기계환기관련 폐렴치료 시 Aerosolized Colistin의 효과 및 안전성에 대한 체계적 문헌 고찰 및 메타분석

백민우,정경혜,김은영 한국임상약학회 2017 한국임상약학회지 Vol.27 No.4

Background: It is recommended to use aerosolized (AS) colistin in patients undergoing mechanical ventilation therapy as anadjunctive in the latest guidelines, in spite of high nephrotoxicity and limited studies. In this study, systematic reviews and metaanalyzeswere conducted to evaluate the safety and efficacy of AS colistin in patients with ventilator-associated pneumoniaMethods: Two authors independently searched related literature published from Pubmed and EMBASE until July 2016 and includeda study comparing adjunctive AS colistin with intravenous (IV) colistin monotherapy. The primary outcome was the clinical responserate, the secondary outcome was the overall mortality, and nephrotoxicity. The publication bias was evaluated using the Egger'stest. Results: Of the total 279 articles, nine were finally included in the final analysis. There was a significant difference between theadjunctive AS colistin group and the IV colistin monotherapy group for the treatment-response rate (odds ratio (OR), 1.56; 95% CI,1.14-2.14; p = 0.005; I2 = 36%), although there was no significant difference in overall mortality (OR, 0.77; 95% CI, 0.57-1.04; p =0.09; I2 = 20%). However, there was no significant difference between the two groups in nephrotoxicity (OR, 1.13; 95% CI, 0.74-1.74;p = 0.57; I2 = 4%). Conclusion: The addition of aerosolized colistin to IV colistin monotherapy showed better results in terms ofefficacy than IV colistin monotherapy and did not show any significant difference in terms of total mortality and nephrotoxicity. Additional large-scale studies of this need to be verified.

고양이의 급성기 뇌지주막하출혈시 뇌혈류 변화에 대한 Naloxone 효과

백민우,강준기,박춘근,김영,조태훈,정철구,윤석훈,김달수,송진언 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.1

The immediate fall in cerebral blood flow(CBF) and the early clinical picture following subarachnoid hemorrhage (SAH) correlate well with the prognosis of most of the patients. But the cause of this fall in CBF is not fully understood. Recently attention has been focused on the role of endogenous opiates in the pathogenesis of cerebral ischemia. This research was planned to observe the acute change of regional cerebral blood flow (CBF) in experimentally induced SAH, to investigate whether endogenous opiate plays a role in the mechanism of the acute reduction in CBF following SAH, and to document the therapeutic value of naloxone. We have studied the effects of naloxone, an opiate antagonist, on CBF, cardiovascular system, intracranial pressure (ICP) and electroencephalography (EEG) in pentobarbital anesthetized cats. Twenty-five adult cats were divided into four groups as follows: control group(group Ⅰ; 5 cats), naloxone-treated control group (group Ⅱ; 5 cats), SAH group (group Ⅲ; 7 cats) and naloxone-treated SAH group (group Ⅳ, 8 cats). The measurement of CBF was done by hydrogen clearance methods, and carried out every 20 minutes from the beginning to 140 minutes following SAH. Naloxone (10 ㎎/㎏) was intravenously administered to cats, three times: 40, 80 and 120 minutes following SAH. The results were as follows: 1) We have induced SAH in 18 cats, in which 15 cats showed the immediate reduction in CBF following SAH( incidence rate: 83%). 2) Significant elevations in the mean arterial blood pressure (MABP: 141±10.7 to 146±12.3㎜Hg) and ICP(19±35 to 21±3.9㎜Hg) were observed immediately after SAH, followed by reduction respectively to the levels of baseline value within 40 minutes after SAH. Naloxone had no significant influence on the changes in MABP and ICP. 3) Baseline values of CBF in group Ⅰ and Ⅱ were 445±6.9 to 50,l±5.4㎖/100g/min, and were not changed by naloxone. 4) Induction of SAH resulted in a significant reduction of blood flow to 34.8±5.9 to 38.4±5.6㎖/100g/min(p<0.005), and the reduced value was not significantly changed through the experiment. Reduction in CBF was usually greater on the side of the lesion. 5) In group Ⅳ, the initial administration of naloxone made the reduced CBF increase to about 46㎖/100g/min(p<0.05), and the increased CBF value was maintained by the additional injections of naloxone. 6) Cats subjected to SAH exhibited progressive loss of amplitude and decreased frequency in EEG, which were improved by the administration of naloxone. These data suggest that endogenous opiate, which may cause decrease of cerebral metabolic rate and vasoconstriction, can play an important role in the mechanism of the acute reduction in CBF following SAH. Naloxone may induce increase in CBF by reversing the effects of endogenous opiate and its direct cerebral vasodilat or properties.

상공 대기 입자 포집을 위한 회전식 다단임팩터 시스템 개발

백민우,이송희,박재범,김우영,안강호,이한돌 한국대기환경학회 2022 한국대기환경학회 학술대회논문집 Vol.2022 No.10

전이성 뇌흑색종(Melanoma) 치험 1예

백민우,배상도,이승재,박효일,허곤 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.2

Malignant melanoma is known to metastasize to all organs of human body and acounted for the third most frequent primary neoplasm in the intracranial metastases. In a srieses of melanomas, cerebral symptoms have developed clinically only in 6% although the metastatic cerebral lesions were found by autopsy as high as 39%. The authors have experienced a case of metastatic melanoma on the Rt. frontoparal lobe with Jacksonian epillepsy as its presenting symptom.

