면역저하 환자에서 발병한 양측성 이중성 대상포진과 난치성 대상포진후신경통 -증례 보고-

임세훈,이근무,이원진,최들녘,이정한,조광래,김명훈,기승희,김지훈 대한마취통증의학회 2017 Anesthesia and pain medicine Vol.12 No.1

Herpes zoster is caused by the reactivation of the varicella-zoster virus, and it typically presents as single dermatomal rash and vesicles. It can cause postherpetic neuralgia as a common complication. In immunocompromised patients, the lesions can be cutaneous, disseminated into two non-contiguous dermatomes, and this entity is referred to as herpes zoster duplex unilateralis or bilateralis. We present a case of postherpetic neuralgia after herpes zoster duplex bilateralis in a 60-year-old immunocompromised man. He had a past history of acute lymphocytic leukemia and was treated with allogeneic peripheral blood stem cell transplantation 1 year before herpes zoster reactivation. His postherpetic neuralgia pain was difficult to treat and it was refractory to conservative medication and neuraxial block.

부동산 경매절차상 유치권의 법적지위 및 비판적 고찰-소멸주의와 인수주의를 중심으로-

임세훈 한국민사집행법학회 2018 民事執行法硏究 : 韓國民事執行法學會誌 Vol.14 No.-

The purpose of this study is to review the legal status of lien in real estate auction procedure, to conduct critical study on the amendment of civil law and related laws around principle of extinction and principle of takeover, and to suggest reasonable improvement plans of the legal system that considered the balance of principle of extinction and principle of takeover. There are opposing opinions about an issue of whether to adopt the principle of extinction or the principle of takeover regarding a lien as an opinion that the principle of extinction should be adopted for auctions by the request of lien holders and that principle of takeover should be adopted because the objective is the encashment from the nature of formal auction. The auction procedure involving liens has many problems for both formal auction and substantive auction. The Ministry of Justice tried to solve this problem by revising Civil Law and Civil Execution Act in 2013, and selected a plan of abolishing liens on real estate on the amendment. However, this study suggested supplementation of the system in balanced viewpoint because abolition of the expedient real estate lien can violate rights of the interested party by causing another problem. In other words, this study suggested that institutional complementarity of maintaining the current real estate lien system and extinguishing through sales by recognizing the preferential performance is the right improvement direction of real estate lien system than subdividing into general mortgage system set by creditors as expense payers, not lien holders, in current real estate lien system, special mortgage system converted from real estate lien system, and in registered real estate. 본 연구는 부동산 경매절차상 유치권의 법적지위를 검토하고, 소멸주의와 인수주의를 중심으로 민법 및 관련법률 개정안의 비판적 고찰과 소멸주의 및 인수주의의 균형을 고려한 법제도의 합리적인 개선방안을 제시하는데 목적이 있다. 유치권에 관하여 소멸주의를 채택할 것인가 인수주의를 채택할 것인가의 문제는 유치권자의 신청에 의한 경매의 경우 소멸주의를 채택하여야 한다는 견해와 형식적 경매의 성질상 현금화가 목적이므로 인수주의를 채택하여야 한다는 견해가 대립하고 있다. 유치권이 개입된 경매절차는 형식적 경매이든 실질적 경매이든 많은 문제를 안고 있다. 이에 법무부는 지난 2013년 민법개정과 민사집행법 개정을 통해 이 문제를 해결하려 하였으며, 개정안에서는 부동산유치권을 폐지하는 방안을 택하였다. 그러나 본 연구에서는 이러한 편의주의적 부동산유치권의 폐지는 또 다른 문제점을 야기하여 이해관계인의 권리를 침해할 수 있으므로, 균형적 관점에서 제도의 보완을 제안하였다. 즉, 개정안처럼 현행부동산유치권제도와 부동산유치권에서 전환된 특수한 저당권제도 및 등기된 부동산에서 유치권자가 아닌 비용지출자 등 채권자가 설정하는 일반 저당권제로 세분화하기 보다는, 현행 부동산유치권제도를 유지하고 다만 우선변제적 효력을 인정하여 매각으로 소멸하게 하는 제도적 보완이 오히려 올바른 부동산유치권제도의 개선방향임을 제시하였다.

