C6 glial 세포에서 Glutamate에 의해 유발된 세포사멸에 Morphine이 미치는 보호효과

최덕화,안진영,이철 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

This study was designed to investigate the effect of morphine on the glutamate-induced toxicity of rat C6 glial cells. Glutamate increased the death of C6 glial cells in a time and dose-dependent manner, which was revealed as apoptosis characterized by genomic DNA fragmentation. Caspase family cysteine proteases including caspase-3, -8 and -9 proteases were not activated in C6 glial cells by glutamate. However, cleavage of PARP was occurred at 12 hr after treatment of glutamate. Glutamate also activated the transcriptional activators including NF-_KB and AP-1 in C6 glial cells. Glutamate-induced cytotoxicity was prevented by morphine and antioxidants such as NAC and GSH, whereas it was not inhibited by MK-801, an antagonist of glutamate receptor NMDA and opioid agonists including DAMGO, DPDPE, and U69593. A morphine antagonist naloxone did not inhibit the protective effect of morphine on cytotoxicity by glutamate but it prevent the death of C6 glial cells. Glutamate significantly decreased the intracellular contents of GSH and increased the generation of H_2O_2 in C6 glial cells. On the contrary, morphine significantly inhibited the depletion of GSH as well as generation of H_2O_2 in C6 glial cells by glutamate.

147일 기록 - 서보분회 투쟁

최덕화 한국비정규노동센터 2004 비정규 노동 Vol.31 No.-

척추 마취 후 발생된 마미증후군 : 증례보고

최덕화,이철,전철용 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.1

복강경하 산부인과 수술시 삽관 튜브의 고정위치 변화

최덕화,김향이,하정량 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

Background: The purpose of this study was to evaluate changes in the distance between the tip of endotracheal tube(ETT) and the carina by the pneumoperitoneum with Trendelenburg lithotomy position during lapaorscopic gynecologic surgery. Methods: We selected clinical patients who received laparoscopic gynecologic surgery on 20 degree of Trendelenburg lithotomy position under about 12㎝ H_2O of abdominal insufflation pressure. We checked a distance from the tip of ETT to the carina using a fiberoptic bronchoscope. Group 1 (n = 24) was measured the distance after the intubation and the pneumoperitoneum with trendelenburg lithotomy positions 10 minute later, respectively. Group 2 (n = 20) was measured the distance after intubation. And then measurements were taken in the pneumoperitoneum with trendelenburg lithotomy position 10 minute later after the positioning of the ETT fixed with 1 ㎝ shortly. Results: There was a significantly difference in the distance from the ETT to the carina within the Group 1. In group 2, the distance of between the tip of the ETT and carina was not altered significantly. Conclusion: The ETT has been shown to migrate towards the carina during laparoscopic gynecologic surgery. We suggest that the safety position for the ETT during laparoscopic gynecologic surgery should be shorter than fixation length of the ETT in supine position.

환지통 환자에서 케타민 정주요법의 효과

최덕화,김정훈,하정량,주민철 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

Phantom limb pain is a kind of neuropathic pain which annoy patient severely for life. Postamputation pain syndromes have been described after the loss of body parts, including the nose, tongue, breast, finger, teeth, testes, penis, bladder, and anus. Because many peripheral sensory nerve synapse in the dorsal horn of the appropriate spinal cord segment. That axons that form the dorsal columns only send collaterals to the segmental apparatus; their first synapse is in the medulla, raising the possibility that abnormal activity in the dorsal column nuclei could also play a role in phantom sensation. After centralization, abnormal ephatic relays occur, patients complain of burning pain, cramping pain, proximal lancinating pain, and dullness. Now many remedies are available but a panacea dose not exit. Ketamine is an antagonist of the N-methyl-D-aspartate ( NMDA ) receptor that gas a crucial role in central sensitization. We met a 53 years old man who had suffered from phantom limb pain. He complain of tactile, stabbing, cramping, cold allodynia, paresthesia and burning pain. We tried nerve blocks two times and medicated various drugs but the outcome was not satisfactory. We tried ketamine infusion theraphy. We use PCA(Patient Controlled Analgesia) machine. Ketamine basal Infusion dose is 0.5mg/hr, bolus dose is Img, lockout interval is ten minutes. The patient injected ketamine for fifteen days. The result was excellent.

태양광 에너지를 이용한 LED표식장치 설계

최덕화(Choi, Deok-Hwa),이흥주(Lee Hoong-Joo) 한국산학기술학회 2009 한국산학기술학회 학술대회 Vol.- No.-

본 논문에서는 태양전지-LED 시스템을 설계하여 부하·발전·배터리 용량을 산정하고, 상용 예비전력을 도입한 독립형 태양광발전시스템을 구현하였다. 또한, LED 조명부하에 대한 휘도 시뮬레이션 및균일성 검사를 거친 후, 이를 태양광발전시스템과 함께 설치하였다. 태양전지-LED 시스템에 대하여설계, 설치 및 운영에 관한 현장 시험을 통해 시스템의 신뢰성과 성능 및 제반 문제점을 확인하고, 태양광 에너지를 이용한 LED 표식장치의 다양한 응용을 위한 기초적 근거를 마련하였다.

