증례보고 : Rocuronium 투여 후 발생한 아나필락시스 -증례보고-

이혜미 ( Hae Mi Lee ),송선옥 ( Sun Ok Song ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1

Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Even when treated appropriately, these reactions are usually unpredictable and potentially life-threatening. A 26-year-old male patient, who had previously undergone surgery under general and spinal anesthesia twice without any problems, was scheduled for a reconstruction of the anterior cruciate ligament. Lidocaine, thiopental sodium and rocuronium were injected sequentially to induce general anesthesia. Two minutes after the rocuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. These unexpected events resulted in the operation being aborted. The patient recovered without any significant complications under immediate proper intensive care. (Korean J Anesthesiol 2006; 51: 101~4)

나노라만 분광학 (Nano-Raman Spectroscopy)의 최근 연구 동향

이혜미(Hae Mi Lee),서영덕(Yung Doug Suh) 한국고분자학회 2012 고분자 과학과 기술 Vol.23 No.4

복합부위통증증후군 2형에서 중추 재구성을 나타내는 fMRI 소견 -증례보고-

이혜미 ( Hae Mi Lee ),박홍림 ( Hong Lim Park ),송선옥 ( Sun Ok Song ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3

The patients suffering with complex regional pain syndrome (CRPS) reveal sensory, motor and autonomic abnormalities. The pathogenesis of CRPS is poorly understood. Some recent studies have reported that the functional magnetic resonance image (fMRI) findings support that cortical reorganization occurred in the patients with CRPS. We compared the cortical responses on fMRI in a 54-year-old right-handed male patient who suffered with type 2 CRPS on his left hand following an injury 4 years ago. He complained of severe pain and allodynia on the left hand that spread up to the left chest, and he showed abnormal involuntary movement and significant hypothermia on the left hand. The fMRI findings, when a mechanical stimulus was applied on both hands with a brush, showed significantly increased abnormal cortical responses on the primary and secondary somatosensory areas and the distinct parietal association area on the contra-lateral side of the brain to the stimuli on the affected painful hand relative to the stimuli on the unaffected hand. We report on the fMRI findings showing the cortical reorganization in a patient with type 2 CRPS. (Korean J Anesthesiol 2009; 56: 353~7)

임상연구 : 부비동 내시경 수술에서 지속적으로 주입한 Remifentanil이 비강 내 충전에 의한 Epinephrine의 혈역학적 변화에 미치는 영향

이혜미 ( Hae Mi Lee ),김세연 ( Sae Yeon Kim ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.3

Background: Epinephrine is commonly used to reduce bleeding by constriction of nasal vessels in endoscopic sinus surgery. However, when it absorbs to other organs systemically, tachycardia and hypertension may occur and result in more bleeding. This study is performed to evaluate the dose response effects of remifentanil infusion to suppress these adverse responses without delaying emergence. Methods: Sixty healthy patients who scheduled for endoscopic sinus surgery were randomly allocated into three groups by the dose of remifentanil infusion. For induction and maintenance of anesthesia, 0.05, 0.15, 0.25μg/kg/min of remifentanil and 3.5μg/ml of intravenous propofol by TCI were infused to each group. Systolic and diastolic blood pressure, heart rate and bispectral index were measured for 15 minutes at the 1 minute intervals after nasal packing of epinephrine. Results: Systolic and diastolic blood pressure in R0.15 and R0.25 group were significantly lower compared to R0.05 group during 9 to 12 minutes after epinephrine packing, but heart rate and bispectral index were not significantly different among the groups. The frequency of hypotension and bradycardia were significantly higher in R0.25 than R0.05 and R0.15. Conclusions: Continuous infusion of 3.5μg/ml of propofol with 0.15μg/kg/min of remifentanil attenuate hypertension and tachycardia induced by epinephrine with little side effects. (Korean J Anesthesiol 2007; 52: 262~8)

아로니아 베리 열매 및 잎 추출물의 항산화 활성

이혜미 ( Hye Mi Lee ),공봉주 ( Bong Ju Kong ),권순식 ( Soon Sik Kwon ),김경진 ( Kyeong Jin Kim ),김해수 ( Hae Soo Kim ),전소하 ( So Ha Jeon ),하지훈 ( Ji Hoon Ha ),김진숙 ( Jin-sook Kim ),박수남 ( Soo Nam Park ) 대한화장품학회 2013 대한화장품학회지 Vol.39 No.4