말초성 안면신경마비에 대한 중성어혈약침과 봉약침 효과 비교 연구

임세훈,이민준,이승민,김은석,이승훈,강중원,김용석 대한침구의학회 2014 대한침구의학회지 Vol.31 No.2

Objectives : This study was designed to compare the effects of Jungsongouhyul pharmacopuncture treatment with bee venom pharmacopuncture treatment in hospitalized patients with peripheral facial paralysisMethods : This study was done on a total of 41 patients with peripheral facial paralysis who were admitted into the Korean Medicine Hospital from February 1st, 2013 to April 30th, 2014. Wedivided patients into two groups. The Jungsongouhyul group was treated by Jungsongouhyul pharmacopuncture once a day and the bee venom group was treated by bee venom pharmacopuncture once a day. To compare the therapeutical effects of the two treatments, we used Yanagihara’s unweighted grading system, House-Brachmann grading system, lip-length & snout indices and facial disablity index twice - before initial treatment and after final treatment. Results : Both Yanagihara’s score and House-Brachmann grading system score improved in each group. However, there were no significant differences in improvement between the bee venom group and the Jungsongouhyul group. Conclusions : Jungsongouhyul pharmacopuncture treatment appears to be as effective as bee venom pharmacopuncture treatment to improve symptoms of peripheral facial paralysis.

Vocal cord paralysis following general anesthesia with endotracheal intubation: a clinical review on 43 cases

임세훈,김동춘,조광래,김명훈,문성호,조학무,기승희 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.2

Background: Vocal cord paralysis (VCP) is one of the most stressful experiences for patients undergoing general anesthesia. Moreover, it is a risk factor for aspiration pneumonia and may increase morbidity and mortality. We examined several clinical features of the condition by reviewing the medical records of patients who experienced VCP following general anesthesia. Methods: We reviewed the medical records of 321 patients who consulted an otolaryngologist owing to hoarseness, sore throat, throat discomfort, or dysphagia after general anesthesia. Among these, we included in the present study 43 patients who were diagnosed with VCP by laryngoscopy, who did not have symptoms of suspected VCP before surgery, who had no past history of VCP, and for whom endotracheal intubation was not continued after surgery. Results: The mean age of patients with VCP was 51.28 years. With respect to surgical site, the most common was upper limb surgery, performed in 12 cases (9 cases were performed in sitting posture. With respect to surgical duration, only 11 cases lasted less than 3 h, whereas 32 cases required a surgical duration longer than 3 h. The most common symptom of VCP was hoarseness. Nine of the patients with VCP recovered spontaneously, but VCP persisted in 13 cases until the final follow-up examination. Conclusions: We hope that this study might call attention to the occurrence of VCP following general anesthesia. Moreover, it is necessary to further evaluate the reasons for the higher incidence of VCP in upper limb surgery performed in sitting posture.

헬리콥터 비행착각 예방을 위한 모의비행훈련장치 개발에 대한 연구

임세훈 한국항행학회 2023 韓國航行學會論文誌 Vol.27 No.2

Vertigo refers to a state in which awareness related to the location, posture, movement, etc. of a helicopter is insufficient in space. It is easy to fall into flight illusion when flying in dense fog or night flight, and even if it has a wide field of view, it can be caused by visual causes such as cloud shapes, wind conditions, conditions of ground objects, and sensory causes such as changes in air posture or gravitational acceleration. The design and program of the motion system are studied that applied a six-axis motion system to a conventional commercial flight simulator program for pilot training, depending on the specificity of helicopter flight training that requires perception and sensitivity. Using the motion-based helicopter simulator produced in this study to train pilots, it is expected to have a positive effect in prevent of vertigo, where high performance could not be confirmed in the previously used visual-based simulation training device. 비행착각(Vertigo)이란 공간상에서 헬리콥터의 위치, 자세, 움직임 등과 관련된 인지가 부족한 상태를 일컫는다. 짙은 안개 속이나 야간비행 등, 지평선이 보이지 않는 상황에서 비행할 때 비행착각에 빠지기 쉽고 시야가 넓더라도 구름 모양이나 바람 등 기상 조건, 지상물의 상태 등 시각적인 원인, 기체의 자세나 중력가속도의 변화 등과 같은 감각적인 원인에 의해 빠지기도 한다. 조종사 비행 훈련에 있어 지각 및 감각을 요구하는 헬리콥터 비행 훈련의 특수성에 따라 조종사 훈련을 위해 기존의 상용 비행 시뮬레이터 프로그램에 6축 모션 시스템을 적용한 모의비행훈련장치 모션 시스템의 설계와 프로그램에 관하여 연구하였다. 본 연구를 통해 제작된 모션 기반 헬리콥터 시뮬레이터를 활용하여 조종사의 훈련에 활용할 경우 기존에 활용되던 시각 기반 모의비행훈련장치에서 높은 성과를 확인할 수 없었던 비행착각 예방에 긍정적인 효과가 나올 것으로 예상된다.

