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기관내 삽관 후 발생한 기관 괴사와 협착증 : 증례보고 A case report
권진형,구자욱,유시현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Tracheal necrosis and stenosis are rare complications of prolonged endotracheal intubation. A 62 years old female was performed cerebral aneurysmal neck clipping under general anesthesia via endotracheal intubation and transferred to the 12th intensive care unit. The patient was mechanically ventilated and tracheostomy was done on the postoperative day. Necrotic tissue, pus and stenosis were found around the ballooning site of the trachea. T-tube insertion was done on the both postoperative day and the patient was discharged on the 80th postoperative day.
유아의 기관절개술에서 발관방지를 위해 고안된 기관절개 튜브
권진형,김성운,오천환 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Tracheostomy in infants and children is associated with a high rate of accidental decannulation in the early postoperative period. The most common complication in infants and children, which most often results in death, is accidental decannulation. Other authors advocate suturing tracheostomy tubes in place in infants and children under general anesthesia in operating room for avoiding decannulation. The authors designed tracheostomy tube for the prevention of accidental decannulation following tracheostomy in infant, so report with review of literatures.
권진형,조영례,모근석 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.2
Coronary artery bypass grafting(CABG) without extracorporeal circulation(ECC) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. We experienced a case of CABG without ECC in a 20 year old female patient with complete occlusion of the right coronary artery. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. Nitroglycerine and dopamine were given to stabilize the hemodynamics during intra- and post-operative periods. And esmolol was administered with a loading dose of 30 mg over 1 min, followed by a continuous infusion of 50∼100 g/kg/min to maintain the heart rate(50∼60 beats/min) and systolic blood pressure(60∼80 mmHg) during distal anastomosis. The patient was recovered uneventfully and discharged on the 8th postoperative day. (Korean J Anesthesiol 1997; 33: 381∼384)
심한 척추후측만증 환자의 대퇴골절 복원술을 위한 부위마취 : 증례보고 A case report
김지은,박대용,유시현,강규식,권진형,김천숙,안기량 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Kyphoscoliosis is a disease manifested as lateral curvature of spine and accompanying rotation of the vertebrae, resulting in distortion of rib cage. Restrictive lung disease and pulmonary hypertension progressing to cor pulmonale are the major cause of mortality in patients with kyphoscoliosis. We had experienced a successful spinal and caudal epidural anesthesia for the open reduction and internal fixation with plate of fractured femur shaft in two patients with severe kyphosoliosis. We had chosen regional anesthesia as an anesthetic method because of there poor pulmonary function and severe deformities of thoracolumbar spine. We could achieve the adequate anesthetic sensory dermatome level, T_(5) and T_(8), for operation without any significant deterioration of blood pressure and respiration. We recommended that regional anesthesia is a useful anesthetic method for a patients with severe kyphoscoliosis when the operation on hip or lower extremity is required.
누두흉 환자에서 Nuss 금속막대 제거 전 · 후 폐 역학 변화
강규식,백남순,김천숙,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1
Nuss operation is one of the surgical procedure for pectus excavatum and it's method is the insertion of convex steel bar under the sternum through small bilateral thoracic incision. As the patients is growing, the thorax can be compressed gradually by steel bar. So Nuss bar needs to be removed two years after Nuss operation. This study was undertaken to assess the effect on the repiratory mechanics before and after the removal of the Nuss bar. Twenty patients with previous Nuss operation were allocated for the removal of Nuss bar. Lung mechanics (dynamic lung compliance, static lung compliance, and airway resistance), hemodynamic change (heart rate, systolic pressure, and diastolic pressure), and pulmonary gas exchange (arterial oxygen tension, arterial carbon dioxide tension, pulse oximeter saturation, and end tidal carbon dioxide tension) were measured before and after removal of Nuss bar. Respiratory mechanics (dynamic and static lung compliance, inspiratory airway resistance), pulmonary gas exchange and hemodynamic parameter were unchanged before and after the removal of Nuss bar. We concluded that lung mechanics were not changed before and after the removal of Nuss bar in the patients with pectus excavatum and the 95% patients were satisfied with operation.
권도현,권진형,조영례 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.1
Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty. (Korean J Anesthesiol 1997; 33: 162∼166)
권도현,권진형,조영례 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.6
Jehovah,s Witnesses who require operation represent a challenge to the physician because of the patient,s refusal to accept blood transfusion. An orthotopic heart transplantation was succesfully performed in a 40-year old Jehovah,s Witness without use of any blood product. During the operation, cell saver was used for shed blood and aprotinin was administered intravenously. The use of blood conserving methods, meticulous operative technique and brisk postoperative diuresis has added to the efficacy of heart transplantation in this patient. Total postoperative drainage was 860 ml and the lowest hemoglobin level was 11.8 g%. The patient recovered uneventfully and discharged on the 60th postoperative day. (Korean J Anesthesiol 1997; 32: 1023∼1027)