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배선준,구본녀,김종훈,Philip S. Doh,김기환,신양식 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.5
In recent years epidural anesthesia and analgesia techniques were used in pediatric surgery owing to the development of pediatric epidural catheter needles. And the need of postoperative pain control in pediatric patients is also increasing. We compared combined general-epidural anesthesia and analgesia technique with intravenous fentanyl analgesia after general anesthesia for postoperative analgesic effect and complications in these pediatric patients. We randomly allocated 91 pediatric patients undergoing lower extremities surgery into epidural lidocaine group (n=61) and IV fentanyl group (n=30). During the operation, end-tidal sevoflurane concentration (ETsev) was controlled to maintain the blood pressure and heart rate within 10% of preoperative value. At the postoperative period, Parent Visual Analog Scale (PVAS), Objective Pain Score (OPS) and the incidence of nausea/ vomiting were checked immediately, 6 hours and 24 hours after the patient's arrival at general ward. ETsev was significantly low in epidural lidocaine group (p<0.05). Compare to IV fentanyl group, epidural lidocaine group had significantly lower OPSs at 6 hours after arrival. Epidural lidocaine group had significantly lower PVASs immediately, 6 hrs and 24 hours after arrival. There was no significant difference in the incidence of postoperative nausea and vomiting. A combined general-epidural anesthesia technique significantly reduces intraoperative end-tidal sevoflurane concentration compared to general anesthesia alone. And continuous patient-controlled epidural analgesia reduces postoperative pain scores significantly more than continuous patient-controlled IV fentanyl analgesia without any serious complications in pediatric lower extremity surgery.
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배선준,조장희,이배환 대한의사협회 2009 대한의사협회지 Vol.52 No.2
The study of pain has recently received much attention, especially in understanding its neurophysiology by using new brain imaging techniques, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), both of which allow us to visualize brain function in vivo. Also the new brain imaging devices allow us to evaluate the patients pain status and plan to treat patients objectively. Functional activation of brain regions are thought to be reflected by increases in the regional cerebral blood flow in the brain imaging studies. Regional cerebral blood flow increases to noxious stimuli are observed in second somatic (SII) and insular regions and in the anterior cingulate cortex and with slightly less consistency in the first somatic area (S1), motor area, supplementary motor area, prefrontal area, amygdala and contralateral thalamus. These data suggest that pain has multidimensions such as sensory-discrimitive, motivational-affective and cognitive-evaluative.
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배선준,이종화,이기영 대한의사협회 2010 대한의사협회지 Vol.53 No.12
Fluid and electrolyte therapies including nutritional support are markedly developing in medicine and many kinds of commercial fluids are being introduced to clinical practice. Understanding the characteristics and usefulness of intravenous fluids is necessary to manage patients properly. Disputes about the usefulness of crystalloid or colloid solutions for specific clinical conditions still continue. To make ideal fluid therapy possible, many kinds of fluids will be developed and applied to clinical practice in the near future by mimicking the composition and functions of human body fluids. The selection of crystalloid and colloid solutions for fluid therapy should be performed by considering patients’clinical and pathophysiological conditions and the characteristics and usefulness of each intravenous fluid.
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배선준,이기영 대한의사협회 2011 대한의사협회지 Vol.54 No.7
Hospital personnel are subject to various occupational hazards. Along with the development of modern medicine, novel and diverse medical appliances have been introduced to enhance the safety of the hospital environment. But paradoxically, some advancement of the appliances have led to exposure to greater risk for the personnel in the operation room. In the past, the greatest risk factor in the operation room was outbreak of fire and explosion, but the risk of explosion has vanished by the development of nonexplosive anesthetics. However, newly introduced electrical appliances and unknown infectious diseases appear to be new risk factors affecting health workers in the operation room. The goal of this review is to investigate the current risk factors and thereby prepare suitable preventive methods. We have reviewed the main occupational hazards affecting health workers in the operation room: accidents such as fires,explosions, electrical accidents; exposure to residual anesthetic gas; radiation; various infections;drug dependencies.
