읍내리 주민의 기생충 및 병원성 장내세균 감염에 대한 분포조사

송후빈,강명식,박재성,윤승렬,최병록,최태윤 全北大學校 學徒護國團 1981 全國大學生學術硏究發表論文集 Vol.6 No.-

This survey was carried out to get hold of the distribution of parasitic and pathogenic enterobacteria infectivity of the general population in Ubne-ri Chung cheong Nam Do, Korea. 1. The total number of 430 specimens (male: 201 , female: 229) were collected from July 27 to August 21. 2. The isolation of parasites from the stool were performed by means of formalin-ether sedmentation method. 3. The resutls were summerized as follow: a. The infection rate parasites was 32.28 percent (156 out of 430) in total. b. By sex. the infection rate of parasites in female was somewhat higher than that in male. c. Male was 32.34 percent (65 out of 201) and Female 39.74 percent (91 out of 229). d. The most frequently infected one was Trichuris trichiura (16.78 percent), Endolimax nana was next (6.28 percent), Trichostrongylus orientalis and Entamoeba histolytica was the least often (0.47 percent). e. The positive rate was 22.27 percent as the result of intradermal reaction test of clonorchis sinensis that papule size is over 60mm^2. f. Three salmonella strain were isolated from stool specimens, it serotype was identified as group C (2 strains) and B (1 strain).

全脊髓 및 硬膜外遮斷으로 鞭打性 損傷의 痛症治驗 : 4例 報告 Report of Four Cases

朴澳,玉時英,宋厚彬 순천향대학교 1986 논문집 Vol.9 No.1

For the relief of pain in 3 cases of whiplash syndromes (case Ⅰ, Ⅱ and Ⅳ) and in one of reflex sympathetic dystrophy (case Ⅲ), we have carried out six intentional total spinal blocks (TSB) which attempted two times in case Ⅰ, three in case Ⅱ and one in case Ⅲ whose various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case Ⅳ whose acute symptom lasted 4 days following the cervical injury (see tables from 1 to 9). During the TSB, we have observed clinically the sequential changes of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient´s subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8∼10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2 % mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of C7-T1 interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient´s were hasten to change Trendelenburg´s position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No.18G Tuohy needle into the epidural space on the same region and posture as the above without premedication. The suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupil was equal between 5 to 20 minutes, but the pupil of the dependant side on the lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had never responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent. Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the dependent. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 torr at the 2nd block of case 1. There were bradycardias between 65 to 85 minutes in case Ⅰ and Ⅱ but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43∼45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case Ⅳ,and light(10∼20%) in case Ⅰ and Ⅱ but no improvement in case Ⅲ. 5. The right arm weakness has been complicated as to be injected accidently the "COLD" local anesthetic at the 2nd block of case Ⅰ.

Norepinephrine에 의한 신혈관 수축에 신관류압이 미치는 영향

송후빈,양훈모 순천향대학교 1994 논문집 Vol.17 No.2

The purpose of this study was to determine whether the sensitivity of the renal vasculautre to norepinephrine depends on the renal perfusion pressure. In pentobarbital-anesthetized dogs with suprarenal aortic occluder and electromagnetic flow probes around the renal artery, renal blood flow (RBF), renal arterial pressure (RAP), and mean arterial pressure (MAP) were measured 1) during control condition in which RAP was allowed to change during norepinephrine (NE) infusion, 2) when RAP was maintained constant at NE-preinfusion levels, and 3) when RAP was maintained at levels where autoregulation of RBF no longer occurs. During control condition, NE (0.3㎍/kg/min) increased MAP from 119±3 to 123±4 mmHg and renal resistance (RR) from 0.569±0.048 to 0.593±0.056 mmHg.min/ml. There was no significant change in RBF. The maintenance of RAP at preinfusion level prevented RR from increasing during NE infusion. However, when RPP was reduced to and maintained at RAP below which autoregulation no longer occurs (70±2ml), NE infusion decreased RBF and increased RR. These data indicate that the local autoregulation of the kidney affects vascular resistance during NE-induced hypertension, and that the enhanced sensitivity of renal vasculature to NE at RAP below the autoregulatory limit is likely to be due to the lack of tubuloglomerular feedback-mediated vasodilation at the low pressure levels.

