Rocuronium의 애별투여방법이 모지내전근의 이완에 미치는 영향

최영균,김승수,이원진,조광래,이상은,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 인제대학교 2009 仁濟醫學 Vol.30 No.-

Objective : There are controversies in pnmmg technique of rocuronium whether it can or can't shorten the onset time. We want to compare the effects of two different priming doses and intervals of rocuronium. Materials and Methods : After giving propofol, 50 patients were randomly assigned to 5 groups. Group I received a placebo, followed 3 min later by rocuronium 0.6 mg/kg. Priming doses and intervals of Group II, Ill, N, V were 0.06 rng/kg and 2 min, 0.12 mg/kg and 2 min, 0.06 rug/kg and 3 min, 0.12 mg/kg and 3 min, respectively. Total dose of rocuronium was 0.6mg/kg. Train of four (TOF) count or ratio and 1st twitch height of TOF (T1) were monitored with 15 secondsintervals. TOF ratio of each groups just before bolus injection, duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were compared. Results : Duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were decreased in priming groups compared to Group 1 (P < 0.01) In group V, significant depression of TOF ratio just before bolus injection was seen (P < 0.05). Conclusion : Priming technique with rocuronium is effective method to shorten the onset of neuromuscular block. But priming dose of rocuronium itself could cause hypoxia and aspiration in awake patients and should be used carefully. Priming dose of rocuronium 0.06 mg/kg and 2 minutes interval maybe relatively safe method.

간호사에서 항암제 취급양상과 건강증상

신혜숙,이세훈 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

To evaluate the subjective symptoms among nurses handling anticancer drugs, we investigated symptom prevalence in 487 nurses exposed to anticancer drugs and 242 control nurses, who are working at 14 university hospitals in Korea by self-administered questionnaire. Safety regulations for handling anticancer drugs in these hospitals as well as the level of knowledge on safety rules of them among nurses were also evaluated. The results were as follows: 1. Only 1.5% of nurses used the biological safety cabinet always, 32.7% could not use it during evening time and on holidays, and 65.8% could not use at all since lack of it. When nurses prepared anticancer drugs, they were gloves(49.7%), gown(7.2%), goggle(1.6%), and mask(11.5%). And 46.1% of them answered that they ate and drank in the anticancer drugs preparation room. 2. The level of knowledge on safety rules of anticancer drugs were generally low in both exposed(12.7/17 items) and control(12.7/17 items) group. The questions which nurses answered wrong exceeded fifty percent were : the possibility of exposing to anticancer drugs when they correct their make-ups; and when they handled body fluids of cancer patients. Only 20.3% of the nurses were acknowledged with the hours for the cancer patients' body fluids being considered to be contaminated after receiving chemotherapy. 3. The prevalence of allergic disease was higher in exposed group than in control group. Among 43 symptoms of total, the prevalence of 10 symptoms (nausea, skin rash, itching, chronic throat irritation, tachycardia, alopecia, skin hyper pigmentation, loss of libido, leukopenia, thrombocytopenia) were higher in exposed group than in control group. 4. The prevalence of ten symptoms which showed higher prevalence in exposed group was significantly correlated with eating and drinking in the preparation room for anticancer drugs, the degree of skin contact with anticancer drugs, and the amount of anticancer handling them, and BMI. It was shown that eating and drinking in anticancer drug preparation room, and the amount of handling them, significantly affected the prevalence of 10 symptoms among nurses exposed after stepwise multiple regression analysis. The results of this study suggest that nurses handling anticancer drugs have potential risk of exposure to anticancer drugs, and the preventive measures for the protection of nurses' health be needed by education, and improvement of their working environment.

Stem cell과 Myeloperoxidase가 스티렌, 하이드로퀴논 및 트리클로로에틸렌에 의한 림프구의 자매염색분체 교환과 소핵체 유도에 미치는 영향

