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간이식 수술 후 발생한 술 후 섬망의 위험 인자에 대한 고찰
윤진선 ( Jin Sun Yoon ),김영리 ( Young Ri Kim ),최지원 ( Ji Won Choi ),고저스틴상욱 ( Justin Sang Wook Ko ),곽미숙 ( Mi Sook Gwak ),김갑수 ( Gaab Soo Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.5
Background: Postoperative delirium (POD) after liver transplantation is a serious complication. This study investigated the incidence and the risk factors of POD in liver transplantation recipients. Methods: Three hundred and sixty eight adult recipients who had undergone liver transplantation were included. We reviewed medical records and the POD was determined by either psychiatric consultation or established diagnostic criteria. Recipients were divided into two groups according to the occurrence of POD: POD group (n=150) and non-POD group (n=218), and risk factors were assessed. Results: One hundred fifty (40.8%) of the 368 recipients developed POD after liver transplantation. History of alcohol consumption and alcoholic liver disease, history of hepatic encephalopathy, preoperative mental status changes, ventilator care, dialysis, hypotension, and ICU care were significantly higher in the POD group. In the preoperative laboratory test, sodium was lower while bilirubin, PT (INR) and MELD score were higher in the POD group. Postoperative variables including dialysis, ventilator care duration, ICU stay, hospital stay, glucose and ammonia were significantly higher in the POD group. Three variables were identified as independent predictors of POD in a multiple regression analysis: history of alcohol consumption (odds ratio, 2.04; 95% confidence interval [CI], 1.12-3.72; P=0.02), history of hepatic encephalopathy (odds ratio, 2.54; 95% CI, 1.46-4.41, P<0.01), and MELD score (odds ratio, 1.03; 95% CI, 1.00-1.06; P=0.02). Conclusions: The development of POD and related morbidity and mortality would be reduced if we identified the recipients with risk factors preoperatively and applied early intervention. (Korean J Anesthesiol 2009;57:584∼9)
증례보고 : 척추마취하 치핵 절제술 종료 직후에 발생한 스트레스성 심근병의증
최락민 ( Rak Min Choi ),윤진선 ( Jin Sun Yoon ),노재훈 ( Jae Hoon Noh ),강경오 ( Kyoung Oh Kang ),김민석 ( Min Suk Kim ),조삼순 ( Sam Soon Cho ),전희정 ( Hee Jung Jun ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4
A 48-year-old healthy woman was admitted in our hospital for elective hemorrhoidectomy. She developed sudden headache and chest pain, and showed sinus bradycardia, arrhythmia and hypotension forty minutes after spinal anesthesia with 0.5% hyperbaric bupivacaine. An EKG showed ST depression and an transthoracic echocardiogram performed in PACU demonstrated mild LV dysfunction with hypokinesia of LV inferolateral wall. An coronary angiography on postoperative day 1 revealed normal coronary vessel and akinesia of LV inferior wall. Levels of CK-MB and Troponin I were mildly elevated. With medical therapy, the patient`s symptoms improved and recovered without any complication. (Korean J Anesthesiol 2009;56:470~3)
배성훈(Seoung Hun Bae),임정선(Jung Sun Lim),신광민(Kwang Min Shin),윤진선(Jin Seon Yoon),강상규(Sang Kyu Kang),이솔희(Sol Hee Lee),김민관(Min Kwan Kim),이정우(Jung Woo Lee),김준현(Jun Hyun Kim),신민수(Min Soo Shin),한창희(Chang Hee H 한국산업경영시스템학회 2015 한국산업경영시스템학회지 Vol.38 No.1
It is difficult to make an accurate estimate of the economic value and effects on societal economy of Nano-technologies. This research measures an economic value of Nano-technologies quantitatively and analyzes its influences on societal economy. This paper chooses some major industries as analysis targets and adapts the DEFRA comparative methodology model which has been developed in the UK and recommended by OECD. For this reason, some industries which are in range of economic value assessment were investigated and related data were collected. Also, the economic value and societal influences of Nano-technologies were calculated, through the procedure of the model. In addition, this study conducts a questionnaire to experts for the validity of measurement results and procedures. This paper suggests a guideline for economic value and effects on societal economy of Nano-technologies assessments through quantitative Defra comparative methodologies.
