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김건신,송영신,朴允昌 성균관대학교 기초과학연구소 1985 論文集 Vol.36 No.2
Trace levels of inorganic and organic mercury ions in aqueous solution were concentrated on several ion exchange resins and their distribution coefficients were found by Cold Vapor Atomic Absorption (CVAA) technique. Of ion exchange resins used for experiments, moderately basic anion exchange resin (Cl^--from, Dowex-2 2×8-100) showed the best distribution coefficient, resulting in the effective concentration of mercury ions. Also, better distribution coefficients were obtained for highly crosslinked in exchange resins. As the temperature of mercury solution increased the amount of the mercury ions absorbed on the resins increased. Inorganic and organic mercury ions were selectively reduced by SnCl_2, NH_2OH·HCl and NaBH_4, respectively, and SnCl_2, NH_2OH·HCl showed a better results for inorganic mercury and NaBH_4 for organic mercury. Although the addition of NaBH_4 to solutions containing mercury ions as a reducing agent showed high absorbances, it did not obey Beer's law satisfactorily when the concentration became high. With the aid of HNO_3 and NH_4Cl sobution, sobutions containing both types of mercury could be preserved for more than a week. In solutions with inorganic and organic mercury ions, inorganic mercury ions were selectively determined by SnCl_2, NH_2OH·HCl. The organic mercury content of the solution could be determined after total mercury and inorganic mercury were analyzed separately.
뇌 동맥류 수술을 위한 Isoflurane 마취시 Sodium Nitroprusside 가 혈소판 응집기능에 미치는 영향
김건식,이희주,손창호,강화자,최영규,신광일 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.2
Background: The intravenous infusion of sodium nitroprusside is widely used as a means of producing deliberate hypotension in a variety of clinical situations. However, sodium nitroprusside reported to inhibit platelet aggregation. So we studied the effects of sodium nitroprusside on platelet function in patients undergoing intracranial aneurysm surgery with isoflurane anesthesia. Methods: Platelet rich plasma from the patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated from the samples collected at pre-sodium nitroprusside infusion, 30min and 90min after sodium nitroprusside infusion, respectively. At the same time, bleeding time was measured. Results: The mean maximum aggregation rate of adenosine diphosphate, epinephrine and collagen at pre-sodium nitroprusside infusion decreased significantly 30min and 90min after sodium nitroprusside infusion, respectively(P$lt;0.05). But the maximum aggregation time showed no significant change. Prolongation of bleeding time was not observed after sodium nitroprusside infusion. Correlation between the total sodium nitroprusside dose delivered and the maximum aggregation rate of adenosine diphosphate, epinephrine and collagen were significant (r=0.797(P$lt;0.05), r=0.732(P$lt;0.05) and r 0.737(P$lt;0.05)). Conclusions: In situation where sodium nitroprusside is administered for deliberate hypotensive anesthesia during intracranial aneurysm operation, the platelet aggregation was inhibited by sodium nitroprusside. However, bleeding time was not prolonged.
Clinidine 과 lidocaine 전투여가 마취유도시 사용한 ketamine 의 심혈관 반응에 미치는 효과
김건식,강화자,최영규,권무일,신광일,이현화 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.5
Ketamine may increase blood pressure and heart rate and should be avoided in hypertensive patients. However, in hypovolemic and asthmatic patients, ketamine is used as an induction agent because of its cardiovascular stimulating effect and bronchodilating effect. This study aims to assess the effects of clonidine and lidocaine on the cardiovascular response of intravenous ketamine administration during induction of anesthesia. sixty patients were divided into 3 groups as followed: group I: control (received no lidocaine or no clonidine) group II: received lidocaine (1.5 mg/kg IV) 3 minutes before intubation group IIl: received clonidine (0.3 mg PO) 90 minutes before induction of anesthesia The changes of blood pressure, heart rate and rate pressure product following intubation were measured at different time interval (before induction,before intubation just after intubation, postintubation 1, 3, 5, 10 min) and compared with the value of control (2 hours before induction of anesthesia). The results are as follows 1) Group I and Group II: The systolic and diastolic blood pressure increased significantly compared to the control value from preinduction to 5 minutes after intubation(p$lt;0.05). It recovered to the control value in 10 minutes, but heart rate and rate-pressure product increased significantly for 10 minutes after intubation(p$lt;0.05) 2) Group III: The systolic and diastolic blood pressure, heart rate and rate-pressure product of preinduction and preintubation values decreased significantly compared to control values but 1 minute after intubation,all values increased significantly(p$lt;0.05). The systolic and diastolic blood pressure and rate-pressure product values recovered to control value in 3 minutes after intubation and heart rate recovered in 5 minutes. Comparing group III with group I and II, it showed significant changes(p$lt;0.05). From the above results, it can be concluded that clonidine inhibits cardiovascular stimulating response by ketamine during induction of anesthesia. the above results, it can be concluded that clonidine inhibits cardiovascular stimulating response by ketamine during induction of anesthesia.