이경재,김형아,신민정,성재혁,박정일,한훈,이세훈 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 스티렌, 하이드필퀴논 및 트리클로로에틸렌 (TCE)이 사람의 stem cell과 human myeloperoxidase (MPO)에 의해 대사성 활성화되는 지를 규명하고자 스티렌, 하이드로퀴논 및 TCE에 사람의 stem cell 또는 MPO 효소의 첨가가 이들 화학물질에 의한 자매염색분체교환(SCE)과 소핵체 (MN) 빈도에 미치는 영향을 관찰하였다. 방법 : 건강한 남자의 전혈에서 림프루를 분리하여 72시간동안 이중배양하되 배양개시 24시간만에 0.05mM 하이드로퀴논, 1.50 mM 스티렌, 혹은 1.50mM TCE를 전체용량이 30 ㎕가 되도록 아세톤에 희석하여 배양액에 주입하였고 대조군은 아세톤으로 처리하였다. 화학물질 처리 후 즉시 1.3×106 및 2.6×106 cells/ml 농도의 제대혈액으로부터 나온 stem cell 세포액의 상층액이나 1.0 및 2.0 unit의 human myeloperoxidase를 H2O2와 함께 첨가하였다. SCE분석을 위한 배양액에는 배양종료 2.5시간 전에 colchicine을 가한 후 수확하여 Giemsa염색을 하여 metaphase 세포에서 SCE빈도를 분석하였다. MN분석을 위한 배양액에는 배양개시 44시간만에 cytochalasin-B를 가하였고 acridine orange 염색 후 이핵체에서 MN수를 분석하였다. 결과 : 1. stem cell이나 MPO 자체는 SCE나 MN의 빈도에 영향을 미치지 않았다. 2. stem cell이나 MPO는 스티렌에 의해 유도되는 SCE의 빈도를 용량-반응관계로 유의하게 증가시켰고, MN빈도의 경우 step cell이나 MPO에 의해 증가되는 경향이 있었으나 2.0 unit MPO를 첨가한 경우에만 첨가하지 않은 경우에 비하여 유의하게 증가하였다. 3. 하이드로퀴논은 stem cell이나 MPO가 없는 상태에서도 대조군에 비하여 SCE빈도가 대조군에 비하여 높았다. stem cell이나 MPO는 하이드로퀴논에 의한 SCE 빈도를 용량 반응관계로 유의하게 증가시켰지만, MN의 경우에는 증가시키는 경향만 있을 뿐 유의한 차이는 아니었다. 4. TCE자체는 SCE나 MN빈도를 증가시키지 않았다. stem cell은 1.3 ×106 및 2.6 × 106 cells/ml 농도 모두에서 SCE빈도를 유의하게 증가시켰고 MPO는 2.0 unit농도에서만 유의하게 증가시켰다. stem cell이나 MPO모두 TCE에 의한 MN빈도를 증가시키는 경향이 있었으나 유의한 차이는 아니었다. 결론 : 저자들은 스티렌, 하이드로퀴논, 및 트리클로로에틸렌에 의해 유도되는 자매염색분체교환과 소핵체의 빈도가 사람의 stem cell이나 myeloperoxidase에 의해 증가됨을 발견하였으며, 이러한 결과는 myeloperoxidase가 이들 물질의 대사성활성화에 관여함을 암시하고, 또한 아마도 이 물질들의 골수독성과 관련이 있는 것이라고 제시된다. Objectives : The objective of this study was to identify the possible role of stem cell and myeloperoxidase (MPO) in the metabolic activation of styrene, hydroquinone and trichloroethylene, by investigating the effects of stem cell from umbilical cord blood and MPO on the frequency of sister chromatid exchange (SCE) and micronuclei (MN) induction in cultured human peripheral lymphocytes exposed to hese chemicals. Methods : Islated lymphocytes from whole blood were cultured for 72 hours. The cells were treated with 1.50 mM styrene, 50 μM hydroquinone and 1.50 mM trichloroethylene dissolved with acetone (30㎕ in total volume) at 24 hours after the beginning of culture. Control group was treated with acetone only. Immediately after adding these chemicals, 1.3×106 cells/ml and 2.6×106 cells/ml stem cell/ml stained with Giemsa's solution, and acridine orange for sister chromatid exchange, and for micronucleus analysis, respectively. Results : The results were as follows: 1) Myeloperoxidase and stem cell did not significantly affect the frequencies of SCE or MN in the control group. 2) The frequency of SCE or MN with exposure to styrene did not different from control in the absence of stem cell or MPO. Sister chromatid exchange induced by styrene was significantly increased by adding stem cell or MPO in dose-dependent relationship. The frequency of MN induced by styrene significantly increased in the presence of 2.0 unit MPO. 3) The frequency of SCE was significantly increased with exposure to hydroquinone than acetone treated control in the absence of stem cell or MPO. Sister chromatid exchange induction by hydroquinone significantly increased dose-dependently in the presence of stem cell or MPO. There was a tnendency of increase of the MN frequency induced by hydroquinone in the presence of stem cell or MPO, but not significant. 4) It was found that trichloroethylene itself did not increase SCE or MN frequency. Frequency of SCE induced by trichloroethylene was significantly increased with adding stem cell (low and high) and 2.0 unit MPO. Even though them cell or MPO increased the frequency of MN of lymphocyte exposed to trichloroethylene, the difference was not significant. Conclusions : Authors found that the frequencies of both sister chromatid exchange and micronucleus induced by styrene, hydroquinone, and trichloroethylene were increased significantly with the treatment of stem cell or myeloperoxidase. It was suggested that myeloperoxidase may therefore play an important role in the metabolic activation of styrene, hydroquinone, and trichloroethylene and myeloperoxidase probably be involved in the myelotoxicity of these chemicals.

