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.

간세포암종에서 간절제술 후 이환율과 사망률에 영향을 미치는 위험 인자

김완욱,이광웅,최성호,허진석,김용일,김성주,이대성,이환효,백승운,고광철,이준혁,최문석,유병철,조재원 대한간학회 2004 Clinical and Molecular Hepatology(대한간학회지) Vol.10 No.1

목적: 간세포암종은 우리나라에서 간절제의 가장 흔한 적응증이다. 그러나 간경변을 동반한 경우가 많아 수술 후 이환율과 사망률이 높아 수술 전후 처치에 주의를 요한다. 최근에는 외과적 술기의 발전과 수술 전 및 수술 후 처치의 향상으로 이환율과 사망률이 감소하고 있으나 다른 수술에 비해 여전히 높다. 이에 본 연구에서는 간세포암종의 수술 중 위험 인자를 알아보고 수술 후 이환율과 사망률을 줄일 수 있는 방법을 찾아보고자 하였다. 대상과 방법: 1994년 11월부터 2001년 12월까지 간세포암종으로 진단받고, 간절제술을 시행받은 환자 510명을 대상으로 하였다. 대상 환자의 평균 연령은 51.6세였고, 남녀 비는 4.01 : 1이었다. 수술 전 HBsAg (+)는 76.0%, 수술 전, anti-HCV (+)는 8.2%였으며 종양의 크기는 평균 5.19 ㎝이었다. 환자 중 26.2%에서 수술 전 경도자 동맥색전술의 병력이 있었으며 8.7%에서 수술 전 경피적 간문맥색전술을 시행받았다. 시행받은 수술은 종양절제술 55예, 분절절제술 127예, 구역절제술 77예, 반간절제술 214예, 동반 혹은 확대 반간절제술 37예였다. 위험 인자로 나이, 성별과 각종 임상 지표(간기능 수치, 프로트롬빈시간, 혈청 알부민, 혈당, 알파태아단백, ICG 검사, 수술 전 경도자 동맥색전술, 경피적 간문맥색전술 시행 여부) 등의 수술 전 인자, 수술의 종류, 수술 시간, 수혈량 등의 수술 인자, 그리고 종양의 크기, 종양의 수, 간경변 여부 등의 병리조직학적 인자 등을 분석하였다. 분석자료는 대상 환자들의 의무기록을 통해 후향적 방법으로 조사하였다. 수술 사망은 수술 후 30일 이내에 사망한 경우로 정의하였고, 입원 사망은 수술 후 합병증으로 퇴원하지 못하고 사망한 경우로 정의하였다. 단변량 분석은 student t test와 x² test를 이용하였으며, 다변량 분석은 logistic regression을 이용하였다. 결과: 수술 후 합병증은 총 56예(10.5%)에서 나타났으며, 조절되지 않는 복수 19예, 호흡기 합병증 10예, 상처 합병증 8예, 간기능 이상으로 인한 고빌리루빈혈증 6예, 출혈 5예, 고질소혈증 4예 등이었다. 수술 사망은 5예(0.98%), 입원 사망은 수술 사망을 포함하여 6예(1.1%)였다. 이중 간부전과 연관된 사망이 5예였고, 간부전과 동반된 흡인성 폐렴으로 사망한 예가 1예 있었다. 이환율에 영향을 미치는 인자를 다변량 분석을 통해 알아본 결과, 수술 중 수혈량(P=0.002), 프로트롬빈시간(P=0.038), 혈당 수치(P=0.002)가 통계학적으로 의미가 있었고, 다변량 분석 상 수술 후 사망률과 관련된 인자로는 나이(P=0.028), 혈당 수치(P=0.011), 수술 전 경도자 동맥색전술 시행 여부(P=0.046) 등이 의미 있는 것으로 나타났다. 결론: 위의 위험 인자 분석을 통해 간세포암종에서 간절제시에 수술 후 이환율을 중이기 위해 가능한한 수술 중 출혈을 최소화하면서 불필요한 수혈을 피하고, 당뇨 환자에서는 수술 후 이환율과 사망률이 상대적으로 높고, 고령 환자에서는 사망률이 상대적으로 높으므로 수술 전후 처치에 세심한 주의가 필요함을 알 수 있었다. 수술전 경도자 동맥색전술 시행 여부가 수술 후 사망률과 유의한 상관성이 있었고 이에 대한 지속적인 연구가 필요하리라 생각된다. Background/Aims: Recently, mortality following surgical resection for hepatocelluar carcinoma has been reduced significantly. Morbidity, however, is still significant. This study evaluated the risk factors leading to morbidity and mortality. Methods: 510 patients who had a hepatic resection form Nov. 1994 to Dec. 2001 were included. The patient demographics showed a mean age of 51.6 years with a male to female ratio of 4:1. The HBsAg was positive in 76.0% and the anti-HCV was positive in 8.2%. The mean tumor size was 5.2 cm, 26.2% of patients had preoperative transcatheter arterial embolization (TAE), and 8.7% had preoperative percutaneous transhepatic portal embolization (PTPE). Limited resection was performed in 259 cases (50.7%), and major resection was conducted in 251 cases (49.1%). Risk factors included age, sex, laboratory findings (liver function test, prothrombin time, albumin, glucose, α-fetoprotein, ICG test), preoperative TAE, PTPE, operation type, operation time, intraoperative transfusion, tumor size, and cirrhosis. Results: The morbidity was 10.5% (54 cases). Operative death occurred in 5 cases (1.0%). Hospital death, including operative death, occurred in 6 cases (1.2%). Five cases were associated with hepatic failure and 1 case was associated with aspiration pneumonia accompanying hepatic failure. Transfusion (P=0.002), glucose (P=0.002), and prothrombin time (P=0.038) were significantly related to morbidity. Age (P=0.028), glucose (P=0.011), and TAE (P=0.046) were significantly related to mortality. Conclusions: Intraoperative transfusion, which is mainly related to intraoperative bleeding, should be reduced if possible to decrease morbidity. Diabetes mellitus patients and the elderly need careful perioperative management.(Korean J Hepatol 2004;10:51-61)

