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)

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)

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.

수술 전 불안지수와 혈중 Potassium 농도와의 상관관계

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

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.

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.

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.

韓國 在來山羊에 있어서 分娩後 子宮 및 膣上皮細胞의 形態學的 變化

咸泰守,邊明大 한국동물생명공학회(구 한국동물번식학회) 1991 Reproductive & developmental biology Vol.15 No.1

한국 정상 소아의 혈청 교질 삼투압

함태수,김성덕,임승운 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.4

We measured serum colloid oncotic pressure(COP) in ll3 children in good physical state (ASA class 1), admitted to Seoul National University Children's Hospital for elective operations. After adequate NPO time for each age group, they were transferred to the operating room. Immediately after induction of anesthesia, we sampled 4 to 5 ml of blood from femoral artery and measured serum COP. The mean COP was 20.4±2.2 mmHg. No significant difference were found between male and female. Compared with Previous Kims report, COP in children under 12 years old was lower than that of adults, The younger the children are, the lower the COPs are(Key Words: COP, normal children, Korea).

Dexamethasone , Nor - adrenalin 및 ACTH 의 투여가 자성 Rat의 생식기에 미치는 영향

함태수,변명대 ( Tae Su Ham,Myung Dae Byun ) 한국축산학회 1982 한국축산학회지 Vol.24 No.4

The present study was initiated to examine the effects of dexamethasone, nor-adrenalin and ACTH on the reproductive organs of immature female rats. 21day old female rats caged in groups of dexamethasone noradrenalin and ACTH, received oradexon, nor-adrenalin and ACTH subcutaneously daily for 10 days or 21 days, respectively. Rats were sacrificed 24 hr after the last injection. The results obtained in this experiment were as follows: 1. Body weight was significantly (p $lt;0.01) decreased in the dexamethasone-treated rats when compared with the control group. But noradrenalin and ACTH-treated groups were not affected significantly by chronic nor-adrenalin and ACTH treatment for 10 days or 21 days. 2. Mean ovarian weight of immature female rats injected with dexamethasone, nor-adrenalin and ACTH for 10 days were significantly (p $lt; 0.01) reduced as compared to that of control group. The ovarian weight of noradrenalin-treated group increased significantly (p$lt;0.05) after 21 days of treatment with nor-adrenalin. Dexamethasone ACTH-treated group had no significant difference, but they tend to decrease. 3. Uterine weight of female rats decreased significantly (p $lt; 0.01) after injection of dexamethasone for 10 days but noradrenalin treated group receiving nor-adrenalin increased significantly (p $lt; 0.01). Groups injected with dexamethasone, noradrenalin and ACTH for 21 days had no significance but dexamethasone-thasone-treated group tends to decrease in weight of uteri. 4. Adrenal weight of female rats receiving dexamethasone and noradrenalin for 10 days were significantly decreased, while ACTH-treated group were significantly greater (p$lt;0.01) than in rats receiving dexamethasone and nor adrenalin. Dexamethasone group were significantly decreased as compared to that of control group after 21 days of treatment of dexamethasone but ACTH-treated group were significantly increased. Noradrenalin treated group had no significance but it tends to decrease. 5. Compared to those of controls, Liver were 69.8 % lighter in 31-day old females, while spleens were 185.3% heavier. The weights of the liver and spleen were reduced by 64.5 % and 27.2 % respectively in 42-day old female. Kidney and heart weights were not affected significantly by chronic dexamethasone treatment. 6. In histological findings of rat ovaries treated with dexamethasone, granulosa cells had necrosis and the majority of follicles showed varying degrees of atresia. 7. Histological appearances of the ovaries showed numerous follicles after 10 days of treatment of nor-adrealin. Luteal cells showed proliferation of fibroblast and vacuolization after 21 days of treatment. Histological studies indicated that corpora lutea showed retrogressive changes. 8. In the overies of ACTH-treated rats for 10 days, granulosa cells of follicles were ruptured and follicular atresia were increased. Luteolysis was observed in rat ovaries treated with ACTH for 21 days but was not remarked as compared to that of noradrenalin treated group.