요추부 수술후 경막외 Morphine Sulfate와 Bupivacaine의 지속적 주입에 의한 통증 조절의 효과

신문수,이병희,최훈규,노재섭,안정용,신승훈,이병희,정봉섭,Shin, Moon Soo,Lee, Byung Hee,Choi, Hun Kyu,Noh, Jae Sub,Ahn, Jung Young,Sheen, Seung Hun,Lee, Byung Hee,Chung, Bong Sub 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n=20) and control group(n=15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.

서울大學校 綜合化 10個年計劃의 紹介

申文秀(Shin Moon Soo) 대한토목학회 1973 대한토목학회지 Vol.21 No.1

요추부 수술 후 경막외 무통방법과 지속적 정맥 주입에 의한 통증 조절의 효과 비교

오규성,신문수,길현주,허륭,최훈규,안정용,권성오,Oh, Kyu Sung,Shin, Moon Soo,Gil, Hyun Joo,Hur, Ryoong,Choi, Hun Kyu,Ahn, Jung Yong,Kwon, Seong Oh 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.12

Objective : The purpose of this non-randomized prospective study was to evaluate the safety and efficacy of continuous intravenous nalbuphine-ketorolac-droperidol(CIA) versus continuous infusion of epidural morphine-bupivacaine(CEA) for pain control after lumbar spinal surgery. Methods : Twenty-one patients who underwent spine surgery including laminectomy, fusion with fixation were assigned to receive an intravenous bolus of nalbuphine 5mg and ketorolac 15mg, followed by a continuous infusion of nalbuphine 25mg, ketorolac 105mg, and droperidol 5mg mixed with normal saline 98cc(2cc/hr). Twenty patients received a bolus infusion of morphine 2mg and 0.125% bupivacaine 8cc followed by a continuous intravenous infusion of 100cc 0.125% bupivacaine and morphine sulfate 8.0mg(2cc/hr). Pain score was measured on a visual analogue scale(VAS). It's safety and efficacies were compared with the results of continuous infusion of epidural morphine-bupivacaine, which was reported previously by same authors. A continuous infuser was used to give epidural morphine-bupivacaine and intravenous nalbuphine-ketorolac-droperidol. Results : In general, mild pain, pain less than 3 VAS scores, was observed postoperatively from 30minutes to 72hours in CEA group, and from 6 hours to 72 hours in CIA group. The early postoperative pain was controlled easily in 6 hours in CEA group, compared to CIA group(p<0.05). However, there was no statistical significance in 72 hours on pain scores between CEA and CIA groups after 6-12hours of pain managements. Pruritus, nausea and vomiting, and urinary retention were more frequent in CEA group. Conclusion : CIA and CEA are considered effective methods in postoperative pain managements. However, adequate doses in early intravenous infusion and continuous intravenous analgesia with nalbuphine-ketorolac-droperidol will be needed for better control in early postoperative pain with less side effects.

이산사건 시뮬레이션 시스템을 활용한 생산성 개선 사례 연구

김상태(Sang tae Kim),신문수(Moon soo Shin),류광열(Kwang yeol Ryu),조용주(Yong ju Cho) 한국산업경영시스템학회 2015 한국산업경영시스템학회지 Vol.38 No.4

Up-to-date manufacturing companies have faced a market-driven environment of pull production order. There should be a difference in operating manufacturing resources according to the type, quantity, and delivery time of manufactured products, because the process situation in pull production is changed by customer orders. And it should be taken into account from the stage of preparing for production such as process design and the placement and utilization of manufacturing resources. However, the feasibility of production plans is limited because most of small manufacturing businesses make production/supply plan of the parts and products assuming that equipment abilities in scheduling is sufficient without managing process standard information systemically. In this study, a discrete event simulation system based on BOM (bill of material), that is F-OPIS (online productivity innovation system), is introduced and a case study on application of the system leading to improving productivities is presented. F-OPIS deals with a decision-problem on production management and it is specialized for small-and- medium sized manufacturing companies. The target company of this case study is a typical small-and-medium sized manufacturing company in Korea, that produces various machined parts. The target company adopts make-to-stock production management to prevent tardy delivery because of fluctuations in demand. Therefore, it is required to apply an efficient inventory control solution for improving produc-tivities. In this paper, based on the constraints of working capacity of manufacturing resources, the bottleneck process is analyzed as production conditions are changed. Consequently, an improvement plan is proposed, that eventually enhances overall utilization rates of resources in the bottleneck process and reduces overall production lead-time and inventory level.