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최적재난대피로 안내를 위한 실시간 대피 시뮬레이션 시스템 개발
배선준(Seon-Joon Bae),이주식(Ju-Sik Lee) 한국화재소방학회 2022 한국화재소방학회 학술대회 논문집 Vol.2022 No.추계
화재 발생에 따른 인명피해에 안전관리에 대한 사회적 관심이 높아지고 있고 사전 예방을 위해 다양한 교육을 실시하고 있으며, 시설에 대한 사전점검 또한 다양한 과학 기술의 적용으로 지속적으로 발전하고 있다. 본 논문에서는 화재 발생시 분진(연기)확산과 화재 열(온도) 전도에 따른 화재 확산 모델을 구현 한 후 3D 도면 기반에 인간 특성이 반영된 재난 대피 시뮬레이션 알고리즘과 최적 퇴거로 알고리즘을 적용하여 재난(화재) 발생시 최적의 퇴거로를 실시간으로 산출 또는 화재 발생에 따른 대피소요 시간을 사전에 제시 할 수 있도록 구현한 내용을 다룬다. 화재(재난) 발생시 건물내 재실자 수 정보를 파악하여 외부에 알리거나 또는 화재(재난) 발싱구역에 따른 최적의 퇴거로를 건물내 재실자들에 실시간으로 정보를 전달하여 안전을 보장하기 위해 해당 관리시스템을 개발 하였다. 본 시스템은 화재 유형에 따라 최적경로 산출 알고리즘과 안전도를 우선순위로 하여 안전성이 보장된 최적의 퇴거로를 상황에 맞게 제공하여 안전한 퇴거로를 실시가능로 제시하는 맞춤형 재난 퇴거 시뮬레이션 시스템이다. 대피 시뮬레이션은 군중 밀도와 같은 재난 상황에서의 인간특성이 반영되었고 국제적 시뮬레이션 기준을 사전에 모두 수행하여 기준을 만족함을 검증하였다(IMO Test, SFPE Example Problem, SAFEGUARD Validation Data Set, Capacity Estimation, Merging Behavior, NIST Test). 3D 뷰어 기능을 탑재하여 건물의 구조를 시각적으로 확인하고 층, 계단, 벽과 같은 건물 구조별 속성을 부여하여 Navigation Mesh 생성을 가능하게 하였다. 뷰어 및 대피 시뮬레이션 수행 시 건물의 내부 및 외부 구조화 대피 양상 인지를 돕기 위해 층별 Alpha 값을 부여하는 기능을 탑재 하였다. 화재 및 재난에 따른 인명 피해를 최소화 하고 화재 발생 즉시 안전한 대피로 제공 및 인원의 재실 유무를 외부에 알려 구조에 조금이라도 도움이 되고자 한다.
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실험연구 : 흡입마취제인 Desflurane의 심실근세포에서의 활동전위 연장 효과에 대한 전기생리학적인 연구
배선준 ( Sun Jun Bae ),김명희 ( Myung Hee Kim ),채지은 ( Jee Eun Chae ),김종훈 ( Chong Hoon Kim ),민경태 ( Kyung Tae Min ),이민정 ( Min Jung Lee ),박윤곤 ( Wyun Kon Park ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5
Background: Desflurane has been reported to prolong the QTc. Several ionic currents that contribute to the prolongation of the action potential (AP) duration were investigated using guinea pig (GP) and rat ventricular myocytes. Methods: The normal APs were measured in isolated GP papillary muscles at 37℃. Ventricular myocytes were obtained from GP and rat hearts. Both the delayed outward K+ current (IK) and the inward rectifier K+ current (IKI) were assessed using a voltage ramp protocol. A more detailed study on the IK was performed. The ICa, L was measured. In the rat ventricular myocytes, the transient outward K+ current (Ito) was obtained. All the patch clamp experiments were carried out at room temperature. The values are presented as mean ± SD. Results: 0.91 mM desflurane significantly prolonged the APD in the GP ventricular myocytes. Using a linear voltage ramp protocol, the IKI at -130 mV and the peak outward IKI at -60 to -50 mV were not found to be significantly reduced by 0.78 and 1.23 mM desflurane, respectively. However, the peak outward IK at +60 mV was significantly reduced to 63 ± 19% and 58 ± 12% of the baseline by 0.78 and 1.23 mM desflurane, respectively. At a membrane potential of +60 mV, 0.78 and 1.23 mM desflurane reduced the Ito to 80 ± 8% and 68 ± 7%, respectively. A concentration-dependent reduction in the ICa, L was observed. Conclusions: The prolongation of the APD induced by clinically relevant concentrations of desflurane in GP and rat ventricular myocytes is most likely the result of IK and Ito suppression. (Korean J Anesthesiol 2006; 50: 557~66)
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