Pulse Oximetry and Skin Temperature Gradient as Diagnostic Tools of Successful Caudal Block

Duk Kyung Kim,Kyoung Min Lee,Won Kyoung Kwon,Chung Sik Oh,Sung Whan Jang 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6

Background: Though caudal block is a relative simple technique, it has not been widely used in adults because of a high failure rate. We assumed that any tests to quantify the changes of sympathetic tone in the affected areas would be excellent indicators of successful block. We tested the usefulness of two candidates (pulse oximetry plethysmographic waveform amplitude measured at 5th toe and calf minus 5th toe skin temperature gradient) as indicators of successful caudal block. Methods: In 45 adult patients undergoing anal surgery with caudal block, these two variables were simultaneously measured at 2-min intervals for 20 min. A two-fold increase in the plethysmographic waveform amplitude from baseline and skin temperature gradient of 0°C were predefined as test criteria of successful block. Results: While the sensitivity, specificity, positive predictive value, and negative predictive value of the skin temperature gradient test were 45.9%, 100%, 100%, and 9.1%, those of the plethysmographic waveform test were 86.5%, 100%, 100%, and 28.6%. The plethysmographic waveform test showed a significantly higher discriminative capacity than the skin temperature gradient test (94.9% vs. 48.7%, P < 0.05) Conclusions: Unlike the skin temperature gradient test, the plethysmographic waveform test showed a considerably high validity in detecting successful block. Considering its simple and real time monitoring potentials together with a high failure rate of caudal block in adults, we cautiously recommend it as a supplemental diagnostic tool to predict successful block, especially when verbal communication with patient is difficult. (Korean J Anesthesiol 2007; 53: S 19∼25)

Pharmacokinetics and Biodistribution of a pGT2-VEGF Plasmid DNA After Administration in Rats

Son, Mi-Kyung,Choi, Jae-Hoon,Lee, Dong-Sop,Kim, Chae-Young,Choi, Seul-Min,Kang, Kyung-Koo,Byun, Jonghoe,Kim, Duk-Kyung,Kim, Byong-Moon Lippincott Williams Wilkins, Inc. 2005 Journal of cardiovascular pharmacology Vol.46 No.5

Intramyocardial administration of gene therapy vectors expressing angiogenic factors have been attempted as an alternative to conventional surgical methods for the management of myocardial ischemia. In this study, we have developed the pGT2-VEGF, a plasmid DNA vector expressing human VEGF165, for the management of ischemic cardiovascular disease and investigated in vivo pharmacokinetics and tissue distribution of pGT2-VEGF after intramyocardial and intravenous administration in rats. A high concentration of pGT2-VEGF was observed in the heart after intramyocardial injection of 300 μg, which is in line with the assumption that direct intramyocardial delivery enables extended localization at the administration site. Leakage of the pGT2-VEGF to the blood circulation was observed after intramyocardial injection, with an area under the curve (AUC) of 3.8 μg min/mL, as compared with 37.3 μg min/mL after intravenous injection of the same dose. The pGT2-VEGF concentration in blood peaked at 5 minutes after intramyocardial administration and declined rapidly to undetectable levels by 2 hours post-administration. In tissue distribution studies, pGT2-VEGF peaked at 5 minutes post-administration in various organs but was undetectable at 2 hours in all organs except heart, lung, and liver. Taken together, the results suggest that intramyocardial-delivered pGT2-VEGF was degraded rapidly in vivo and mainly persisted in target tissues, the heart. In addition, intramyocardial-administered pGT2-VEGF was expressed for longer periods than the persistence of the pGT2-VEGF plasmid DNA in a target tissue. Therefore, a direct myocardial injection of pGT2-VEGF might be useful for local therapeutic angiogenesis.

