COPA(cuffed oropharyngeal airway)를 이용한 마취 유도 시 근이완제 사용 유무에 따른 반응

김상태,배진호,김상범,임승운,민병상,신영덕 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3

Background : COPA (cuffed oropharyngeal airway) is a convenient device for airway management in patients undergoing general anesthesia for elective surgery in supine position. It causes less pharyngeal trauma than LMA(Laryngeal mask airway). The purpose of this study was to compare the effect of COPA with and without muscle relaxant. Methods : Forty patients with ASA physical status I and II for elective surgery were randomly assigned to two groups. Anaesthesia was induced with propofol (2 mg/kg) and vecuronium (1.5 mg/kg) and was administered intravenously in Group I but not in Group II. Mask ventilation was done for 5 min with 0: 5 L/min. COPA was placed and heart rate, and systolic, mean, diastolic blood pressure and peak inspiratory pressure were measured at 1 min interval for 5 min. Anaesthesia was maintained with pro- pofol 150 ㎍/kg/min, fentanyl 1 ㎍/kg/hr, O_2 2 L/min and N_2O 2 L/min. Results : There were no significant differences between Group I and Group II in heart rate, systolic, mean and dstolic blood pressure. PIP (Peak inspiratory pressure) was increased and hiccups occurred significantly (p $lt; 0.05) in Group II. Complete airway obstruction occurred in one patient of Group I and severe coughing, body movements and gagging occurred during induction and insertion in Group II. conclusions : With the use of appropriate muscle relaxant, we can use COPA without increased inspiratory pressure or significant complication. (Korean J Anesthesiol 2000; 38: 399~403)

Multiple Markers of Contrast Induced Nephropathy after the Percutaneous Coronary Intervention

Byoung-won Park,Seong Soon Kwon,Min Ho Lee,Do Hoi Kim,Min Su Hyon,Duk Won Bang 순천향대학교 순천향의학연구소 2018 Journal of Soonchunhyang Medical Science Vol.24 No.1

Objective: Contrast-induced nephropathy (CIN) frequently occurs after percutaneous intervention. Objective of this study was to investigate the usefulness of serum cystatin C, neutrophil gelatinase-associated lipocalcin (NGAL), urinary kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) as early predictors for CIN after percutaneous coronary intervention (PCI). Methods: In 53 patients who underwent PCI were enrolled. Serum creatinine and cystatin C level were measured immediately before, and 24 hours and 48 hours after catheterization. Serum NGAL, urinary KIM-1, and IL-18 were measured immediately before, and 4 hours, 24 hours, and 48 hours after catheterization. CIN was defined as a rise in creatinine 0.5 mg/dL or 25% above baseline. Results: CIN occurred in four patients (7.5%). Serum cystatin C levels were higher at 24 hours and 48 hours in CIN patients than in those without CIN (P<0.05). Serum NGAL levels were higher at 48 hours in CIN patients than in those without CIN. Urinary KIM-1 levels were higher at 48 hours in CIN patients than in those without CIN. There were no significant markers of CIN on multi-variate analysis. Conclusion: In this study, the occurrence of CIN after PCI was 7.5%. Although there were some time-course changes in serum cystatin C and urinary KIM-1 after PCI, there was no significant predictor for CIN after PCI.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

초기 자궁내막암 환자에서의 복강경유도하 질식 자궁절제술과 복식 자궁절제술에 대한 비교 연구

김민규 ( Min Kyu Kim ),최동석 ( Dong Seok Choi ),김우영 ( Woo Young Kim ),최철훈 ( Chel Hun Choi ),김태중 ( Tae Joong Kim ),이정원 ( Jeong Won Lee ),김병기 ( Byoung Gie Kim ),이제호 ( Je Ho Lee ),배덕수 ( Duk Soo Bae ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12

Objective: To compare laparoscopic surgery with conventional abdominal surgery in patients with early stage endometrial cancer. Methods: A retrospective review of 63 patients with early stage endometrial cancer managed between March 2003 and May 2005. Two groups were defined whether they had been treated by laparoscopy (case group: n=26) or by laparotomy (control group: n=37). We compared age, body mass index (BMI), hemoglobin change, operation time, number of pelvic lymph nodes, hospital stay, case with adjuvant treatment and recurrence between two groups. Results: There was no statistical difference in characteristics (age, BMI, nulliparity, previous abdominal surgery, FIGO stage, histologic grade). between case and control group. In addition, there was no statistical difference in operation data and outcomes between two groups. Hemoglobin changes were 1.1 g/dL (case group) vs 1.7 g/dL (control group) (p=0.072). Operation time was 131 min vs. 115 min. The numbers of lymph nodes obtained were 8.7 vs 7.7 (right) 9.2 vs. 7.6 (left). Hospital stays were 8.4 vs. 9.2 days. Adjuvant treatment cases were 7 vs. 15. Recurrent case was one in each group. Two patients initially evaluated by laparoscopy were converted to laparotomy due to bleeding and adhesion. Conclusion: Laparoscopic surgery for treatment of early endometrial cancer is a safe and effective alternative to laparotomy . However, long-term survival and risk of recurrence have yet to be determined.

