http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례보고 : 신장이식수술 중 발생한 반대측 본연 신장의 자발성 파열
정순호 ( Soon Ho Cheong ),조재흥 ( Jae Heung Cho ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),이정한 ( Jeong Han Lee ),이근무 ( Kun Moo Lee ),최영균 ( Young Kyun Choi ),김영재 ( Young Jae Kim ),신치만 ( Chee Mahn Shin ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.3
Spontaneous rupture of a kidney can occur as a complication of an acquired cystic kidney lesion. Herein, one case of a spontaneous rupture of a contralateral native kidney, due to the rupture of a cystic lesion during kidney transplantation surgery, is described. The patient was a 24 year old female admitted for left kidney transplantation due to chronic renal failure. During the operation, her arterial blood pressure and central venous pressure gradually decreased after anastomosis of the renal vessel, but without significant bleeding in the operative field or any suspected cause of the decreasing arterial blood pressure. On the first postoperative day, she underwent an abdominal CT, where a retroperitoneal hematoma was found. Therefore, a right nephrectomy was performed. She also had a right perirenal hematoma due to the rupture of cystic lesion in the native kidney. While a spontaneous rupture of the kidney is very rare, especially during the perioperative period, it is important to consider this complication when evaluating the corresponding clinical picture. (Korean J Anesthesiol 2007; 53: 355~8)
임상연구 : Remifentanil과 Porpofol을 사용한 마취유도 시 교류저항 심장도 검사를 이용한 혈역학적 변화의 측정
정순호 ( Soon Ho Cheong ),박대식 ( Tae Sik Park ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),이정한 ( Jeong Han Lee ),이근무 ( Kun Moo Lee ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Background: Remifentanil-propofol combination is used to minimize the cardiovascular responses during anesthetic induction; however, it may generate side effects such as hypotension or bradycardia. The authors investigated the changes of stroke volume and cardiac output using impedance cardiography (ICG) when hypotension or bradycardia is generated during propofol-remifentanil anesthetic induction. Methods: Ninety ASA physical status class I patients who were scheduled to undergo elective ambulatory surgery were randomly assigned to one of three groups (n = 30 each). Normal saline (Group S), remifentanil 0.25μg/kg/min (Group R0.25), or remifentanil 0.5μg/kg/min (Group R0.5) was infused intravenously. Propofol was slowly administered two minutes after the administration of remifentanil or normal saline. Heart rate, mean arterial pressure, cardiac output and stroke volume were measured at preinduction (baseline), preintubation and postintubation. Results: Mean arterial pressure in Group R0.5 at preintubation decreased compared to that of the baseline, however, the stroke volume index was sustained. The stroke volume index at postintubation decreased proportionally as heart rate increased in heart rate in all groups, and then cardiac index was preserved. Conclusions: Hypotension was generated during induction of anesthesia when remifentanil 0.5μg/kg/min and propofol 1.0 mg/kg were used, however, the stroke volume index was sustained. (Korean J Anesthesiol 2007; 53: 42~7)
뇌 손상 환자에서 이중분광계수를 사용한 의식수준의 측정
조재흥 ( Jae Heung Cho ),정순호 ( Soon Ho Cheong ),김현식 ( Hyun Sik Kim ),김세훈 ( Se Hoon Kim ),조광래 ( Kwang Rae Cho ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),이정한 ( Jeong Han Lee ),이근무 ( K 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.2
