북부 동-정맥루공 전신마취 1례

정종달 朝鮮大學校 附設 醫學硏究所 1986 The Medical Journal of Chosun University Vol.11 No.1

36 years old male patient admitted for surgical correction of an arteriovenous fistula between right common iliac artery and inferior vena cava. Thiopental sodium and succinylcholine were injected for tracheal intubation and the anesthesia was maintained with nitrous oxide, oxygen and halothane. The EKG, blood pressure, Pulse rate, CVP were monitored continuously. After aorta was cross-clamped, arterial systolic and diastolic pressure rose moderately, CVP was slightly decreased and no significant changes were seen after declamping. This patient was discharged after 1 month in good condition.

수술후 경막외강에 주입한 ketamine의 진통효과에 관한 연구

정기호,조남수,임경준,유병식,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1993 The Medical Journal of Chosun University Vol.18 No.1

Author divided 60 patients who got lower abdomen or lower extremity surgical operation into three groups. Each group consisted of 20 patients. We injected ketamine 10㎎, 20㎎, and 30㎎ respectively into the epidural space when the patient complained of pain postoperatively and observed the postoperative analgesic effect of ketamine. Finally, we concluded the following : 1) The onset time of analgesic effect. : The analgesic effect appeared within 10 minutes in 3 groups and the significant difference among them was not seen. 2) The duration of analgesic effect : The duration of analgesia was relatively short with less than 1 hour on an average in all 3 groups and was not constant. 3) Cardiopulmonary system. : The significant change of blood pressure, pulse and respiratory rate was not seen in all three groups and and the difference among them also was not seen. 4) Side effects. : Sedative action(16%), nausea(10%), dizziness(5%), headache(3.3%) From above results, the epidural administration of ketamine is not suitable for postoperative pain management because of a lot of side effects as well as short and inconstant duration of analgesic effeet.

척수강내 Bupivavacain에 첨가한 소량의 Neostigmin의 진통효과와 부작용

소금영,정종달,김병철,유벙식,안태훈,김훈정,임경준 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Spinal cholinergic receptor has been shown to have a antinociceptive action, an effect that can be mimicked by spinal cholinesterase inhibitor. Intrathecal injection of neostigmine cause analgesia and adverse effect in a dose-dependent pattern in the patients. The purpose of this study was to determine whether small doses of intrathecal neostigmine (10, 25 and 50 ㎍) produce analgesia and any side effects. Method : After getting informed consents, 60 patients scheduled for orthopedic surgery of lower extremities under spinal anesthesia were randomly assigned to one of four groups. Using dose-ranging design, patients received either normal saline or neostigmine l0, 25 or 50 ㎍ in a 1-㎎ solution of 5% glucose in normal saline with heavy bupivacaine 12 ㎎. Heart rate, blood pressure, degree of motor and sensory block were recorded. The assessment of postoperative analgesia included time to first rescue, total number of rescue medication and pain score on visual analog scale (VAS) at 1, 3, 6, 9, 12, 24 hour. Nausea and vomiting were assessed by using the visual analog scale at 24 hr postperatively and the incidence of them was recorded postoperatively. Result : There were no significant differences among the four groups in characteristics of spinal blocks. Compared to saline, neostigmine groups significantly prolonged time to first rescue medication and decreased total number of rescue medication and pain visual analog scale score, but incidence of nausea and 24hr nausea VAS score were not increased in neostigmine group compared to control group. Conclusion : These data in patients injected intrathecal neostigmine suggest that analgesia may occur at doses less than neostigmine 50 ㎍ and neostigmine 50㎍ has a better analgesia effect with fewer side effects than other doses for postoperative analgesia.

