반대편 눈확위신경 영역에 재발된 대상포진 1 예

손지선(Ji Seon Son),오광조(Kwang Jo Oh),이준례(Jun Rae Lee),최훈(Huhn Choe),한영진(Young Jin Han) 대한통증학회 2001 The Korean Journal of Pain Vol.14 No.2

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통증 조절을 위한 경막외 차단 후 발생한 경막외 농양

김대현 ( Dae Hyun Kim ),김동찬 ( Dong Chan Kim ),이준례 ( Jun Rae Lee ),한영진 ( Young Jin Han ),최훈 ( Huhn Choe ) 대한통증학회 2003 The Korean Journal of Pain Vol.16 No.2

악구강영역 생검예에 대한 임상통계학적 분석

조남표(Nam-Pyo Cho),진우정(Woo-Jeong Jin),이준례(Jun-Rae Lee),신효근(Hyo-Keun Sin),김오환(Oh-Whan Kim) 대한치과의사협회 1997 대한치과의사협회지 Vol.35 No.10

Propofol 마취유도 시 기관내 삽관에 따른 심혈관계 변동을 최소화하기 위한 Remifentanil의 효과처 농도는?

김성규 ( Seong Kyu Kim ),김덕규 ( Deok Kyu Kim ),손지선 ( Ji Seon Son ),고성훈 ( Seong Hoon Ko ),이준례 ( Jun Rae Lee ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.54 No.1

기관내 삽관시 Flexiblade 후두경과 Macintosh 형 후두경 사용에 대한 비교

장선영,이상귀,이준례 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

Comparison between the Flexiblade Laryngoscope and the Macintosh Blade Laryngoscope in Endortracheal Indubation Sun-Young Jand, M.D., Sang-Kyi Lee, M.D., and Jun-Rae Lee, M.D. Department of Anesthesiology, Chonbuk National University Medical School, Jeonju, Korea Background: The Flexiblade laryngoscope has a unique structure that is composed of a blade and a handle with a trigger. When the trigger of the Flexiblade laryngoscope is squeezed, the hyoepiglottic ligament is depressed, the epiglottis is moved anteriorly, and then the laryngoscopic grade is improved. This study was designed to compare the Flexiblade laryngoscope with the conventional Machintosh blade laryngoscope in the laryngoscopic view in endotracheal intubation. Methods: Following induction of general anesthesia, the laryngoscopic grades of 110 patients were evaluated while five different blade positions of the Flexiblade laryngoscope and a laryngoscopy with the Macintosh blade were performed. The laryngoscopic grades which were described by Cormack and Lehane were classified from 1 to 4. Results: With the Macintosh blade laryngoscope, 98.2% of the patients were grade one and two, and 98.2% of the patients was laryngoscopic grade one and two with partial depression of the trigger of the Flexiblade laryngoscope. The laryngoscopic grade of maximal depression of the Flexiblade trigger had similar results to partial depression of the trigger. However, the partial depression of the Flexiblade laryngoscope showed better laryngoscopic views than the maximal depression of the Flexiblade laryngoscope or the Macintosh blade laryngoscope, respectively. In the overall success rate of endo-tracheal intubation and using the adjusting maneuvers, the Flexiblade laryngoscope was superior to the Macintosh blade laryngoscope. Conclusions: The Flexiblade laryngoscope is comparable to the Macintosh blade laryngoscope for endotracheal intubation, therefore, the Flexiblade laryngoscope can be recommended as the first choice for endotracheal intubation. (Korean J Anesthesiol 2001; 41: 289~296)

구강외과 환자의 전신마취관리

이준례 全北大學校 齒醫學硏究所 1984 전북치대논문집 Vol.2 No.1

201 patients who underwent surgical operation at the Department of oral surgery, school of Dentistry, Chon-buk National University from January 1983 to December 1984 were analyzed statistically according to age, sex, disease, endotracheal intubation and anesthetic technique. The results were as follows ; 1. The most frequent age group was in the 3rd decade(29%), and sex distribution was male (78%) and female(22%). 2. Of the total 201 operations, open reduction of maxillofacial bone fracture was 131 cases, cheiloplasty and palatorrhaphy 27 cases, benign and malignant tumor surgery 10 cases, orthognathic surgery 6 cases, osteomyelitis 4 cases. Caldwell-Luc operation 19 cases and radical neck dissection 3 cases, bone graft 1 cases. 3. The nasotracheal intubation and orotracheal intubation were performed in 179 cases and 25 cases respectively. In 6 cases, tracheostomy was done because of the difficulty in endotracheal intubation. 4. For anesthesia of the patients the semiclosed circle system was practiced using mainly halothane-O_2-N_2O and pancuronium as muscle relaxant in adults. Jackson-Rees technique using halothane-O_2-N_2Owithout muscle relaxant was used in children.

