전신 마취 후 발생한 고양이의 일시적인 급성 시력상실 1례

손원균,정보영,권태억,서강문,이인형 한국임상수의학회 2009 한국임상수의학회지 Vol.26 No.5

A 2-year-old, castrated male, Scottish fold cat was referred to Veterinary Medical Teaching Hospital of Seoul National University (VMTH-SNU) for evaluation of acute bilateral blindness after general anesthesia. For dental prophylaxis in local animal hospital, general anesthesia had been induced with intravenous acepromazine and ketamine, and maintained with isoflurane after intubation. At VMTH-SNU on next day, complete blood count, electrolytes and serum chemistry values were within normal ranges. On neurologic examination, visual placing and postural reactions like as hopping, hemiwalking and wheelborrowing were reduced on right hindlimb. On ophthalmic examination, menace responses were absent on both eyes and pupillary light reflex (PLR) reduced on right eye, but other reflex and fundus were normal. Prednisolone (2 mg/kg sid for 3 days) was administrated orally and tapered. Visual placing was possible on 2nd day, and postural reactions were recovered on 4th day after dental prophylaxis. Based on the process and recovery, this case was considered as postoperative visual loss (POVL) after general anesthesia.

말에서 Granulosa Cell Tumor에 의한 무발정 치료 예

서종필,손원균,강수진,김형진,김대용,이충섭,이인형 한국임상수의학회 2009 한국임상수의학회지 Vol.26 No.5

An 8-year-old Thoroughbred mare showing anestrus for longer than 6 months with left ovarian mass was referred to Veterinary Medical Teaching Hospital of Seoul National University. For 6 months, the mare had received 2 times hormonal therapies with PGF2α and progesterone. The mare had not responded to these therapies and not shown estrous behavior. On rectal palpation, the left ovary was enlarged and contralateral ovary was small and inactive. Transrectal ultrasonographic examination of the left ovary revealed a mass composed of multiple, irregularly shaped follicles. Granulosa cell tumor (GCT) was suspected according to her history. Ovariectomy was performed through the left flank laparotomy with a standing position in a simple chute located outside of horse farm. The mass was diagnosed as GCT on histopathology. The mare was recovered without any problem and became pregnant next spring.

호흡마취 유도제로서 alfaxalone의 후향적 평가: 150례

장민,손원균,조상민,이인형 한국임상수의학회 2017 한국임상수의학회지 Vol.34 No.2

This study was performed to evaluate the clinical efficacy of alfaxalone for induction of inhalation anesthesia in small animal practice. Patient data were collected according to anesthetic records (136 dogs and 14 cats) presented to the Veterinary Medical Teaching Hospital of Seoul National University for surgeries and diagnostic imaging from July 2013 to March 2014. Anesthetic results included signalment, American Society of Anesthesiologists (ASA) grade, premedicated drugs, procedures, induction quality, and recovery after anesthesia. One hundred fifty anesthetic events were classified according to the ASA grade. Three patients were ASA grade I, 52 patients grade II, 86 patients grade III, and 9 patients grade IV, respectively. The most common premedication was midazolam and hydromorphone combination (n = 59, 39.3%) follow by acepromazine and hydromorphone combination (n = 22, 14.7%). The majority of anesthesia procedures were diagnostic imaging (n = 33, 22.0%) and ophthalmic surgeries (n = 31, 20.7%), followed by soft tissue surgeries (n = 27, 18.0%), and orthopedic surgeries (n = 20, 13.3%). Intravenous alfaxalone provided smooth induction for inhalation anesthesia in almost cases, but transient apnea and twitching/paddling were observed after induction and during recovery, respectively. In addition, alfaxalone did not show pain response during intravenous administration. Alfaxalone showed smooth induction of inhalation anesthesia in dogs and cats with mild to severe systemic disease (ASA 2-4). Alfaxalone was considered as an acceptable induction agent for patients with higher risk in small animal practice.