Bicycle Ergometer 작업을 시작한 직후의 심박수와 산소섭취량의 변동

김순태,정종원,이달영 가톨릭대학산업의학센타 산업의학연구소 1974 韓國의 産業醫學 Vol.13 No.1

In order to examine the responses of heart rate and oxygen uptake during the first minutes of bicycle ergometer work with different loads, we measured the heart rate and oxygen uptake on 975, 100, 125, 150, 175, 200 and 225 watts. The results obtained were as follows: 1. Time required for reaching a steady state of heart rate and oxygen uptake was delayed with increasing work loads and it was more significant in case of oxygen uptake. 2. Statistically significant difference was existed in heart rate among different work loads of ergometer cycling except between 125 and 150 watts and between 200 and 225 watts. 3. Statistically significant difference was existed in oxygen uptake among different work loads, especially within 1 minute after onset of ergometer cycling. 4. The changes in the rates of increase of heart rate( HR%) and oxygen uptake( VO₂%) during the work, which were calculated as percentage to the values at 3 minutes after onset of ergometer cycling showed approximately the same pattern regardless of work loads, and the rate of increase was greater in heart rate than in oxygen uptake within 1 minute after onset of ergometer cycling.

비호지킨 림프종의 REAL 분류와 cyclin D1, bcl-2, p53및 bcl-6 단백발현

이미자,전호종,정종달,박유환,김민 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background and Objectives : There has been a continuous evolution of the lymphoma classification and recently a Revised European-American Lymphoma (REAL) classification was proposed by the International Lymphoma Study Group. This new classification requires information on immunophenotypic and molecular biologic markers in addition to the usual histologic findings. The distinction between mantle cell lymphoma (MCL) and other low grade B cell lymphomas is important because MCL has a more aggressive clinical course. The aim of this study is to determine the clinical characteristics and the relative frequency of malignant non-Hodgkin’s lymphomas (NHL) and analyze the expression of the cyclin D1, bcl-2, p53 and the bcl-6 protein. Materials and Methods : One hundred and twelve cases of NHL were recategorized by the newly described REAL classification categories and investigated for the expression of the cyclin D1, bcl-2, p53 and bcl-6 protein by the immunohistochemical method. Results : There were higher rates of extranodal lymphoma, diffuse large B cell lymphoma, and angiocentric lymphoma and lower rates of T cell lymphoma and follicular center lymphoma compared with Western countries. Cyclin D1 is expressed in all cases of MCL. But no cases except for MCL showed positive for cyclin D1. The expression of bcl-2 had decreased in high-grade lymphomas. Conclusion : It suggests that the cyclin D1 expression in mantle cell lymphoma could be reliably distinguished from its expression in other non-Hodgkin’ s lymphomas. In addition, bcl-2 may be useful for the differentiation of the low grade lymphoma from the high grade lymphoma.

수술후 통증조절을 위한 지주막하강내 모르핀 투여시 Epinephrine 첨가효과

송민엽,송경준,정종달,소금영,김용일 조선의대 1996 The Medical Journal of Chosun University Vol.21 No.2

기관내 삽관시 Slow induction과 Fentanyl 정주가 심혈역학적 변화에 미치는 영향

윤재천,채종한,조남수,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2

Tracheal intubation is accompanied by varying degrees of sympathetic stimulation as reflected by increases in blood pressure and heart rate. Several clinical trials to reduce these effects by deepening anesthesia, using pharmacologic agents such as alpha and beta blockers,calcium channel blockers, fentanyl and lidocaine have been reported. To evaluate the effects of slow induction and fentanyl on responses of cardiovascular system induced by endotracheal intubation, we administered thiopental sodium 5㎎/㎏ (group Ⅰ), slow induction with O_(2)-N_(2)O-halothane( group Ⅱ), fentanyl 3uμ/㎏ with thiopental sodium 4㎎/㎏(group Ⅲ) for induction of anesthesia, and measured systolic and diastolic pressures, and heart rates before induction, and at 1,2,3,4, and 5 minutes after intubation. 1) In group Ⅰ, intubation caused a significant increase in systolic pressure (10%) diastolic pressure (15%) and heart rate (28%) at 1 min. after intubation but each parameter returned to the normal level within 5 min. 2) In group Ⅱ, increases in systolic pressure (12%), diastolic pressure (22%) and heart rate (23%) at 1 min. after intubation but there were no significant differences compared to group Ⅰ. 3) In group Ⅲ, the increase in systolic and diastolic pressure induced by intubation was abolished by fentanyl and showed significant decrease compared to group Ⅱ, increase in heart rate (4%) at 1 min. after intubation but were of no significance, and showed significant decrease compared to group Ⅱ but not at 3 min., 4 min. after intubation. These results suggested that a low dose of fentanyl significantly blunts postintubation hypertenion and tachycardia when used as an adjunct to thiopental sodium.

