심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

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.

전신마취 후 발생한 악성고열증 환자의 치료 경험

이근무,정승환,이정한,정순호,최영균,김영재,신치만,박주열,이영민 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Malignant hyperthermia is the disorder of calcium regulation within skeletal muscle associated predominantly with anesthesia. It is triggered by volatile anesthetics and depolarizing neuromuscular blocking agents. We experienced a case of malignant hyperthermia. 50 years old female patient was transferred to our emergency room that she was developed tachyarrhythmia and high fever. She was taken arthroscopic examination under the general anesthesia with enflurane and succinylcholine. We suspected malignant hyperthermia and promptly treated her with dantrolene sodium. She was developed disseminated intravascular coagulopathy and acute renal failure then we were intensive care to her. She was discharged without sequela. We experienced successful management of malignant hyperthermia.

인터넷 중독 청소년들의 정신병리 및 대처 방식

안영균(Young Kyun Ahn),신영철(Young Chul Shin),고복자(Bok Ja Koh),심진현(Jin Hyun Shim),김범조(Bum Jo Kim),이승민(Seung Min Lee),이길홍(Kil Hong Lee) 한국중독정신의학회 2005 중독정신의학 Vol.9 No.1

This study was conducted to investigate the differences in psychopathology and coping strategies among internet addictors, over users and non addictors in high school students. Subjects were 273 high school students in Seoul city. Self rating questionnaires included demographic data, Young’s Internet Addiction Scale, SCL-90-R, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and The Way of Coping Strategy. Subjects were classified into 3 groups (addiction, over use, non addiction) by Internet Addiction Scale score. Prevalence of internet addiction was 4.3% and male adolescents were more addictive than female. Students who were mainly involved with internet chatting or game showed higher internet addiction score. The addiction group and over use group showed higher level of somatization, obsession, interpersonal sensitivity, depression, anxiety, hostility, and paranoia than non-addicted group. Addiction group and over use group used passive coping strategies more frequently in the stressful situation than nonaddicted group. Also, the regression analysis for finding out causal factors that predicts internet addiction showed that emotion relieving strategy were important variable which predict internet addiction. Interpersonal sensitivity and emotion relieving coping strategy was important to predict addiction. This study showed that problematic internet use was closely associated with psychopathology and psychiatric comorbidity. And high interpersonal sensitivity and emotion relieving coping strategy were related with internet addiction in adolescence.

극단 저체중 신생아에서의 동맥관 개존증 결찰술을 위한 진정맥 마취 경험 2례

최영균,고명진,이상은,조광래,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Running title: Cases of anesthesia for extremely low birth weight infant. Extremely low birth weight infants (birth weight < 1000 g) are prone to various morbidities such as respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia, patent ductus arteriosus, necrotizing enterocolitis and retinopathy. To accomplish successful anesthetic management, many precautions must be continuously taken during the operation. First, inspired oxygen concentration should be adjusted to avoid oxygen toxicity. Second, body temperature must be maintained adequately. Third, hemodynamic parameters should be kept stable. We report 2 cases of successful anesthetic management for extremely low birth weight infant who underwent ligation of patent ductus arteriosus at the neonatal intensive care unit.

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.

전기경련요법에서 remifentanil이 혈역학에 미치는 효과

정순호,이상은,임세훈,이정한,이근무,최영균,김영재,신치만 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: Electroconvulsive therapy (ECT) is often associated with transient hypertension and tachycardia. Acute hemodynamic change may produce serious complications. Remifentanil is a potent ultra short acting opioid and has been found to reduce blood pressure and heart rate. The goal of this study was to evaluate effects of remifentanil on seizure duration, recovery parameters and hemodynamic changes during ECT. Methods: Ten ASA Ⅰ, Ⅱ patients enrolled in this prospective, randomized trial, each receiving more than four electroconvulsive therapy. Patients were randomized to receive placebo, group P (propofol 1mg/kg+0.9% normal saline 1ml, n=10), and propofol with remifentanil, group R (propofol 1mg/kg+remifentanil 1ug/Kg n=10). Supplemental dose of propofol was given as required to achieve loss of consciousness. We recorded hemodynamic parameters, seizure duration, and recovery parameters. Results: Seizure duration and recovery parameters were similar in group R and group P. Blood pressure and Hear rate after ECT were significantly lower in group R. Conclusions: Remifentanil(1ug/kg) attenuated the acute hemodynamic response to ECT under propofol anesthesia without adversely affecting the duration of seizure activity and recovery profile. Adjunctive use of remifentanil may be good alternative regimens for ECT.