마취 중 내관 침 시술이 수술 후 오심구토 예방에 미치는 효과

최덕화(Deok Hwa Choi),이수경(Su Kyung Lee) 한의병리학회 2011 동의생리병리학회지 Vol.25 No.6

65세 이상 골다공증 환자에서의 족관절 골절의 임상적 특징

채수욱,최덕화,김영진,김병수 대한골다공증학회 2012 Osteoporosis and Sarcopenia Vol.10 No.3

Objectives: Fracture of multiple sites can occur by minor trauma because decreased bone quality and bone density in osteoporotic patients. To investigate clinical characteristics of ankle fracture in osteoporotic patients over sixty-five years of age. Materials and Methods: From January 2009 to December 2011, excluding distal tibial shaft and pilon fracture, 40 patients (over 65 years old) who were diagnosed the osteoporosis and observed over 6 months after ankle surgery. We measured age, gender, body mass index (BMI, kg/m2), bone mineral density (BMD, mg/cm3) and T-score through P-QCT. Type of fracture was classified into Danis-Weber and AO classification and whether or not of syndesmotic injury and concomitant disease. Surgery performed under AO principle. We investigated by wound healing, fixation failure and bone union during follow-up. Results: The mean age was 70.3 years at surgery, 21 patients were male, and 19 patients were female. Mean BMI was 24.1 kg/m2 (mean weight 63.4 kg/mean height 162.2 cm), mean BMD was 63.6 mg/cm3, and T-score was -3.77. In all cases occurred by low energy rotational injury. Lateral malleolar fracture was 19 cases (48%), bimalleolar fracture was 10 cases, medial malleolar fracture was 7 cases, and trimalleolar fracture was 4 cases. Danis-Weber type B was 28 cases (70%), AO classification type B1 was 18 cases, type B2 was 5 cases, type B3 was 5 cases. In AO classification type A, medial malleolar fracture was 7 cases, bimalleolar fracture was 3 cases, lateral malleolar fracture was 1 case. Type C segmental fibular fracture was only 1 case (C2). There was no case with syndesmotic injuried, there was only 1 case with ankle subluxation in trimalleolar fracture. In case of concomitant disease were 24 cases. There were no wound infection and fixation failure. We obtained bone union in all case after 6 month. Conclusions: Ankle fracture in osteoporotic patients over sixty-five years of age occurred by minor trauma, in all cases, there were Danis-Weber AO B1 type and there were no syndesmotic injury. Surgery was performed under only AO principles without augmentation method for osteoporosis, and we obtained bone union in all cases without complication like as fixation failure and wound problem.

전신마취환자에서 기관내 삽관과 후두 마스크의 폐흡인 위험도의 비교

김태요,최덕화,유수진,김혁동,정영표,박수경,조동규,윤재승 대한응급의학회 1998 대한응급의학회지 Vol.9 No.1

Background: There were several studies for the incidence of gastroesophageal reflux associated with the laryngeal mask airway(LMA), but the results of those studies were much different from one another. The aim of this study was to compare the incidence of gastroesophageal reflux and regurgitation of gastric contents between the LMA and the endotracheal tube(ETT). Method: Ninety patients scheduled for elective orthopedic surgery with a standardized general anesthetic technique were randomly allocated to receive either a LMA(n=49) or a ETT(n=41) for airway management. The esophageal manometry was carried out for the exclusion of esophageal motility disorders and the 24-hour ambulatory pH metry was done from one day before the operation. A methylene blue(50mg) capsule was swallowed just before the induction and the simultaneous recordings of pH were maintained during anesthesia. At the end of anesthesia, the episodes of regurgitation of gastric contents above hypopharynx were analyzed by the pharyngeal blue staining and the pH metric data were analyzed for the detection of gastroesophageal reflux episodes during anesthesia. Results: There was no significant difference in the incidence of gastroesophageal reflux(pH? 4) between two groups; only two patients in LMA and three patients in ETT had reflux episodes during the removal or arousal phase. There was no episode of the pharyngeal blue staining in both group. All of the gastroesophageal reflux patients in both group developed a cough or straining during those phases. There was no clinical evidence of aspiration of gastric contents in both group. Conclusion: In comparison with ETT, use of LMA does not appear to increase the incidence of gastroesophageal reflux and regurgitation above hypophryngeal level in positive pressure ventilating patients during long surgical procedures. Therefore, the risk of aspiration in LMA will not be much more than ETT.

갈색세포종의 복강경 적출동안 마취 관리

이철,강영란,최덕화 圓光大學校 醫科學硏究所 2004 圓光醫科學 Vol.19 No.1