota, USA) and Beckman 8,000 r-Counter, in these shock model with following results. 1) Hemorrhage and endotoxin induced shock produced a significant increase in plasma B-endorphin to about 3 times control and reversed by naloxone treatment (0.4 mg/kg) significantly as compared with saline control. 2) As compared with the saline control, in both hypovolemic and endotoxin experiments naloxone pretreatment (0.4 mg/kg) could prevent the increase of plasma B-endorphin significantly.

Thiopental 이 성숙가토의 GOTI 에 미치는 영향

조용호,신광일,신옥영 대한마취과학회 1983 Korean Journal of Anesthesiology Vol.16 No.4

In order to determine the engyme activity, as eBpresaed in Reitman-Frankel unit, of GOT isogyme present in whole homogenate, mitochondrial fraction and supernatant fraction wereprepared from brain tissues of normal adult rabbit, br a differential centrifugal method. The effect of thiopental on the GOT isogyme activity in each fraction was determined and thefollowing results were obtained. 1) The activity of GOT isogrme in whole homogenate of normal rabbit train tissues wasfound to be 545±2.068 units/mg of wet weight whereas the corresponding figure for thesupernatant GOT isosyme was 512±3. 081 and the value for the mitochondrial GOT isogymewas found to be 34.9±1.224. 2) The supernatant GOT isozyme existing in a floating states within the cytoplasm accou-nted for 94 percent followed br 6.35 percent of mitochondrial GOT isogyme. 3) The activated-peak of mitochondrial GOT isozyme contained in the whole homogenateof adult rabbit hrain tissues was found to be at # 15 on the tube of elution in comparison tothat of # 73 for supernatant GOT isoByme, as analyged by the DEAE·Cellulose colomn chro-matography. 4) The supernant GOT isozyme from the thiopentaltreated brain was proportionalr distortedwhile mitochondrial GOT isozyme was not influenced.For example, treated with thiopental, the supernatant GOT isozyme was divided to he # 63& fl 73 on the tube in comparison to # 15 for the mitochondrial GOT isogyme. 5) The activity of supernatant isogyme was proportionaly reduced as the concentration ofthiopental. 6) Fifty percent inhibition aose(1,o) of thiopental on the supernatant GOT isofyme wasfound to be 0.63 mM. 7) The inhibitory effect of thiopental on the supernatant eOf isozyme was very high sig-nificantly 8) The mechanism by which thiopental inhibits the supernatant GOT isozyme in the adult rabbit brain was found to bh uncompetitive inhibition as its Michaelis-Menten constant oKm = 58.07 mM demonstrated. In view of the above findings it ie suggested that the thiopental inhibited selectively thactivity of supernatant GOT isozyme of the adult rabbit brain tissues while it did not inhibithat of mitochondrial GOT isozyme. The GOT isozyme of adult rabbit brain tissues wadivided into thiopental-sensitive GOT isozyme(supernatant GOT isozyue) and thiopent:insensitive GOT isozyme (mitochondrial GOT isozyme) Furthermore, it is suggested that thcellular function of the brain can be somewhat hindered, when thiopental is injected intthe brain cell, while mitosis of the brain cell is not influenced.

Thalamonal-Pentothal-N2O-O2 마취법의 임상적 응용

문현수,황규현,신광일,김용락 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

The authors have introduced a method of Thalamonai dripping with concomitant use of small doses of Pentothal for rapid and smooth loss of consciousness and induction of anesthesia, and maintaining anesthesia with intermittent injectionq of Thalamonal and Pavulon as well as N2O inhnlation. From 21 cases, the following results were obtained: 1) Average dose of fentanyl as a premedicant was l. 143ug/kg (Thalamonal, 0. 023cc/kg). 2) Average dose of fentanyl during induction of anesthesia ivas 3. 48ug/kg (ThaJamonal, 0, 695 cc/10kg), and concomitant injection of Pentothal (average, l. 83mg/kg) achieved rapid and smooth induction of anesthesia. During induction, changes of blood pressure and pulse rate were insignificant. 3) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at every 30 minute interval, and average dose of fentanyl was 0.64ug/kg/30min. 4) Seventeen cases among 21 recovered promptly after discontinuation of N2O, and the recovery was delayed in the,remainder. Two patiencs had awareness without pain during operation, Delayed recovery of consciousness seemed related to overdosage of the droperidol component in Thalamonal, but not to total operating time.