혈소판농축액 보관 시 교반 중단 및 백혈구의 제거가 혈소판의 품질에 미치는 영향

노상근,정의석,최원철,위재호 대한진단검사의학회 2008 Annals of Laboratory Medicine Vol.28 No.3

Background : This study aimed to analyze the influence of the interruption of agitation and removal of leukocytes on platelet concentrates (PCs), and determine the maximum amount of time the agitation could be interrupted without impairing PCs’ effectiveness during the storage period. Methods : Four ABO-identical random donor platelets agitated for 24 hr were pooled, and divided into 4 units, and 2 units of them were leukoreduced. Then 52 pooled units were categorized into 4 groups, non-leukoreduced continuous agitation (Non-LRCA), non-leukoreduced interrupted agitation (Non-LRIA), leukoreduced continuous agitation (LRCA), and leukoreduced interrupted agitation (LRIA), and preserved for 6 days (total 7 days). Mean platelet volume (MPV), pH, HCO3 -, pO2, pCO2, CD62P, CD61, glucose, lactate, ammonia and free fatty acid were measured during the period. Results : Starting from the Day 4, the pH and HCO3 - of Non-LRIA group begun to decrease while the amount of lactate production, glucose consumption, and MPV increased compared to the Non- LRCA group (P<0.01). An increase in pO2 level was observed in the interrupted agitation groups as the storage period prolonged (P<0.01). The pH levels of all the units in the agitation groups remained higher than 6.4 up to Day 7, while those of the non-leukoreduction group did so only up to Day 2, but those of leukoreduction in the interrupted agitation groups did so up to Day 4. Conclusions : The interruption of agitation reduced the platelet’s capacity to utilize oxygen, increasing lactate amount and reducing pH level. However, the in vitro parameters of the Non-LRIA and Non-LRCA groups on Day 2 were similar to each other and the pH level remained at 6.4 or higher, making one day of agitation interruption possible after 24 hr of agitation. With leukocytes removed, the effective agitation interruption period may become longer. (Korean J Lab Med 2008;28:221-9)

유리체내 주사 시 사용하는 주사기에서의 실리콘기름 방출 비교 실험

송용연,이종하,이민우,이영훈,백승국 한국망막학회 2021 Journal of Retina Vol.6 No.2

Purpose: This study aimed to compare the release of silicone oil (SO) by different brands of off-label syringes for intravitreal injection after agitation by flicking. Methods: Syringes of 3 different brands were analyzed for rates of SO release under four conditions using a light microscope; group 1: bevacizumab with agitation; group 2: bevacizumab without agitation; group 3: fluid with agitation, group 4: fluid without agitation. Results: The presence of SO droplets showed significant difference according to syringe type (p < 0.001, 65%, 7.5%, 40%, respectively). For qualitative data on the presence of SO droplets according to agitation, Syringe 1 and Syringe 3 showed significantly higher frequency in the agitation group (p < 0.001, p = 0.003). For quantitative data on the number of SO droplets according to agitation, Syringe 1 and Syringe 3 released significantly more SO droplets in the agitation group (p < 0.001, p = 0.001). However, there was no difference in the comparison of frequency and number of SO droplets according to fluid type in all syringes. Conclusions: Specific syringe use for intravitreal injections has potential to release more SO droplets than other syringes, especially after agitation by flicking. We advise avoidance of agitation during intravitreal injection and recommend manufacturers consider producing syringes specific for ophthalmic use. 목적: 국내 유리체내 주사에 사용되는 주사기의 실리콘기름 방울 방출 정도를 비교하고자 하였다. 대상과 방법: 세 가지 종류의 주사기를 네 가지 조건 하에서 실리콘기름 방출 여부 및 방울 수를 광학현미경을 사용하여 분석하였다. 1군: 아바스틴 충전 후 교반을 시행한 그룹; 2군: 아바스틴 충전 후 교반을 하지 않은 그룹; 3군: 증류수 충전 후 교반을 시행한 그룹; 4군: 증류수 충전 후 교반을 하지 않은 그룹. 결과: 실리콘기름 방울의 방출 빈도는 주사기 종류에 따라 차이를 보였으며 1번 주사기에서 가장 높았다(p < 0.001). 교반 유무에 따른기름 방출 빈도는 1번 주사기와 3번 주사기에서 교반을 시행한 군에서 교반을 시행하지 않은 군보다 많았다(p < 0.001, p = 0.003). 교반 유무에 따른 기름 방울 수 또한 1번 주사기와 3번 주사기에서 교반을 시행한 군에서 교반을 시행하지 않은 군보다 많았다(p < 0.001, p = 0.001). 유체 종류에 따른 기름 방출 빈도 및 방울 수에서는 세 주사기 모두 차이를 보이지 않았다. 결론: 유리체내 주사에 사용되는 특정 주사기는 실리콘기름 방울을 많이 방출할 가능성이 있으며, 교반 시에 더 많이 방출하므로 주사시 교반을 피하고 제조업체에서는 안내용 주사기를 별도로 생산하는 노력을 기울일 것을 제안한다.

