Sevoflurane이 흰쥐적출심장에서 허혈시 심근기능과 관상동맥 관류량에 미치는 영향

민두재,이윤숙,김운영,김재환,박영철,장문석 대한마취과학회 2005 Korean Journal of Anesthesiology Vol.48 No.6

Morphine Attenuates Endothelial Cell Adhesion Molecules Induced by the Supernatant of LPS-Stimulated Colon Cancer Cells

민두재,박상희,지이화,이윤숙,김태우,김재환,김운영,박영철 대한의학회 2011 Journal of Korean medical science Vol.26 No.6

A large reservoir of bacterial lipopolysaccharide (LPS) is available in the colon and this could promote colon cancer metastasis by enhancing tumor cell adhesion, intravasation,and extravasation. Furthermore, adhesion molecules like ICAM-1, VCAM-1, and E-selectin play important roles in the adhesion of tumor cells to endothelium. This study was designed to determine whether morphine can attenuate the expressions of adhesion molecules up-regulated by the supernatant of LPS-stimulated HCT 116 colon cancer cells (LPS-Sup). In this study, we divided to three groups by cell-growth medium of human umbilical vascular endothelial cells (HUVECs): the control group was incubated in growth factor-free endothelial medium, the Sup group was incubated in the supernatant of HCT 116 cells (Sup), and the LPS-Sup group was incubated in LPS-Sup. To observe effect of morphine to the adhesion molecules expressions in the LPS-Sup group, we co-treated morphine with LPS or added it to LPS-Sup. Adhesion molecule expressions on HUVECs in all three groups were measured during incubation period. Consquentially, ICAM-1,VCAM-1, and E-selectin expressions on HUVECs were significantly lower when morphine was co-treated with LPS than not co-treated. Thus, we suggest that morphine affects the expressions of adhesion molecules primarily by attenuating LPS stimuli on tumor cells.

Morphine Postconditioning Attenuates ICAM-1 Expression on Endothelial Cells

민두재,김중일,김재환,노경희,김태우,김운영,이윤숙,박영철 대한의학회 2011 Journal of Korean medical science Vol.26 No.2

The purpose of this study is to determine 1) whether morphine postconditiong (MPostC)can attenuate the intercellular adhesion molecules-1 (ICAM-1) expression after reoxygenation injury and 2) the subtype(s) of the opioid receptors (ORs) that are involved with MPostC. Human umbilical vein endothelial cells (HUVECs) were subjected to 6 hr anoxia followed by 12 hr reoxygenation. Three morphine concentrations (0.3, 3, 30 μM)were used to evaluate the protective effect of MPostC. We also investigated blockading the OR subtypes’ effects on MPostC by using three antagonists (a μ-OR antagonist naloxone, a κ-OR antagonist nor-binaltorphimine, and a δ-OR antagonist naltrindole) and the inhibitor of protein kinase C (PKC) chelerythrine. As results, the ICAM-1 expression was significantly reduced in the MPostC (3, 30 μM) groups compared to the control group at 1, 6, 9, and 12 hours reoxygenation time. As a consequence, neutrophil adhesion was also decreased after MPostC. These effects were abolished by coadministering chelerythrine, norbinaltorphimine or naltrindole, but not with naloxone. In conclusion, it is assumed that MPostC could attenuate the expression of ICAM-1 on endothelial cells during reoxygenation via the κ and δ-OR (opioid receptor)-specific pathway, and this also involves a PKC-dependent pathway.

Dexmedetomidine Preconditioning Attenuates Cisplatin-Induced Ototoxicity in Zebrafish

민두재,김운영,하영란,정인영,주인영 대한이비인후과학회 2014 Clinical and Experimental Otorhinolaryngology Vol.7 No.4

Objectives. Utilisation of high-frequency drills is known to increase noise induced hearing loss due to increasing the dam- ages of inner ear cells. This study aimed to investigate whether preconditioning by using dexmedetomidine (DEX) decreased the occurrence of ischemia in inner cells of the ear. Methods. We utilised a transgenic zebrafish line Brn3C, and the embryos were collected from breeding adult zebrafish. Five-day-old larvae were cultured at the density of 50 embryos, and the larvae were classified into 4 groups: control, cisplatin group, DEX group, and DEX+yohimbine; adrenoreceptor blocker group. The DEX group was categorised into 3 subgroups by dosage; 0.1, 1, and 10 μM. Preconditioning was performed for 150 minutes and then exposed to cisplatin for 6 hours. The experiment was performed in 7 replicates for each group and the number of hair cells in 3 parts of the neuromasts of each fish was determined. Results. Hair cell apoptosis by cisplatin was attenuated more significantly in the DEX preconditioning group than in the control group. However, the preconditioning effects were not blocked by yohimbine. Conclusion. The results of this study suggest that hearing loss caused by vibration-induced noise could be reduced by using DEX and may occur through other mechanisms rather than adreno-receptors.

