복강경하 대장절제술을 시행 받는 환자에서 라모세트론과 온단세트론외 술 후 오심 및 구토 예방 효과 비교

김효중;어전영;어근무;어정한;엄세훈;조광래;김명훈 인제대학교 2011 仁濟醫學 Vol.32 No.-

Objectives : We evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) in laparoscopic colectomy. Methods and Materials : Eighty patients who received laparoscopic colectomy were randomly divided into two groups: R group (ramosetron 0.1mg PO) and O group (ondansetron 4mg twice IV). Injection or oral medication was administered before the induction of anesthesia in each group. Injection was administered at the end of surgery in O group. General anesthesia was induced using propofol and rocuronium, and maintained with sevoflurane, remifentanil and air (FiO2 0.5), We investigated the incidences of PONV in each group by the Rhodes index of nausea, vomiting and retching (RINVR) at postoperative 6 and 24 hours. Results : The incidence of PONV was not different between group at each time points after surgery (at postoperative 6 hours: 20% in group R, 17.5% in group 0, at postoperative 24 hours; 12.5% in group R, 7.5% in group 0). There was no difference in the severity of PONV, satisfaction, rescue drug usage. Conclusion : Prophylactic therapy with ramosetron is as effective as conventional prophylactic therapy with ondansetron for preventing PONV in general anesthesia for laparoscopic colectomy.

당뇨병과 동반된 화농성 간농양의 임상상 및 예후인자

오은숙,강무일,이원영,오기원,임동준,이소영,이정민,고승현,김성래,안유배,손현식,윤건호,차봉연,이광우,손호영,강성구 대한당뇨병학회 2000 임상당뇨병 Vol.1 No.1

