만성 신부전 환자에서 0.45% 및 0.9% 식염수액이 혈중 소디움 농도에 미치는 영향

권민아 ( Min Ah Kwon ),김갑수 ( Gaab Su Kim ),홍정길 ( Jung Kil Hong ),조현성 ( Hyun Sung Jo ),김진경 ( Jin Kyung Kim ),양미경 ( Mi Kyung Yang ),이병달 ( Byung Dal Lee ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.4

난치성 흉통 환자에서 발견된 양성 및 악성 종양

권민아 ( Min Ah Kwon ),박정헌 ( Jeong Heon Park ),유래근 ( Rea Geun Yoo ),김태형 ( Tae Hyung Kim ),심우석 ( Woo Seog Sim ) 대한통증학회 2005 The Korean Journal of Pain Vol.18 No.2

대마초 및 메스암페타민 남용자들의 기질 및 성격 특성

권민,민정아,최지혜,김대진,Kwon, Min,Min, Jung-Ah,Choi, Ji-Hye,Kim, Dai-Jin 대한생물정신의학회 2012 생물정신의학 Vol.19 No.2

Objectives : This study aims to identify temperament and characteristics of cannabis and methamphetamine abusers for elucidating psycho-biological variables related to certain substance abuse. Methods : A total of 320 patients who registered in the 'Hepatitis C cohorts study of intravenous drug users' between March 2006 and March 2010 participated in this study. Data on demographic variables were obtained and the Temperament and Character Inventory (TCI) and measures for nicotine dependence, alcohol dependence, depression and anxiety were assessed. After comparing TCI between cannabis, methamphetamine, and co-abusers, correlations between TCI and other clinical variables were examined. Results : The methamphetamine abuser group showed significantly higher scores in Novelty Seeking (NS2) and Harm Avoidance (HA3) in temperament than the cannabis abuser and co-abuser groups, whereas the cannabis abuser group had higher scores in purposefulness (SD2), congruent second nature (SD5), and self-directedness (SD) in character than the methamphetamine abuser group. In addition, temperaments and characters correlated with various psychiatric symptoms. Conclusions : We found the differences in temperament and characters among cannabis abusers, methamphetamine abusers. These findings might contribute to further understanding of mechanisms of cannabis and methamphetamine abuse.

증례보고 : 산후 두통 중 뇌내 출혈과 경막 천자에 의한 두통의 감별 -증례보고-

이숙영 ( Suk Young Lee ),권민아 ( Min Ah Kwon ),최덕환 ( Duck Hwan Choi ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6

We report a patient with a postpartum headache, who was later diagnosed with an intra cerebral hemorrhage. She underwent a cesarean section under the combined spinal-epidural anesthesia, and complained of a suspicious post-dural puncture headache (PDPH) in the puerperium. The headache was partially improved with analgesics and she was discharged. The day after discharge, the headache became aggravated and she visited our labor floor for further treatment. An epidural blood patch (EBP) was performed because the headache regarded as aggravation of PDPH. However, hemiparesis and dysarthria developed 40 minutes after the EBP. Computed tomography was revealed an intracerebral hemorrhage in the right side basal ganglia. She was transferred to the neurosurgical intensive care unit. She was treated conservatively and has almost completely recovered. This case highlights the need to consider an intracranial hemorrhage, a cerebrovascular accident, nonspecific headache and PDPH when making a differential diagnosis of postpartum headache, particularly when an atypical postpartum headache is noted. (Korean J Anesthesiol 2006; 50: 727~30)

성인 생체 부분 간이식 시 정정맥우회술의 사용 유무에 따른 혈액 응고 양상의 비교

신병섭 ( Byung Seop Shin ),김갑수 ( Gaab Soo Kim ),곽미숙 ( Mi Sook Gwak ),김정수 ( Chung Su Kim ),권민아 ( Min Ah Kwon ),정익수 ( Ik Soo Chung ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.4

