수근관증후군 증상을 보이는 환자의 전기신경생리 검사의 평가

강귀빈,김세주 大韓再活醫學會 1993 Annals of Rehabilitation Medicine Vol.17 No.1

LNAME(L-nitrow arginine methyl ester)와 MB(methylene blue)로 전처치한 토끼 대동맥환에서 Enflurane과 Desflurane 의 작용

임상호,권은정,강귀빈 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.4

Background : Desflurane is a new inhaled anesthetic with the lowest blood/gas partition coefficient and enflurane is one of the major anesthetics in these days. But the effect of volatile anesthetics and the site of action on the blood vessel are still controversial. Since Furchgott(1980) discovered endothelium derived relaxing factor(EDRF) from endothelium, many investigators have studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels. In this study, we evaluated that the effect and the action site of enflurane and desflurane on isolated aortic rings of the rabbit. Methods : Each of obtained thoracic aorta from rabbits(1.5∼2.5 kg) was divided into 4∼6 mm rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME(inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB(inhibitor of solub guanylyl cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then enflurane(1%, 2%, 3%, 4%) or desflurane(6%, 9%, 12%) was administered to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. Results : It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of enflurane and both intact and denuded rings were maintained from control tension in all concentrations of desflurane. Conclusion : It is concluded that enflurane in all concentrations has an endothelium-mediated vasoconstriction effect and desflurane in all concentrations has no effect on isolated aortic rings of rabbit. (Korean J Anesthesiol 1997; 33: 583∼590)

수혈환자의 임상적 고찰

김완식,박동호,황영희,정창우,강귀빈,민경호,유희구,정춘근 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.3

It is a well known fact that the test method of determining need for transfusion is the accurate measurement of blood loss related to the patient's status and surgical maneuvers during operation. There are many complications of blood transfusion and their pathophsiologic mechanism, and theprevention and management has been discussed. Among the complications of blood transfusion, urticaria is the most common symptom, The pathophyaiologic mechanism of urticaria is understood in some degree at the present time but there are many different opinions as to its prevention and management. Furthermorr antihistamine has been widely use6 for the prevention of urticaria but there are many debatable events about the use of antihistamine. This study was undertaken to investigate the recent reports concerning the use of antihista mine for the prevent in and management of urticaria. Two hundred eighty eight transfuser patients among the total of six thousand four hundred forty eight surgical cases done at the Hanyang University Hospital from January 1at to December 31th 1983. were reviewed. The result are as follows : 1) The incidence of urticaria was 28 cases(9.72%) among the 288 transfused cases an(there was no sex difference. 2) The age distribution was 10 cases(12%) in the 2nd decade and 9 cases(11.9%) in the 4th decade. 3) The lowest incidence of urticaria was 5 cases(5.3%) with A blood type and high of incidence with 3, 0 and AB blood types. 4) The Physical status of class 3 was seen in 10 cases(43.5fl) as the most common occurrence of urticaria. 5) The highest incidence of urticaria was observed in 9 (45%) of 20 obstetric cases. 6) There was no significant difference of urticaria incidence between the group3 whic] did an4 did not use antihistamine. Also in the group which recieved histamine 10 minute before transfusion there was a significant decrease 6 cases(3.41%) among the 178 transfuse cases. 7) There was no significant statistical difference between blood loss and transfused blood volumes. 8) There was no significant statistical change in the mean values of hemoglobin and hematocrit which were measured preoperatively, in recovery room and 24 hours after operation. 9) In the patient's who were transfused with more than 10 pints of whole blood, urticaria develpped in 9 cases(50%) among 18. From the results of this study, 1 consider the most effective method for the prevention of urticaria to he the administration of histamine 10 minutes before transfusion. Further investigation of this method will be carried out.

