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쇄골상위식 쇄골하정맥 도관삽입술 후 발생한 혈종격 (증례보고)
안기량 순천향대학교 1989 논문집 Vol.12 No.1
Percutaneous insertion of 16 gauge angiocatheter has been essential for case of the massive fluid or blood adminstration, parenteral hyperalimentation, and CVP monitoring. However, their placement is an invasive procedure, and then, this procedure rarely cause potential complication. Hence, accurate knowledge of their procedure relation is essential for catheterization. We have experience a case of hemomediastinum as a complication of subclavian vein catheterization. We report the case with review of the literature of central venous catheterization and its possible complication.
한찬수,김태정,김일호,김유재,김천숙,안기량 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2
Aspiration of a foreign body in the airway is common cause of sudden obstructive breathing, crouping cough, hoarseness, and wheezing. Especially that caused serious problem in case of the young children. A past history of foreign body aspiration is itself an indication for bronchoscopic examination of the airway, because some children with aspirated foreign bodies are without symptoms and chest X-ray films may not show abnormalities. So the anesthesiologist should take a notice of removing foreign body in the anesthetic procedure. The author have experienced 36 cases removal of foreign bodies in the airway under general anesthesia from July, 1982 to January, 1996 in Chunan Hospital, College of Medicine, Soonchunhyang University. The results were as follows 1) Among the 36 cases, 25 cases(69.7%) were under the age of 5. The ratio of male and female was 1.8 : 1. 2) In duration of lodgement, there was most frequent within one day in 15 cases(41.7%) and the longest duration was 20 days. 3) The most common symptom, sign and auscultation finding were cough 19 cases(52.8%). chest retractions 7 cases(19.4%) and decreased breathing sound 20 cases(55.6%) 4) Abnormalities in the chest X-ray were found in 15 cases(41.7%) among 36 cases. 5) Vegetable foreign bodies, expecially peanut were the most common airway foreign body(28.7%), followed by plastic foreign body(14.4%) and mucous plug(11.3%). 6) The foreign body involved the right bronchus 16 cases(45.7), left bronchus 10 cases(28.6%), trachea 5 cases(14.3%), and larynx 4 cases(11.4%). 7) Foreign body induced complications occurred in 9 cases(25.0%); pneumonia 8 cases and pneumomediastinum 1 case, and all of postoperative complication was pneumonia(25.0%). 8) 34 foreign objects(94.4%) were removed by endoscopy but tracheostomy was required in two patients.
전신마취 후에 발견된 좌측 내경동맥 폐색에 의한 뇌경색 : 증례보고 A case report
안기량,박해남,권진형 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Stroke is defined as a focal neurological deficit lasting more than 24 hours. The complication related to the central nervous system after general anesthesia is unusual and difficult to discover the exact causes. We experienced a case of an unexpected cerebral infarction after lung decortication and clousure of bronchopleural fistula (BPF). His medical problem included diabetus mellitus, pulmonary tuberculosis, and history of several episode of focal neurological deficit. Anesthesia was induced with thiopental and succinylcholine and maintained with 50% N_(2)0 and 2.0-3.0 vol% enflurane in oxygen. After approximately 10 h in intensive care unit, he was still very lethargic. Immediate brain magnetic resonance angiography(MRA) revealed acute cerebral infarction in left middle cerebral artery (MCA) and anterior cerebral artery(ACA) territory due to left internal carotid artery (ICA) obstruction. An emergency decompressive craniectomy was performed. Therefore cerebral thrombosis, hypotension could be considered the possible etiology. We concluded that cerebral infarction can unexpectedly develop during perioperative and after postoperative and that close monitoring of patient and adequate management are essential.
안기량 순천향대학교 1993 논문집 Vol.16 No.4
Myasthenia Gravis is now considered as one of autoimmune disease entites and characteristics by progressive muscle weakness upon exertion and high sensitivity to the motor end-plate. It's relatively common in young women. The author anesthelized 10 cases of myasthenia gravis for thymectomy and obtained following results. 1) Premedication was glycopyrrolate 0.004㎎/㎏ and ativan 0.08㎎/㎏ IM. Anesthetic induction of 3 cases was by thiopental 2-6㎎/㎏ with the inhalation of halothane 1-2% (or) enflurane 2-4% and 7 cases was bythiopental 2-6㎎/㎏ with inhalation agent and N-M bloker. 2) Mean duration from the end of operation to extubation was 6.3±2.0 hrs. All patients did not require reintubation. 3) Complication were occured 1 case of slight pulmonaryedema, and 1 case of cardiac congestion. 4) Abstinence of muscle relaxants, adequate respiratory care and the protection from cholinergic crisis wer the most important factors for successful management.
전신마취 후 점액으로 인한 기관내관 폐쇄 : 증례보고 A case report
안기량,엄희상,김지은 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Nasotracheal intubation is commonly and safely used in the anesthetic management of patients undergoing oral cavity surgery. But endotracheal tube obstruction causes serious complications, including pneumothorax, pulmonary edema, brain injury and death. We experienced a case of endotracheal tube obstruction due to mucous crust after general anesthesia. A 5-year-old woman with cleft palate was intubated with a 4.5 mm amored tube for general anesthesia. During the surgery, vital signs were within normal limits. In the intensive care unit, she exhibited sign of complete airway obstruction. We exchanged the tube with another tube after failure of suction. The airway obstruction was due to a dried mucous crust attached to the bevel of the endotracheal tube. We should keep in mind the presence of an amored endotracheal tube cannot be regarded as a guarantee of a patent airway.
중환자실에서 기관절개술을 받은 환자의 기도세균에 대한 관찰
김천숙,안기량 순천향대학교 1990 논문집 Vol.13 No.1
The control of infection in the intensive care unit is a very important problem in the critically ill patients. Particularly for the patient with tracheostomy, the possibility of infection may impose an added risk when the general condition is poor. This study was undertaken to investigate the incidence of upper respiratory infection in patients with tracheostomies who had respiratory care in the intensive care unit. The total number of cases in this study was 25, and the specimens for bacteriologic culture were taken especially from the regions of the upper respiratory tract via tracheostomy tubes. The results obtained from the bateriologic culture were as follows: 1) The organism found most frequently was Pseudomonas aeruginosa, and the next common organisms were Klebsiella and Neisseria catarrhalis, followed by α-hemolytic streptococcus. Gram negative bacilli were 63% of all cultured organisms. 2) The greatest number of organism was seen over the tenth day, and also seen in high rate on the first day.