치매 환자의 격앙행동과 주간호자의 대처행동

김혜숙,박희옥 한국지역사회간호학회 2012 지역사회간호학회지 Vol.23 No.3

Purpose: The purpose of this study was to investigate agitation in home-dwelling persons with dementia and coping behaviors of primary family care-givers to agitation. Methods: The research was designed as a descriptive study. A total of two hundred and five subjects had participated in this study. To measure agitation in persons with dementia, Cohen-Mansfield Agitation Inventory was used. To measure coping behaviors of primary family care-givers to the agitation, a questionnaire was used. Descriptive statistics, t-test, ANOVA, Scheffé test were used to answer the research objectives. Results: 'Repetitive mannerisms' and 'repeating sentences' were the most commonly occurred agitation in home-dwelling persons with dementia. 'Leaving the situation', 'allowing certain time', and 'soothing by talking' were the most common coping behaviors occurred in primary care-givers. Conclusion: The findings of the current study would provide meaningful data to develop nursing programs to control agitation for home-dwelling persons with dementia and education programs for primary care-givers to cope with persons' agitation.

임상연구 : 소아에서 Sevoflurane 마취 시 Remifentanil 병용 투여가 수술 후 회복시간과 각성흥분에 미치는 영향

남복희 ( Vo Ki Nam ),김미운 ( Mi Woon Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.6

Background: Sevoflurane anesthesia may show emergence agitation and delirium in children, compared to other inhalation agents. Therefore, we studied the effect of low dose sevoflurane on recovery time and emergence agitation in children. Methods: We studied 50 patients who were planned for surgery under general anesthesia, aged between 2 and 8 years. They were randomly divided into two groups. Patients of group S were anesthetized with sevoflurane 2.5-3 vol%, whereas those of group R were given sevoflurane 1.2-1.5 vol% and continuous intravenous infusion of remifentanil 0.1-0.2μg/kg/min. All patients received N2O:O2 50:50 during maintenance of anesthesia. After the surgery, the anesthesiologist recorded recovery time and determined agitation score using 5-point scoring scale in both groups. Agitation score, incidence of emergence agitation and recovery time were compared with each other between the two groups. Results: The agitation scores were 2.72 ± 0.98 and 2.64 ± 0.95 in S and R groups, respectively, showing statistical insignificance. The incidence of emergence agitation score 4 or 5 was not significantly different, either. The recovery time was statistically shorter in R group (P<0.05). Conclusions: Compared with sevoflurane inhalation anesthesia alone, the use of sevoflurane and remifentanil in combination provided shorter recovery time, but no effect on emergence agitation. (Korean J Anesthesiol 2007; 52: 675~80)

Caco-2 세포 단층막 투과 실험시 교반이 약물의 투과계수에 미치는 영향

홍순선,유호정,이홍,정석재,김대덕,심창구 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.2

The unstirred water layer (UWL), which has been known to exist in the boundary of the intestinal lumen and intestinal wall, often behaves as an absorption barrier especially for lipophilic drugs. The intestinal absorption of drugs is often characterized using Caco-2 cell monolayers grown on Transwell polycarbonate membranes. The permeability (Pare) of drugs across the cell monolayer might be influenced by the agitation of the donor compartment, since the width of UWL on the surface of the cell monolayer would be reduced by the agitation. In this study, the effect of agitation of the donor compartment with 60 rpm on the permeability was measured for 12 drugs with a wide range of lipophilicity and permeability. The of mannitol, tributylmethyl ammonium, cimetidine, ranitidine, hydrocortisone, benzylpenicillin and loxoprofen was not influenced by the agitation, while the P_(app) of theophylline, propranolol, YH439, phenylpropanolarnine and testosterone was increased by the agitation. There was a significant correlation between the increase of P_(app) by agitation and the lipophilicity for the compounds having P_(app) > 2 x 10^(-5) cm/sec. No correlation was observed for the difference in P_(app) by agitation and the molecular weight, or lipophilicity of the drugs. Therefore, the agitation rate of the donor compartment in the Caco-2 cell monolayer study should be carefully controlled in order to estimate Pap, reproducibly especially for iipophilic drugs.