Cerebral hemorrhage presenting as alteration of consciousness during the anesthesia recovery period -A case report-

민두재,김운영,이세화,이윤숙,김재환,박영철 대한마취통증의학회 2011 Anesthesia and pain medicine Vol.6 No.3

Catastrophic neurological events can occur rarely in anesthetic recovery period and they must be quickly diagnosed. We report here on a spontaneous intracerebral hemorrhage (SICH) that developed during the anesthesia recovery period in a 52-year-old man who had undergone uneventful orthopedic surgery. He had predisposing factors including 25 year history of heavy alcohol consumption and smoking. The risk of spontaneous intracerebral hemorrhage following non-cardiovascular and non-neurovascular surgery is exceedingly small during the anesthesia recovery period,especially for a patient with no history of hypertension and coagulopathy. We also describe the differential diagnosis of an altered mental status that occurs during anesthetic recovery period. (Anesth Pain Med 2011; 6: 266∼269)

비마취통증의학과 의료진을 위한 쉬운 진정요법

민두재 대한의사협회 2020 대한의사협회지 Vol.63 No.1

Currently, sedation anesthesia is increasingly used in many medical fields, from gastroscopy to medical imaging. The demand for sedation anesthesia is expected to increase gradually with increasing number of day surgeries and increased expectations from medical services. The demand for sedation anesthesia is considerably higher than the available pool of anesthesiologists; therefore, in a significant number of cases, sedation anesthesia is induced by non-anesthesiologists. However, there is no systematic provision of education or expertise for non-anesthesiologists in delivering sedation anesthesia. In cases of non-anesthesiologists inducing anesthesia, social controversy is often caused by medical accidents and substance abuse. In this review, I have briefly summarized what non-anesthesiologists should know about sedation anesthesia and have presented guidelines simplifying sedation anesthesia for nonanesthesia medical personnel.

복와위로 척추 수술을 받는 경우 stroke volume variation을 이용한 수액 요법의 적절성 평가

민두재,최윤지,이지윤,차재령,이근수,이윤숙,김운영,김재환 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.2

Background: Static parameters such as central venous pressure and pulmonary artery occlusion pressure, have limitation in evaluation of patients’ volume status. Dynamic parameters such as stroke volume variation (SVV), have been used to evaluate intraoperative hemodynamic volume status, in various operations. We examined if SVV is also effective for patients undergoing operation with prone position for fluid management. Methods: Eighteen patients that received spinal surgery under prone position November 2015 to May 2016, were enrolled. Patients were kept at an SVV value less than 14% during surgery. Changes of pre-, post-operative volume status were evaluated, using transthoracic echocardiography. Results: Mean fluid administered was 1,731.97 ± 792.38 ml. Left ventricular end-diastolic volume was 72.85 ± 13.50 ml before surgery, and 70.84 ± 15.00 ml after surgery (P value = 0.594). Right ventricular end-diastolic area was 15.56 ± 1.71 cm2 before surgery, and 13.52 ± 2.65 cm2 after surgery (P value = 0.110). Inferior vena cava diameter was 14.99 ± 1.74 mm before surgery, and 13.57 ± 2.83 mm after surgery (P value = 0.080). Conclusions: We can confirm that fluid management based on SVV is effective, even in prone position surgery. So, SVV, that can be measured by continuous arterial pressure, can be considered a guideline for effective fluid management in spinal surgery.

