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Successful intubation using video laryngoscope in a child with CHARGE syndrome - A case report -
최소론,김정호,홍정인,채경린,윤경섭,박상융,이승철,이종환,정찬종 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.1
CHARGE syndrome is a rare genetic disorder with CHD7 gene mutation. CHARGE is an acronym for coloboma (C), heart disease (H), atresia of choanae (A), retardation of growth (R), genitourinary malformation (G), and ear abnormalities (E). Patients with CHARGE syndrome need to undergo many surgeries due to their various congenital anomalies. Since airway abnormalities frequently accompany CHARGE syndrome, general anesthesia remains a challenge. Here we report a case of difficult intubation in a 35-month-old boy with CHARGE syndrome during general anesthesia and the experience of successful intubation using D-blade of C-MAC® video laryngoscope.
소아에서 Sevoflurane 마취 시 Bispectral Index와 Spectral Entropy의 비교
최소론,정찬종,박상원,이수일 대한마취통증의학회 2009 Anesthesia and pain medicine Vol.4 No.2
Background: Bispectral index (BIS) is a useful tool to assess depth of anesthesia. Recently, spectral entropy has been promoted as a monitor of anesthetic depth in adult, but its characteristics in children remains poorly defined. This study was to compare BIS and entropy indices during sevoflurane anesthesia in children. Methods: Forty children (aged 1−12 yr) scheduled for ENT surgery, were included. Anesthesia was induced with 5.0% sevoflurane in O2 6 L/min. Tracheal intubation was performed with rocuronium 0.6 mg/kg. Heart rate, blood pressure, end-tidal sevoflurane concentration (Etsev), BIS, response entropy (RE) and state entropy (SE) were measured every 5 minutes. The correlation between BIS and entropy index and Etsev was calculated, Results: The BIS, SE and RE values decreased with induction and increased with recovery. The BIS, RE, and SE values were inversely proportionally related to the Etsev. The RE and SE values were closely correlated with the BIS values (respectively r = 0.948 and r = 0.946, P < 0.001). Conclusions: We demonstrated a close correlation of SE and RE with Etsev and with BIS during sevoflurane anesthesia in children. State entropy and RE seem to be useful electroencephalographic measures of sevoflurane drug effect in children.
소아마취에서 주술기 호흡기 부작용의 위험 요인; 다기관 연구
최소론,정찬종,고병주,곽미정,김갑수,김희수,박성식,안태훈,이일옥,이종화,이지영,장철호,한종인 대한마취통증의학회 2012 Anesthesia and pain medicine Vol.7 No.1
Background: Perioperative respiratory adverse events remain a major cause of postoperative morbidity and mortality during pediatric anesthesia. This multicenter study was designed to evaluate the incidence of perioperative respiratory adverse events during elective pediatric surgery and to identify the risk factors for these events. Methods: Pediatric patients undergoing elective surgery under general anesthesia in 11 hospitals were randomly selected for this prospective, multicenter study. Preanesthetic assessments, anesthetic and surgical conditions were recorded by anesthesiologists in charge. Adverse respiratory events were registered. Results: Eight hundred and twenty-three patients were included. The overall incidence of any perioperative respiratory adverse respiratory event was 15.1%. The incidences of perioperative bronchospasm, laryngospasm, coughing, desaturatioin (oxygen saturation <95%), and airway obstruction were 0.1, 0.5, 10.2, 4.1,and 1.6% respectively. According to the multivariate analysis, five risk factors were identified: multiple attempts for airway device insertion, odds ratio (OR) 2.88; recent URI (≤2 weeks), OR 1.96;induction with intravenous anesthetics, OR 1.95; airway related surgery, OR 1.88; ASA class ≥2, OR 1.62. Conclusions: Multiple attempts for airway device insertion, recent URI, induction with intravenous anesthetics, airway related surgery and ASA class ≥2 were associated with increased risk for perioperative respiratory adverse events.
Comparison of clinical performance of i-gelⓇ and Baska MaskⓇ during laparoscopic cholecystectomy
최소론,이태영,김성완,박상융,정찬종,김정호 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.6
Background: The supraglottic airway device is an appropriate alternative to tracheal intubation in laparoscopic surgery. We compared the Baska MaskⓇ with i-gelⓇ by measuring the oropharyngeal leak pressure (OLP) and hemodynamic and respiratory parameters during laparoscopic cholecystectomy. Methods: A total of 97 patients were randomly allocated to either i-gel group (n = 49) or Baska Mask group (n = 48). Insertion time, number of insertion attempts, fiber-optic view of the glottis, and OLP were recorded. Heart rate, mean arterial pressure, peak airway pressure (PAP), lung compliance, and perioperative complications were assessed before, during, and after pneumoperitoneum. Results: There were no significant differences between the two groups regarding demographic data, insertion time, fiber- optic view of the glottis, and the use of airway manipulation. The OLP was higher in the Baska Mask group than in the i-gel group (29.6 ± 6.8 cmH2O and 26.7 ± 4.5 cmH2O, respectively; P = 0.014). Heart rate, mean arterial pressure, PAP, and lung compliance were not significantly different between the groups. The incidence of perioperative complications was small and not statistically significant. Conclusions: Both the i-gel and Baska Mask provided a satisfactory airway during laparoscopic cholecystectomy. Compared with the i-gel, the Baska Mask demonstrated a higher OLP.