하수처리의 문제점과 연속접촉회분식 반응조를 이용한 고도처리

신항식,남세용,이상형 경산대학교(대구한의과대학) 1999 環境硏究 Vol.4 No.1

The volume of sewage increases as the population grows and the standard of living rises, and also varies in direct proportion to the volume of available water supply. Present1y(at the end of 1998), the sewage treatment ratio is 60%, and 85 facilities are woiking for sewage treatment While sewage treatment plant has been constructed in large cities and heavily industrialized cities, the most treatment plant employ one type of process, i.e. activated sludge process, which may not be desirable for some cities in economical point of view and also in terms of process optimization. Moreover, poor sewer systems resulted in lower strength influet than the designed strength. In this study, to develop a proper process for treating low strength sewage several existing sewage treatment plants were diagnosed. A continuously contacted sequencing batch reactor composed of pre-anoxic contact zone and intermittently aerated zone was operated for biological nitrogen removal. The removal efficiencies of organic matter (SCOD) and total nitrogen (T-N) were 89% and about 60% at the TCOD/T-N ratio as low as 6.0, respectively.

어린이에서 함치성 낭과 연관된 매복 소구치와 대구치의 치료

신차욱,김영재,김정욱,장기택,이상훈,김종철,한세현 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

치아 매복은 어린이 환자 진료시에 자주 관찰되는 맹출 장애이다. 어린 환자에서 매복된 치아가 존재하는 경우,함치성 낭과 연관이 있을 가능성이 높다. 함치성 낭은 제3대구치를 제외하고는 상악 견치,하악 소구치 부위에서 가장 호발하며,점진적인 증식으로 악골이 팽윤되어 안모를 변화시키며,주위 악골의 파괴와 치근의 흡수를 야기하거나 침범된 치아의 변위를 유발할 수 있으므로,조기 진단과 적절한 치료가 무엇보다도 중요하다. 함치성 낭과 연관된 치아가 과잉치나 지치라면,치아의 발거를 포함한 완전한 낭종 적출술이 적절한 치료라 할 수 있지만,그렇지 않은 경우에는 환자의 심리적,정선적 외상을 예방하기 위해 원인 치아의 보존이 고려되어야 할 것이다. 이뿐만 아니라,치아의 변위 정도,골 파괴 정도,치근의 성숙도,주위 치아와의 관계,환자의 교합과 구강 악안면 영역의 성장 양상 등도 같이 고려되어야 할 것으로 생각된다. 본 증례에서는 위와 같은 사항들을 고려하여,함치성 낭과 연관된 매복 소구치와 대구치블 낭종 적출술 후 공간 유지,외과적 수술과 교정적 견인,외과작 발거 후 교정적 배열 등의 방법을 통해 양호한 치료 결과를 얻었기에 보고하는 바이다. Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features. unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatrnent required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth. complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise. preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement. osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

코일과 클립을 선택적으로 적용해서 성공적으로 치료했던 다발성뇌동맥류 1례 : A case report

이덕구,김범태,황선철,임수빈,이세영,신원한 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The author report a case of multiple cerebral aneurysm successfully treated with an appropricate selection of surgical clipping and coil embolization. A 64 years old female patient was admitted with stuporous consciousness. Initial 3D CT angiography showed diffuse subrarachnoid hemorrhage on the basal cisterns, saccular aneurysms on the terminal basilar artery and right middle cerebral artery(MCA). Converntional angiography confirmed the ruptured aneurysm was basilar one. Coil embolization was perfromed on the basilar aneurysm with 6 Guglielmi detachable coils(GDC) on the 3 days after ictus. Sugical clipping was done on the unruptured right MCA aneurysm on 10 days after ictus without any morbidity. Each treatment modalities can be appropriate indicated for the coiling or clipping aneurysms.

니켈-크롬 합금에 폭로된 치과기공사들에서 자매염색분체 교환 빈도

신민정,성재혁,김웅철,이세훈 가톨릭대학산업의학센타 산업의학연구소 2002 韓國의 産業醫學 Vol.41 No.2

Nonprecious metal alloys were used in dental laboratories, may contain nickel, chromium, cobalt, molybdenum, beryllium, and small amounts gallium, ruthenium, or aluminum. Nonprecious metal alloys tend to rapid increase in use due to the economical merit. Despite the widespread use of Nickel-Chromium alloys, claims for safety of these alloys have not yet been accepted universally. This study was performed to investigate cytogenetic toxicity of Nickel-Chromium alloy in human cultured lymphocytes by sister chromatid exchange(SCE) which is a sensitive indicator of carcinogen and mutagen. Total subjects was divided into the two groups, including 34 Nickel-Chromium alloy exposed dental technicians and 24 control group members. 1. The frequencies of SCE were high in older than 40 years, but these was no statistical significance in two groups. 2. The effect of smoking on SCE values as higher than non-smokers in two groups, but there was no statistical significance. 3. The work duration also affected SCE frequencies, but these values didn't show any statistical difference between two groups. 4. The significant difference of SCE frequencies was found between Nickel-Chromium alloy exposed group and control group. 5. The SCE frequencies of current smoking exposed group was the highest and that of non-smoking control group was the lowest. The present study has shown that occupational exposure to Nickel-Chromium alloy is associated with an increase in SCE frequency.