Effect of ketamine on intravenous patient-controlled analgesia using hydromorphone and ketorolac after the Nuss surgery in pediatric patients

민두재,김운영,정원주,최재호,이윤숙,김재환,박영철 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.2

Background: Nuss surgery is preferred in pectus excavatum repair because this procedure produces excellent cosmetic results and prevents postoperative distressed pulmonary function. However, the procedure causes severe pain due to thoracic expansion. This study was designed to investigate the analgesic effect of small doses of ketamine on an intravenous patient-controlled analgesia (IV-PCA) using hydromorphone and ketorolac for pain control after Nuss surgery. Methods: Forty-four patients undergoing elective Nuss surgery were randomly assigned to receive hydromorphone 3μg/kg/hr, ketorolac 0.05 mg/kg/hr and ondansetron 0.1 mg/kg/day (Group HO, n = 22) or hydromorphone 3 μg/kg/hr, ketorolac 0.05 mg/kg/hr, ondansetron 0.1 mg/kg/day and ketamine 0.15 mg/kg/hr (Group HK, n = 22) via an IVPCA pump after surgery. A blind observer evaluated each patient using the Modified Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) for the assessment of pain control. The total administered PCA volume, side effects and parents satisfaction with pain control were assessed at postoperative 1, 4, 8, 12, 24, and 48 hours. Results: There were no significant differences in Modified CHEOPS between the groups during postoperative 48hours. The total PCA volume in group HK was significantly lower than that in group HO (P < 0.05). The side effects in both groups did not significantly differ except for pruritus. The levels of satisfaction from the parents were not significantly different between the groups. Conclusions: A small dose of ketamine on IV-PCA reduced the total administered dose of IV-PCA with hydromorphone and ketorolac and reduced the incidence of pruritus after the Nuss procedure in pediatric patients. Background: Nuss surgery is preferred in pectus excavatum repair because this procedure produces excellent cosmetic results and prevents postoperative distressed pulmonary function. However, the procedure causes severe pain due to thoracic expansion. This study was designed to investigate the analgesic effect of small doses of ketamine on an intravenous patient-controlled analgesia (IV-PCA) using hydromorphone and ketorolac for pain control after Nuss surgery. Methods: Forty-four patients undergoing elective Nuss surgery were randomly assigned to receive hydromorphone 3μg/kg/hr, ketorolac 0.05 mg/kg/hr and ondansetron 0.1 mg/kg/day (Group HO, n = 22) or hydromorphone 3 μg/kg/hr, ketorolac 0.05 mg/kg/hr, ondansetron 0.1 mg/kg/day and ketamine 0.15 mg/kg/hr (Group HK, n = 22) via an IVPCA pump after surgery. A blind observer evaluated each patient using the Modified Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) for the assessment of pain control. The total administered PCA volume, side effects and parents satisfaction with pain control were assessed at postoperative 1, 4, 8, 12, 24, and 48 hours. Results: There were no significant differences in Modified CHEOPS between the groups during postoperative 48hours. The total PCA volume in group HK was significantly lower than that in group HO (P < 0.05). The side effects in both groups did not significantly differ except for pruritus. The levels of satisfaction from the parents were not significantly different between the groups. Conclusions: A small dose of ketamine on IV-PCA reduced the total administered dose of IV-PCA with hydromorphone and ketorolac and reduced the incidence of pruritus after the Nuss procedure in pediatric patients.

Adding preferred color to a conventional reward method improves the memory of zebrafish in the T-maze behavior model

김연화,민두재,이근수,박애란 한국통합생물학회 2017 Animal cells and systems Vol.21 No.6

Zebrafish have become a useful model for studying behavior and cognitive functions. Recent studies have shown that zebrafish have natural color preference and the ability to form associative memories with visual perception. It is well known that visual perception enhances memory recall in humans, and we suggest that a similar phenomenon occurs in zebrafish. This study proposes that adding a visual perception component to a conventional reward method would enhance memory recall in zebrafish. We found that zebrafish showed greater preference for red cellophane over yellow in the training session but could not remember the preferred place in the memory test. However, the test memory recall was greater when the zebrafish were exposed to the red cellophane with a food reward during the training session, when compared with the use of food reward only. Furthermore, the red cellophane with food reward group showed more predictable memory recall than the food reward only group. These results propose that visual perception can increase memory recall by enhancing the consolidation processes. We suggest that color-cued learning with food reward is a more discriminative method than food reward alone for examining the cognitive changes in the zebrafish.

Anesthetic management of hypertensive crisis in a three-year-old patient with undiagnosed severe renal artery stenosis -a case report-

박상희,민두재,김운영,김재환,박영철,이윤숙 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.4

Pediatric hypertensive crisis is a potentially life threatening medical emergency, usually secondary to an underlying disease. Hypertension commonly occurs during general anesthesia, and is usually promptly and appropriately treated by anesthesiologists. However in children with severe, unexplained, or refractory hypertension, it has the potential to cause morbidity and even mortality in susceptible patients. We report an anesthetic management of an unexpected hypertensive crisis that developed during general anesthesia in a three-year-old girl with undiagnosed severe left renal artery stenosis.