연구배경: 감염질환은 혈관질환과 함께 당뇨병의 중요한 사망원인의 하나이며, 혈당조절이 불량할수록 감염 빈도가 증가됨은 잘 알려져 있다. 간농양의 발생이 있어서도 당뇨병은 중요한 기저질환 중의 하나이다. 일반적으로 간농양의 가장 흔한 원인균은 Escherichi coli라고 알려져 있으나, 최근 당뇨병을 가진 간농양 환자에서 Klesiella pneumoniae의 검출이 증가되고 있다. 또 최근 연구에 의하면 K.pneumonie가 간농양의 가장 흔한 원인균이며, K. pneumoniae에 의한 간농양은 K.pneumoniae 이외의 균주에 의한 간농양보다 당뇨병과 밀접히 관련되어 있다고 보고된 바 있다. 이에 저자들은 간농양 환자를 대상으로 당뇨병환자의 빈도를 알아보고, 그 원인균 및 특징을 비당뇨병 환자들의 경우와 비교해 보고자 하였다. 방법: 1992년 1월부터 1999년 6월까지 방사선학적 검사 혹은 수술에 의해 간농양이 확인되거나, 경피적 천자나 수술을 통한 배농액 배양, 혹은 혈액 검사에서 원인균이 증명된 182명의 환자를 대상으로 후향적 임상고찰을 실시하였다. 결과: 화농성 농양을 가진 167명의 환자(남:94명, 여:73명)중 당뇨병을 가진 환자는 54명 (남:30명, 여:24명)으로 32.3%를 차지하였다. 환자의 평균나이는 당뇨군에서 62.1 ± 13.4세, 비당뇨군에서는 55.1 ±15.5세로 당뇨군에서 높았으며(p=0.0021), 남녀간의 평균나이 비교 시 두 군 모두 여성의 나이가 의미있게 높았다. 비당뇨군에 비하여 당뇨군의 경우 저알부민혈증의 빈도와 aspartate transaminase가 증가되어있었다. 원인균주는 K. pneumoniae (당뇨군54%, 비당뇨군 39.1%), E. coli(당뇨군 17.5%, 비당뇨군 18.8%), Pseudomonas aeruginosa, Streptococcus viridans, Enterococcus 순이었으며 두 군간의 의미는 차이는 없었으나 K. pneumoniae의 경우 다른 균종에 비해 단독감염의 빈도가 높았다(82.8%). 사망률은 당뇨군에서 16.7%, 비당뇨군에서 7.1%로 당뇨군에서 의미있게 높았으며(p=0.019), 당뇨군에서의 사망환자는 모두 패혈증이 동반되어 있었다. 당뇨환자의 사망군은 생존군에 비해 당뇨병 이환기간이 길고 혼합감염의 빈도가 높았다(p=0.046). 검사실 소견에서는 총 빌리루빈 및 알카리성 포스파타제의 증가가 관찰되어 있었다. 결론: E. coli가 간농양의 주된 원인균이라는 기존 보고와는 달리 당뇨군과 비당뇨군 모두 K. pneumoniae가 간농양의 주된 원인균이었다. 또한 당뇨 유병기간이 길고 당뇨조절이 불량한 환자에서 혼합감염이며 총 빌리루빈 및 알카리성 포스파타제의 증가등과 같은 위험인자가 존재할 경우 사망률이 증가될 수 있으므로 이들 군에서는 적극적인 치료가 필요할 것으로 사료된다. Background: Liver abscesses are commonly associated with underlying disease, particularly diabete mellitus. The number of the liver abscesses caused by Klebslella pneumoniae in diabetic patient has been increased in Korea nowadays. This study was conducted to clarify the clinical presentation and prognostic factors of pyogenic liver abscesses, especially in diabetic patients and to determine the proportion of K. pneunomiae as a pathogen in liver abscess in Korea. Methods: Medical records of 167 patients treated for pyogenic liver abscess from January, 1992 through June, 1999 were reviewed retrospectively in detail. Major Pathogenic organism, clinical manifestations, prognostic factors, the importance of diabetes mellilus as an underlying disease and its effect on clinical features and prognosis were analyzed. Results: Among 167 cases of pyogenic liver abscess, underlying diabetes mellitus was present in 32.3%. The mean age of patients was 62.7 13.4 years in diabetic liver abscess group and 55.1 15.5 years in non-diabetic liver abscess group. Most liver abscesses were cryptogenic in origin or secondary to the billary tree diseases. The clinical presentations among the two groups were not significantly different. When compared to patients without diabetes, patients with diabetes had significantly higher proportions of hypoalbuminemia and elevated aspartate transaminase level. The most common organism of the pyogenic abscess was K. pneumoniae in both groups. Percutaneous drainage of the abscess with appropriate antibiotics was the most commonly used therapeutic modality in liver abscess. The mortality rate of diabetic liver abscess is 16.1 % and 7.1% in nondiabetic liver abscess. Complications, especially septicemla, were found more frequently in patients with diabetes than in patients without diabetes (64.8% vs 28.3%, septicemia : 31.5% vs 9.7%). The factors influencing mortality in the diabetic liver abscess were disease duration, mixed infection, presence of septicemia, elevated bilirubin and alkaline phosphatase. Conclusions: In contrast to prior report that the E. coli was the most common pathogen in liver abscess, we found that K. pneumoniae was the most common organism cultured in liver abscess. Diabetic patients have more complications and higher mortality than patients without diabetes. Early detection and proper treatment are needed to improve the outcome for diabetic patient with liver abscess.

