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Clonidine 정맥전처치가 마취중 혈압 및 심박수에 미치는 영향
박한석,진영준,예운해 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.6
Laryngoscopy and endotracheal intubation are potent stimuli that can induce increased sympathetic activity, tachycardia and hypertension. The authors studied the effects of intravenous clonidine pretreatment, a centrally acting α _2-adrenoceptor agonist, on hemodynamic responses to laryngoscopy and tracheal intubation, and on anesthetic requirements during operation. Forty ASA I -II patients undergoing elective minor general surgery were allocated randomly to receive either 5㎍/kg clonidine or 3 ml of 0.9% normal saline as control intravenously 10 minutes before induction of anesthesia. The results obtained were as follows. Compared to baseline values, blood pressure and heart rate at 1 minute after intubation were significantly increased in control group, but significantly decreased in clonidine group. They were maintained at lower values throughout the whole duration of operation in clonidine group than in control group. More doses of fentanyl were needed in the control group but not in the clonidine group during operation, and because of bradycardia and hypotension, atropine or ephedrine was needed in the clonidine group. In conclusion, the elevation of blood pressure and heart rate accompanying tracheal intubation were preventable with less requirement of supplemental fentanyl, but bradycardia and hypotention were infrequently seen as a side effects, when 5㎍/kg intravenous injection of clonidine 10 minutes before induction.
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Ketamine 과 Midazolam 의 직장강내 전처치에 대한 효과
정찬종,진영준,예운해 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.3
The preanesthetic management of preschool children is rather difficult. They worry about separation from their parents, the strange hospital environment, surgery, and are not always amenable to reasoned explanation. Therefore, the preoperative sedation is necessary to reduce anxiety and minimize psychologic trauma to children. To determine which type of intrarectal administration is the most effective in preanesthetic sedation, 90 children were randomly assigned to three groups. Group I was administered with intrarectal midazolam (0.5 mg/kg), group II, intrarectal ketamine (5 mg/kg), and group III, intrarectal midazolam (0.5 mg/kg) with ketamine (5 mg/kg). Most of children separated easily from their parents 30 minutes after intrarectal administration (above 80%). In all groups, the loss of consciousness were below 40% and sedation states were above 80%. But in group III, the loss of consciousness and the sedation states were much better than those of the other two groups. The anxiety level of group III was lower than that of the other groups (p$lt;0.05) and the sedation level of group I and III were better than that of group II (p$lt;0.001). Complications and recovery time were similar among each group. Following intrarectal administration of 0.5 mg/kg of midazolam with 5 mg/kg of ketamine, reliable sedation was obtained 20-30 min after intrarectal administration. Therefore we believe that intrarectal midazolam with ketamine is a useful teehnique for the reliable preoperative sedation in children.
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Aquaporin 4 water channel 인산화에 의한 수분 투과도의 조절
박권희,정동근,정진섭,이재숙,예운해,서덕준,배혜란 한국생명과학회 2000 생명과학회지 Vol.10 No.5
Aquaperin 4 (AQP4) is the mercurial water channel expressed abundantly in brain, especially the region related with cerebrospinal fluid reabsorption and osmoregulation. The primary structure of AQP4 water channel was elucidated but the molecular mechanism of AQP4 channel regulation is still unknown. To investigate the possible regulation of AQP4 water channel by phosphorylation via various protein kinases, osmotic water permeability of AQP4 expressed in Xenopus oocytes was measured by videomicroscopy technique. Forskolin (10 $\mu$M) did not affect osmotic water permeability of oocytes injected with AQP4 cRNA, excluding the regulation of AQP4 water cnannel by protein kinase A. Osmotic water permeability (P아래첨자) of AQP4-expressed oocytes was ingibited by the pretreatmeat of BAPTA/AM (up to 500$\mu$M), an intracellular Ca윗첨자 chelator, and calmidazolium (100$\mu$M), a specific Ca윗첨자/calmodulin antagonist, in a dose-dependent manner. The inhibition of osmotic water permeability (P아래첨자) by the calmidazolium treatment was completely reversed by the addition of calyculin A (0.1$\mu$M), a nonspecific phosphatase inhibitor. Phorbol 12-myristate 13-acetate (PMA), a protein kinase C activator, had biphasic effects on osmotic water permeability in AQP4 cRNA injected oocytes depending on its concentration; 21% increase by 100 nM PMA, 35% decrease by 1$\mu$M PMA. These effects were reversed with 2$\mu$M staurosporine, a nonspecific PKC inhibitor. These results suggest that phosphorylation of AQP4 water channel by Ca윗첨자/calmodulin kinase and protein kinase C might regulate the osmotic water permeability.
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