2.5% Pentothal sodium 전처치가 Propofol 정주시 발생되는 통증에 미치는 효과

옥시영,김순임,김선종 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Background: propofol has a high incidence of pain with intravenous injection, and many different methods have been used to minimize the incidence and severity of this pain. In this study, we have compared the effect of saline pretreatment with that of 2.5% pentothal 50 mg pretreatment of propofol injection pain. Methods: Sixty two patients scheduled for general anesthesia were randomly divided into two groups. each patient received one of the pretreatment drugs via 18 g angiocatheter inserted in the antecubital fossa. Control group (n=31)received 2 ml of 0.9% saline pretreatment, 2.5% pentothal group (n=31) received 50 mg of pentothal pretreatment followed intravenous injection of 2 mg/kg of propofol at a rate of 1 ml/sec. After 50 mg of propofol were injected, patients were assessed for pain score. The severity of pain was classified as 0, 1, 2, 3 (none, mild, moderate, severe) by one observer. Results: The severity of pain were significantly reduced in 2.5% pentothal group compared with ontrol group for intravenous injection fo propofol (p<0.05) but incidence is similar. Conclusions: 2.5% pentothal 2 ml (50 mg) pretreatment could significantly reduce the sever the severity of pain for intravenous injection of propofol.

Lidocaine과 Pentotal 전투여가 Propofol 정주 시 발생되는 혈관통에 미치는 영향

옥시영,김순임,김선종 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Background: Propofol is a good induction agent. But it has a disadvantage of pain on intravenous injection. Pretreatment of lidocaine or pentothal have been reported to reduce pain on injection. Thus we have evaluated the quantity and quality of analgesic effect of lidocaine and pentothal. Methods: Ninety three patients scheduled for general anesthesia were randomly divided into three groups. Each patient received one of the pretreatment drugs via 18 G angiocatheter inserted in the antecubital fossa. Control group (n=31) received 2 ml normal saline and lidocaine group (n=31) received 40 mg (2%, 2ml) and petothal group (n=31) received 50 mg (2.5%, 2 ml) followed intravenous injection of 2 mg/kg of propofol at a rate of 1 ml/sec.After 50 mg of propofol were injected, patients were assessed for pain score. The severity of pain was classified as 0,1, 2, 3 (none, mild, moderate, severe) by one observer. Results: The severity and incidence of pain were significantly reduced in lidocaine group and pentothal group compared with control group for intravenous injection of propofol (P<0.05). And the incidence of pain in lidocaine group and pentothal group is similar but severity of pain is more reduced in lidocaine group Conclusions: Lidocaine 40 mg or pentohal 50 mg pretreatment to induction by propofol revealed a good analgesic effect for propofol injection pain. And lidocaine is more effective for iv propofol injection pain.

압박띠와 Lidocaine 전처치 및 Pentothal 전처치를 이용한 Propfol 정주통의 예방효과

옥시영,김순임,김선종 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Background: Pain on injection of propofol is a common problem, the cause of which remains unknown, We evaluated the effect of a tourniquet with intravenous lidocaine and pentothal pretreatments, to decrease the incidence and intensity of pain during intravenous propofol injection. Methods: One hundred fifty five patients scheduled for general anesthesia were randomly divided into three groups. Each patient received one of the pretreatment drugs via 18 G angiocatheter inserted in the antecubital fossa. Control group (CG) (n=31) recived 2 ml normal saline and lidocaine group (LG) (n=31) received 40 mg (2%, 2 ml) and pentothal group (PG) (n=31) received 50 mg (2.5%, 2 ml) and lidocaine tourniquet group (LTG) (n=31) received 40 m g(2%, 2ml) under tourniquest 1 minute inflated and pentothal tourniquet group(PTG) (n=31) received 50 mg (2.5%, 2 ml) under tourniquet 1 minute inflated followed intravenous injection of 2 mg/kg of propofol at a rate of 1 ml/sec. after 50 mg of proplfol were injected, patients were assessed for pain score. The severity of pain was classified as 0, 1, 2, 3 (none, mild, moderate, severe) by one observer. Results: The severity and incidence of pain were significantly reduced in lidocaine group and pentothal group compared with control group for intravenous injection of propofol (P<0.05). But effect of tourniquet is minimal. And the quantity and quality of analgesic effect of lidocaine and petothal on propofol iv injection is similar. Conclusions: Lidocaine 40 mg or pentothal 50 mg pretreatment to induction by propofol revealed a good analgesic effect for propofol injection pain. But effect of tourniquest is minimal.

