노인 마취의 임상적 고찰

이기남,이종현,문준일,최효섭 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.1

Due to improvements in medical care, the socioeconomic level and public health, life expectancy has dramatically increased. Thus, advances in the development of life-support systems and the control of infection have resulted in many surgical and anesthetic procedures being performed on extremely elderly patients. In contrast to younger patients, elderly patients may manifest more than one pathologic process associated with progressive degenerative changes in various organs of the aged, espe- cially in the heart, brain, and kidney. Since both progressive degenerative change occuring in the elderly population and the cumulative incidence of disease in that population result in death intraoperatively or during the immediate postoperative period, the anesthesiologist must be particularly alert to the possibility of anesthetic risks in the elderly. The elderly patient is more likely to have hypertension, congestive heart failure, cardiac dysrhythmias, chronic pulmonary disease, and diabetes. Preoperative evaluation and treatment of those conditions must be extensively reviewed prior to the induction of anesthesia. To evaluate geriatric anesthetic experiences, 539 cases of patients aged over 60 years of 4,266 anesthetic cases admitted to P.M.C. from January to December, 1986 were analyzed according to age, sex, physical status, anesthetic technique an6 agents, surgical department, preoperative chest X-ray findings, preoperative E.C.G findings, and postoperative complica-tions. The results are as follows. 1) f 4,266 anesthetic patients 539(12.6%) were over 60 3ears of age and 322(59.7%) were males and 217(40.3%) females. 2) In the classification of physical status, the most common evidence was class 2 in 303 cases. Emergency surgery comprised 27.1% 1Yo. 3) The snesthesia technique employed was usually general anesthesia and this suggested that balanced anesthesia used with narcotics offers several advantages to geriatric patients. 4) In the surgical department, 310 cases(57.5%) were for general surgery, 75 cases(13,9%), orthopedic surgery; 57 cases(10.6%), urology; and 49 cases(9.1%), neurosurgery, respectively. Cancer was present in 198 cases(36.7%), 5) Preoperative chest X-ray findings: The most common finding was pulmonary tuberculosis in 44 cases(8.2%). Pneumonia, pulmonary emphysema, and so forth were also observed. 6) Preoperative E.C.G findings: The most common findings was myocardial ischemia in 48 cases(8.9%). Also myocardial infarction observed in 8 cases(1.5%) 7) Postoperative complications were as follows: The most common incidence was wourid infection in 29 cases(5.4%) followed by pneumonia. There were a number of miscellaneous complications. but postoperatively, they did not present any significant problems. 8) The overall mortality rate was 3.5%(19 cases). The difference in the mortality rate related to age was not statistically significant(p$gt;0.1), but the mortality rate related to physical status was statistically significant(p$lt;0.001). 9) Optimizing a patient's preoperative condition by the anesthesiologist, consultants, and other physicians was assumed to reduce perioperative morbidity and mortality.

흉막에 접한 폐종괴 : 초음파 유도하 흉곽경유 생검술의 유용성

이기남 대한영상의학회 1994 대한영상의학회지 Vol.31 No.4

비정질 As-Ge-Se-S 박막에서 선택적 에칭을 통한 2차원 엠보싱형 홀로그램 제작

이기남,정홍배 대한전기학회 2006 전기학회논문지C Vol.55 No.7(C)

- In this paper, we investigated the selective etching rate of amorphous As-Ge-Se-S thin film due to the photoexpansion effect and fabricated the 2-dimensional embossing type diffraction grating hologram. We measured the thickness change with the etching time among NaOH solution after forming 1-dimension diffraction grating. As a results, we found that the selective etching rate were 2.5Å/s, 3.3Å/s, 3.9Å/s where NaOH solution concentration were 0.26N, 0.33N, 0.36N, respectively. Also after the formation of 2-dimensional diffraction grating by the 90˚ degree of circulation on the formed 1-dimensional diffraction grating, we etched selectively during 60sec, among 0.26N NaOH solution and obtained 2-dimensional embossing diffraction grating. As the results of AFM (Atomic Force Microscopy), we confirmed the formation of distinct embossing type 2-dimensional diffraction grating hologram, successfully.

