수술후 통증조절을 위한 경막외 차단후 발생한 고위척추차단 - 증례보고 -

정성수(Sung Su Chung),유경연(Kyung Yeon Yoo),채영 대한통증학회 1996 The Korean Journal of Pain Vol.9 No.1

High spinal block is a rare complication during epidural block, but it may result in seri- ous events. 56-year-old man with gall stones was scheduled for cholecystectomy under gen- eral anesthesia. After operation, lumbar epidural catheterization was done at T inter- space for postoperative pain control. At the recovery room, initial bolus drug(0.1% bupivacaine IOml containing fentanyl 100 μg) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia occurred. Hartman' solu- tion was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continu- ously. The location of intrathecal catheter was confirmed by cerebrospinal fluid(CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged I week later in good health.

행동조절장애 환자에서 치과치료를 위한 외래마취의 분석

반민희,정성수,Ban, Min-Hee,Chung, Sung-Su 대한치과마취과학회 2014 Journal of Dental Anesthesia and Pain Medicine Vol.14 No.1

Background: The aim of this study was to analyze outpatient anesthesia for dental treatment in handicapped patients with behavior disorder in order to use data for carrying out better and safe anesthetic management. Methods: The data were drawn from the 100 patients with behavior disorder who visited CNUDH dental clinic for disabled based on anesthesia record to investigate patient's systemic condition, cooperative level, anesthesia method according to patients cooperation, and side effects after recovery time. Results: Mental retardation (58%) is the most reason to choose general anesthesia. The methods of induction according to cooperative level are intravenous propofol injection in 22 cases and inhalation of sevoflurane in 78 cases. Induction time of anesthesia were within 10 seconds in cases of propofol induction and average $48.8{\pm}18.5$ seconds in cases of inhalation induction. The time spent on dental treatment was average $3.2{\pm}1.1$ hours. After the end of treatment, average time to move from unit chair to recovery bed, to recliner, and to discharge from hospital are $10.4{\pm}5.1$, $36.9{\pm}17.1$ and $72.4{\pm}16.0$ minutes, respectively. During recovery, there are nausea with 9%, vomiting with 4%, dizziness with 2%, finger injury with 1%. Conclusions: This study showed our successful anesthetic outcomes without any severe side effects or complications. Through this study, it will be used for safe anesthetic management as useful reference data.

Propofol에 의한 전신마취 후 회복 시 발생한 근경련 -증례 보고-

김병환,정성수,Kim, Byung-Hwan,Chung, Sung-Su 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1

There are a few case reports describing persistent seizure following propofol. A 45-year-old female underwent operation of mastoidectomy and tympanoplasty. She had no personal or family history of epilepsy. Anesthesia was induced with propofol and rocuronium, and maintained with sevoflurane-remifentanil after tracheal intubation. Any event was not noted during surgery. Seizure-like movement and shivering were developed after surgery in recovery room. Symptom was relieved by benzodiazepines, especially lorazepam. She was discharged in the 9th postoperative days without any sequelae.

정규수술환자 중 마취통증의학과로 협진 의뢰한 환자의 분석

하지원,정성수,Ha, Ji-Won,Chung, Sung-Su 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1

Background: This study was carried out to contribute to effective management of operated patients by analyzing cooperative details about patients who were taken elective operation and consulted to the department of anesthesiology. Patients and Methods: One thousand patients who have been consulted to department of Anesthesiology, Chonnam National University Hospital from 2008. November to 2009. March were analyzed. The gender, age, cooperative departments, cooperative reason, the number of cancelled cases and cancelled reason were evaluated. Results: Among 1000 patients, there were 470 females and 530 males. After adjusting for age, middle-aged people which range 45 to 64 year-old are 39.9% and over 65 year-old people are 30.3%. Cooperative department is distributed to orthopedics which is highest occupying 20.6%, neurosurgery, otorhinolaryngology, obstetrics and gynecology in order. Dentistry occupied 2.0%. By specifying reasons of cooperation, cardiovascular diseases distribute to 38.4% which is the highest, the respiratory diseases, 17.5% and the endocrine diseases including diabetes 13.2%. Arranging details, hypertension is 23.9%, ECG abnormality 14.5%, chronic bronchitis in chest radiographic interpretation 14.2%. Of 1,000 consulted patients, delayed or cancelled cases are 58. And the reasons were 26 cases of need of appropriate the blood-sugar level. 26 cases needed appropriate treatment for comorbidities and others 6. Conclusion: Thoroughly evaluating patients before operation and maintenace of active cooperative system between operative department and anesthesiology department can contribute to reduction of cancellation rate and effective management of both hospitalizing and operating rooms.

