실험연구 : 백서의 일과성 척수 허혈에서 저체온하 경막내 Bupivacaine의 효과

이정락 ( Jeong Rak Lee ),임정길 ( Jeong Gil Leem ),황승준 ( Seung Jun Hwang ),장동민 ( Dong Min Jang ),김정원 ( Jung Won Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2

Background: Local anesthetics can reduece excitotoxic neuronal injury from ischemia. We investigated neuroprotective effects of intrathecally administered bupivacaine and hypothermia in rat model of transient spinal cord ischemia. Methods: A PE-l0 intrathecal catheter was implanted into thirty six male Sprague-Dawley rats through L4-5 interlaminar space. Animals of normothermia (N) and hypothermia (H) groups were administered 15 μl of normal saline, and 15 μl of 0.5% bupivacaine for bupivacaine (B) and bupivacaine-hypothermia (BH) groups. Transient spinal cord ischemia was induced by inflation of a 2 F Fogarty catheter placed into aortic arch for 12 minutes. During ischemia, rectal temperature was maintained to 37.0 ± 0.5℃ for N and B groups, 34.5 ± 0.5℃ for H and BH groups. Motor and sensory deficit score were assessed 2 and 24 hour after reperfusion. Lumbar spinal cords were harvested for histopathology, and for immunoreactivity of heat shock protein 70 (HSP70). Results: The motor and sensory deficit score of N and B group was significantly higher than H group (P < 0.05) and BH group (P < 0.05). There were also significant difference in the motor and sensory deficit score between Hand BH group at 24 hr (P < 0.05). Neuronal cell death and immunoreactivity of HSP70 was frequently observed in the N and B groups, but not in the H and BH groups. Conclusions: These results suggest that intrathecal bupivacaine did not provide neuroprotection during normothermic transient spinal cord ischemia in rats, but it can enhance neuroprotective effects of hypothermia. (Korean J Anesthesiol 2006; 51: 207~15)

동래온천의 장기적인 수질 변동 특성

전항탁 ( Hang-tak Jeon ),함세영 ( Se-yeong Hamm ),이철우 ( Cholwoo Lee ),이종태 ( Jong-tae Lee ),이정락 ( Jeong Rak Lee ) 대한지질공학회 2020 지질공학 Vol.30 No.3

본 연구에서는 1922년부터 2019년까지 동래온천수의 장기적인 온천수 수질 변화 특성을 살펴보았다. Mann-Kendall 분석과 Sen의 기울기에 의해서 동래온천수의 장기적인 수질 특성 변화를 분석하면, 온도, Ca, SiO₂, HCO₃는 증가 추세를 보이는 반면에 EC, Na, K, Mg, Cl, SO₄은 감소 추세를 보이거나 또는 거의 추세 변화를 보이지 않는다. 동래온천수의 수질유형은 시간경과에도 변하지 않고 Na-Cl형에 안정적으로 속하고 있다. 2004년, 2009년, 2014년, 2019년의 수질 자료를 이용한 공간 분포도에 의하면, 시기별로 변동을 보이며, 시료 채취 지점에 따라 값의 변화를 보인다. 이는 장기적인 온천수 개발에도 불구하고 동래온천수의 공간적인 수질 특성은 거의 일정하다는 것을 지시한다. In this study, Long-term change of water quality in Donrae Hot Spring was characterized using water quality data from 1922 to 2019. According to Mann-Kendall analysis and Sen's slope using long-term water quality data of Dongnae Hot Spring from 1922 to 2019, temperature, Ca, SiO₂, and HCO₃ show an increasing trend whereas EC, Na, K, Mg, Cl, and SO₄ show a decreasing trend or negligible trend. In addition, the water type of Dongnae Hot Spring stably belongs to Na-Cl type over time. The spatial distributions of water temperature and chemical constituents in 2004, 2009, 2014, and 2019 show variable patterns with showing some difference depending on sampling locations in different years. These results indicate that despite the long-term pumping of the hot spring water, the water quality is quite stable during the entire study period.

증례보고 : 전방십자인대 파열 수술 중 발생한 폐동맥혈전색전증의 응급체외순환을 이용한 치료

장동민 ( Dong Min Jang ),김경태 ( Kyung Tae Kim ),김정원 ( Jung Won Kim ),최원주 ( Won Joo Choe ),이정락 ( Jeong Rak Lee ),이상일 ( Sang Il Lee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.3

슬관절 전치환술 환자에서 지혈대고혈압과 Bispectral Index 와의 관계

이정락,권삼희,곽미정,임정길 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.42 No.3

당일수술센타를 통한 정신과 환자의 전기경련요법

이정락,박선정,임정길,양홍석 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.4

We experienced two cases of electroconvulsive therapy (ECT) through ambulatory surgery units. In case 1 patient was a 17 year old male with depressive disorder and the case 2 patient was a 64 year old male also with depressive disorder. A trial of various antidepressants had proved ineffective. They were treated with six ECTs for each case. The case 1 patient complained two times of myalgia suspected to be due to the adverse effects of succinylcholine administration and the case 2 patient showed tachycardia and hypertension due to sympathetic stimulation after application of the current, but the two cases were successfully cared for by ambulatory surgery unit and discharged without severe complications. perioperative care for individuals who undergo outpatient ECT is similar to the care provided for scheduled ambulatory surgery. Successful performance of ambulatory ECT requires collaboration by psychiatrists, anesthesia care providers, skilled perioperative nurses, affected individuals, and family members. (Korean J Anesthesiol 2002; 43: 520~524)

염증매개물질과 Tumor Necrosis Factor-α 에 대한 침해수용성 신경축삭의 반응

이정락,박선정,임정길,Geoffrey, M. Bove 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.1

