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백승완,정규섭,김인세,문이섭 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.6
The purpose of this clinical stydy was to cvaluat the postoperative pulmonary function and ventiltory reserve in patients over 60 years of age. The author analysed 40 anesthetic patients who underwen abdominal surgery at the Department of Anesthesiology of Pusan National University Hospital from March 1, 1987 through July 31, 1988. Only those patients who have had normal or nearly normal cardiopulmonary function were selected and those who developed post operative pulmonary complications were excluded from the study. The results were as follows: 1) On the frst postoperative day, the FCC of the upper abdominal surgery group was 44% of the preoperative value, 2.84±0.68 l/sec, and that of the lover abdominal surgery group was 64% of the preoperative balue, 2.88±0.36 l/sec,(p<0.001). 2) On the frst postoperative day, the FEVI of the upper abdominal surgery group was 37% of the preoperative value, 2.24±0.64 l/sec, and that of the lover abdominal surgery group was 51% of the preoperative balue, 2.43±0.31 l/sec,(p<0.001). 3) On the frst postoperative day, the MMEF of the upper abdominal surgery group was 55% of the preoperative value, 2.50±0.36 l/sec, and that of the lover abdominal surgery group was 75% of the preoperative balue, 2.55±0.71 l/sec,(p<0.001). 4) The preoperative FEVI/FVC ratio of the upper abdominal surgery group was 79%, and that of the lower abdominal surgery group was 84%. In the postoperative period, there were no singificant differences between the upper and lower abdominal surgery group. 5) In the upper and lower abdominal surgery groups, postoperative pH and PaCO2 values were found to be changed insignificantly. 6) In the upper and lower abdominal surgery groups, postoperative PaO2 values were found to be decreased significantly (p<0.05).
패혈증 백서에서 각종 마취제에 의한 복강내 대식세포 iNOS m-RNA의 발현에 관한 연구
백승완,선병호 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.6
Background : It is a well known phenomenon that alveolar and peritoneal macrophages exposed to bacterial lipopolysaccharide (LPS) induce a large output of nitric oxide (NO) and an inducible nitric oxide synthase (iNOS) m-RNA expression. The author elucidate the effects on NO production and iNOS m-RNA expression of various anesthetics, inhalational (halothane, enflurane, sevoflurane) and intravenous (ketamine, propofol), on endotoxemic rats. Methods : To examine the production of NO in peritoneal macrophages, NO concentrations were measured from the rats following 2 hours exposure to LPS and 2 hours administration of various anesthetics, respectively. Culture supernatants were collected 24 hours after exposure to LPS and anesthetics and assayed by ELISA (Enzyme Linked Immunosorbent Assay) for production of NO. iNOS m-RNA expression was measured using PCR (Polymerase Chain Reaction) techniques and autoradiography. Results : In the control group, the NO concentration was measured at 120 minutes after infusion of LPS to rats, and showed 12±4μM. After insufullation of anesthetics to experimental animals, NO concentration increased in the halothane, enflurane, sevoflurane, propofol, and ketamine groups, 132±27 (P< 0.05), 49±19 (P< 0.05), 23±14 (P< 0.05), 37±11 (P< 0.05), and 17±2μM respectively. The size and brightness of the iNOS m-RNA bands were large in halothane, enflurane, sevoflurane, propofol and ketamine, in order. Conclusions : Intravenous anesthetics showed more stability than inhalation anesthetics with regand to production of NO and iNOS m-RNA expression in sepsis on rats. The mechanism is not clear, but it is related to the strong stimulating effect to the airway tract in from inhalational anesthetics. (Korean J Anesthesiol 1999; 37: 1125∼1134)
마취심도와 통증 측정 시 카오스 이론의 유용성에 대한 연구
백승완,김해규,신상욱,김경훈,민상기,예수영,전계록 대한정맥마취학회 2001 정맥마취 Vol.5 No.1
Background: During operation, patient's pulse wave signal among ECG, EEG and pulse wave, which are vital signals, are very useful to find out mechanical situation of heart, blood flow, and rarely received electrical noise from high frequency equipment. In this study, we analyzed anesthetic depth during surgical operation and pain stiffness of cancer patients using patient's pulse wave. Methods: To analyze non-linear feature of physiological parameter, we reconstructed a strange attractor using time-serial data with quantity and quality methods. The quantity method is a return-map and the quality method is a correlation-dimension. For reconstructing a strange attractor, two factors were needed, delayed time and dimension. After detecting correlation dimension values based on delay-time, embedding dimension, we compare BIS index to indicate depth of anesthesia and stiffness of cancer patient to correlation-dimension values. Results: According to the return-map, getting lower correlation-dimension values, it showed the more unstable patient's situation. Return-map of low correlation-dimension values showed that geometrical structures were small, discrete and simple. The results of correlation-dimension values using second differential in pain stiffness showed over 2.5 at normal, 1.5 - 2.0 at good, 1.1 - 1.3 at fair and below 1.1 at poor state. The results of correlation-dimension values from using second differential reflected patient's state of painless or painful. Also they showed over 90% accuracy respected to doctor's diagnosis. Conclusions: Continuous and efficient studies analyzing the feature of parameters will be needed. In the future, they will be able to apply to the patients who have autonomic dysfunction, vascular disease, nerve system disease as will as patients in the intensive care unit by using pulse waves which reflect state of patient suffering from the pain.
백승완,김해규,정규섭,강용업,김인세,백선용 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.3
소의 신선한 대뇌피질로부터 분리한 synaptosomal plasma membrane vesicles(SPMV)에서의 barbiturates 침투정도를 형광 probe법으로 검색하였다. Barbiturates는 SPMV 외부 단층(outer monolayer)의 표면에 주로 분포하되 지질용해도와 마취능에 비례하여 소수성 부위에 분포되는 양이 증가되는 현상을 보여주었다. Thiopental sodium, pentobarbital, hexobarbital, amobarbital 및 phenobarbital은 SPMV 외부 단층의 표면(친수성 부위)에 분포되는 것이 소수성 부위에 분포되는 것에 비하여 각각 4.3, 20.6, 22.1, 39.8 및 49.2배가 된다는 것을 확인하였다.