장기간 항갑상선제 투여 후 임의 중단 뒤 재복용시 발생한 무과립구증 1 예

김승만;김태영;박수영;배영환;서영경 정은주;김태균;권민정;박정현;이순희 인제대학교 2011 仁濟醫學 Vol.32 No.-

Agranulocytosis, one of the major side effects of antithyroid a gents, probably occurs in less than 0.25% of cases treated with antithyroid agents. It usually occurs within the first several weeks or months after the initiation of therapy, when drug dosage is higher. Most reported cases of agranulocytosis have occurred during the first 3 months of therapy. We describe here a rare case that did not experience the side effect for 6 years of antithyroid agent treatment but presented with agranulocytosis in one month after re-exposure. It suggests that the major side effect such as agranulocytosis can occur in patients who had undergone prior uneventful antithyroid drug therapy.

성인병에 대한 한방치료법(증치의학과 사상의학)에 관한 연구 : 고혈압에 대한 한방치료법(중치의학과 사상의학)에 관한 연구

박동일,김영균,안창범,이인선,김종원,권정남,장경전,이인선,이성근,장용우,신영민 동의대학교 한의학연구소 1999 동의한의연구 Vol.3 No.-

We had a result of the treatment as below when is devided Korean medicine Tx.. Western medical Tx., Cooperative Tx.. 1) At the improvement of BP control, an average in Korean medicine Tx. (from 170㎜Hg/100㎜Hg to 150㎜Hg/90㎜Hg), an average in Western medical Tr. (from 170㎜Hg/100㎜Hg to 130㎜Hg/80㎜Hg), an average in Cooperative Tx.(from 180㎜Hg/110㎜Hg to 130㎜Hg/90㎜Hg), generally all pars had improvements of BP control. But it is not significant of each case. 2) At the improvement of symptoms by the apologetics, Cooperative Tx. is profitable in cases of 'GanHwa',' DamEum', 'EumYangYangHer', 'EumHer'. Korean medicine Tx. is superior in case of 'GiChe'. 3) At the improvement of symptoms by a questionnaire, Korean medical Tx., Western medical Tx., Cooperative Tx. groups had improvements, but each practice group didn't have specific significance. Only it was somewhat profitable to Korean medical Tx. in the 210㎜Hg/110㎜Hg, Western medical Tx. in the 180㎜Hg/110㎜Hg, Cooperative Tx, in the 170㎜Hg/90㎜ Hg. 4) There are the apparent improvements in patients whose BP are over 200㎜Hg of Korean medical Tx. group, whose BP are over 190㎜Hg of Western medical Tx. group and whose BP are over 170㎜Mg of Cooperative Tx. group. There are the improvement of diastolic BP in 110㎜Mg(Korean medical Tx., Western medical Tx.) and 90㎜Hg(Cooperative Tx.). 5) At the improvement of Pulse pressure, generally Pulse pressure are decreased. There are similar improvements in all of Korean medical Tx., Western medical Tx., and Cooperative Tx.. 6) At the Symptomatic approvement according to ages, Korean medical Tx., Cooperative Tx. are somewhat good for his twentieth, and Western medical Tx. is somewhat good for his forties. 7) the correlation of Obesity-grade and BP, as Obesity-grade is higher as BP is higher, but there are no similarity in the improvement. 8) At the EAV improvements, as examination into correlation with the point of 1~3th, we could get results as below. There are high improvements of DRHTM, DRALM, DLLYM, DLLIM in Cooperative Tx. There are high improvements of DRPASI, DLLARI in the Korean medical Tx. group. There are high improvements of DRFADM in Western medical Tx. group.

바터 팽대부에 생긴 유암종 1예

강명주,지삼룡,박석주,이재익,조영완,김준영,박성재,박은택,이연재,이상혁,설상영,배상균 인제대학교 2006 仁濟醫學 Vol.27 No.-

Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi and gastrointestinal tract. Within the gastrointestinal tract, appendix is the most common location for carcinoid, followed by the distal small intestine, the rectum, and the stomach. Among these, primary involvement of the ampulla of Vater is extremely rare. We report a case of carcinoid tumor of ampulla of Vater. A 62-year-old man presented with epigastric soreness. Gastroduodenal endoscopy showed hyperemic bulging mass on ampulla of Vater and diagnosed as carcinoid tumor by histologic finding, with immunohistochemical study. In ^(111)In-octreoscan, tumor had regional lymph node metastasis, but no evidence of distant metastasis. Pancreatoduodenectomy with lymph node dissection was performed.