척수인견에 의한 국소 척수혈류 변화 : 실험적 연구 An Experimental Cat Model

백민우,이재수,박춘근,조태훈,하영수,김문찬,강준기,송진언 대한신경외과학회 1984 Journal of Korean neurosurgical society Vol.13 No.3

The tethered cord syndrome is a clinical entity manifested by progressive motor and sensory changes in the legs, incontinence, back or leg pain, and scoliosis in young children. Based on remarkable neurological improvement after release of cord tension by sectioning the filum, it might be concluded that the neurological deficit was effected by cord tethering. The main objective of this experiments was to elucidate the pathophysiology involved in the tethere cord by observing the effect of tethered cord on regional spinal cord blood flow (rSCBF) and somatosensory evoked potentials (SEPs) and define a threshold relationship between SEP and rSCBF. Thirty adult cats, weighing 2.7 to 4.2kg were used in this study. The cats were divided into three groups as follows: Control group= non-tethered ( 0 cats) 5g-traction group = cord traction with 5g weight (10 cats). 10g-traction group = cord traction with 10g weight (10 cats). The rSCBF and SEP measurements were performed immediately after cord traction in each animal, at 30, 60, 90, 120 minutes and the final rSCBF at 3 hours by the hydrogen clearance technique.

전교통 동맥류의 분류와 수술을 시행한 135 예에 대한 임상보고

백민우,김달수,김영,박춘근,김문찬,이상원,조태훈,조병일,이재수,윤석훈,하영수,강준기,송진언 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.1

During the 10-year period up to December 1984, 176 patients with anterior communicating aneurysm (ACOMA) among total 467 patients of intracranial aneurysms were admitted to this Catholic Medical Center. Of these, 135 cases of ACOMA were operated by direct intracranial procedures. To analyse the factors influencing the mortality involving in surgery of 135 patients with ACOMA, a classification of ACOMA was attempted. The origins and projections of aneurysms, anatomical variations were analysed with the aid of angiography, intraoperative findings and intraoperative photographs which permitted the establishment of a classification of ACOMA with their direction. Our classification of operated 135 cases of ACOMA are seven types: 32 anterior(23.7%), 30 anterior-rostral(22.2%), 42 anterior-caudal (31.1%), 3 posterior(2.2%), 18 posterior-rostral(13.4%), 4 posteriorcaudal (3.0%), caudal 6(4.4%), respectively. Most of ACOMA projecting anteriorly, anterio-rostrally were situated above or between the optic nerve, and the less frequent posterior-caudal and inferior aneurysms were in close proximity to hypothalamic branches of the anterior communicating artery and A₂ segment. There was on overall operative mortality of 6%. The surgical morbidity and mortality were significantly higher in the posteriorly projecting group, garticulary in the posterior-caudal direction. In direct surgery of ACOMA, subpial resection of the gyrus rectus was sffective for not only anteriorly, but also posteriorly directing aneurysms.

전산화 단층촬영을 이용한 요추간반 탈출증 진단

백민우,조병일,김달수,강준기,송진언 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.2

A prospective study was deviced to determine the correlation between myelography and computed tomography (CT) in the evaluation of abnormalities of the lumbar intervertebral disk. We compared 12 operated cases, all of whom had both myelogram (either pantopaque or metrizamide) and lumbar computed tomogram preoperatively. On comparison of 15 operated interspace levels of the 12 cases, 15 CT and 12 myelographic diagnoses agreed with the operative diagnoses. A false negative diagnosis and a false positive diagnosis of herniated nucleus pulposus, and a false negative diagnosis of lateral recess stenosis were made on myelography. In addition to demonstrates lumbar disk disease as effectively as myelography, high-resolution CT also reveals the facet joints and cross-sectional area of the spinal canal and eliminate the invasive diagnostic procedure that involves risk.

두개강외로 다발성전이를 일으킨 악성수막종 : 1예 보고

백민우,허곤,이승재,박효일,주종은 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.1

Meningioma is generally regarded as benign and extracranial metastasis of intracranial meningioma is rare. About 60 cases of distant metastasis of meningioma have now been reported. Angioblastic meningioma, although a rare type, shows rapid growth and sarcomatous change frequently, and has higher incidence of metastasis than other types of meningioma. The authers report a case of malignant angioblastic meningioma arisen in left olfactory groove with multiple metastasis to skeletal system. The available literature regarding these tumors is reviewed.

뇌 동맥류 수술도중 체성감각유발전위 추적감시

백민우,조경석,홍용길,김달수,강준기,최창락 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.3

Somatosensory evoked potentials(SEPs) in response to median nerve stimulation have been recorded as a guide to cortical function during temporary occlusion of the parent vessels in the treatment of 27 aneurysms of middle cerebral artery and internal carotid artery. The central conduction time(CCT), the time between the N14 peak and the N20 peak, were preserved for variable times during temporary occlusion, ranging from no significant change after 18 minutes of occlusion to disappearance of the N20 after 2 minutes. The rapid disappearance of N20 within three minutes after temporary occlusion was observed in all three cases which was developed new postoperative neurological deficits, neither permanent, and in one case of death. The total arterial occlusion time of each of these postoperative deficit cases was no longer than 20 minutes and the shortest time was 12 minutes. The rapid loss of the cortical wave after temporary occlusion, therefore, suggests the safty duration of the temporary occlusion would be short. Monitoring of the SEPs during intracranial aneurysm surgery can help the surgeon in the management of proximal vessel control and reduce the morbidity of aneurysm operation.

154kV 변압기 외부고장 발생 시 CT 포화에 의한 오동작 방지 알고리즘

백민우(Min-Woo Baek),손진우(Jin-Woo Son),조진혁(Jin-hyuk Cho) 대한전기학회 2023 대한전기학회 학술대회 논문집 Vol.2023 No.10-2