신경병증 백서에서 척수신경절 신경원의 Capsaicin에 대한 반응성 및 나트륨 전류의 변화

신광일,임정길,이정락,임태하,김종욱,황재현 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.2

Background : Allodynia, one of the most debilitating symptoms of neuropathic pain syndromes, can be defined as `pain due to a stimulus that does not normally provoke pain'. Subsets of dorsal root ganglion (DRG) neurons involved in nociception are characteristically expressed capsaicin sensitivity and high proportion of tetrodotoxin resistant sodium current (TTX-R INa). We performed an experiment to elucidate whether nerve injury induced mechanical allodynia could be resulted from elctrophysiological modulation of large, nonnociceptive afferent neurons to nociceptors. Methods : Whole cell patch clamp recordings were made from acutely dissociated dorsal root ganglion (DRG) neurons of normal and experimental neuropathic rats. We compared the proportion of capsaicin sensitive neurons which responded to capsaicin (1uM) with an inward current ≥ 100 pA in amplitude and the proportion of sodium channel subtypes measured in the absence and presence of tetrodotoxin (1 M), in small and large DRG neurons. Results : Th proportion of capsaicin sensitive cells to total number of cells tested was not changed by nerve injury in both small and large cell populations. In large cell population of nerve injured rats, the proportion of TTX-R INa was significantly increased as compared with normal group (p<0.05), and in small cell population of nerve injured rats, TTX-S INa was increased, but there was no statistical significance. Conclusions : These data indicate that expression of the sensitivity to capsaicin in DRG neurons would not be altered by nerve injury and increased TTX-R INa in large cell population of nerve injured DRG may underlie increased excitability. (Korean J Anesthesiol 1998; 35: 259∼268)

부위마취하 경동맥내막절제술에서 뇌허혈을 감지하는 뇌파와 체성감각유발전위 검사의 효율성

최윤,이동명,임정길,이정락 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.6

Background : Carotid endarterectomy has been proven to be beneficial for the prevention of strokes in both symptomatic and asymptomatic patients with significant carotid stenosis. Even if there is no consensus as to the most appropriate monitoring method for detecting cerebral ischemia during carotid endarterectomy, electroencephalography (EEG) and/or somatosensory evoked potential (SSEP) has been extensively used to evaluate cerebral functions. We estimated the efficacy of EEG and SSEP for detecting cerebral ischemia during carotid endarterectomy in conscious patients. Methods : One or both of 16-channel EEG and SSEP monitoring were performed in 103 patients scheduled for carotid endarterectomy under cervical plexus block. We estimated the sensitivity and specificity of EEG and SSEP for detecting cerebral ischemia expressed by altered consciousness and shunt insertion. Results : During carotid clamp in 74 cases studied, significant EEG changes were noted in 5 of the 16 patients who had cerebral ischemia, however 11 patients had no EEG changes despite cerebral ischemia. During carotid clamp in 84 cases studied, significant SSEP changes were noted in 7 of the 19 patients who had cerebral ischemia, however 12 patients had no SSEP changes despite cerebral ischemia. The sensitivity and specificity for detecting cerebral ischemia were 31% and 86% for EEG and 37% and 95% for SSEP, respectively. Conclusions : We conclude that EEG and SSEP monitoring during carotid endarterectmy under regional anesthesia is not a sensitive method for detecting cerebral ischemia. (Korean J Anesthesiol 1999; 37: 1074∼1083)

뇌허혈 발생전 K통로 조작이 해마의 [K+] 및 Glutamate 농도에 미치는 영향

조명원,류판동,최규택,박형섭,서병태,이정락 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.3

Background : Cerebral ischemia causes an increase in extracellular potassium ([K ]e) through activation of the KATP channel. This increase in [K ]e could result in neuronal depolarization and a reversal of the glutamate uptake system in glia. This may further contribute to the excessive concentrations of glutamate and asparate in the extracellular space during ischemia. If the early rise in [K ]e during ischemia could be attenuated, less excitotoxic neuronal damage may be the result. However, activation of KATP channels has been shown to attenuate the anoxia induced depolarization in the hippocampus and may reduce the release of excitatory neurotransmitters during cerebral ischemia. In this study, we address the question of whether KATP channel modulation affects [K ]e and whether it is related with extracellular glutamate concentrations. Methods : After approval by the Animal Care and Use Committee, 18 New Zealand white rabbits were anesthetized with halothane and mechanically ventilated to maintain normocarbia. Microdialysis catheters were inserted into the left dorsal hippocampus and perfused with artificial cerebrospinal fluid at 2 ml/min. K sensitive microelectrodes were inserted into the contralateral hippocampus. A pneumatic tourniquet was placed loosely around the neck. Animals were randomized to receive glibenclamide (n=5, KATP blocker, 3.7 mg/kg) or cromakalim (n=5, KATP opener, 0.5 mg/kg). The control group (n=6) had neither drug. Ten-minute period of global cerebral ischemia was produced by inflation of the tourniquet combined with induced hypotension. Hippocampal [K ]e was measured throughout the periischemic period and glutamate concentrations in dialysate were determined by high-performance liquid chromatography. Peak levels were compared by ANOVA. Results : Glutamate concentration significantly increased during ischemia period for all groups (p<0.05). In glibenclamide treated animals, brain glutamate concentration increased markedly during early reperfusion (t=I 15) compared to other goups (p<0.05). There were no statistical differences on ischemia-induced increases in [K ]e among the three groups. Conclusions : Although it was not possible to demonstrate an effect of modulators of the ATP sensitive K channel on [K ]e, glibenclamide increased glutamate during reperfusion. This paradoxical increase in glutamate after administration of a K channel blocker suggests that the mechanism of glutamate release is not related to [K ]e change. (Korean J Anesthesiol 1999; 36: 510∼517)