Hydrothorax with alveolar-pleural fistula mimicking re-expansion pulmonary edema during liver transplantation -a case report-

우재희,정락경,백희정,김윤진 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.2

We present a case of an alveolar-pleural fistula with hepatic hydrothorax in a patient undergoing orthotropic liver transplantation,which was detected by drainage of transudate through an endotracheal tube during operation. A standard endotrachealtube was changed to a double-lumen tube to provide differential lung ventilation. The patient was diagnosedwith an alveolar-pleural fistula by direct vision of an air leak during positive-pressure ventilation through a diaphragmaticincision. There was still a concern about worsening his ventilation due to persistent aspiration of pleural effusiontowards the ipsilateral lung during the remaining operation period. Surgeon repaired the defect on the exposed lungsurface via diaphragmatic opening. Anesthesiologists should consider an alveolar-pleural fistula as a possible differentialdiagnosis with re-expansion pulmonary edema when transudate emanating from the endotracheal tube is obtained inpatients with massive hydrothorax.

Does Intravenous Ketamine Enhance Analgesia after Arthroscopic Shoulder Surgery with Ultrasound Guided Single- Injection Interscalene Block?: A Randomized, Prospective, Double-Blind Trial

우재희,김윤진,백희정,한종인,정락경 대한의학회 2014 Journal of Korean medical science Vol.29 No.7

Ketamine has anti-inflammatory, analgesic and antihyperalgesic effect and prevents painassociated with wind-up. We investigated whether low doses of ketamine infusion duringgeneral anesthesia combined with single-shot interscalene nerve block (SSISB) wouldpotentiate analgesic effect of SSISB. Forty adult patients scheduled for electivearthroscopic shoulder surgery were enrolled and randomized to either the control group orthe ketamine group. All patients underwent SSISB and followed by general anesthesia. During an operation, intravenous ketamine was infused to the patients of ketamine groupcontinuously. In control group, patients received normal saline in volumes equivalent toketamine infusions. Pain score by numeric rating scale was similar between groups at 1, 6,12, 24, 36, and 48 hr following surgery, which was maintained lower than 3 in bothgroups. The time to first analgesic request after admission on post-anesthesia care unit wasalso not significantly different between groups. Intraoperative low dose ketamine did notdecrease acute postoperative pain after arthroscopic shoulder surgery with a preincisionalultrasound guided SSISB. The preventive analgesic effect of ketamine could be mitigatedby SSISB, which remains one of the most effective methods of pain relief after arthroscopicshoulder surgery.

Effect of Propofol and Desflurane on Immune Cell Populations in Breast Cancer Patients: A Randomized Trial

우재희,백희정,김치효,정락경,김동연,이귀용,Eun Hee Chun 대한의학회 2015 Journal of Korean medical science Vol.30 No.10

Several factors can affect the perioperative immune function. We evaluated the effect of propofol and desflurane anesthesia on the surgery-induced immune perturbation in patients undergoing breast cancer surgery. The patients were randomly assigned to receive propofol (n = 20) or desflurane (n = 20) anesthesia. The total and differential white blood cell counts were determined with lymphocyte subpopulations before and 1 hr after anesthesia induction and at 24 hr postoperatively. Plasma concentrations of interleukin (IL)-2 and IL-4 were also measured. Both propofol and desflurane anesthesia preserved the IL-2/IL-4 and CD4+/CD8+ T cell ratio. Leukocytes were lower in the propofol group than in the desflurane group at 1 hr after induction (median [quartiles], 4.98 [3.87-6.31] vs. 5.84 [5.18-7.94] 103/μL) and 24 hr postoperatively (6.92 [5.54-6.86] vs. 7.62 [6.22-9.21] 103/μL). NK cells significantly decreased 1 hr after induction in the propofol group (0.41 [0.34-0.53] to 0.25 [0.21-0.33] 103/μL), but not in the desflurane group (0.33 [0.29-0.48] to 0.38 [0.30-0.56] 103/μL). Our findings indicate that both propofol and desflurane anesthesia for breast cancer surgery induce a favorable immune response in terms of preservation of IL-2/IL-4 and CD4+/CD8+ T cell ratio in the perioperative period. With respect to leukocytes and NK cells, desflurane anesthesia is associated with less adverse immune responses than propofol anesthesia during surgery for breast cancer. (Clinical trial registration at https://cris.nih.go.kr/cris number: KCT0000939)

