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무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향
최윤숙,윤소희,조승연,송승은,김상림,Choi, Yun Suk,Yun, So Hui,Cho, Seung Yeon,Song, Seung Eun,Kim, Sang Rim 제주대학교 의과학연구소 2021 The Journal of Medicine and Life Science Vol.18 No.1
In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.
최윤숙,한기철,한은정,박금주,박종석,성종환,정성현,Choi, Yun-Suk,Han, Gi-Cheol,Han, Eun-Jung,Park, Keum-Joo,Park, Jong-Suk,Sung, Jong-Hwan,Chung, Sung-Hyun 대한약학회 2006 약학회지 Vol.50 No.6
The pharmacological properties of ginseng are mainly attributed to ginsenosides, the active constituents that are found in the extracts of different species of ginseng. Lately; the studies on ginsenosides are mainly focused on IH-901, a major intestinal bacterial metabolite of ginsenosides. In this study; we examined the anti-diabetic activity of IH-901 in C57BU61 db/db mice model. IH-901 was administrated orally at a dose of 20 mg/kg for 5 weeks. During the experimental period, body weight and blood glucose levels were measured every week. After 5 weeks, db/db mice were sacrificed and diabetic parameters were analyzed. IH-901 treated group showed a significant decrease in fasting blood glucose levels (from 10.5 mM to 9.4 mM), insulin resistance index (from 163.6 to 100.2) and triglyceride levels (from 115.3 to 70.1) compared to the diabetic control. In Pancreatic islets morphology; IH-901 treated group revealed much less infltrated mononuclear cells, indicating that IH-901 recovered ${\beta}$-cell damage due to hyperglycemia. In addition, IH-901 upregulated expressions of glucose transporter 4 (GLUT4) and PPAR-${\gamma}$ in skeletal muscle and adipose tissue, respectively. Taken together IH-901might be a potential anti-hyperglycemic agent with insulin sensitizing effect.
증례 : 혈액종양 ; 간 전이를 동반한 VIPoma에서 간동맥 색전술을 이용한 현저한 증상 호전
최윤숙 ( Yun Suk Choi ),고기영 ( Gi Young Ko ),류민희 ( Min Hee Ryu ),강신광 ( Shin Kwang Khang ),김정은 ( Jeong Eun Kim ),송준선 ( Joon Seon Song ),강윤구 ( Yoon Koo Kang ) 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Vasoactive intestinal polypeptide-secreting tumors (VIPomas) cause VIPoma syndrome, which is characterized by watery diarrhea, hypokalemia, and achlorhydria. The treatment options for metastatic VIPomas include somatostatin analogs, cytoreductive surgery, and chemotherapy. We report the case of a 54-year-old male who presented with a peripancreatic mass with multiple hepatic metastases on computed tomography. After resection, the peripancreatic mass was demonstrated pathologically to be a neuroendocrine tumor. Although the patient received systemic chemotherapy and somatostatin analogs for the hepatic metastatic masses, the tumor increased in size. The patient then experienced severe diarrhea, despite treatment with the somatostatin analogs. Elevated serum VIP levels (3,260 pg/mL) and typical symptoms confirmed the diagnosis of VIPoma. We performed hepatic artery embolization (HAE) to reduce the tumor volume and control his symptoms, which led to a very rapid symptomatic response. The patient has remained symptom-free for 18 months with repeated HAE. (Korean J Med 2014;87:363-368)
증례보고 : 술후 발생한 극심한 요통환자에서 후지내측지 신경차단 치료
최윤숙 ( Yun Suk Choi ),김용철 ( Yong Chul Kim ),신혜영 ( Hye Young Shin ),이승윤 ( Seung Yun Lee ),박상현 ( Sang Hyun Park ),정승현 ( Seung Hyun Chung ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
Lower back pain commonly develops following spinal anesthesia. This pain is likely caused by strain on the ligaments associated with paraspinous muscle relaxation and positioning during the operation. We describe a case involving a healthy 61-year-old woman with a varicose vein that was scheduled for phlebotomy under spinal anesthesia. Two days after spinal anesthesia, the patient experienced severe lower back pain that was markedly aggravated by twisting and extension of the spine, but subsided with rest. Immediately after a lumbar medial branch block was performed at the area of tenderness the pain subsided. Thease results suggest that immediate treatment of acute lower back pain is important for preventing progression to chronic low back pain. (Korean J Anesthesiol 2009;56:574~7)
Compound K의 인슐린분비 및 탄수화물 대사에 미치는 영향
최윤숙(Yun Suk Choi),한기철(Gi Cheol Han),한은정(Eun Jung Han),박금주(Kum Ju Park),성종환(Jong Hwan Sung),정성현(Sung Hyun Chung) 고려인삼학회 2007 Journal of Ginseng Research Vol.31 No.2
