실험연구 : 백서의 중증 근무력증 모델에서 TOF 자극에 대한 근 반응의 특성과 아세틸콜린 수용체의 변화

전진영 ( Jin Young Chon ),이해진 ( Hae Jin Lee ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.3

Background: The aim of study is to investigate the initial functional changes of muscle in rats induced to have myasthenia gravis, experimental autoimmune myasthenia gravis (EAMG). The authors investigated the functional changes of muscle evaluated by mechanomyography (MMG) and the expression of acetylcholine receptors (AChRs). Methods: After the institutional approval, 39 male Lewis rats were randomly allocated into study. 26 animals were immunized to induce EAMG by Torpedo AChR (T-AChR) emulsified with complete Freund`s adjuvant (CFA) and phosphate buffer saline (PBS)/bovine serum albumin (BSA) 0.01% at the base of tail, and received booster immunizations twice by T-AChR with incomplete Freund`s adjuvant (IFA) and PBS/BSA 0.01% at all different site on the upper back. 13 animals were sham immunized as control group by the same method of EAMG except T-AChR. Clinical EAMG scores were examined. Anti T-AChR and anti rat-AChR (R-AChR) antibodies (Ab) were compared by using 125I-α-bungarotoxin (125I-α-BuTx) radioimmunoassay. Under the anesthesia, neuromuscular functions were monitored by MMG using single twitch (ST) and TOF. AChRs were quantitated using 125I-α-BuTx. Results: Overall weight gain and final body mass, muscle force (ST), specific muscle force of ST, TOF fade ratio and AChRs were reduced in EAMG score 3 compared to control (P < 0.0001). Anti T-AChR Ab and anti R-AChR Ab were increased in score 3 EAMG (P < 0.0001). Conclusions: EAMG score 3 rats showed characteristic neuromuscular functions as depressed initial ST and its specific force, initial TOF fade and increased anti AChR Abs. Those above characteristics had significant correlations with the clinical EAMG scores. AChRs were significantly down-regulated according to their functional characteristics and clinical EAMG scores. (Korean J Anesthesiol 2007; 52: 310~7)

폐 기능검사가 불량한 2기 폐암환자에서 시행한 우전폐절제술 - l예 보고 -

진웅,이선희,전진영,홍성진,심성보,박재길,곽문섭,Jin, Ung,Lee, Sun-Hee,Chon, Jin-Young,Hong, Sung-Jin,Sim, Sung-Bo,Park, Jae-Kil,Kwack, Moon-Sub 대한기관식도과학회 2000 大韓氣管食道科學會誌 Vol.6 No.2

Pulmonary function test is used as a guideline for safe pulmonary resection without complications. Usually FEVl lower than 1 liter is considered as a contraindication of lobectomy. Therefore, the curative operation of resectable lung cancer can not be performed in the case of poor pulmonary functions. Nowadays, there are some arguing points about the value of preoperative PFTs before the pulmonary resection. We performed a right pneumonectomy for stage H lung cancer in a patient with poor lung function test; FVC 2.17L, FEVl 0.97L, FEVl/FVC 44%, FEF 25-75% 0.42L/sec, MVV 28L/min, TLC 5.18L, RV 2.99. During 4 months follow up, the patient had been tolerable. The follow up PFTs at postoperative 3 months 18 days showed up as follows; FVC 1.20L, FEVI 0.63L, FEVl/FVC 53%, FEF 25-75% 0.31L/sec, MVV 25L/min, TLC 3.80L, RV 2.33L.

임상연구 : 제왕절개술 초기 Bispectral Index를 이용한 Thiopental과 Propofol의 재평가

이해진 ( Hae Jin Lee ),전진영 ( Jin Young Chon ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1

Background: Patients undergoing a cesarean section are at risk of experiencing intra-operative awareness. Thiopental and propofol are both commonly used to induce anesthesia in patients undergoing a cesarean section. This study compared the effect of propofol and thiopental on the anesthetic adequacy of parturients who received inhalation anesthetics using the bispectral index (BIS) in the early period of a cesarean section. Methods: Forty-five parturients were randomly assigned to receive either thiopental 4 mg/kg or propofol 2 mg/kg followed by 1% isoflurane with 50% N2O. The BIS, systolic and diastolic arterial pressure, heart rate, and the end-tidal concentration of isoflurane were recorded every minute for 10 minutes after intubation. The apgar score at 1 and 5 minutes and cord blood gas were assessed. Results: The systolic and diastolic pressure immediately after intubation were significantly lower in the Propofol group than in the Thiopental group. All the BIS values from 0 to 9 minutes after intubation were significantly lower in the Propofol group than in the Thiopental group. The Apgar scores and umbilical cord blood gas analysis were similar both groups. Conclusions: These results suggest that propofol is more suitable for the anesthetic adequacy and intraoperative awareness in the early period of a cesarean section than thiopental. (Korean J Anesthesiol 2007; 52: 49~54)

