A Narrative Inquiry of Medical Students' Experiences of Expulsion and Military Service / 의학교육논단

The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.

Autonomic Hyperreflexia - Case report / 대한마취과학회지

Autonomic hyperreflexia in spinal cord lesion is due to interruption of inhbitory im from higher centers. Especially, dramatic disturbance is seen in cord lesions above the fifth thoracic se and consist of hypertension, bradycardia and sweating. Sometimes marked hypert results in fatal cerebral hemorrhage or subarachnoid hemorrhage ao that the anesthesic gets used to its control and treatment. In current methods of control of hypertension, there are general anesthesia with halothane or enflurane, spinal anesthesia and ganglionic blockers. Ganglionic blockers, such as hexamethonium, drsmatically suppress marked arterial hypertension, also. We have experienced 3 cases of tetraplegic patients. Two cases given local anesthesia developed autonomic hyperreflexia but one case given general anesthesia did not have the hyperreflexia.

Cardiac Arrest after Changing Position / 대한마취과학회지

Positional change under the anesthesia may cause marked hypotension, particularly in the critically ill patient. Therefore, positional change must be accomplished slowly and gently, and blood pressure observed throughout the procedure. Basic components for the safe positioning is knowledge, forethought, teamwork and housekeeping. Patients with paraplegia, quadriplegia, or a critical illness may require intravenous vasopressor drug before turning, and the lightest possible level of anesthesia is used. The authors experienced a case of cardiac arrest after changing position of a paraplegic patient under general anesthesia. The patient was resuscitated.

A Csse of Spinal Anesthesia for Obstetric Patient with Multiple PVC`s / 대한마취과학회지

It was learned in 1960 that pregnancy could cause respiratory and circulatory changes, and that severe labor pain could cause tachycardia and cardiac arrythmias. We have experienced successful anesthetic management for cessarean section of a full term pregnant woman with multiple premature ventricular contractions under spinal anesthesia. PVC's could be caused by systemic hyposia, hypokalemia, acidosis hypercapnia, hypocalcemia, regional myocardial ischemia, etc. We could not confirm the cause of this woman's PVCs, but we assume that either deterioration of the respiratory and cardiac changes or severe labor pain could be implicated.