Effects of clonidine on the activity of the rat glutamate transporter EAAT3 expressed in Xenopus oocytes

우재희,한종인,백희정,이희승 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.3

Background: Clonidine has been shown to be a potent neuroprotectant by acting at α2 receptors on glutamatergic neurons to inhibit the release of glutamate. The aim of this study is to investigate the effects of clonidine on the activity of EAAT3 that can regulate extracellular glutamate. Methods: EAAT3 was expressed in the Xenopus oocytes. Using a two-electrode voltage clamp, membrane currents were recorded after application of 30 μM L-glutamate both in the presence and absence of various concentrations of clonidine. To determine the effects of clonidine on the Km and Vmax of EAAT3 and the reversibility of clonidine effects, membrane currents were recorded after the application of various concentrations of L-glutamate both in the presence and absence of 1.50 × 10-7 M clonidine. Results: Clonidine reduced the EAAT3 responses to L-glutamate in a concentration-dependent manner. This inhibition was statistically significant at higher concentrations than at the clinically relevant range. Clonidine at 1.50× 10-7 M reduced the Vmax, but did not affect the Km of EAAT3 for L-glutamate. Conclusions: These results suggest that the direct inhibition of EAAT3 activity is not related to the sedation effect of clonidine and that the clonidine-induced reduction of EAAT3 activity provides additional data for the possible involvement of glutamatergic hyperactivity in the proconvulsant effect of clonidine. Background: Clonidine has been shown to be a potent neuroprotectant by acting at α2 receptors on glutamatergic neurons to inhibit the release of glutamate. The aim of this study is to investigate the effects of clonidine on the activity of EAAT3 that can regulate extracellular glutamate. Methods: EAAT3 was expressed in the Xenopus oocytes. Using a two-electrode voltage clamp, membrane currents were recorded after application of 30 μM L-glutamate both in the presence and absence of various concentrations of clonidine. To determine the effects of clonidine on the Km and Vmax of EAAT3 and the reversibility of clonidine effects, membrane currents were recorded after the application of various concentrations of L-glutamate both in the presence and absence of 1.50 × 10-7 M clonidine. Results: Clonidine reduced the EAAT3 responses to L-glutamate in a concentration-dependent manner. This inhibition was statistically significant at higher concentrations than at the clinically relevant range. Clonidine at 1.50× 10-7 M reduced the Vmax, but did not affect the Km of EAAT3 for L-glutamate. Conclusions: These results suggest that the direct inhibition of EAAT3 activity is not related to the sedation effect of clonidine and that the clonidine-induced reduction of EAAT3 activity provides additional data for the possible involvement of glutamatergic hyperactivity in the proconvulsant effect of clonidine.

Compression stockings reduce the incidence of hypotension but not that of cerebral desaturation events in the beach-chair position: a randomized controlled trial

우재희,김윤진,정지선,채지선,이영롱,전진영 대한마취통증의학회 2018 Korean Journal of Anesthesiology Vol.71 No.2

Background: The beach-chair position (BCP) results in decreases in venous return, cardiac output, and cerebral perfusion pressure. In this randomized, prospective study, we investigated whether applying thigh-high compression stockings affected the maintenance of regional cerebral tissue oxygen saturation (rSO2) in the BCP. Methods: Patients undergoing orthopedic surgery in the BCP under general anesthesia were included and assigned randomly to the control or the compression stocking group. Appropriately sized thigh-high compression stockings were applied to the patients in the stockings group. All patients were tilted, up to 45°, throughout the operation. Non-invasive blood pressure, invasive arterial blood pressure zeroed at the external auditory meatus, and rSO2 were recorded. Results: Data were analyzed from 19 patients per group. In the BCP, the values of rSO2 and blood pressure decreased significantly compared with those at baseline, with no significant difference between the groups. The incidences of cerebral desaturation events (CDEs) were similar between the groups; however, that of hypotension was significantly lower in the compression stocking group. During 36 CDEs, the levels of rSO2 and blood pressure decreased significantly compared with those at baseline in both groups. No significant correlation was found between rSO2 and blood pressure. Conclusions: Thigh-high compression stockings reduced the incidence of hypotension but not that of CDEs. Our results suggest that other factors, beyond hypotension itself, contribute to CDEs and in other words, efforts just to reduce the incidence of hypotension may not mainly contribute to a reduction of CDEs occurrence in the BCP under general anesthesia.

