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- 저자 : ( Cheung Soo Shin ) (검색결과 53 건)
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Cheung Soo Shin,Jin Mo Ahn,Gab Soo Kim,Song Mi Lee Korean Society of Critical Care Medicine 1998 Acute and Critical Care Vol.13 No.1
Bezoars are not uncommonly found during upper gastrointestinal investigations (UGI), are known to be associated with conditions causing stasis changes in gastrointestinal tract. We described here a curious presentation of an oropharyngea bezoar associated with medication and tube feeding. Only few cases of regurgated esophageal bezoar have been reported. A 54 years old man with amyotropic lateral sclerosis required ventilatory support. Nasogastric tube was placed, enteral feeding with special liquid diet (Geenvia TF) was begun. In addition, almagate was given via the feeding tube. Tracheotomy was done for long term mechanical ventilation support. On the 10th day of ICU stay, he complained of foreign body sensation in oral cavity. We could find a white brown colored 15cm solid mass in deep oropharynx. Some factors including sucralfate and the peripheral neuropathy have been suspected to be ascribed forming the esophageal bezoar. Gastrointestinal motility was decrease in patients with peripheral neuropathy. In this case, aluminum hydroxides, one of the aluminium substance like sucralfate, was given to the patient with the peripheral neuropathy. From this experience, we became to know that it is necessary to use the aluminium compound anti-ulcer drug with caution in the patients with the gastrointestinal depression.
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신증수,남용택,이명식 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.1
Acute intermittent porphyria(AIP) is a rare hepatic disorder resulting from defects in the synthesis of heme. This occurs in approximately 0.01% of the general population and is even rare in black and orientals. Acute episode of this disease can be triggered by surgery, certain drug, pregnancy, mensturation, fasting and etc. We report a porphyrinogenic neuropathy occured after general anesthesia in a oriental woman who presented with abdominal pain and other typical sign and symptom. 56 year-old female patient was diagnosed as acute appendicitis for 2 days of constipation and abdominal pain and appendectomy was performed under general anesthesia at local clinic. Anesthesia was induced with penthothal and maintained with halothane, and she was recovered from anesthesia without event. After operation she experienced difficult swallowing and generalized weakness which were aggrevated day by day. Therefore she was transferred to our hospital on fourth postoperative day. Physical examination revealed Grade II motor weakness of Gxtremities and decreased deep tendon reflex. Neostigmine test and Jolly test were done under impression of myasthenia gravis but revealed negative. Guillian-Barre syndrome was difficult to rule out in this patient, but urinalysis revealed increased δaminolevulinic acid and urine color changed dark under light. Therefore we diagnosed her as AIP. 6 days after appendectomy she complained severe dyspnea with vital capacity 350 ml and arterial blood gas analysis revealed PO₂ of 56 mmHg and PCO₂ of 44 mmHg under nasal oxygen 5 1/min inhalation. Therefore we diagnosed this peripheral neuropathy as AIP and report here with references.
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신증수,남용택,정현정 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.1
Adult Respiratory Distress Syndrome(ARDS) is defined as a syndrome of acute respiratory failure characterized by noncardiogenic pulmonary edema with severe hypoxemia caused by right to left intrapulmonary shunting secondary to atelectasis and air space filled with edema fluid. On the past respiratory failure was thought to be the most common cause of mortality of ARDS in the past but recent research suggests the importance of non-pulmonary organ failure. And this has been increasingly recognized as a major cause of death in patients who develope a acute lung injury. Therefore the prognosis of ARDS depends on the associated clinical disorders. But there are very few reports about the prognosis and predisposing factor of ARDS in korea. We performed a retrospective study on ARDS in association with sex prevalance, in 103 ARDS patients. Age distribution, associated disease and prognosis. The results were as follows 1) ARDS occurred more frequantly in male.(male female=1.9: 1) 2) Common clinical disorders associcated with development of ARDS were sepsis(26%), pneumonia(16%), gastric aspiration(12%) and etc. 3) Overall mortality was 54%, but the mortality was high in trauma patient with 80%. 4) Mortality of ARDS increased by age.
