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유병훈(Byung Hoon Yoo),김경태(Kyung Tae Kim),김영 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.1
N/A Background: We studied the effects of lumbar spinal root block (RB) prospectively in 21 patients who had suffered from low back pain with radiating pain even treated epidural steroid injection three times. Method: RB was performed under the fluoroscopic C-arm guide. When the needle was in correct position, we confirmed the needle placement and expected drug spreading by injection of contrast medium (Isovist®-300, Schering, Germany). Next 2% mepivacaine 1 ml mixed to 40 mg of Depomedrol was injected. Pain assessment was carried out 7 days after RB by numeric pain score regarding the pain just before RB was 10. Remained pain after RB was graded as excellent; 0-2, good; 3-5, bad; 6-8 and poor 9-10. Results: Mean age of the patients was 52.3 years. 38.1% and 47.6% of the patients showed excellent and goo dresults after RB, respectively. Conclusion: We cancluded that RB is easy and safe procedure to perfirm and effective for the treatment of remnant pain following epidural steroid injection, especially in the patients who had spinal stenosis.
섬유근통 증후군 환자에서 Somatomedin C (Insulin - Like Growth Factor 1)의 농도와 임상증상과의 관계
유병훈(Byung Hoon Yoo),강정권(Jeong Kweon Kang),오 대한통증학회 1999 The Korean Journal of Pain Vol.12 No.1
N/A Background: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive histological or laboratory abnormality in diagnosis, it has often been considered a form of psychogenic rheumatism. Fibromyalgia causes much distress to the affected patients and often frustrates physicians, who are unable to start rational therapy on any logical disease pathology. Methods: Growth hormone is essential for muscular homeostasis. In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormones anabolic actions and is a prerequisite for normal muscle homeostasis. Serum levels of somatomedin C using acid-extraction procedure and two-site immunoradiome-tric assay (IRMA) and number of tender points were measured in 27 female patients with fibromyalgia from 40 to 60 years old and 27 healthy controls. Results: There were no differences in the concentration of somatomedin C between fibromyalgia patients and controls (mean+SD: 178.3+75.5 ng/ml versus 166.3+76.6 ng/ml; p 0.55). And there were no correlations between number of tender point and serum somatomedin C level by linear regression analysis. Conclusions: These findings did not support that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a fibromyalgia syndrome. But we can not discard the hypothesis that disturbed sleep predispose to muscle pain.
전승규 ( Seung Gyu Jeon ),유병훈 ( Byung Hoon Yoo ),임윤희 ( Yun Hee Lim ),이상석 ( Sang Seok Lee ),홍기혁 ( Ki Hyuk Hong ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
An 11-year-old boy underwent thoracolumbar surgery to correct a deformity caused by congenital kyphoscoliosis from the 6th thoracic vertebra to the 2nd lumbar vertebra. During a screw insertion, some tore and cerebro-spinal fluid (CSF) leaked. After CSF leakage, the amplitude of the motor evoked potential in the left lower extremity was reduced by 90% compared to baseline value, but there was no nerve damage at the surgical site. His post-surgical mental status did not recover completely. Brain computed tomography revealed a subdural hemorrhage in the inter-hemispheric fissure, with both tentorium and right frontotemporooccipital and diffuse brain edema. On the 4th postoperative day, mental status recovered to near alertness, but upper motor strength was grade II, right lower motor strength was grade II and left lower motor strength was grade I. Right hemifacial palsy was also noted. At 2.5 months after surgery, right facial palsy remained, but motor function recovered to near normal levels with conservative care. (Korean J Anesthesiol 2009;56:116~9)
김명수(KIM, Myung Soo),유병훈(Yoo, Byung Hoon),이창희(Lee, Chang Hee) 대한교통학회 2017 대한교통학회 학술대회지 Vol.76 No.-
본 연구는 충청권 광역철도의 노선 확정에 따른 서대전역의 이용률 증가를 고려하여 서대전역의 가로현황 및 역현황을 개선하고 이에 따라 서대전역의 활성화를 도모하는 설계를 제안하고자 한다. 서대전역의 이용자 수는 2004년부터 꾸준히 증가하는 추세인 반면, 같은 지역의 대전역은 그 이용자 수용능력이 포화상태에 이르러 대전시 내에 그 초과이용자를 수용할 수 있는 대체시설이 필요한 시점이다. 서대전역은 국가기관교통망으로써 호남KTX로 용산~광주를 연결하고 충청권 광역철도로 논산~청주공항을 신속히 연결하여 이용자의 지역 간 이동을 원활이 하도록 지원하는 역할이다. 따라서 증가하는 차량 및 보행 이용자를 고려하여 그에 맞는 역의 환경을 조성하고 이용자들의 편의를 도모하며 더불어 서대전역을 활성화 시키는 개선 및 활성화 방안을 계획한다.
