진단되지 않은 다공질횡격막증후군(porous diaphragm syndrome) 환자에서 부인과 수술 후 복강내 다량의 출혈로 인한 혈흉 -증례 보고-

함태수,함지선 대한마취통증의학회 2011 Anesthesia and pain medicine Vol.6 No.3

Porous diaphragm syndromes are characterized by the passages of substances such as fluids, blood and gases through diaphragmatic defect from the peritoneal cavity into the pleural space. Clinically, they usually present with pleural effusions,hemothorax, pneumothorax and even empyema, secondary to the abdominal pathology. This condition may give rise to respiratory and cardiovascular problems in peri-anesthetic period. We report a case of progressive hemothorax induced by postoperative abdominal bleeding leading to cardiac arrest in gynecologic patient with undiagnosed porous diaphragmatic syndrome. (Anesth Pain Med 2011; 6: 280∼283)

수술 전 불안지수와 혈중 Potassium 농도와의 상관관계

함태수,조현성,서성원 대한마취과학회 2005 Korean Journal of Anesthesiology Vol.48 No.5

SevofIurane을 이용한 마취유도 시 삽관용 후두마스크를 이용한 기관내삽관에 대한 반응: 삽관용 후두마스크 삽입 시점에 따른 비교

함태수 대한마취과학회 2004 Korean Journal of Anesthesiology Vol.46 No.3

한국재래산양에 있어서 흡유 및 GnRH의 처리가 혈장 호르몬 및 뇌하수체의 성선자극호르몬 함량에 미치는 영향

함태수,변명대 영남대학교 자원문제연구소 1998 資源問題硏究 Vol.17 No.-

This study was conducted to examine the effects of suckling or exogenous gonadotropin releasing hormone(GnRH) in hormone levels and pituitary gonadotropins content in Korean native goats. At parturition, 24 goats were divided into suckled(n= 12) or nonsuckled(n= 12) groups and were injected daily with 1 doses of 150㎍ GnRH from the day of kidding until d 36 postpartum. Jugular blood samples were collected by venipuncture at 6 day intervals from d 12 to 36 after parturition for assail of progesterone, LH and FSH. Concentrations of LH, PSH and prolactin in the pituitaries were measured at day 12, 24, 30 and 36 after parturition and determined after 24 and 36 d of GnRH treatment in the goats. Concentrations of progesterone in plasma samples after treatment with GnRH did not differ between suckled and nonsuckled goats. Plasma concentrations of LH in suckled goats after GnRH were increased gradually until 24 day after parturition. Afterward, the levels declined to basal values by d 36. The concentrations of plasma LH after GnRH treatment were greater in suckled than in non-suckled goats. However, Concentrations of LH in suckled and nonsuckled goats were similar for the 18 day after GnRH treatment. The concentration of plasma FSH at each sample time after GnRH treatment was considerably greater in suckled than in nonsuckled goats. Goats slanghtered at days 12, 30 and 36 had less pituitary LH than goats slanghtered after day 24(1.12±0.01, 1.37±0.05, 1.38±0.09 and 1.89±0.03 mIU/mg fresh tissue, respectively) Concentrations of FSH and PRL in pituitaries tended to increased slightly with the interval after parturition. Pituitary concentrations of LH and prolactin after GnRH treatment were slightly greater in suckled than in nonsuckled goats at days 24 and 36 postpartum. The concentration of FSH in pituitary glands of nonsuckled goats were slightly greater than the concentration in pituitary from suckled goats. The rsults indicate that factors controlling the synthesis of LH may be responsible for resumption of ovarian cycles after parturition.