근이완제 Vecuronium 이 안압에 미치는 영향

김일호,황경호,송후빈,김성렬,김용익 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.2

Thirty healthy patients were studied to evaluate the effect of muscle relaxants on intra-ocular pressure (IOP) during anesthesia. The patients were divided intro three groups-succinrlcholine group(Img/kg,n=10) , pancu-ronium group(0.08mg/kg,n=10), and vecuronium group(0, Img/kg,n=10) according to the muscle relaxants used. All patients were premedicated with robinul 0.2mg and lorazepam 4mg one hour before surgery. Tracheal intubation was fellowed by thiopental sodium 5mg/ kg and muscle relaxant. Anesthesia was maintained with O2-N2O-enflurane and respiration and was controlled by anesthetic ventilator (Dameca). The 1OP was measured hy Schotz tonometer, before induction of anesthesia, at 75∼100% depression of twitch height on train-of-four after injection of muscle relaxant, and at 1,3, 5, 10, minutes after intubation respectively. Heart rate, mean arterial pressure, and end-tidal CO_2 tensions were also measured simultaneously. The results were as follows ; 1) At 75∼100% depression of twitch height, 1OP w elevated significantly in succinylc-holine group but reduced significantly in both pancuronium and vecuronium groups as Compared With pre-induction value. 2) 1OP was elevated in all groups after 1 minute of intubation, there were no statistical significance in pancuronium or vecuronium group as compared with pre·induction value. After 3 minutes of intubation, 1OP was reduced in all groups in proportion to the depth of anesthesia. 3) Cardiovascular changes in vecuronium group were less than those in succinrlcholine or pancuronium group. In conclusion vecuronium, with less cardiovascular changes, may be indicated for anest-hesia of open eye injury compare other muscle relaxants.

전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告))

박오,옥시영,송후빈,Park, Wook,Ok, See-Young,Song, Hoo-Bin 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.1

For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

전척수 및 경막외차단으로 편달성 손상의 통증치험

박 욱,옥시영,송후빈 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.1

For the relief of psin in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. Total spinal blocks (TSB) which attempted two times in case I, three in case II and one in case III whose various symptoma were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case I whose acute symptom lasted 4 days following the cervical injury (see tables from 1 to 9). During the TSB, we have observed clinically the sequential changes of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patients subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8-10 hours, the preparations of immediate cardiopulmonary resu- scitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of Cv-Ti interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patienth were hasten to change Trendelenburgh position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervieal epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epiduralspace on the same region and posture as the above without premedication, The suprascapular nerve block was done by injecting of 0. 5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on the lateral pcsition was dilated 1 to 3 minutes earlier than that of the independent. The patients had never responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent. Secondly the neck and upper limb moved 6 to 15 rninutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the dependent. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/l30 torr at the 2nd block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43-45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvemeat in case III. 5. The right arm weakness has been complicated as to be injected accidently the $quot;COLD$quot; local anesthetic at the 2nd block of caseⅠ.

삼차 신경절 액조내 글리세롤 주입에 의한 삼차신경통 치험(12예 보고)

박욱,황경화,김용익,김일호,송후빈,김성열,Park, Wook,Hwang, Kyung-Ho,Kim, Yong-Ik,Kim, Il-Ho,Song, Hoo-Bin,Kim, Sung-Yell 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.2

In 1983, Sten H$\ddot{a}$kanson first reported the clinical safety and efficacy of retrogasserian glycerol injection as a treatment of typical trigeminal neuralgia in 96 of 100 patients during a follow-up period of 1~6 years. Since September 1987, we have injected sterile pure glycerol into the trigeminal cistern using an anterior percutaneous approach via the foramen ovale (H$\ddot{a}$rtel route) for treatment of tic douloureux in 12 patients who were suffering from attacks pain of following discontinuation of carbamazepine. The results were as follows; 1) Eight patients were completely free from pain attacks with a single dose of glycerol (0.4 ml). The remaining four patients needed a second dose (0.4 ml) several days later following the single dose. The degree of patient's subjective satisfaction by those injections was very good in 11 and fair in one. 2) During the follow-up period (1~13 months), persistent sensory deficit as determined by the pin prick test, appeared to be mild in 10 and moderate in one patient. There was no sensory deficit in one patient. further attacks of pain from those injections were still noted. 3) As a transient complication, there was headache in all patient, facial hematoma in 4, nausea and vomiting in two each, and vertigo and herpes simplex in one each. In conclusion, we confirmed that the above glycerol injections into the trigeminal cistern were clinically very effective as a treatment of tic douloureux even though the follow-up period was short.

