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      • KCI등재후보

        회복기 소아에서 상용량의 meperidine 정주 후 발생한 심한 근경축 -증례 보고-

        강봉진 대한마취통증의학회 2010 Anesthesia and pain medicine Vol.5 No.4

        Severe muscular rigidity is a rare but potentially serious side effect from the use of opioid, usually in high dose. However it has also been reported with the use of low to moderate dose of opioids in a few occasions. The age of the patients varied from newborn to old. These diverse and unpredictable natures of clinical manifestations seem to be related to the unknown mechanisms in the subcortical areas which are difficult to study. Now the author reports the case of severe muscular rigidity which occurred in the 5 year old child who received the usual analgesic dose of meperidine, notably in rapid injection. And after reviewing the related literatures, the author puts some emphasis regarding management of this problem.

      • KCI등재

        교정시설에서의 자살시도 특징 및 정신사회적 위험요인

        강봉진,고석만,이홍식,홍강의,남윤영 대한신경정신의학회 2009 신경정신의학 Vol.48 No.5

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        Objectives: Suicide is one of the most common causes of deaths in correctional institutions. This study aimed to examine the characteristics of suicide attempts and its related psycho-social factors in correctional institutions. Methods: This study examined the characteristics of 101 suicide attempts from 2006 to 2007 in the two regional correctional headquarters. Thirty-seven male inmates (43 suicide attempts) and 40 matched controls were included in interviews and reviews of personal records. Psychiatric illnesses were examined using the Structured Clinical Interview for DSM-IV and medical outcomes of their suicide attempts with the Lethality Scale of Diagnostic Interview for Genetic Studies. Results: Over a half of suicide attempts occurred in solitary cells and the most common method was hanging. Medically, 70% of the suicide attempts were more than severe. Poor social support, a lifetime history of suicide attempts, and incarceration were associated with suicide attempts. Additionally, psychiatric illnesses were more likely to increase the risk of suicide. Conclusion: This study implies that mental health issues and monitoring systems are important to reduce suicides in the correctional system. Regular checks and management of suicide risk and mental illness are crucial to prevent suicide in correctional institutions. 자살은 교정시설 내 중요한 사망원인의 하나이다. 본 연구는 국내 14개 교정시설에 수감 중인 재소자를 대상으로 자살 위험과 관련된 인구사회학적, 정신의학적 요인들을 규명하고 교정시설에서의 자살시도 특징을 탐색하고자 시행하였다. 본 연구에서는 자살시도의 상당수가 집중적인 감시와 관리가 제공되는 독거실에서 발생하며, 치사도가 높은 교상을 사용하여 시도되고 있고, 자살시도 후 의학적으로 심각한 상태에서 발견되는 것으로 나타났다. 그리고 자살시도 위험 요인인 제1축 정신질환이나 자살시도의 과거력과 재소자의 자살시도 사이의 연관성과 함께 취약한 사회적 지지체계, 과거 수감 경력도 자살시도 위험과 관련되는 것으로 분석되었 다. 따라서 본 연구 결과는 교정시설에서의 자살을 예방하기 위해 수감되어 있는 재소자들에 대한 정신보건 측면에서의 관리를 강화하고, 특히 정신질환자에 대한 치료와 함께 자살 고위험군에 대한 집중적인 관리가 필요할 것을 시사한다.

      • KCI등재

        Auto-PEEP-like condition recognized by a sudden decrease in airway pressure during pressure controlled ventilation and low-flow anesthesia -A case report-

        강봉진 대한마취통증의학회 2015 Anesthesia and pain medicine Vol.10 No.3

        During mechanical ventilation in the intensive care unit, auto-positive end-expiratory pressure (auto-PEEP) has been reported to occur in obstructive airway conditions aggravated by inappropriate ventilator settings. In this paper, we report a case of auto-PEEP-like problem during anesthesia, mainly caused by excessive sputum. After being positioned prone for spine surgery, the patient received pressure controlled ventilation at a low fresh gas flow rate. One hour after the start of surgery, sudden decreases in pressure and flow occurred. The typical maneuvers which could be performed by the anesthesiologists in the situations suggesting leakage within the breathing circuit consist of pressing the oxygen flush valve and manual hyperventilation for the initial evaluation. But from our experience in this case, we have learned that such maneuvers could cause unacceptable aggravation in the event of auto-PEEP. Also in this report, we discuss the difficulties in prediction based on the present knowledge of preoperative evaluation and the presumably best management policy regarding this type of auto-PEEP.

      • KCI등재SCOPUS

        문제바탕학습에서 사용한 개념도의 유용성에 대한 학생의 설문반응과 개념도의 유형

        강봉진,김석곤 한국의학교육학회 2009 Korean journal of medical education Vol.21 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        Purpose: Concept maps have been studied and used in diverse ways in scientific fields. This study aimed to investigate the usefulness and limitations of using concept maps during problem-based learning (PBL) in Year 3 medical students. Methods: After each PBL module, we gathered concept maps from each pair of students and questionnaires about the usefulness and limitations of concept maps, and analyzed them. Results: There were two types of concept maps, with some modifications. The students felt that concept maps provided overall understanding, analysis, and reorganization of problem cases. But, they also criticized shortage of disciplines related to drawing skills and rationales for each type of map. A strong need for expert maps and feedback for students resulted. Conclusion: For optimal use of concept maps, we recommend that the committee implements a plan to teach drawing skills, explains rationales for each type of map, and gives feedback to students.

      • SCOPUSKCI등재

        Cis A2B3형 환자의 마취경험

        강봉진 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.40 No.1

        Cis A2B3 is a rare blood type with unusual inheritance pattern of A2, B3 genes on the same chromosome in contradiction to the general Mendelian pattern. Unlike the AB blood type, cis A2B3 shows weaker B antigenicity and unexpectedly has moderate amount of anti-B antibody in serum. Thus it has the potential of misidentification as blood type A or AB and the possibility of acute major transfusion reaction from transfusion of the usually known AB blood group RBCs. This is a case report of anesthetic management of one patient with his blood type discovered as cis A2B3 Preoperatively. During hip surgery he received 2 units of washed O RBCs without any problems. I report the anesthetic experience with a brief review of literature. (Korean J Anesthesiol 2001; 40: 95~99)

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