본 연구에서는 아로니아 베리 열매 및 잎 추출물의 항산화 활성을 비교 연구하였다. 아로니아 베리 열매의 에틸아세테이트 분획 및 아글리콘 분획의 free radical 소거 활성(FSC₅₀)은 각각 16.29 μg/mL 및 12.29 μg/mL이었으며, 열매추출물의 free radical 소거활성은 잎 추출물 경우보다 높게 나타났다. Luminol-의존성 화학발광법을 이용한 Fe³⁺-EDTA/H₂O₂계에서 생성된 활성산소종(reactive oxygen species, ROS)에 대한 아로니아 베리 열매 추출물의 총 항산화능(OSC₅₀)은 에틸아세테이트 분획의 경우 2.86 μg/mL, 아글리콘 분획은 1.80 μg/mL로, 아글리콘 분획의 총항산화능은 ascorbic acid (1.50 μg/mL)와 비슷한 활성을 나타내었다. 총항산화능에서도 열매 추출물이 잎 추출물 보다 활성이 높은 것으로 나타났다. 사람 적혈구의 ¹O₂로 유도된 세포손상에 대한 보호 효과 실험에서 열매의 아글리콘 분획은 농도의존적(5 ~ 50 μg/mL)으로 세포보호 효과를 나타내었다. 열매 아글리콘분획의 τ₅₀은 10 μg/mL에서 72.3 min으로 지용성 항산화제로 알려진 (+)-α-tocopherol (38.0 min)보다 1.9 배 더 큰 세포보호 효과를 나타내었다. 이상의 결과들은 아로니아 베리의 열매 추출물이 잎 추출물보다 높은 항산화능을 나타내며, 태양 자외선에 노출된 피부에서 발생되는 ¹O₂를 포함하는 ROS에 대항하여 세포를 보호함으로써 기능성 항산화 화장품 소재로서의 응용 가능성이 있음을 시사한다. In this study, the antioxidative effects of Aronia melanocarpa fruit and leaf extracts were investigated. The free radical (1,1-diphenyl-2-picrylhydrazyl, DPPH) scavenging activities (FSC₅₀) of the ethylacetate and aglycone fractions of fruit extracts were 16.29 μg/mL, and 12.29 μg/mL, respectively. The free radical scavenging activity of fruit extract was higher than that of leaf extracts. Reactive oxygen species (ROS) scavenging activities (OSC₅₀) of the ethylacetate and aglycone fractions of fruit extracts on ROS generated in Fe³⁺-EDTA/H₂O₂ system using the luminol-dependent chemiluminescence assay showed 2.86 μg/mL, and 1.80 μg/mL, respectively. ROS scavenging activity of the aglycone fraction of fruit extracts was similar to that of L-ascorbic acid (1.50 μg/mL). The ROS scavenging activity of fruit extracts was higher than that of leaf extracts. The cellular protective effects of aglycone fraction of fruit extracts (τ₅₀ = 72.3 min) on the ¹O₂-induced cellular damage of human erythrocytes especially were increased in a concentration dependent manner (5 ~ 50 μg/mL). τ₅₀ (72.3 min) of the aglycone fraction showed 1.9 times higher than (+)-α -tocopherol (38 min), known as lipophilic antioxidant at 10 μg/mL. These results incidicate that A. melanocarpa fruit extracts have higher antioxidant effects than leaf extracts and could be applicable to functional cosmetics materials for antioxidants by protecting skin exposed to solar UV radiation against ROS including ¹O₂.

