보행마취(步行麻醉)

김영석,김완식,황호성,이진근,유희구,김흥대 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

An imaginative innovation to shorten hospital stays as a means to reduce patient charges, is out-patient surgery. This procedure also minimized the inconvenience and disruption of the family unit, reduced the opportunities for cross-infection, and freed hospifal beds for the more serriously ill patienta Since the concept of out-patient surgical service was organized, managed, and performed in the Hanyang Medieal Center, we had experience of 132 ambulatory anesthetics during the last two years (from Jan. 1974. to Dec. 1975 ). The results are summarized as follower 1. Preanesthetic examination should be routinely cheeked with Hb., Hct., urinalysis and chest x-ray. 2. Premedication should be administered preanesthetically, atropine sulfate intravenously. 3. ASA class 1 patients should be rhnsen fnr short (less than 1 hour) procedures. 4. Anesthesia is induced with Epontol+S.C.C. and maintained with Halothane+N2O+O2. 5. We suggest that ambulatory anesthesia should be more carefully planned, organized, and managed.

소아마취의 임상통계학적 고찰

김완식,박동호,황영희,김흥대,안기량,석민호,김지영,장경덕,서병태 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.1

Midazolam maleate, a water soluble banzodiazepine unlike diazepam, was synthetized by Walser and Fryer in 1975. In order to ealuate the effectiveness as an induction agent for general anesthesia, 22 elective surgical patients belonging to ASA classification 1 and 2 were selected. And ten patients (male 7, female 3, average 33.5 years old) were induced with midazolam maleate 0.2mg/kg and twelve patients (mdale 7, female 5, average 32.5 years old) with diazepam 0.3mg/kg. The results were summarized as follows. 1) Anesthesia was induced in all of midazolam group by one intravenous injection, but only 6 patients of diazepam group could induced by one injection and the other 6 patients needed 2 or more injections. 2) The changes of blood pressure and pulse rate after induction and intubation were almost similar in the two groups, but greater individual variation was seen in diazepam group. 3) A buring sensation following intravenous injection was noted in 11 cases of diazepam group, but none in midazolam group and no phlebitis in either group. From the above results, diazepam and midazolam are almost similar in nature but midazolam is definitely effective as an induction agent and has less side effects. Therefore midazolam maleate is regarded as a more effective agent than diazepam as an induction for general anesthesia.

급성 골수성 백혈병(M6)에 합병된 중추성 요붕증 1 예

김성연,조보연,이홍규,고창순,민헌기,김병국,김노경,신찬수,이명식,강덕현,조종태 대한내과학회 1989 대한내과학회지 Vol.37 No.2

Leukemia is known to be an extremely rare cause of diabetes insipidus. We report a case of diabetes insipidus as a complication of leukemia. An 18 year-old man was admitted because of polyuria polydipsia and fever. Bone marrow aspiration and biopsy revealed the diagnosis of acute erythroleukemia (AML, M6). On the water deprivation test, the diabetes insipidus was confirmed to be of the central type. He was managed with intranasal vasopressin for diabetes insipidus with good response. Induction chemotherapy was administered without response, and the patient died of septicemia and respiratory failure 2 months after initial diagnosis. A short review of the literature related to this subject is also presented.

경막외마취 확산의 비교 관찰

김영석,김완식,황영희,김흥대,김교상,장경덕 대한마취과학회 1981 Korean Journal of Anesthesiology Vol.14 No.1

The segmental spread of epidural analgesia was measured in seventeen surgical patients aged between 17 and 52 years, and in fourteen patients between 60 and 77 years. The upper level in the young was 6.29(±1.56) thoracic vertebra level, but in the elderly was 4(±0.65) thoracic vertebra level at 20 minutes after epidural injection of 1.5% lidocaine 20㎖. A given volume of solution spreads to 0.9, 1.07, 1.54, 2.29 segments greater upper extent at 5, 10, 15, 20 minutes after epidural injection and 0.57, 1.07 segments greater lower extent at 5, 10 minutes in the elder than young. So with increasing age relatively small amounts of solution are required, to produce the same extent of anesthesia in the yonung.

