Sevoflurane을 이용한 불응성 간질지속상태의 조절

하명화,김선희,정상호,송남원 대한마취통증의학회 2007 Korean Journal of Anesthesiology Vol.52 No.4

Refractory status epilepticus is defined as seizure activity that continues after treatment with conventional anticonvulsants. An 8-month-old male had an operation for repair of small bowel perforation, and he suffered a febrile seizure that developed into refractory status epilepticus. Febrile seizure is the most common etiology for children with status epilepticus. We report here on a case of a patient with refractory status epilepticus, and he was managed with sevoflurane, an inhalational anesthetic. The patient was given an inspired concentration of 0.6-2 vol% sevoflurane for 15 days. After stopping of sevoflurane inhalation, he continued to experience intermittent convulsive status epilepticus that was successfully managed with using conventional anticonvulsants.

골절치료의 생체역학

이기병,이진영,송하명 한림대학교의료원 1992 人間科學 Vol.16 No.2

요추 후외방 고정술에 사용한 이식골 종류에 따른 유합율의 비교

박인헌,이기병,송경원,이진영,송하명 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2

Posterolateral fusion of the lumbar spinal segments with instrumentation was performed in 61 patients from March 1988 to April 1991. Fusion was examined with the plain radiography and ultrasonography and analysed the fusion rate according to the diffirent types of grafted bones and the number of fused spinal segments. The results are as follows; 1.Overall fusion rate of lumbar posterolateral fusion with instrmentation is 85.2%. 2.Of 29 cases using autograft alone, 27 cases(93.1%) show union. 3.Fusion rates of autograft with allograft(16 cases) and autograft with artificial bone graft(9 cases) are 87.5% and 88.9% respectively. 4.allograft cases without autograft show lowest fusion rate of 42.9%. 5.Fusion rates according to the nember of spinal segment show 84.8% in 1 segment, and 86.7% in 2 segments(p>0.05). In conclusion, lumbar posterolateral fusions with instrumentation show statistically different fusion rates according to the types of grafted bones and these findings suggest that autograft is nacessary for the posterolateral fusion even if internal fixator is applied. Fusion rate ralating to the nember of fused segments is not different statistically and seems to be much ralated to the types of grafted bones.

척추마취시 최면제 및 진통제 투여에 따른 저산소증의 발생 빈도에 대한 연구

최인철,조성두,김영생,송남원,하명화 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.6

Background : The purpose of this study was to find out the effect of hypnotics and analgesics on oxygen saturation by pulse oximetry in surgery patients under spinal anesthesia. Methods: Sixty-five patients classified ASA physical status 1 or 2 scheduled for surgery under spinal anesthesia were studied. These patients were divided into three groups. The 22 subjects of the first group did not receive either midazolam or fentanyl. The 22 subjects of the second group received midazolam. The 21 subjects of the third group received midazolam (0.03 mg/kg) and fentanyl (1.0㎍/ kg). Oxygen saturation was measured with a pulse oximetry. Measurements were made before spinal anesthesia, 5 minutes, and 10 minutes after starting of spinal anesthesia, 5 minutes, 10 minutes, 30 minutes, and 60 minutes after the start of the operation or intravenous injectian of drugs. In addition, measurements were made on arrival in the recovery room, and 5 minutes, 10 minutes, 20 minutes, and 30 minutes after amval in the recovery room. Results : There were statistically significant differences in oxygen saturation at 5 minutes after the start of the operation or intravenous injection of drugs. The mean oxygen saturation for the first group was 98.2±1.8%, for the second group 97.9±2.6%, and for the third group 92.4±2.8%. Hypoxia cases at 5 minutes after the start of the operation or intravenous injection of a drug occurred in 4.5% of the first group, 9.1% of the second group, and 57.1% of the third group Conclusions: We concluded thsat oxygen saturation monitoring should be done routinely in patients receiving hypnotics and analgesics during spinal anesthesia, and oxygen should be administered to patients who develope hypoxia during spinal anesthesia. (Korean J Anesthesiol 2000; 39: 792-797