복강경 담낭절제술 시 공기배증 전에 주입한 복강 내 lidocaine의 공기배증 후 혈압상승 완화효과

송선옥 ( Sun Ok Song ),이혜미 ( Hae Mi Lee ),윤성수 ( Sung Soo Yun ),유화림 ( Hwarim Yu ),심수영 ( Soo Young Shim ),김흥대 ( Heung Dae Kim ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2

Background: We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient`s hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. Methods: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. Results: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). Conclusion: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient`s hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

원산지별 감초추출물의 항산화활성 증가를 위한 효율적인 추출조건 탐색

하지훈 ( Ji Hoon Ha ),이혜미 ( Hye Mi Lee ),권순식 ( Soon Sik Kwon ),김해수 ( Hae Soo Kim ),김문진 ( Moon Jin Kim ),전소하 ( So Ha Jeon ),정유민 ( Yoo Min Jeong ),황준필 ( Jun Pil Hwang ),박종호 ( Jong-ho Park ),최영기 ( Yung-key 대한화장품학회 2013 대한화장품학회지 Vol.39 No.4

본 연구에서는 한국 및 중국산 감초(Glycyrrhiza uralensis), 그리고 우즈베키스탄산 감초(Glycyrrhiza glabra)를 대상으로 추출용매, 추출온도, 추출시간 등 추출조건별 추출물을 제조하고 이들 추출물들의 추출 수율과 항산화 활성을 비교하여 최적의 추출조건을 선정하였다. 항산화 활성 중 자유 라디칼(1,1-phenyl-2-pic-rylhydrazyl, DPPH) 소거활성은 85% 에탄올로 60 ℃에서 6 h 동안 추출한 조건에서 한국 감초로부터 얻은 추출물이 가장 높은 활성(46.05%)을 나타내었다. 루미놀 발광법을 이용한 추출물들의 총 항산화능 측정 실험과 피부 광노화에 중요한 ¹O₂으로 유도된 세포막 손상에 대한 추출물들의 세포 보호 효과를 측정한 실험 모두에서도 위의 조건에서 가장 높은 항산화 활성을 나타내었다. 특히, 한국 감초는 τ₅₀이 116.4 min으로 비교 물질인(+)-α-tocopherol (28.5 min)보다 약 4 배나 높은 세포 보호 효과를 나타내었으며, 추출 수율은 18.75%로 우즈베키스탄 및 중국 감초보다 각각 1.2 배 및 2.5 배의 추출 수율을 나타내었다. 따라서, 본 연구 결과는 항산화 소재로 화장품에 응용하기 위하여 감초로부터 추출물을 얻기 위한 최적의 조건은 85% 에탄올로 60 ℃에서 6시간 동안 추출하는 것임을 보여주었다. In this work, licorice extracts were prepared using various extraction conditions such as extraction solvent, temperature, and time from Glycyrrhiza uralensis (G. uralensis) produced in Korea and China and Glycyrrhiza glabra (G. glabra) in Uzbekistan. The optimum extraction condition was selected from the extraction yields and antioxidative activities of extracts. Korea licorice extracts showed the highest free radical (1,1-diphenyl-2-picrylhydrazyl, DPPH) scav-enging activity (46.05%) under the extraction condition of 85% ethanol at 60 ℃ for 6 hours. The prominent ROS (reactive oxygen species) scavenging activity using luminol-dependent chemiluminescence assay and the cellular protective effect against ¹O₂ induced cellular membrane damage were also shown from the extracts obtained from the same condition. Especially, Korea G. uralensis extracts exhibited the higher prominent protective effect (τ₅₀ = 116.4 min) than (+)-α-tocopherol (τ₅₀ = 28.5 min) and the extraction yield of Korea licorice extract was 18.75%, which is 1.2 times and 2.5 times higher than that of Uzbekistan and China, respectively. These results indicate that the extraction condition of 85% ethanol at 60 ℃ for 6 hours is optimal to prepare licorice extracts, which can be applicable as antioxidative cosmetic materials.

유네스코 세계문화유산 방문동기 수준별 집단 특성 연구

김기현(Kim, Ki-Hyun),이혜미(Lee, Hae-mi),남승민(Nam, Seung-min) 한국관광레저학회 2018 관광레저연구 Vol.30 No.6

대장수술 후에 발생한 급성신부전의 위험인자

이혜미,황창재,김재황,김흥대,박대팔,서일숙,송선옥,김세연,이덕희,지대림 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2

연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률은 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려고 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술 시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다. Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.