연구논문 : 「나노기술개발 촉진법」개정방향에 관한 연구
이동환 ( Dong Hwan Lee ),임정선 ( Jung Sun Lim ),신광민 ( Kwang Min Shin ),윤진선 ( Jin Seon Yoon ),이명수 ( Myoung Soo Lee ),신명숙 ( Myoung Sook Shin ),강상규 ( Sang Gyu Kang ),김제완 ( Je Wan Kim ),신민수 ( Min Soo Shin ),배성 한남대학교 과학기술법연구원 2014 과학기술법연구 Vol.20 No.2
나노기술은 미래 산업의 핵심 기반기술로써, 현 정부가 제시하는 이른바 ‘창조경제론’의 실현에 핵심적인 역할을 할 것으로 기대되고 있다. 그러나 나노기술이 창조경제를 뒷받침하고, 또한 급변하는 세계적 시대상황을 반영하기 위한 법제개선은 이루어지지 않은 실정이다. 따라서 나노기술촉진정책의 시각에서 정부의 정책기조를 분석하고, 이를 실현하기 위한 「나노기술개발 촉진법」 개정방향을 살펴볼 필요가 있다. 본 논문에서는 그 개정 방안으로 첫째, 나노기술개발 촉진법의 목적을 기술혁신ㆍ상용화 및 나노안전까지 포괄할 수 있도록 확대할 것. 둘째, 확대된 나노기술촉진업무의 책임행정조직으로 미래창조과학부의 위상과 책임을 분명히 하고, 정부지원체계도 가능한 범위 내에서 미래창조과학부 중심으로 일원화 할 것. 셋째, 기술혁신과 상용화의 시각에서 혁신과 안전이 상호 기여하는 관계로 나노제품ㆍ나노안전 및 나노안전인증 등과 관련된 주요 법·정의조항들을 보완할 것을 제시한다. Since South Korea first introduced ``NANOTECHNOLOGY DEVELOPMENT PROMOTION ACT`` in 2002, Korean nanotechnology society has witnessed many dramatic changes of technology development and manufacturing environments in domestically as well as globally. As innovation of manufacturing and commercialization of nanotechnology become priority policies and strategies of president Park government, the environmental, health, and safety(EHS) issues are becoming more critical and complicated not only in nano science?technology?industry fields, but also in law society to accelerate the crossing valley of death. This article covers the past, present, and future of nanotechnology legislation in South Korea, focusing on the cooperation?coordination of agencies and nano-safety activities for innovation with commercialization. After brief researches on the president Park government``s new policy?strategy of innovation, and current international issues of nano convergence, the authors suggest an amendment of the current ``NANOTECHNOLOGY DEVELOPMENT PROMOTION ACT`` of 2002 including legal ground for innovation of nano-manufacture, Public Private Partnership, and National Inter-Agency Committee for Coordination of Nanotechnology Policy.
Propofol/Rocuronium을 이용한 신속 기관 내 삽관 시 Remifentanil의 세 가지 지속 정주 용량에서의 혈역학적 반응
곽미숙 ( Mi Sook Gwak ),최수주 ( Soo Joo Choi ),윤진선 ( Jin Sun Yoon ),이준용 ( Jun Yong Lee ),양미경 ( Mi Kyung Yang ),김갑수 ( Gaab Soo Kim ),이상민 ( Sang Min Lee ),김명희 ( Myung Hee Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.4
Background: This study compared the effect of the three different infusion doses of remifentanil on the hemodynamic response to rapid sequence anesthesia induction and tracheal intubation. Methods: In this prospective, randomized double-blind study, 60 ASA I or II patients without any airway abnormalities, who were scheduled to undergo elective surgery requiring endotracheal intubation, were allocated to receive remifentanil 0.25, 0.5, or 1.0μg/kg/min. Anesthesia was induced with a remifentanil infusion and propofol 2.0 mg/kg. Rocuronium 1.0 mg/kg was given after a loss of consciousness and endotracheal intubation was performed 1 min after the rocuronium injection. The remifentanil infusion was stopped immediately before intubation. The noninvasive blood pressure (BP) and heart rate (HR) were recorded before induction (baseline), immediately before intubation, and at 1 min intervals until 5 min after intubation. Results: The HR and BP measured immediately before intubation decreased significantly in the three doses. The HR was similar in the three doses, and the BP was significantly different only between the 0.25 and 1.0μg/kg/min doses (P < 0.05). The hemodynamic response to endotracheal intubation was very well blunted in 0.5 and 1.0μg/kg/min, but not in 0.25μg/kg/min. The HR and BP increased significantly 1 min after intubation in the 0.25μg/kg/min (P < 0.05). There were no significant differences between the 0.5 and 1.0μg/kg/min doses until 5 min after intubation. Conclusions: Remifentanil 0.5μg/kg/min infusion without a bolus provides excellent hemodynamic stability for a rapid sequence endotracheal intubation using propofol and rocuronium. There are no advantages in using remifentanil doses higher than 0.5μg/ kg/min. (Korean J Anesthesiol 2006; 50: 385~9)