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2003-2004 절기 서울지역의 인플루엔자 바이러스 분리 및 아형 분석
황영옥,이재인,서병태,Hwang Young-Ok,Lee Jae-In,Seo Byung-tae 한국미생물학회 2005 미생물학회지 Vol.41 No.1
인플루엔자바이러스는 거의 매년 겨울철에 유행을 일으키는 급성 호흡기 질환의 주요한 원인 바이러스중의 하나로 막대한 사회 경제적 손실을 가져온다. 본 실험은 2003-2004절기 동안 $38^{\circ}C$이상의 갑작스러운 발열과 더불어 기침 또는 인후통을 보이는 401명의 인플루엔자의사환자(ILI : Influenza-like illness) 검체로부터 124주의 인플루엔자바이러스를 분리하여 형 및 아형 분석과 그에 따른 유행양상을 분석하였다. 인플루엔자 의사환자 연령별 분포를 살펴보면 20-49세의 성인층의 환자수가 $23\%$로 가장 많았으며, 바이러스 분리율은 7-19세의 학령기에서 $50\%$로 가장 높았다. 분리된 인플루엔자바이러스 124주 중 A/H3N2 type는 83주, Type B는 41주였다. 지역별 인플루엔자 의사환자 발생율은 노원구, 서초구, 강남구의 발생율이 타 지역에 비해 비교적 높았으며 바이러스 분리율은 용산구 $66.7\%$, 강남구 $50.0\%$, 노원구 $39.9\%$, 강북구 $36.8\%$ 서초구 $27.8\%$, 동작구 $21.2\%$ 순이었다. 인플루엔자 의사환자의 예방접종현황조사결과 접종을 받았음에도 불구하고 인플루엔자 의사환자로 보고된 경우가 $40\%$였으며, 접종율은 20-49세 성인층이 가장 높았다. 이와 같은 인플루엔자 실험실 표본감시체계 결과의 분석을 통하여 새로운바이러스형 출현을 감시하며, 현행 예방백신의 효과 및 유행양상을 예측하여 국가 인플루엔자 관리대책을 수립하는데 활용하고자 한다. Influenza is an important public health problem which occurs almost every winter in temperate climates and is often associated with increased rates of hospitalization and death. In 1999, our influenza surveillance was initiated with 4 voluntary sentinel physicians and the Public Health Center. During the 2003-2004 influenza season, 124 influenza viruses were isolated from 401 clinical specimens, which were collected from patients with Influenza-like illness(ILI) in Seoul. The case definition of ILI is a case with fever more than $38^{\circ}C$ and systemic symptoms; cough, or sore throat. ILI was the highest at the 20-49 age $group(23\%)$ and the rate of virus isolation was the highest at the 7-19 age $group(50\%)$. Among 124 influenza viruses, isolates 83 were identified as A/H3N2 type and others were subtyped as influenza B viruses in 2003-2004 season. Influenza viruses were collected $39.1\%$ at Nowon-Gu, $13.5\%$ Gangnam-Gu and Seocho-Gu etc. and the isolate rate of virus had the area difference; Yongsan-Gu $66.7\%$, Gangnam-gu $50.0\%$, Nowon-Gu $39.9\%$, Kangbuk-Gu $36.8\%$, Seocho-Gu $27.8\%$, Dongjak-Gu $21.2\%$. Out of 401 individuals, 160 was vaccinated $(40\%)$ and the vaccination rate was the highest at the 20-49 age $group(32\%)$. These findings may contribute to the recommondation of the influenza vaccine formulation and the development of influenza control measure.
판막질환의 개심술시 Creatine Kinase MB Isoenzyme 측정에 의한 심근손상 평가에 대한 소고
박평환,서병태 대한마취과학회 1985 Korean Journal of Anesthesiology Vol.18 No.3
During a 3-month period in 1984, 12 patients undergoing scheduled valvular replacement were Studied by CK and CK-MB isoenzyme to evaluate the myocardial damage during open heart operation. Total creatine kinase value was 58.3±25.6 u/L at control, 59.8±23.5 U/L at prebypass period, 85.5±49.6 U/L at during bypass period, 20.2±87.6 at poatbypass period respectively. It began to rise in prebypass period and showed higbest level in postbypass period. CK-MB value was low in most cases below 20U/L but in 2 patients postbypass period showed high level which above 40U/L. Initial isoenzyme activity was detected in 2 patients prior to anesthesia, in 2 patients prior to bypass, in 5 patients during bypass, and in all others after termination of bypass. Considering above data we concluded that anesthetic manage-ment during prebypass period and myocardial preservation during bypass period required more proper and aggressive management despite of good operation results.
