Pharmacological and non-pharmacological intervention for rocuronium-induced withdrawal movement in the Korean population: a meta-analysis of 41 studies including 4,742 subjects

최근주,이상석,이정혁,박슬기,강현 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.66 No.6

Background: We purposed to systemically review studies investigating the prophylactic effect of both pharmacological and non-pharmacological modalities against rocuronium induced withdrawal movement (RIWM) in the Korean population. Methods: Literature search was performed using MEDLINE, EMBASE, CENTRAL, Koreamed, KMBASE, KISS and RISS up to March 2014. Randomized controlled trials (RCTs) comparing pharmacological and non-pharmacological interventions with placebo aimed for the Korean population were included. Outcome measures were the incidence and severity of RIWM. We conducted subgroup analyses according to each intervention method. Results: Data were analyzed from 41 RCTs totaling 4,742 subjects. The overall incidence of RIWM was about 80% (range 56-100%). Incidence and severity of RIWM were significantly reduced with lidocaine (risk ratio [RR] 0.60, 95% CI 0.49-0.74; standardized mean difference [SMD] -0.74, 95% CI -1.05 to -0.44), opioids (RR 0.28, 95% CI 0.18-0.44; SMD -1.71, 95% CI -2.09 to -1.34) and hypnotics (RR 0.36, 95% CI 0.25-0.52; SMD -2.20, 95% CI -2.62 to -1.79). Regardless of tourniquet use, lidocaine showed a prophylactic effect against incidence and severity of RIWM: tourniquet (RR 0.36, 95% CI 0.21-0.62; SMD -1.51, 95% CI -2.15 to -0.86); non-tourniquet (RR 0.58, 95% CI 0.47-0.71; SMD -0.74, 95% CI -1.05 to -0.44). Dilution and slow injection of rocuronium decreased incidence and severity of RIWM: dilution (RR 0.47, 95% CI 0.39-0.56; SMD -1.64, 95% CI -2.47 to -0.81); slow injection (RR 0.34, 95% CI 0.17-0.70; SMD -2.13, 95% CI -2.74 to -1.51). Conclusions: The greater part of pharmacological and non-pharmacological interventions showed prophylactic effect against the incidence and severity of RIWM in the Korean population.

On the road to make KJA’s review process robust, transparent, and credible: retracted study in systematic review

최근주,강현 대한마취통증의학회 2022 Korean Journal of Anesthesiology Vol.75 No.3

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흡착특성이 다른 내분비계 장애물질 3종, Amitrol, Nonylphenol, Bisphenol-A의 GACs에서의 흡착 특성

최근주,김상구,권기원,지용대,김승현,김창원 한국물환경학회 2004 한국물환경학회지 Vol.20 No.3

Adsorption characteristics of three endocrine disruptors, amitrol, nonylphenol, and bisphenol-A, were evaluated depending on the type and service duration of activated carbon (AC). Bituminous coal-, wood-, and coconut-based coals were tested. Bituminous coal-based AC (BCAC) had the greatest sorption capacity for the three chemicals tested, followed by wood-based AC (WAC) for nonylphenol and coconut palm-based AC (CAC) for bisphenol-A. During the column test, amitrol removal efficiency increased over time, indicating that hydrophilic endocrine disruptors are biodegraded in the AC column. Removal efficiencies of hydrophobic compounds such as nonylphenol and bisphenol-A decreased over time since the main removal mechanism was adsorption. The order of the amitrol removal was: BCAC-5.9 yr , CAC-3.1 yr > BCAC-2.2 yr > BCAC-virgin > CAC-virgin > WAC-virgin > WAC-3.1 yr. In general, used AC had greater removals than virgin AC. The order of the bisphenol-A removal was: CAC-virgin > BCAC-2.2 yr > CAC-3.1 yr > WAC-virgin > BCAC-5.9 yr > WAC-3.1 yr. The order of the nonylphenol removal was: BCAC-virgin > WAC-virgin > CAC-3.1 yr ,WAC-3.lyr> BCAC-2.2 yr > BCAC-5.9 yr > CAC-3.1 yr. Bituminous coal AC performed the best over time. Endocrine disruptors such as these three compounds appear to be removed effectively by activated carbon through biodegradation and adsorption. Wood and coal based among the virgin ACs and 3.1 years used wood base among the used ACs appeared the lowest carbon usage rate(CUR) for nonylphenol removal by prediction model. Virgin and used coconut base ACs except BCAC had the lowest CUR for removal Bisphenol-A. Biodegradation of nonylphenol and Bisphenol-A did not occurred during the 9,800 bed volume experiment period. BCAC had the highest biodegradation capacity of 46% for amitrol among virgin ACs and the used coal based ACs had 33-44% higher biodegradation capacity than virgin's for amitrol so biodegradation is the effective removal technology for hydrophilic material such as amitrol.