저시정 조건에서 회전익 항공기 조종사 에러 발생율 및 비행특성

임세훈,조영진 한국항행학회 2024 韓國航行學會論文誌 Vol.28 No.1

The majority of civil aviation accidents are caused by human factors, and especially for rotary-wing aircraft, accidents often occur in situations where pilots unexpectedly or unintentionally enter into instrument meteorological conditions (IIMC). This research analyzed the error rates of rotary-wing aircraft pilots under low visibility conditions from various angles to gain insights into flight characteristics and to explore measures to reduce accidents in IIMC situations. The occurrence rate of errors by pilots under low visibility conditions was examined using a flight simulator equipped with motion, with 65 pilots participating in the experiment. Flight data obtained through the experiment were used to aggregate and analyze the number of errors under various conditions, such as reductions in flight visibility, the presence or absence of spatial disorientation, and the pilot's qualifications. The analysis revealed peculiarities in flight characteristics under various conditions, and significant differences were found in the rate of error occurrence according to the pilot's qualification level, possession of instrument flight rules (IFR) qualifications, and during different phases of flight. The results of this research are expected to contribute significantly to the prevention of aircraft accidents in IIMC situations by improving pilot education and training programs. 민간항공사고의 대부분은 인적요인에 의해 발생하고 특히 회전익 항공기는 예상하지 못하거나 의도하지 않게 악기상으로 진입하는 IIMC (instrument meteorological conditions) 상황에서의 사고가 많이 발생하고 있다. 이 연구는 저시정 조건에서 회전익 항공기 조종사의 에러율를 다각적으로 분석하여 비행특성에 관한 통찰력을 얻고 IIMC 상황에서의 사고를 줄이기 위한 방안을 연구하였다. 저시정 조건에서 조종사의 에러 발생율을 모션이 장착된 비행 시뮬레이터를 활용하였으며 65명의 조종사가 실험에 참여하였다. 실험을 통해 획득한 비행 데이터로 비행시정 감소, 공간정위상실 유무, 조종사 자격 등 다양한 조건에 따라 에러 발생율을 비교분석하였다. 분석결과 다양한 조건에서 비행특성에 대한 특이점을 발견할 수 있었고 조종사의 자격 등급, 계기비행 (IFR; instrument flight rules) 자격 유무, 비행단계별 에러 발생율에 유의미한 차이가 발생하였다. 이와 같은 연구의 결과는 조종사의 교육 및 훈련프로그램을 개선하고 IIMC 상황에서 항공기 사고예방에 중요한 기여를 할 것으로 기대된다.

The question of preoperative anxiety and depression in older patients and family protectors

임세훈,오윤미,조광래,김명훈,문성호,기승희 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.2

Background: Higher levels of anxiety increase the risks of surgery, including morbidity and mortality. The objectives of this study were to measure anxiety and depression during the preoperative period and to identify the degree of knowledge and concerns of older patients and their family protectors regarding anesthesia, and the causes of these concerns. Methods: We administered a questionnaire to older patients scheduled to undergo surgery and their family protectors one day prior to the surgery. The questionnaire included tools for quantifying anxiety and depression (Anxiety-Visual Analogue Scale, the Amsterdam Preoperative Anxiety and Information Scale, State-Trait Anxiety Inventory Korean YZ Form, and Short Form Geriatric Depression Scale). We also asked about the concrete causes of anxiety using pre-created forms. Results: There were 140 older patients and family protectors who participated in the study. The majority of older patients (n = 114, 81.4%) undergoing surgery and their family protectors (n = 114, 81.4%) indicated that they were anxious. Most of the older patients and their family protectors responded that they had insufficient knowledge about anesthesia, and they were mostly worried about failure to awaken following surgery, and postoperative pain. Older patients with higher anxiety scores showed higher depression scores. There were significant differences in depression scores depending on the presence of cohabitating family members. Conclusions: It is important to remember that older patients with higher depression scores have higher anxiety during the preoperative period.