유무인 전기자동차를 위한 자동/수동 조향 메커니즘의 설계

이기남,김대영,유영재,장영학,김규하,권용기 제어로봇시스템학회 2011 제어로봇시스템학회 국내학술대회 논문집 Vol.2011 No.5

韓愈의 생애와 사상

이기남 용인대학교 중국학과.중국학술연구회 2000 中國學報 Vol.1 No.1

The Inhibitory Effects of Cannabinoids of Cannabis Against Human Skin Melanoma Cells

이기남,김명신,백승화,Lee Ki-Nam,Kim Meung-Shin,Back Seung-Hwa Society of Preventive Korean Medicine 1998 대한예방한의학회지 Vol.2 No.1

제라니올 (1), 올리비톨 (2), 카나비노이드 (3 과 4)와 5-플로르우라실 (5)을 MTT 정량분석법과 SRB 정량분석법으로 인체 피부흑색종세포에 대하여 성장 억제효과를 평가 하였다. 이들 화합물(1, 2, 3, 4와 5)은 마이크로 몰 농도의 범위에 대하여 억제 활성을 나타내었다. 일반적으로 이들 화합물은 $1{\mu}M\;-\;100{\mu}M$ 농도범위에서는 투여량에 따라 항암활성을 나타내었다. 인체 피부흑색종세포에 대한 이들 화합물의 50 %억제 농도 효과에 대한 비교는 다음과 같은 순서로 항암활성이 감소하였다. MTT 정량분석법 ; OLVTL >CBG > CBD > 5-FU >GRNL, SRB 정량 분석법 ; CBG > OLVTL > CBD > CRNL > 5-FU, 카나비노이드 (3 과 4)와 5-플로르우라실 (5)을 MTT정량분석법과 SRB정량분석법으로 인체정상세포에 대하여 독성효과를 측정하였다. 이들 화합물은 마이크로몰농도의 농도범위에서는 투여량에 따라 세포독성을 보였다. 인체정상세포에 대한 이들 화합물의 50 % 독성효과에 대한 비교는 다음과 같은 순서로 세포독성이 감소하였다. MTT정량분석법과 SRB정량분석법 ; CBD > 5-FU > CBG. 따라서 카나비지놀 (3)은 인체정상세포에 대하여 가장 낮은 세포독성을 나타내었다. 따라서 카나비지놀 (3)은 인체 피부흑색종세포에 대하여 가장 강한 성장억제활성을 보였다. Geraniol (1), olivetol (2), cannabinoids (3 and 4) and 5-fluorou.a.il (5). were tested for their growth inhibitory effects against SK-MEL-3 cell lines using two different 3-(4,5-dimethylthiazol- 2yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and sulforhodamine B protein (SRB) assay. These compounds showed inhibitory activity in vitro in the micromolar range against SK-MEL-3 cell lines. In general, the antitumor activity of these compounds (1, 2, 3, 4 and 5) was in a dose-dependent over the micromolar concentration range $1\;to\;100{\mu}M$. The comparison of $IC_{50}$ values of these compounds in tumor cell lines shows that their susceptibility to these compounds decrease in the following order : OLVTL > CBG > CBD > 5-FU > CRNL in MTT assay, CBG > OLVTL > CBD > GRNL > 5-FU in SRB assay. Cannabinoids (3 and 4) and 5-fluorouracil (5) were tested for their cytotoxic effects on NIH 373 fibroblasts using two different MTT assay and SRB assay. These compounds exhibited potent cytotoxic activities in vitro in the micromolar range against NIH 373 fibroblasts. In general, the cytotoxic activities of these compounds (3, 4 and 5) were in a dose-dependent over the micromolar concentration range $1\;to\;100{\mu}M$. The comparison of $CD_{50}$ values of these compounds on NIH 373 fibroblasts shows that their susceptibility to these compounds decrease on the following order ; CBD > 5-FU > CBG in MTT assay and SRB assay. Cannabigerol (3) was shown the least cytotoxic activity on NIH 373 fibroblasts. Cannabigerol (3) exhibited the most growth-inhibitory activity against SK-MEL-3 cell lines.

방사선 조사에 의한 가토 폐의 손상에 관한 실험적 연구 : 연부조직 X-선, 고해상 전산화단층촬영 및 병리소견의 비교

이기남 대한영상의학회 1994 대한영상의학회지 Vol.31 No.4

Superoxide에 의존하여 내피세포에서 유리되는 이완성 물질의 특성에 대한 실험적 연구

이기남,이원석,임병용,홍기환,Lee, Gi-Nam,Lee, Won-Suk,Rhim, Byung-Yong,Hong, Ki-Whan The Korean Society of Pharmacology 1990 대한약리학잡지 Vol.26 No.2