Background: It is important to assess the level of consciousness in patients with brain injuries to determine modes of treatment and prognosis. We evaluated the Bispectral Index (BIS) to determine if it could be used as an objective tool for evaluation of the level of consciousness in brain-injured patients. We also compared the BIS values to clinical sedation scales such as the Glasgow Coma Scale (GCS), Richmond Agitation-Sedation Scale (RASS), and the Reaction Level Scale (RLS). Methods: Thirty eight patients with brain injuries that were admitted to the neurosurgery intensive care unit (NSICU) were enrolled in this study. An investigator evaluated the clinical sedation scales (GCS, RASS, RLS), while a blind observer noted the BIS in the same patient. The BIS score was obtained three times at an interval of 5 hours. The BISs were measured for 1 minute at 5 min prior to the nursing assessment, during the nursing assessment, and at 5 min after the nursing assessment. The BISs used in the data analysis were the maximal, minimal, and mean values obtained during 1 min, which were defined as BISmax, BISmin, and BISmean. A Spearman`s rank correlation coefficient was used to determine if the clinical sedation scales were correlated with the BIS scores. Results: In 38 patients, the BISmax, BISmin, and BISmean were found to be significantly correlated with the GCS, RASS, and RLS. The BISmean had the highest correlation with GCS (r=0.445, P<0.01), while the BIS min had the lowest correlation with RLS (r=-0.278, P<0.01). Conclusions: The results of BIS monitoring were found to be significantly correlated with sedation scales in patients with brain injuries. These findings suggest that BIS can be used as an objective and continuous method for assessment of the level of consciousness in patients with brain injury. (Korean J Anesthesiol 2009;57:185∼9)
떨림과 경직이 발생한 척추수술후증후군 환자에서 척수자극술에 의한 치료 경험 -증례 보고-
김영재,김명훈,임세훈,이정한,이근무,정순호,최영균,신치만,Kim, Young Jae,Kim, Myoung Hun,Lim, Se Hoon,Lee, Jeong Han,Lee, Kun Moo,Cheong, Soon Ho,Choe, Young Kyun,Shin, Chee Mahn 대한통증학회 2006 The Korean Journal of Pain Vol.19 No.1
Tremor is a rhythmic, involuntary and oscillatory movement of body parts, and it is the most common movement disorder. Spasticity is also one of the movement disorders that is commonly accompanied with Complex Regional Pain Syndrome; however, the basic nature of spasticity has not yet been proved. A 25-year-old male patient had two operations and he was being treated because of a back injury that occurred 4 years ago. He suffered from pain, tremor and spasticity on both his lower legs, and his symptoms were diagnosed as failed back surgery syndrome. The tremor and spasticity were aggravated despite of continuous treatments. We then treated him with spinal cord stimulation. His pain, tremor and spasticity disappeared after spinal cord stimulation.
임상연구 : Desflurane 흡입마취 시 Remifentanil 지속정주가 기도반응성에 미치는 효과
안성태 ( Sung Tae Ahn ),이정한 ( Jeong Han Lee ),정순호 ( Soon Ho Cheong ),이근무 ( Kun Moo Lee ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: Because desflurane can cause airway reactivity, the use of opioids are aimed at its reduction. This study was designed to evaluate the effect of continuous remifentanil infusion on the airway reactivity during desflurane inhalation. Methods: 108 adult ASA physical status class I patients were enrolled in this study. The patients were divided into four groups. The breathing circuit was primed with 8 vol% desflurane in 3 L/min each of N2O and O2. Anesthesia was induced with 0.2 mg/kg of intravenous etomidate. After 2 minutes, either 20 ml/hr saline, or 0.15, 0.25 or 0.35μg/kg/min remifentanil, groups S, R1, R2 and R3, respectively, was infused. Each patient inhaled the gas mixture through a tight fitting facemask. During this period, the coughing, secretions, breathing hold, laryngospasms, excitatory movements and hemodynamics were measured. Results: The coughing, spasms, secretions and excitatory movements were significantly lower in the remifentanil than the saline infusion group (P<0.05). However, the breathing hold was significantly higher in group R3 (P<0.001). The mean arterial pressure and heart rate were more stable in groups R1 and R2. Conclusions: These results demonstrate that groups R1 and R2 had significantly reduced airway reactivity, with stabilize hemodynamics, during desflurane inhalation. (Korean J Anesthesiol 2007; 53: 448~52)