Rocuronium의 애별투여방법이 모지내전근의 이완에 미치는 영향

최영균,김승수,이원진,조광래,이상은,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 인제대학교 2009 仁濟醫學 Vol.30 No.-

Objective : There are controversies in pnmmg technique of rocuronium whether it can or can't shorten the onset time. We want to compare the effects of two different priming doses and intervals of rocuronium. Materials and Methods : After giving propofol, 50 patients were randomly assigned to 5 groups. Group I received a placebo, followed 3 min later by rocuronium 0.6 mg/kg. Priming doses and intervals of Group II, Ill, N, V were 0.06 rng/kg and 2 min, 0.12 mg/kg and 2 min, 0.06 rug/kg and 3 min, 0.12 mg/kg and 3 min, respectively. Total dose of rocuronium was 0.6mg/kg. Train of four (TOF) count or ratio and 1st twitch height of TOF (T1) were monitored with 15 secondsintervals. TOF ratio of each groups just before bolus injection, duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were compared. Results : Duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were decreased in priming groups compared to Group 1 (P < 0.01) In group V, significant depression of TOF ratio just before bolus injection was seen (P < 0.05). Conclusion : Priming technique with rocuronium is effective method to shorten the onset of neuromuscular block. But priming dose of rocuronium itself could cause hypoxia and aspiration in awake patients and should be used carefully. Priming dose of rocuronium 0.06 mg/kg and 2 minutes interval maybe relatively safe method.

국민학교 학생들의 비만도에 따른 체격과 체력에 관한 연구

이종완,이광무 釜山敎育大學校 1994 부산교육대학 논문집 Vol.30 No.1

The purpose of this study was to determine a study on physique, physical fitness in elementary school students according to obese rate. I had examined the difference in elementary school students according to different of obese rate such as in 6 model groups(-20% below, -19.9~-10%, -9.9~0%, 0.1~10%, 10.1~20%, 20% over). I had come to following conclusion after examining 952 6th grade boys and girls. 1. Physique 1) Standing height in the 6 groups had no significant differences according to obese rate. 2) Body weight in the 6 groups had significant differences according to obese rate(P<0.001). 3) Chest circumference in the 6 groups had significant differences according to obese rate(P<0.001). 4) Sitting height the 6 groups had no significant differences acceding to obese rate. 2. Physical Fitness 1) 100m run in boys and girls had high record according to decrease of obese rate. 2) Standing board jump in boys had high record according to decrease of obese ate. And girls had no significant differences according to obese rate. 3) Long run in boys and girls had high record according to decrease of obese rate. 4) Distant throw in boys and girls had no significant differences according to obese rate. 5) Pull-up in boys and girls had high record according to decrease of obese rate. 6) Long pulling in bar in girls had high record according to decrease of obese rate. 7) Sit-up in boys had low record according to increase of obese rate. And girls had no significant differences according to obese rate.

시상출혈 환자의 지연 순목반사

박종무,김호진,윤창호,이용석,노재규,이광우 대한신경과학회 1999 대한신경과학회지 Vol.17 No.5

신부전이 동반된 당뇨병 환자에서 발생된 침습성 모균증 : 수술과 Liposomal amphotericin B 및 GM-CSF 병합 요법에 의한 성공적인 치험 1예

이원영,오기원,임국희,장재혁,이동건,최정현,강무일,신완식,차봉연,이광우,손호영,강성구 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.4

저자들은 신부전이 동반된 당뇨병 환자에서 발생된 부비동형 모균증에 대하여 수술과 함께 liposomal amphotericin B 및 GM-CSF의 복합치료를 하여 성공적으로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Mucormycosis (zygomycosis) primarily affects diabetic or immunocompromised patients and typically progresses rapidly, necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are needed for cure, but it has the risk of causing significant renal toxicity. The recent development of liposomal amphotericin B allows antifungal therapy to be administered with potentially improved efficacy and reduced nephrotoxicity. We have experienced a case of paranasal mucormycosis successfully treated with surgery, liposomal amphotericin B and GM-CSF. A 59-year-old male suffering from diabetes mellitus for 6 years was admitted with pain at left maxillary area. He was diagnosed as mucormycosis after cytologic exam on the necrotic nasal mucosa, which showed typical hyphae. He have had diabetic nephropathy with macroproteinuria and had rapidly rising serum creatinine levels with the amphotericin B treatment: creatinine levels reverted to basal level with the use of liposomal amphotericin B. Despite surgical excision and continued antifungal therapy, his infection was not effectively controlled. Therefore, GM-CSF was administered additionally to improve phagocytic activity of leukocytes. He was finally cured after receiving a combination of aggressive surgery, liposomal amphotericin B and GM-CSF. To our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with liposomal amphotericin B in Korea.

