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불인성 미골통에 Caudal Epidural Steriod 이용 -증례보고-
안명자,서재현,김성년,Ahn, Myung-Ja,Suh, Jae-Hyun,Kim, Sung-Nyeun 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.1
Coccygodynia is a pain syndrome resulting from trauma, fractures, infection and tumor, and is usually amenable to conservative treatment. We present one case of coccygodynia that developed 2 days after percutaneous cordotomy done for pain control of cervix cancer unresponsive to conservative treatment which subsequently was treated with a caudal injection of lidocaine and triamcinolone. Caudal epidural steroid injection is less invasive and has less potential for complication than the neurosurgical interruption of the pain pathway.
불인성 미골통에 Caudal Epidural Steroid 이용
안명자(Myung Ja Ahn),서재현(Jae Hyun Suh),김성년(S 대한통증학회 1992 The Korean Journal of Pain Vol.5 No.1
Coccygodynia is a pain syndrome resulting from trauma, fractures, infection and tumor, and is usually amenable to conservative treatment. We present one case of coccygodynia that de- veloped 2 days after percutaneous cordotomy done for pain control of cervix cancer unrespon- sive to conservative treatment which subsequently was treated with a caudal injection of lido- caine and triamcinolone. Caudal epidural steroid injection is less invasive and has less potential for complication than the neurosurgical interruption of the pain pathway.
경막외 Droperidol 투여로 발생한 Neuroleptic Malignant Syndrome - 1예 보고 -
안명자(Myung Ja Ahn),서재현(Jae Hyun Suh),김성년(S 대한통증학회 1991 The Korean Journal of Pain Vol.4 No.1
N/A The neuroleptic malignant syndrome (NMS) is an uncommon but dangerous complication of treatment with neuroleptic drugs. This syndrome is characterized by autonomic dysfunction, extrapyramidal dysfunction, and hyperthermia. NMS seems more frequent with parentral neuroleptic use. We report a patient in whom suspicious NMS was developed in the ward after epidural administration of 2. 5mg of droperidol with morphine for postoperative pain control. Extrapyramidal symptoms and autonomic dysfunction were treated with diazepam, but tem- perature was spontaneously deereased after l6 hours and 40 minute after receiving epidural droperidol.
상경신경절 차단에 의한 흰쥐 뇌의 스트레스 유도성 c-fos 발현 저해
안명자,박종민,정현주,정동석,변형진 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.6
Background : Using c-fos expression one of the immediate early gene, as a marker of altered neuronal response, we investigated the effect of superior cervical ganglion block (SCGB) exhibiting the same effect of SGB of human on the activity of several brain regions which are considered as located on autonomic neural pathway and neuroendocrine axis in rat. Method : The 48 Sprague-Dawley strain rats were divided into 4 groups, as saline/stress (control) group, SCGB/stress (tested) group, saline group, SCGB group. Superior cervical ganglion block was conducted in the SCGB/stress group and SCGB group while saline/stress and saline group were sham operated. After then restraint stress was imposed on the animals of SCGB/stress group and saline/stress group. And 2 hour after injection (saline, SCGB group) or restraint stress (saline/stress, SCGB/stress group), c-fos protein (Fos) was localized by immunocytochemistry. Results : Much stronger Fos immunoreactivity was induced in the several brain region of control group rats compared to other three groups and the numbers of Fos positive cell count of tested group were significantly decreased in paraventricular hypothalamic nucleus (P<0.01), A5 (P<0.01), raphe pallidus (P<0.05), nucleus tractus solitaius (P<0.01) compared to control group. Conclusion : This study demonstrate that superior cervical ganglion block attenuates stress induced neuronal activities of paraventricular hypothalamic nucleus, A5, raphe pallidus, nucleus tractus solitarius. (Korean J Anesthesiol 1997; 33: 1029∼1036)
흰쥐에서 척수강내 투여한 Ketamine 이성체가 포르말린 자극 반응과 척수내 c-fos 발현에 미치는 영향
안명자,김현숙,정현주,정동석,민상훈,김종분,한영문 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.2
Background : This study was designed to investigate the different analgesic potency and the action mechanism of the intrathecal isomers of ketamine. For these purpose, we evaluated the effect of intrathecal ketamine isomers on the behavioral response and the spinal c-fos expression in the formalin tested rats. Method : The subjects were divided into 2 groups(NF group, Fgroup). The NF group was designed for the purpose of the drug itself's effect on the induction of c-fos. Saline(NF/saline group), S(+) ketamine(NF/SK group), R(-) ketamine(NF/RK group) and ketamine(NF/K group) were administered intrathecally to be examined by immunocytochemical method. Same drugs were administered in the F group(F/saline, F/SK, F/RK, F/K) and formalin was injected into right hind paw of the rats after 30 minutes of intrathecal drug administration. The number of flinching was counted at intervals of 5 minutes for 60 minutes. In NF and F group, Fos immunoreactive neurons was counted after 2 hours of formalin injection and intrathecal drug injection respectively. Results : In F/saline group, flinching was developed immediately after formalin injection and revealed biphasic response. The number of flinching in F/SK group, F/RK group, F/K group was significantly smaller than that of F/saline group. The number of flinching of F/SK group by comparison of F/SK vs F/RK was significantly smaller, and that of F/K group by comparison of F/RK vs F/K was significantly smaller. There was no significant difference among NF group on the total number of Fos immunoreactive neurons. In F group, Fos immunoreactive neurons increased significantly in comparison with NF group. The total number of Fos immunoreactive neurons in F/SK group, F/RK group and F/K group were significantly smaller than that of F/saline group. Of F group, the number of Fos immunoreactive neurons of F/SK was the smallest and F/K, F/RK followed increasing order. Attenuation of Fos induction by the ketamine isomers was observed in the whole spinal cord of F/SK group and F/K group but in the superficial and deep laminae of F/RK group. Conclusion : This study suggests that intrathecal ketamine isomers have an inhibitory effect on pathologic pain and c-fos expression in the rats and different analgesic effect which is lamina specific. (Korean J Anesthesiol 1998; 35: 269∼276)