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RISS 인기검색어
- 검색키워드
- 저자 : Ian S . Robb (검색결과 7 건)
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문경수,오흥근,Ian S . Robb 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.1
Many attempts have been made to device a simple, yet accurate, laboratory method to evaluate the ventilation and acid-base disorders in patients. This study compares the values for Pco2, pH and Po2 of blood samples drawn simultaneously from a radial artery and a vein on the back of the other hand during general anesthesia in 62 cases. The mean arterial and mean venous Pco2 and pH differences were 0. 924 torr and 0. 00013. These differences were too small to be of clinical importance and also varies slightly dependent on the main anesthestics used. Therefore we feel that the use of peripheral venous blood for pH and Pco2 determination during general anesthesia is a reliable indirect method of arterial Pco2 and pH.
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朴東浩,全毅喆,韓景植,김완식,Ian. S. Robb 中央醫學社 1968 中央醫學 Vol.14 No.3
Recently, many investigations have been made regarding the way in which the newborn infant changes over in a first minutes of life from a passive intrauterine existence to more active extrauterine life. Establishment of an extra-uterine circulatory system involves separating the systemic and pulmonary circulation and the obliteration of the placental circulation. When should the cord be clamped in relation to its haemodynamic and respiratory effects on the infant, if the placental blood is transfused into the infant, in the first week of life there is a significant increase in the erythrocyte count and hemoglobin as compared to the infant in which clamping was early. Furthermore, failure of the infant to receive its placental blood may lead to a deficiency of iron during the first year of life, and if the baby does not receive this placental blood a hypovolaemic state may ensure. The principle of possibly a more physiological method is to extract infant and placenta together, without. cutting the cord, and then to establish an environment which allows the placental blood volume to be transfused according to the infant's circulatory demands. This has been done Severance Hospital, Yonsei University Medical College, Department of Anesthesiology. Out of a series of 735 delivered cases from October 1966 to May 1967, it was used in 20 infants delivered by caesarian section and 30 normally delivered infants, after clamping of the umbilical cord from the moment of birth to spontaneous birth of the placenta, and it is very easy to carry out. There seems to be no essential difference between the blood volume transfused after delivery by caesarian section and after normal vaginal delivery. In most of transfused infants this consisted about 23% of total blood volume and was 50 to 100ml. From the view point of the haemoglobin, if the infant is deprived of this placental blood there is a significant reduction of the haemoglobin as compared to infants in which clamping was delayed. The described procedure is still experimental, and it is too early to say whether better results are possible. A larger series has been started and we are studying, in correlation with the obstetricians, the physiology of respiratory and circulatory changes in relation to different forms of delivery.
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Ketamine 이 해명(Guinea pig)의 자궁운동에 미치는 영향
김영숙,김종래,안영수,오흥근,최령,홍사석,Robb, Ian S .,김원준 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.2
Postpartum bleeding of the uterus is an important cause of maternal death. It is thought that the inhibitory effect of the majority of potent inhalation anesthetics on uterine contraction is often responsible (Munson, 1970; Lim et al., 1971; Kim, 1972). There have been numerous reports that ketamine stimulates uterine contraction clinically Chodoff and Stella, 1966; Little et al, 1972; Galbert and Gardner, 1973; Corssen, 1974). Jawa- lekar and associates(1972) reported that ketamine increased resting tension, contractile amplitude nd frequency of the uterine strips of pregnant mice. And Kim(1975) reported research on the offects of ketamine on the isolated uterus of rabbits. According to Kim(1975), ketamine exerted .a stimulatory action on the uterus under the influence of progesterone. This progesterone-depenent uterine stimulatory action of ketamine is not concerned with adrenergic and cholinergic mechanisms but appears to have a direct effect on the uterine muscle. The present study was undertaken to determine whether or not ketamine also exerted a stimlatory action on the uterus of the guinea pig and to follow up whether or not stimulatory action ef ketamine also depends upon progesterone in the guinea pig. Adult female non-pregnant guinea pigs and rabbits weighing approximately 0, 5 kg and 2. 