만성골수성 백혈병환자에서 발생한 요천추부 Chloroma로 인한 좌하지통증의 치료경험 1예 보고

성춘호(Choon Ho Sung),정운혁(Woon Hyok Chung) 대한통증학회 1989 The Korean Journal of Pain Vol.2 No.1

N/A Chloroma is a localized myeloblastic tumor which may develop during the course of myelogenous leukemia or as a presenting sign of the disease. A 47-year-old female diagnosed as chronic myelogenous leukemia in her hematologic remission period complained of left lower leg pain. The lumbar-spine aeries showed multiple osteolytic changes in the left lateral border of the lumbar spine. An inhomogenous soft tissue mass involving left lateral aspects of lumbar vertebrae was identified by CT-scanning. At the first pain attack, lumbar epidural steroid and local anesthetic injection could abolish her pain and the patient could go a few days without pain. The following radiation therapy could also improve the symptom and retain the pain free interval. One month later, a second pain attack occurred and lumbar and caudal epidural steroid and local anesthetic injections could result only in an incidental relief of pain. Radiation and chemotherapy were started but failed to relieve pain. A neurolytic block was considered but the patients general condition was aggravated and even verbal communication with her became impossible.

소아의 기도이물제거에 대한 마취 : 54 례 보고 Report of 54 Cases

정운혁,변성환,권경덕 대한마취과학회 1981 Korean Journal of Anesthesiology Vol.14 No.3

Trachobronchial aspiration of foreign bodies is one cause of fatal accidents in children. Serious complications and death of these children is avoided by early diagnesis and early removal of foreign bodies. The purpose of this report is to analyze the alteration of anesthetic method for removal of tracheobronchial foreign bodies in 54 childrn(62 anesthesia) experienced in St. Mary's Hospital, Catholic Medical College, Seoul, Korea, from Jan. 1,1963 to Sep. 30, 1980. The removal of trac heobronchial foreign bodies for all cases was done under general anesthesia. Results were as follows: 1) Most tracheobronchial foreign bodies appeared in the 1~3year old group(24 cases among 54 dhildren). 2) The kinds of foreign bodies were foods and metals. Most were peanuts and beans, which were not visible on chest X-ray films. These foregn bodies can cause atelectasis and emphysema in 24 hours, which was evidenced by chest X-ray. 3) During bronchoscopy, the chest was compressed manually after mask ventilation. Recently 100% oxygen was inhaled through a thin plastic catheter lodged side the bronchoscope. Intravenous ketamine with 100% oxygen through thin catheter allowed safe anesthesia for bronchoscopic procedure. 4) Anesthetic time required for bronchoscopic procedrue was 31~60 minutes on the average. 5) Pulse rate was increased in 33 cases during bronchoscopic procedure.

手術後의 鎭痛劑의 役割

鄭雲赫 최신의학사 1968 最新醫學 Vol.11 No.5

開業醫를 爲한 全身麻醉

鄭雲赫 대한의학협회 1974 대한의학협회지 Vol.17 No.9

韓國의 痲醉科學問題

鄭雲赫 대한의학협회 1972 대한의학협회지 Vol.15 No.7

呼吸障害治療를 爲한 長期氣管內揷管에 對한 最新見解

鄭雲赫 최신의학사 1968 最新醫學 Vol.11 No.10

麻醉科學會의 決算과 새해의 展望

鄭雲赫 亞洲藥品 1989 臨床 醫藥 Vol.5 No.2

새로운 정신안정제 Ro 5-3350의 임상 사용경험

정운혁,최수영,서복순 中央醫學社 1974 中央醫學 Vol.26 No.4

Ro 5-3350 is a benzodiazepine derivative, which has shown muscle relaxant, sedative and anti-convulsant effects in animal experiments. This study was done to investigate its suitability for use in anesthesiology. The patients were selected at random and divided into three groups. The first. group was given 10 mgs of the drug intramuscularly one hour prior the proposed. surgery. The second group was given additional 10 mgs of the-drug intramuscularly on the evening before the operation. The third group was given diazepamnn and treated similarly, i. e., 10 mgs of diazepam was given intramuscularly twice as the second group. The pre-operative psychic sates, the circulatory, respiratory and muscle relaxation during the surgery and the post-operative recovery status was analyzed statistically by applying the x' test. The conclusions can be summarized as follows: 1) The patients could sleep soundly with Ro 5-3350 on the night preceding the. surgery but there was no statistical difference between Ro 5-3350 and diazepam with equivalent doses in sleep inducing action. 2) *Sedative effect of single injection of the drug was equivalent with double injection of diazepam. Sedative effect was enhanced with the doubt doses of Ro 5-3350. 3) During the surgery, respiration and circulation was not affected by the drug. The difference between Ro 5-3350 and diazepam in potentiating muscle relaxation, during the surgery was not significant. 4) The difference between the drug and diazepam group in post-operative-recovery was highly- significant. Ro 5--3350 sedated the patients better and -exerted analgesic effect significantly. Vomiting and appetite was aggreviated with diazepam, especially after penthrane anesthesia compared with halothane -anesthesia. Ante- and retrograde amnesia was observed in several cases. 5) Application to anesthesia for cardioversion was found improper, because the -drug caused prolonged sleep and air-way obstruction due to muscle relaxation after the procedure. 6) Hiccough and hallucination was observed in small number of the cases. For pre-medication, single dose of Ro 5-3350 prior to the surgery was recommended and additional dose given at the night before surgery was poorly tolerated by the patients. Post-operative use to alleviate pain was found to be effective.

장폐새증 마취후에 발생한 폐전새증 일례

정운혁,박경웅 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.3

This is a case report of pulmonary embolism which occurred as a complication of mesenteric venous stasis with sepais. This 49 year old nun was operated upon for an obstructed intestine under general anesthesia with halothane and d-tubocurarine. She had had a hystrectomy for myoma 2 years ago and has ailed for 6 days from this condition. The patient became dyspneic and cyanotic suddenly three hours after the surgery. The chest X-ray revealed three or four bilateral, rounded and moderately increased densities, and her ECG showed a large S wave in limb leads, P-pulmonare, and right ventricular strain pattern with right axis deviation. CPPV with 100% oxygen by the manual method improved the condition of the patient for about three hours, but tachycardia and a failing heart could not be corrected in site of digitalis, steroid, diuretics and heparinization. The patient died 11 hours after the operation.

새로운 정맥내마취제 Althesin 의 임상사용경험

정운혁,김창겸 대한마취과학회 1978 Korean Journal of Anesthesiology Vol.11 No.4

Althesin(CT 1341), a new steroid anesthetic, was tried clinically as an induction agent. All 24 patients were in the physical status class 1 by A.S.A. classification. Dosage of althesin given intravenously was 50μ1/kg B.W. and the injection speed for the given dose was 15 seconds. The following results were obtained. 1) Induction time was 42±19. 7 seconds. 2) No significant changes in pulse rate were found after intravenous injection of althesin. 3) Systolic blood pressure was decreased 8mmHg (p$lt;0.01) after one minute of injection and 11 mmHg (p$lt;0.01) after three minutes and raised to preanesthetic level after five minutes. No significant change was found in diastolic blood pressure. 4) Respiratory rate was increased 3/min. (p$lt;0.05) after three minutes. 5) Minute voulme was decreased 170Gml (p$lt;0.01) after one minute and 700ml (p$lt;0.05$gt; after three minutes. 6) As complieations, involuntary muscle movement of extremities was observed in two cases and transient apnea in one case.