비탈분극성 근육이완의 길항시 Atropine, Pyridostigmine과 Glycopyrrolate, Pyridostigmine의 혼합정주가 심박수에 미치는 영향

소금영,채종한,조남수,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.1

Changes in heart rate during reversal of neuromuscular block have been a subject of clinical investigation for many years. A number of studies, have compared the effect used anticholinergics and anticholinesterase. In most studies, the drugs were administered simultaneously. Atropine and glycopyrrolate were studied in dose of 15㎕/㎏, 20㎕/㎏ and 7㎕㎕/㎏, lO㎕/㎏, given intravenously in a mixture with pyridostigmine 200㎕/㎏ at the end of operation. 15 ASA Class Ⅰ, Ⅱ patients, aged between 16 to 65, were selected in each group. Anesthesia was maintained with halothane(1.0 vol%), N20(3L/ min), O2(3L/min) and vecronium bromide 0.07㎎/㎏ was used as a muscle relaxant. The results were as follows ; 1) Atropine 15㎕/㎏, 20㎕/㎏, showed significant initial increase in pulse rate, atropine ZO㎕㎕/㎏ showed more initial increase than atropine 15㎕/㎏ Atropine 15㎕/㎏ showed more rate decrease than atropine 20㎕/㎏. 2) Gylcopyrrolate 7㎕/㎏ 10㎕/㎏ showed significant initial increase in pulse rate gylcopyrrolate 7㎕/㎏, 10㎕/㎏ showed less initial increase than atropine 15㎕/㎏, 20㎕/㎏. Atropine 20㎕/㎏ showed more late decrease than glycopyrrolate 10㎕/㎏.

Duchenne 근이영양증 환자에서 Propofol과 Remifentanil을 이용한 전정맥마취 경험 : 증례보고

김상훈,이현영,소금영,정종달,고지현 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S

Patients with Duchenne's muscular dystrophy are considered to be at risk of peri-operative complications. It's patients can be associated with cardiac arrest, rhabdomyolysis, malignant hyperthermia during anaesthesia. This is a case report of a 14 years old male patient who had known Duchenne muscular dystrophy was scheduled for open reduction and internal fixation of right humerus fracture. Regional anesthesia was refused by the patient. Total intravenous anesthesia (TIVA) was performed with propofol and remifentanil, which was started at the targeted effect concentration of 3.0μg/ml and 10ng/ml via target controlled infusion. After the end of operation, the patient was awaken without any problem and was transferred to recovery room.

골관절염 환자에서 관절내 Sodium Hyaluronate(Hyruan®)의 투여가 슬관절통에 미치는 영향

김훈정,임경준,위상우,정종달,유벙식,안태훈,소금영 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Sodium Hyaluronate has been found to be deficient in the synovial fluid of patients with osteoarthritis. We evaluate the effect of intraarticular Sodium Hyaluronate(Hyruan®) on the knee joint pain in patients with osteoarthritis. Method : Ten patients with osteoarthritis of the knee were participated in this study. Sodium Hyaluronate was injected into knee joints weekly for 5 weeks consecutively. Clinical evaluations were performed using visual analogue scale(VAS) for pain, tenderness and swollen joint counts weekly for the first 5 weeks and at 10 weeks postinjection. Result : VAS, tenderness and swollen joint were all significantly improved from 2 weeks to 10 weeks. There was no complication, except pain on injection site in two patients. Conclusion : Intraarticular injection of Sodium Hyaluronate has been shown to be effective on the treatment of patients with osteoarthritis of the knee.