뇌동맥류에 의한 신경 압박의 GDC 색전 치료 반응

박진영,안정용,허륭,최훈규,이병희,신문수,정봉섭,Park, Jin Young,Ahn, Jung Yong,Huh, Ryoong,Choi, Hun Kyu,Lee, Byung Hee,Shin, Moon Soo,Chung, Bong Sub 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Objectives : Embolization of intracranial aneurysms by using Guglielmi detachable coils(GDC) is proving to be a safe method of protecting aneurysms from rupture. Occasionally, patients with unruptured intracranial aneurysms present with symptoms related to the aneurysm's mass effect on either the brain parenchyma or cranial nerves. In the present study, the authors conducted a retrospective review to evaluate the response to GDC embolization in a series of 6 patients presenting with cranial nerve dysfunction due to mass effect. Patients and Methods : Aneurysms were classified by size, shape, and amount of intraluminal thrombus. Patients were classified by duration of symptoms prior to GDC treatment(range<1 month to>4 years). Clinical assessment was performed within days of the GDC procedure and at later follow-up appointments(range 5-16 months, mean 9 months). Results : In the immediate post-GDC embolization period, one of the five patients had transient worsening of third nerve palsy, which later improved to better than baseline status. Two patients who presented with third nerve deficit from a internal carotid artery-posterior communicating artery junction aneurysm had complete recovery. One patient who presented with hemiparesis and dysarthria from a giant mid-basilar aneurysm showed improvement of these symptoms. One patient who presented with sixth cranial nerve deficit from a cavernous aneurysm showed no change at the 8-months follow-up examination. Conclusion : The endovascular treatment of intracranial aneurysms by using GDC is suggested as an alternative therapeutic method for improving or alleviating neurological deficits produced by mass effect.

자동차 화상시뮬레이터에서 운전 중 동시과제 수행에 고농도 산소와 향 자극이 미치는 영향

지두환(Doo-Hwan Ji),민철기(Cheol-Kee Min),류태범(Tae-Beum Ryu),신문수(Moon-Soo Shin),정순철(Soon-Cheol Chung),강진규(Jin-Kyu Kang),민병찬(Byung-Chan Min) 한국산업경영시스템학회 2012 한국산업경영시스템학회지 Vol.35 No.4

In this study, it was observed through the ability of performing secondary tasks and baseline fetal heart rate how the supply of lavender, peppermint and highly concentrated oxygen (40%) affected distraction due to the performance of secondary tasks in the driving environment. Twelve male university students conducted secondary tasks while driving in the environments (6 in total) mixed and designed with oxygen concentration (21%, 40%) and the condition of odors (Normal, Lavender, Peppermint). The test was proceeded in order of stable state (5mins), driving (5mins), and secondary tasks (1min), and by extracting ECG data from every section by 30secs, the mean value of baseline fetal heart rate was calculated. As a result of analysis, in the ability of performing secondary tasks, a percentage of correct answers showed no difference in oxygen concentration and the condition of odors (p > 0.05). In performance completion time, a percentage of correct answers decreased showing a statistically significant difference in the condition of odors compared with the condition where odors were not provided (p < 0.05). As for baseline fetal heart rate, in the comparison between sections, while performing secondary tasks, it increased showing a significant difference compared with stable state and driving state (p < 0.05). The effect of interaction was observed in oxygen concentration and the condition of odors. When odors were not provided, baseline fetal heart rate decreased in 40% oxygen concentration compared with 21% oxygen concentration (p < 0.05), however, when peppermint was provided, it increased in 40% oxygen concentration compared with 21% oxygen concentration (p < 0.05). In conclusion, the fact that the condition of odors increased the ability of calculation, and when only the highly concentrated oxygen was provided, parasympathetic nerve system was activated, however, when highly concentrated oxygen was provided with peppermint at the same time, sympathetic nervous system (sns) was activated, which had a negative effect on the autonomic nervous system was drawn.