임상연구 : 관상동맥우회술을 위한 내시경두렁정맥채취 시 동맥혈액가스의 변화
강동욱 ( Dong Uk Kang ),유병훈 ( Byung Hoon Yoo ),이상석 ( Sang Seok Lee ),연준흠 ( Jun Heum Yon ),송철민 ( Cheol Min Song ),장지민 ( Ji Min Chang ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.2
Background: Endoscopic surgical procedure has recently been applied to not only intraabdominal or intrathoracic surgery but also saphenous vein harvesting, because it is less invasive and more cosmetically advantageous. Carbon dioxide insufflation during an endoscopic saphenous vein harvesting may cause an adverse effects on arterial blood gas and hemodynamic variables. This study was conducted to evaluate the safety of carbon dioxide insufflation during endoscopic saphenous vein harvesting. Methods: Patients in ASA physical status III or IV, scheduled for an endoscopic saphenous vein harvesting (n=30) were gathered for the evaluation. Until the end of the procedure, controlled mechanical ventilation (tidal volume: 10 ml/kg, respiratory rate: 10 rates/min) and ventilator mode was fixed in this tidal volume and respiratory rate. Arterial blood gas analysis, end-tidal carbon dioxide, blood pressure and heart rate were measured before and at 10, 20, 30, 40 minutes after carbon dioxide insufflation. Results: Preinsufflation values of PaCO2 (partial pressure of arterial carbon dioxide) and PETCO2 (partial pressure of end-tidal carbon dioxide) were 33.4 ± 3.6 mmHg and 24.1 ± 4.1 mmHg, respectively. PaCO2 was significantly increased at 30 and 40 minutes after carbon dioxide insufflation (40.1 ± 7.4 mmHg and 41.4 ± 8.6 mmHg). PETCO2 was significantly increased at 20, 30 and 40 minutes after carbon dioxide insufflation(27.6 ± 5.5 mmHg, 28.9 ± 7.0 mmHg and 29.6 ± 7.8 mmHg). But, the magnitude of difference between PaCO2 and PETCO2 was not significantly different. Conclusions: During endoscopic saphenous vein harvesting, PaCO2 was significantly increased compared with preinsufflation values. Careful monitoring of PaCO2 is mandatory during the procedure. (Korean J Anesthesiol 2007; 53: 194~8)
임상연구 : Propofol 주입 시 기관내 삽관에 따른 심혈관 반응을 억제하는 성별 Remifentanil의 효과처 농도
이해광 ( Hae Kwang Lee ),유병훈 ( Byung Hoon Yoo ),이상석 ( Sang Seok Lee ),임윤희 ( Yun Hee Lim ),연준흠 ( Jun Heum Yon ),홍기혁 ( Ki Hyuk Hong ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.5
Background: Tracheal intubation induces clinically adverse hemodynamic changes. Various pharmacological strategies for controlling these reponses have been suggested with opioids being widely used. The purpose of this study was to determine the effect site concentration of remifentanil in blunting the cardiovascular responses to tracheal intubation according to gender. Methods: Eighty ASA physical status I or II patients, aged 20-40 years undergoing elective surgery, were classified into a male group (n = 40) and a female group (n = 40). Anesthesia was induced using a propofol target controlled infusion (TCI: Marsh model). A propofol target effect-site concentration of 4μg/ml was chosen. Rocuronium 0.6 mg/kg was administered after the patients lost consciousness. Remifentanil TCI (Minto model) was started 1 min after the propofol injection. Initially, an effect-site concentration of 3 ng/ml was chosen. The next concentration was chosen using the up-and-down method reported by Dixon. The non-invasive blood pressure and heart rate were recorded before induction (baseline), after the remifentanil injection, immediately after intubation as well as 1 and, 3 minutes after intubation. Results: Probit analysis revealed a remifentanil effect-site EC50 and EC95 in the male group to be 1.94 ng/ml (95% CI, 1.60-2.27 ng/ml ), 3.07 ng/ml (95% CI, 2.65-4.06 ng/ml), respectively. The EC50 and EC95 in the female group were 1.69 ng/ml (95% CI, 1.35-2.01 ng/ml), 2.81 ng/ml (95% CI, 2.39-3.81 ng/ml), respectively. There were no significant differences between the two groups. Conclusions: The effect-site concentration of remifentanil blunting the cardiovascular responses to tracheal intubation during propofol TCI anesthesia was between 2 and 3 ng/ml. There were no gender differences. (Korean J Anesthesiol 2007; 52: 521~5)
김명수(Kim, Myung Soo),유병훈(Yoo, Byung Hoon),김혜원(Kim, Hye Won),송재민(Song, Jae Min) 대한교통학회 2017 대한교통학회 학술대회지 Vol.77 No.-
본 연구는 정보통신기술로 나아갈 4차 산업에 흐름에 따라 인공지능과 정보통신의 혁신으로 태어난 자율주행 자동차에 대한 개념을 정립하고 자율주행 자동차의 연구를 통해 프로세스와 기술단계을 도출하였고 이를 바탕으로 국내·외 현황을 통해 보완할 점을 찾아내 자율주행 자동차를 상용화 할 수 있는 방안을 제시하는 것을 목적으로 한다. 자율주행 자동차를 일생생활에서 접하게 되었을 때 우선적으로 법과 제도를 마련하여 큰 문제가 발생하는 것을 방지하고 문제가 발생하여도 해결할 수 있는 토대를 만들도록 한다. 또한, 자율주행 자동차에 필요한 교통시설을 설치하고 이를 알려 자율주행 자동차가 대중화 되었을 때 혼잡하지 않도록 방지 한다.
증례보고 : Klippel-Feil 증후군 환자의 마취경험
정영호 ( Young Ho Jung ),유병훈 ( Byung Hoon Yoo ),이상석 ( Sang Seok Lee ),우승훈 ( Seoung Hoon Woo ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4
We present a 12-year-old female Klippel-Feil syndrome patient who underwent a surgical correction of thoracolumbar scoliosis. The patient had congenital fusion of the cervical vertebrae (C2,3,4,5,6) and showed the classic triad consisting of a low posterior hairline, short neck, and neck motion limitation. Because these patients may have a risk of neurological damage during airway management and subsequent positioning, anesthesiologists need to take care regarding the cervical spine pathology and degree of instability. In this case, fiberoptic bronchoscope guided intubation was performed. We discuss the anesthetic management of Klippel-Feil syndrome patients with a review of the relevant literature. (Korean J Anesthesiol 2006; 51: 480~2)