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Midazolam을 전투약한 환자에서 propofol 용량에 따른 의식 소실과 무호흡의 빈도
황정원,오용석,한성희 대한정맥마취학회 1997 정맥마취 Vol.1 No.2
Propofol은 작용발현과 회복이 빠르고 작용지속시간이 짧은 정맥마취제이지만 고용량을 투여했을 경우 위험한 합병증으로 혈압이 감소하고 호흡이 억제된다. 저자들은 propofol 마취시 투여용량에 따른 무호흡의 발생 빈도 및 지속시간과 의식소실의 빈도를 관찰하고 midazolam의 마취전투여가 그에 미치는 영향을 연구하였다. 방법: 수술 전 의식이 명료하고 호흡억제가 없었던 194명의 성인남녀를 선택하여 대조군과 midazolam을 투여한 midazolam군으로 나눈 후 propofol의 용량에 따라 다시 세군으로 나누었다. Midazolam군은 마취유도 10분 전에 0.06 ㎎/㎏의 midazolam을 정주하였고 대조군은 마취전 투여를 시행하지 않았으며 propofol(1, 1.5, 2 ㎎/㎏)의 일시정주 후 기도를 유지하면서 안면마스크를 이용해 100%의 산소를 투여하였다. 각 군별 의식소실의 빈도와 10초 이상 지속되는 모호흡의 빈도와 지속시간을 측정, 비교하였다. 결과: 대조군과 midazolam군 모두에서 propofol의 용량 증가에 따라 무호흡의 빈도 및 지속시간이 증가하였다. Propofol 투여용량이 같을 경우 대조군과 midazolam군의 무호흡의 지속시간의 차이는 보이지 않았으며 무호흡의 빈도는 1.5 ㎎/㎏의 propofol을 투여했을 경우에만 midazolam군이 87.1초로서 62.5초의 대조군에 비해 증가하였고 다른 용량에서는 통계적 차이를 보이지 않았다. 의식소실의 경우 대조군에서는 61.1%, 75.0%, 97.1%로서 propofol의 용량증가에 따라 의식소실의 빈도가 증가하였으나 midazolam 군에서는 96.9%, 100%, 100%로서 propofol의 용량과 무관하게 거의 모든 환자에서 의식이 소실되었다. 결론: propofol을 이용한 마취시midazolam을 전투여하면 의식소실을 위한 propofol의 투여용량을 줄일 수 있고 무호흡의 빈도 및 지속시간을 감소시킬 수 있다.
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자간전증 임산부에서의 마취 관리: 혈역학적 감시 및 수액요법
황정원 대한마취통증의학회 2015 Anesthesia and pain medicine Vol.10 No.2
Preeclampsia is a hypertensive disorder involving multiple organs during the late gestational period. It may cause maternal and fetal morbidity and mortality. Preeclampsia parturients have an increased risk of cesarean delivery for several reasons including growth retardation of the intrauterine fetus, fetal distress and termination of pregnancy for treatment of severe preeclampsia. The hemodynamic state of preeclampsia varies depending on the onset, the severity of preeclampsia and the involved organs. Spinal anesthesia is recommended for preeclampsia parturients because of its rapid onset, stable hemodynamics and fewer neurologic complications. Hypotension during spinal anesthesia occurs less in preeclampsia, as compared to healthy pregnant women. Hemodynamic monitoring and planned fluid administration are important to anesthetic management of preeclampsia parturients.
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교육체험 강화를 위한 온라인 뮤지엄 전시디자인 연구 - 포크와 디어킹의 맥락적 학습모형을 중심으로 -
황정원,최정아 한국문화공간건축학회 2021 한국문화공간건축학회논문집 Vol.- No.74
In the age of digital transformation, online museum exhibitions have attracted more public attention as a new method of museum education with the convergence of digital technology. This study intended to specify how to reinforce the educational experience of online museum exhibitions, based on Falk and Dierking's contextual model of learning. First, theoretical reviews, regarding the changing role and education of museums, online museum exhibitions, the contextual model of learning and smart learning, were conducted. Based on Falk and Dierking's contextual model of learning, characteristics of Online Museum Exhibitions were developed, which is personalization, interaction, viewing, mobility, information characteristic. With these, case analysis were carried out. After then, the results were following. First, online museum exhibition did not support individualization elements in personal context. Second, most of the ways of interacting with others in a sociocultural context were through link sharing and educational contents on video platforms. Third, in terms of physical context, the online museum exhibition supported viewing behavior by zooming in on the work. And also It supports mobility by discontinuous transitions rather than continuous transitions. It also helped to recognize information about the exhibition through audio-visual information elements such as text, image, audio, and video. Finally, the direction of online museum exhibition in terms of contextual learning to reinforcement of educational experience is as follows. First, temporary exhibitions of online museums require database-based personalized services to build an educational environment tailored to individuals in terms of personal context. Second, in terms of socio-cultural aspects temporary exhibitions of online museums require services to share experiences to intereact with learners. And it also requires educational programs through various platforms. Third, in order to support viewing behavior in online exhibitions in terms of physical context, viewing elements, mobility elements, and audio-visual information elements should be actively utilized.
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뇌혈관조영술 후 발생한 고신호강도급성재관류표지자 영상을 보인 조영제유발뇌병증 의증
황정원,김건엽,여태영,임대혁,정진만 대한신경과학회 2020 대한신경과학회지 Vol.38 No.4
Contrast-induced encephalopathy (CIE) is a rare complication of angiography and endovascular intervention following administration of iodinated intravenous contrast agents. Neuroimaging findings of CIE usually show cerebral edema, leptomeningeal enhancement, and parenchymal signal abnormality on fluid-attenuated inverse recovery (FLAIR). Hyperintense acute reperfusion marker (HARM) generally implies an enhancement of the subarachnoid cerebrospinal fluid space on brain FLAIR imaging in cases of acute ischemic stroke or hyperperfusion syndrome. We report a case of possible CIE following cerebral angiography, accompanied by HARM sign.
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황정원 대한영상의학회 1988 대한영상의학회지 Vol.24 No.5
Authors analysed the CT findings of the congenital ear anomalies of twenty-nine patients for 2 years and 3 moths. The results were as follows: 1.Most of the patients were under the age of 20 (82.7%) and prevalent in male (72,4%) 2. Clinically congenital ear anomalies were detected in 20 patients (68.9%) conductive hearing loss in 4 sensorineural hearing loss in 1 and the remained 4 patients were detected incidentally without clinical symptom. 3. In the cases of unilateral involvement of 20 patients right ear was more common (12/20), Eight of 9 bilateral involvement showed similar degree. 4. The middle ear malformations were found in 22 patients(75.9%) and bilateral in 4 patients. 26 cases of middle ear malformations had been classified by Frey into 4 groups; Group in 5 Group II in 9 Group III in 9 and Group IV in 3. 5. Incidentally found ear anomaly was lateral semicircular canal formed a single cavity with the vestibule in aoo patients(5 pts) 6. Inner ear malformations accompanying sensorineural hearing loss were found in 3 patients with bilateral involvement and middle ear malformations were accompanied in 2 patients, The degree of involvement of labyrinth was variable.
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