중증근무력증 환자의 흉선절제술 마취 1 예 보고

김완식,박동호,황영희,심재철,유희구,정창우,강귀빈,민경호 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.4

말초 전기침 자극의 임상적 연구

김완식,박동호,심재철,서정국,정창우,황영희,김유재,강귀빈,유희구 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.2

Recent studies in western countries have reported that the mechanism of pain are concorded with gate control opiate receptor binding sites and the release of intrinsic morphine like substances, sodium glutamate and also with bradykinin, serotonin, histamine and prostaglandin E. Otherwise the mechanism of the stimulation producing analgesia has been reported to involve a neurophysiologic and neurohumoral inhibitory effect at the level of spinal cord, brain stem, thalamus and cortex. This has been clarified but further study should improve the chance of understanding the mechanism of pain. From the standpoint of pain management, medications used to manage pain have some unfortunate side effects. Nerve blocks cause anesthesia toxicity, major neurosurgical procedures have many complications. Subarachnoidal and epidural analgesics have unknown irritation pneumonia and drug toxicity, and celiac plexus or pituitary gland block with phenol or alcohol has unevenful complication. From January 1980 to december 1982, electrical acupuncture stimulation has been used on 210 cases at HANYANG university hospital in the pain clinic I found it useful in relieving pain which has not responded to various conventional methods which included medications, nerve blocks, neurosurgical intervention and neuropolytics. The results are as follows; 1) There are two kinds of treated patients; One is consultation case-12 from internal medicine, 16 from orthopedic surgery, 10 from neurosurgical and 2 from psychiatry. Another 170 cases were patients who directly to the clinic. And the age distribution shows the higest number of patients in the 3rd decade (21%) and in the 4th decade (24.8%). 2) The region of pain was 21% lumbar, 13.8% shoulder, 10% lower leg and head or face with 9.5%. 3) The duration of the pain showed 10 days 25.7%, 1~2 month 18.6%, one year 11.4% and the longest up to 20 years. 4) Patients who were able to walk into the clinic were 19.5%, moderate cases who to be accompanied were 58.6% and bedridden cases were 21.9%. 5) Treatment was conducted mainly on low frequency stimulation with various waves that included the general dynamic activity point plus reactive electro permeable point (REPP) 81.9% and REER plus head in situ needle 18.1%. 6) In 16.7% only one treatment was administered, in 46.1% 2~5 treatments were given, in 28.6% 6~10 treatments were given and in 3 cases more than 100 treatments were administered. 7) Of the 210 cases, 43.3% showed marked improvement, 41.4% were improved, 13.8% showed transient improvement and there were 3 cause of no improvement. The total confidence was 84.7%. 8) There are no serious complications except hypertensive shock case, submucosal hemorrhagic petechia 7 cases and generalized fatigue 18 cases. In conclusion, electrical acupuncture stimulation of the peripheral nervous system can be used to relieve pain replacing such conventional means as medications, nerve blocks, major neurosurgical procedures, neuroytics and physiopsychic therapy which are generally less effective.

Enflurane 과 Halothane 마취제가 간기능에 미치는 영향의 임상적 비교 연구

김완식,박동호,심재철,서정국,김유재,서병태,황영희,정창우,강귀빈,유희구 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.1

Halothane was introduced in 1956. It has been used worldwidelr as a relatively safe inhalation anesthetic but it Is generally accepted that it can causu decrease of liver function. But the causative factor has not yet been pinpointed. Enflurane also seems to decrease liver function but the exact cause is not yet known. In order to study the effects of enflurane and halothane on liver function, we used 10 cases of spinal anesthesia as a control group, and 20 cases each of enflurane and halothane anesthesia respectivly as experimental groups. We then checked serum GOT, GPT, total bilirubin, alkaline phosphatase, and eosinophil count in peripheral venous blood before operation and 6 days after operation and looked for the existence of high fever of more than 99"C. 3 daya postoperatively. The results are as fellows : 1) We found statistical significant change of serum GOT, GPT, total bilirubin, alkaline phosphatase and eosinophil count in spinal, enflurane, or halothane anesthesia before and after operation. There was no statistically significance beween the control and experimental groups. 2) No patient developed high fever of more than 3g"C. until. 9 days after anesthesia in any group. 3) No si☞nificant change of mean arterial blood pressure was observed before and during anesthesia in each group. In this study no definite conclusion that enflurane and halothane might have affected the liver function.