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무통분만시 수막강내 Sufentanil에 첨가된 Bupivacaine의 효과
김수창,최덕환,김지애 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.6
Background : The combination of a local anesthetic and an opioid has been shown to produce effective epidural labor analgesia. It was reported that the combination of intrathecal opioid and bupivacaine could produce labor analgesia with longer duration and less side effects. This study was done to evaluate the effect of intrathecal bupivacaine mixed with sufentanil for labor analgesia. Methods : Eighty women requesting labor analgesia were randomly assigned to receive intrathecal 10 mcg of sufentanil (S group, n = 40) or 2.5 mg of bupivacaine plus 10 μg of sufentanil (SB group, n = 40) diluted in a total volume of 2.2 ml with normal saline. The analgesia was performed using combined spinal-epidural technique in the lateral position. Visual analogue scales (VAS) for pain, sensory changes to cold, duration of analgesia, motor block, hypotension, fetal heart rate, pruritus, and other side effects were assessed for 30 minutes after intrathecal drug injection. Results : There were no significant differences in he VAS pain scores and sensory levels at 5 minutes after intrathecal drug injection between groups. However, VAS pain scores were significantly lower and sensory levels higher in the SB group at 15 minutes and 30 minutes after intrathecal drug injection. The duration of analgesia provided by intrathecal sufentanil (n = 31) was 103.4 41.1 min, by intrathecal sufentanil plus bupivacaine (n = 29) 113.0 32.1 min (P = 0.30). Motor block assessed by a modified Bromage scale was significantly frequent in the SB group (P< 0.001). Not only adverse effects such as hypotension, fetal bradycardia, pruritus, and nausea, but also satisfaction scores were similar in both groups. Conclusions : The addition of bupivacaine to intrathecal sufentanil produced more frequent motor block and extensive sensory block, but better analgesia. However, duration of analgesia, side effects and satisfaction score did not change. (Korean J Anesthesiol 1999; 37: 1068∼1073)
신장수여자의 수술경과시간에 따른 자기존경감, 희망감, 염려 및 스트레스원의 차이
이 철,김창윤,한오수,박인호,유희정,한덕종 울산대학교 의과대학 1993 울산의대학술지 Vol.2 No.2
This study attempted to examine the differences of self - esteem, hopes, concerns and total stress scores of 110 kidney recipients in before(N=32) and fellowing kidney transplantation [1 to 6 months(N=29), 6 to 12 months(N=23), 12 to 36 months(N=26)] and utilizing severity rating scale of 44 potential stressors on a 5-point scale of 110 kidney recipients in before(N=32) and following kidney transplantation operation [1 to 6 months(N=29), 6 to 12 months(N=23), 12 to 24 months(N=15) and 24 to 36 months(N=11)]. On scores of hopes and total stress, pretransplant group exhibited significantly higher scores than three posttransplant recipient groups. But, it was found that there was no significant differences among four transplant kidney recipient groups on the scores of self - esteem and concerns. In the pretransplant group, craving for foods was identified as the most stressful event, on the contrary, changes in friends was identified as the lowest stressful events. In the 1 to 6 months posttransplant group, side effect of medications was identified as the most stressful event, however, loss of contact with dialysis patients was identified as the lowest stressful event. In the 6 to 12 months posttransplant group, cost of medication, changes in body appearance were identified as the most stressful event, on the other hand, managing of medications at home was identified as the lowest stressful event. In the 12 to 24 months posttransplant group, cost of medication and insurance coverage were identified as the most stressful event, but possibility of dying and competence of nursing staff were identified as the lowest stressful event. In the 24 to 36 months posttransplant group, changes of body appearance was identified as the most stressful event, on the contrary, possibility of infection was identified as the lowest stressful event. Insurance coverage was a continuing concern throughout posttransplant period.
( Jae Min Lee ),( Hoon Jai Chun ),( In Kyung Yoo ),( Seung Joo Nam ),( Seung Han Kim ),( Hyuk Soon Choi ),( Eun Sun Kim ),( Bora Keum ),( Yoon Tae Jeen ),( Hong Sik Lee ),( Chang Duck Kim ),( Ho Sang 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Many patients with gastrointestinal bleeding show anemia and usually need red blood cell transfusion. But clinicians are concerned about low hemoglobin affects prognosis and clinical outcome after discharge. This study aimed to assess whether discharge hemoglobin infi uence on outcomes, or not, in patient with acute non-variceal gastrointestinal bleeding. Methods: Retrospective analysis was carried out on patients who had upper gastrointestinal bleeding between January 2011 and December 2012. We analyzed the patients who had lowest hemoglobin below 10 g/dL during hospitalization. Patients with variceal bleeding, stroke, or cardiovascular disease were excluded. We divided the patients into two groups by discharge hemoglobin (Low discharge hemoglobin group; 8 g/dL = hemoglobin and compared clinical outcomes and hemoglobin level changes. Results: A total of 212 patients with upper gastrointestinal bleeding were undergone the endoscopic hemostasis during study periods. One hundred two patients were satisfi ed the inclusion criteria. fifty patients discharged with hemoglobin level under 10 g/dL and fi fty two patients discharged with hemoglobin level over 10 g/dL. Patients in low discharge hemoglobin group showed a lower consumption of pRBC and shorter hospital days than patients in high discharge hemoglobin group. Hemoglobin levelswere not fully recovered at out-patient department until 7 days after discharge. But, most patients showed hemoglobin recovery at 45 days after discharge.Conclusions: In patients with acute gastrointestinal bleeding, discharge hemoglobin between 8 to 10 g/dL was showed favorable outcomes during out-patient department follow-up. It seems to be tolerable level without additional pRBC transfusion. Our result can increase the evidence available to support restrictive transfusion strategies in patients with acute non-variceal upper gastrointestinal bleeding.