혐기성소화조의 교반방식이 음폐수 처리효율에 미치는 영향

이상윤 ( Sangyoon Lee ),배재호 ( Jaeho Bae ) 한국폐기물자원순환학회 2022 한국폐기물자원순환학회지 Vol.39 No.5

Anaerobic digestion is a method for the proper management of the continuously increasing amount of food waste leachate, although it is costly and time consuming and requires enormous sites. Therefore, improving digestion efficiency with proper operation can be a realistic alternative. In this study, the effects of agitation methods on the performance of anaerobic digesters treating food waste leachate were evaluated by comparing two agitation methods: gas agitation and mechanical agitation. After changing gas agitation to mechanical agitation, the daily amount of food waste leachate treated increased from 131 to 147 t. In addition, the organic removal efficiency was improved by up to 6%. Digestion gas production also increased from 0.33 to 0.50 Nm3/kg CODcr-added. Moreover, it was found that it was possible to reduce electricity consumption by 40%. The above results indicate that the mechanical agitation method is more advantageous for the treatment of food waste leachate than the gas agitation method.

Risk Factors of Emergence Agitation in Adults Undergoing General Anesthesia for Nasal Surgery

김효진,김덕경,김효열,김진경,최승원 대한이비인후과학회 2015 Clinical and Experimental Otorhinolaryngology Vol.8 No.1

Objectives. To identify the incidence and the risk factors of emergence agitation in adults undergoing general anesthesia for nasal surgery. Methods. We retrospectively examined 792 patients aged ≥18 years who underwent general anesthesia for elective nasal surgery between July 2012 and August 2013. Patients in the postanesthesia care unit with a Richmond Agitation Sedation Scale≥+1 at any time were considered to have emergence agitation. Results. The overall incidence of emergence agitation is 22.2%. From multivariate regression analysis, the following six variables were found to be significantly associated with emergence agitation (P<0.05): younger age, recent smoking, sevoflurane anesthesia, postoperative pain on the numerical rating scale (NRS)≥5, presence of a tracheal tube, and presence of a urinary catheter. Presence of a tracheal tube was the greatest risk factor, increasing the risk of developing emergence agitation by approximately fivefold (odds ratio, 5.448; 95% confidence interval, 2.973 to 9.982). Younger age was also a strong risk factor (odds ratio, 0.975 for each 1-year increase; 95% confidence interval, 0.964 to 0.987). Current smoking, sevoflurane anesthesia, postoperative pain of NRS≥5, and the presence of a urinary catheter nearly doubled the risk of emergence agitation. Conclusion. Emergence agitation following general anesthesia is a common complication in adult nasal surgery patients. To reduce the occurrence and consequences of agitation episodes, elimination of the associated risk factors is necessary, especially in at-risk patients.

The effect of remifentanil versus N_2O on postoperative pain and emergence agitation after pediatric tonsillectomy/adenoidectomy

Hey-Ran Choi,Jae Keun Cho,이상석,Byung Hoon Yoo,Jun Heum Yon,김계민 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.2

Background: Remifentanil can be an alternative to N_2O in general anesthesia. Intraoperative remifentanil may lead to acute opioid tolerance. This study aims to assess the effect of remifentanil substituted for 70% N_2O on postoperative pain in children undergoing tonsillectomy/adenoidectomy. In addition, we evaluated the effect of remifentanil infusion on incidence of emergence agitation in these patients. Methods: Eighty children, aged 2-12 years, undergoing tonsillectomy/adenoidectomy were randomly allocated to the N_2O group (Group N; n = 40, sevoflurane and 70% N_2O) or remifentanil group (Group R; n = 40, sevoflurane with remifentanil infusion at the rate of 0.17 μg/kg/min). In the recovery room, severity of pain and agitation were assessed by an investigator blinded to the assigned group. Time to eye opening and incidence of severe pain and agitation were compared between groups. Logistic regression was used to identify factors related to occurrence of severe pain and agitation. Results: Number of patients with severe postoperative pain was 6 and 16 in groups N and R, respectively (P = 0.012). Incidence of emergence agitation was not significantly different between groups. Remifentanil infusion was a significant factor related to the occurrence of severe postoperative pain (P = 0.015), and age was inversely related to occurrence of emergence agitation (P = 0.001). Conclusions: In children undergoing tonsillectomy/adenoidectomy, intraoperative remifentanil infusion may increase incidence of severe postoperative pain compared to N_2O, but it may not affect incidence of emergence agitation.