증례보고 : 전신마취하 제왕절개술 중 발생된 고도 방실 차단

이해진 ( Hae Jin Lee ),전진영 ( Jin Young Chon ),오용석 ( Yong Seog Oh ),김나현 ( Na Hyun Kim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.5

This report is presented in which an asymptomatic parturient with Mobitz I second degree heart block developed high grade heart block during cesarean section under general anesthesia with enflurane. Progression of the block might be associated with vagal reflex. The event in this case suggests that the patients with pre-existing heart block may be a risk factor for development of high grade atrioventricular block during general anesthesia and surgery. (Korean J Anesthesiol 2006; 51: 641~3)

증례보고 : 근긴장성 이양증 환자에서 질식 자궁근종절제술 시 Bispectral Index를 이용한 전정맥마취

이해진 ( Hae Jin Lee ),전진영 ( Jin Young Chon ),황수진 ( Su Jin Hwang ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2

We report a patient with myotonic dystrophy, who underwent a transvaginal uterine myomectomy. Anaesthesia was induced and maintained with remifentanil and the target-controlled infusion of propofol titrated according to the bispectral index (BIS). A ProSeal laryngeal mask airway (PLMA) was inserted, and mechanical ventilation was performed without a muscle relaxant. The time from the end of anaesthesia to the patient-awakening was approximately 8 minutes. The rapid offset of the action of remifentanil and low-dose propofol facilitated early recovery without respiratory complications. The total intravenous anaesthesia using the BIS and the PLMA without a muscle relaxant is a useful anaesthetic technique in myotonic dystrophy patients. (Korean J Anesthesiol 2007; 53: 238~41)

실험연구 : 말초신경 손상 통증모델에서 쥐 NK 세포의 세포독성 변화

강유진 ( You Jin Kang ),송호경 ( Ho Kyung Song ),전진영 ( Jin Young Chon ),유주현 ( Joo Hyun You ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.2

Background: Chronic pain is often associated with changes in the immune responses, which highlights the need for the aggressive pain control to obtain a better prognosis. This study examined splenic NK cell cytotoxicity in an attempt to assess the possible changes in the immune function under chronic neuropathic pain after a partial transsection of the sciatic nerve. Methods: After confirming tactile allodynia in response to the von Frey filament, a modified lactate dehydrogenase (LDH) release assay was used to determine the cytotoxic activity of splenic NK cells on the YAC-1 cell line in C3H/HeN (H-2k) mice (n = 6). NK cells as effector cells were mixed with YAC-1 cells as target cells (1 × 104/100μl), resulting in an effector-target ratio of 1:25, 1:50, 1:100 in the culture medium. Results: At 1 and 2 weeks after the nerve injury, all the subjects showed significant mechanical sensitivity compared with those observed before surgery. The percentage of NK cell cytotoxicity of the neuropathic mice increased significantly 1 week after the nerve injury but decreased within 2 weeks compared with the normal mice. Conclusions: In terms of the altered NK cell cytotoxicity, neuropathic pain can cause changes in the normal performance of the immune function. (Korean J Anesthesiol 2007; 52: 219~23)

영문논문 : 복강경하 담낭 절제술 시 기복강법과 복벽거상법에 의한 생리적 반응

홍성진 ( Sung Jin Hong ),조은정 ( Eun Jung Cho ),이지영 ( Ji Young Lee ),전진영 ( Jin Young Chon ),주창은 ( Chang Eun Ju ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.6

발작성 야간 혈색소뇨증(Paroxysmal Nocturnal Hemoglobinuria) 환자의 개심술을 위한 마취 (증례보고)

홍성진 ( Sung Jin Hong ),이지영 ( Ji Young Lee ),전진영 ( Jin Young Chon ),박정현 ( Jung Hyun Park ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.2

