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증례보고 : Eisenmenger씨 증후군 환자의 응급 개두술을 위한 마취 관리
정금희 ( Kum Hee Chung ),김승호 ( Seung Ho Kim ),전덕희 ( Duk Hee Chun ),이종연 ( Jong Yun Lee ),박성철 ( Seong Cheol Park ),박정현 ( Chung Hyun Park ),김민구 ( Min Goo Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5
Eisenmenger`s syndrome describes the elevation of pulmonary arterial (PA) pressure to the systemic level caused by an increased pulmonary vascular resistance with reversed or bi-directional shunt through an intracardiac or aortopulmonary communication. We report a case of an emergent craniotomy for cerebellar abscess in a 21-year-old male patient with Eisenmenger syndrome secondary to Large VSD. A PA catheter was inserted via right femoral vein, but could not be advanced pass the pulmonic valve. After futile attempts to place the catheter tip in the right ventricle. Anesthesia was induced with etomidate, rocuronium, midazolam and fentanyl and maintained with only high dose fentanyl. Milinone and norepinephrine were infused continuously to decrease right to left shunt. He was transferred to the intensive care unit under intubated state and treated with antibiotics for a few days due to intermittent high fever. The operation ended without major complications and the patient was discharged 42 days later. (Korean J Anesthesiol 2009;57:666∼9)
증례보고 : 승모판 부전 환자에서 간정맥으로 이탈된 폐동맥 카테터
전덕희 ( Duk Hee Chun ),정금희 ( Kum Hee Chung ),이종연 ( Jong Yun Lee ),송지은 ( Ji Eun Song ),김준영 ( Jun Young Kim ),이정향 ( Jung Hyang Lee ),박정현 ( Chung Hyun Park ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5
A 47-year-old woman was scheduled for mitral valvoplasty. Before induction of anesthesia, a pulmonary artery catheter (PAC) was placed via right internal jugular vein. Central venous pressure or right atrial pressure was traced until about 60 cm of PAC insertion and right ventricular pressure curve appeared without arrhythmias. We withdrew and advanced the catheter several times, but pressure tracing showed the same pattern. And we could not obtain the pulmonary artery pressure. We decided to leave the PAC in the right ventricle. No ventricular arrhythmia was detected. Postoperative chest x-ray revealed that PAC traveled through inferior vena cava and looped in the hepatic vein with the tip of the catheter in the right ventricle. Under fluoroscopic guidance, PAC was inserted to the pulmonary artery. No sign of hepatic vein obstruction was detected. (Korean J Anesthesiol 2009;57:633∼6)
임상연구 : 서혜부 탈장 환아에서 Sevoflurane 마취 후 각성 흥분: Thiopental Sodium, Propofol과 Ketamine 마취 유도의 비교
김욱종 ( Wook Jong Kim ),길현주 ( Hyun Jue Gill ),김용찬 ( Yong Chan Kim ),이종연 ( Jong Youn Lee ),정금희 ( Kum Hee Chung ),이상우 ( Sang Woo Lee ),손석우 ( Suk Woo Son ),신용섭 ( Yong Sup Shin ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6
Background: This study compared the incidence of emergence agitation and the recovery profile from sevoflurane anesthesia after thiopental sodium, propofol or ketamine induction in pediatric inguinal herniorrhaphy. Methods: Forty eight children aged 1-7 years undergoing high ligation due to an inguinal hernia were examined. All patients received a 0.004 mg/kg glycopyrrolate injection for premedication prior to induction and were randomly assigned to receive thiopental sodium 5 mg/kg (Group T, n = 16), propofol 2 mg/kg (Group P, n = 16) or ketamine 1 mg/kg (Group K, n = 16) for induction. The side effects during the induction time were checked. All patients received sevoflurane (2-2.5 vol%)-N2O (2 L/min)-O2 (2 L/min) for the maintenance of anesthesia. Ventilation was given to assist spontaneous ventilation using a facial mask. The agitation score, pain score, discharge score, incidence of emergence agitation and postoperative side effects in the three groups were assessed at the recovery room and compared. Results: The emergence time in Group T (7.5 ± 1.8 min) was significantly rapid. The agitation and pain scores were significantly low in Group P. The discharge score was more rapid in Groups P and K than in Group T. The incidence of emergence agitation was similar in all three groups. Conclusions: Although recovery was faster and emergence agitation was low in the propofol group, propofol induction was not smooth compared with thiopental or ketamine induction. The incidence of emergence agitation after sevoflurane anesthesia in pediatric inguinal herniorrhaphy was similar in the thiopental sodium, propofol or ketamine induction groups. (Korean J Anesthesiol 2006; 50: 616~22)
Budd-Chiari syndrome 산모의 제왕절개술을 위한 마취 -증례보고-
송지은 ( Ji Eun Song ),양현정 ( Hyeon Jeong Yang ),박성철 ( Seong Cheol Park ),전덕희 ( Duk Hee Chun ),정금희 ( Kum Hee Chung ),이종연 ( Jong Yeon Lee ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.6
Budd-Chiari syndrome (BCS) represents a spectrum of disease states resulting in hepatic venous outflow occlusion. Prothrombotic disorders, such as protein S deficiency may cause thrombosis of the portal and hepatic veins. We report the management of a 30-year-old BCS primigravida with protein S deficiency and destroyed lung by the pulmonary tuberculosis scheduled for Cesarean section. Moreover, patient`s lungs were destroyed by the pulmonary tuberculosis. Spinal anesthesia was selected for the anesthetic management. The patient recovered without any complication and discharged from hospital on the fifth postoperative day. (Korean J Anesthesiol 2009; 57: 793∼5)
영국 High-Tech 건축에 나타난 Louis I. Kahn의 공간 개념에 관한 연구
정진수,정금희 영남대학교 공업기술연구소 1999 工業技術硏究所論文集 Vol.27 No.2
This study, as the purpose of the space analysis being done in the British High-Tech Architecture today, is to identify the space concept of Louis I. Kahn from the basis and to study its effect and the potential possibility of development. On the basis of recognition of the order of space, Kahn tried the separation of space -sered space and servant space- with the realization of the nature of material that emptiness of stones material different to solid stones in the past is possible due to the physical characteristic of modern material. The separation and expression of space suggested by Kahn arise as a major design method of modern architecture, especially in High-Tech Architecture. Now Kahn's theory is widely adopted by High-Tech Architecture aiming at developing the new composition method in order to achieve the ideal of flexible space with equal environment. In other words, searching for the integration of space, High-Tech Architecture attempts to define the space of the main space of a building -served space- and the attendant space -servant space- explicitly and secure the individuality of each space through separation of plane and division of mass.