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증례보고 : 승모판 성형술 중 BIS 및 대뇌산소포화도에서 이상 소견을 보인 환자에서 수술 후 발생한 가역적인 시각 장애
김혜진 ( Hye Jin Kim ),이윤경 ( Yoon Kyung Lee ),함경돈 ( Kyung Don Hahm ),심지연 ( Ji Yeon Sim ),최인철 ( In Cheol Choi ),( Long Zhe Piao ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
Cerebral complication after cardiac surgery with cardiopulmonary bypass varies widely focal neurologic deficit, stupor, coma, dementia, memory deficit, or seizures. The incidence of visual loss from ischemic optic neuropathy is from 0.06% to 0.113%. Visual loss is a rare but devastating complication of cardiac surgery. This report describes a patient who had reversible visual loss in postoperative period. She had undergone the decrease of bispectral index, cerebral oxygen saturation and the increase of suppression ratio during mitral valvuloplasty. (Korean J Anesthesiol 2006; 51: 490~4)
최병문 ( Byung Moon Choi ),진지현 ( Ji Hyun Chin ),김영국 ( Young Kug Kim ),함경돈 ( Kyung Don Hahm ),심지연 ( Ji Yeon Sim ),최인철 ( In Cheol Choi ),황규삼 ( Gyu Sam Hwang ),한성민 ( Sung Min Han ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
An inguinal hernia shows that the protruding viscus exits from the endoabdominal fascial sac through the internal inguinal ring. Because an inguinal hernia is usually associated with incarceration, obstruction and even strangulation, it must be quickly treated whenever observed. Although there are several predisposing factors of the development of inguinal hernia, relatively little is a case report of the inguinal hernia developed by the increased intra-abdominal pressure during general anesthesia. In this case, we report a patient who developed the unexpected recurrence of left inguinal hernia following lumbar spinal surgery in prone position by increasing intra-abdominal pressure. After manual reduction was performed promptly by general surgeon, the patient was discharged without any complication on the eighth postoperative day. (Korean J Anesthesiol 2006; 51: 239~42)
급성 폐손상 토끼에서 고빈도부분액체환기 시 흡호기대비가 환기 및 산소화에 미치는 영향
송명희 ( Myung Hee Song ),최인철 ( In Cheol Choi ),함경돈 ( Kyung Don Hahm ),정용보 ( Yong Bo Jeong ),최규택 ( Kyu Taek Choi ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.2
Background: We examined the effects of varying inspiratory to expiratory (I:E) ratio on gas exchange and hemodynamics during high frequency partial liquid ventilation (HFPLV), a combination of high frequency ventilation (HFV) and partial liquid ventilation (PLV), in a rabbit model of acute lung injury. Methods: Twelve rabbits treated with repeated saline lavage were divided into two groups. In the HFPL group (n=6), 6 ml/kg of perfluorodecaline was administered through the endotracheal tube. Rabbits in this group and in the HFJ group (n=6) were treated with high frequency jet ventilation (HFJV) at I:E ratios of 1:1, 1:2, and 1:3 for 15 minutes, and arterial blood gas, mixed venous blood gas and hemodynamic parameters were measured. Results: We observed no significant respiratory and hemodynamic differences between the two groups. At an I:E ratio of 1:1, the PaO2 was significantly higher, and the shunt rate and PaCO2 were significantly lower in both groups, compared with I:E ratios of 1:2 and 1:3. Cardiac output at the 1:3 I:E ratio was significantly higher than at 1:1. Conclusions: These findings indicate that, in this model, a 1:1 I:E ratio was superior for oxygenation and ventilation than I:E ratios of 1:2 or 1:3, while having no detrimental effects on hemodynamics. (Korean J Anesthesiol 2009;57:203∼9)
증례보고 : Budd-Chiari Syndrome 환자의 간이식 수술 중 예상 밖의 대량출혈
송하나 ( Ha Na Song ),정성문 ( Sung Moon Jeong ),서영주 ( Young Joo Seo ),김희영 ( Hee Yeong Kim ),전혜영 ( Hye Young Jeon ),최재문 ( Jae Moon Choi ),송준걸 ( Jun Gol Song ),함경돈 ( Kyung Don Hahm ),황규삼 ( Gyu Sam Hwang ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Budd-Chiari syndrome (BCS) is a heterogenous group of disorders characterized by obstruction of hepatic venous outflow. Severe liver cirrhosis and limited cardiac reserve in patients with BCS makes them less tolerant to liver transplantation. We experienced two cases of massive bleeding during living donor liver transplantation in patients with BCS. Blood products and fluids were rapidly infused with a rapid infusion system, final infusion volume in these two patients were 177 L and 193 L, and the use of Cell Savers allowed for the patient`s blood products to be saved. The patients were managed successfully and recovered uneventfully with advanced monitoring, including monitoring of their jugular venous oxygen saturation and continuous cardiac output. Therefore, rapid infusion systems and Cell Savers, along with advanced monitoring, are necessary in the event of massive bleeding during liver transplantation. (Korean J Anesthesiol 2007; 53: 796∼802)
고양이에서 급성출혈성 쇽 및 수액소생시 대기 혹은 100% 산소가 소화관 점막 산소화에 미치는 효과
이유미,함경돈 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.4
Background : This study was purposed to study the effect of 100% oxygen on the oxygenation of gut mucosa in a feline model subjected to a hemorrhagic shock followed by reperfusion. Methods : Eighteen cats were divided into three groups : For group I, 6 cats were subjected to sham operation as a control group ; for group Ⅱ, 6 cats were subjected to a hemorrhagic shock for 2 hours prior to reperfusion and ventilated with air as a medical air group ; for group Ⅲ, 6 cats were ventilated with 100% oxygen, continued during the shock and reperfusion periods as a 100% oxygen group. Mesenteric PvO₂, mesenteric PaO₂, mesenteric venous arterial(v-a) lactate difference, mesenteric P(v-a)CO₂and mesenteric pH(a-v) were measured for every 30 minutes during the shock and reperfusion. Results : For group Ⅱ and group Ⅲ, the lactate(v-a) was increased during the shock. The values of pH(a-v) and P(v-a)CO₂ were increased during the shock but not retumed to the baseline value after reperfusion. For both pH(a-v) and P(v-a) CO₂, there were not statistically significant differences between group Ⅱ and group Ⅲ during the shock and reperfusion. For group Ⅲ, the PaO₂ was increase during the shock and reperfusion, there were statistically significant differences(p<0.05) between group Ⅱ and control, and between group Ⅲ and control. Conclusions : We conclude that the 100% oxygen does not improve the oxygenation of gut mucosa in the feline model undergone a hemorrhagic shock followed by reperfusion.