최근 본 교실에서는 two-bath system을 이용하여 혈관 내피세포에서 superoxide에 의존한 혈관 이완성 물질을 동정하여 발표하였다. 본 실험에서는 상기 system을 이용하여 돼지의 관상동맥 내피세포에서 유리되는 superoxide에 의존한 이완성 물질이 고양이의 흥부 대동맥 내피 및 소의 대동맥 배양내피세포에서 얻어진 이완성 물질에 의한 이완과 매우 유사함을 관찰하여 다음과 같은 결과를 얻었다. 1. 고양이 흥부 대동맥, 돼지 관상동맥의 내피세포 및 소 대동맥 배양 내피세포 등에서 유리되는 superoxide에 의존한 이완 물질은 모두 유사한 이완 작용을 나타내었다. 2. 돼지 관상 동맥 내피세포에서 유리되는 superoxide 의존성 이완 물질이 고양이의 흥부 대동맥 내피세포나 소의 대동맥 배양 내피세포에서 유리되는 이완 물질과는 다소 다른 점도 있었다. 즉, 돼지 관상동맥 내피세포에서 유리되는 이완 물질의 작용은 catalase나 superoxide dismutase(SOD)에 의하여 억제되었으나, 후자의 두 동맥 내피세포에서 유리되는 이완 물질은 SOD에 의해서만 억제되었다. 3. 이러한 이완성 물질들의 생성은 여러 lipoxygenase억제제인 gossypol, nordihydroguaiaretic acid, AA 861 및 eicosatetraynoic acid 등의 전처치에 의하여 봉쇄되었다. 4. Cyclooxygenase 억제제인 indomethacin이 나 cytochrome P-450 monooxygenase 억제제인 proadifen과 cimetidine에 의하여는 봉쇄되지 아니하였다. 이상의 결과로부터 이러한 이완성 물질들은 비록 각기 다른 종의 동물 모델에서 얻었다고 하더라도 장기에 따라 다소 반응의 차이는 있으나 동질성 이완 물질이며, 나아가 이러한 이완성 물질은 여러 조직의 허혈-재관류 손상에 있어서 병리생리학적으로 관련될 것으로 사료된다. We recently reported a development of an experimental system which can identify the release of a superoxide-dependent vasorelaxant factor from endothelial cells using a two-bath system. In the present work, we further exploited the above system and observed whether the superoxide-dependent relaxing factor(s), released from the porcine coronary artery (PCA) endothelium, was similar in relaxation to those obtained from cat thoracic aortic endothelium and cultured endothelial cells of bovine aorta. However, there was observed a novel difference among the former one and the latter two relaxing factors; the release of relaxing factor from PCA endothelium can be inhibited either by catalase or by superoxide dismutase (SOD), whereas the latter two can be inhibited only by SOD. It was further attempted to characterize the synthetic mechanisms of the relaxing factors: (1) They were readily inhibited by various lipoxygenase inhibitors (gossypol, nordihydroguaiaretic acid, AA 861, and eicosatetraynoic acid). (2) They were not inhibited by cyclooxygenase inhibitor (indomethacin) and by cytochrome P-450 monooxygenease inhibitors (proadifen and cimetidine). Thus, it is likely that these relaxing factors, although obtained from different species, show common functional roles of arteriolar relaxation. It is suggested that they are related to pathophysiological involvement of various tissue ischemia-reperfusion injuries.

악성 고열증 예방에 대한 Dantrolne Sodium 의 효과

이기남,이종현,문준일,염승수 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.4

Malignant hyperthermia is defined as a potentially fatal hypermetabolic syndrome characteriged by hyperpyrexia, muscle rigidity, tachycardia, respiratory and metabolic acidosis. cyanosis etc. It is susceptible in patients with musculoskeletal diaease such as strabismus, kyphoscoliosia, hernia, cleft palate, cryptorchidism, but there is no single diagnostic method to detect a susceptible patient. Fortunately s-CPK is elevated in 70% of carriers, so we checked a-CPK and a-LDH before operation in patients scheduled for correction of congenital strabismus and classified into group 1 (norirlal a-CPK group) and group Ⅱ (elevated s·CPK group) . We administered Dantrolene sodium to group Ⅱ before operation and compared the changes of s-CPK and s-LDH after operation. The results are as fallows, 1) s-CPK was lowered after administration of Dantrolene sodium in group Ⅱ . (from 76.4 IU/L to 48.5IU/L) 2) s-CPK elevation after operation was much less in group Ⅱ than group 1. (56.1±58.7 IU/L vs 164.7±127.1 IU/L) In conclusion, it would seem that Dantrelene sodium was affective in prevention of malignant hyperthermia.

전신 마취중 발생한 양측 긴장성 기흉 1 예 보고

이기남,이종현,문준일,고석신,염승수 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.2

Pneumothorax was recognized as a potential hazard of mechanical ventilation shortly after the introduction of the technique of tracheal intubation in the 19 th century. Because the gases used in anesthesia are delivered from cylinders and wall outlets at higher than atmospheric pressure, the possibility of camage to the lung is ever present. Immediate, prompt and adequate management of bilateral tension pneumothorax are essential, otherwise the patient dies rapidly. We had a case of bilateral tension pneumnthorax in a 3 year-old boy who underwent a B-E amputation of a severely crushed hand. We report this case along with a review of the literature on pneumothorax.