췌장암 환자에서 알코올 내장신경 신경파괴블럭 후 발생한 간염

이상은,최석환,김영환,임세훈,이정한,이근무,정순호,최영균,김영재,신치만 인제대학교 2008 仁濟醫學 Vol.29 No.-

Splanchnic neurolytic block(SNB) with alcohol improves the management of pancreatic cancer pain. Adverse effects of alcohol SNB which include regional pain, hypotension, diarrhea, and acute alcohol intoxication are common, but acute hepatitis caused by alcohol neurolytic block is rare. A 63-year-old patient with pancreatic head cancer and liver metastasis had complete pain relief after both retrocrural tansdiscal SNB with 100% alcohol 10 ml. But, 1 day later, liver function test showed a high elevation in the aspartate aminotransferase (AST, 2182 IU/L) and alanine aminotransferase (ALT, 1807 IU/L). The patient had slight jaundice, general weakness, chilling, nausea and vomiting after SNB. Both AST and ALT decreased to 46 and 119 IU/L within 10 days with only supportive therapy. But, 19 days later, the patient died due to pneumonia. Our case illustrates the importance of clinical surveillance especially in patient with hepatic disease after alcohol SNB.

유기인제 농약 사용에 따른 혈청 콜린에스테라제 활성치의 변화와 농약 중독 자각증상

이순규,신민정,이세훈 가톨릭대학교 산업의학센터 2000 韓國의 産業醫學 Vol.39 No.3

The purpose of this study is to examine the change of serum cholinesterase activity according to pesticide splaying habits, working place, protective equipments, and the neurotoxic symptoms. Blood samples and questionnaires were collected from the 45 healthy pesticide spraying workers and 39 controls from June, 1998 to March, 1999. The results were as follows : 1) In pesticide treatment habits, those who opened coverlets with bare hand occupied 82.2%, and those who did not wash the pesticide-contacted skin during the preparation and spraying pesticide were 22.2% and 86.6%, respectively. Among 45 subjects, only 8 farmers used all protective equipments, and 18 workers did not use protective equipments at all. 2) The major symptoms of the subjects after spraying pesticide were headache, nausea and vomiting, productive coughing, and dyspnea in order. 3) Mean cholinesterase activity before exposure of pesticide was 8570.9±1648.9 U/L in pesticide spraying farmers and 8319.5±1444.9 U/L in controls. The cholinesterase activity at 2 hours after pesticide exposure decreased 9.1±8.8% and the inhibition rate of 24 hours after the exposure was 18.1±9.8%. (p=0.0001). 4) The cholinesterase activities were more decreased in vinyl house farmer than outdoor farmers; in those used protective equipments than those did not use; in farmers complained toxic symptoms than those did not complain; in farmers who washed immediately after skin exposure to pesticide than those who did not wash; however, none of their difference were statistically significant. 5) The number of subjects who complained pesticide-poisoning symptoms was significantly less among farmers used protective equipments than among those who did not use protective equipments. In conclusion, it was recommended that the farmers be worn protective equipments from the opening the coverlets of pesticide container to the end of spraying pesticides, and wash the skin immediately after contacted with pesticide. Particular education and attention to the farmers spraying pesticide in vinyl houses are needed because there is a risk of higher absorption of pesticide when working in the vinyl houses than working at the outdoors.

다공성 여재를 이용한 축산폐수의 영양물질 제거에 관한 연구

이영훈,김세정,홍태기,이영신 한서대학교 산학협력연구원 부설 환경연구소 2000 환경연구소 논문집 Vol.3 No.-

The fixed bio-reactor with the porous media was used to remove the nutrients in livestock wastewater. The dilution ratio and the reaction time for the removal efficiency of the nutrients in livestock wastewater were made a thorough investigation. The removal efficiency of total nitrogen(T-N) and total phosphorus(T-P) was 25 to 57% and 19 to 41% for treatment of 3 to 6 hour respectively, and >84.9% and >61.9% for treatment of 12 hour respectively. Therefore the reaction time for the effective removal of the nutrients in livestock wastewater must be more than 12 hour. Also the removal efficiency of total nitrogen(T-N) and total phosphorus(T-P) depends on the dilution ratio. As the dilution ratio increases, the reaction rate for the removal of nutrients also increases. By using the fixed bio-reactor with the porous media, it is possible to remove the nutrients in livestock waste water effectively and successively.