Lidocaine, Verapamil 및 Lidocaine-Verapamil 혼합 사용이 기관내 튜브 발관시 혈압과 심박수에 미치는 영향
김건식,이봉재,신옥영,강화자,이병익,신광일 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.2
Background : Tracheal extubation, as well as intubation, causes hypertension and tachycardia. The aim of this study was to compare the effect of verapamil, lidocaine to lidocaine-verapamil combination in attenuating the cardiovascular changes following tracheal extubation and emergence from anesthesia. Methods : Eighty patients (ASA physical status 1) were randomly assigned to one of four groups (n=20 each) ; saline (control), 1 mg/kg lidocaine, 0.05 mg/kg verapamil and lidocaine-verapamil combination. These medication were given intravenously 2 min before tracheal extubation. Changes in blood pressure and heart rate were measured following tracheal extubation. Results : Lidocaine, verapamil and their combination all attenuated the changes of heart rate and blood pressure. The inhibitory effect on changes of heart rate and blood pressure were miximum in group of the combination of lidocaine and verapamil. Conclusion : We conclude that the verapamil 0.05 mg/kg and lidocaine 1 mg/kg given iv concomitantly 2 min before tracheal extubation is a more effective prophylaxis than verapamil or lidocaine for attenuating the cardiovascular changes associated with tracheal extubation. (Korean J Anesthesiol 1999; 36: 250∼255)
척추마취하 경요도 전립선 절제술시 사용한 10 % Pentastarch 에 의한 혈역학적반응의 변화
김건식,강화자,이두익,신광일,윤현경 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.4
Background: Isotonic crystalloid solutions have been intravascularly administered before spinal anesthesia for prevention of spinal anesthesia induced hypotension in TURP, hawever many investigators have suggested that synthetic colloids administered before spinal anesthesia is more effective than equal volume of crystalloid solutions. In this study, effect of 10% pentastarch comparing with eqaul volume of crystalloid solution before spinal anesthesia on cardiovascular response were examined. Methods: 30 patients undergoing elective TURP were randomly allocated to receive either 7 ml/kg of isotonic saline (saline group) or 7 ml/kg of 10% pentastarch (pentastarch group) for 15 minutes before spinal anesthesia. Blood pressure, heart rate and central venous pressure (CVP) were measured before and after operation. Results: In pentarstarch group, systolic blood pressure and CVP were significantly higher than saline group untill 55minutes and 15 minutes after spinal anesthesia respectively. Conclusions: 10% pentarstarch administered before spinal anesthesia is more effective than equal volume of isotonic saline in TURP with respect to preserving blood pressure and CVP.
젊은 환자와 노인 환자에 있어서 Vecuronium과 Atracurium의 Priming에 대한 연구
김건식,유재욱,최영규,신광일 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.36 No.4
Background : Succinylcholine is the muscle relaxant of choice for rapid endotracheal intubation, but may produce many side effects such as hyperkalemia, myalgia, increase intraocular pressure. Nondepolarizing muscle relaxants were used instead of succinylcholine, still late onset time was be dangerous. For this reason, priming principle was reported and applied to rapid intubation using nondepolarizing muscle relaxation. We studied the effect of priming with vecuronium and atracurium on elderly and young patients. Methods : We were randomly assigned 40 patients and observed the effects of priming doses of vecuronium (0.01 mg/kg) and atracurium (0.05 mg/kg). Ten young (20∼35 yrs) and ten elderly (65∼75 yrs) patients were each placed in vecuronium and atracurium group. Arterial blood gas analysis and train of four (TOF) were determined before priming. All tests were performed again 4 min after vecuronium and 3 min after atracurium. We asked for symptoms and signs of muscle weakness. Results : In arteriablood gas analysis and TOF ratio were decreased in both groups. There is no significant difference between two groups in all tests. PaO2 and TOF ratio were reduced more in elderly patients, significantly (P<0.05). Symptoms and signs of muscle weakness such as ptosis, dizziness, diplopia, swallowing difficulty and respiratory difficulty in elderly patients were more frequent than in young patients. Conclusions : Priming doses of vecuronium and atracurium produced greater decrease in muscle strength, PaO2 and TOF ratio in the elderly than in their younger counterparts. So using priming method in elderly patients, we need adequate pre-oxygenation and thorough monitoring before endotracheal intubation. (Korean J Anesthesiol 1999; 36: 599∼605)