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( Yoojin Lee ),( Oran Kwon ),( Cheung Soo Shin ),( Song Mi Lee ) 한국임상영양학회 2015 Clinical Nutrition Research Vol.4 No.1
Malnutrition is common in the critically ill patients and known to cause a variety of negative clinical outcomes. However, various conventional methods for nutrition assessment have several limitations. We hypothesized that body composition data, as measured using bioelectrical impedance analysis (BIA), may have a significant role in evaluating nutritional status and predicting clinical outcomes in critically ill patients. We gathered clinical, biochemical, and BIA data from 66 critically ill patients admitted to an intensive care unit. Patients were divided into three nutritional status groups according to their serum albumin level and total lymphocyte counts. The BIA results, conventional indicators of nutrition status, and clinical outcomes were compared and analyzed retrospectively. Results showed that the BIA indices including phase angle (PhA), extracellular water (ECW), and ECW/ total body water (TBW) were significantly associated with the severity of nutritional status. Particularly, PhA, an indicator of the health of the cell membrane, was higher in the well-nourished patient group, whereas the edema index (ECW/TBW) was higher in the severely malnourished patient group. PhA was positively associated with albumin and ECW/TBW was negatively associated with serum albumin, hemoglobin, and duration of mechanical ventilation. In non-survivors, PhA was significantly lower and both ECW/TBW and %TBW/fat free mass were higher than in survivors. In conclusion, several BIA indexes including PhA and ECW/ TBW may be useful for nutritional assessment and represent significant prognostic factors in the care of critically ill patients.
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김진옥,신증수,남용택,김진,정우희,배선준 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.7
Oxygen therapy is clear benefit in the treatment of tissue hypoxia, but high concentrations and long term exposures of oxygen carry the risks of detrimental physiologic changes and tissue damages. Tissue damages involve decreased surfactant production,alveolar edema, and alveolar hemorrhage. In spite of these damage, diagnosis of oxygen toxicity is difficult in many clinical settings. In this study, we measured lung compliance to evaluate the oxygen toxicity in 60 white rat of 100-150 g body weight Rats were divided into 6 groups. Group I was control graup, exposed to room air, group II -group V were exposed to 100% oxygen, group II for 24 hours, group IlI for 48 hous, group IV for 72 hours, and group V for 96 hours. Group VI was exposed to oxygen in serial as 30% oxygen for 24 hours, 60% oxygen for 24 hours and then 100% oxygen for 96 hours. After oxygen exposure we obseved changes of lung compliance and pathologic findings, compliance of group V was 15.94 mL/cmH2O significantly lower than that of eontrol group (p$lt;0.05) and lung weight of group V was 2.16 g/100 g heavier than the other groups (p$lt;0.05). Although we found oxygen tolerance was developed in group V, we could not differentiate the degree of pathologic damage cauesd from oxygen toxicity by pathologic findings. We concluded that the measurement of lung compliance is valuable in diagnosis of oxygen toxicity and thus in reducing lung damages.
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Kim, Jae Kyeom,Shin, Eui-Cheol,Lim, Ho-Jeong,Choi, Soo Jung,Kim, Cho Rong,Suh, Soo Hwan,Kim, Chang-Ju,Park, Gwi Gun,Park, Cheung-Seog,Kim, Hye Kyung,Choi, Jong Hun,Song, Sang-Wook,Shin, Dong-Hoon Hindawi Publishing Corporation 2015 Journal of analytical methods in chemistry Vol.2015 No.-
<P>Few studies have investigated <I>Seomae</I> mugwort (a Korean native mugwort variety of <I>Artemisia argyi</I> H. Lév. & Vaniot), exclusively cultivated in the southern Korean peninsula, and the possibility of its use as a food resource. In the present study, we compared the nutritional and chemical properties as well as sensory attributes of <I>Seomae</I> mugwort and the commonly consumed species <I>Artemisia princeps</I> Pamp. In comparison with <I>A. princeps, Seomae</I> mugwort had higher contents of polyunsaturated fatty acids, total phenolic compounds, vitamin C, and essential amino acids. In addition, <I>Seomae</I> mugwort had better radical scavenging activity and more diverse volatile compounds than <I>A. princeps</I> as well as favorable sensory attributes when consumed as tea. Given that scant information is available regarding the <I>Seomae</I> mugwort and its biological, chemical, and sensory characteristics, the results herein may provide important characterization data for further industrial and research applications of this mugwort variety.</P>
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가토에서 헤파린은 허혈 재관류로 인한 신장의 조직 손상을 완화하는가?
