노인 마취의 임상적 고찰

이기남,이종현,문준일,최효섭 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.1

Due to improvements in medical care, the socioeconomic level and public health, life expectancy has dramatically increased. Thus, advances in the development of life-support systems and the control of infection have resulted in many surgical and anesthetic procedures being performed on extremely elderly patients. In contrast to younger patients, elderly patients may manifest more than one pathologic process associated with progressive degenerative changes in various organs of the aged, espe- cially in the heart, brain, and kidney. Since both progressive degenerative change occuring in the elderly population and the cumulative incidence of disease in that population result in death intraoperatively or during the immediate postoperative period, the anesthesiologist must be particularly alert to the possibility of anesthetic risks in the elderly. The elderly patient is more likely to have hypertension, congestive heart failure, cardiac dysrhythmias, chronic pulmonary disease, and diabetes. Preoperative evaluation and treatment of those conditions must be extensively reviewed prior to the induction of anesthesia. To evaluate geriatric anesthetic experiences, 539 cases of patients aged over 60 years of 4,266 anesthetic cases admitted to P.M.C. from January to December, 1986 were analyzed according to age, sex, physical status, anesthetic technique an6 agents, surgical department, preoperative chest X-ray findings, preoperative E.C.G findings, and postoperative complica-tions. The results are as follows. 1) f 4,266 anesthetic patients 539(12.6%) were over 60 3ears of age and 322(59.7%) were males and 217(40.3%) females. 2) In the classification of physical status, the most common evidence was class 2 in 303 cases. Emergency surgery comprised 27.1% 1Yo. 3) The snesthesia technique employed was usually general anesthesia and this suggested that balanced anesthesia used with narcotics offers several advantages to geriatric patients. 4) In the surgical department, 310 cases(57.5%) were for general surgery, 75 cases(13,9%), orthopedic surgery; 57 cases(10.6%), urology; and 49 cases(9.1%), neurosurgery, respectively. Cancer was present in 198 cases(36.7%), 5) Preoperative chest X-ray findings: The most common finding was pulmonary tuberculosis in 44 cases(8.2%). Pneumonia, pulmonary emphysema, and so forth were also observed. 6) Preoperative E.C.G findings: The most common findings was myocardial ischemia in 48 cases(8.9%). Also myocardial infarction observed in 8 cases(1.5%) 7) Postoperative complications were as follows: The most common incidence was wourid infection in 29 cases(5.4%) followed by pneumonia. There were a number of miscellaneous complications. but postoperatively, they did not present any significant problems. 8) The overall mortality rate was 3.5%(19 cases). The difference in the mortality rate related to age was not statistically significant(p$gt;0.1), but the mortality rate related to physical status was statistically significant(p$lt;0.001). 9) Optimizing a patient's preoperative condition by the anesthesiologist, consultants, and other physicians was assumed to reduce perioperative morbidity and mortality.

기도 내 종양의 형태로 나타난 비호지킨 림프종 1례

이기남,김재석,정진숙,지삼룡,손춘희,최익수 대한내과학회 1999 대한내과학회지 Vol.56 No.6

Endobronchial involvement in non-Hodgkin's lymphoma is rare. We experienced 36-year-old woman with endobronchial non-Hodgkin's lymphoma whose first presentation was breathless ness due to the total atelectasis of the left lung. The patient underwent fiberoptic bronchoscopy and the histologic finding with immunohistochemical staining confirmed CD30(+), EMA(+) anaplastic large cell lymphoma. Although the patient showed dramatic response to radiation therapy and combination chemotherapy, subsequently she died of disease progression.

조영제의 혈관내 투여로 인한 부작용의 발생에 관한 전향성 연구

이기남 대한영상의학회 1984 대한영상의학회지 Vol.20 No.1

In this prospective study, it was aimed to survey the incidence of untoward reactions and overall problems occurred when iodinated contrast media was used for the purpose of diagnostic radiology. So, the causes of adverse reactions to the contrast media in 34 patients were analyzed from 474 cases, and the following results were obtained : 1. The incidence of adverse reactions were noticed in 34 cases among 474 cases. (7.15%) 2. Positive allergic history or previous examinations was not related to present examination statistically. 3. The erythema, less than 2mm in diameter after skin test was not paralleled with the occurrence of side reaction, but when over 5mm, it was significantly associated with the reaction. 4. The incidence was neither related to sex or age, but the frequency was especially lower in person, below 20 years of age. 5. The frequent symptoms and signs in side reactions were chilling (24.5%), nausea (22.6%), and flushing (15.1%) 6. The dosage of Hypaque or dorray had correlation with the incidnece of side reactions, but Urografin and Biligrafin did not. 7. Patients experiencing fear and anxiety did not show any relationship in the incidence of adverse reactions.