후두마스크를 유도자로 이용한 기관내 삽관시 맹안적 삽입법과 굴곡성 후두경 이용법의 비교

이준례,임용순,이상귀 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.2

Background: The laryngeal mask airway (LMA) has an established role in difficult airway management as a ventilatory device and airway intubator. In is eas to view the laryngeal aperature with a fiberscope througha laryngeal mask airway, so it offers a route to obtainingrapid access to the larynix. The objective of this study was to evaluate a narrowing degree of LMA by the epiglottis and to compare the intubation time and success rate of the blind intubation technique with the fiberscope-guided intubation technique through the laryngeal mask airway. Methods: The LMA (#4) was placed into the hypopharynx after induction of anesthesia and muscle paralysis. The fiberscopic findings through the lumen of the LMA were recorded after the LMA placements. The degree of narrowing of the LMA by the epiglottis was estimated as 0%, 1-25%, 26-50%, 51-75%, or 76-100%. The breathing circuit of the anesthesia circle system was then disconnected from the LMA and a well-lubricated, cuffed, 5.5 mm ID endotracheal tube was inserted into the trachea through the lumen of the LMA either by the blind techniques or fiberscope-guided techniques, and then intubation time and success rate were measured. Results: The most frequent incidence (44/60, 73.3%) of narrowing by epiglottis in both groups was 76-100%. The success rate for fiberscope-guided intubation was 100%, while the success rate for blind intubation was 20%. The average intubation time of fiberscope-guided intubation was 26.0 s, while the average intubation time of blind intubation was 17.7 s. Conclusions: The fiberscope-guided tracheal intubation technique through the LMA is a more reliable method than the blind intubation technique through the LMA. (Korean J Anesthesiol 1999; 37: 210~215)

개구리 皮膚의 Na 輸送에 關與하는 Dopamine係

李俊禮,崔峰奎 全北大學校 齒醫學硏究所 1988 전북치대논문집 Vol.6 No.1

To ascertain the existence of dopaminergic receptors involved in active transport of sodium in the frog skin and to delineate the physiological role, the effects of dopamine (DA), apomorphine (Apo) and bromocryptine (BRC) on the potential difference (PD), short-circuit current (SCC) and total skin conductance (TSC) of the isolated frog skin, as well as the influences of dopaminergic and alpha-adrenergic blockers upon the effects of dopaminergic agonists were studied in Rana nigromaculata. PD and SCC were determined by utilizing the Ussing technique. Both sides of the isolated frog skin were perfused with Ringer solution for cold-blooded animal. All the drugs were applied to the serosal side of the skin. Results were summarized as follows : 1. The responses to DA(6.5×10^-6 - 2.0×10^-4M), Apo(3.74×10^-6 - 3.74×10^-4M), and BRC(1.53×10^-6 - 4.60×10^-5M) were characterized by elevation of PD and SCC roughly in a dose-related fashion, but the maximal effects attained by DA were greater than those of Apo and BRC. Both Apo and BRC induced graeater increases in PD than SCC, resulting in slight decrease of TSC, whereas no change in TSC was noted with DA. 2. These increments of PD and SCC were inhibited by dopaminergic blockers, such as haloperidol (8.0×10^-5M), metoclopramide (1.0×10^-4M) and sulpiride (8.8×10^-5M). 3. The stimulatory effects of dopamine on PD and SCC were significantly inhibited also by prazosin (2.6×10^-6M), a specific alpha-1 adrenoceptor blocker and were completely abolished by phenoxybenzamine (3.3×10^-6M), an irreversible alpha-adrenoceptor blocking agent. 4. Norepinephrine (6×10^-8 -6×10^-5M), produced increases in PD and SCC. However, these effects were inhibited by prazosin but not influenced by sulpiride pretreatment. These results suggest that the dopaminergic system may play a role in the control of sodium transport in the frog skin, and that alpha-adrenoceptors may also be involved in the dopamine-induced increase of sodium transport. However, based on evidence at hand, no conclusion could be drawn on the subtypes of dopamine receptors mediating in the stimulation of sodium transport in the frog skin.

전신마취후에 발생한 후두육아종 2례보고

이준례 全北大學校 齒醫學硏究所 1983 전북치대논문집 Vol.1 No.1

Intubation granuloma is one of the remote complications of endotracheal intubation. 2 cases of intubation granuloma are presented in this report. A 43-year-old male patient developed granulation on the medial aspect of the arytenoid 2 months after lobectomy under general anesthesia using Carlen's tube. This granulation was completely removed with laryngeal microsurgery(LMS). A 33-year-old female patient had hoarseness and mild degree of bronchial secretion 3 weeks after appendectomy under general anesthesia. A polyp-like mass was found on the left membrane of the vocal cord and completely removed with laryngeal microsurgery.

악교정 수술환자에서 Labetalol 을 이용한 유도 저혈압 마취가 출혈량 및 혈압에 미치는 영향

이준례 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.5

Background : The worst problem in anesthetic management of maxillofacial surgery is bleeding from bone cutting site. Induced hypotension reduces bleeding and minimizes the need for blood transfusion. This study was performed to evaluate the effects of induced hypotension with labetalol on blood loss and blood pressure in maxillofacial surgical patients. Methods : Twenty-four adult patients, either sex, ASA physical status I or II, undergoing orthognathic surgery were randomly selected and divided into two groups; one group was administered 20 mg of labetalol and the other group was not. Anesthetic maintenance was consisted of O2-N2O-enflurane(2∼2.5 vol%). Then 20 mg of labetalol was given intravenously at skin incision time in the labetalol group. Hemodynamic variables were recorded before induction of anesthesia, at the beginning of the labetalol infusion and at 10 min, 20 min, 30 min, 60 min and 90 min after the infusion. Blood loss determined by measuring the weight of the sponges and by measuring the volme of blood in suction-trap bottle. Results : There was no significant difference in preoperative hemoglobin and postoperative hemoglobin between two groups. The amount of blood loss in the labetalol group(408 202 ml) was less than those in the control group(450 255 ml), but statistically not significant. The blood pressure was significantly decreased in the labetalol group than those of the control group at 20 minutes after the labetalol infusion. Conclusions : Labetalol is a useful agent for inducing hypotension. But 20 mg of labetalol was insufficient to decrease the blood loss. So I think the more amount of labetalol required to reduce the blood loss. (Korean J Anesthesiol 1998; 34: 1009∼1013)