동맥혈 채혈후 시간 경과 및 온도 변화가 가스분압 및 PH 에 미치는 영향에 관한 연구

김동수,이승환,김건식,강화자,신광일,여민구 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.6

Blood gas samples are highly susceptible to preanalytic error due to improper methods of obtaining or handling the sample prior to delivery to the laboratory. The errors in the measurement of blood gas analysis are currently derived from the exposure of sample to atmosphere, effects of anticoagulant itself, temperature difference between the measuring electrode and drawn blood and the delay in running the sample. To study the effects of the delay in measuring the sample and the temperature difference between the measuring electrode and drawn blood on values of blood gases and pH, we analyzed the arterial sampling from the 24 patients who were taking elective surgery or on his/her recovery period with indwelling arterial catheter. The plastic sampling syringes were kept at 4。C (refrigerator) or 22。-24。C (room temperature) and analyzed at regular intervals (1, 10, 30, 60,120 min) for 120 minutes. The following results were obtained: 1) When the arterial blood drawn from the anesthetized patients were stored 4。C, partial pressure of oxygen (PaO₂) decreased significantly after 20 min, whereas those stored at room temperature decreased significantly after 10 min. 2) When the arterial blood drawn from the recovery patients were stored at 4。C, PaO₂ did not decrease significantly through the experimental period of 120 min. Although those stored at room temperature did not decrease significantly through the period of 120 min. 3) Partial pressure of carbon dioxide in the arterial blood (PaCO₂,) drawn from the anesthetized patients increased significantly by 120 min. at 4。C, whereas those at room temperature increased significantly after 20 min. 4) PaCO₂, of the recovery patients increased signigicantly by 120 min. at 4。C, whereas those at room temperature increased significantly after 30 min. 5) pH of the arterial blood drawn from either anesthetized or recovery patients decreased significantly by 120 min. at 4。C, whereas those at room temperature decreased significantly after 60 min. 6) No significant changes al oxygen saturation (SaO₂) and content (CaO₂) were noted in either anesthetized or recovery. patients in accordance with time elapsed at 4。C or room temperature. In summary, as the changes of PO₂ in particular higher than physiologic PO₂ and PCO₂ in the arterial blood stored at room temperature are significant in accordance with the delay in measuring, it would be advisable to analyze the sample in a short period of time or to store it in a cool place when the measuring will be delayed.

서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

고온가열처리에 의한 바다방석고둥 ( Omphalius pfeifferi capenteri ) 의 식품성분 변화

하진환(Jin Hwan Ha),송대진(Dae Jin Song),김풍호(Poong Ho Kim),허민수(Min Soo Heu),조문래(Moon Lae Cho),심효도(Hyo Do Sim),김혜숙(Hey Suk Kim),김진수(Jin Soo Kim) 한국수산과학회 2002 한국수산과학회지 Vol.35 No.2

바다방석고둥을 원료로 한 신제품 개발에 관한 일련의 기초 연구로 저장성 부여를 위하여 시도하는 고온가열처리 조건 (F_0 5분, F_0 10분, F_0 15분 및 F_0 20분)에 따른 바다방석고둥의 성분변화에 대하여 살펴보았다. 바다방석고둥 통조림은 살균을 5분 이상 처리하는 경우 저장 중 팽창관이 발생하지 않았고, 또한 생균수가 검출되지 않아 저장성이 있었다. 고온가열처리 정도가 증가할수록 바다방석고둥의 일반성분 중 수분함량은 감소하였고, 조단백질 함량은 증가하였으며, 조지방 및 조회분 함량은 거의 변화가 없었다. 또한 바다방석 통조림은 고온가열처리 정도가 증가할수록 이취에 관여하는 휘발성염기질소 함량, pH와 색조에 관여하는 갈변도는 증가하였고, 영양에 관여하는 구성아미노산, 무기질과 맛에 관여하는 유리아미노산, TMAO, total creatinine 및 수율 둥은 감소하였다. 이들을 색조, 조직감 및 맛에 대하여 관능검사한 결과 자숙 처리한 시료에 비하여 모든 항목에서 F_0 10분까지는 차이가 없었으나, 그 이상 가열처리한 경우 품질이 저하하였다고 인지되었다. 이상의 결과로 미루어 보아 바다방석고둥을 고온가열처리하여 신제품을 개발하고자 하는 경우 F_0 값이 10분 이상이면 바람직하지 않은 것으로 판단되었다. The top shell, Omphalius pfeifferi capenteri meat vacuum-packed in can (diameter× height, 74.1 ㎜ × 50.7 ㎜) were heated at 115℃ up to F_0 values of 5 min, 10 min, 15 min and 20 min, and the changes in food components were studied. After 14 days storage at 37℃ and 55℃, no growth of microorganism and panelling were recognized from the canned meats which were sterlized at 115℃ with F_0 value of 5 min and over. In the case of proximate composition of the canned meats, the moisture content decreased with the increase of F_0 value, while crude protein increased. The increase of volatile basic nitrogen content, pH and degree of browning and the decrease of mineral, total amino acid, free amino add, trimethylamine oxide, total creatinine contents and yields were observed during thermal processing. In sensory evaluation on color, texture and taste in the canned meats, no significant difference was observed among a boiled sample and the canned meats heated at F_0 value of 10 min and below. But, in the canned meats heated at F_0 value of over 15 min, its sensory scores decreased with the increase of F_0 value. From these results, the reasonable F_0 value for preparation of the heat-treated top shell meats was in the range of 5∼10 min.

