Does preoperative anxiety felt by patients requested to participate in clinical trials related to general anesthesia before elective surgery depend on temperament?

신우종,신우종,박수인,김경헌 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.3

Background: Preoperative anxiety may differ according to patient temperament. It will be increased when patients are requested to participate in a study involving anesthesia. The purpose of this study was to show that the anxiety felt when patients are requested to participate may differ according to temperament in both patients who agree and disagree to participate. Methods: Three hundred and twenty-one patients over age 18 with American Society of Anesthesiologists 1 and 2 completed a survey questionnaire. The degree of anxiety was measured according to patient temperament. It was compared on the basis of the State-Trait Anxiety Inventory (STAI) and visual analogue scale (VAS). Results: In the agreed group, the degree of anxiety measured by “usual, present STAI” and VAS in the monitors (those who want to know as much as possible about anesthesia and surgery) was significantly higher than that in the blunters (those who want to know as little as possible) (P = 0.041 for the “usual STAI,” 0.017 for “present STAI,” and 0.001 for VAS, respectively). Among patients with a lower educational level, the numbers of blunters and monitors were 57 (79%) and 32 (59%), respectively, indicating that the ratio of blunters was significantly higher (P = 0.026). Conclusions: Both traits of patients in each group were influenced by psychological burdens. The anxiety of the monitors who agreed to participate was significantly higher than that of blunters. In addition to temperament, education level affects participation. Obtaining consent for participation by understanding temperament and considering factors that may reduce the participation rate will be required.

Glutaric Aciduria Type I

신우종,문여옥,동은실,안영민,윤혜란,Sin, U-Jong,Mun, Yeo-Ok,Dong, Eun-Sil,An, Yeong-Min,Yun, Hye-Ran,Yamaguchi, Seiji 대한유전성대사질환학회 2002 대한유전성대사질환학회지 Vol.2 No.1

출생 이후 머리둘레가 커지는 1개월 남아에게서 뇌초음파상 지주막하 공간이 확장되어 있고 백질의 음영이 증가되어 있었고 뇌 MRI 소견은 sylvian fissure의 확장과 양측 대뇌, 소뇌 피질과 백질이 T1 강조 영상에서 저신호강도와 T2 강조영상에서 고신호강도를 보였고 검사상 GA1 의심되었고 경피생검으로 얻은 섬유아세포 배양에서 glutaryl CoA dehydrogenase의 활성도가 전혀 없어 GA1을 확진하게 되었다. 이후 특수분유인 Glutatex(Abbott사) 수유와 riboflavin, carnitine 보충요법을 시행하여 대사성 위기나 급성 뇌증 위기는 없었고 양호히 발달하는 것을 경험하였기에 보고하는 바이다.

The general anesthesia experience of deletion 8p syndrome patient -A case report-

신우종,김상덕,김경헌 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.4

A deletion 8p syndrome is a relatively uncommon congenital disease characterized by mental retardation associated with multiple malformation that make anesthetic management a challenge. Anesthetic management of a patient with deletion 8p syndrome may pose a serious problem mainly from difficult tracheal intubation, aspiration complication and cardiac malformation. We experienced a case of 10 year-old boy with a deletion 8p syndrome who underwent appendectomy under the general anesthesia. Intubation was performed by video glidescope after unsuccessful attempt with Macintosh laryngoscope. A high arched palate, short neck, poor patient cooperation due to mental retardation and occasional autistic behaviour made airway management difficult. This case should alert anesthesiologists to the greater difficulties of managing patients with deletion 8p syndrome.