Introduction to Umbrella Reviews as a Useful Evidence-Based Practice

최근주,Hyun Kang 한국지질동맥경화학회 2023 지질·동맥경화학회지 Vol.12 No.1

The umbrella review (UR) is a novel methodological approach that has been established to address the ever-expanding research volume of published systematic reviews. In this study, we examined the rationale underlying URs, the concepts and goals of URs, and their applicability in clinical settings. Additionally, we briefly assessed the process of conducting URs and discussed the current challenges in this regard. URs are used to integrate, evaluate, and synthesize the findings of related systematic reviews. By organizing and summarizing the abundant information in accordance with the level of evidence, URs can serve as a useful methodological tool and provide appropriate entry points to clinicians or decision-makers in the medical field. Considering the availability of many suitable interventions for specific conditions in a broad field, URs can enable evidence-based decision-making and offer a broad perspective for the resolution of issues in healthcare by summarizing the evidence and providing directions on a variety of topics. URs are clearly contributing to the management of the deluge of evidence in evidence-based medicine. However, despite the availability of several directions for conducting URs, some points of confusion persist, especially when determining the certainty of evidence. Therefore, advanced guidelines for the appropriate performance of URs are required to provide more reliable evidence through URs.

성문 위 기도유지 기구의 안전성과 임상적 유용성

최근주,강현 대한의사협회 2015 대한의사협회지 Vol.58 No.10

Supraglottic airway devices (SADs) are used to keep the upper airway open and provide adequate ventilation and oxygenation. Their use is increasing, and various kinds of SADs have been introduced to routine clinical practice. This review describes the characteristics and illustrates the use of those SADs that have been introduced to and/or are available in Korea. Particular attention is paid to the use of SADs in special clinical settings such as a difficult airway, prehospital care, resuscitation, and intubation. There has been a paradigm shift in the emphasis of difficult airway management from endotracheal intubation to adequate ventilation and oxygenation. SADs have proven to be useful alternatives to tracheal intubation; however, they also have potential disadvantages such as the risk of regurgitation of gastric contents and pulmonary aspiration. Advances in SAD design such as drainage tubes or double cuffs, which lessen the possibility of harmful events and complications, are discussed. The evolution and widespread use of SADs have changed the clinical theory and practice of airway management. Clinicians should be aware of the strengths and limitation of each SAD and understand the limited evidence currently available for guidance.

The Potential Role of Dyslipidemia in COVID-19 Severity: an Umbrella Review of Systematic Reviews

최근주,김현민,강현 한국지질동맥경화학회 2020 지질·동맥경화학회지 Vol.9 No.3

Objective: The aim of this study was to analyze the available knowledge about the potential association between dyslipidemia and the severity of coronavirus disease 2019 (COVID-19) as reported in previous published systematic reviews. Methods: In this umbrella review (an overview of systematic reviews), we investigated the association between dyslipidemia and COVID-19 severity. A systematic search was performed of 4 main electronic databases (MEDLINE, Embase, Scopus, and the Cochrane Library databases) from inception until August 2020. We evaluated the methodological quality of the included studies using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool and used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence for the outcome. In addition, we evaluated the strengths and limitations of the evidence and the methodological quality of the available studies. Results: Out of 35 articles identified, 2 systematic reviews were included in the umbrella review. A total of 7,951 COVID-19-positive patients were included. According to the AMSTAR 2 criteria and GRADE system, the quality of the included studies was not high. A history of dyslipidemia is likely to be associated with the severity of COVID-19 infection, but the contrary is the case for cholesterol levels at hospitalization. Conclusions: Although existing research on dyslipidemia and COVID-19 is limited, our findings suggest that dyslipidemia may play a role in the severity of COVID-19 infection. More adequately powered studies are needed.