총경동맥 폐쇄시간에 따르는 국소 뇌혈류 변화 : 실험적 연구 An Experimental Cat Model

강준기,성태경,조병일,백민우,김문찬,허춘웅,하영수,송진언 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.3

The microvasculature of the brain is also quite susceptible to ischemic insult, and substantial portions of the brain are not reperfused after restoration of the blood supply following overtime of critical ischemic periods. The purpose of this series of experiments was to determine the effects of ischemia on subsequential regional cerebral blood flow measurements and cortical electric activities following reperfusion after ischemia and also to define the proper time of vascular occlusion without irreversible neural damage. Cerebral ischemia was induced in cat by bilateral common carotid occlusions for periods of 10, 30, to 60 minutes, and the blood supply was reperfused for 3 hours after clamp-off. Regional cerebral blood flow(rCBF) was measured by hydrogen clearance technique following ischemia, restoration of blood supply and electroencephalogram recovery could be predicted according to the rCBF. Forty adult cats weighing 2.7 to 4.0㎏ were used in this study. The animals were divided into 4 groups of 10 cats each : normal control, 10 min-clamped, 30 min-clamped, and 60 min-clamped groups. The results obtained were as follows : 1) The mean rCBF was 24.6±7.0㎖/100g/min in control group. 2) Bilateral carotid occlusions resulted in a reduction of the rCBF(12.4±4.1㎖/100g/min) to 50% of control flow on both hemispheres. 3) Sequential changes of the rCBF after reperfusion : (1) There was restored the rCBF(21.3±5.1㎖/100g/min) to control flow in the 10 minutes-clamped group. (2) There was a 85% recovery of control flow in the 30 minutes-clamped group. (3) There was a only 25% recovery of control flow in the 60 minutes-clamped group. 4) A close correlation was found between cortical electrical activity and rCBF suggesting a threshold relationship. (1) The changes of cortical electric activity began to notice at rCBF less than 17.4±4.7㎖/100g/min. (2) The recovery of cortical electric activity noted at rCBF more than 10.2±2.3㎖/100g/min. 5) There was no evidence of ischemic involvement at the cortex, white matter and basal ganglia in the 10 minutes clamped group, but demonstrated a dense wedge shaped infarct at the cortex and uncus herniation in the 60 minutes clamped group. The rCBF and cortical electric activity restored to normal values in reperfusion within 10 minutes after occlusion of both common carotid arteries.

백서 척수후근절로부터 슈반세포의 효과적인 체외 배양법

김성민,이종호,김남열,안강민,최원재,최시호,차미주,이주영,황순정,장정원,명훈,최진영,서병무,정필훈,김명진 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Schwann cells(SCs), an important component of the peripheral nervous system, intract with nerous to mutually support growth and replication for the peripheral nerve regentation. Recently, ading SCs to the lumen of guidance channel is widely tried to improve regeneration or to make regeneration possible over otherwise irreparable gaps. however, it is not easy to isolate and multiplicate SCs as much as enough to help the axonal regeneration. For the allogeneic SCs source for tubular nerve guidance, we developed a little bit improved technique of harvesting and multiplicating SCs. by culturing dispersed dorsal root ganglia in specially designed medium with growth factors and serial processing, we repeatedlly generate relatively homogenous SC cultures. Our technique was compared with other methods of literature using immunostaining methods such as GFAP, S100, BDNF and the total SC count assessment at different time interval after primary culture.

Fast Eating Speed Increases the Risk of Endoscopic Erosive Gastritis in Korean Adults

Min-Kyung Kim,Byung Joon Ko,E-Yeon Kim,Byoung-Duck Han,조경환 대한가정의학회 2015 Korean Journal of Family Medicine Vol.36 No.6

Background: Fast eating or overeating can induce gastrointestinal diseases such as gastritis. However, the association between gastritis and speed of eating is unclear. The aim of this study was to determine whether eating speed is associated with increased risk of endoscopic erosive gastritis (EEG). Methods: We carried out a cross-sectional study involving 10,893 adults who underwent a general health checkup between 2007 and 2009. Two groups, EEG patients and EEG-free patients, were compared by using the t-test and the chi-square test. Multiple logistic regression analyses were performed to investigate the association between eating speed and EEG. Results: The group with EEG had a higher proportion of males, average age, body mass index, and percentages of current smokers and risky drinkers than those without EEG. After adjusting for anthropometric, social, and endoscopic parameters, the group with the highest eating speed (<5 min/meal) had 1.7 times higher risk for EEG than the group with the lowest eating speed (≥15 min/meal) (odds ratio, 1.71; 95% confidence interval, 1.20–2.45). Conclusion: High eating speed is an independent risk factor for EEG. Our results indicate the need for further studies to clarify the role of eating speed in gastritis.