부산 경남지방에 발생한 쭈쭈가무시병 64예의 임상적 고찰

이상훈,전명호,신병철,박기찬,김영효,배성,전광수,김종성 동아대학교의과대학 1992 동아의대학술지 Vol.4 No.1

경연 대회를 통한 초ㆍ중고생의 창의력 신장 효과에 관한 연구

이희복,육근철,류해일,김현섭,김희수,박달원,유병환,김선효,김여상,서광수,변두원,서명석,배성효,박종석,심규철,이성희 공주대학교 과학교육연구소 2001 과학교육연구 Vol.32 No.1

미래 사회를 대비하기 위한 개인의 개성을 존중과 창의적인 능력을 지닌 인간을 양성을 목적으로 충청남도 지역의 초 ㆍ 중고등학생들을 대상으로 한 창의력 경연대회가 공주대학교 과학교육연구소에서 개최되었다. 충청남도 초 ㆍ중 ㆍ 고등학생들을 대상으로 실시한 창의력 경연대회는 창조적 아이디어를 내어 스스로 문제를 해결해 나갈 수 있는 교육 프로그램을 제공하는 좋은 기회였음이 확인되었으나, 일부의 팀에서만 참신하고 재미있는 아이디어들이 제안되었다. 여학생의 참가자 수가 상당히 증가하였으며, 대체적으로 입상권의 학생들의 상당 부분이 여학생이라는 것이 특이할만하다. 학년이 올라감에 따라서 창의적인 아이디어를 내는 양이나 질에 있어서 뒤떨어지는 것으로 분석되었으며, 토론 학습의 적응력이 미흡하고 발표력 및 청취력에 있어서도 떨어지는 것으로 나타났다. 따라서 중 ㆍ고등학교의 학교교육에서도 학생들에게 프로젝트형 탐구학습 프로그램의 적용은 물론 토론식 수습을 통한 학생들의 사고의 전환의 기회를 제공해야 할 것으로 사료된다. The creativity competition was held to foster the creativity of elementary and secondary school students in the Institute of Science Education, Kongju national University. It was found that the creativity competition effected on the improvement of inventing creative ideas and problem solving activities. But, only some competitors participated in semifinal and final contests, presented original and interesting ideas. More female students participated in competition than last year. More female participants were awarded a prize than males. Totally, participants were defective in discussion and communication, and presentation and listening ideas. Increasing grades correlated inversely with creativity and originality. There is need of inquiry project teaming programs and presenting opportunities of conversion of thinking by discussing instructions in school

구개부에 발생한 다형성선종의 치험례

이창진,김태열,김효언,김희광,전인성,윤규호 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50 per cent of all cases of tumors, and approximately 90 per cent of all benign salivary gland tumors. Since the term mixed tumor' was introduced by Broca for its dual origin of epithelial and mesenchymal elements, the term plemorphic adenoma suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The parotid gland is the most common site but it may occur in any of the salivary glands. It is somewhat more frequent in women and in the fourth to sixth decades, but they are also relatively common in young adult and have been known to occur in children. Treatment of choice is surgical excision. Adequate surgery with safe margin reduce its recurrence rate. We represent a case of pleomorphic adenoma with literature review in 65-year old male occured in the palate. The lesion was successfully treated by surgical excision.