물리적 처리에 의한 강력분 밀가루 Gliadin의 항원성 변화

강보경(Bo-Kyeong Kang),김꽃봉우리(Koth-Bong-Woo-Ri Kim),김민지(Min-Ji Kim),박시우(Si-Woo Bark),박원민(Won-Min Pak),김보람(Bo-Ram Kim),안나경(Na-Kyung Ahn),최연욱(Yeon-Uk Choi),최정수(Jung-Su Choi),최호덕(Ho-Duk Choi),안동현(Dong-Hyun A 한국식품영양과학회 2014 한국식품영양과학회지 Vol.43 No.4

본 연구에서는 가압가열 및 microwave 처리가 gliadin의 항원성에 미치는 영향을 살펴보기 위해 강력분에 가압가열과 microwave를 단독 또는 병행으로 처리하여 Ci-ELISA, SDS-PAGE 및 immunoblotting을 실시하였다. 가압가열 처리의 경우 시간이 길어질수록 IgG와의 결합력이 감소하였으며, 특히 50분 처리구에서 약 87%로 가장 낮은 결합력을 보였다. 또한 SDS-PAGE와 immunoblotting 결과에서도 무처리구에서 강하게 보였던 gliadin band가 가압가열처리에 의해 거의 소실되고 항체와 반응하지 않았다. 가압가열 및 microwave를 병행 처리 시도 마찬가지로 gliadin의 결합력이 감소하였으며, 처리구 중 가압가열 50분, microwave 5분 처리구에서 약 93%로 가장 낮은 결합력을 보였다. 반면 microwave를 단독으로 처리한 경우에는 일부 단백질의 변화는 관찰되었으나, 항원성 감소에는 효과가 없음을 확인하여 단백질 변화가 항원성에는 큰 효과를 준 것 같지 않다. 이상의 결과를 통해 가압가열 단독 처리 및 가압가열 및 microwave의 병행처리 시 gliadin의 항원성이 감소함을 확인하였다. This study was conducted to evaluate the effects of physical treatments on the antigenicity of gliadin in strong wheat flour. Strong wheat flour was treated with an autoclave (5, 10, 30, 50 min), a microwave (1, 5, 10 min), or both (10, 30, 50 min/ 5, 10 min), followed by SDS-PAGE, immunoblotting, and Ci-ELISA using anti-gliadin IgG. The results indicated that the binding ability of IgG to gliadin in strong wheat flour slightly decreased after autoclaving or autoclaving/microwaving. In particular, the binding ability was reduced to about 87% after autoclaving for 50 min and to 89% after autoclaving/microwaving (50/5 min). In addition, gliadin bands in the 50 min autoclaved group disappeared in both SDS-PAGE and immunoblotting. On the other hand, the antigenicity of gliadin was unaffected by microwaving alone. In conclusion, the results of this study suggest that autoclaving may reduce the antigenicity of gliadin in strong wheat flour.

자유생활아메바의 isoenzyme 양상에 관한 연구

韓慶淑,閔得暎,蘇鎭琸 연세대학교 의과대학 1982 연세의대논문집 Vol.15 No.2

한국형 우울장애 약물치료 알고리듬 2006 (Ⅰ)

서정석,민경준,김원,석정호,박원명,송해철,이상열,전덕인,전현태,홍진표,한국형 우울장애 약물치료 알고리듬 2006 연구그룹 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Objectives : Since the publication of Korean Medication Algorithm Project for Major depressive Disorder (KMAP-MD) in 2002, there has been a substantial need for a revision due to rapid progress in the pharmacological management for depressive disorder. We revised KMAP-MD to Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2006. This paper is one of the following 4 papers consisting of Korean pharmacological algorithm for depressive disorder. Methods : The questionnaire consisted of 4 parts ; initial treatment of 1) non-psychotic depressive disorder, 2) psychotic depressive disorder, 3) treatment strategy for clinical subtypes and drug choice considering adverse effects, and 4) treatment for depressive disorder in women. It was composed of 22 questions, and each question had 54 sub-items. The questionnaire was completed by the review committee consisting of 101 experienced Korean psychiatrists. We classified the expert opinion to 3 categories (the first-line, the second-line, or the third-line). Results : For non-psychotic major depression, regardless ofthe severity of an episode, the antidepressant (AD) monotherapy was the optimal first-line treatment. SSRI, venlafaxine, and mirtazapine were the 1st-line AD. In case of a partial or no response to initial strategy, adding another AD was recommended. For psychotic major depression, combination of an AD and an atypical antipsychotic (AAP) was the treatment of choice. Among AAPs, quetiapine, rispendone, olanzapine were preferred. For non-responder to initial strategy, the next step was adding or changing AD before changing AAP. For women with premenstrual dysphoric syndrome or postpartum depression without psychotic features, AD monotherapty was a preferred strategy while for psychotic postpartum depression, combination of AD and AAP was recommended. Experts recommended various ADs according to adverse effect. Conclusion : These results suggest that the medication strategies for depressive disorder are rapidly changing and reflect the recent studies and clinical experiences.

