의과대학생을 위한 진로개발: 프로그램 개발과 운영 시 고려할 것은?

정성수,Sung-soo Jung 연세대학교 의과대학 2024 의학교육논단 Vol.26 No.1

Ketamine 이 Fentanyl 과 Diazepam 의 병용에 의한 혈역학 억제 효과에 미치는 영향

정성수,임웅모,위금량,정선민 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.2

To investigate the effects of ketamine on the hemodynamics decreased by fentanyl-diazepam, twenty-five patients were randomly assigned to three groups. In all patients fentanyl (10 ug/kg) diazepam (0.2 mg/kg) was intravenously administered, and then patients in group 1 recevied saline only, group 2 and group 3 recevied 1 and 2 mg/kg of ketamine, respectively. Hemodynamic parameters were obtained before and 5 minutes after durg in each group. In group 1, fentanyl-diazepam produced a decrease in heart rate (HR:17%), mean arterial pressure (MAP:27%), cardiac index (CI:40%) and sroke volume index (SVI:14%), and a increase in mean pulmonary arterial pressure (MPAP:27%) and pulmonary capillary wedge preasure (PCWP;25%), but no significant change in central venous pressure (CVP) and systemic vascular resistance index (SVRI). Patients in group 2 had decreases in HR(16%), MAP(10%), CI(10%) and SVI(16%), and decrease in MPAP(21%), PAWP(21%), PCWP(26%), CVP(58%) and SVRI(24%), but theae hemodynamic changes were no significant difference compared to those of group 1 except a bit increase in CVP and SVRI. In group 3, HR(11%), MAP(11%), CI(23%), and SVI(13%) were decreased, but MPAP(14%), PCWP(14%), CVP(69%) and SVRI(26%) were increased and these values were no difference compared to those of group 2. These results demonstrated that ketamine did not significantly affect the hemodynamics decreased by fentanyl-diazepam except CVP and SVRI were increased by ketamine. Base on this study, the author suggeeted that the mechanism of cardiovascular depression caused by diazepam-fentanyl might to be the result of myocardial depression, ketamine produced its sympathomimetic actions primarily by direct stimulation of central nervous system, and ketamine might to be unuseful to improve the hemodynamics to patients with cardiovaseulsr depreseion caused by fentanyl-diazepam.

칸 아카데미

정성수,Jung, Sung Soo 연세대학교 의과대학 2020 의학교육논단 Vol.22 No.1

종골 관절내 골절의 수술적 치료

정성수,이종서,서재곤,박윤수,황태규 대한골절학회 1998 대한골절학회지 Vol.11 No.4

The calcaneus is the most commonly fractured tarsal bone, but the appropriate care of calcaneal fracture continue to be an unsolved dilemma. As technology in imaging has improved, operative treatment is more suggested. The purpose of this study is to evaluate the results of operative treatment in intra-articular calcaneal fracture and to analyse the results in accordance with various prognostic factors. We analysed retrospectively 13 patients, 17 intra-articular calcaneal fractures undergone operative treatment. Mean follow-up period was 27 months (range:13 - 44 months). There were I 1 males and 2 females with 41 year old mean age (range:18 63 years old). Clinical assessment used the modified Creighton-Nebraska health foundation assessment sheet for fracture of the calcaneus. We obtained excellent result in 7 cases (4I.2%), good in 2 cases (11.8%), fair in 7 cases (41.2%) and poor in I case (5.8%). Clinically age and body weight, radiologically Bohler angle, fibulo-calcaneal distance and subtalar joint discrepancy are related to the prognosis of intra- articular calcaneal fracture following operative treatment. Postoperative complications are limping (2 case), heel pain (3 cases), hump bump of calcaneus (1 case) and subtalar arthritis ( 1 case). In conclusion, on the basis of our results, there is a relationship between anatomical abnormalities of the heel and a poor clinical outcome. Therefore, in operative treatment of intra- articular fracture of calcaneus, we recommend anatomical reduction, if possible, not only of the subtalar joint but also of the Bohler angle and fibulo-calcaneal distance.

