제왕절개술 마취중 Vecuronium(Norcuron)투여후에 발생한 서맥

정춘근 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.1

마그네슘 투여에 의한 제왕절개술산모의 기관삽관에 따른 심혈관계 자극억제 효과

정춘근,배진성 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.6

Background; Tracheal intubation for cesarean section is usually performed with rapid sequence induction. Under this light stage of anesthesia, marked hypertensive changes of maternal hemodynamic responses following tracheal intubation may occur, which are the common cause of maternal and neonatal complications. We have studied the matemal cardiovascular blunting effect of magnesium sulfate following tracheal intubation in cesarean section. Methods; After obtaining the written informed consents, ninety ASA class I parturients scheduled for cesarean section were randomly allocated to one of three groups: group 1 received thiopental 4 mg/kg and succinylcholine 1.5 mg/kg, group 2 received fentanyl 1.5 ㎍/kg additionally, and group 3 received fentanyl 1.5 ㎍/kg and MgSO₄ 40 mg/kg additionally. Systolic, mean, diastolic blood pressure, and heart rate were measured before induction, immediately after intubation. Serum magnesium concentrations were measured before administering magnesium and near the end of surgery. Train of four ratio was monitored during whole period of anesthesia. Neonatal Apgar scores and neurologic and adaptive capacity scores (NACS) were checked. Results; Blood pressure changes were more stable in group 2 and group 3, especially group 3, than group 1 (p$lt;0.05). No statistical differences were found in heart rat;. changes in all groups. No significant differences were noted in neuromuscular recoveries, neonatal Apgar scores and NACS. Conclusions; Magnesium sulfate may be successfully used for blunting the cardiovascular response to tracheal intubation in parturients undergoing general anesthesia for cesarean section.

심폐소생술

鄭春根 대한의학협회 1993 대한의학협회지 Vol.36 No.6

Immunohistochemical Study on the Hair Growth Promoting Effect of Yonnyuniksoogobon-dan

정춘근,박민희,성주원,박성규,김선예,김윤범,정혁상,손낙원,손영주,이현삼 대한한의학회 2008 대한한의학회지 Vol.29 No.5

Objectives:This study evaluates the hair growth promoting effect of Yonnyuniksoogobon-dan on shaved C57BL6 mice. Methods:Yonnyuniksoogobon-dan was administered orally (Group I) and both orally and by skin application (Group II) once a day for 12 days. The experimental groups were compared to Control, which was orally administered physiological saline solution. Hair regrowth was photographically and histologically determined during the experim- ental period. The levels of hair growth cycle related factors (EGF, TGF-β1) and vascular factors (VEGF, iNOS) were also determined by immunohistochemistry. On gross observation of hair growth, both Group I and Group II shaved C57BL6 mice showed accelerated hair regrowth. Results:The hair regrowth index of Group I increased significantly from 7 days (P<0.05) to 12 days (P<0.01) after shaving and that of Group II was significantly higher at 12 days (P<0.05). On histological observation, both Group I and Group II demonstrated histological improvement and increases in the number and diameter of the hair follicles. EGF expression on the root sheath of hair follicles was up-regulated in both Group I and II. TGF-β1 expression on the root sheath of hair follicles was unchanged in both Group I and II. VEGF expression in the tissues surrounding hair follicles was up-regulated in both groups. iNOS expression in the tissues surrounding hair follicles was down-regulated in both groups. Conclusions:These results suggest that Yonnyuniksoogobon-dan promotes hair growth and this effect is related to up-regulation of EGF and VEFG expression and down-regulation of TGF-β1 and iNOS expression on hair roots. Objectives:This study evaluates the hair growth promoting effect of Yonnyuniksoogobon-dan on shaved C57BL6 mice. Methods:Yonnyuniksoogobon-dan was administered orally (Group I) and both orally and by skin application (Group II) once a day for 12 days. The experimental groups were compared to Control, which was orally administered physiological saline solution. Hair regrowth was photographically and histologically determined during the experim- ental period. The levels of hair growth cycle related factors (EGF, TGF-β1) and vascular factors (VEGF, iNOS) were also determined by immunohistochemistry. On gross observation of hair growth, both Group I and Group II shaved C57BL6 mice showed accelerated hair regrowth. Results:The hair regrowth index of Group I increased significantly from 7 days (P<0.05) to 12 days (P<0.01) after shaving and that of Group II was significantly higher at 12 days (P<0.05). On histological observation, both Group I and Group II demonstrated histological improvement and increases in the number and diameter of the hair follicles. EGF expression on the root sheath of hair follicles was up-regulated in both Group I and II. TGF-β1 expression on the root sheath of hair follicles was unchanged in both Group I and II. VEGF expression in the tissues surrounding hair follicles was up-regulated in both groups. iNOS expression in the tissues surrounding hair follicles was down-regulated in both groups. Conclusions:These results suggest that Yonnyuniksoogobon-dan promotes hair growth and this effect is related to up-regulation of EGF and VEFG expression and down-regulation of TGF-β1 and iNOS expression on hair roots.