척추마취시 진정제로서의 Midazolam 과 Propofol 이 심폐기능에 미치는 영향

이기남,이준학,문준일,김용국 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.6

Many agents such as analgesics and sedatives have been used to decrease pain, anxiety and awareness during anesthesia. The effects of midazolam and propofol on cardiopulmonary functions and sedation were evaluated in a clinical study during spinal anesthesia. Thirty adult patients were received either midazolam 0.05mg/kg IV or propofol 1.25mg/kg IV after spinal anesthesia. Minute volume, arterial oxygen saturation, blood pressure, and heart rate were checked before and 20min after spinal anesthesia, as well as 2 min, 5 min, 10 min, 30 min, 60 min after each drug administration. The results were as follows ; 1) Minute volume and SaO2 were decreased from 2 min to 10 min in each group. 2) Mean arterial pressure was decreased from 2 min to 60 min in each group, but there was no significant difference between the two groups. Heart rate was increased at 2 min in propofol group. 3) Recovery time from sedation was faster in the propofol group than the midazolam group. From the above results, we have concluded that midazolam and propofol have some effects on cardiopulmonary function and many advantages if used carefully during spinal anesthesia.

척추골절 환자에서 미추 경막외 차단 중 발생한 혈관미주신경성 실신

이기남,박상철,이준학,이수종,문준일,윤채식 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.3

Vasovagal Syncope during a Caudal Epidural Block in a Patient with Vertebral Fractures - A case report - Jun Hak Lee, M.D., Soo Jong Lee, M.D., Sang Cheol Park, M.D. Chae Sik Yun, M.D., Ki nam Lee, M.D., and Jun Il Moon, M.D. Department of Anesthesiology, Presbyterian Medical Center, Jeonju, Korea Age-related vertebral fractures occour frequently in the elderly recently. An epidural block has been introduced as an effective management for the treatment of pain with vertebral compression fractures. While an epidural block is considered to be reasonably safe, serious complications may occur even when this invsive procedure is related to pain. Vasovagally mediated episodes of hypotension and bradycardia are thought to be a common cause of recurrent unexplained syncope. Precipitating factors include pain, trauma, fatigue, blood loss, or prollonged motionless standing. We report one case of vasovagal syncope associated with severe bradycardia and hypotension in a 78 year0old male patient with vertebral fractures. Syncopal attacks occurred during a caudal epidural block. The patient was resuscitated successfully and recovered without any adverse effects. (Korean J Anesthesiol 2001; 41: 383~387)

李珥의 十萬養兵論에 대한 재검토

이기남 栗谷학회 2002 율곡학연구 Vol.5 No.-

道敎 思想 韓方養生學 形成에 대한 小考

이기남 원광대학교 원불교사상연구원 1999 원불교사상과 종교문화 Vol.23 No.-

코오넬의학지수(Cornell Medical Index)에 의한 남·녀 대학생의 건강실태 조사연구

이기남,이종섭,유은주 圓光大學校 醫科學硏究所 1987 圓光醫科學 Vol.3 No.2

This study was conducted to evaluate the Health Status of 584 students enrolled in WonKwang University by Cornell Medical Index Questionaire from March to May 1987. The conclusion is as follows ; 1. Inaducacy, eyes and ears, fatigue in CMI items was showed high Complaints rate of more than 30% 2. For the purpose of understanding the Health Problem according to the general characteristics of students implemented Analysis of Variance Test. The results that according to sex, age, marital status, income, native place, medical institution looking for firstly, college are significant difference appeared. 1) Sex ; Female students shows higher complaints rate than male students. 2) Age; The younger, the higher complaints rate appeared. 3) Marital Status ; Single shows higher complaints rate than married. 4) Native Place ; Students who grown in middle, small city and large city shows higher complaints rate than rural students. 5) College ; Medical college, the others (humanistic, sociological arts college), Herb medical college, in regular sequence high complaints rate appeared.

P . 5 : 자연산물을 이용한 니켈독성의 해독에 관한 연구

이기남,유임수,이종섭 대한보건협회 1994 대한보건협회 보건종합학술대회 Vol.- No.-

흉막 결핵에 병발된 흉막 Mantle 세포 림프종 1 예

이기남,최익수,김재석,정진숙,노미숙,이수걸,한진영,손춘희,장광열,최필조,이현수 대한내과학회 2002 대한내과학회지 Vol.62 No.4