급성신부전을 동반한 알콜성 횡문근융해증 2례

김영민,오동렬,이원재,김형국,황두영,이환,최경호,정시경,김세경,김영옥 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Rhabdomyolysis is a biochemical and clinical syndrome caused by lysis of skeletal muscle cell and release of muscle cell contents into the circulation. In addition to traumatic cause, various nontraumatic causes have been reported. Rhabdomyolysis has frequently been associated with seamy aspects of life and society: alcoholic abuse, drug addiction, sadistic drill exercise, war events and attempted suicide. The abuse of alcohol causes many hazards in many organs. One of these is acute alcoholic myopathy that may present as a fulminent syndrome of muscle pain and tenderness associated with rhabdomyolysis and acute renal failure. Because the prognosis of adequately treated rhabdomyolysis is excellent, early recognition and prompt management are essential in emergency situation. We experienced two typical cases of alcohol-induced rhabdomyolysis with acute renal failure and report these cases with literature review.

관상동맥 질환에서 SDF-1α의 농도

김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

안와내벽의 단독외향골절에서 골절정도와 안구함몰정도와의 관계

진홍률,신시옥,추무진,최영석,양상권,김종욱 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.5

신축학교 실내공기질이 초등학생들의 인지기능에 미치는 영향

김태섭,김선주,박시영,전만중,김규태,김창윤,정종학,백성옥,사공준 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.1

목적: 신축초등학교와 대조학교를 선정하여 교실 내 포름알데히드와 TVOCs를 측정하고 컴퓨터 신경행동검사를 이용하여 실내공기 오염물질이 학생들의 인지기능에 미치는 영향을 평가하였다. 방법: 신축초등학교 5학년 71명을 실내공기 오염물질 노출군으로 하고, 개교한지 12년째인 대구시의 일개 초등학교 5학년 2학급 63명을 대조군으로 하여 실내공기 오염물질농도 측정 및 컴퓨터 신경행동검사를 실시하였다. 결과: 신축학교에서 의도적으로 창문을 개방한 학급에서 1교시 포름알데히드 농도는 34.6 ㎍/㎥, 4교시에는 27.3 ㎍/㎥, 창문을 개방하지 않은 학급에서 1교시 80.2 ㎍/㎥, 4교시 127.1 ㎍/㎥, 대조학교에서는 2학급 각각 1교시에 12.6 ㎍/㎥, 7.5 ㎍/㎥, 4교시에 19.8 ㎍/㎥, 25.2 ㎍/㎥였다. TVOCs의 경우 신축학교의 의도적으로 창문을 개방한 학급에서 1교시에 농도는 487.2 ㎍/㎥, 4교시에 428.2 ㎍/㎥, 창문을 개방하지 않은 학급에서 1 교시에 농도는 1,283.5 ㎍/㎥, 4교시에 1,715.4 ㎍/㎥, 대조학교의 경우 2학급에서 각각 1교시에 농도는 240.9 ㎍/㎥, 150.8 ㎍/㎥, 4교시에 농도는 371.9 ㎍/㎥, 448.0 ㎍/㎥였다. 부호숫자 짝짓기의 평균반응시간은 대조학급이 1교시에 2,585 msec에서 4교시에 2,459 msec으로 감소한 반면 신축학교의 창문을 의도적으로 개방한 학급은 2,343 msec에서 2,510 msec으로, 평소대로 수업한 학급은 2,340 msec에서 2,563 msec으로 반응시간이 각각 167 msec, 223 msec 증가하였다. 1교시의 부호숫자 짝짓기 의 반응시간을 100%로 했을 때 창문을 의도적으로 개방 한 학급은 4교시에 5.9% 증가하였고(p<0.01), 평소대로 수업한 학급은8.3% 증가하였다(p<0.01). 반면에 대조학급은 4교시에 5.0% 감소하였다(p<0.01). 결론: 향후 학교의 실내공기질의 안전성 평가는 샘플링 된 공기의 오염수준의 측정뿐만 아니라 학생들의 건강영향도 함께 고려되는 것이 바람직할 것이다. Objectives: Most studies on the indoor air quality of newly built schools have focused only on the number of schools exceeding a standard or on subjective symptoms, such as sneezing, irritated eyes and an irritated nose. However, there has been no report on how poor indoor air quality affects children's academic performance. This study evaluated the effects of indoor air quality on the neurobehavioral performance of elementary school children. Methods: This study measured the indoor air pollutants and compared children's performance, using a computerized neurobehavioral test, between a newly built and a 12-year-old school. In addition, a questionnaire was administered regarding the indoor air quality related symptoms of children in a newly built and a 12-year-old school. Results: In the newly built school, the formaldehyde levels in the 1^(st) and 4^(th) classes with an open window were 34.6 and 27.3 μg/㎥, respectively. The levels in the 1^(st) and 4^(th) classes with the window closed were 80.2 and 127.1 μg/㎥, respectively. In the 12-year-old school, the formaldehyde levels in 1^(st) and 4^(th) class with open and closed window were 12.6 and 7.5 μg/㎥, and 19.8 and 25.2 μg/㎥, respectively. With respect to total volatile organic compounds, the levels in the 1^(st) and 4^(th) classes with the window open in the newly built school were 87.2 and 428.2 μg/㎥, respectively. In the 1^(st) and 4^(th) classes with the window closed, the total volatile organic compounds were 1,283.5 and 1,715.4 μg/㎥, respectively. In the 12-year-old school, the total volatile organic compounds were 240.9 and 150.8 μg/㎥, and 371.9 and 448.0 μg/㎥ in the 1^(st) and 4^(th) classes, respectively. In the case of a newly built school, the performance of the students in the neurobehavioral test in the 4^(th) class with the window closed was 8.3% lower than for those in the 1^(st) class with the window closed, but was only 5.9% lower when the windows were open. There was a statistical significant difference in the total numbers of symptoms between the two schools. Conclusions: These results suggest a proper evaluation of the indoor air quality within schools is required into both the level of contamination and the health effects of these contaminants toward children.