Expression of Bcl-2 Family in 4-Nitroquinoline 1-Oxide-Induced Tongue Carcinogenesis of the Rat

최재욱,정성수,이금숙,김병국,김재형,국은별,장미선,고미경,정권,최홍란,김옥준,Choi, Jae-Wook,Chung, Sung-Su,Lee, Geum-Sug,Kim, Byung-Gook,Kim, Jae-Hyeong,Kook, Eun-Byul,Jang, Mi-Sun,Ko, Mi-Kyeong,Jung, Kwon,Choi, Hong-Ran,Kim, Ok-Joon Korean Academy of Orofacial Pain and Oral Medicine 2005 Journal of Oral Medicine and Pain Vol.30 No.3

The number of patients with tongue carcinoma is increasing rapidly among young individuals in many parts of the world. Oral carcinoma progresses from hyperplastic lesion through dysplasia to invasive carcinoma and the concept of "field cancerization" with molecular alteration has been suggested for oral cavity carcinogenesis. Significant improvement in treatment and prognosis will depend on more detailed understanding of the multi-step process leading to cancer development. To induce tongue carcinoma in rat by 4-NQO, each drinking water was made to 10 ppm, 25 ppm, 50 ppm and control (only D.W. without 4-NQO). Specimens were classified into 4 groups such as control, I (mild & moderate dysplasia), II (severe dysplasia and carcinoma in situ), III (carcinoma). The mRNA expressions of Bcl-2 family were evaluated by RT-PCR technique. For anti-apoptotic Bcl-2 family, mRNA expression of Bcl-w was down-regulated in all stages of tongue carcinogenesis model. However, mRNA expression of Bcl-2 was up-regulated. For pro-apoptotic Bcl-2 family, all members were down-regulated in all stages of tongue carcinogenesis model except for Bad mRNA in group III. In terms of BH3 only protein, mRNA expressions of Bok and Mcl-1 were down regulated in all stages of specimen, but Bmf in group II and BBC3 in group III were up-regulated. Our current findings demonstrated the involvements of mRNA expression of Bcl-2 family in multi-step tongue carcinogensis. This highlights the necessity for continued efforts to discover suitable biomakers (Bcl-2 family) for early diagnosis of the disease, and to understand its pathogenesis as a first step in improving methods of treatment. The discovery of these potential biomarkers and molecular targets for cancer diagnostics and therapeutics has the potential to significantly change the clinical approach and outcome of the disease.

구강작열감 증후군 환자에서 Nd-YAG 레이저 조사에 대한 구강점막 부위의 통증 인지도와 점막세포 각화도와의 관계

김지연,김병국,정성수,Kim, Ji-Yeon,Kim, Byung-Gook,Chung, Sung-Su 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

In order to determine how oral mucosal change relates to inducing factors of burning mouth syndrome, the difference in pain perception scale and keratinization rate between burning mouth syndrome patients and normal subjects were investigated. Twenty patients (13 female, 7 male, mean age: 59 years), presenting in the Department of Oral Medicine, Chonnam National University Hospital were participated in this study. All subjects had been complaining of constant oral burning pain for more than a year, none took any strong analgesics, and none had oral mucosal lesions. Twenty volunteers (11 females, 9 males, mean age: 25 years) were also participated in this study as a control group. The control subjects had never had any symptoms of oral burning pain. A thermal stimulation using a Nd-YAG laser and cytological smear were carried out to anterodorsal part of tongue, tip of tongue, the left buccal mucosa, the lower lip mucosa and the chief complaint site. Stimulation of the dorsum of left hand was also carried out to contrast the mucosal area of burning mouth syndrome subjects and the control subjects. The laser output power could be adjusted from 0.75W to 4W. The pain perception scale of the burning mouth syndrome subjects were lower than in control subjects in the chief complaint area, the anterodorsal part of tongue and the buccal mucosa(p<0.01). The keratinization rate of burning mouth syndrome subjects, however, was higher keratinization rate than in normal subjects in the same area and lower lip mucosa(p<0.001). From above results, the anterodorsal part of tongue is the most appropriate site to use diagnostic laser stimulation. The higher level of keratinization and the lower level of thermal pain perception of the burning mouth syndrome subjects are explained as a protective mechanism against xerostomia and burning sensations. The application of Nd-YAG laser stimuli and cytological smear to oral mucosal surface could therefore be usefully employed as appropriate and standardized diagnostic tools for chronic orofacial pain subjects.

