Use of methylene blue in vasoplegic syndrome that developed during non-cardiac surgery - A case report -

오인덕,신은실,전종미,우현호,최정현 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.4

Background: Vasoplegic syndrome is an increasingly recognized disease in perioperative medicine and is characterized by severe hypotension, normal or elevated cardiac output, and decreased systemic vascular resistance. It occurs commonly after cardiopulmonary bypass but may also occur after other types of surgery. Case: Vasoplegic syndrome developed in our patient during posterior lumbar interbody fusion because of administering nicardipine after phenylephrine. However, the blood pressure did not increase as expected despite simultaneous use of norepinephrine and vasopressin to increase the reduced systemic vascular resistance. Conclusions: We present a case of vasoplegic syndrome that developed during posterior lumbar interbody fusion and was treated successfully with methylene blue.

항콜린제를 복용중이던 환자에서 전신마취 후 발생한 중추성 항콜린성 증후군

오인덕 ( In-duk Oh ),김영순 ( Youngsoon Kim ),김건식 ( Keon-sik Kim ) 경희대학교 경희의료원 2017 慶熙醫學 Vol.32 No.1

Acetylcholine serves as a continuous mediator between several neurotransmitters in the central nervous system. Central anticholinergic syndrome is defined as an absolute or relative reduction in cholinergic activity in the central nervous system. Many drugs used in anesthesia are associated with blockade of central cholinergic neurotransmission. As there is no diagnostic test, the diagnosis is made by exclusion of hypoxia, hypercapnia, hyperthermia, hypothermia, urea and electrolyte and acid-base disturbances, endocrine abnormalities, and neurological disturbance from surgery, vascular disease or trauma. We report a case of central anticholinergic syndrome after general anesthesia in patient taking anticholinergic agent.

GOLDEN 성격유형검사의 한국 타당화 연구

오인수,성태제,송해덕,김랑,이보람,손지향 부산대학교 교육발전연구소 2022 교육혁신연구 Vol.32 No.4

연구목적: 본 연구의 목적은 Carl Jung의 성격유형론과 성격 5요인 모델을 통합한 Golden 검사(Golden Personality Type Profiler)를 15세 이상의 청소년 및 성인이 사용할 수 있도록 한국판으로 타당화하는 것이다. 연구방법: Golden 성격유형검사를 한국 실정에 맞게 번안하였고, 전국의 20대부터 60대까지 총 1,450명의 성인을 연구참여자로 선정하였다. 이후 Golden 검사의 요인구조를 확인하고, 신뢰도와 타당도를 검증하였다. 연구결과: 탐색적 요인분석을 통해 Golden 성격유형검사의 요인구조를 확인한 결과 5요인 구조가 가장 적절한 것으로 나타났다. 다음으로 확인적 요인분석을 실시한 결과 세부척도(Facet Scales)의 표준화 요인부하량이 대부분 적합하게 나타나 대응되는 포괄척도(Global Scales)의 하부요인으로 적합한 것으로 확인되었다. 또한 신뢰도와 타당도를 확인하기 위하여 내용타당도, 구인타당도, MBTI성격유형검사와의 공인타당도를 검증하였고 적절한 신뢰도 계수를 얻음으로써 Golden 검사의 신뢰도를 검증하였다. 논의 및 결론: 본 연구의 결과를 통해 성격검사에서 가장 신뢰를 받고 있는 성격 5요인(Big 5 Model)을 유지하면서 동시에 유형론이 가지는 유용성을 지닌 검사가 한국에서도 타당화 되었다는 점에서 의의를 지닌다. 특히 Jung의 성격유형론에 기반을 둔 기존의 성격유형검사에는 포함되지 않은 긴장(Tense)과 차분(calm) 척도와 36개의 세부척도를 활용한다면 실제 상담과 교육 현장에서의 유용한 도구가 될 수 있을 것이다.

Extracorporeal membrane oxygenation for takotsubo cardiomyopathy that developed after mitral valve replacement

최종현,오인덕,신은실,이상호,전종미,김형탁,윤효철 대한중환자의학회 2020 Acute and Critical Care Vol.35 No.1

Takotsubo cardiomyopathy is a transient systolic and diastolic left ventricular dysfunction that presents several wall-motion abnormalities, while the coronary artery shows normal findings. Because patients with Takotsubo cardiomyopathy present with symptoms similar to acute coronary syndrome, the initial diagnosis and treatment are often difficult. The condition is often precipitated by acute emotional or physical stress and frequently occurs in postmenopausal women. Takotsubo cardiomyopathy may also occur in the perioperative period after cardiac and noncardiac surgery; surgery-associated Takotsubo cardiomyopathy reportedly accounts for 3%–23% of all cases. Of these perioperative cases, cardiothoracic surgery accounted for 16%. However, few cases have been reported in patients undergoing cardiac surgery and managed with extracorporeal membrane oxygenation (ECMO). We report a case of Takotsubo cardiomyopathy managed with ECMO in a patient in the intensive care unit after mitral valve replacement.

