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정현주,홍성진,정동석,채인 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.6
We experienced a case of retrobular hemorrhage during cardiopulmonary bypass. Following factors are suspected as the cause retrobulbar hemorrhage in this patient; l ) Rupture of preexisting AV malformation or aneurysm. 2) Accidental high flow to innominate artery by Coanda effect or miscannulation, 3) Obstruction of right jugular venous drainage and therefore cerebrofacial flow is increased, 4) Increase bleeding tendency during cardiopulmonary bypass. Fortunetely, patient has no neurologic complication and well recovered from retrobulbar hemorrhage.
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Midazolam 전처치가 마취유도시 혈역학적 변화 및 혈중 Cathecolamine 에 미치는 영향
최정환,전진영,이승균,채인,강유진,송호경 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.3
The present study atternpted. to expiore the new benzodiazepine, midazolam, which is water-soluble, shorter-acting, more potent, and less irritating to inject than diazepam, and which has been used as premedication before induction of anesthesia in various elective surgeries. Forty patients (aged 20 to 50 and in ASA class I or II ) about to undergo simple elective surgery under general anesthesia entered the study. The patients were divided into the study group (n=20) that recieved 0.07 mg/Kg i.m midazolan premedication and the control group (n= 20) that recieved normal saline as sham premedication. The changes in the values of various hemodynamic parameters, i.e., heart rate and systolic, diastolic, mean arterial pressures, were monitored first before tracheal intubation, then at the time of intubation and 5, 10 and 30 minutes after intubation. The concentrations of plasma catecholamines i.e., epinephrine and norepinephrine, were measured before intubation and 5, 30 minutes after intubation. Systolic pressure and plasma epinephrine concentration before induction was significantly low in the study compared with the controls. At the time of intubation, sytolic, diastolic & mean arterial pressures were significantly low in the study group compared with the controls. Heart rates measured at 10 and 30 minutes postintubation were significantly low at 30 minutes postintubation in the study group compared with the controls as was plasma epinephrine levels at each instance of its measurement. In conclusion, midazolam-premedicated patients appear to maintain stable hemodynamies and plasma catecholamine levels. Our findings support that midazolam premedication effectively reduces stress response during induction period making it suitable induction for elective surgery.
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Bleomycin 을 투여한 흰쥐에서 고농도 산소 폭로가 폐에 미치는 효과
최용우,문세호,이해진,성춘호,정운혁,채인 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.2
The bleomycin is a chemotherapeutic agent useful in the treatment of selected neoplasms, including non-seminomatous testicular carcinoma. An increased incidence of respiratory failure postoperatively in patients previously treated with bleomycin has been reported. And an increase in the toxicity of high concentration of oxygen in oxygen therapy has been demonstrated in rodents after administration of bleomycin. However, the use of an enriched inspired oxygen concentration 41% was reported not hazardous in a testicular cancer population who were exposed to significant doses of bleomycin. The pulmonary toxicity of bleomycin therapy in combination with high oxygen exposure is still controversial. The aim of this study is to analyze the effect of exposure to 50% oxygen in the mice pretreated with bleomycin. Bleomycin were administered intraperitoneally to the mice, 4 mg/ kg twice a week for 5 weeks. After administeration of bleomycin to the mice, the half of the miee, the experimental group, were exposed to 50% oxygen for 24 hours. And the other control group were exposed to room air. Morphometric analysis with light microscopy was performed to the following parameters; number of total pulmonary cell count, percentage of consolidation of lung parenchyma and degree of intensity of fibrosis of lung parenchyma. The area of diseased lung was increased in mice given with bleomycin and hyperoxia compared with that of those treated with bleomycin only. The results were as follows; l) In the control group given 4 mg/kg bleomycin and room air, the number of total pulmonary cell count were 36.21±6.53/10^(-8)㎡ and the percentage of consolidation was 1.2±0.4%. 2) In the experimental group given with 4 mg/kg bleomycin and 50% oxygen for 24 hrs, the number of total pulmonary cell count were 59.67±9.13/10^(-8)㎡ and the percentage of area of consolidation of lung parenchyma was 5.8±2.3%, 3) Fibrosis of the lung parenchyma was seen only in the experimental group to which oxygen was given after administration of bleomycin. In conclusion, this study demonstrated that hyperoxia potentiated the pulmonary damage by bleomycin in the mice.
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