현미경적 요추 추간판 제거술의 증상 호전율

이종서(Chong Suh Lee),정성수(Sung Su Chung),박무송(Moo Song Park),정광훈(Kwang Hoon Chung),김종혁(Jong Hyouk Kim) 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.6

일반논문 : 구성주의 지식론의 교육적 재개념화 -한국의 교육현상을 중심으로-

정석환 ( Seok Hwan Chung ),정성수 ( Sung Su Jung ) 한국교육철학회 2015 교육철학 Vol.56 No.-

This study discussed about the educational meanings of Constructivism of knowledge introduced to resolve problems resided in traditional theory of knowledge. Previous Constructivism theory of knowledge related studies focused mainly on justifying their own theory. However, the study wasn``t good enough to prove whether it resolved the problems when Constructivism theory of knowledge was adapted to an educational course. This study analyzed and proved the background where Constructivism theory of knowledge was introduced to Korean education. Also, it discussed the educational implication after surveying how structural theory of knowledge applied educational viewpoint has been functioning in current Korean education system. A result of this study suggests that educational programs based on Constructivism theory of knowledge has been carried out while various problems caused by the traditional theory of knowledge in education system has not been fixed. Educational problems caused by traditional theory of knowledge that structuralism criticized is still taking place in the field. It is about time to make transitions in views on studies related to educational philosophy. Which means it should change into studies regarding information in social use rather than studies on its types or application methods. It is important to change the study into fundamental cause to be used socially and reduce educational errors took place repetitively so far.

임상연구 : Doxapram Hydrochloride가 후두마스크기도를 이용한 전 정맥마취 시 환기반응에 미치는 영향

윤영철 ( Young Chul Yoon ),곽상현 ( Sang Hyun Kwak ),정성태 ( Sung Tae Jeong ),김석재 ( Seok Jai Kim ),배홍범 ( Hong Beom Bae ),정성수 ( Sung Su Chung ),정창영 ( Chang Young Jeong ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4

Background: Intravenous anesthetics causes depression of ventilatory response to hypercapnea. Doxapram stimulates ventilation via peripheral and central chemoreceptors. This study was aimed to evaluate the effect of doxapram on ventilation during total intravenous anesthesia (TIVA). Methods: 60 patients undergoing operation under spontaneous ventilation via laryngeal mask airwaywere randomly divided into 3 groups: Control group received 5% dextrous infusion, D-2 group received doxapram injection of 1 mg/kg followed by continuous infusion of 2 mg/kg/hr, and D-4 group received doxapram injection of 2 mg/kg followed by continuous infusion of 4 mg/kg/hr. Anesthesia was induced and maintained with propofol and remifentanil. Respiratory rate, tidal volume (VT) and arterial carbon dioxide tension (PaCO2) were measured before and 15 min after induction of anesthesia, 0(15 min after start of operation), 1, 2, 3, 5, 15, 30, 45, and 60 min after start of doxapram infusion during TIVA. Results: VT was significantly increased 1 min after start of doxapram infusion and returned to the value of pre-doxapram infusion immediately. In D-4 group, VT was significantly (P<0.05) increased again 5 min after doxapram infusion compared with the value of pre-doxapram infusion and control group. PaCO2 was decreased 1 min after start of doxapram infusion and then increased again 2 min after doxapram infusion. In D-4 group, the degree of increase of PaCO2 was significantly (P<0.05) less than those of D-2 group. Conclusions: Doxapram injection of 2 mg/kg followed by continuous infusion of 4 mg/kg/hr improved the depression of ventilatory response during TIVA. (Korean J Anesthesiol 2007; 53: 470∼6)

백서를 이용한 포르말린 통증 모형하에서 뇌실 내 Gabapentin의 효과

윤명하(Myung Ha Yoon),곽상현(Sang Hyun Kwak),정성수(Sung Su Chung),유경연(Kyung Yeon Yoo),정창연(Chang Young Jeong),임응모(Woong Mo Im) 대한통증학회 2000 The Korean Journal of Pain Vol.13 No.2

N/A Background: Systemic or intrathecal administration of gabapentin has been shown to reverse various pain states. However, until now, the effect of intracerebroventricular (ICV) gabapentin to noxious stimuli has not been reported. The authors aim of this study was to determine the effect of ICV gabapentin on the inflammatory nociceptive model, formalin test, in rats. Methods: ICV catheters were implanted under halothane anesthesia. For the nociceptive test, 50μl of 5% formalin was subcutaneously injected into the hindpaw. The effect of ICV gabapentin, administered 10 min before formalin injection, were examined on flinching, mean arterial pressure and heart rate evoked by a injection of formalin. Results: Injection of formalin into the paw resulted in a biphasic flinching and cardiovascular response. ICV gabapentin produced a dose-dependent suppression of the flinching and mean arterial pressure response during phase 1. In contrast, in phase 2, ICV gabapentin did not attenuate the pain behavior. ICV gabapentin did not affect on the baseline mean arterial pressure and heart rate. Conclusions: ICV gbapentin was effective for the acute noxious stimulus but it had no effect on the facilitated states induced by tissue injury.