화상 자동차 시뮬레이터에서 운전 중에 경적음 자극에 대한 후각자극의 마스킹 효과

민철기(Cheol-Kee Min),지두환(Doo-Hwan Ji),고복수(Bok-Soo Ko),김진수(Jin-Soo Kim),이동형(Dong-Hyung Lee),류태범(Tae-Beum Ryu),신문수(Moon-Soo Shin),정순철(Soon-Cheol Chung),민병찬(Byung-Chan Min),강진규(Jin-Kyu Kang) 한국산업경영시스템학회 2012 한국산업경영시스템학회지 Vol.35 No.4

In this study, the masking effect of olfactory stimulus on the awakening state due to sound stimuli while driving using Graphic Driving Simulator was observed through the response of autonomic nervous system. The test was conducted for 11 males in their twenties. The siren of ambulance car was presented to them as auditory stimulus for 30 secs while driving in a situation of high way in the condition of both peppermint and control, respectively, and LF/HF ratio of HRV (Heart Rate Variability), the activity index of sympathetic nerve, and GSR (Galvanic Skin Response) response were examined. The test was proceeded in the order of three stages, that is, sound stimuli (test 1), driving performance, and sound stimuli (test 2), and fragrance stimulus, driving performance, and sound stimuli (test 3), and the physiological signal of GSR, HRV was measured in the whole stages. As a result of test, comparing the results of before and after auditory stimulus test (1) (p < 0.01), test (2) (p < 0.05), and test (3) (p < 0.01), driving performance test (2) (p < 0.01), test (3) (p < 0.01), and olfactory stimulus test (3) (p < 0.05), respectively, GSR response increased, showing significant difference in all the tests. It indicates that when auditory stimulus was presented to the subjects, they were in the awakening state as sympathetic nervous system got activated. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was no significant difference in GSR response. The LF/HF ratio of HRV increased, showing a significant difference only in test (2) (p < 0.05), and in driving performance test (2) (p < 0.05) in auditory stimulus, however, it showed no significant difference in olfactory stimulus. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was a decrease, showing significant difference (p < 0.05) in LF/HF ratio of HRV. That is, it means that the activation of sympathetic nervous system decreased, and that parasympathetic nervous system got activated. From these results, it was observed that while driving, the awakening level due to auditory stimulus was settled with olfactory stimulus. In conclusion, it was drawn that while driving, olfactory stimulus could have the masking effect on auditory stimulus.

뇌동맥류 환자에서 수술과 백금코일 색전술의 비교 - 98 예에서의 전향적 연구 ( The Management of Intracranial Cerebral Aneurysms Surgery Versus GDC Embolization )

신승훈(Seung Hun Sheen),정봉섭(Bong Sub Chung),최훈규(Hun Kyu Choi),신문수(Moon Soo Shin),안정용(Jung Yong Ahn),이병희(Byung Hee Lee) 경희대학교 경희의료원 1999 慶熙醫學 Vol.15 No.4

원인불명의 자발성 지주막하 출혈환자의 예후

신문수,최문철,조기홍,김한규,조경기 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.3

A clinical analysis and follow-up study were performed with 35 cases of subarachnoid hemorrhage of unknown etiology among 217 cases of spontaneous subarachnoid hemorrhage who were diagnosed by cerebral pan-angiography and brain C-T scan and treated at department of neurosurgery, Chonju Presbyterian Medical Center from 1977 to 1982. The duration of follow-up study was 6 months to 8 years (mean 4.4 years). The author obtained the following results. 1) Subarachnoid hemorrhage of unknown etiology was 16% of 217 cases of spontaneous hemorrhage. 2) The incidence of subarachnoid hemorrhage of unknown etiology was high in 5th decade and higher in women. 3) Manifestations of subarachnoid hemorrhage of unknown etiology were similar to those of ruptured aneurysm. 4) When primary cerebral pan-angiography was normal, the secondary cerebral pan-angiography was not so meaningful. 5) The overall prognosis of the cases of unknown etiology was good in 30 among 35 cases (86%) who were able to return to their previous occupation. 6) Age and blood pressure were probably major prognostic factor.

후하방 흉추간판탈출증에서 전측방 도달법으로 Carbon Cage를 이용한 골융합술

신문수,정봉섭,최훈규,김용인 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

The authors report a case of thoracic disc herniation at T11/12 level which was downward migrated, presenting with signs of progressive spinal cord compression. The lesion was diagnosed by MRI. The operation was done by transthoracic transpleural approach using surgical microscope and the rib was not resected due to floating ribs of T11, 12. A Carbon cage with cancellous bones were used for the graft at the partial corpectomy site. The result of operation was good.