운동후 측복통과 함께 발생한 급성 신부전 1 예

김종순,박영주,조종태,이정임,신민호,구천희,박태용,한승수,강진화 대한내과학회 1996 대한내과학회지 Vol.50 No.6

We report a case of acute renal failure with severe loin pain and patchy renal vasoconstriction after exercise. An immediate postcontrast computed tomogram of this case shows multiple patchy areas of poor contrast enhancement in the cortex of the both kidneys. A 24-hours delayed scan without further injection of contrast dye shows multiple wedge-shaped contrast enhancement in the coincident areas of poor enhancement in the immediate scan. The 2 and 5 days delayed scans show that wedge-shaped contrast enhancement becomes disappeared gradually to the renal cortex, and the 8 days delayed scan shows complete disappearance of contrast enhancement. The renal scintigrams with technetium-99m-methylene diphosphonate and dimercaptosuccinic acid show diffuse increased uptakes and multiple patchy photon deficient areas in the both kidneys respectively. The follow-up renal scintigrams show nearly normal findings, This patient had an uneventful hospital course and recovered completely without dialysis.

늑막조직생검으로 진단한 Pleural Paragonimiasis 1 예

김기영,이승환,박진현,이재갑,용석중,신계철,홍욱균,김향인,진춘조 대한내과학회 1991 대한내과학회지 Vol.40 No.5

We report a 28-year old female patient with pleural paragonimiasis who did not have the usual diagnostic triad for this parasitic disease. She did not have chronic hemoptysis, there were no pulmonary infiltrations, and stool, sputum and pleural fluid examinations did not yield paragonimus ova. The diagnosis was made on the basis of ova found in the pleural biopsy. Paragonimus pleural effusion was resolved with frequent thoracentesis and oral praziquantel therapy.

육성돈에서 Phytase 첨가가 Extrusion 한 쌀겨의 P 이용성에 미치는 영향

김영길,김인호,손중천,김은주,권기범,문태현 한국영양사료학회 1999 韓國營養飼料學會誌 Vol.23 No.3

본 시험은 육성돈에 있어 extrusion된 쌀겨에 대한 P의 이용성과 extrusion된 쌀겨에 phytase를 첨가하므로서 P의 이용성에 미치는 영향을 구명하고자 영양소 소화 시험을 실시하였다. Extrusion된 쌀겨와 extrusion된 쌀겨에 phytase을 첨가한 구간의 비교는 phytase의 첨가에 의해 건물 소화율이 약간 증가하는 경향을 보였다(P<0.04). N 소화율은 쌀겨구 보다는 extrusion된 쌀겨구에서 약간의 증가를 보였다(P<0.07). Ca(P<0.06)과 P(P<0.01)의 소화율은 모두 extrusion된 쌀겨에 phytase의 첨가수준이 다를 경우 500 unit보다는 1,000 mini에서 더 좋은 효과를 보였다. 분 중 P 배설량(2.72g/d vs 3.89g/d)은 extrusion된 쌀겨보다는 extrusion된 쌀겨에 phytase을 첨가하므로서 줄어들었다(P<0.08). 또한 phytase의 첨가수준이 증가할수록 P의 축적량이 증가함을 알 수 있었다(P<0.04). 한편 Ca 섭취량, 배설량 및 축적량은 모든 처리구 간에 통계적인 유의성을 찾아볼 수 없었다. 그러나 최종 Ca 축적량은 쌀겨에 비해 extrusion된 쌀겨의 경우 15%가 향상되었다(6.64g/d vs 5.77g/d). An experiment was conducted to determine the effects of microbial phytase and feed processing on production and phytate P utilization of pigs. Four crossbred barrows with average initial body weight of 30㎏ were used in 24-d metabolism experiment(4 x 4 latin square) to determine the effect of extruded rice bran and phytase supplementation on nutrient utilization. Digestibility of DM in pigs fed extruded rice bran with phytase improved compared to that in pigs fed extruded rice bran(P<0.04). N digestibility was greater for extruded rice bran than rice bran(P<0.07). However, there was no effect of phytase supplementation to extruded rice bran. Digeshbilities of Ca(P<0.06) and P(P<0.01) were greatest for extruded rice bran with phytase 1,000 unit. Fecal excretion of P(2.72g/d vs 3.89g/d) was less for extruded rice bran with phytase than without phytase(P<0.08). Also, when phytase supplementation was increased in diet, there was increased P retention(P<0.04). There were no treatment effects intake, excretion and retention of Ca. However, Ca retention improved by 15% in extruded rice bran compared to rice bran(6.44g/d vs 5.77g/d).