개의 전침마취가 Vital sign 및 혈액가스치 변화에 미치는 영향

임연수,송근호,유명조,서지민,김명철,김덕환,Lim, Yeon-Soo,Song, Kun-Ho,You, Myung-Jo,Seo, Jee-Min,Kim, Myung-Chul,Kim, Duck-Hwan 대한수의학회 2003 大韓獸醫學會誌 Vol.43 No.1

The present study was performed to elucidate the effect of canine electroacupuncture anesthesia on vital signs and blood gas values. Groups were divided into experimental (electroacupuncture: EA) and control (ketamine) groups. The vital signs (body temperature, respiration rate and pulse) and blood gas values (pH, $pCO_2$ and $pO_2$) of venous and arterial blood were determined. Body temperatures of EA group were significant higher than than of ketamine group at 15 min., 30 min., 45min. and 60 min. (p<0.05) after anesthesia, respectively. The respiration rates of EA group were higher than those of ketamine group, however, significant differences were not observed between both groups. The pulses of EA group were significant higher than those of ketamine group at 5 min. (p<0.05), 10 min. (p<0.01), 15 min. and 30 min. (p<0.05) after anesthesia, respectively. The arterial and venous blood pHs of ketamine group were slightly higher than those of EA group, respectively, however, no significant differences were found between both groups. Significant differences were not observed between both groups in the arterial and venous blood $pCO_2$, respectively. The arterial blood $pO_2$ of EA group was significant higher than those of ketamine group at 5 min. (p<0.05) after anesthesia. No significant differences were observed between both groups in the venous blood $pO_2$. These results suggest that the changes of vital signs and blood gas values of EA group are similar to those of ketamine group with the exception of changes in the body temperature, pulse and arterial blood $pO_2$.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

방향성 마스크를 이용한 칼라지도영상에서 직선 및 곡선 추출

김성영,김민환,김종민 釜山大學校生産技術硏究所 1995 生産技術硏究所論文集 Vol.49 No.-

칼라지도영상에서 지도의 구성요소 (등고선, 해안선, 도로, 문자등)를 추출하려는 연구[1,5,7]가 있었으나, 기존의 방법으로는 굵기가 가는 직선 및 곡선형태의 대상물을 효과적으로 추출할 수 없다는 문제가 있다. 이러한 문제를 해결하기 위해, 본 연구에서는 가는 직선과 곡선의 구조적인 특성을 반영하고 추출된 선의 연결성을 보장하기 위한 방향성 마스크(directional mask)를 설계하였으며, 이를 이용한 대화식(interactive) 선추적기법을 개발하였다. 또한 추출 대상물의 공간적 칼라 분포특성을 분석하였으며, 이러한 특성을 Mahalanobis distance를 이용하여 추출방법에 반영하였다. 본 연구에서 제안한 방법은 기존의 칼라지도로 부터 벡터링 작업에 필요한 지도의 구성요소들을 효과적으로 추출해 줌으로써, 지리정보 시스템을 구축하는데 활용될 수 있다. There were some studies that extracted vectoring objects(contour, shoreline, road, character and etc) from scanned color map images, but these methods could not extract thin line type objects, effectively. To solve this problem, in this paper, we designed the directional masks which reflected geometric characteristics of thin line type objects and ensured connectivity of extracted lines. And we developed an interactive line tracing method using these directional masks. Also, we analyzed 3D color distribution characteristics of line type objects and reflected these characteristics in the extraction method using the Mahalanobis distance. The method proposed in this paper can be used for constructing the small scale GIS application using existing color maps.

척추수술시 LABETALOL 을 이용한 유도저혈압

김종수,도상환,민성원 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.1

The effect of labetalol on induced hypotension was studied in 13 patients undergoing major spine surgery. Hypotension was induced with initial dose of labetalol 0.4 mg/kg i.v. followed by 0.01 mg/kg/min i.v.infusion. BP, HR, and CVP were measured before, during, and after hypotension. Anesthesia was maintained with isoflurane (0.5-2 vol%) and N2O in 50% O2 supplemented by pancuronium. The time to systolic BP 75-85 mmHg or mean BP 55-65 mmHg was 18.5±2.8min and the time for systolic BP to recover 90% of prehypotensive value was 45.5±4.2 min. Heart rate was reduced signiTicantly after hypotension but remained stable at 80-90 beats/min thereafter. Central venous pressure showed no significant change irrespective of hypotension. The results suggest that combined use of fentanyl with labetalol or disuse of pancumnium may reduce the required dose of labetalol.

서울의 PPNG 발생 빈도(1991-1992)

김재홍,윤기범,박평원,김영진,전경민,김영태,김중환,곽호,구상완,송민석,유옥,지혜구,김동원,문상은,박영립,정승호,성범진,성순제,엄주용,황정열,이기홍,이주협,전태진 대한화학요법학회 1994 대한화학요법학회지 Vol.12 No.1

The prevalence of PPNG among pretreated gonorrhea cases isolated at the STD clinic of Choong-Ku Public Health Center in Seoul has been studied and reported annually since 1981. In 1991, 123 strains of N.gonorrhoeae were isolated, among which 58(47.1%) were PPNG. In 1992, 98 starains of N.gonorrhoeae were isolated, among which 51(52.0%) were PPNG. In all, 109(49.3%) strains were found to be PPNG among 221 strains isolated between 1991-1992. The prevalence of PPNG in Seoul showed increased tendency till 1989, thereafter, it has been stationary or slightly decreasing.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1997)

김재홍,문득곤,김정수,김용준,임동진,박상훈,김희성,이민수,송기훈,김갑형,김형석,성소영,이인섭,김석우,황지환,조창근,김경문,부태성 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

Background : In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. Objective & Methods : For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results : In 1997. 99 strains of N. gonorrhoeae were isolated, among which 45(45.5%) were PPNG. Conclusion : The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 45.5% in 1997.

하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례

김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.