항혈청으로 처리된 Acanthamoeba species,YM-4의 형태학적 변화

임명준,민득영,김경민 한양대학교 의학교실 1988 한양의대 학술지 Vol.8 No.2

Free-living amebas including Acanthamoeba species and Naegleria species may cause primary amebic meningo-encephalitis in human and experimental animals, and they are widely distributed in the natural circumstances. Acanthamoeba species, YM-4, isolated from gill of freshwater fish, carassius carassius, was experimentally proved as a pathogenic strain for mice. The present study was performed to evaluate the effect of antiserum on fine structure of this ameba. Amebas were subcultured in casitone, glucose and vitamin (CGV) medium. For the experiment amebas were inoculated in mixed medium containing 20% (v/v) of antiserum for 2 hours, and the observed with scanning and transmission electron microscopes. The results are summarized as follows: 1. The trophozoites projected many acanthopodia and the shape was irregular on SEM. 2. Antiserum-treated trophozoites showed round, immobilized ones without projection of acanthopodium on SEM. Partial destruction of plasma membrane was often observed. 3. On TEM normal trophozoites were consisted of acanthopodia, large and round nucleus, food and contractile vacuoles, Golgi-complex, endoplasmic reticula, mitochondria, spongiomes around contractive vacuoles, and peroxisomes. 4. Antiserum-treated trophozoites showed partial destruction of plasma membrane, and projections of acanthopodium were rarely observed. In nucleus chromatin materials were aggregated, and on the wrinkled and irregular nuclear membrane ribosomal arrangement was increased. In the endoplasms decreased numbers of ribonsomes, glycogen particles and lipid droplets were observed. Rough endoplasmic reticula were increased in distribution and often seen around mitochondria. Sometimes they surrounded mitochondria. Mitochondria were edematous and degenerated. Spongiome and peroxisome were could be not distinguished and not confirmed. With above results it is presumed that specific antiserum destructs plasma membrane directly, and induces disturbances of ion exchanges and cell respiration follwing immobilization and cell lysis.

수지상 내생균근 Glomus Etunicatum의 접종이 석탄폐광지 토양에 식재한 아까시나무의 생육 및 생리에 미치는 영향

홍승진,임경민,박용우,구창덕,우성민 忠北大學校 農業科學硏究所 2012 農業科學硏究 Vol.28 No.2

본문참고

안지오텐신 변환효소 억제제와 안지오텐신 II 수용체 차단제 투여 후 발생한 급성 신부전과 폐부종으로 전원된 선천성 단일신 환자의 치료 1예

백두현,김경진,홍성철,강석형,송하응,김혜인,김수현,오현정,강혜원,김서우,유민아,류동열,최규복,강덕희 이화여자대학교 의과대학 2010 EMJ (Ewha medical journal) Vol.33 No.1

Blockers of renin-angiotensin system(RAS) including ACE inhibitor or ARB are one of the most frequently prescribed medications for the treatment of hypertension, heart failure and proteinuria. One of the major side effects of these RAS blockers is the deterioration of renal function, mainly due to a reduction of intraglomerular pressure. Therefore, close monitoring of renal function is recommended when RAS blockers are initially prescribed, especially for the patients with impaired renal function. We report a patient who was transferred to our hospital due to the sudden development of oliguria and dyspnea after treatment for hypertension with ACEi and ARB. She was finally diagnosed as RAS blocker-induced acute renal failure with pulmonary edema complicated on congenital solitary kidney. After hemodialysis and conservative treatment, her renal function was recovered with maintenance of normal urine output. Conclusion:This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.

