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이세린,박철수,정현식,최종호,이재민,홍상현,이성현 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.65 No.3
Background: Acute liver failure (ALF) is a rapidly progressing and fatal disease for which liver transplantation (LT) is the only treatment. Posttransplant mechanical ventilation tends to be more prolonged in patients with ALF than in other LT patients. The present study examined the clinical effects of prolonged posttransplant mechanical ventilation (PMV), and identified risk factors for PMV following LT for ALF. Methods: We reviewed data of patients undergoing LT for ALF between January 2005 and June 2011. After grouping patients according to administration of PMV (≥ 24 h), donor and recipient perioperative variables were compared between the groups with and without PMV. Potentially significant factors (P < 0.1) from the univariate intergroup comparison were entered into a multivariate logistic regression to establish a predictive model for PMV. Results: Twenty-four (25.3%) of 95 patients with ALF who received PMV had a higher mortality rate (29.2% vs 11.3%, P = 0.038) and longer intensive care unit stay (12.9 ± 10.4 vs 7.1 ± 2.7 days, P = 0.012) than patients without PMV. The intergroup comparisons revealed worse preoperative hepatic conditions, more supportive therapy, and more intraoperative fluctuations in vital signs and less urine output in the with- compared with the without-PMV group. The multivariate analysis revealed that preoperative hepatic encephalopathy (≥ grade III), intraoperative blood pressure fluctuation, and oliguria (< 0.5 ml/kg/h) were independent risk factors for PMV. Conclusions: PMV was associated with deleterious outcomes. Besides care for known risk factors including hepatic encephalopathy, meticulous attention to managing intraoperative hemodynamic circulatory status is required to avoid PMV and improve the posttransplant prognosis in ALF patients.
이세린,허재원,이재상,이재민 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.2
Background: Existing laryngoscopes are designed to be handled by the left hand, whereas most healthcare professionals are right-handed. However, controlling the laryngoscope device requires considerable strength and refinement to control the blade. We examined the usefulness of a right-handed laryngoscope to validate its clinical applicability. Methods: One hundred sixty-four patients for general anesthesia were involved. Laryngoscopy was performed twice for each patient, once using a conventional left-handed Macintosh No. 3 laryngoscope and once using a right-handed one, by 25 right-handed and 18 left-handed laryngoscopists. The perpendicular distance from the tip of the maxillary incisor to the flange of each blade was measured when the maximum visibility of the glottis was obtained. We compared the distances, chances of directly contacting the tooth, laryngoscopic views and subjective feeling of difficulty in handling device between the two laryngoscopes. Results: For the right-handed laryngoscopists, distance varied significantly between the two laryngoscopes (5.0 ± 3.5 and 5.7 ± 3.7 mm [mean ± standard deviation] for the conventional and right-handed laryngoscopes, respectively [P < 0.001]). The righthanded laryngoscope was associated with a decreased chance of directly contacting the teeth (P = 0.001). Additionally, the right-handed laryngoscope provided a better view than the conventional one (P = 0.005). Conversely, most of the left-handed laryngoscopists felt that the procedure using a conventional laryngoscope was easier than with a right-handed one. Conclusions: When a right-handed laryngoscopist uses a right-handed laryngoscope, a better laryngoscopic view and a reduced chance of blade contact with the teeth can be achieved.
Intraoperative predictors of early tracheal extubation after living-donor liver transplantation
이세린,사계절,김윤아,박철수 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.2
Background: Prolonged mechanical ventilation after liver transplantation has been associated with deleterious clinical outcomes, so early tracheal extubation posttransplant is now increasing. However, there is no universal clinical criterion for predicting early extubation in living-donor liver transplantation (LDLT). We investigated specific predictors of early extubation after LDLT. Methods: Perioperative data of adult patients undergoing LDLT were reviewed. “Early” extubation was defined as tracheal extubation in the operating room or intensive care unit (ICU) within 1 h posttransplant, and we divided patients into early extubation (EX) and non-EX groups. Potentially significant (P < 0.10) perioperative variables from univariate analyses were entered into multivariate logistic regression analyses. Individual cut-offs of the predictors were calculated by area under the receiver operating characteristic curve (AUC) analysis. Results: Of 107 patients, 66 (61.7%) were extubated early after LDLT. Patients in the EX group showed shorter stays in the hospital and ICU and lower incidences of reoperation, infection, and vascular thrombosis. Preoperatively, model for end-stage liver disease score, lung disease, hepatic encephalopathy, ascites, and intraoperatively, surgical time, transfusion of packed red blood cell (PRBC), urine output, vasopressors, and last measured serum lactate were associated with early extubation (P < 0.05). After multivariate analysis, only PRBC transfusion of ≤ 7.0 units and last serum lactate of ≤ 8.2 mmol/L were selected as predictors of early extubation after LDLT (AUC 0.865). Conclusions: Intraoperative serum lactate and blood transfusion were predictors of posttransplant early extubation. Aggressive efforts to ameliorate intraoperative circulatory issues would facilitate successful early extubation after LDLT.
친환경 비납계 페로브스카이트 기반 발광 다이오드의 연구 동향
이세린,김도영,정재근,김현우,이병현,박민호 한국세라믹학회 2022 세라미스트 Vol.25 No.3
Metal halide perovskites (MHPs) are promising candidate materials for next-generation optoelectronic device applications such as light-emitting diodes (LEDs), solar cells, and photodetectors. However, the toxicity and poor stability issues of lead-based MHPs (LHPs) are still challenging to fulfill a restriction of hazardous substances directive (RoHS) and industrial standards for the commercialization of LHP devices. Therefore, eco-friendly and lead-free halide perovskites (EHPs), which are superior to LHPs, should be developed. In this review, we will review the promising strategies to substitute a lead cation with non-toxic metal cations such as tin (Sn), bismuth (Bi), antimony (Sb), and copper (Cu), and discuss the synthetic methods, crystal structures, luminescent properties, and their LED applications.