일차 배양 해마신경세포에서 NMDA- 및 Glutamate- 유도전류의 특성

김일만,손은익,김동원,김인홍,임만빈,송대규,박원균,배재훈,최하영,Kim, Il-Man,Son, Eun-Ik,Kim, Dong-Won,Kim, In-Hong,Yim, Man-Bin,Song, Dae-Kyu,Park, Won-Kyun,Bae, Jae-Hun,Choi, Ha-Young 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Objectives : This study was performed in cultured rat hippocampal neurons to investigate the acute electrophysiological features of ionotropic glutamate receptors which act as a major excitatory neurotransmitter in mammalian brain. Method : Glutamate receptor agonists were applied into the bath solution embedding in whole-cell patch-clamp recording of single hippocampal neuron. Results : In voltage-clamped at -60mV and the presence of 1mmol $Mg^{2+}$, extracellulary applied NMDA did not induce any inward current. Both the elimination of $Mg^{2+}$ and addition of glycine in bath, however, elicited a NMDAinduced inward current. $Mg^{2+}$ block current was increased gradually in more negative potentials from -30mV, showing a negative slope in I-V plot with $Mg^{2+}$. Glutamate-induced current represented an outward rectification. A non-NMDA receptor component occupied about 40% of glutamate-induced current in the voltage range of -80mV to +60mV. Conclusion : Present study suggests that glutamate activates acutely the non-NMDA receptors which induces an inward current in the level of resting membrane potential. This makes the membrane potential increase and can activate the NMDA receptors that permit calcium influx against $Mg^{2+}$ block. At the depolarized state of neuron, there may be recovery mechanisms of membrane potential to repolarize irrespective of voltage-dependent potassium channels in the hippocampal neurons.

Dobutamine 투여 후 발생한 개의 서맥 1례

장민,손원균,황혜신,조상민,이강재,윤정희,이인형 한국임상수의학회 2014 한국임상수의학회지 Vol.31 No.4

A 13-year-old, castrated male, Shih Tzu dog with a history of acute ataxia was referred to veterinary medicalteaching hospital and anesthetized for diagnostic magnetic resonance imaging of cervical intervertebral disk disease. After preanesthetic evaluation including physical examination, blood chemistry, radiography and ultrasound, the patientwas premedicated with intravenous butorphanol (0.2 mg/kg). Anesthesia was induced by intravenous propofol (6 mg/kg) and maintained with isoflurane at 1.2 minimal alveolar concentrations. Because the mean arterial pressure (MAP)decreased from 70 to 58 mmHg at 70 minutes after induction, dobutamine was administered by constant rate infusion(5 μg/kg/min) to treat hypotension. However MAP did not increase, and heart rate rapidly decreased from 100 to 55beats per minute (bpm). To treat bradycardia, intravenous glycopyrrolate (5 μg/kg) was administered, and heart rateincreased to 165 bpm. After extubation of endotracheal tube, the patient showed normal recovery without any problemsrelated to cardiovascular system. Unexpected dobutamine-induced bradycardia was considered as Bezold-Jarisch reflex. It is recommended that clinicians know and prepare the possibility of bradycardia during dobutamine therapy undergeneral anesthesia.

Retrospective Analysis of Chief Complaints and Causes of Dogs and Cats during Emergency Visits: 3,180 Cases

이혜경,손원균,서지민,김현욱,이인형 한국임상수의학회 2014 한국임상수의학회지 Vol.31 No.2

This study was performed to investigate on the frequent chief complaints and the causes of dogs and catsvisiting to an emergency department, and to suggest the minimum requirements for veterinary emergency clinics inSouth Korea. The medical records were reviewed for 2,368 dogs and 347 cats visiting the emergency department ofHaemaru Referral Animal Hospital from March 2012 to August 2013. Among them, 255 dogs and 35 cats visitedmore than one time and each visit was considered as an individual case. Therefore, 2,784 cases of dogs and 396cases of cats were reviewed. The medical records were analyzed according to the criteria such as signalment, chiefcomplaints, diagnoses, hospital admission, and outcome. In dogs, vomiting, diarrhea, or both were the most commonchief complaints, followed by dyspnea, trauma, seizure, and lethargy. The most common causes of emergency visitswere gastrointestinal disorders, followed by neurologic, cardiovascular, respiratory, urologic, and hematologic disorders. In cats, dyspnea was the most common chief complaint, followed by vomiting, diarrhea, or both, trauma, dysuria,and lethargy. The most common causes of emergency visits were urologic disorders followed by gastrointestinal,respiratory, infectious, and cardiovascular disorders. According to the results, vomiting, diarrhea, dyspnea, and traumawere the most frequently encountered chief complaints, which accounted for approximately 48.6% of all cases in bothdogs and cats. However common causes were differed between the dogs and the cats. In order to provide properemergency service, it is required to prepare the clinicians and facilities to diagnose and stabilize these emergencypatients.

