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      • Calcium chloride 添加에 의하여 惹起되는 摘出腸管收縮에 미치는 포도당의 影響

        鄭興琯,金重暎 慶北大學校 醫科大學 1987 慶北醫大誌 Vol.28 No.3

        마우스의 적출십이지장을 사용하여 KRB영양액중의 CaCl_2를 제거한 상태에서 CaCl_2첨가에 의하여 회복되는 양상을 초기의 급격한 수축(phasic contraction, PC)과 이에 수반되는 완만한 수축(tonic contraction, TC)으로 구분하여 그 변화를 glucose를 제거한 상태, 2-DG 및 DNP가 존재한 상태, 개스공급을 중단한 상태에서 비교 관찰하여 다음과 같은 결과를 얻었다. Glucose가 없는 상태에서는 PC는 감소되지 아니하였으나, TC는 감소되는 경향을 보였다. 2-DG 및 DNP 존재하에서 PC 및 TC가 감소되는 경향을 보였으나, TC의 감소가 PC에 비하여 현저하다. 개스공급을 중단한 상태에서도 PC 및 TC가 감소되는 경향을 보였으나, TC의 감소가 PC에 비하여 더욱 현저하였다. 이상의 결과로 미루어 CaCl_2첨가에 의하여 야기되는 수축은 PC에 비하여 TC가 에너지를 필요로 하는 것 같다. In the using isolated duodenum from mouse, recovery patterns of contraction by CaCl_2 addition in calcium-free KRB solution were observed in glucose free; in the presence of 5.5mM 2-deoxy glucose(2-DG) and 0.1mM 2, 4-dinitrophenol(DNP); and in discontinuation of O_2:CO_2(95:5) mixed gas. The recovery patterns are biphasic response that consisted of an initial, rapid, transitory contraction-the phasic contraction, PC-followed by a slower more sustained contraction-the tonic contraction, TC. In the glucose-free medium, PC was not reduced, but TC is displayed reduced tendency. In the addition of 2-DG or DNP, both PC and TC are showed decreased tendency, and then the decrease of TC is more significant than that of PC. In the discontinuation of the mixed gas supply like 2-DG or DNP presence both PC and TC is displayed the tendency of reduction, that of TC is greater than that of PC. With these result, it is assumed that TC rather than PC induced by calcium addition in calcium-free is more markedly required energy.

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        악성 고열증 1 예

        김태우,정흥관,견일수 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.6

        Malignant hyperthermia is a genetically transmitted, catastrophic, hypermetabolic syndrome that is induced by potent volatile anesthetics and/or depolarizing muscle relaxants. It is now well established that the pathophysiology is related to a malfunction of the intracellular calcium homeostasis in skeletal muscle. Morbidity has been correlated to the duration of symptoms. Dantrolene decreased release of calcium from the sarcoplasmic reticulum. We recently encountered a fulminant case during halothane anesthesia. Anesthesia was induced with thiopental and succinylcholine without jaw tightness or stiffness. After induction, tachycardia, arrhythmias, increased end-tidal CO₂, and high body temperature were noted. Arterial blood gas analysis showed a severe, mixed acidosis. Intensive treatment with body cooling was immediately initiated. But dantolene could not be available. The patient died of renal failure and disseminated intravascular coagulation 41 hours after induction of anesthesia.

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        원발성 Aldosteronism 환자의 마취관리

        최경혜,정흥관,견일수 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.11

        Increased and inappropriate production of aldosterone from the adrenal gland is known as primary aldosteronism and leads to sodium retention with hypertension, suppression of plasma renin, and hypokalemia and its manifestations. It is due mainly to a solitary adenoma, bilateral hyperplasia, or rarely an adrenal carcinoms. Primary aldosteronism due to an adenoma is usually treated by surgical excision. Preoper-ative managements include the correction of hypokalemia, volume derangement, and metabolic alkalosis with spironolactone and the trestment of existing hypertension. The authors report a case of unilateral adrenalectomy and anesthetic considerations during perioperative periods.

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        성상 신경절 차단에 의한 Adult Onset Still`s Disease의 치료 경험

        서영배,천범수,정흥관,견일수,정재혁 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.1

        A 31-year-old woman was referred to our pain clinic department under the diagnosis of an adult onset Still's disease. She had been suffering from high fever, skin rash, multiple arthralgia, morning stiffness and lymph node enlargement for 16 months. She had taken conventional medication with steroid and NSAIDs, but the symptoms were a remittent nature. And also, she complained of systemic side effects of corticosteroids. Stellate ganglion block with 0.25% bupivacaine was performed 67 times for the treatment of adult onset Still's disease and then, her symptoms were improved eventually. We could discontinue steroid and NSAIDs, laboratory data were satisfactory. As we experienced an adult onset still's disease improved with stellate ganglion block, we report this case with a review of the literature. (Korean J Anesthesiol 1998; 35: 186∼189)

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        카데터의 위치에 따른 중심정맥압치의 평가

        전재규,정정길,정흥관 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.1

        Several methods for the management of intractable pain for various conditions including malignant disorders, herpes zoster, and low back pain and/or sciatica in 80 patients were described and analyzed. Neurolytic blodks of celiac plexus were given to the patienta suffering from intra-abdominal pain from malignant origin or chronic pancreatitis. Herpes zoster was treated mainly by chemical sympathectomy via paravertebral route and occassionaly corticosteroid was administered epidurally with the local anesthetic, bupivacaine. All the patients with low back pain and/or sciatica were given epidural corticosteroid one to three times. Other peripheral verve blocks and regional corticosteroid therapy were given to the rest of the patients. Fair to excellent result was obtained in 71% of the patients but the response was poor in the remaining 28% of the patients. It seems that the earlier the patients were referred to the pain clinic, the better the results were.

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