Clonidine 과 Prazosin 이 Ketamine 의 심박수와 혈압에 미치는 영향

정성수,임웅모,이만식 대한마취과학회 1987 Korean Journal of Anesthesiology Vol.20 No.6

Ketamine, a dissociative anesthetic, produces an increase in heart rate and blood pressure, but the precise mechanism of the cardiovascular stimulating affects of ketamine is not understood clearly. Clonidine, an antihypertensive agent, is an alpha-2 agonist that appears to act primarily on the CNS, where it apparently produces a decrease in the sympathetic outflow from the brain. Prazosin is antihypertensive agent that appears to exert its vasodilator action through the blockade of postsynaptic alpha-1 receptors. In order to investigate the effects of clonidine and prazosin on the heart rate and blood pressure increased by ketamine, ketamine was administered intravenously following administration of clonidine or prazosin in conscious patients. The results were as follows : 1) Intravenous ketamine (2 mg/kg) produced significant increases in heart rate and blood pressure by as much as 25%. 2) Intravenous clonidine (1.25 ug/kg) produced a decrease in the heart rate by 5 beats per minute and decreased blood prssure significantly. 3) In the clonidine pretreated group (1.25 ug/kg, Ⅳ), intravenous ketamine (2 mg/kg/kg, Ⅳ) produced significant increases in the heart rate and blood pressure without attenuation with clonidine 4) In the prasosin pretreated group (2 mg/kg∼70 kg, PO), ketamine (2 mg/kg, Ⅳ) produced increases the in heart rate and blood pressure without attenuation with prasosin. From the above results, it was inferred that the action site of the cardiovascular stimulating effect of ketamine isn't a postsynaptic alpha-1 receptor and is different from the action site of clonidine.

경추부 골절환자의 후방인대군 손상

정성수,이종서,정호원,김지형 대한척추외과학회 2001 대한척추외과학회지 Vol.8 No.2

연구목적 : 자기 공명 영상을 이용하여 경추 골절 환자에서 경추 후방 인대 복합체 손상의 임상적, 방사선학적 특징을 정의하고자 하였다. 대상 및 방법 : 경추 손상으로 수술을 받은 40명의 환자에 대해 자기 공명 영상과 단순 방사선 촬영으로 손상 기전과 유형을 분류하였고 이 중 후방 또는 전ㆍ후방 수술을 이행했던 25명에 대해 자기 공명 영상 소견과 수술 소견을 비교 평가하여 상관 관계를 조사하였다. 결 과 : 후방 인대 복합체 손상은 전체 40명 환자 중 75%(30명)에서 발견되었으며, 신연ㆍ굴곡 손상 20명 중 90%(18명)에서, 압박ㆍ굴곡 손상 15명 중 73%(11명)에서 후방 인대 복합체 손상이 발견되었고, 수직ㆍ압박 손상 4명 중에서는 25%(1명) 만이 발견되었으며, 신연ㆍ신전 손상에서는 발견되지 않았다. 완전 척수 손상 환자 23명 중 96%(22명)에서 후방 인대복합체 손상이 관찰되었으며, 완전 척수 손상을 받지 않은 17명의 환자 중 (15명은 불완전 척수 손상, 2명은 척수 손상이 없었음) 47%(8명)에서 후방 인대 복합체 손상이 발견되었다. 후방 또는 전ㆍ후방 수술을 시행했던 25명에 대해 자기공명 영상 소견과 수술 소견을 비교 평가한 결과 수술 소견과 자기 공명 영상 촬영 소견은 높은 상관 관계를 보였다.(p<0.05). 결 론 : 경추 골절에서 후방 인대 복합체의 손상은 신연ㆍ굴곡 손상과 완전 척수 손상에서 가장 많이 동반되었으며, 손상 소견은 자기 공명 영상 촬영으로 잘 관찰할 수 있었다. 경추 골절 환자에서 후방 인대 복합체 손상시 자기 공명 영상은 수술 소견과 비교하여 민감도, 측이도, 정확도가 매우 높은 검사법으로 사료되며 치료 방법의 설정에도 도움이 될 것으로 생각된다. Objective : To define the clinical and radiological characteristics of the patients with injury of the posterior ligament complex of the cervical spine using MR imaging. Materials and Methods : Forty patients with acute cervical spine fracture who underwent surgery were examined with MR imaging and plain radiography. Twenty-five patients underwent posterior fusion. The MR findings were correlated with surgical findings, clinical findings. and plain radiographs. Results : Posterior ligament complex injury was detected in 75%(n=3O) of all patients. Of the 20 patients with distractive-flexion injury. 9O%(n=18) had posterior ligament complex injury (p<0.05). Of the 15 patients with compressive-flexion injury. 73% (n=11) had ligament injury. Of the 4 patients with vertical compression injury. 1 patient (25%) showed ligament injury. One patient with distractive-extension injury did not show ligament injury. Of the 23 patients with complete spinal cord injury. 96% (n=22) showed ligament tear (p<O.05). Of the 17 patients without complete cord injury (15 incomplete injury, 2 no cord injury), 47%(n=8) had ligament injury. Surgical findings were well correlated with MR imaging in patients who underwent posterior surgery (p<O.05). Conclusions : Injury of the posterior ligament complex in patients with cervical spine fracture was most common in patients with distractive-flexion injury and was more frequent with complete cord injury. MR imaging could reliably reveal such injuries.

