• The Korean Journal of Pain
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• 제9권1호
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• pp.264-267
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• 1996

Cervical epidural block can be useful in the management of acute and chronic pain of the head, neck, shoulder, and arm, for selected patients. In spite of the widespread use of cervical epidural blocks for pain, there is limited published data on the specific technique and complications regarding the procedure. High levels of epidural block do not appear to be associated with clinically significant circulatory or ventilatory changes unless the concentrations of local anesthetics used are great enough to produce paralysis of intercostal and phrenic nerves. However, high level of epidural block is associated with sympathetic block which may affect responses of circulatory and ventilatory systems. Accordingly, the possibility of major complications of cervical epidural block must be borne in mind. We experienced two cases of respiratory arrest during cervical epidural block with bupivacaine. This is a report regarding complications of cervical epidural block.

• Journal of Chest Surgery
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• 제17권2호
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• pp.189-196
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• 1984

Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

• Journal of Chest Surgery
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• 제28권7호
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• pp.721-725
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• 1995

One case of surgical correction of a large aortopulmonary window in a 4 months old female is reported in detail. Clinical symptoms consisted of fatigue when feeding and recurrent upper respiratory tract infection. Under cardiopulmonary bypass with moderate hypothermia and cardioplegic arrest of the heart, the aortopulmonary window was approached through a vertical incision at the anterior wall of window itself. The defect was closed with pericardial patch using continuous suture posteriorly and sandwitch technique anteriorly. The patient was weaned from the cardiopulmoanry bypas without hemodynamic problem and postoperative course was uneventful. This surgical technique is recommandable as it provides good exposure of the defect and can be performed easily and safely.

• 대한방사선기술학회지:방사선기술과학
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• 제41권3호
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• pp.193-199
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• 2018

The purpose of this study was to evaluate the convenience and image quality of patients with acute lumbar pain patients at a general hospital in Daejeon using ancillary devices for postural changes and correction. The results of the study are summarized as follows. First, the Turbo S pin Echo technique(TS E) using ancillary equipment has the highest image evaluation rating with an average score of 4.440, which is highly valuable on a diagnosis. Second, the average score for patient the questionnaire 'When using ancillary equipment, I feel that my body is calibrated to side without bias.' was shown as 4.440, which is very useful for the correction of the patient's body when using ancillary equipment. Finally, Breath Hold technique(BH) is very effective in shortening test time of acute lumbar pain patients, because it can reduce test time 86.4% faster than Turbo Spin Echo technique(TSE). The results of the study showed that the use of ancillary equipment to perform the test through the side lying postures helped to reduce the pain and control the patient's breathing, and the diagnostic value of the image was high.

• The Korean Journal of Physiology
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• 제1권1호
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• pp.57-66
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• 1967

Cold $(0^{\circ}C)$ or warm $(25^{\circ}C)$ fresh and sea water were flooded into the lungs of rabbits through tracheal canule. Respiratory arrest ensued in 19.5 minutes in the warm fresh water flooded rabbits and was the longest survival time among the experimental groups. The survival times in the other groups were: 2.32 minutes in cold fresh water group, 2.75 minutes in .warm sea water group, and 4.57 minutes in cold sea water group. Cardiac output was measured by means of T-1824 dilution technique after 2 or 3 minutes of flooding in 27 rabbits. Blood pressure was observed by mercury manometer throughout the survival time in 40 rabbits. The following results were obtained. 1. Cardiac output in the warm fresh water flooded and sea water flooded animal was smaller than that of control rabbits. In the cold fresh water flooded animal cardiac output was greater than that of the control animal. 2. Time constants of T-1824 dilution curve of experimental group were elongated than the normal curve. 3. Central blood volume showed an increase in the fresh water group, a decrease in cold sea water group and no change in warm sea water group. 4. In all of the experimental groups arterial blood Pressure showed an abrupt and great variations after flooding of lungs and lasted about 30 seconds. Thereafter, arterial pressure remained at a plateau level until the sudden fall to zero and this was almost coincided with the time of respiratory arrest. The Plateau level of arterial Pressure in fresh water group was about 10 mmHg higher than the control value, and it was lower than the control value in warm sea water group. In cold sea water group the plateau was made up by fluctuations around the control value. 5. Osmosis of water through the lung alveolar membrane occured in all animals. Fresh water caused hemodilution and sea water caused hemoconcentration. 6. In sea water flooded animal more volume of water was recovered through the tracheal canule than the volume injected into trachea. This was interpreted as the consequence of the shift of water from plasma to alveolar sac. 7. Relative freight of lung was greater in fresh water group than sea water group. In all animal lung edema ensued. 8. The mechanisms of cardiac output variations were discussed.

• Journal of Chest Surgery
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• 제35권8호
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• pp.573-579
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• 2002

배경: 본 연구에서는 영아기에 변형 블라록-타우시히 단락술을 시행 받은 환자들을 대상으로 술후 경과, 개통율, 사망률과 사망원인 및 이에 영향하는 위험인자 들을 분석해봄으로써 그 유용성을 검증하고자 하였다. 대상 및 방법: 1990년 11월부터 2002년 6월까지 서울대학교 어린이병원 흉부외과에서, 폐동맥성형술을 함께한 경우까지만 포함한 블라록-타우시히 단락술을 시행받은 환자들을 대상으로 후향적으로 병록지 분석을 하였다. 수술 당시 평균 연령은 43.0$\pm$36.6 일이었고 남.녀 성비는 남: 여, 60 : 40 이었다. 진단은 54례가 활로씨사징증이었으며, 그 외 단심증, 각종 대혈관전위증, 양대혈관우심실기시증 등의 복잡심기형이었다. 결과: 환자의 술 후 산소포화도의 변화 양상은 수술 직후에서 약 24시간까지는 다소 불안정한 상태로 유지되다가 48시간정도 이후부터 안정되기 시작하여, 술 후 2~7일 사이에 서서히 회복되는 것이 관찰되었다 수술 사망은 8례로 수술 도중 발생한 저산소증관리의 실패(2), 수술 직후 발생한 단락 폐쇄(2), 심기능부전과 심낭삼출 등으로 인한 저심박출증(2), 패혈증(2)등이었다. 완전교정술을 기다리다가 사망한 3례의 만기 사망환자의 사망 원인은 심도자술 시행 시 발생한 급성 호흡정지(1), 심한 저산소성 심부전(1), 부정맥(1) 등으로 술 후 131~324 일 사이에 발생하였다. 단락술 후 사망에 관여하는 인자로 수술년도, 단락크기, 연령, 심기형의 복잡성정도 등을 살펴보았으나 모두 사망의 유의인자가 아니었다. 수술 사망을 제외한 92명에 대한 다음 단계 수술까지의 단락 개통유무를 기준으로 살펴본 6개월의 개통률은 97% 였으며, 전체 연구 기간을 대상으로 한 개통률은 96%였다. 결론: 저자 등은 본 연구를 통하여 신생아 및 조기 영아기 환자에 시행한 변형 블라록-타우시히단락술이 적어도 술 후 1, 2년 동안의 완전 교정술까지의 고식 목적으로 또는 폐동맥 준비과정으로 그 유용성이 있음을 입증하였다. 그러나 양호한 성적을 위해서는 안정적인 술기의 확보, 단락술 후의 혈역학의 변화에 대한 이해를 바탕으로 한 술 후 관리, 정중 흉골절개를 통해 얻을 수 있는 보다 정교한 수술 등이 필수적이라는 사실도 지적되어야 한다.