膀胱의 單臟器成 Shwartzman反應에 관한 超微形態學的 硏究

권민아,장세국,서인수,손태중 慶北大學校 醫科大學 1990 慶北醫大誌 Vol.31 No.4

본 연구는 감염성 방광염의 성립의 조건으로 Shwartzman반응의 기전이 참여할 것인가를 검토하고, 방광의 단장기성 Shwartzman반응에서 초기의 형태적 변화를 알아보기 위하여 시도하였다. 실험은 백색 암컷 가토를 실험동물로 하여 방광내에 내독소를 주입하고 24시간후에 정맥내로 같은 내독소를 주사하여 야기조작 15및 30분, 1, 2 및 4시간후에 방광을 적출하여 육안, 광학, 주사전자 및 투과 전자현미경으로 관찰하였던 바 그 성적을 요약하면 다음과 같다. 광학 현미경으로는 반응의 초기부터 표재세포가 호산성 덩어리로의 변성 및 괴사 탈락이 나타나고, 중간세포 및 기저세포는 야기조작 수시간 후부터 공포성 변성을 보이고, 같은 시기에 상피하 미소혈관은 울혈 및 주변 조직의 부종을 보이고, 호중구의 침윤도 관찰되었다. 주사 전자현미경으로는 표재세포 표면의 microridge의 blurring과 표면구조의 편평화 및 세포간 결합장치의 이완등을 초기에서 부터 볼 수 있었고, 수시간이 지난 후에는 군데군데에서 상피의 괴사 탈락이 관찰되었다. 투과 전자현미경으로는 포재세포의 apoptosis를 초기에서부터 볼 수 있었고, 수시간 후에는 상피층 전층의 괴사까지 관찰되었고, 기저세포에는 autophage가 증가된 것이 관찰되었다. 가장 특징적 변화는 상피직하 점막하층 미소혈관계의 변화로 반응의 초기에서부터 내피세포의 종창등의 상해성 변화를 보였고, 수시간후에는 혈소판의 응집과 호중구의 변연화 및 유주등을 관찰할 수 있었다. 이상의 성적으로 보아 방광염의 성립에 Shwartzman반응의 기전이 참여할 수 있는 것으로 생각되며, 방광의 단장기성 Shwartzman반응의 주된 반응을 하는 장소는 상피직하부의 미소혈관계인 것으로 사료된다. This study was carried out to investigate the possible role of Shwartzman reaction in the development of the cystitis and the morphologic changes in early stage of the reaction. Endotoxin extracted from E. coli was injecting same endotoxin via ear vein, 24 hours after first infection. Animals were sacrificed 15 and 30 minutes, and 1, 2 and 4 hours after the last injection. The Urinary bladders were extracted out and examined with the light, transmision electron, and scanning electron microscopes. The results obtained were summarized as follows: Ligth microscopy showed eosinophilic degradation, necrosis and detachment of the superficial cells within 1 hour after provocation treatment. Intermediate and basal cells also showed swelling after few hours. Subepithelial microvasculatures showed congestion with perivascular edema and neutrophilic infiltration from the early stages. Scanning electron microscopy dischlosed blurring of microridge structures on superficial cells with loosening of the intercellular junction from early stage. Necrosis and detachment of epithelial cells were noted in several areas after few hours, only remaining basement membranes. Transmission electron microscopy showed apoptosis of the superficial cells, with partial necrosis through total thickness of the epithelial layer after several hours. Many autophagic vacuoles were found in basal cells. Characteristic vascular change was noted in the microvasculatures on the submucosa, consisting of swelling and archade formation of the endothelial cells with platelet aggregation, and margination and emigration of neutrophils. The results suggest that Shwartzman reaction could be participated on the development of cystitis, and subepithelial small vessels were the main focus of the reaction.

암성통증관리에서 정주된 케토롤락의 모르핀 절감 및 장폐색 치유효과

한태형,권민아 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.1

Background : Pain management in the terminal stage of advanced cancer is often complicated by opioid-related bowel syndrome and other problems. This study was conducted to investigate the safety and efficacy of ketorolac as an adjunctive analgesic in cancer pain management. Methods : 10 acutely ill cancer patients suffering from pain, complications of advanced disease, and opioid side effects were included. Except one acute leukemia, all of the patients had metastatic solid tumors. Pain complaints consisted of visceral, somatic and opioid bowel syndrome. They were treated with intravenous morphine patient-controlled analgesia infused with a repeated ketorolac bolus dosing. Demographic data, cancer diagnosis, change of pre- and post-treatment morphine infusion rates, and days until pain control or relief of opioid bowel syndrome were evaluated. Results : Excellent pain relief with improvement of opioid bowel syndrome was achieved in a majority of cases. Ketoralac showed good morphine sparing effects. None of the patients reported gastrointestinal side effects. Conclusion: Ketorolac appeared to be well-tolerated in the clinical dose range and for short-term use in acutely-ill terminal cancer pain patients. It also seems to be very effective in relieving opioid- related bowel synclmmes. (Korean J Anesthesiol 2000; 39: 98~103)

중추성 통증 증후군에서 부가적 진통제로서 투여된 가바펜틴

한태형,권민아 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.6

Background: This study was undertaken to investigate the analgesic efficacy and safety of gabapentin in central pain syndrome. Methods: With a diagnosis of central pain syndrome, a total 24 patients were accumulated in the outpatient pain clinic. Patients had been stabilized in their analgesic regimen at least four week prior to the study. Anticonvulsants, if taken, were discontinued for two weeks wash-out. Pretreatment baseline pain scores (visual analog scale and pain intensity score) were obtained. Oral administration of gabapentin 300 mg was started in all patients. Initial doses were given from 300 mg per day with gradual titration over two weeks until 1) the onset of analgesic effect, 2) the maximum of 2,400 mg per day, and 3) the onset of intolerable side effects. Dosage was adjusted weekly. At the four-week study end point, VAS, PIS, pain improvement scores judged by family members, drug efficacy, tolera-bility and overall evaluation were assessed. The incidence of side effects was also noted. Results: Fifteen patients dropped out due to various reasons. Data was collected from 9 patients (male = 4, female - 5). Among these, 3 had strokes and 6 spinal cord lesions due to trauma, cancer metastasis or syringomyelia. The average disease duration was 4.2 years. Analgesic onset was within two weeks and the average dose taken was 477.7 mg. At the end of the study, the VAS score and PIS revealed significant pain relief. These results were objectively reflected in pain improvement scores observed by family members. The majority scored good or excellent in all scales of drug evaluation. Sedation was the most frequently reported side effect. Others included dry mouth, weakness, and diarr-hea, which were spontaneously resolved with lower dose maintenance. Conclusions: Gabapentin showed analgesic effect for central pain syndrome at a lower dose range than any other neuropathic pain syndromes. It appears to have different analgesic dose requirements in this difficult pain syndrome. (Korean J Anesthesiol 2000; 39: 834~841)