전신성 홍반성 낭창

정성수,김성윤 한국의학사 1994 診斷과治療 Vol.14 No.10

개에서 Protamine Sulfate 에 의한 혈압 하강 기전

정성수,유경연,임웅모,임성진,심승진 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.1

Introduction : Protamine reversal of heparin anticoagulation often produces profound hypotension. However, the precise mechanisms of its hypotensive effect have not been fully elucidated. Using a canine model, we explored the effects of cyclo-oxygenase inhibitor, indomethacin (INDO), and nitric oxide synthetase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME) either alone or both on the cardiopulmonary responses to protamine. Methods : Fifty-four mongrel dogs in five groups were studied during 1.5% halothane anesthesia. GroupI(n=17) received heparin (300 IU/kg iv) followed by protamine (3 mg/kg iv over 30 s) 5 min after the heparin. The same protocol were used in groups II(n=11), III (n=12), and IV (n=7), except that L-NAME (20 mg/kg), INDO (10 mg/kg), and INDO (10 mg/kg) plus L-NAME (10 mg/kg) were infused over 10 min beginning 30 min before the protamine injection, respectively. Animals in group V (n=7) were given protamine (3 mg/kg) alone. Mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), left ventricular end-diastolic pressure (LVEDP), LVdP/dt and cardiac output and left circumflex coronary flow (LCX flow) via Doppler flowmeter and heart rate were continuously recorded in baseline conditions and up to 15 min. Plasma NOx (NO2-, NO3-) levels were also measured before (baseline) and 3, 5, 10, and 15 min after protamine injection. Results: In group I, protamine caused immediate but transient decreases of MAP (41%), cardiac index (CI, 58%), dP/dt (28%), and LVEDP (62%) and increases of MPAP (38%) and systemic and pulmonary vascular resistance indices (SVRI, 30%; PVRI, 316%). INDO significantly attenuated the hemodynamic responses to protamine, whereas L-NAME did not affect them at all. INDO plus L-NAME prevented protamine-induced hypotension, but CI ( 24%) and LVEDP ( 30%) showed similar changes as those in group II. Protamine increased MPAP but inconsistently, meanwhile no correlation was found between the magnitude of increase of MPAP and decrease of MAP at peak responses in groups I-IV. LCX flow increased significantly (124∼188%) immediately after protamine infusion without any changes in plasma NOx levels in groups I-IV. Neither significant hemodynamic effects nor NOx release was found in animals given protamine alone. Conclusion : Protamine in the presence of heparin induces profound hypotension which may be mediated by a prostanoid and other potent vasodilators. In addition, increase of PAP and NO release may not play a significant role in the protamine-induced hypotension. (Korean J Anesthesiol 1998; 34: 27∼38)

기숙형고등학교 정책집행과정 분석 : 교육재정의 관점에서

정성수 대구교육대학교 초등교육연구소 2017 초등교육연구논총 Vol.33 No.1

볼밀링한 WO₃-CuO 나노복합분말의 조성에 따른 수소환원 거동

정성수,강윤성,이재성,Jung Sung-Soo,Kang Yun-Sung,Lee Jai-Sung 한국분말야금학회 2006 한국분말재료학회지 (KPMI) Vol.13 No.3

The effect of Cu content on hydrogen reduction behavior of ball-milled $WO_3$-CuO nanocomposite powders was investigated. Hydrogen reduction behavior and reduction percent(${\alpha}$) of nanopowders were characterized by thermogravimetry (TG) and hygrometry measurements. Activation energy for hydrogen reduction of $WO_3$ nanopowders with different Cu content was calculated at each heating rate and reduction percent(${\alpha}$). The activation energy for reduction of $WO_3$ obtained in this study existed in the ranging from 129 to 139 kJ/mol, which was in accordance with the activation energy for $WO_3$ powder reduction of conventional micron-sized.