토목섬유-흙간의 접촉마찰특성 연구

이광열,김수석,송무효,김병일 東西大學校 1998 동서논문집 Vol.4 No.-

In this study, interfacial angles for two adjacent materials were investigated for the design of geosymthetics in earthen structures specially a liner systems of waste landfills. The purpose of the study is to determine interface friction angles of geosynthetids to various soil types and to examine the tensile strength of geosynthetics in side slope of waste landfills. To determine interface friction angles, the direct shear testing apparatus was modified in accordance with ASTM D5321. Three different types of soils and four geosynthetics are applied for the test to determine the interface friction angles. Equilibrium analysis were performed to estimate the required tensile strength of geosynthetics using a model of liner systems in a side slope. Form this study it is found that the textured type of HDPE is more efficiency than smooth type of HDPE and using soil-bentonite liners is more stable than using compacted clay liners underlying the HDPE sheet.

乾熱調理法에 의한 饌物類의 分析的 考察

李光子,李孝枝 漢陽大學校 韓國生活科學硏究所 1987 韓國 生活 科學 硏究 Vol.- No.5

I have studied the kinds of side dishes, the changes of food, the materials of food and used times of the materials by dry cooking method of Korean side dishes according as ages which included many Korean cook books written from 1970 to 1943. The results of study and analysis are as following. 1) There were Jun, Jock, Gui, Nurmi, Bockum and Jihi cooked dy dry cooking method. 2) Forth-eight Kinds of Jun, Thirty kinds of Jock, Forty-seven kinds of Gui, Eigfteen kinds of Nurmi, Thirteen Kinds of Bockuman Two Kinds of Gihi were the continual foods. 3) Jun, Jock, Gui, Nurmi (and Bockum were the continual cooking method, but the record Nurmi) could not find in the cook books written from 1943. The record for Jihi could find tn the Umsickdimibang (Korean Cooking Method Method Book) written in 1670 and after then nobody Knows that. 4) Used materials and spices for Jun, Jock, Gui, Nurmi, Bockum and Jihi were meat and poultry, fish and shell fish, dried fish, vegetables, mushrooms, bean and bean products, seaweeds, egg, fruits wheats, flour and corn starch. Seasonings were seasame oil, cotton seeds oil, soybean sauce, salt, pepper, green onion and so on.

생약의 생리활성에 관한 기초연구

이효구,유광원 공주대학교산업개발연구소 2000 産業開發硏究 Vol.8 No.-

The active polysaccharides purified from Atractylodes lancea DC. rhizomes suggested that neutral glactosyl chains and RG II-like moiety should play an important role in the potent intestinal immune system modulating action. The acidic pectic polysaccharides from Bupleurum falcatum remarkably enhanced immune complex binding activity through Fc receptors of macrophages, and an acidic polysaccharide fractions also showed a significant anti-ulcer activity against HCl-ethanol induced ulcerogenesis in mice. Oral administration of Polygalae Radix-extract and sinapic acid significantly increased the ChAT activity in the cerebral cortex of basal forebrain lesioned rats.

초 연약지반 안정의 소요시간 추정기법에 관한 연구

이종보,이광열,송무효 東義大學校産業技術開發硏究所 1998 産業技術硏究誌 Vol.12 No.-

Dredged soils used in coast reclamation are soft clay that have different characteristics, depending upon the sites. In this study, the consolidation behavior of the soft clay are analyzed by conducting consolidation tests. Also, results by the test are compared with those of numerical analysis of "LRSC" equation to assess predictions of the consolidation settlement. Dredged soils used in this study are the expendable clay with the coefficient of peameability in the range of 6.1×10-7∼5.0×10-5cm/s, and a long term consolidation settlement calculated by "LRSC" equation showed higher values than experimental results. From the column tests, it is found that the maximum excess pore pressure takes place at the lower part of the column and this unusual phenomenon is supposed to be affected by the self-consolidation process.

상태방정식을 이용한 고압 기액평형의 계산과 상호작용계수의 일반화

이장목,배효광,박원규 영남대학교 공업기술연구소 1985 연구보고 Vol.13 No.2

The vapor-liquid equilibria (VLE) at high pressure of the binary systems, carbon dioxide-hydrocarbon and methane-hydrocarbon are calculated by using the equations of state given by Peng-Robinson and Soave that are even simple but, comparatively, able to predict accurately. The interaction parameters included in the equations of state are shown in figures. It is known that the parameters are dependent of the characteristic temperature defined in this text. As the same calculation procedure for binary systems, parameters are obtained from the binary VLE data of the systems that are composed of each component of ternary systems, CO₂-CH₄-C₂??, CO₂-C₂H₄-C₂??, N₂-Ar-O₂ and N₂-Ar-CH₄. For the prediction of the VLE of the ternary systems, the parameters are used and the results are compared with the observed data. The mixing rule proposed by Chueh and Prausnitz[3]is used for the systems.