현대문학: 국방부 정훈매체 『국방』의 문예면 연구 -한국전쟁기 정훈문학 연구,2-

박태일 ( Tae Il Park ) 한국문학언어학회(구 경북어문학회) 2011 어문론총 Vol.55 No.-

Agitation-Propaganda Literature is a tool for propaganda war and ideological war which are essential for the victory. 『Kook Bang』 is the three services integrated, monthly magazine published by the Ministry of National Defense. Based on the literature section of 『Kook Bang』 which is not well-known part so far, this writing aims to look around the publication environments and the characteristics of poetry and novel First, 25 volumes of 『Kook Bang』 were published between 1950.12 and 1953.7 armistice. The place of publication were changed from Daegu to Busan. 272 literary works were included in the publications. During the three years of war period, [『Kook Bang』 introduced the most literary works. Nevertheless, there was almost no diachronic and synchronic change in writers. The majority of the writers comprised of the writers in the military, general soldiers, and a few ordinary people were at the center of the right-wing literary world in Seoul around the independence. Second, 129 poems written by 79 people, which is main contents of the publication, were published in the literature section of 『Kook Bang』. Various kinds of Agitation-Propaganda Poetry were introduced including not only old generation poets, but also new generation poets after restoration of independence. These poems can be categorized as poet of service in war by a soldier writer, by in civvy street poet, by a soldier. Generally, poems that contain Agitation-Propaganda theme show high degree of completion. Third, the literature section of 『Kook Bang』 includes 25 novels by 20 writers. Most of writers were old generation and there were no participation of soldier. Focusing on background of the literature works, novels can be categorized as the front novel, the front-backward crossing novel and the backward novel. With the background of the war period, Agitation-Propaganda novel in 『Kook Bang』 contained various Agitation-Propaganda themes which aim not only reality of description and immediacy of effect, but also victory of war. By this writing, it was identified for the first time that the literature section of 『Kook Bang』 is the key to look around the features of literature in 1950s. For this reason, whole story of 『Kook Bang』 and many Agitation-Propaganda mediae should be discovered and explained in the future.

Clinical Research Article : The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia

( Yoon Sook Lee ),( Woon Young Kim ),( Jae Ho Choi ),( Joo Hyung Son ),( Jae Hwan Kim ),( Young Cheol Park ) 대한마취과학회 2010 Korean Journal of Anesthesiology Vol.58 No.5

Background: The rapid emergence and recovery from general anesthesia afforded by sevoflurane is associated with a high incidence of emergence agitation in children. Small doses of ketamine reduce the incidence of emergence agitation. This study compared the effects of ketamine 0.25 mg/kg and 0.5 mg/kg on emergence agitation and postoperative pain. Methods: The effects of added intravenous ketamine were evaluated in 93 children, ASA I-II, 2-14 years old, undergoing an adenotonsillectomy. The patients were allocated randomly to one of three groups receiving saline (group C), ketamine 0.25 mg/kg (group K0.25) or ketamine 0.5 mg/kg (group K0.5). The children in each group were administered the study drugs 10 minutes before the end of surgery. The recovery characteristics, including the time to extubation, delivery time from the PACU, postoperative nausea and vomiting, agitation and pain were assessed. Results: There were no significant differences in the extubation time, delivery time and postoperative nausea and vomiting between the three groups. There were significant differences in modified CHEOPS (Children`s Hospital of Eastern Ontario Pain Scale) between the three groups. The incidence of emergence agitation was low in the K0.25 and K0.5 groups compared to the control group. However, there was no significant difference between the K0.25 and K0.5 groups. Conclusions: There was no significant difference in the incidence of emergence agitation between K0.25 and K0.5 groups. However, K0.5 group showed a lower pain score than K0.25 group. (Korean J Anesthesiol 2010; 58: 440-445)