광양만에서 춘계와 하계 영양염류 첨가가 식물플랑크톤군집의 성장에 미치는 영향

배시우,김동선,최현우,김영옥,문창호,백승호,Bae, Si Woo,Kim, Dongseon,choi, Hyun-Woo,Kim, Young Ok,Moon, Chang Ho,Baek, Seung Ho 한국해양학회 2014 바다 Vol.19 No.1

춘계와 하계 광양만에서 식물플랑크톤 군집구조와 그들의 성장에 영향을 미치는 영양염제한 특성을 파악하기 위해서 만내외측의 20개 정점에서 생물학적 요인과 무생물학적 요인을 조사했다. 또한 식물플랑크톤 군집에 대한 영양염 첨가 효과를 알아보기 위해서 실험실에서 현장 20개 정점의 표층수를 이용하여 생물검정실험을 수행하였다. 전체 식물플랑크톤 군집의 90%이상을 규조류가 차지하였다. 이들 규조류중 Eucampia zodiacus와 Skeletonema costatum-like 종이 춘계와 하계에 각각 우점하였다. E. zodiacus와 S. costatum-like 규조류의 개체군 밀도가 춘계와 하계에 높은 밀도를 유지하게 된 이유를 간단히 설명하면, E. zodiacus 의 성장은 춘계 투명도가 높게 나타나 유광층내 광량의 증가가 원인으로 생각된다. 즉 유광층내 광량의 증가는 E. zodiacus의 개체수를 폭발적으로 증가시킬 수 있는 방아쇠 역할을 한 것으로 판단된다. 하계에 S. costatum-like이 전해역에서 우점한 이유는, 섬진강 담수 유입에 의한 낮은 염분과 함께 공급된 다량의 영양염은 그들 생물의 증식에 중요한 bottom-up 효과를 보였다고 판단된다. 실험실의 생물검정실험에서는 비록 내만(정점 8)과 외해(정점 20)에서 식물플랑크톤 군집의 최대 성장율은 유사하였지만, 인산염에 대한 반포화계수($K_s$)는 내만정점보다 약간 낮았다. 상대적으로 낮은 영양염농도에 적응한 세포는 낮은 인산염농도에서 충분히 성장할 수 있고, 다른 미세조류에 비하여 낮은 영양염농도의 조건에서 경쟁의 우위를 차지 할 것이다. 특히, 하계의 N영양염 첨가군의 효율은 대조군과 P영양염 첨가군에 비해서 높았다. 이는 광양만에서 하계에 N영양염의 공급이 섬진강을 통하여 계속적으로 유입되지만, 빠른 식물플랑크톤의 증식으로 인하여 N영양염 제한이 일어날 수 있다는 것을 시사할 수 있다. 반면, 규산염은 식물플랑크톤의 성장에 영향을 미치는 제한인자로 나타나지 않았고, 규조류의 분해로 인하여 Si의 재순환과 담수로부터 공급된 높은 규산염농도는 광양만에서 규조류 생태계를 유지할수 있는 유리한 조건이라 생각된다. In order to estimate the effect of nutrients addition for phytoplankton growth and community compositons in spring and summer season, we investigated the abiotic and biotic factors of surface and bottom waters at 20 stations of inner and offshore areas in Gwangyang Bay, Korea. Nutrient additional experiments were also conducted to identify any additional nutrient effects on phytoplankton assemblage using the surface water for the assay. Bacillariophyceae occupied more than 90% of total phytoplankton assembleges. Of these, diatom Eucampia zodiacus and Skeletonema costatum-like species was mainly dominated in spring and summer, respectively. Here, we can offer the season why the two diatom population densities were maintained at high levels in both seasons. First, light transparency of spring season in the euphotic zone was greatly improved in the bay. This improvement is one of important factor as tigger of increase in E. zodiacus population. Second, low salinity and high nutrient sources supplied by Seomjin River discharge are a main cue for strong bottom-up effects on S. costatum-like species during the summer rainy season. Based on the algal bio-assays, although maximum growth rate of phytoplankton communities at inner bay (St.8) were similar to those of outer bay (St.20), half-saturation constant ($K_s$) for phosphate at outer bay was slightly lower than those of inner bay. This implied that adapted cells in low nutrient condition of outer bay may have enough grown even the low phosphate and they also