가토에서 CCNU 로 유발된 골수 저형성증의 혈액학적 소견과 골수스캔의 변화에 관한 연구

김승택,이명철,최두혁,고창순,김병국,이문호,박선양,최성재,김노경,최영희 대한내과학회 1986 대한내과학회지 Vol.30 No.1

To understand systematically the hematological changes including the bone marrow changes in chemotherapeutic agent-induced bone marrow hypoplasia and to define the relationship between hematological and bone marrow scan findings and prognosis of the hypoplasia, CCNU (lomustine) was given orally to 44 rabbits to induce hypoplasia of the bone marrow. And serial changes of peripheral blood and bone marrow findings and (111)In Cl(3)((111)In scan)/(99m)Tc tin colloid bone marrow scan((99m)Tc scan) were checked before and after induction of hypoplasia. With assessment of 28 evaluable rabbits, the following results were obtained: 1) Significant hypoplasia of the bone marrow developed around day 4 of CCNU administration and recovered around day 14(cellularity 51,4±13.5% and 24. 5±14.97o before and after CCNU respectively, p<005). Megakaryocyte count was significantly depressed from 95.67,26% to 36.7$gt;31.82%(P$lt;0.005). M: E ratio was decreased from 162±1.19 to 0, 0.5$lt;0. 43(p±0.005). Shift to left(475), maturation a(40%), naked nucleus and degenerated cells(20%), increase of lymphocytes(47%), monocytes and reticulum cells were also found. 2) The uptake ratio of the 99(m)Tc tin colloid bone marrow scan was markedly increased in contrast to the depression of the bone marrow(4.4±2.12 and 14.1±7.06 before and 4 days after CCNU, respectively, p40. 005). Tc scan uptake ratio was inversely related to the cellularity(r=-0.442, p$lt;0.05) and megakaryocyte number of the bone marrow(r= 0.89, p< 0.01) and peripheral blood granulocyte (r = 0. 54. Pg0.01) and platelet count(r=0.40, p$lt;0.05). There was not significant correlation between (111)In scan uptake ratio and hematologic parameters. 3) The amplitude of the change of the (99m)Tc scan uptake ratio was significantly related to the prognosis of the rabbits with experimentally induced hypoplasia of the bone marrow(dead 5.1±2,67, survivors 2,5±0.96, P<0.01). The change of the (111)In scan uptake ratio was not related to the prognosis of these rabbits. In experimentally induced rrow hypoplasia, morphologic changes in addition to the numerical changes of the bone marrow elements were observed. And serial (99)Tc scan of the bone marrow appears to be helpful assessing the severity and predicting the outcome of bone marrow hypoplasia.

소장내용물의 위내역류 및 위내용물 배출시간에 관한 연구

김진호,박승철,이형호,안일민,박영태,김열흥,이창흥 대한내과학회 1986 대한내과학회지 Vol.30 No.2

Radionuclide enterogastric scintigraphy was done with (99m)Tc-DISIDA and (111)In-DTPA in 35cases; control group 5, gastric ulcer group 6, subtotal gastrectomy with Billroth g group 5, and functional gastrointestinal disorder group with or without grossly mixed bile in the gastric juice 19 cases. The results were: 1) Enterogastric reflux was very significantly increased in the subtotal gastrectomy with Billroth II group (p$lt;0, 001), 2) Gastric emptying was significantly delayed in the functional gastrointestinal disorder groups with or without grossly mixed bile (p$lt;0.05, p$lt;0. 001). 3) Enterogastric reflux was not significantly increased in the gastric ulcer group. 4) Enterogastric reflux was not significantly different between the functional gastrointestinal groups with or without grossly mixed bile in the gastric juice. 5) Inverse correlation between the gastric emptying indices and the enterogastric reflux indices was not proved (r=-0.37).