청소년의 진로정체감 증진을 위한 미래 학교교육의 방향

우재희 한국미래교육학회 2017 미래교육연구 Vol.7 No.2

미래는 다양성을 융통적으로 발휘하여 함께 어울림이 가능한 사람만이 바람직한 삶을 살아갈 수 있는 시대이다. 이를 위해 학교 교육은 기존의 학교라는 틀에서 벗어나 학생의 진로에 영향을 미치는 다양한 교육의 형태와 내용을 제공해야 한다. 이를 위해 본 연구는 중학생의 진로정체감에 영향을 미치는 다양한 요인들을 살펴보았고, 학교교육의 형태에서 진로정체감에 영향을 주는 다양한 요인들을 제공하기 위한 발전적 방향을 제시하고자 한다. 본 연구는 한국아동ㆍ청소년 패널조사(Korean Children and Youth Panel Survey, KCYPS) 2015년 중학교 1 학년 패널 5차년도 자료를 활용하였고, 총 2,056명이 연구대상이였다. 연구결과는 학업성취가 자아인식과 또래애착이 진로정체감 사이에서 매개효과를 갖는다는 것을 밝혔다. 첫째, 청소년의 자아인식과 학업성취, 또래애착과 학업성취, 학업성취와 진로정체감, 자아인식과 진로정체감, 또래애착과 진로정체감의 경로를 검증한 결과 유의미한 것으로 나타났다. 둘째, 청소년의 자아인식, 또래애착이 진로정체감에 미치는 영향에 대한 학업성취의 매개효과를 검증한 결과, 학업성취의 매개효과가 유의미한 것으로 나타났다. 본 연구를 바탕으로 청소년들의 진로정체감을 증진시키기 위해 자아인식, 또래애착을 바탕으로 한 학업성취를 고취시키는 진로지도를 연구하는 것이 중요하게 고려되어진다. 본 연구의 결과를 바탕으로 실천적 함의가 논의되어졌다. The future is an era where only a person can live together in a way that can lead to a desirable life. To this end, school education should provide a variety of educational and educational aspects that affect students ' careers and affects their careers. To this end, the study looked at various factors affecting the identity of middle school students, and intends to provide a developmental direction to present various factors that affect career congestion in the form of future school education. The 5-year longitudinal data from the Korean Children & Youth Panel Survey (KCYPS) were collected from 1th grade middle school students. The data were analyzed by the structural equation modeling and sobel testing. The results of this study were as follows. First, The result revealed that the positive path from self-awareness to academic achievements, from peer attachment to academic achievements, from academic achievements to career identity, from self-awareness to career identity, from Peer attachment to career identity. Second, the result of verifying the moderating effect of career identity showed that career identity was a full moderator between self-awareness, peer attachment to academic achievements. Based on these results, the practical implications were discussed.

The degree of labor pain at the time of epidural analgesia in nulliparous women influences the obstetric outcome

우재희,김종학,이귀용,백희정,김윤진,정락경,윤두균,임채황 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.3

Background: The increased pain at the latent phase can be associated with dysfunctional labor as well as increases in cesarean delivery frequency. We aimed to research the effect of the degree of pain at the time of epidural analgesia on the entire labor process including the mode of delivery. Methods: We performed epidural analgesia to 102 nulliparous women on patients’ request. We divided the group into three based on NRS (numeric rating scale) at the moment of epidural analgesia; mild pain, NRS 1–4; moderate pain, NRS 5–7; severe pain, NRS 8–10. The primary outcome was the mode of delivery (normal labor or cesarean delivery). Results: There were significant differences in the mode of delivery among groups. Patients with severe labor pain had a significantly higher cesarean delivery compared to patients with moderate labor pain (P = 0.006). The duration of the first and second stage of labor, fetal heart rate, use of oxytocin and premature rupture of membranes had no differences in the three groups. Conclusions: Our research showed that the degree of pain at the time of epidural analgesia request might influence the rate of cesarean delivery. Further research would be necessary for clarifying the mechanism that the augmentation of pain affects the mode of delivery.