민간보험 도입 후 개원의사들이 느끼는 진료환경의 변화

이성원,신건희,최은영,박일환,송후빈,정유석 한국의료윤리학회 2015 한국의료윤리학회지 Vol.18 No.1

After the introduction of private insurance, there have been significant changes in clinical practice patterns. In October 2014, 87 private practitioners from the Chungcheong province participated in our survey (18 on-line, 69 off-line). The survey focused on the positive and/or negative effects of private insurance on clinical environment. The results of our survey show that almost half (47.1%) of private practitioners replied that although private insurance doesn't seem to benefit patients’ health, the majority (90.9%) feel private insurance puts added pressure to their practice. The 79.2% replied that the effect of private insurance on the doctor-patient relationship is negative compared with only 4.6% saying it had a positive effect. The 58.6% replied that private insurance had little or no impact on hospital management and 72.4% replied that private insurance negatively affected objective and conscientious decision making. Overall, 50.6% of our participants replied that the private insurance system was flawed with negative side effects, while 49.4% replied that despite its flaws the private insurance system was bearable. No participants felt the private insurance system was positive and benefited the national insurance system. The 48.2% of participants voiced the need for a governing network between health services, private insurance companies, patients and the government. 민간의료보험의 도입 이후 의사들의 진료패턴의 변화가 불가피해졌다. 연구자들은 2014년 10월 충청지역 개원의사들 87명(온라인 18명, 오프라인 69명)을 대상으로 민간의료보험의 진료부담, 장단점에 대한 설문을 실시하였다. 연구 결과, 임상의사들은 민간의료보험 관련한 진료에 대해서 환자들의 건강에는 그다지 긍정적이지 않은 반면(47.1%), 일정 부분 이상 진료에 부담감을 느끼고 있었다(90.9%). 민간의료보험의 활성화가 의사-환자 관계에 미치는 영향 역시 부정적(79.2%)이라는 응답이 긍정적(4.6%)이라는 응답보다 훨씬 높았다. 병의원의 경영에는 별 도움이 되지 않는다는 응답이 많았으며(58.6%), 진료의 객관적이고 양심적인 판단에도 72.4%가 부정적 영향을 준다고 하였다. 민간의료보험에 대한 전반적 평가 항목에서는 부작용이 큰 제도라는 견해(50.6%)와 부작용이 있지만 감내할 만하다(49.4%)라는 견해가 비슷한 비율로 나온 반면, 국민건강에 기여하는 좋은 제도라는 항목에는 동의하는 응답자가 없었다. 해결책으로는 ‘민간의료보험의 부정적 기능을 보완하기 위한 의료ㆍ보험회사ㆍ정부ㆍ환자 간 협의체가 필요하다’는 견해가 많았다(48.2%).

Melkersson-Rosenthal Syndrome

김태정,이성근,김일호,황경호,김선종,박 욱,송후빈,김성열 대한통증학회 1989 The Korean Journal of Pain Vol.2 No.1

The Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternately on both sides of face, (2) non-inflammatory facial edema, and (3) fissuring of tongue. A 59 years old female patient developed the left facial palsy on September, 1988. Right facial palsy developed continuously 2 months later after the spontaneous remission of left facial palsy. On February, 1989, we have found out M-R syndrome which accompanied with migraine type of intermittent headache, and hypertension in one attack of cerebral stroke several years ago, there were no diabetes mellitus, pulmonary tuberculosis and brain tumor in clinical studies. Although the causes of this syndrome were not noted, we performed the stellate ganglion block and transcutaneous electrical nerve stimulation for treatment of the palsy, but the clinical effectiveness of these were not satisfactory.

삼차 신경절 액조내 글리세를 주입에 의한 삼차신경통 치험 : 12예 보고

김용익,김일호,황경호,박 욱,송후빈,김성열 대한통증학회 1988 The Korean Journal of Pain Vol.1 No.2

In 1983, Sten Hakanson^(4)) first reported the clinical safety and efficacy of retrogasserian glycerol injection as a treatment of typical trigeminal neuralgia in 96 of l00 patients during a follow-up period of 1-6 years. Since September 1987, we have injected sterile pure glycerol into the trigeminal cistern using an anterior percutaneous approach via the foramen ovale (Harte! Route^(5))) for treatment of tic douloureux in 12 patients who were suffering from attacks pain of following discontinuation of carbamazepine. The results were as follows; 1) Eight patients were completely free from pain attacks with a single dose of glycerol (0.4 ml). The remaining four patients needed a second dose (0.4 ml) several days later following the single dose. The degree of patient's subjective satisfaction by those injections was very good in 11 and fair in one. 2) During the follow-up period (1-13 months), persistent sensory deficit as determined by the pin prick test, appeared to be mild in 10 and moderate in one patient. There was no sensory deficit in one patient. further attacks of pain from those injections were still noted. 3) As a transient complication, there was headache in all patient, facial hematoma in 4, nausea and vomiting in two each, and vertigo and herpes simplex in one each. In conclusion, we confirmed that the above glycerol injections into the trigeminal cistern were clinically very effective as a treatment of tic douloureux even though the follow-up period was short.