제왕절개 수술시 고비중 0.5% Bupivacaine과 고비중 0.5% Tetracaine을 이용한 척추마취의 임상적 비교

함태수 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.2

Background : Marcaine is a recently introduced hyperbaric bupivacaine and may be suitable for spinal anesthetic solution in parturients undergoing cesarean section. Therefore, we have compared bupivacaine with tetracaine mostly used for spinal anesthesia in cesarean section, about maximum level of analgesia, the time taken to reach it, degree of motor block of lower extremities, degree of patient's satisfaction and cardiovascular variables. Methods : Forty eight parturients were allocated to bupivacaine(n=26) or tetracaine(n=22) groups in random order. All patients received an infusion of lactated Ringer' solution(1,000 ml) and no premedication before spinal anesthesia. We used standardized techniques and injected the equal dose(10 mg) in equal volume(2 ml) intrathecally for spinal anesthesia. Maximum level of analgesia and time taken to reach it were checked by pinprick test, and degree of motor block was scored by Bromage scale. Blood pressure and heart rate were measured. Results : There were no differences in maximum level of analgesia, motor block of low extremities, patient's satisfaction, blood pressure and heart rate between two groups. But the time taken to reach maximum level of analgesia was faster in the tetracaine group(8.3±2.3 min) than in the bupivacaine group(10.5±2.1 min)(p$lt;0.05). The incidences of hypotension(systolic blood pressure$lt;30% of preanesthesia value) were fewer in the bupivacaine(1 of 26) group than in the tetracaine group(6 of 22)(p$lt;0.05). Conclusions : 0.5% hyperbaric bupivacaine reaches slower the maximum level of analgesia but induces fewer incidences of hypotension than 0.5% hyperbaric tetracaine. Therefore, hyperbaric bupivacaine is a safe and reliable anesthetic solution for spinal anesthesia in cesarean section. (Korean J Anesthesiol 1997; 32: 219∼225)

The Effect of 2 Hz and 100 Hz Electrical Stimulation of Acupoint on Ankle Sprain in Rats

함태수 대한의학회 2007 Journal of Korean medical science Vol.22 No.2

The electrical stimulation of acupoint (ESA) releases several endogenous neuropeptides, which play important roles in management of pain and inflammation. ESA with low and high frequencies has been shown to release different neuropepides, suggesting its various therapeutic effects. Pain and edema are major problems for ankle sprain. However, there have been few reports on the effects of ESA for ankle sprain. We aimed to investigate that ESA can reduce pain and edema resulting from ankle sprain, and whether there is a difference in therapeutic effects between low and high frequency ESA. To induce ankle sprain in Sprague-Dawley rats, the ankle of right hindpaw was overextended in direction of simultaneous inversion and plantar flexion. Stepping force and edema in the paw of the sprained ankle were measured by electronic balance and plethysmometer, respectively. In both 2 and 100 Hz ESA groups, stepping force was increased significantly in similar degrees (p< 0.05). Only 2 Hz ESA produced the significant rapid decrease in ankle edema. This study demonstrates that ESA of 2 Hz and 100 Hz shows comparable analgesic effects, but only 2 Hz ESA can facilitate the reduction of edema caused by ankle sprain.

Protective Effects of Gabapentin on Allodynia and α2δ1-Subunit of Voltage-dependent Calcium Channel in Spinal Nerve-Ligated Rats

함태수,안현주,배창대,임승운,조현성,이상민,심우석,김지애,곽미숙,최수주,김한섭 대한의학회 2009 Journal of Korean medical science Vol.24 No.1

This study was designed to determine whether early gabapentin treatment has a protective analgesic effect on neuropathic pain and compared its effect to the late treatment in a rat neuropathic model, and as the potential mechanism of protective action, the α2δ1-subunit of the voltage-dependent calcium channel (α2δ1-subunit) was evaluated in both sides of the L5 dorsal root ganglia (DRG). Neuropathic pain was induced in male Sprague-Dawley rats by a surgical ligation of left L5 nerve. For the early treatment group, rats were injected with gabapentin (100 ㎎/㎏) intraperitoneally 15 min prior to surgery and then every 24 hr during postoperative day (POD) 1-4. For the late treatment group, the same dose of gabapentin was injected every 24 hr during POD 8-12. For the control group, L5 nerve was ligated but no gabapentin was administered. In the early treatment group, the development of allodynia was delayed up to POD 10, whereas allodynia was developed on POD 2 in the control and the late treatment group (p<0.05). The α2δ1-subunit was up-regulated in all groups, however, there was no difference in the level of the α2δ1-subunit among the three groups. These results suggest that early treatment with gabapentin offers some protection against neuropathic pain but it is unlikely that this action is mediated through modulation of the α2δ1-subunit in DRG.

An immunohistochemical study of the serotonin-immunoreactive cells in the developing pancreas of the chicken embryos

함태수,Ham, The-su The Korean Society of Veterinary Science 2001 大韓獸醫學會誌 Vol.41 No.2