관상동맥색전증에 의한 급성심근경색증 4예

김민근,주혜원,강경필,최병돈,박민석,변영섭,고충원,이건주,김병옥 인제대학교 2006 仁濟醫學 Vol.27 No.-

Acute myocardial infarction(AMI) due to coronary embolism can occur in patients with normal coronary artery. Coronary embolism is believed to be a cause of acute myocardial infarction when emergent coronary angiography shows perfectly normal coronary trees, except for the finding of coronary artery occlusion. In this report, we describe four patients with AMI due to coronary embolism who were successfully treated using a thrombus aspiration device and anticoagulation, and those patients had intracardial thrombus arising from the left atrium due to chronic atrial fibrillation and valvular heart disease. Patients with chronic or paroxysmal atrial fibrillation can present with AMI due to coronary embolism, and thrombus aspiration with percutaneous aspiration device is a feasible treatment option for these patients along with anticoagulation the rapy.

선인장 양심실 보조장치의 설계 및 임상적용을 위한 평가

민병구,박찬영,최재순,이혁수,황창모,김삼성,윤걸중,김종원,선경,이경갑,정종태,김원곤 제주대학교 인공심장이식연구소 2001 인공심장 연구 Vol.2 No.1

현재 개발되고 있는 맥동형 이식형 인공심장은 완전이식형 인공심장과 좌심실보조장치 뿐이다. 좌심실보조장치를 장착한 환자의 10~15%가 우심실의 보조를 필요로하고 완전이식형 인공심장의 장착을 위해서는 자연심장을 제거해야하는 상황에서 이식형 양심실보조장치에 대한 필요성이 대두되고 있다. 본 연구진은 완전이식형 인공심장으로 개발된 한국형 인공심장을 개선하여 양심 실 보조장치를 개발하였다. 양심실보조장치는 이동형 작동기식 미케니즘을 이용하고 있으며 에너지 변환장치와 감속기로 구성된 작동기와 혈액주머니, 그리고 내장형 제어기로 구성되어 있다. 선인장 펌프로 명명된 KAH350은 캐뉼라의 연결을 위한 커넥터를 포함하여 길이 177mm, 폭 164mm, 높이 67 이고 무게 780g이며 최대 심박출량은 5L/min 이다. 양심실보조장치로 개발된 선인장펌프는 좌심실보조장치로도 응용이 가능하다. 이식적합성과 생체적합성을 평가하기 위하여 좌심실보조장치로 5회, 양싱실보조장치로 6회의 동물실험을 수행하였다. 각각 최장 28일간 생존하였으며 11회의 동물실험중 장치의 결함에 의한 것이 3회 있었는데 이들은 모두 전자장치의 결함과 방수처리문제였다. 현재 이식적합성과 일박출량을 향상시킨 KAH400모델이 개발중이다. The types of pulsatile implantable artificial hearts that are on the way of development and have been developed are totally implantable artificial heart and implantable left ventricular assist device (LVAD). Approximately 10% to 15% of all patients Implanted with wearable VADs have required right heart support with another device. And it is reluctant to patient who should remove his or her own heart to be implanted with total artificial heart. These situations drive the development of implantable bi-ventricular assist device (BVAD). The Korean BVAD was develophed by modifying the moving actuator type Korean artificial heart. This electro-mechanical BVAD comprises actuator including energy converter and reduction gear train, blood sacs, and internal motor and energy controllers. The KAH350 which is named as 'Cactus Pump' is 177mm in length, 164mm in width, and 67mm in thickness including connectors and nuts. The weight and maximum cardiac output of Cactus Pump is 780g and 5L/min, respectively. The Cactus Pump that was developed as BVAD could be used as LVAD by attaching compliance caps on the 2 ports of one ventricle. The animal experiments were undergone 5 times for LVAD, and 6 times for BVAD. The best records were 28 days survival in both applications. There were 3 times of device failure and they were all associated with electrical connection and hermetic sealing. The KAH400 that has improved anatomical fitting characterisitcs and stroke volume is on development.

Improved Properties of Nanocrystalline Cellulose Isolated from Kraft Pulp by Electron Beam Irradiation

Kim, Sun-Young,Lee, Byoung-Min,Lee, Yeong-Ju,Kim, Du-Yeong,Jeun, Joon-Pyo,Kang, Phil-Hyun American Scientific Publishers 2016 Journal of Nanoscience and Nanotechnology Vol.16 No.10

<P>In this study, we investigated an improvement to the properties of nanocrystalline cellulose (NCC) from kraft pulp using electron beam irradiation (EBI). The EBI of the kraft pulp was performed at various doses (25, 50, and 75 kGy) and then hydrolyzed with 55% sulfuric acid at 50 degrees C (preheated) for 20 min. The hydrolysate of kraft pulp was characterized using X-ray diffraction (XRD), particle size distribution, thermogravimetric analysis (TGA), and transmission electron microscopy (TEM). The NCC of pristine kraft pulp was obtained with a broad size distribution (0-700 nm), an average particle size of 220 nm, and a 75.5% crystallinity index after 20 min of acid-hydrolysisat 50 degrees C. However, isolated NCC from 75 kGy irradiated kraft pulp was obtained with a narrow size distribution (0-530 nm), an average particle size of 160 nm, and 83.2% crystallinity after 20 min of acidhydrolysisat 50 degrees C. These results indicate that the size and crystallinity of NCC were easily controlled by adjusting the EBI dose.</P>