http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Cold Agglutinin Hemolytic Anemia 환자의 전신마취중 체온유지
허대석,이국현,곽미숙 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.5
Cold hemagglutinin disease is a form of immune hemolytic anemia caused by cold-reactive immunoglobulins. Cold agglutinins are autoantibodies, usually of the IgM type, that cause red blood cell agglutination at reduced temperatures. When the agglutinated antibody-covered red blood cells return to the central circulation, the classical complement pathway is activated. Complement components combine with the antibody-covered red blood cells, inducing membrane changes that result in intravascular hemolysis. Clinical manifestations of cold hemagglutinin disease, which occur only on cold exposure include acrocyanosis, purpura, Raynauds phenomenon, acral gangrene, immune complex nephritis, and hemolytic anemia. We experienced a case of 66-year-old woman with cold agglutinin disease, gastric cancer and gall bladder stone. Preoperative plasmapheresis and intraoperative forced air convective warming to minimize red blood cell agglutination and hemolysis were performed. The operating room was prewarmed to 31∼32℃. The paient had her lower body and the upper extremities covered with warming blankets. Inspired gases were humidified at 37℃ and intravenous fluids were warmed with a blood warmer. Peripheral body temperature was maintained above 36.5℃ throughout the procedure. Subtotal gastrectomy and cholecystectomy were done successfully without complication. It can be concluded that the maintenance of central and peripheral body temperature above the thermal aetivity of the cold agglutinin is required during the perioperative period.
허대석,Heo, Dae-Seok 한국가톨릭의료협회 2005 Health & mission Vol.3 No.-
매년 11만 명의 새로운 암환자가 발생하고, 이중 6만여 명이 암으로 사망을 하고 있음에도 정부나 사회, 심지어 의료인조차도 호스피스는 종교단체가 행하는 자선운동의 한 형태 정도로 바라보고 있는 것 같다.
허대석 대한의사협회 2009 대한의사협회지 Vol.52 No.9
There has been a controversy in Korea regarding a ‘death with dignity’ in comparison to a ‘natural death’. However, the issue of patient autonomy is often overlooked. Decision on withholding or withdrawing life-sustaining treatment should be based on the patients’ selfdetermination, prefereably in the form of advance directives. Consensus developed by the National Evidence -based Healthcare Collaborating Agency is as follows: ① a doctor should offer a detailed explanation to patients, including about hospice-palliative care and advance directives, ② when a terminally ill patient expresses reluctance regarding cardiopulmonary resuscitation or an artificial respirator in advance, such medical actions can be removed, with basic nutrition supply and pain control maintained. However, more discussions should be made in the case of a patient in “persistent vegetative state”.
Adjuvant Chemotherapy in Stomach Cancer
허대석 가톨릭중앙의료원 가톨릭암센터 1997 암심포지움 Vol.- No.2
현재까지 수행된 항암화학요법의 결과는 진행위암환자에서 보조항암화학요법의 실시가 환자의 경과에 도움을 주었다는 객관적인 증거가 없다. 따라서, 위암환자에 대한 보조항암화학요법의 적용은 통상진료의 범위에서 시행되는 것은 정당화되기 어려우며, 엄격한 기준에 근거한 임상시험의 일환으로 이루어지는 것이 추천된다.