2-Methylisoborneol(2-MIB)제거를 위한 산화 및 흡착공정의 특성

최근주,김상구,류동춘,신판세,손인식,오광중 한국환경과학회 2002 한국환경과학회지 Vol.11 No.3

One of the Musty and earthy smell compounds in raw water is generally attributed to 2-methylisoborneol (2-MIB). It is well known that activated carbon and oxidants such as O_3, ClO_2 are effective ways to control 2-MIB. In isotherm equilibrium experiments, 2-MIB in distilled water was much more adsorbed to the activated carbon(A/C) than raw water containing dissolved organic carbon (DOC). The Freundlich constants(k) of distilled water and raw water were 3.36 and 0.049, and 1/n values were 0.80 and 0.42, respectively. The 2-MIB residual rate were Y = e^(0.55_x)~ e^(-0.54_x) with Ozone(O_3) dose by 5 minutes contact time at the 241 and 353 ng/L initial concentrations. The 2-MIB residual rate were Y = e^(-0.32_X)~ e^(-0.35_X) with Chlorine dioxide(ClO_2) dose by 15 minutes contact time at the 89 and 249 ng/L initial concentrations. 2-MIB was decreased from 1911 ng/L to 569ng/L by post-ozonation(70%removal efficiency) and removal efficiencies of 2-MIB by the following 4 kinds Granular Activated Carbon(GAC) process such as coal base, coconut base, wood base and zeolite+carbon base were 95.8, 89.5, 88.4, and 93.7% respectively.

연구자로서의 의사 인생 2막을 시작하며

최근주 한국생물공학회 2016 BT NEWS Vol.23 No.1

상기도 감염의 병력이 있는 환자에서 전신마취 유지 중에 발생한 기관지경련

최근주 외 중앙대학교 의과대학 의과학연구소 2009 中央醫大誌 Vol.34 No.1/2

Bronchospasm is an anesthetic emergency that can lead to disastrous outcome unless an appropriate treatment is administered. An anesthesiologist must immediately initiate treatment if bronchospasm is suspected in order to avoid negative sequelae. The following is a case report of a 60-year-old woman undergoing laparoscopic cholecystectomy who was asymptomatic but had a recent history of an upper respiratory tract infection. The patient developed severe bronchospasm during the maintenance of general anesthesia, but she was promptly managed, and showed successful outcome.

내분비계장애물질의 정수처리 제거 기술

최근주 ( Keun Joo Choi ),김상구 ( Sang Goo Kim ),노재순 ( Jae Soon Roh ),손희종 ( Hee Jong Son ),권기원 ( Ki Won Kwon ),신판세 ( Pan Se Shin ) 한국수처리학회 2004 한국수처리학회지 Vol.12 No.3

N/A We have studied removal efficiency of three endocrine disruptors (Amitrol, Nonylphenol, Bisphenol-A) by oxidation, coagulation and adsorption processes by activated carbon (including the used carbons). Ozonation and chlorination can oxidate nonylphenol, bisphenol-A and the more dose of powder activated carbon(PAC) the more removal efficiency. Coal Based carbon had more adsorption capacity of amitrol, nonylphenol and bisphenol-A than other two carbons on isotherm test, next was wood based carbon for nonylphenol, and coconut based carbon for bisphenol-A. Used coal and coconut based carbon had higher removal efficiency for amitrol than virgin carbon with service time. Three virgin carbons had 0-20% adsorption efficiency and the used carbons had 79-90% biodegradibility for amitrol. It was showing that hydrophilic material can be removed by biodegradation. The hydrophobic materials like as nonylphenol and bisphenol-A were effectively adsorbed onto all carbons tested in this study. The adsorption capacity reduced with the operation year, and the extent of the reduction was different depending upon the carbon type and the operation year. The adsorption parameters for nonylphenol and bisphenol-A provided by this study could be valuable when GAC adsorption was considered to handle an accidental spill of nonylphenol and bisphenol-A.