하부 운동신경원 손상 기간이 Mivacurium 의 작용발현 및 회복에 미치는 영향

전진영,김성년 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3

Background : The purpose of this study was to investigate whether the effects of mivacurium on onset and recovery were affected by the duration of more than 2 weeks after injury of the lower motor neuron in rabbits. Methods : The animals were divided into five groups. The control group was without lower motor neuron injury, In the experimental groups, the lower motor neuron injury was made by denervating with a 75 ―80% lesion on the common peroneal nerve to the right anterior tibialis muscle. The experimental groups were subdivided as 1, 2, 3 and 4 week groups (named group 1 wk, 2, 3 and 4 wks) according to the duration of the denervation of the common peroneal nerve. The response relationship of mivacurium on the muscle twitches induced by TOF (train of four) stimulation (supramaximal stimulus of 0.2 ms duration, squarewava pulses, 2 Hz rate and 10 mA, repeated every 10 seconds) was studied in the anterior tibialis muscles and compared between all groups. Neuromuscular responses (onset, recoverytime to T1(1), T1(25), T1(75), T1(95) and recovery index) of muscle twitches to intra venous mivacurium (0.18 mg/kg) were studied. After recording the muscle twitches, macroscopic findings were observed. Results : The recovery time, T(1) of group 4 wks was significantly longer than those of group 1, 2 and 3 wks (P $lt; 0.05), but not different frorn the control group. The recovery time, T1(25), T1(75) and T(95) of group 4 wks was significantly longer than those of all other groups (P $lt; 0.05), but the onset times of all groups were not significantly different. The recovery index of group 4 wks was significantly higher than that of the control group (P $lt; 0.05), but those of groups 1, 2 and 3 wks were #not significantly different from that of the control group. The mass of the anterior tibialis muscle was significantly decreased at 4 weeks after the lower motor neuron injury (P $lt; 0.05). Conclusions : Our results therefore suggest that the neuromuscular response to intravenous mivacurium on recovery in rabbits becomes prolonged according to the durations of the denervation and represents sensitivity at 4 weeks after the lower motor neuron injury. (Korean J Anesthesiol 2000; 38: 309 ~ 517)

토끼에서 하부 운동신경원 손상 기간이 Mivacurium 의 근이완 효과에 미치는 영향

전진영,김성년 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.4

Background : The purpose of this study was to investigate whether the effects of mivacurium on muscular relaxation were similar by the duration of rnore than 2 weeks after the injury of lower motor neurons in rabbits. Methods : The animals were divided into five groups. The control group was without lower motor neuron injury. 1n the experimental groups, the lower motor neuron injury was made by denervating with 75 ―80% lesion on the common peroneal nerve to the right anterior tibialis muscle. The experimental groups were subdivided as 1, 2, 3 and 4 week groups (referred to ad the 1 wk, 2, 3 and 4 wks group) accordirig to the durations of the denervation of common peroneal nerve, respectively. The dose-response relationship of mivacurium on the muscle twitches induced by TOF (train of four) stimulation (supramsximal stimulus of 0.2 ms duration, square-wave pulses, 2 Hz rate, repeated every 10 seconds) was studied by calculating EDso and EDgs in the anterior tibialis muscles and compared between all grups. After recording the muscle twitches, microscopic findings were observed. Results : The effective dose for 95% twitch depression (ED_(95)) of mivacurium at lweek after denervation was significantly higher than that of the control group (P $lt; 0.05), but the ED_(50) of 2, 3 and 4wks groups were not significantly different from that of the control group. However, the ED_(95) of 3 and 4wks group were inclined to be lower than that of the control and si,gnificantly lower than 1 wk group (P $lt; 0.05). There was no significant difference in the effective dose for 50% twitch depression (ED_(95)) of mivacurium in all groups. The size of the anferior tibialis muscle was significantly decreased at 4weeks after the lower motor neuron injury (P $lt; 0.05), but the number of its sarcoplasmic nuclei was increased, according to the duration after the denervation. Conclusions : Our results therefore suggest that neuromuscular response of denervated anterior tibial muscie was resistant to intravenous mivacurium in early periods of 1 or 2 weeks but sensitive 4 weeks after the lower motor neuron injury. (Korean J Anesthesiol 2000; 38: 697~707)