소량의 Fentanyl 투여에 의한 기관내 삽관시의 심혈관자극 억제효과

정춘근 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.1

The hemodynamic response evoked by tracheal intubation was observed in 20 adult normotensive patients undergoing elective surgery. Patients were randomly assigned to receive either thiopental 6 mg/kg(n=10) or fentanyl 6㎍/kg with thiopental 3 mg/kg (n=10), for induction of anesthesia. Systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP) and heart rate(HR) were measured at 1 min., 3 min. and 5 min. after intubation. In the thiopental group, intubation caused a significant rise in SBP, DBP, MAP, HR(p<0.05) but each parameter returned to normal within 5 min. In the fentanylthiopental group intubation caued little cardiovascular change, byt within 5 minutes MAP decreased significantly from 101 mmHg to 83 mmHg (p<0.05). It is concluded that a low-dose of fentanyl which may cause minimal postoperative respiratory depression, significantly prevents postintubation hypertension when used as an adjunct to thiopental for the induction of anesthesia.

급성 B형 바이러스성 간염환자의 Isoflurane 마취후 간기능 장애의 회복

정춘근,최강,한용성 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.2

Elective operation should be postponed in patient with acute hepatitis because of the increased risk of morbidity and mortality. Especially, surgery carried out in the presence of acute viral hepatitis is associated with high incidence of major complications The authors have recently experienced a patient who was performed emergency craniotomy for epidural hematoma. At that time, the patient was in midst of acute viral hepatitis B. Major in-halational anesthetic was isoflurane and muscle relaxant was atracurium. Fortunately, the preoperative hepatic dysfunction was not exacerbated and recovered uneventfully. The choice of anesthetics and the proper pre-and intraoperative anesthetic managements are reviewed.

심폐소생술의 최신 지견

정춘근 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.5

Ritodrine(Yutopar)투여 산모의 제왕절개술중에 발생한 급성패부종

정춘근 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.6

Two selective β_2-sympathonimetic drugs are presently used to arrest preterm labor ritodrine (Yutopar) and terbutaline. As the use of rltodrine becomes more widespread an increasing number of cases of pulmonary edema is 7eing observed Besides pulmonary edema many other complications such as myocardial ischemia, cardiac arrhythmias, hypotension, hypertension, cerebral vasospaun, hyperglycemia and miscellaneous metabolic alterations have been recongnized. We recently experienced a previously healthy parturient who suddenly develeped severe pulmonary edema during a cesarian section under epidural anesthesia. She had been treated wish ritodrine for 4 days in an attempt to arrest preterm labor which ultimately failed. Close, aggresaive patient care, mechanical ventilatory support with PEEP and diuretics could dramatically relieve poteotiatty fatal pulmonary edema within 24 hours. The anesthetist should be aware of the potential, life·threatening complications. It is necessry for the aneathetist to know how to screen, monitor and treat a patient with compllcatitions associated with tocolytic agents.

중추성 현훈 환자의 뇌자기공명영상 소견

정춘근,김상준,김유미,차민정,이영석,김재일,이근호,이정구,박현민 대한영상의학회 1998 대한영상의학회지 Vol.39 No.5

Purpose: To investigate brain lesions and their locations in patients with central vertigo, as seen on MR imaging. Materials and Methods: We retrospectively reviewed MR images of 85 patients with central type vertigo diagnosed on the basis of clinical symptoms and vestibular function test (VFT), and analyzed lesions and their locations. Those located along the known central vestibular pathway were included in our study. Results: In 29 of85 patients (34%), lesions considered to be associated with central vertigo were detected on MR imaging. These included infarction (18 patients), hemorrhage (5), tumor (2), cavernous angioma(1), cerebellopontine angle cyst(1), tuberous sclerosis(1) and olivopontocerebellar atrophy(1) ; they were located in the parietal lobe(6patients), the lateral medulla(5), the pons(5), the middle cerebellar peduncle(4), the corona radiata(3), and the cerebellar vermis(3). Thirty-eight cases showed high signal intensity lesions in deep cerebral matter, the basal ganglia, and pons but these were considered to be unrelated to central vertigo. Conclusions : MR imaging could be a useful tool for the evaluation of patients with central vertigo.

기관내 삽관시 Nicardipine 정주에 의한 심혈관계 자극 억제효과

정춘근,임정만,강기철 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.2

Background : Direct laryngoscopy and tracheal intubation frequently induce transient hypertension, tachycardia and arrhythmia. This study was to evaluate the effect of nicardipine on the changes of the blood pressure and heart rate induced by direct laryngoscopy and tracheal intubation. Methods : Sixty patients were randomly divided into three groups: Group 1 (nicardipine 0.02 mg/kg, n=20), Group 2 (diltiazem 0.2 mg/kg, n=20), Group 3 (normal saline 3 cc, n=20). Two minutes after intravenous injection of 2 mcg/kg of fentanyl, thiopental 5 mg/kg and nicardipine or diltiazem or normal slaine was administered intravenously. Then succinylcholine 1.5 mg/kg was administered. One minute after succinylcholine injection, direct laryngoscopy and tracheal intubation was done and vecuronium 0.1 mg/kg was injected. Anesthesia was maintained with 50% nitrous oxide in oxygen and 2 vol % of enflurane. Blood pressure and heart rate were measured at the period of preintubation, immediately after intubation, 1, 3 and 5 minutes following intubation by noninvasive method. Results : After tracheal intubation, the increase of systolic blood pressure was supressed significantly in nicardipine and diltiazem group compared with control group (nicardipine group 11%, diltiazem group 13%, control group 24%). The increase of heart rate was greatest in nicardipine group (nicardipine group 38% diltiazem group 29%, control group 20%). Conclusions : Nicardipine was effective in attenuating pressor responses to laryngoscopy and intubation, but in nicardipine group, increase of heart rate was greater than control group. (Korean J Anesthesiol 1998; 34: 303∼307)