Anesthetic considerations during surgical intervention in Woake’s syndrome -a case report-
최소론,김정호,채경린,이승철,박상융 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.3
Background: Woake’s syndrome (WS) is a recurrent nasal polyposis, accompanied by broadening of the nose, frontal sinus aplasia, dyscrinia, and bronchiectasis. There has been no previous report on anesthetic management in patients with WS. Case: We describe a case involving a 13-year-old male patient with WS who was scheduled for septorhinoplasty for necrotic ethmoiditis. Anesthesia was induced and maintained with propofol and remifentanil using a target-controlled infusion device. The anesthetic considerations of this rare syndrome and the advantages of an intravenous infusion method over local and volatile anesthesia for these patients are discussed. We report on caveats, such as pulmonary dysfunction during the anesthetic management, and nasal structural problems encountered in WS patients. Conclusions: Given that conventional inhaled anesthesia reduces ciliary movement and that local anesthesia with sedative has several disadvantages, perioperative control and precautions against respiratory infections by using antibiotics, and preventing cilio-depressant actions, are important for anesthetic management.
실험연구 : 말초신경손상 쥐에서 중추신경계 α2-아드레날린성 수용체 아형의 발현
최소론 ( So Ron Choi ),이형창 ( Hyung Chang Lee ),정찬종 ( Chan Jong Chung ),김해규 ( Hae Kyu Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
Background: The change of expression of the α2-adrenergic receptor (α2-AR) subtypes in the thalamus and hypothalamus were investigated in a neuropathic pain rat model. Methods: The left sciatic nerve was clamped for creating a neuropathic pain model in five rats. A sham operation was done in three rats as control group. Behavioral tests for pain were conducted by using mechanical stimuli applied to the hind paws. After 7 days, the expression of α2-AR subtype mRNA in the rat thalamus and hypothalamus was measured using real time polymerase chain reaction. Results: Mechanical allodynia were developed on postoperative 1, 3, and 7 days in the neuropathic pain model. The expression of α2A-AR, α2B-AR, and α2C-AR was significantly higher in the thalamus and hypothalamus in the neuropathic pain model (P > 0.05). Conclusions: These results would suggest that the subtypes of α2-AR in thalamus and hypothalamus may contribute to produce neuropathic pain. (Korean J Anesthesiol 2006; 51: 468~75)
Adrenal incidentaloma: a case of asymptomatic pheochromocytoma
박상융,최소론,임종철,조현철,이윤찬,김정아 고신대학교(의대) 고신대학교 의과대학 학술지 2018 고신대학교 의과대학 학술지 Vol.33 No.2
An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 ㎝) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.
Antinociceptive Effect of BPC-157 in the Formalin-induced Pain Model
박상융,최소론,김정호,이승철,정성엽,정준호,이태영 고신대학교(의대) 고신대학교 의과대학 학술지 2021 고신대학교 의과대학 학술지 Vol.36 No.1
Objectives: Body protective compound-157 (BPC-157) is a stable gastric pentadecapeptide that has been effective in trials aiming to increase wound healing capabilities and decrease inflammatory cell influx, including studies on the healing of muscles and tendons. There are no studies about the effect of BPC-157 on pain transmission via nociception. This study examined the antinociceptive effects of BPC-157 using formalin tests and immunohistochemistry. Methods: Rats were randomly divided into the control, morphine and BPC-157 groups. Pain behavior was quantified periodically at 5- and 35- min intervals (representative values of phases 1 and 2) by counting the number of flinches exhibited by the injected paw after injection. The dorsal root ganglia (DRG) and spinal cords (SC) were collected, and then, the number of cytokine-positive cells was determined via immunostaining. Results: BPC-157 dose-dependently decreased the number of flinches during phase 1 but did not decrease the number of flinches during phase 2. During phase 1, interleukin-1β (IL-1β) in the DRG tissue was significantly different in the morphine, 10 μg/kg BPC-157, and 20 μg/kg BPC-157 groups. During phase 2, statistical significance was achieved in the DRG tissue in the morphine, 20 μg/kg BPC-157, and 40 μg/kg BPC-157 groups. During phase 1, interleukin-6 was significantly different in the DRG tissue in the morphine group and the SC tissue in the 10 μg/kg BPC-157 group. During phase 2, statistical significance was achieved in the morphine group and the BPC-157 20 μg/kg group in both the DRG and SC tissues. There were no significant differences in tumor necrosis factor-α between the DRG and SC tissues. Conclusions: BPC-157 was effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 decreased the expression of IL-1β in the DRG tissue in phases 1 and 2.