한국형 우울장애 약물치료 알고리듬 (Ⅳ) : 우울장애의 아형 및 부작용에 따른 항우울제의 선택과 여성우울장애에서의 치료전략

전현태,이상열,김원,민경준,박원명,서정석,석정호,송해철,전덕인,홍진표,한국형 우울장애 약물치료 알고리듬 2006 연구그룹 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : In 2002, the Korean Medication Algorithm Project for Major depressive Disorder (KMAP-MD) was published, but there has been a need for a guideline about detailed issues of depressive disorder. We revised KMAP-MDD andreestablished Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2006. Methods : A questionnaire had been developed by the executive committee for KMAP-DD. The review committee consisted of 101 experienced psychiatrists. From the total of 22 questions in the questionnaire, 7 questions were evaluated for these subjects . We classified the expert opinions to 3 categories according to its confidence interval; first, second and third line. Results : SSRI and venlafaxine were the first line antidepressants (AD) for atypical and melancholic depression. For dysthymic disorder and minor depressive disorder, SSRI was recommended as the first line medications. Only AD medications was a preferred initial strategy for treating premenstrual dysphoric disorder, mild to moderate and severe non-psychotic postpartum depression. In severe psychotic postpartum depression, combination therapy of AD and atypical antipsychotics was the treatment of choice. SSRI was preferred when considering sedation, anticholinergic and cardiovascular adverse effects. Also, experts recommended mirtazapine against gastrointestinal adverse effects and bupropion in avoiding sexual dysfunction. Conclusion : These results suggest that clinicians have to consider both clinical situations and drug adverse effects in the choice of antidepressant medications.

한국형 우울장애 약물치료 알고리듬 2006 (Ⅲ) : 정신병적 양상을 동반한 주요우울삽화

김원,박원명,서정석,민경준,석정호,전덕인,전현태,이상열,송해철,홍진표,한국형 우울장애 약물치료 알고리듬 2006 연구그룹 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Since the publication of Korean Medication Algorithm Project for Major DepressiveDisorder (KMAP-MD) in 2002, there has been a substantial need for a revision due to rapid progress in the pharmacological management of depressive disorder. We revised KMAP-MD 2002 and developed the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) 2006. Methods : We developed a questionniare for surveying the opinion of experts on pharmacotherapy of depressive disorder. The questionnaire consisted of 4 parts ; 1) treatment of non-psychotic depressive disorder, 2) treatment of psychotic de-pressive disorder, 3) treatment according to clinical subtypes and drugs choice considering adverse effects, and 4) treatment of depressive disorder in women. The questionnaire was completed by the review committee consisting of 101 experienced Korean psychiatrists. It is composed of 22 questions, and each question includes 54 sub-items. We classified the expert opinionto 3 categories (the first-line, the second-line, or the third-line) by χ²-test. Results : For depressive disorder with psychotic features, most reviewers prefer the combination of antidepressant and atypical antipsychotics. Electroconvulsive therapy and the combination of antidepressant and typical antipsychotics were the second-line treatment. Among antidepressants, venlafaxine was the most preferred, and SSRI and mirtazapine followed. Among atypical antipsychotics, quetiapine, risperidone and olanzapine were the most preferred, in this order. In patients who have no response to the first-line treatment, many reviewers recommended switching to another antidepressant or adding another atypical antipsychotics Conclusion : For severe depressive disorder with psychotic features, the combination of antidepressant and atypical antipsy-chotics was preferred for the first-line treatment. These results suggest that the medication strategies of depressive disorder are rapidly changing and reflects the recent studies and clinical experiences.