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민병우,고준석,백승기,반종석 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.4
Malignant hyperthermia still carries a high mortality despite of the increased understanding of the problem involved. A 33 year old relatively healthy male patient was admitted to this hospital via emergency room because of panperitonitis due to peptic ulcer perforation. We experienced acase of malignant hyperthermia which developed 20 minutes after induction of general anesthesia with thiopental sodium, succinyl choline chlovide, halohane, N_2O and O_2. The body temperature (esophageal) rose altupthy up to 41.2℃ and continued as a high fever for about 3 hours. The blood pressure and heart rate also increased and ventricular dysrrhythmia appeared. The etiology, triggering factors, clinical features, diagnosis treatment and rafe anesthesia of malignant hyperthermia are discussed.
민병우,황정한,고준석 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.4
Alcoholic celiac plexus blocks have been used to relieve intractable upper abdominal cancer pain. Various techniques have been proposed including the use of the X-ray and CT scanner to improve results and to avoid complications. We used th CT scanner and the X-ray fluoroscope for 36 cases of alcoholic celiac plexus blocks to determine the depth and position of the needle without previous diagnostic blocks. Good to excellent pain relief occured in more than 72% of the patients and the advantages of the use of the CT scanner showed that 1) placement of the needle tip is easily eatablished according to the surrounding anatomical structures 2) the operator can introduce the needle without anxiety 3) the time required for block are saved.
Result of Internal Fixation for Stable Femoral Neck Fractures in Elderly Patients
민병우,이경재,배기철,이시욱,이석중,최정훈 대한고관절학회 2016 Hip and Pelvis Vol.28 No.1
Purpose: This study was conducted to evaluate the results of internal fixation for stable femoral neck fractures occurring in patients over 65 years old. Materials and Methods: Between 2008 and 2014, we evaluated 25 patients over 65 years old with Garden type 1 and 2 femoral neck fractures that were treated with internal fixation after a minimum follow up of 1 year. There were 5 males and 20 females and the average age was 72.3 years (range, 65-84 years) at the time of surgery. Fracture site union, horizontal shortening and complications were evaluated as radiographic parameters and change of walking ability (as measured using Koval walking ability score) was investigated as a clinical parameter. Results: Union of fracture site was achieved in 24 out of the 25 cases (96.0%). The average length of horizontal shortening was 6.5 mm (range, 0.2-19.7 mm). At final follow up, 3 cases experienced complications: nonunion (n=1), avascular necrosis (n=1), and subtrochanteric fracture after minor trauma (n=1). Walking ability decreased an average of 1 step at the final follow up. Conclusion: Internal fixation for stable femoral neck fractures occurring in patients over 65 years showed satisfactory union rates. However, care should be taken with this technique given the possibility of decreased walking ability resulting from horizontal shortening.
Pentoxifylline 및 Adenosine이 E. coli 내독소에 의한 폐상해에 미치는 영향
민병우,곽정식,손태중 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.1
This study was carried out to investigate the effects of pentoxifylline and adenosine on the pulmonary injury induced by E. coli endotoxin. The counts of circulating neutrophils in peripheral blood and pulmonary sequestration of neutrophils after injection of endotoxin, endotoxin with pentoxifylline, or endotoxin with adenosine, additionally electron microscopy of the lungs were carried out. To account the circulation neutrophils, six white rabbits were intravenously injected 4㎎/㎏ of E. coli 026 : B6 lipopolysaccharide, and then counted circulating neutrophils at 0, 1, 2, 4, and 8 hours after injections. Another six were injected 4㎎/㎏ of endotoxin simultaneously with 100㎎/㎏ of pentoxifylline (40㎎/㎏ at 0 hour and 20㎎/㎏ at 1, 2, and 4 hours after first injection), then neutrophils were counted at 0, 1, 2, 4, and 8 hours after injection of the endotoxin. The third six were injected 4㎎/㎏ of endotoxin simultaneously with 50㎎/㎏ of adenosine(20㎎/㎏ at 0 hour and 10㎎/㎏ at 1, 2, and 4 hours after first injection), also the neutrophils were counted at 1, 2, 4, and 8 hours after endotoxin injection. Neutrophilic pulmonary sequestration was counted at 8 hours after injection of endotoxin, endotoxin with pentoxifylline, or endotoxin with adenosine. Electron microscopy of the lungs was carried out at 1, 4, and 8 hours after injections in each group. The results were as follows: The number of circulating neutrophils was markedly decreased at 1 hour after endotoxin injection and sustained until 8 hours after injection. In the pentoxifylline and adenosine injected groups, circulating neutrophils were decreased in number at 1 hour, however, nearly recovered at 8 hours after injections. Pulmonary sequestration of neutrophils was marked in endotoxin injected group. In contrast, endotoxin with pentoxifylline and endotoxin with adenosine injected groups demonstrated mild sequestration of the neutrophils. Ultrastructural changes of the lungs were swelling, formation of cytoplasmic projections, and seperation of the cytoplasm from the basement membrane in the endothelium, swelling of type Ⅱ pneumocytes, and interstitial edema appeared in pentoxifylline and adenosine injected groups. According to the above results, it is concluded that pentoxifylline and adenosine inhibit pulmonary sequestration of the neutrophils in endotoxemia and suppress pulmonary injury induced by endotoxin.
민병우,배운호,황정한 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.1
Postherpetic neuralgia, the most feared complication of acute herpes zoster, may agonize the pain clinician because the appropriate management of intractable pain can fail inspite of various and prolonged therapeutic techniques. Of all patients with herpes zoster. approximately 5-10% will develop postherpetic neuralgia. Postherpetic neuralgia is very rare in young patient but very common in patients over 60. In other words, the older, the highter incidence. In our pain clinics, 13 postherpetic neuralgic patients were treated with sympathetic blocks, local infiltration with local anesthetics and steroids, TEN S, Laser and various drugs including antiderpressant. The results of management of pain in 13 patrents were as follows. l. Excellent pain control:4(30.8%) 2. Good pain control:3(23.0%) 3. Fair pain control:2(15.4%) 4. No effect :4(30.8%)