척추측만증이 있는 개에서 안구후방마취 후 발생된 안구심장반사 1례

박영우,손원균,김세은,서강문,이인형 한국임상수의학회 2009 한국임상수의학회지 Vol.26 No.5

Enucleation of a 9-year-old, spayed female Pekingese's right eye was scheduled because of recurrent eyeball rupture caused by chronic corneal ulcer and descemetocele. Scoliosis of the thoracic vertebra was observed on thoracic radiography. Complete blood count, electrolytes, serum chemistry profiles were within normal ranges except of alkaline phosphatase, which was markedly improved, compared with that of five months ago. Severe respiratory sinus arrhythmia was observed before induction of anesthesia, it disappeared after induction. Retrobulbar block was performed with 0.5% bupivacaine, 2% lidocaine, 0.1% epinephrine combination (4 : 1 : 0.2 ratio of volume) before start of surgery. After retrobulbar block, heart rate decreased from 110 to 76 beats/min and sinus arrhythmia recurred. It was considered as oculocardiac reflex caused by increase of intraorbital pressure from retrobulbar block, atropine (0.025 mg/kg, Ⅳ) was administered and intermittent positive pressure ventilation was started. Three minutes after atropine administration, abnormal waveform of the electrocardiograph was appeared, it suspected as ventricular or supraventricular tachycardia, so lidocaine (2 mg/kg, Ⅳ) was administered. Then, heart rate was maintained around 130 beats/min, and the surgery was finished without the other problems. Although, retrobulbar block is performed to provide analgesia and to prevent oculocardiac reflex in ophthalmic surgery, occasionally it could induce oculocardiac reflex by infiltrated volume.

개의 전이도적출술 중 전기지혈에 의해 발생한 삼차신경심장반사 1례

조상민,손원균,장민,김완희,이병천,이인형 한국임상수의학회 2016 한국임상수의학회지 Vol.33 No.4

A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical TeachingHospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosedby computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemichypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heartvalves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog waspremedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone(2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heartrate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintainedwithin normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). Duringsubcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In notime at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done becausemean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidalisoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardiaafter electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It isrecommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.

Sedative and analgesic effects of intravenous xylazine and tramadol on horses

서종필,손원균,이인형,Sujin Gang 대한수의학회 2011 JOURNAL OF VETERINARY SCIENCE Vol.12 No.3

This study was performed to evaluate the sedative and analgesic effects of xylazine (X) and tramadol (T) intravenously (IV) administered to horses. Six thoroughbred saddle horses each received X (1.0 mg/kg), T (2.0 mg/kg), and a combination of XT (1.0 and 2.0 mg/kg, respectively) IV. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), indirect arterial pressure (IAP), capillary refill time (CRT), sedation, and analgesia (using electrical stimulation and pinprick) were measured before and after drug administration. HR and RR significantly decreased from basal values with X and XT treatments, and significantly increased with T treatment (p < 0.05). RT and IAP also significantly increased with T treatment (p < 0.05). CRT did not change significantly with any treatments. The onset of sedation and analgesia were approximately 5 min after both X and XT treatments; however, the XT combination produced a longer duration of sedation and analgesia than X alone. Two horses in the XT treatment group displayed excited transient behavior within 5 min of drug administration. The results suggest that the XT combination is useful for sedation and analgesia in horses. However, careful monitoring for excited behavior shortly after administration is recommended.

횡격막허니아에 병발한 긴장성기흉 1례

김현석,윤수경,손원균,장민,황혜신,조상민,신지원,김완희,윤정희,이인형 한국임상수의학회 2016 한국임상수의학회지 Vol.33 No.4

A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of SeoulNational University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatichernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During thesurgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterialblood (PaO2): 52 mmHg, pulse oximetry (SpO2): 87%, arterial hemoglobin oxygen saturation (SaO2): 85.8%). In additionto hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxiaand hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure withinthe thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tubewas placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoringwith the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothoraxis difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothoraxshould be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.