다른 광물질과 혼합된 크롬 피콜린산 급여가 비육돈의 성장 , 도체특성 , 혈액성상에 미치는 영향

김지훈,한인규,김진동,김대성,양종석,손현수,현영 한국영양사료학회 1999 韓國營養飼料學會誌 Vol.23 No.5

본 시험은 여러 가지 광물질과 혼합된 크롬 피콜린 산을 첨가한 사료의 급여가 비육돈의 성장, 도체특성, 혈액성상에 미치는 영향을 알아보기 위하여 수행되었다. 개시체중이 69㎏인 총 513두의 비육돈을 돈방당 16∼21두씩 수용하여 사양시험을 수행하였으며, 9마리가 대사시험에 사용되었다. 처리구는 2개의 단백질 수준별 대조구 (Con 12, Cen 14)와 외산 크롬 피콜린산 (CrP-CaCO₃ ; Prince사 제품). 크롬 제오라이트 (CrP-Zeolite 12, 14), 국산 크롬 피콜린산 1 (CrP-CaCO₃; KIST 개발), 크롬 피콜린산-산화아연 (CrP-CaCO₃-ZnO 12, 14) 그리고 국산 크롬 피콜린산 2 (CrP-CaCO₃ ; M. H. Lee 개발)이었다. 성장성적에 있어서는 일당중체량, 일당사료섭취량, 사료효율 등 모든 조사항목에서 처리구간의 차이가 발견되지 않았으나, 등지방 두께는 크롬 피콜린산 첨가에 의해 감소하는 경향이 발견되었고, 이러한 경향은 출하체중이 무거울수륵 뚜렷하게 나타났다. 도체등급은 크롬 제오라이트구와 크롬 피콜린산-산화아연처리구에서 높게 나타났으며, 혈액내 콜레스테를의 함량도 크롬 제오라이트구와 크롬 피콜린산-산화아연처리구에서 대조구에 비해 유의적으로 감소하였다 (p<0.05). 크롬 피콜린산-산화아연처리구와 크롬 피콜린산구에서 건물 및 단백질 소화율이 향상되었다 (p<0.05). This experiment was conducted to investigate the effects of chromium picolinate in different combinations with minerals on growth, carcass characteristics, serum traits and nutrient digestibility in finishing pigs. Five-hundred and thirteen pigs (69.0 ㎏ of initial weight) were assigned to 9 treatments, each containing three replicates of sixteen to twenty-one pigs each. Additional nine pigs were used in a digestion trial. Treatments were two controls (12% CP and 14% CP), foreign CrP-CaCO₃, two CrP-Zeolite (12% CP and 14% CP), domestic CrP-CaCO₃ 1, CrP-CaCO₃-ZnO (12% CP and 14% CP) and domestic CrP-CaCO₃ 2. ADG was not significantly different among the treatments. Tenth rib backfat thickness tended to be decreased by feeding diet with CrP. Carcass grade was improved by using zeolite and CaCO₃ + ZnO along with CrP in diets. Serum cholesterol level was significantly reduced by feeding diets containing CrP with CaCO₃ + ZnO or Zeolite compared with the control. Supplementation of Cr with CrP-CaCO₃ + ZnO or CrP-CaCO₃ in diets significantly improved the digestibility of crude protein and dry matter (p<0.05). The excretion of nitrogen was lower in pigs fed diets containing Cr regardless of the combinations with minerals. The excretion of phosphorus was lowest in the CrP-CaCO₃ + ZnO group which showed the highest phosphorus digestibility.