have a competitive advantage against other algal species under low nutrient condition. In particular, efficiency of N (+) addition in summer season was higher compared to control and P added experiments. In the bay, silicon was not a major limiting factor for phytoplankton growth, whereas nitrogen (N) was considered as a limiting factor during spring and summer. Therefore, a sufficient silicate supply form water mixing Si recycled from diatom decomposition and river water is favorable form maintaining diatom ecosystems in Gwangyang Bay.

일 간호대학의 지역사회 방문간호사업 사례

강윤숙,최양자,고영애,전시자,조갑출,이옥철,주혜경,신기수,안은숙 적십자간호전문대학 2000 적십자간호전문대학논문집 Vol.22 No.-

혈액 투석 환자에서 중심정맥 협착에 대한 스텐트 삽입술 : Wallstent Placement

임대승,노상필,이유선,정승현,김보영,이정우,강정아,김정희,이민수,정준용,최시완,정진옥,성인환,이강욱,신영태 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

Stenosis of central vein is a common complication arising after percutaneous subclavian vein catheter insertion performed for temporary vascular access in chronic renal failure patients undergoing hemodialysis. There are several treatment methods for the condition like percutaneous angioplasty(PTA), stent insertion, and surgery, but recent trend is toward PTA and stents. Among the patients diagnosed with chronic renal failure from March 1993 to May 2002 and undergoing hemodialysis through AV fistula, the 14 Patients in whom central vein stenosis arose were selected for the study. A total of 28 percutaneous interventions(5 PTA and 23 stent placement) were performed, and restenosis rate and the time taken till the restenosis in de novo lesions and instant lesions were compared. All 28 cases were operated successfully. The 14 cases that received both anigioplasty and stent placement initially. (de novo lesion : 14 cases), Among the 10 cases with de novo lesion that followed up more than 1 year, 3 cases are currently undergoing hemodialysis without restenosis, and the remaining 7 cases have recurred stenosis with the mean time to restenosis of 10.9 months. In the 7 cases in whom stenosis recurred, 11 interventions were done(instent lesion: 11 cases). 4 of these were using only ballon angioplasty with 100% restenosis rate and the mean time of 3 months until restenosis. The remaining 7 cases were using both balloon angioplasty and stent placement, also with 100% restenosis rate but with the mean time of 12 months until restenosis, which was later than the group receiving only balloon angioplasty. In treating the patients with central vein stenosis, stent placement seems to be more advantageous over PTA in terms of restenosis rate and the mean duration of patency. In the case of instent lesion, inserting the stent for the second time after stenosis recurred lengthened the duration of patency compared to performing balloon angioplasty alone.