전신지구성 운동이 비만여고생들의 체지방조직 면적에 미치는 영향

이광무,김태운 釜山大學校 附設 體育科學硏究所 1993 體育科學硏究所 論文集 Vol.9 No.-

The purpose of this study was to determine the effect of endurance exercise training on adipose tissue area in obese high school girls. Obese high school girls were adapted to have exercises of endurance by suing intensity of 70~85% HRmax and RPE 13∼15 for 60 min/day, 4 times/week for 10 weeks. The conclusion of the study was as follows: 1. Total trunk area and trunk subcutaneous adipose tissue area have reduced significantly by endurance exercise training(P<0.01). 2. Total abodomen area and abdomen subcutaneous adipose tissue area have reduced significantly by endurance exercise training(P<0.01). 3. Total midthigh area, deep midthigh area and midthigh subcutaneous adipose tissue area have reduced significantly by endurance exercise training(P<0.05, P<0.01).

복싱選手의 體重減量에 따른 安靜時와 最大運動時의 血液化學成分 變化에 관한 硏究

李光茂,金泰運 釜山大學校 附設 體育科學硏究所 1990 體育科學硏究所 論文集 Vol.6 No.-

The purpose of this study was to examine the effect of weight reduction on biochemical constituents in blood during rest and maximal exercise in boxers. The subjects were 5 boxers of boxing team at Dong-A University. The biochemical constituents in blood during rest and maximal exercise were tested before and after body weight reduction. Paired t-tests was used to examine that the differences of each variable before and after body weight reduction were significant. The results were obtained as follows: 1) As for changes in biochemical constituents in blood during rest and maximal exercise following body weight reducing period, there were no significant changes in TG and Glucose during rest and maximal exercise. FFA during rest and maximal exercise increased significantly(P<0.01). And T-cholesterol and HDL-cholesterol at rest increased significantly. (P<0.05), and during maximal exercise somewhat increased but there were no significant changes. Lactate during maximal exercise decreased significantly(P<0.05), but at rest there was no significant change. 2) As for the changes in biochemical constituents in blood during rest and maximal exercise following maximal exercise before and after body weight reducing period, TG, T-cholesterol, HDL-cholesterol, and Lactate somewhat decreased and Glucose increased by body weight reduction increased significantly and that of after body weight reduction decreased significantly (P<0.01). In conclusion, there results suggested that the 5% body weight reduction by diet control and exercise training had little effects on biochemical constituents in blood during rest and maximal exercise in boxers.

이온교환법에 의한 수은이온의 흡착에 관한 연구

李承務,崔光鎬 연세대학교 대학원 1980 延世論叢 Vol.16 No.2

This investigation on the adsorption of Hg (II) to chelating resin in the fixed bed ion exchange column was carried out to obtain the mass transfer coefficient, and showed by the equilibrium experiment in batch system, that this process was approached to an irreversible reaction, in dilute solution ranging from 1.25×10-7 mol/ml to 1×10-6 mol/ml. Under the irreversible liquid film mass transfer model, kLs was subsequently not only independent of both initial concentration of Hg (II) and amounts of resins, but also proportional to the 0.25 power of the velocity, thereby expressed as following equation; kLS= 0.34 U0.25 This study also brought about another worthwhile conclusion that the irreversible liquid-film mass transfer model in adsorption of Hg (II) would be valid by compared with Selke and Dryden's experimental results, using dimensionless analysis between Reynolds number and j-factor.

견관절 유착성 관절낭염에서 도수의학 치료의 유용성

이경무,이광래,한기석 大韓再活醫學會 2000 Annals of Rehabilitation Medicine Vol.24 No.4