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- 저자 : 안덕선(Deok Sun Ahn) (검색결과 5 건)
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장성호(Seong Ho Chang),안덕선(Deok Sun Ahn),유세화(Se Wha Yoo),김형규(Hyoung Kyu Kim) 한국의학교육학회 1993 Korean journal of medical education Vol.5 No.1
This study was carried out to provide some principles for the improvement of clinical training in medical students. To investigate the current problems in our systems of clinical training, we made sev eral questionnaires and distributed to the individuals of each survey groups. Senior medical students (59), interns (31), residents (14) and medical staffs (15) were included in these survey groups. The summarized current problems in clinical training are as follows : 1) lack of personnels in charge of clinical training, 2) lack of objective criteria for the evaluation of clinical training, 3) lack of involvement of students in clinical patient management, 4) needs of improvement in contents of clinical education, 5) lack of strict execution of education program, 6) lack of places for clinical education, 7) lack of interests in clinical training of the staffs, 8) needs of the orientation for the students about hospital systems. With this summary we held workshop for the staffs (29) in charge of clinical education. The summarized methods to improve clinical education were to promote interests in clinical education of staffs, to select the personnel in charge of clinical education, to make assignment of patient to the students, to let the student write patient progress note, to improve evaluation method for clinical education, to orient student about clinical education.
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조성동(Sung Dong Cho),김정준(Jeong Joon Kim),김형진(Hyung Jin Kim),팽재필(Jae Phil Paeng),박지훈(Ji Hoon Park),권순영(Soon Young Kwon),최종욱(Jong Ouck Choi),안덕선(Deok Sun Ahn),정광윤(Kwang Yoon Jung) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.1
Background: Free flaps have become a very important role in the ablative head and neck surgery with functional preservation of defect sites. The forearm free flap has many advantage of lack of bulk, ease of dissection, vascularity, and malleability. Patients and Methods: A review of 51 radial forearm free flaps performed between may 1990 and feburary 2001 at the Korea University was undertaken to determine outcome. Patient age ranged 27 to 72 years (mean 56). There were 44 men and 7 women. The most prevalent neoplasm was squamous cell carcinoma. Results: The tans verse cervical artery and the external jugular vein were the most frequent receipient sites for microvascular anastomosis. Total flap loss occurred in 2 cases (4%) and other complications were seen in 42%. Fifteen patients received preoperative irradiation and the complication was higher than non-irradiation patients, but statistically not significant. Conclusion: The radial forearm free flap offers a variety of reconstructive options for head and neck. Its low flap loss and complication rates offer the best choice for reconstruction of defect of head and neck malignancy.
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안면의 화학적 박피술시 Midazolam, Fentanyl 그리고 Esmolol 을 사용한 Deep Sedation 마취의 임상적 고찰
이혜원,김난숙,장성호,임혜자,안덕선,김지연,임성연 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.1
To investigate the clinical usefulness of the intravenous anesthesia of the facial chemical peeling with midazolam(0.1 mg/kg)-fentanyl(3 ㎍/kg) - esmolol(initial 500 ㎍/kg,maintenance 200 ug/kg/min), the authors took 133 cases into consideration. The results of the statistical evaluation were as follows: 1) Most of the cases were small pox scar(70.7%). 2) One point five percent of the cases dreamed during anesthesia. 3) Ninety-four point seven percents of the cases were in the emotion of $quot;Peaceful and relaxed$quot; and 60.1% of them were in the mood of Pleased or very pleased and the others were $quot;So and so$quot;. 4) Ninety-one point seven percents of the cases were willing to choose the same anesthetic method next time. 5) Fifty-two point six percents of the cases showed hypertensive episodes during anesthesia. 6) The incidence of the cases with SaO lower than 85% was 36.8%. The anesthetic technique with intravenous midazolam-fentanyl-esmolol for the facial chemical peeling with trichloroacetic acid(TCA) gives the patient comfortness and preference for this anesthetic technique. Close monitoring of the respiration is needed, because it can depress respiratory function. And control of the high blood pressure during anesthesia seems to be needed. (Korean J Anesthesiol 1995; 29: 59-63)
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안면의 화학적 박피술시 Midazolam과 Ketamine을 이용한 Deep Sedation 마취의 임상적 고찰
장성호,김난숙,임혜자,공명훈,조헌,안덕선 고려대학교 의과대학 1994 고려대 의대 잡지 Vol.31 No.2
Various kinds of chemical compounds are used for the practice of facial chemical peeing. Most of the patients who are going to take chemical peeling operation do not need anesthesia except light sedation. But in case of using 50% trichloroacetic acid for that procedure there may be some needs of anesthesia because of severe pain. Deep sedation with midazolam(0.1mg/kg) and ketamine(1mg/kg) was performed for the facial chemical peeling in 85 patients and its clinical effects with usabilities were evaluated. The results are as follows : 1. No one could recall about one's operation. 2. Dreams occurred in 18.8% of the cases, of which 3.5% were bad dreams. 3. On recovery 89,450 of the cases were peaceful and relaxed, only 3.5% of them were in bad mood. 4. The percentage of the cases who would recommend this anesthesia technique for facial chemical peeling was 87.1. 5. Most common complication of this anesthesia technique was hypertension (83.5%). Although the above anesthetic method is relatively safe and selected by most of the patients, the control of the high blood pressure is not so easy and sometimes there can be severe hypoxia, so meticulous control of high blood pressure and continuous monitoring of arterial oxygen saturation are needed.
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안면의 화학적 박피술을 위한 Deep Sedation 마취시 Midazolam-Ketamine과 Midazolam-Fentanyl을 사용한 방법의 비교
장성호,이혜원,임혜자,김난숙,채병국,안덕선 고려대학교 의과대학 1995 고려대 의대 잡지 Vol.32 No.2
For the facial chemical peeling with 30-50% trichloroacetic acid, deep sedation was done for the patients to lessen the perception of pain. This time the authors tried to compare midazolam (0.1mg/kg)-ketamine (1mg/kg) (ketamine group) and midazolam (0.1mg/kg) -fentanyl(3-4ug/kg) (fentanyl group) techniques for the sedation of the patients. Total 232 patients were included in this study and 133 of them received midazolam-fentanyl and the remaining 99 received midazolam-ketamine. All the patients in both groups were given 0.5mg/kg (initial) and 0.2mg/kg/min (continuous infusion) of esmolol for the control of tachycardia and hypertension. The results were as follows : In both groups small pox and acne scar occupied most of the portion of the cases. Recovery time was shorter in the fentanyl group(p<0.05) and frequency of dream was greater in the ketamine group (14.2%) than fentanyl group (1.5%) (p<0.006). The status of emotion and mood was better in the fentanyl group than the ketamine group(p=0.0026, P=4.88 E-10 respectively). The preference of the patients for anesthetic techniques made no difference in both groups. The increase in blood pressure and heart rate were higher in the ketamine group than those in the fentanyl group(p<0.05) and the fentanyl group revealed no change in heart rate. The decrease in arterial oxygen saturation was greater in fentanyl group (p<0.001), but the risk of decrease in SaO₂ less than 85% is possible in both groups, so even if we choose either one anesthetic technique for the facial chemical peeling vigilant monitoring of SaO₂ seems to be necessary, and further improvement in technique to block the increase in blood pressure is needed.
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