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임상연구 : TIVA 및 VIMA시 내분비 스트레스 반응 및 마취특성 비교
정홍수 ( Hong Soo Jung ),김대우 ( Dae Woo Kim ),최진우 ( Jin Woo Choi ),강유진 ( Yoo Jin Kang ),임용걸 ( Yong Gul Lim ),유건희 ( Keon Hee Ryu ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.3
Background: Anesthetic procedures are major potent stimulus for the neuroendocrine hormonal axis, which results in release of the stress hormone. It is important to know the influence of specific anesthetic procedures on those host responses. We compared endocrine stress response and anesthesia characteristics for TIVA (total intravenous anesthesia) and VIMA (volatile induction and maintenance of anesthesia). Methods: Forty patients scheduled for elective total abdominal hysterectomy were randomly assigned to TIVA or VIMA group. The patients in TIVA group (n = 20) received target controlled infusion (TCI) of propofol and fentanyl TCI with Stelpump software, and the patients in VIMA group (n = 20) received sevoflurane-nitrous oxide for induction (6%) and maintenance (1.5%) of anesthesia. Blood sampling was done 5 minutes before induction (baseline blood sample, BBS), just after intubation (intubation blood sample, IBS), just after extubation (extubation blood sample, EBS), and at arrival in recovery room (recovery room blood sample, RBS). Plasma concentration of glucose, cortisol, epinephrine, norepinephrine were measured. Bispectal Index (BIS) and systolic, diastolic blood pressure, heart rate, induction and recovery profiles were also measured. Results: In both groups, there was significant increase of the blood cortisol and glucose level in EBS and RBS. But only in VIMA group, there was significant increase of the blood cortisol level in IBS. There was no change of the blood epinephrine and norepinephrine in both groups at EBS and RBS, but only in VIMA group, there was significant increase of epinephrine and norepinephrine at IBS. Blood pressure and heart rate increased significantly at IBS in VIMA group, compared with TIVA group. Conclusions: In VIMA group, there was significant increase of stress response and hemodynamic change only during induction of anesthesia. However, in TIVA group, there was no significant increase of stress response and hemodynamic change during induction, maintenance and recovery of anesthesia. (Korean J Anesthesiol 2006; 51: 278~84)
한국인에서 β3AR, UCP2 유전자의 다형성과 체질량지수의 관련성
정홍수 ( Hong Soo Jung ),이주현 ( Joo Hyun Lee ),사공준 ( Jun Sakong ),배성욱 ( Sung Wook Bae ),김정희 ( Jung Hye Kim ),김재룡 ( Jae Ryong Kim ) 영남대학교 기초/임상의학연구소 2007 Yeungnam University Journal of Medicine Vol.24 No.2
Background:Obesity is the most common nutritional disorder in Western society as well as in Korea. Obesity results from a combination of genetic, environmental, and behavioral factors. Materials and Methods:In an attempt to investigate the association of obesity with its candidate genes, β3 adrenergic receptor (β3AR) and uncoupling protein 2 (UCP2), we analyzed polymorphisms of β3AR Trp64Arg and UCP2 -866G/A by PCR-RFLP analysis and the obesity-related phenotypes, including body mass index (BMI), fasting glucose concentration, and plasma lipid profiles in 750 subjects. 1) Results:The Trp64Arg polymorphism in the β3AR gene was not statistically associated with the BMI. The UCP2 -866G/A polymorphism was significantly higher in obese than in non-obese subjects (P<0.05). However, the UCP2 -866A/A polymorphism was higher in the non-obese subjects. Conclusion:These results suggest that the UCP2 -866G/A polymorphism might be more useful for the prediction of obesity and obesity-associated diseases in Korean patients than the β3AR Trp64Arg polymorphism.
신경병증성 통증모델 쥐에서 리도케인의 ERK 1/2와 CREB 단백질 억제효과
주진덕 ( Jin Deok Joo ),인장혁 ( Jang Hyeok In ),정홍수 ( Hong Soo Jung ),김용신 ( Yong Shin Kim ),김대우 ( Dae Woo Kim ),최우영 ( Woo Young Choi ),신은영 ( Eun Young Shin ),전연수 ( Yeon Soo Jeon ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.3
Background: In addition to causing the loss of voluntary sensory and motor function, spinal cord injury (SCI) often creates a state of central neuropathic pain. Rats given SCI display increases in the activated form of transcription factors ERK 1/2, p38 MAPK, and CREB in the spinal cord, which correspond to allodynia in a model of neuropathic pain. The current study was designed to determine if lidocaine had an effect on the development of neuropathic pain in response to SCI. Methods: Male Sprague Dawley rats were anesthetized and then received a L5-L6 spinal nerve ligation (neuropathic rats). The levels of intracellular cell-signaling protein, ERK 1/2 and CREB were then assessed by western blot analysis of samples collected from a sham operated (control) group, a neuropathic pain and normal saline (NP+NS) group, and a neuropathic pain and 5% lidocaine (NP+Lido) group. Results: The increased levels of ERK 1/2 and CREB protein that were observed in the neuropathic pain model were reduced by continuous infusion of 5% lidocaine. Conclusions: The current results suggest that lidocaine therapy may be an effective method of preventing and treating central neuropathic pain following SCI, and that these effects may occur via the reduced expression of ERK 1/2 and CREB in the intracellular cell-signaling pathway. (Korean J Anesthesiol 2009; 56: 319~24)
만성 부비동염 환아에서 단순 부비동 X선 검 사 소견과 부분적 전산화 단층촬영검사 소견의 비교
김현미,홍수종,김영휘,문형남,홍창의,정경일,최혜영,유시준 대한알레르기학회 1993 천식 및 알레르기 Vol.13 No.2
Assessment of the status of the paranasal sinuses is important in the management of childhood sinusitis. Conventional radiography such as plain PNS view is generally less reliable in accurately evaluating the paranasal sinuses in children. Although slice CT provides superior definition of both intrasinus disease and sinus bony margins, a complete CT examination has the disadvantages of higher cost and radiation dose compared with conventional radiography. We performed a prospective study of 19 children with a clinical history of chronic sinusitis, and compared conventional radiographs with limited CT scans of the paranasal sinuses to determine if plain radiographs can be used to accurately diagnose sinus disease. Sixteen cases were diagnosed as sinusitis involved with more than one sinus, but three cases were normal by CT scans of the sinuses. Out of sixteen cases, maxillary sinus were involved in 14 cases(87.5%), ethmoid sinus 14 cases (87.5%), sphenoid sinus 9 cases(56.3). Compared with CT scan of paranasal sinuses, the false positive and false negative ratio of plain X-ray films were as followed: 35.7% (5/ 14 sinuses) and 9.5% (2/21 sinuses) in maxillary sinuses, 11.1% (1/9 sinuses) and 9.5% (2/ 21 sinuses) in ethmoidal sinuses, 4.5% (1/22 sinuses) and 58.8%(7/12 sinuses) in sphenoid sinuses. So the false positive ratio was high in maxillary sinuses, and the false negative ratio was high in sphenoidal sinuses. Sinusitis in children is often overdiagnosed in the maxillary sinuses and underdiagnosed in the sphenoid sinuses on the basis of findings on plain radiographs of the sinuses. Limited slice CT scans of the paranasal sinuses can be used to evaluate the paranasal sinuses in children with recurrent chronic sinusitis.