정현주,신증수,김갑수,방은치,안진모,김정열 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.1
Background : Increasing degrees of medullary hyperemia induced by ischemia reperfusion injury were associated with renal dysfunction. A possible mechanism may be that ischemia causes alterations in the structure and function of vascular membranes which leads to an aggregation of red blood cells in the medullary vessel. It has been shown that heparin prevents postischemic endothelial cell dysfunction. Aim of this study was to evaluate heparin effects on renal hyperemia induced by ischemia reperfusion injury. Method : In this study, fifteen rabbits were randomized to either heparin treatment group(500 IU/kg IV bolus 10 minutes before renal artery occlusion, n=8) or control group(n=7). One side kidney underwent 60 minutes ischemia only by clamping renal pedicle and after that kidney tissue sample was obtained for histologic evaluation. The other side of kidney were permitted 60 minutes ischemia following 60 minutes reperfusion and after that kidney tissue sample was obtained for histologic evaluation. Results : There was significant difference in the degree of congestion(2.6±0.2 vs 1.1±0.3, P<0.05) between outer medulla of control and heparin treatment group. Conclusion : Heparin significantly attenuated outer medullary congestion induced ischemic injury. (Korean J Anesthesiol 1998; 35: 23∼28)
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흉강경술을 위한 일측폐환기시 호기말 이산화탄소 분압은 동맥혈 이산화탄소 분압을 적절히 반영하는가 ?
이종석,신증수,임광호,한정욱 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.4
Background: Maintenance of normal arterial carbon dioxide tension(PaCO₂) is not generally a problem if the same tidal volume can be maintained when changing from two-lung(TLV) to one-lung ventilation(OLV). However, there have been a few studies on the use of capnography in monitoring the adequacy of ventilation during one-lung anesthesia. We have therefore studied how closely end-tidal PCO,(PETCO₂) values reflect changes in PaCO in patients undergoing thoracoscopic sympathectomy during TLV and after transition to OLV. Methods: We have measured arterial oxygen tension(PaO₂), PaCO₂ PETCO₂, and (PaCO₂-PETCO₂) in 24 adult, either sex, patients by infra-red spectrometry. They were measured after induction of anesthesia, in supine position(TLV_(sup)) after a lateral decubitus position(TLV_(lat)), at 15 minutes after left OLV(OLV_(LI)), after right OLV(OLV_(RI)), and at 10 minutes in the supine position re-positioned at the end of the operation(TLV_(rep)). Data were analyzed with a one-way analysis of variance with repeated measures followed by multiple comparision. The correlation between PaCO₂ and PETCO₂ were tested using linear regression. Results: PaCO₂ did not significantly change, whereas PETCO₂ significantly decreased at OLV_(LI)OLV_(Rt) compared with TLVsup value (OLV_(LI)29.7 mmHg OLV_(Rt) 30.5 mmHg and TLV(sup) 33.6 mmHg; P$lt;0.05). Compared with TLV_(sup)(0.2 mmHg), (PaCO₂-PETCO₂) significantly increased at OLV_(Lt)OLV_(Rt) TLV,(3.7 mmHg, 2.3 mmHg, 3.5 mmHg). The correlation between PaCO₂. and PETCO₂. in these series is consistent.(r$gt;0.65, P$lt;0.0006) Conclusions: In the patients undergoing thoracoscopic sympathectomy with TLV or OLV in the lateral decubitus position, PETCO₂ is a reliable estimate of the PaCO₂ However, when the operative time is prolonged the arterial PCO₂ may be more reliable than PETCO₂
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