부란 1일부터 부화직후까지의 닭 태자 췌장에서 serotonin 면역반응세포들의 부위별 분포 및 상대적 빈도를 면역조직화학적 방법으로 검색하였다. 췌장은 해부학적으로 배쪽, 등쪽, 제 3엽 및 비장엽의 4개엽으로 구분하였으며, 각 엽은 조직학적으로 외분비 부분, light 및 dark 췌장섬의 3부분으로 세분하였다. 이들의 각 발생단계에 따른 닭 췌장에서 serotonin 면역반응세포들의 분포 및 빈도는 췌장의 엽, 조직학적 부위 및 발생단계에 따라서 매우 다양하게 관찰되었으나, 대체로 원형 또는 난원형의 형태로 모든 엽에서 관찰되었다. 외분비 부분에서 serotonin 면역반응세포들은 비장엽의 경우 부란 13일과 14일에서만 국한되어 관찰되었고, 제 3엽에서는 부란 10일부터 부란 19일 동안 관찰되었다. 또한 배쪽엽에서는 부란 10일부터 부화 직후까지 관찰되었으며, 등쪽엽에서는 부란 11일부터 부화 직후까지 관찰되었다. 췌장섬에서 이들 면역반응세포는 비장엽의 dark 췌장섬에서만 부란 15일과 부란 16일에 국한되어 극소수 관찰되었고 다른 엽 또는 light 췌장섬에서는 관찰되지 않았다. 결론적으로 serotonin 면역반응세포들은 부란 발생 초기에는 다수 관찰된 이후 발생단계에 따라 점차적으로 감소되며 이런 양상은 엽의 종류에 관계없이 나타나는 것으로 관찰되었다. The distributions and relative frequencies of the serotonin-immunoreactive cells were studied in dorsal, ventral, third and splenic lobes of developing chicken pancreas during embryonic periods (10 days of incubation to hatching) by immunohistochemical methods. The regions of pancreas were subdivided into three regions, exocrine, light and dark islets. Round and/or oval shaped serotonin-immunoreactive cells were detected in all four lobes. According to developmental stages, the types of lobes and the regions of pancreas, these immunoreactive cells were showed various distributions and relative frequencies. In exocrine portions, serotonin-immunoreactive cells were found in the splenic lobes at 13-14 days of incubation, in the third lobes from 10 days to 19 days of incubation, in the ventral lobes from 10 days of incubation to hatching and in the dorsal lobes from 11 days of incubation to hatching. In pancreatic islets, these cells were detected only in the dark islets of splenic lobes at 15 and 16 day of incubation with rare frequency. In conclusion, serotonin-immunoreactive cells decreased with developmental stages in all four lobes and their relative frequencies decreased with developmental stages.

Risk Factors for an Intraoperative Arrhythmia during Esophagectomy

함태수,이정진,양미경,김지애 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.3

Purpose: Arrhythmias after an esophagectomy (most commonly atrial fibrillation) are a significant contributing factor to patient morbidity. However, the significance of an intraoperative arrhythmia is not completely understood. The aim of this retrospective study was to determine the occurrence and risk factors for developing intraoperative arrhythmias in patients undergoing an esophagectomy. Materials and Methods: We reviewed the records of 427 patients who underwent a transthoracic esophagectomy between 2001 and 2005. Variables such as age, sex, hypertension, diabetes, cardiac disease, preoperative pulmonary function test (PFT) results, cancer level, combined radiochemotherapy, intrathoracic cavity adhesions and anastomosis site, hemoglobin, central venous pressure (CVP), fluid balance, serum potassium level, dose of vasopressors, temperature, and combined general and epidural anesthesia were analyzed as risk factors for the occurrence of an arrhythmia. We defined this arrhythmia as one not originating from the sinus node. Results: The incidence of intraoperative arrhythmia in this subset of patients was 17.1%, with a 37.2% reoccurrence rate during the first three postoperative days. Univariate and multivariate analysis revealed the presence of heart disease, poor PFTs, cervical anastomosis, elevated CVP, and higher ephedrine doses to be independent predictors of the development of an intraoperative arrhythmia. Conclusion: The incidence of intraoperative arrhythmia during esophagectomy was 17.1% with a 37.2% of reoccurrence rate.

고비중 0.5% Bupivacaine의 척추마취 후에 발생된 지속적인 신경손상 -증례 보고-

함태수,고저스틴상욱,진현승 대한마취통증의학회 2010 Anesthesia and pain medicine Vol.5 No.2

Persistent neurologic injury is a rare but feared complication of neuroaxial anesthesia.Local anesthetics are believed to be an important cause.A 68-year-old man with an ASA physical status of 2 was scheduled to undergo elective knee arthroplasty.He had no clinical evidence of neurological deficits before the operation. Spinal anesthesia was administered using 10 mg of 0.5% bupivacaine and 20μg of fentanyl without difficulty or complications during the procedure.On the second postoperative day, the patient complained of bilateral weakness in his lower extremities. The neurological examination revealed a sensorimotor impairment consistent with cauda equina syndrome.The neurotoxicity of bupivacaine might have been the cause of this neurological deficit.