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진행위암 수술후 복강내 온열관류요법 시행시 저체온 마취에 대한 고찰
정창우,임청현 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.11
Intraperitoneal hyperthermic perfusion(IPHP) is gaining popularity in the world as a method of prevention and treatment of peritoneal metastasis following gatrointestinal cancer. The procedure presents significant problems to the anesthegiologist with regard to tempera- ture control, fluid and electrolyte balance, acid-base change and postoperative care. During IPHP, there is a potential for heat gain from the peritoneal cavity. Several workers have reported a significant increase in core temperature. Therefore, it is true that accurate monitoring of temperature is essential. We studied that acid-base balance, electrolyte balance, level of blood suger following core temperature change in Intraperitoneal Hyperthermo-chemotherapeutic Perfusion patients.
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Labetalol 에 의한 기관내 삽관시 혈압과 맥박수 상승의 억제효과
이호연,김홍렬,정창우,임청현 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.11
Transient increases in blood pressure and heart rate following laryngoscopy and endotra- cheal intubation are common. These stress responses are greatly exaggerated in patients with hypertension and cardiovascular diseases and can lead to cardiac arrhythmia, pulmo- nary edema, and cerebral hemorrhsge. Many approaches have been tried to attenuate these potentially adverse circulatory responses but none has been satisfactory. This study was made to evaluate the hemodynamic responses to tracheal intubation using combined α-and β-adrenoreceptor blocking agent, labetalol. We intravenously administered labetalol or placebo prior to laryngoscopy and tracheal intubation in adult patients with ASA class 1, or 2. Sixty patients were randomly assigned to one of three treatment groups. Group 1 patients (control group,n=20) received normal saline 3ml, Group 2 patients (n=20) received labetalol 0.3mg/kg, and Group 3 patients (n= 20) received labetalol 0.6mg/kg intravenously. These drugs were injected 3 minutes before indtion with thiopental sodium (5mg/kg). Succinylcholine chloride 1.0mg/kg i.v. was used to facilitate endotracheal intubation. After the completion of intubation, nitrous oxide/oxygen with enflurane or isoflurane was administered. The blood pressure and heart rate were measured upon arrival in the operating room (baseline), immediately before intubation, immediately after intubation, 1 minutes after intubation and at 2, 3, 5, 7, 10 minutes after intubation. There were no significant differences in preinduction values of blood pressure and heart rate. A significant reduction in heart rate was observed in the group 3, group 2 in that order compared with the group 1. Similarly, systolic, diastolic and mean arterial pressure de- creased in labetalol groups, but was not significantly different in all groups. None of the patients experienced any untoward side effects, such as hypotension, aignificant bradycardia, bronchospasm or electrocardiographic ehanges. In conclusion, in patients with no history of hypertension or significant cardiac disease, labetalol 0.3 or 0.6mg/kg i.v. is better suited to blunting tachycardia than to blunting hypertension to laryngoscopy and intubation.
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이호연,이동기,김홍렬,임청현,이승림 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.1
In 24 healthy adult patients having orthopedic surgical procedures requiring the use of a tourniquet under general anesthesia with controlled mechanieal ventilation, we have deter- mined ehanges in end tidal CO₂(P_(ET)CO₂) and arterial blood gas values before and after release of tourniquet. After deflation of tourniguet, P_(ET)CO₂ and PaCO₂ increased significantly with the maximal elevation occuring within two minutes. The pH level decreased significantly and maximally within three minutes. There was statistically significant linear correlation between P_(ET)CO₂ and PaCO₂ Sugesting prediction of the PaCO₂, level by monitoring the P_(ET)CO₂ level. On these findings, hyperventilation may be indicated to facilitate the return of PaCO₂ and pH to baseline just before and for several minutes after tourniquet release, especially in patients with increased intracranial pressure. In conclusion, we recommend noninvasive monitoring of the P_(ET)CO₂ level instead of invasive measure-ment of the PaCO₂ level.
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자궁경부암에서 혈청을 이용한 표피성장인자 수용체의 정략적 분석에 관한 연구
김영태,이용호,이규완,조윤정,이낙우,임청현 대한부인종양 콜포스코피학회 2000 Journal of Gynecologic Oncology Vol.11 No.1
Epidermal growth factor receptor (EGFR) is overexpressed in various malignancies including carcinoma of the breast, lung, esophagus, cervix, and stomach. In patients with cervical carcinoma, its overexpression may be associated with advanced stage and poor prognosis. So, we evaluated the levels of serum EGFR in patients with cervical carcinoma. The level of EGFR extracellular domain was determined in serum from 57 cervical carcinoma patients(adenocarcinoma: 2, squamous cell carcinoma: 39, carcinoma in situ(CIS): 16) and 28 cases of healthy control using enzyme-linked immunosorbent assay(Calbiochem). In invasive carcinoma, serum EGFR level was measured in 11 cases of Stage Ia, 9 cases of Stage Ib, 4 cases of Stage Ⅱa, 15 cases of Stage Ⅱb, 2 cases of stage Ⅲ patients. The mean ages of the healthy controls, of the wome with carcinoma in situ(CIS), and with invasive cervical carcinoma were not different(49.3, 44.4, 49.5, respectively, p=0.241). The mean serum level of EGFR in healthy control(n=28), carcinoma situ(CIS)(n=16), and invasive carcinoma patients(n=41) were not significantly different(71.4±12.8fmol/ml, 79.2±26.8fmol/ml, 61.8± 18.4 fmol/ml, respectively, p=0.071). In conclusion, the expression of EGFR was not increased in patients with cervical cancer compared with normal women. And no significant differences were found depending on the clinical stage.
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