진세노사이드의 인슐린 분비 활성을 비교해 본 결과 PPD계열 진세노사이드가 인슐린의 분비를 촉진하는 경향을 보였으며, 그 중에서도 CK의 인슐린 분비 촉진 효과가 가장 뛰어났다. CK는 RIN-m5F cell line과 일차 배양한 췌장 소도세포에서 용량 의존적으로 인슐린의 분비를 촉진하였고 이러한 CK의 인슐린 분비 촉진 기전은 ATP-sensitive K? 채널의 봉쇄에 의한 것임을 확인하였다. H4IIE cell line에서 간세포내 당신생과 관련된 효소의 발현을 측정한 결과 CK는 dexamethasone/cAMP에 의한 PEPCK와 G6Pase의 발현을 억제하였다. 이로 미루어 볼 때, CK는 간에서 당의 신생을 억제하여 공복 시 혈당을 감소시킬 수 있음을 시사하였다. 또한 3T3-L1 cell line에서 TG의 함량과 PPAR-γ 유전자의 발현에 미치는 영향을 살펴본 결과 CK는 PPAR-γ의 발현을 억제하여 결과 지방세포의 분화를 억제하였다. 결론적으로 CK는 췌장에서 ATP-sensitive K? channel을 봉쇄함으로 인슐린 분비를 촉진시키고 또한 간세포에서 당 신생을 억제함으로 식후 및 공복 시 혈당을 감소시킬 것으로 기대된다. Compound K (CK) is a final metabolite of panaxadiol ginsenosides. Although panax ginseng is known to have anti-diabetic activity, the active ingredient is not yet fully identified. Therefore, it would be interesting to know whether and how CK has an anti-diabetic activity. First, insulin secretion-stimulating activity of CK was examined using RIN-m5F cell line and primary cultured islets. CK enhanced the insulin secretion in a concentration dependent manner. This effect, however, was almost completely abolished in the presence of diazoxide, K? channel opener, indicating that the insulin secretion-stimulating activity of CK is presumably due to blockade of ATP sensitive K? channel. In addition, effects of CK on gene expressions of hepatic enzymes (phosphoenolpyruvate carboxykinase[PEPCK], glucose-6-phosphatase[G6Pase]) and on adipocyte differentiation in H4IIE and 3T3-L1 cells, respectively, were examined. CK suppressed the induction of PEPCK and G6Pase mRNA expressions under the dexamethasone/cAMP stimulation condition. CK also reduced the PPAR-γ mRNA expression and triglyceride accumulation in a dose dependent manner as compared to the control. The present study suggests that CK deserves to examine whether it shows an anti-diabetic activity in animal and human studies.
한은정,박금주,최윤숙,한기철,박종석,이경희,고성권,정성현,Han, Eun-Jung,Park, Keum-Ju,Choi, Yun-Sook,Han, Ki-Chul,Park, Jong-Suk,Lee, Kyung-Hee,Ko, Sung-Kwon,Chung, Sung-Hyun 대한약학회 2006 약학회지 Vol.50 No.5
Type 2 diabetes mellitus is a chronic and hard to control disease. In order to develop the therapeutic agent for type 2 DM, many researchers investigated natural products using an in vitro and in vivo assay. In this study, we tried to explore the anti-diabetic activity and mechanisms of ginsam, which is a vinegar-processed ginseng radix. The db/db mice were randomly divided into four groups. The diabetes control (DC) group was orally administrated with distilled water, ginseng radix (GR) or ginsam (GS) was administrated orally at a dose of 150 mg/kg, and the positive control group was orally injected with metformin (MET) at a dose of 300 mg/kg for 5 weeks in db/db mice and measured body weight and blood glucose level every week. All treatment groups decreased the plasma glucose levels compared with diabetic control and GS group significantly lowered the insulin resistance index. GS group also reduced the plasma lipid levels mainly due to reduce the lipogenesis and increase the lipolysis in the fat tissue. In addition, GS group increased the GLUT4 mRNA expression levels in the fat and muscle tissues by 10 fold probably due to increase a $PPAR_{-\gamma}$ mRNA expression in fat tissue. Taken together, GS showed the anti-hyperglycemic and anti-hyperlipidemic activities and those activities may ascribe to over-expression of GLUT4 mRNA level and decrease the lipogenesis in fat tissue.
경막외 진통은 비경막외 진통에 비해 초산부의 분만을 지연시키는가?: 후향성 관찰 연구
장소영,이애령,윤소희,최윤숙,박종국,조우진,Jang, So Young,Lee, Ae Ryoung,Yun, So-hui,Choi, Yun Suk,Park, Jong Cook,Cho, Woo Jin 제주대학교 의과학연구소 2018 The Journal of Medicine and Life Science Vol.15 No.2
We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. This retrospective, observational study based on the review of the medical records from February 2014 to July 2017. Epidural analgesia was initiated with a 10 mL epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. Non-epidural analgesia was initiated with pethidine 12.5 mg bolus, followed by additional boluses as needed. The primary outcome was the duration of the labor. 149 healthy nulliparous women at term pregnancies with no evidence of fetal distress were enrolled in this study. 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. Using a Kaplan-Meier survival analysis, there was no significant difference in the overall duration of the labor(P=0.233). The duration of the first stage of labor was $187.6{\pm}167.3min$ in Group NE, $248.6{\pm}168.7min$ in Group E (Mean${\pm}$SD, P=0.032). The duration of the second stage of labor was $67.1{\pm}57.8min$ in Group NE, $64.1{\pm}47.5min$ in Group E (Mean${\pm}$SD, P=0.693). Epidural analgesia delayed the first stage of labor in this study. But there were no significant differences between the two groups in the duration of the second stage and the total duration of labor.