The efficacy of vitamin C on postlaparoscopic shoulder pain: a double-blind randomized controlled trial

임세훈,문성호,조광래,김명훈,이원진,조용현 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.2

Background: This study evaluated the effect of vitamin C on post-laparoscopic shoulder pain (PLSP) in patients undergoing benign gynecological surgery during the first 72 h. Methods: Sixty patients (aged 20 to 60 years, with American Society of Anesthesiologists physical status classification I or II) scheduled for elective laparoscopic hysterectomy were enrolled in this study. The vitamin C group (Group C) received 500 mg of vitamin C in 50 ml of isotonic saline infusion intravenously twice a day from the day of surgery to the third day after surgery. Patients in the saline group (Group S) received the same volume of isotonic saline over the same period. Post-operative analgesic consumption, pain scores of the incision site and the shoulder, and the incidence of PLSP were all evaluated at 1, 6, 24, 48, and 72 h following surgery. Results: Cumulative post-operative fentanyl consumption was significantly less in Group C at 24 and 48 h after surgery (P = 0.002, P = 0.012, respectively). The pain intensity of PLSP was also significantly lower in Group C 24 h after the operation (P = 0.002). Additionally, the incidence of PLSP was significantly lower in Group C 24 and 48 h after the operation (P = 0.002, P = 0.035, respectively). Conclusions: Perioperative intravenous administration of vitamin C (500 mg, twice a day) reduced post-operative analgesic consumption and significantly lowered the pain intensity and incidence of PLSP.

Fluid loading during spinal anesthesia can reduce bradycardia after intravenous dexmedetomidine infusion

임세훈,이원진,한용재,문성호,조광래,김명훈 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.1

Background: Dexmedetomidine has been widely used during spinal anesthesia to provide sedation. However, dexmedetomidine frequently causes significant bradycardia. This study was designed to evaluate whether fluid loading could reduce the incidence of bradycardia after intravenous dexmedetomidine infusion in patients under spinal anesthesia. Methods: A total of 99 patients, 18 to 65 years of age, with American Society of Anesthesiologists physical status 1 or 2, who were scheduled for elective total knee replacement or internal fixation of lower leg fracture under spinal anesthesia were enrolled. The patients were randomly assigned into one of the three groups, and fluid was loaded as follows: group LOW - 4 ml/kg, group MID - 8 ml/kg, and group HI - 12 ml/kg. After fluid loading and spinal anesthesia, dexmedetomidine was infused as follows: 1 μg/kg of loading dose for 10 minutes, thereafter continuous infusion at 0.4 μg/kg/h. Results: The heart rate of group HI was significantly higher than that of group LOW (P = 0.049). The dosage of atropine administration was significantly lower in group HI than in group LOW (P = 0.003). The change in thoracic fluid contents was significantly higher in group HI than in group LOW (P = 0.018). Conclusions: Fluid loading during spinal anesthesia can reduce the incidence and extent of bradycardia after intravenous dexmedetomidine infusion.

Analgesic effect of preoperative versus intraoperative dexamethasone after laparoscopic cholecystectomy with multimodal analgesia

임세훈,Eun Ho Jang,Myoung-Hun Kim,Kwangrae Cho,이정한,이근무,Soon Ho Cheong,김영재,Chee-Mahn Shin 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.4

Background: Pain after laparoscopy is multifactorial and different treatments have been proposed to provide pain relief. Multimodal analgesia is now recommended to prevent and treat post-laparoscopy pain. Dexamethasone is effective in reducing postoperative pain. The timing of steroid administration seems to be important. We evaluated the analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during laparoscopic cholecystectomy with multimodal analgesia. Methods: One hundred twenty patients aged 20 to 65 years old were allocated randomly into one of three groups (n = 40, in each). The patients in the group N received normal saline 1 hour before induction and after the resection of gall bladder. The patients in the group S1 received dexamethasone 8 mg 1 hour before induction and normal saline after the resection of gall bladder. The patients in the group S2 received normal saline 1 hour before induction and dexamethasone 8 mg after the resection of gall bladder. Results: VAS scores of group S1 and S2 were lower than that of group N during 48 hours after laparoscopic cholecystectomy. There were no significant differences of VAS scores between the group S1 and the group S2. The analgesic consumption of group S1 and S2 were significantly lower than that of group N. Conclusions: A single dose of dexamethasone (8 mg) intravenously given 1 hour before induction or during operation was effective in reducing postoperative pain after laparoscopic cholecystectomy with multimodal analgesia. The analgesic efficacy of preoperative intravenous dexamethasone 1 hour before versus during surgery was not significantly different.