비유를 활용한 STEAM 프로그램 개발 및 효과 : 중학교 ‘태양계’ 단원을 중심으로

한신,김형범,김용기,송하명 대한지구과학교육학회 2020 대한지구과학교육학회지 Vol.13 No.1

이 연구의 목적은 중학교 ‘태양계 단원에서 비유를 활용한 HTE(Here, There, Everywhere) STEAM 프로그 램을 개발하고, 이 프로그램을 세종시 소재 A중학교와 평택시 소재 B중학교의 1학년 중학생 354명에게 적용 하여 프로그램의 효과성을 검증하는 과정을 통해 지능 정보사회를 대비한 창의교육을 실현하는데 있다. 개발 한 STEAM 프로그램은 전문가 집단을 구성하여 3차례 에 걸쳐 수정, 보완하여 타당성을 검증받았으며, 최종 개발된 프로그램은 총 6차시에 걸쳐 현장에 적용하였 다. 이에 따른 효과성을 알아보기 위해 논리적 사고력 검사와 STEAM 관련 태도 검사를 프로그램 처치 전과 처치 후에 실시하였으며, 프로그램에 대한 학생들의 인식을 알아보기 위해 프로그램 처치 후 STEAM 만족 도 검사를 실시하였다. 이 연구의 결과는 다음과 같다. 첫째, 비유를 활용한 STEAM 프로그램이 중학생의 논 리적 사고력 향상에 효과적인 것으로 나타났다. 둘째, 비유를 활용한 STEAM 프로그램이 중학생의 STEAM 태 도 향상에 효과적이었다. 셋째, 비유를 활용한 STEAM 프로그램에 대한 중학생의 인식이 긍정적이며, 과학에 대한 흥미를 일으키는데 효과적이었다. 이러한 결과를 통해 차기 수업에서는 충분한 시간을 통해 STEAM 프 로그램 수업을 수행한다면 중학생들의 수업에 대한 만 족도가 더욱 높아질 것으로 사료된다. This study aimed to develop an HTE (It is an abbreviation for Here, There, and Everywhere) STEAM program combining with the use of an analogy in a middle school subject unit ’the solar system’ and realize creative education for intelligent information society through a process of verifying the effectiveness of the program. For reference, the program was applied to 354 students in the first grade of two middle schools in South Korea – one was A middle school in Sejong City, the other B middle school in Pyeongtaek City. The STEAM program was revised and made up for the weak points for three times by a group of experts, and then it got verified for validity. The final version of the program was applied to middle school education sites in Korea for six periods in total. In other to confirm the effectiveness, two types of tests – logical thinking ability test and STEAM attitude test – were conducted before and after the program treatment. On top of that, the STEAM satisfaction test was also implemented in order to explore the students’ recognition of the program after the program treatment. The results of this study were as follows. First, it turned out the STEAM program using the analogy was effective in improving the students’ logical thinking ability. Second, the STEAM program blended with the analogy was also effective in improving the students’ STEAM attitude. Third, the students’ recognition of the STEAM program using the analogy was quite positive, and the program was efficacious in intriguing the students’ interests in science. Judging from the results of the program, the students’ satisfaction with the classes they take will be expected to be higher if the STEAM program is implemented in the next-term classes with more sufficient time.

중이수술 환자에서 Sevoflurane과 Remifentanil을 이용한 전신마취 시 Ondansetron과 Ramosetron이 술후 오심과 구토에 미치는 효과 비교

윤도근 ( Do Geun Yoon ),정상호 ( Sang Ho Jung ),하명화 ( Myung Hwa Ha ),송남원 ( Nam Won Song ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4

Background: In this randomized, double-blinded study, we evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) after middle ear surgery. Methods: Seventy patients of either sex, ASA 1-2, scheduled middle ear surgery (mastoidectomy and tympanoplasty) under general anesthesia with sevoflurane and remifentanil were included. Patients were randomly divided into two groups and received IV ramosetron 0.3 mg (group R) or ondansetron 4 mg (group O) before the end of operation (n=35 each). The incidence and severity of PONV, pain score (VAS), rescue antiemetic, rescue analgesic and side effects were assessed following 6 hr, 24 hr and 48 hr after surgery. Results: The incidence of PONV showed no significant difference between groups at each time points after surgery. There were no difference in the severity of nausea, pain score, rescue antiemetic, analgesic drug usage and side effects between groups. Conclusions: Prophylactic therapy with ramosetron is as effective and safe as conventional prophylactic therapy with ondansetron for preventing PONV in patients undergoing general anesthesia for middle ear surgery. (Korean J Anesthesiol 2009;56:408~12)

증례보고 : 사지마비환자에서 기관절개술 시 근이완제의 사용없이 후두마스크를 이용한 정맥마취

염승훈 ( Seung Hun Yeom ),정상호 ( Sang Ho Jeong ),하명화 ( Myung Hwa Ha ),송남원 ( Nam Won Song ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6

Quadriplegia is a serious or complete loss of motor function of all four limbs that is commonly caused by spinal cord injuries secondary to damage to the cervical spine. In this situation, there is a higher risk of pneumonia due to paralysis of the respiratory muscles. Tracheostomy is preferred over endotracheal intubation for the effective elimination of sticky bronchial secretion. The safest technique for a tracheostomy is to carry it out under general anesthesia with endotracheal intubation. However, endotracheal intubation may be difficult and cause other complications in patients with laryngotracheal stenosis caused by repeated tracheostomy and a limitation of neck movement as a result of the fixation of the cervical vertebral bodies due to the cervical spine fracture. We report a case of a tracheostomy performed sucessfully under intravenous anesthesia using a laryngeal mask airway without muscle relaxants in a patient with quadriplegia caused by a cervical spine injury. (Korean J Anesthesiol 2008; 55: 747~51)