경옥고의 생리활성(III) -염증, 위궤양, 진통 및 정상체온에 미치는 영향-

황완균,오인세,김용빈,신상덕,김일혁,Whang, Wan-Kyunn,Oh, In-Se,Kim, Yong-Bin,Shin, Sang-Duk,Kim, Il-Hyuk 한국생약학회 1994 생약학회지 Vol.25 No.2

The studies were conducted to investigate the inflammation, gastric ulcer, analgesic and homothrmic of experimental animals by KYUNG OK-KO water extract and drink, which is a traditional preparation in Korea. 1. It was exhibited significantly anti-inflammatory effects to acute inflammation on carragennan edema, and preventive and therapeutic effects to chronic inflammation on Freund's complete adjuvant in rats(100, 200, 400 mg/kg). Especially, preventive effect of KYUNG OK-KO water extracts at doses of 100, 200, 400 mg/kg in rats were showed dose-dependantly. 2. Aspirin-induced gastric ulcer were remarkably repaired by all experimental groups of KYUNG OK-KO water extracts. 3. The number of writing syndromes by acetic acid induced also were decreased which MPI's test was increased by tail flick apparatus in mice remarkably, all doses of water extracts(100, 200, 400 mg/kg) and dose-dependantly. 4. Aminopyrine-induced homothermic effects of KYUNG OK-KO water extract(100, 200, 400mg/kg) and drink (0.7, 1.4, 2.1 ml/kg) were significantly evaluated dose-dependantly in 400 mg/kg, 2.1 ml/kg groups.

Blunting effect of dexmedetomidine on transient cardiovascular changes induced by inhalation of desflurane: a randomized controlled trial

장명수,한진희,박성준,오인덕,안상은,최정현 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.2

Background: A rapid increase in desflurane concentration has been demonstrated to induce transient sympathetic hyperactivity and lead to increases in blood pressure and heart rate (HR). Additionally, the use of dexmedetomidine as an anesthetic adjunct has been reported to attenuate intraoperative sympathetic responses. We examined the hemodynamic effects of dexmedetomidine infusion before anesthetic induction on desflurane-induced cardiovascular changes. Methods: Patients were randomly divided into three groups. They received either normal saline (NS) (group 1, only NS) or dexmedetomidine solution diluted in 50 ml NS (group 2, 0.5 mg/kg; group 3, 1.0 mg/kg) for 10 minutes with a syringe pump before anesthetic induction. Desflurane was administered at a vaporizer dial setting of 8% for 5 minutes by manual ventilation. Results: In group 1, the HR significantly increased above the baseline during the entire 5 minutes after desflurane inhalation and the mean blood pressure (MBP) significantly increased above the baseline at 1, 2, and 3 minutes after desflurane inhalation. However, in groups 2 and 3, the increases in HR and MBP induced by desflurane inhalation were significantly suppressed. The HR and MBP in group 2 remained closer to the baseline than in group 3. Conclusions: A loading infusion of dexmedetomidine for 10 minutes before induction of general anesthesia effectively attenuates the transient cardiovascular stimulation induced by desflurane inhalation, without significant hemodynamic side effects. The HR and MBP remained closer to the baseline after administration of 0.5 mg/kg dexmedetomidine than after administration of a dose of 1.0 mg/kg.

Sugammadex use can decrease the incidence of post-operative urinary retention by avoiding anticholinergics: a retrospective study

차정은,박성욱,최영인,오인덕,강희용,이상협,최정현 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.1

Background: Postoperative urinary retention (POUR) is a common complication after total knee arthroplasty (TKA) and associated with the use of anticholinergics. The introduction of sugammadex has decreased perioperative use of anticholinergics. Since anticholinergics may influence the detrusor muscle, the purpose of this study was to compare incidence of POUR between sugammadex and anticholinergic use for reversal of muscle relaxant. Methods: This study was a retrospective cohort study in a university-affiliated hospital. A total of 571 patients who underwent TKA between 2015 and 2016 with an American Society of Anesthesiologists class ≤ 3 were included in this study. Patients who received sugammadex (group S, n = 208) were compared to those who received glycopyrrolate with pyridostigmine (group C, n = 363) for reversal of neuromuscular blockade. The primary outcome was the incidence of POUR. Secondary outcomes were hospital length of stay (HOS) and daily residual urine drained from intermittent catheterization. Demographic, intraoperative, and laboratory data were collected. Results: The incidence of POUR was significantly lower in group S compared to group C (36.1 vs. 48.8%, P = 0.003). On post-operative day (POD) 0, there was no significant difference in the residual urine volume between the two groups. However, from POD 1 to POD 4, the residual urine volume was significantly lower in group S compared to group C. There was no significant difference in HOS between the two groups. Conclusions: The use of sugammadex was associated with a lower incidence of POUR by avoiding glycopyrrolate in patients underwent TKA.