Enflurane 또는 Propofol을 이용한 전신마취에서 지혈대에 의한 고혈압과 활력징후의 변화
양홍석,박수성,서병태,정월선,김락범 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.4
Background: The tourniquet is associated with severe hemodynamic changes and toumiquet-induced hypertension (T-HTN). Propofol is pferred as an anesthetic agent for rapid induction and recovery, and less nausea and vomiting. The aim of this study was to find the difference in hemodynamic changes and the T-HTN in patients with total knee replacement arthroplasty receiving enflurane or propofol anesthesia. Methods: One hundred patients underwent total knee replacement arthroplasty were divided into four groups; enflurane-control (n = 22), enflurane-elderly (n = 28), propofol-control (n = 22), propofol-elderly (n = 28). Mean arterial blood pressure (MAP), heart rate (HR) and end-tidal CO₂ (PETCO_2) were recorded throughout the operations of each group. Statistical analysis was done using repeated measures of ANOVA, chai-square test (P $lt; 0.05). Results: MAP increased in the propofol group during the toumiquet inflation period compared to the period before toumiquet inflation. The incidence of T-HTN in the propol group (58%) was higher than that of the enflurane group (36%). HR increased in the enflurane group just after toumiquet inflation. PETCO_2 decreased during 20 60 minutes after tourniquet inflation in the propofol group (P $lt; 0.05). MAP decreased and PO increased during the 1, 5 minutes after tourniquet deflation in all groups. There were minimal HR changes after tourniquet deflation in all groups. Conclusions: T-HTN occurrence and MAP were shown to be higher in the propofol anesthesia and both enflurane and propofol can be used as an anesthetic agent for total knee replacement arthroplasty without complications.
한성민,최윤,양홍석,김성렬,서병태,조삼순,윤시네 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.2
Background: The hydrolysis of mivacurium and succinylcholine is impaired in the presence of defects of pseudocholinesterase. Clinical reports are conflicting as to the utility of anticholinesterases, in the reversal of mivacurium- or succinylcholine- induced paralysis. In this study, the role of exogenous bovine pseudocholinesterases (BpChE) and/or neostigmine, pyridostigmine, edrophonium or galanthamine in the reversal of mivacurium- or succinylcholine-induced paralysis, were investigated with the rat phrenic nerve-diaphragm preparation. Methods: Ninety five Sprague-Dawley rats (200 g, male) were divided into 14 groups (n = 10). The phrenic nerve-diaphragm preparation mounted in a bath containing oxygenated Krebs' solution. Twitch response from diaphragmatic muscle evoked by phrenic nerve stimulation were measured. After stabilization of the twitch responses, mivacurium (0.1 ㎍/mlml) or succinylcholine (0.1 ㎍/ml) was administered incrementally in the preparation to obtain more than 95% twitch inhibition. BpE (0.1, 1.0 u/ml), and/or neostigmine (0.1, 1.0 ㎍/ml), pyridostigmine (0.5, 5 ㎍/ml), edrophonium (0.01, 0.1 ㎍/ml) or galanthamine (0.1, 1.0 ㎍/ml) were added for the reversal of mivacurium- and/or succinylcholine-induced block in each group and the twitch responses (0.1 Hz) were monitored for 60 min. The effect of BpChE (0.1 u/ml), in combination with each of the above four anticholinesterases at lower concentrations also were examined. Twitch heights more than 75% was considered an adequate reversal. Results: BpChE 0.1 and 1.0 u/ml were effective in reversal of mivacurium-induced paralysis. When anticholinestrases were added, there was no effective improvement of twitch height at the end of 60 minutes. In succinylcholine-induced paralysis, BpChE was effective for reversal, but when anticholinesterases were added, BpChE potency was inhibited. Conclusions: BpChE will reverse mivacurium-induced block more effectively than anticholinesterase. BpChE is effective in reversing succinylcholine block. The additionanticholinesterases inhibits the activity of pseudocholinesterase.
한성민,김종욱,전희정,이동명,서병태,권태엽 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.2
Moyamoya disease is a rare progressive occlusive disease in the internal carotid arteries, along with the presence of an abnormal capillary network of vessels at the base of the brain. In moyamoya disease, the manitaining of cerebral perfusion and cerebral oxygen saturation are required to reduce complications of this disease including cerebral ischemia and cerebral hemorrhage. The authors measured regional oxygen saturation (rSO_2) nonivasively by INVOS 5100 (Somanetics, USA) in patients with moyamoya disease who were scheduled for an encephalo-duro-arterio-myo synangiosis (EDAMS) operation. We therefore report our findings that deep breathing decreased rSO_2and oxygen, elevated blood pressure, and that the cerebral vasodilating drug increased rSO_2.