Electron-phonon coupling in the ordered phase of Rb on monolayer graphene

신우종,정성원,손영섭,류세희,허민재,김근수 한국물리학회 2020 Current Applied Physics Vol.20 No.4

In the mechanism of two-dimensional (2D) superconductivity in doped graphene, it was predicted that the presence of dopant bands plays a key role. However, it has been challenging to fabricate an ordered phase of alkali metals on graphene owing to its van-der-Waals nature. We systematically study the phase formation of Rb on graphene epitaxially grown on H-passivated SiC(0001). We found a range of control parameters that stabilize the well-ordered 2 × 2 phase (RbC8), as confirmed by in-situ low-energy electron diffraction. Angle-resolved photoemission (ARPES) spectra taken from the 2 × 2 phase show a folded band of graphene and a parabolic band of Rb. In the vicinity of the Fermi level, the self-energy extracted from ARPES data reveals a clear signature of electronic coupling to the in-plane and out-of-plane phonon modes of C and Rb atoms. The electronic coupling of graphene to the in-plane vibration mode of Rb atoms is identified as a key factor for the enhancement of electron-phonon coupling.

Pfannenstiel 절개로 수술후 양측 장골서혜신경과 장골하복신경차단을 이용한 통증관리

신우종,염종훈,김경헌,옥경종,민용진 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.3

Background: Epidural administration of morphine is a common method for postoperative analgesia in the lower abdominal surgery, but many complications can be produced. Since the pfannenstial incision lies within L1 dermatome, bilateral ilioinguinal and iliohypogastric nerve blocks(IINB) should provide analgesia after surgery through that incision. Methods: Forty patients undergoing cesarean delivery or total abdominal hysterectomy(TAH) through a pfannenstiel incision were randomly assigned to one of two groups: epidural morphine group(n=20) received 3 mg of morphine epidurally after surgery with epidural anesthesia; IINB group(n=20) performed IINB with 0.5% bupivacaine, 10 ml to each side after surgery with general anesthesia. Visual analogue scale(VAS) scores at resting and moving state, and complications were checked at 0, 2, 4, 8, 12, 24 hours after surgery. Results : Postoperative VAS scores did not show significant differences between the two groups at rest after 0, 2, 4, 8, 12, 24 hours and at moving state after 0, 2, 4 hours, but IINB group had less pain with movement than epidural morphine group at 8, 12, 24 hours after surgery(p$lt;0.05). The incidence of pruritus was rare in IINB group(P$lt;0.05), but incidences of other complications were not significantly different between the two groups. Conclusions : IINB is effective for analgesia after surgery through a pfannenstiel incision because of a lower incidence of complications and less postoperative pain with movement than epidural morphine, and can be performed to patients who have contraindications and difficulty for epidural analgesia. (Korean J Anesthesiol 1997; 32: 440∼444)

체계적 고찰과 메타분석의 개요

신우종 한양대학교 의과대학 2015 Hanyang Medical Reviews Vol.35 No.1

Systematic reviews and meta-analysis represent a specific type of medical research in which an original article is a unit of analysis. These methods of research are essential tools in integrating scientific information, increasing the internal and external validity of the conclusions of original articles, and suggesting areas for future research. Meta-analysis is becoming popular because it can combine results from similar studies to calculate an overall estimate of a treatment effect. They are also necessary for the practice of evidence-based medicine and the medical decision making. However, conducting good quality systematic reviews is not easy and difficult to interpret. Since analysis of a data with meta-analysis is a relatively new field of research, many clinicians have not had the opportunity to learn about systematic review and meta-analysis systematically. An introduction of the rationale for carrying out meta-analysis will be helpful to the clinician in interpreting the results of meta-analysis.

Is there any quality improvement in the randomized controlled trial abstracts in the Korean Journal of Anesthesiology after the publication of the CONSORT abstract guidelines in 2008?

