증례보고 : 경요도전립선절제술 중 발생한 무증상의 심한 희석성 저나트륨혈증

진지현 ( Ji Hyun Chin ),황규삼 ( Gyu Sam Hwang ),김영국 ( Young Kug Kim ),상보현 ( Bo Hyun Sang ),황재현 ( Jai Hyun Hwang ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6

The transurethral resection of the prostate (TURP) syndrome is caused by intravascular absorption of an electrolyte-free irrigating fluid during TURP for benign prostatic hypertrophy or prostatic carcinoma. The clinical symptoms and signs include hypertension, bradycardia, respiratory distress, hypotension, nausea, vomiting, confusion, blindness, seizure, coma, hyponatremina, and hypoosmolality. In this case, we incidentally detected very severe dilutional hyponatremia (99 mmol/L) without any symptoms during TURP and immediately took measures to treat TURP syndrome. On the third postoperative day, the hyponatremia had resolved within the normal range. (Korean J Anesthesiol 2007; 53: 815∼8)

가상출혈에서 혈관내 용적 지표로서 호흡성 맥파전도시간 변이의 측정

전인구 ( In Gu Jun ),박종연 ( Jong Yeon Park ),상보현 ( Bo Hyun Sang ),박준영 ( Jun Young Park ),주자영 ( Ja Young Joo ),황규삼 ( Gyu Sam Hwang ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3

Background: We examined the usefulness of respiratory pulse transit time (PTT) variation as an intravascular volume index in young, healthy, spontaneous, paced breathing volunteers exposed to simulated central hypovolemia by lower body negative pressure (LBNP). Methods: With paced breathing at 0.25 Hz, beat-to-beat finger blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR), and PTT were measured non-invasively in 18 healthy volunteers. Graded central hypovolemia was generated using LBNP from 0 to -20, -30, -40, and -50 mmHg. Respiratory PTT variation (PTTV) was calculated as the difference of maximal and minimal values divided by their respective means. Respiratory-frequency PTT variability (PTTRF) using power spectral analysis was also estimated. Results: During LBNP, SV, CO and PTT(RF) decreased, but PTT, PTTV and TPR increased significantly. PTTV did not correlate with SV changes (r=-0.08, P=0.52), but PTT(RF) (r=0.58, P<0.01) and PTT (r=0.43, P<0.01) did during progressive hypovolemia. Conclusions: PTT(RF) is more applicable to the changes in intravascular volume than PTT and PTTV, suggesting spectral analysis of PTT might be used as a dynamic preload index in patients with spontaneous and paced breathing condition, which needs further studies. (Korean J Anesthesiol 2009; 56: 265~72)

임상연구 : 건강한 자원자에서 마그네슘 정주에 따른 혈역학 및 자율신경계 변화

김태희 ( Tae Hee Kim ),강수진 ( Su Jin Kang ),상보현 ( Bo Hyun Sang ),신원정 ( Won Jung Shin ),김영국 ( Young Kug Kim ),황규삼 ( Gyu Sam Hwang ),한성민 ( Sung Min Han ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6

Background: Magnesium has been used for treatments and preventions of various situations, such as cardiovascular disease and pre-eclampsia. And it also used for decreasing demands of anesthetics and analgesics during anesthesia. Activity of autonomic nervous system has important roles for homeostasis of cardiovascular system, and its dysfunction affects mortality and morbidity. Because there are few reports about effects of magnesium infusion on autonomic nervous system, we investigated effects of magnesium infusion on hemodynamic and autonomic changes using variable autonomic function tests in healthy volunteers. Methods: Hemodynamic parameters, heart rate variability, blood pressure variability, and baroreflex sensitivity were evaluated before and after magnesium infusion of 30 mg/kg during 20 min in twenty healthy volunteers. Cold face test, valsalva maneuver were also performed before and after magnesium infusion. Results: Low-frequency components of blood pressure variability decreased after magnesium infusion (P = 0.026). There were no significant differences in blood pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, heart rate variablility and baroreflex sensitivity between before and after magnesium infusion. Increases of diastolic blood pressure during cold face test decreased significantly after magnesium infusion (P = 0.022). In addition, no significant hemodynamic and autonomic changes were found during valsalva maneuver. Conclusions: Central sympathetic vasomotor tone decreased after magnesium infusion of 30 mg/kg during 20 min in healthy volunteers. However, it had no effects on parasympathetic system and baroreflex sensitivity. (Korean J Anesthesiol 2008; 55: 691~9)

자속 측정을 통한 유도전동기의 회전자 바 손상 검출기법

황돈하(Don-Ha Hwang),한상보(Sang-Bo Han),강동식(Dong-Sik Kang),김병국(Byong-Kuk Kim),김미정(Mi-Jung Kim),조윤현(Yun-Hyun Cho) 대한전기학회 2006 대한전기학회 학술대회 논문집 Vol.2006 No.7

This paper proposes a new method for detecting broken rotor bars in a squirrel-cage induction motor. The air-gap flux variation analysis was done using search coils inserted in stator slots when broken rotor bar occurs. An accurate modeling and analysis of air-gap flux variation in the induction motor arc developed using finite-clement (FE) software packages, and measurement of the flux are made using search coils. The simulation was done for the induction motor with 380 [V], 7.5 [㎾], 4 Poles, 1,760 [rpm] ratings using the commercial FE analysis tool. The simulation and experiment results can be useful for detecting the broken rotor bar of an induction motor.

녹동균 세포외막 단백질 백신 CFC-1-101의 안정성 및 면역원성 검토 : 임상 제 Ⅰ/Ⅱa상 시험

장인진,김익상,유경상,임동석,김형기,신상구,장우현,박완제,이나경,정상보,안동호,조양제,안보영,이윤하,김영지,남성우,김현수 대한감염학회 1998 감염 Vol.30 No.3

목적 : 제일제당에서는 녹농균의 세포외막 단밸질을 유효성분으로 하는 백신인 CFC-101을 개발하였으며, 동물시험에서 이 백신의 안전성과 유효성을 입증하였다. 본 연구에서는 이 녹농균 백신의 인체에 대한 안전성과 면역원성을 평가하는 동시에 인체 접종시의 최적 투여 용량을 결정하기 위하여 제 I/Ⅱa상 임상시험을 수행하였다. 방법 : 건강한 성인 남자를 피험자로 선별하여 각 용량군에 백신투여자 6명, 위약투여자 2명을 배정하였다. 백신 투여군은 0.25mg, 0.5mg 또는 1.0mg 용량의 녹농균 백신을 7일 간격으로 3회에 걸쳐 근육주사 하였으며, 위약 투여군에게는 세포외막 단백질을 제외한 동일한 성분을 투여하였다. 백신접종 후 국소적 또는 전신적인 반응의 발생여부를 관찰하고, 혈액시료를 체취하여 백신의 역가와 유효성을 검정하였다. 결과 : 녹농균 백신 CFC-101은 모든 접종자에서 양호한 내약성을 보였다. 또한 0.5mg 과 1.0mg 백신 투여군에서는 100%의 항체양전율을 나타내었다. 생성된 항체는 녹농균 세포외막단백질에 특이성을 보였고, 녹농균 감염에 대해 방어효능이 있었다. 결론 : 이와같은 결과로부터 이 녹농균 백신은 인체에 안전하게 투여할 수 있으며, 높은 항체 생성능으로 감염방어 효능을 보이고 0.5mg과 1.0mg이 최적용량인 것으로 판단되었다. Background : We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/Ⅱa clinical trial in healthy male volunteers. Methods : Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Sings of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. Results : The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. Conclusion : We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.