154kV급 가스절연 변압기 개발

우재희,최예림,김경민,이준엽,석복렬 대한전기학회 2005 전기학회논문지C Vol.54 No.12-C

The demand of Gas Insulated Transformer(GIT) using SF6 gas as insulating and cooling medium is being increased dramatically in the underground substation of urban area because it has the advantages of non-flammable and non-explosive, etc. This paper describes the structural features and advantages of the gas insulated transformer compare to an oil immersed transformer, and presents a brief overview of the consideration and technology which apply to SF6 gas insulated transformer.

154kV급 가스절연 변압기 개발

우재희,최예림,김경민,이준엽,석복렬,Woo J.H.,Choi Y.L.,Kim K.M.,Lee J.Y.,Seok B.Y. 대한전기학회 2005 전기학회논문지C Vol.54 No.12

The demand of Gas Insulated Transformer(GIT) using $SF_6$ gas as insulating and cooling medium is being increased dramatically in the underground substation of urban area because it has the advantages of non-flammable and non-explosive, etc. This paper describes the structural features and advantages of the gas insulated transformer compare to an oil immersed transformer, and presents a brief overview of the consideration and technology which apply to $SF_6$ gas insulated transformer.

과잉간섭 양육방식이 휴대 전화의존도에 미치는 영향

우재희(Jea-Hee Woo) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.8

본 논문은 과잉간섭 양육방식이 휴대전화의존도에 미치는 영향에서 우울의 매개효과를 살펴보고자 했다. 연구를 위해 한국아동·청소년 패널조사(Korean Children and Youth Panel Survey, KCYPS) 2015년 초등학교 4학년 패널 5차년도 자료를 활용하였다. 자료는 AMOS를 이용하여 구조방정식 모델을 분석하였고, 매개효과의 유의성은 AMOS의 bootstrapping 검증으로 실행하였다. 연구결과의 내용은 다음과 같다. 첫째, 과잉간섭 양육방식과 우울, 우울과 휴대전화의존도, 과잉간섭 양육방식과 휴대전화의존도의 경로를 검증한 결과 유의미한 것으로 나타났다. 둘째, 과잉간섭 양육방식이 휴대전화의존도에 미치는 영향에 대한 우울의 매개효과를 성별, 지역, 교급을 통제한 상황에서 검증한 결과, 우울의 매개효과가 유의미한 것으로 검증되었다. 이러한 연구결과는 아동이 휴대전화에 의존되는 과정에 부모의 과잉간섭 양육방식이 중요한 원인 변인으로 작용함을 인지해야 하고, 부모의 과잉간섭 양육방식으로 인한 아동의 우울감정을 휴대전화의존 전 단계에서 부터 다루어야 하는 중요 변인이라는 것을 시사한다. 또한 가정환경, 가족관계는 휴대전화 예방 뿐 아니라 아동이 독립된 성인으로 건강하게 성장하기 위해 기본 근간이 되는 바탕이 됨을 인지해야 한다는 것을 시사한다. 본 연구결과를 바탕으로 부모로부터 과잉간섭 양육방식을 받은 아동의 휴대전화의존도 문제에 대한 개입을 위한 실천적 논의가 진행되었다. This study examined the mediating effect of depression on the relationship between over-control parenting styles and mobile phone dependency among children. The 5th-year longitudinal data from the Korean Children & Youth Panel Survey (KCYPS) were collected from 4th grade elementary school students. The data were analyzed by the structural equation modeling and bootstrapping. The results of this study were as follows. First, there is apositive path from over-control parenting styles to depression, from depression to mobile phone dependency, and from over-control parenting styles to mobile phone dependency. Second, depression had a mediating effect on the association betweenover-control parenting styles andmobile phone dependency. Based on these results, more study of elementary school students" reliance on cell phones is needed.