김명철,이수진,이재일,박창식,전무형,김덕환,임승평 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8
A 5 year old, 13kg, Jindo dogs was presented with clinical signs of anorexia, weakness and exercise intolerance, and diagnosed as dirofilariasis by hematology, blood chemistry and ultrasonography. In hematology and blood chemistry, the presence of microfilariae in the blood. anemia, leukocytosis, hemoglobinuria and jaundice were revealed. In ultrasonography, heartworms were found in the right ventricle artery and pulmonary artery as structures of hyperechoic dots or streaks. Because of the dog's poor physical status, the owner requested euthanasia. In autopsy, fifty odd of heartworms were ascertained in the right ventricle and pulmonary artery. Tricuspid valve in the orifice of right ventricle and right atrium, and chordae tendineae were deliquesced.
김명철,이수진,이재일,박창식,전무형,김덕환,임승평 충남대학교 수의과대학 동물의과학연구소 2003 動物醫科學硏究誌 Vol.11 No.-
A 5 year old, 13kg, Jindo dogs was presented with clinical signs of anorexia, weakness and exercise intolerance, and diagnosed as dirofilariasis by hematology, blood chemistry and ultrasonography. In hematology and blood chemistry, the presence of microfilariae in the blood, anemia, leukocytosis, hemoglobinuria and jaundice were revealed. In ultrasonography, heartworms were found in the right ventricle artery and pulmonary artery as structures of hyperechoic dots or streaks. Because of the dog's poor physical status, the owner requested euthanasia. In autopsy, fifty odd of heartworms were ascertained in the right ventricle and pulmonary artery. Tricuspid valve in the orifice of right ventricle and right atrium, and chordae tendineae were deliquesced.
김명철,김덕환,전무형,홍성혁,박창식,이재일,이수진,김영석 충남대학교 수의과대학 동물의과학연구소 2002 動物醫科學硏究誌 Vol.10 No.-
Pain modification is an important part of traditional acupuncture therapies. However, the idea of using acupuncture to alleviate pain has been greatly expanded in the last four decades. It has reached the level that acupuncture may be used as a substitute for conventional anesthesia. Surgical analgesia can be produced by methods involving peripheral or central stimulation, such as Acupuncture Analgesia (AA). The most common method is Electro-Acupuncture Analgesia (EAA), using a special electrostimulator attached to needles in acupuncture points. The major advantages of AA or EAA are its safety in high-risk patients and excellent post-operative pain relief, freedom from complications and enhanced healing which follows surgery under AA. The major disadvantages are the long induction period (10-40 minutes) and variable degrees of analgesia even in skilled hands. The mechanisms of AA involve stimulation of peripheral sensory nerve, spinal cord and supraspinal areas (thalamus, midbrain and hypothalamus). AA can be used effectively in dog. The method has its advantages and disadvantages.
김중계,장덕지 제주대학교 농과대학 제주도축산문제연구소 1989 畜産論叢 Vol.4 No.1
A total 428 Che-ju pony mares were investigated for reproductive efficiency. The average age of first estrus and foaling were I5.1k1.59 and 38.9k5.48 months respectively. The average length of estrus, estrus cycle and gestation of mares were 5.7±1.81, 20.8±2.42 and 333.9±5.41 days respectively. Average parturitional r te of Che-ju mares was 60.9% and recurrence of estrus of foaling appeared to be 21.5±19.0 days. 311 mares were surveyed for reproductive disorder. The total occurrence rate of reproductive disorder for Che-ju mares has turned out to be 27 rnares(l6.1%). In 27 sterile mares reproductive disorder subdivided into ovary dysfunction(14.2%), persistent corpus luteum(2.9%) and absortion(2.9%). 15 anestrus mares were investigated for PGF_(2α) administration. 86.7% of Che-ju pony showed estrus on average 4.8 days and 60% of conception rate after treated PGF_(2α).