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증례보고 : 지속적 사각근간 상완신경총 차단을 이용한 복합부위 통증증후군에 의한 어깨를 포함한 상지 통증의 치료 경험
박중국 ( Chung Guk Park ),이미경 ( Mi Kyoung Lee ),김난숙 ( Nan Suk Kim ),임상호 ( Sang Ho Lim ),최상식 ( Sang Sik Choi ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.6
Complex regional pain syndrome (CRPS) is a condition characterized by regional pain, sensory alterations, motor dysfunction, and abnormality in body temperature, sudomotor activation, skin color changes and regional edema which often appears in the extremities after the onset of a noxious event. CRPS is a disabling disorder with an unknown mechanism. We present a CRPS case which is extremely resistant to conventional pharmaceutical and other therapeutic treatments in the left upper limb, which was treated successfully with continuous interscalene brachial plexus block (BPB). (Korean J Anesthesiol 2006; 51: 749~51)
실험연구 : 허혈/재관류 시 Amiodarone이 허혈 전처치에 의한 심근보호에 미치는 영향
구은혜 ( Eun Hye Koo ),박중국 ( Chung Guk Park ),임상호 ( Sang Ho Lim ),박영철 ( Young Cheol Park ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
Background: Ischemic preconditioning (IPC) has protective effects on myocardial ischemia. These effects may be caused by ATP (adenosine triphosphate) sensitive potassium (KATP) channel activation. Amiodarone also has pharmacologic preconditioning effects, especially suppression of reperfusion arrhythmia. The mechanisms of amiodarone effects are different from that of IPC. The aim of this study using the isolated rat working heart was 1) to confirm whether IPC and amiodarone protected against reperfusion injury; and, if so, 2) to example whether combination of IPC and amiodarone demonstrated additive effect or not. Methods: Isolated rat hearts were stabilized for 30 minutes and were subdivided into four groups. Control group was subjected low-flow ischemia of 5% dextrose water for 30 minutes. IPC group was pretreated with IPC. In Amiodarone group, whole process was same as control group except amiodarone administration during low-flow ischemia. Amiodarone-IPC group, IPC was applied and also administrated amiodarone. Isovolumetric left ventricular end systolic pressure (LVESP), left ventricular end diastolic pressure (LVEDP), dP/dtMAX and heart rate were measured. Results: Group II showed more recovered LVESP, less developed ventricular stiffness, more preserved coronary effluent flow, earlier termination of arrhythmia and smaller infarct size than Group I. Group III showed preserved LVESP and dP/dtMAX, less developed ventricular stiffness, shortest arrhythmia sustaining time, smallest infarct size among all groups. These myocardial protective effects were abolished in Group IV. Conclusions: We observed that IPC and amiodarone administration, each has myocardial protective effects against myocardial ischemia, but when they are dealt at the same time, their beneficial effects diminished. (Korean J Anesthesiol 2006; 51: 455~62)