신우종,김용오,오재훈,정재순,김경헌 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.4

Thiopental 이 가토 복부대동맥의 혈관긴장도에 미치는 영향

신우종,전세웅,서정국 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.6

The characteristics of an ideal intravenous anesthetic agent include stability in solution, rapid onset of action, minimal effect on the cardiovascular and respiratory systems, short elimination half life, and minimal side effects. Using this criteria, the ultra-short acting barbiturate, thiopental has long been considered the gold standard of intravenous agents used for induction of anesthesia. In normovolemic subjects, thiopental produces a transient decrease in blood pressure, and increase in heart rate. In practice, thiopental is administered high dose(30 mg/kg IV) for brain protection, rarely. We tried to confirm the direct vascular effects of thiopental and its mechanism on the rabbit abdominal aorta in vitro. The rabbit abdominal aorta were precontracted with norepinephrine(10^(-7) M) in 5 ml tissue bath and 10^(-5), 10^(-4), and 10^(-3) M thiopental was administrated in cumulative manner. Ten minutes later, changes of the vascular tones were obtained. For confirming the relaxing mechanism induced by thiopental, experiment was performed by indomethacin, methylene blue and LNAME pretreatment, and endothelium removed, respectively. The results were as follows 1) Thiopental at 10^(-5), and 10^(-4) M produced no signifcant changes, and at 10^(-3) M produced signifcant relaxation. 2) There were no significalnt difference in their vascular tones between intact and denuded endothelium group. 3) The vascular tones were not affected by LNAME, methylene blue, and indomethacin pretreatment. These results suggest that thiopental induce vasorelaxation in rabbit abdominal aorta at high concentration(10^(-3) M). The vasorelaxation mechanism is not correlated with NO, cyclic GMP, prostacyclin and endothelium.

이온통로 : 새로운 연구법인 Patch Clamp 방법을 중심으로

신우종 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.3

Sprague-Dawley 백서의 소뇌 과립신경세포에서 Sevoflurane 에 의한 Baseline Potassium Channel 의 활성화

신우종,Winegar,Bruce D 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.1

Background : Volatile general anesthetics have been widely used to produce reversible unconsciousness and analgesia in clinical practice over the last one hundred years, but the basic mechanism of anesthetic action is not yet completely understood. In addition to the well known mechanism of GABA_A and glycine channels, accumulating evidence indicates that neuronal baseline K^+ channels are also activated by volatile anesthetics. The goal of this study was to test the hypothesis that sevoflurane, one of the newly developed volatile anesthetics, activates baseline potassium channels in the cerebellar granule neurons of rats. Methods : whole cell measurement techniques were performed from cultured cerebellar granule neurons of seven day old male Sprague-Dawley rats using patch clamp techniques to see the effects of two MACs of sevoflurane on baseline K^+ channels. Holding potentials were set to -20 ㎷ and collect pulses from -90 to 90 in 10 ㎷ increments of 300 ㎳ duration. The electrode filling solution contained (in mM) 150 KOH, 105 aspartic acid, 3 Nacl, 10 HEPES, 86 glucose, 1 EGTA, 5 MgCl_2 (pH 7.4) and standard saline were used as bath solution. The bath contained 150 NaCl, 3 KCl, 10 HEPES, 12 glucose, 1 EGTA, 5 MgCl_2 (pH 7.4). Results : Analysis of multiple patch clamp experiments showed the presence of outward-rectifying K^+ selective ion channels with a conductance of 1.064 ± 0.32 nS (n = 10) at depolarized potentials. Cerebellar granule neurons exhibit rapid rising, noninactivating, outward-rectifying currents. These channels are insensitive to conventional K^+ channel blockers. Clinically relevant concentrations of sevoflurane (518 ㎛) increased the baseline K^+ channel outward currents from the control value by 225% in a standard saline perfusate (n = 10, P < 0.05, paired t-test). Channel activity enhanced during the duration of the exposure period to sevoflurane returned to the baseline activity level quickly upon wash. Conclusions : These outward-rectifying whole cell Ⅰ-Ⅴ curves are consistent with the properties of tandem pore K^+ channels. Activation of baseline K^+ channels in central neurons by two MACs of sevoflurane causes membrane hyperpolarization and increases neuronal input conductances providing an additional inhibitory mechanism that could contribute to the overall central depressant effects of this compound. (Korean J Anesthesiol 2002; 42: 107~114)