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증례보고 : 자궁경 자궁근종 절제술 중 발생한 희석성 저나트륨혈증
박종택 ( Jong Taek Park ),최재찬 ( Jae Chan Choi ),이지연 ( Ji Yeon Lee ),엄대자 ( Dea Ja Um ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.4
Hysteroscopy is a procedure that may appear minimally invasive, but may result in potentially disastrous complications. A hysteroscopy requires the insertion of a hysteroscope into the uterine cavity and the installation of a suitable distention medium for the visualization of the endometrium. Fluid overload due to the absorption of distention media during hysteroscopy can cause mild to severe complications, including hyponatremia, hypoosmolarity, nausea, vomiting, headache, arrhythmia, blindness, confusion, seizure, cerebral edema, brain herniation, and death. We report a case of a 41 year-old female patient who underwent elective hysteroscopic myomectomy under general anesthesia. Approximately 4 hours after the beginning of the surgery, the patient`s serum sodium concentration dropped to 109 mM. She was treated with furosemide and recovered without sequelae. (Korean J Anesthesiol 2009;57:535∼9)
증례보고 : Sevoflurane 마취 후 발생한 급성 간 기능 장애
박종택 ( Jong Taek Park ),이영복 ( Young Bok Lee ),김종수 ( Jong Soo Kim ),류훈 ( Hoon Ryu ),임현교 ( Hyun Kyo Lim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.2
Halothane, isoflurane and desflurane are metabolized to hepatotoxic trifluoroacetyl proteins. But sevoflurane is metabolized to hexafluoroisopropanol. Hexafluoroisopropanol has a low binding affinity for liver protein and is therefore rapidly converted to glucuronidate that are excreted in the urine. Thus sevoflurane has been considered to have a very low potential for hepatotoxicity. We report a case of a 67 years old woman who developed acute hepatic dysfunction after sevoflurane anesthesia. (Korean J Anesthesiol 2009;57:221∼4)
Peptidoglycan에 의하여 유발된 국소적 염증 및 통각과민에 대한 bee venom 침구점(acupoint) 전처치의 영향
박종택 ( Jong Taek Park ),이지영 ( Ji Young Lee ),이영복 ( Young Bok Lee ),강대영 ( Dae Young Kang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.4
Background: Systemic injection of peptidoglycan (PGN) special polymers, which are the primary structural components of most bacterial cell walls, leads to acute inflammation and pain behavior. This study was conducted to confirm that an intraplantar injection of PGN evoked hindpaw inflammation and hyperalgesia, and to evaluate the effects of bee venom (BV) pretreatment of an acupoint on PGN induced inflammation and hyperalgesia. Methods: Inflammation and hyperalgesia were induced by injecting PGN into the plantar surface of one hindpaw of the rats. Inflammation and hyperalgesia were then evaluated by measuring the thickness of the hindpaw using a caliper and the paw withdrawal time (PWT) in response to noxious thermal stimulus (48℃ hot water). In addition, spinal cord c-fos expression was quantitatively analyzed. The BV pretreatment was injected at the acupoint located 5 mm lower and 5 mm lateral to the anterior tubercle of the tibia in the hind limb. Results: The PGN groups showed increased in paw thickness and spinal c-fos expression two hours after PGN injection, as well as decreased PWT in response to noxious thermal stimulus for each tested time. BV pretreatment of the acupoint was found to inhibit hindpaw thickness and led to a significant increase in PWT, but did not significantly inhibit spinal cord c-fos expression induced by PGN injection. Conclusions: These results indicated that BV pretreatment has both an anti-inflammatory and antinociceptive effect in PGN induced inflammatory pain, which suggests that peptidoglycan may be useful as an inflammatory agent for inflammatory pain models. (Korean J Anesthesiol 2009;57:483∼92)