0 kg respectively were employed in this experiment. At the end of 10 to 14 days following bilateral oophorectomy, non-pregnant guinea pigs and rabbits were injected intramusculary with estradiol benzoate (2,000 I.U./kg) or progesterone (Smg/kg) once a day for four consecutive days, A uterine strip, about 1.5~2,0cm in length, was carefully isolated from the experimental animals and suspended in a muscle chamber containing 50 ml of Lockes solution, maintained at constant temperature of 38C. It was aerated with 100% oxygen bubbling through the bathing fluid by means of a sintered glass plate at the bottom of the muscle chamber. One end of the uterine strip was attached to the bottom of the muscle chamber and the other end to a lever. Motility and tonus were recorded on kymograph paper. After being washed several times with fresh Locke's solution, the uterine strip attained a constant motility and tonus. Ketamine then was added in various concentrations to the chamber. The results are as follows: 1. The uterine mctility of guinea pig shows a higher amplitude and lower frequency compared with that of rabbit. 2. Effects of ketamine on isolated uterine strips of guinea pig pre-treated with estrogen showed no change using 1~20 Υ/ml of ketamine, but with 50 Υ/ml or more, the amplitude of uterine contractions was depressed. 3. On isolated uterine strips of guinea pig pre-treated with progesterone, there was no effect with 1100 Υ/ml of ketamine, depressed amplitude of uterine contractions with 150 Υ/ml and markedly depressed amplitude of uterine contraction with 200Υ/ml. 4. On isolated uterine strips of rabbit pre-treated with estrogen, there was no effect with 20Υ/ml of ketamine, but depressed amplitude of uterine contraction u0Υ/ml. 5. On isolated uterine strips of rabbit pre-treated with progesterone, there was an increase in amplitude and frequency of uterine contractions with up to 150Υ/ml of ketamine, but depressed amplitude with 200Υ/ml or more. From the above results it may be concluded that ketamine exerted a stimulatory action on the uterus of rabbit under the influence of progesterone but not on the uterus of guinea pig. The large amount of ketamine depressed the amplitude of uterine contraction in guinea pig and rabbit and this depressing dose is higher in the animals (guinea pig and rabbit) pre-treated with pro- gesterone than with estrogen.
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김영숙,김종래,박광원,오흥근,정화성,Ian S . Robb,변달섭 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.2
The concept of intensive care has developed from experience in recovery rooms, in anesthetic work, and in early specialized units in different fields of medicine. Between the First and the Second World Wars special units were created in some German hospitals. Intensive care often means a combination of recovery-room service and intensive therapy. Intensive care, especially respiratory care is an important part of the responsibility of the anesthesiologist. So, we have analyzed statistically 3, 072 I.C.U. patients who,were admitted during a period of 7 years beginning October 18, 1968 when the I.C.U. at Severance Hospital was opened, The results are as follows: I. Cases admitted to the I.C.U. (March,1970-August, 1975 ) 1) For 5 and a half years, the total number of patients was 2, 479. These patients were 2.7% of 91,400 patients who were admitted into Severance Hospital. 2) The mortality rate was 20.0% . Mortality rate was highest in 1970 (23. 7%) and lowest in 1975 (13. 5%). It has gradually decreased every year. 3) Total occupied bed days were 9,840 days (average 4,0 days). The occupied bed days of the majority of the patients (83.6%) were below 5 days comprising 88.3% of the total expired patients. 4) 50% of the patients were in the 21 to 50 year age group. The highest mortality rate occurred in the 51 to 60 age group (24.3%). 5) The number of patients admitted in the department of internal medicine was 702 cases (28.3%) which was the highest among all departments. The mortality rates of the departments of pediatric and neurosurgery were 40. 3% and 34. 7% respectively and those were relatively high values. 6) All I.C.U. patients have been divided into two categories, operative and non-operative. The operative cases were 1, 264 (51. 0%) and non-operative 1, 215 (49. 0%,). The mortality ,The Journal of The Korean Society of Anesthesiologists VoI. 9, No. 2, 1976 rate of the non-operative cases (22. 5%) was higher than operative (17. 6%). 7) Cardio-vascular disease was the commonest cause of death of I.C.U, patients (107 cases) admitted from March, 1974 to August, 1975 (30 cases, 28. 0%). II. Respiratory support cases (Oetober 18, 1968-August 31, 1975) ; 1) During the 7 year period, of all I.C.U. admission cases (3,072) 423 cases (13.8%) recei- ved respiratory support. These patients gradually increased every year. 2) The mortality rate was 44. 0% which was more than twice the over-all mortality rate of. I.C.U. admission patients. 3) The mortality rate was highest in the 21 30 age group (18. 7%). 4) The department of internal medicine admitted the largest number of cases (153 cases, 36. 2%). 5) Of all conditions, cardiovascular disease was most frequent (126 cases, 29. 8%). Here we have dicussed the definition of I.C.U., the responsibility and important role of the anesthesiologist in the I.C.U. by illustrating present situations and presenting problems at the I.C.U. in Severance Hospital.
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