Sodium Nitroprusside(SNP)를 사용한 유도 저혈압 마취시 Renin 활성치, Aldosterone, Epinephrine, Norepinephrine의 변동

강기택,구영권,우성,조강희,백세민 인제대학교 1991 仁濟醫學 Vol.12 No.3

악안면 성형재건술 환자 10명을 대상으로한 sodium nitroprusside(SNP) 유도 저혈압 마취에서 SNP를 주입한 후에 체내의 renin-angiotensin-aldosterone system과 sympathoadrenal system이 활성화되었음을 관찰할 수 있었다. Sodium Nitroprusside (SNP) is used during induced hypotension to decrease bleeding in operation site by direct relaxation of vascular smooth muscle. It is known that the infusion of SNP increases plasma renin activity and this activation of remain-angiotensin system is one physiologic mechanism opposing the hypotensive action of SNP. The purpose of this study was to determine plasma renin activity and activation of sympathoadrenal system following infusion of SNP for hypotensive anesthesia in 10 patients needed maxillofacial reconstructive surgery. Blood samples for analysis were drawn according the time sequence of SNP infusion ; Stage 1; After the induction and before SNP infusion, Stage 2 ; 30 min after when mean arterial pressure maintained 60-70 torr and within 30 min after SNP infusion, Stage 3;Before slopping of SNP, Stage4; 30 min after stopping of SNP. The results were as followings, 1) The duration of anesthesia and infusion of SNP were 197.7±131.3 Min and 100.2±40.3 min. 2) Total doses of 0.01% SNP solution were 115.2±36.4 ml through hypotensive anesthesia 3) PRA in stage 2,3 and 4 (25.3±7.6, 26.2±7.2 and 24.5±8.2 ng/dl/hr respectively) were significantly increased compared with the value of stage 1 (8.9±7.0ng/dl/hr) and the level of aldosterone in stage 2, 3, 4 (28.4±12.7, 33.6±20.0 and 32.9±18.0 mg/dl respectively) were significantly increased compared with the value of stage 1 (13.4±9.1 ng/dl). The increased values of PRA and aldosterone fowllowing infusion of SNP were continued eyen after the time of stopping SNP. 4) Norepinephrine in stage 2, 3(545±157.5, 347.7±115.0 pg/ml respectively) and epinephrine in stage 2,3 (178.4±58.7, 132±55.7 pg/ml respectively) were significantly increased compared with the values of stage 1(norepinephrine ; 236.2±107.3, epinephrine ; 111.8±73.9 pg/ml) and they were returned to the control value after slopping of SNP infusion 5) Sodium potassium and chloride were not changed significantly during SNP induced hypotensive anesthesia. In summary, the activity of renin-angiotesin-aldostprone system and sympathoadrenal system were increased following infusion of SNP during SNP induced hypotensive anesthesia.

6 시그마 기법을 이용한 임상약동학 자문 업무의 효율성 개선 : 신속성과 정확성을 중심으로 Focusing on Speed and Accuracy of CPS

김민영,박효정,박향미,손기호,최경업,박영하 한국병원약사회 2001 병원약사회지 Vol.18 No.2

연구 배경 : 적정한 약물요법을 순발력 있게 시행하기 위해서는 CPS 업무가 신속, 정확하게 수행되는 것이 필수적임에도 불구하고 지금까지 CPS 업무의 신속성, 정확성을 향상시키기 위한 객관적인 업무 표준은 물론 그의 측정까지도 전무한 실정이었다. 이에 수요자인 의사의 측면에서, CPS 자문결과의 신임도에 영향을 미치는 업무의 순발력과 정확성을 향상시키기 위해 CPS 업무의 신속성, 정확성에 영향을 미치는 요인을 파악, 분석하고 이를 향상시킬 수 있는 업무 표준을 개발하는 것을 목표로 6-Sigma 기법을 사용하여 본 연구를 진행하였다. 방 법 : CPS 업무의 신속성 평가를 위해 전체 업무 과정과 부분별 업무 과정에 대한 소요 시간을 측정하였고, 정확한 평가를 위해 예측되는 Cpeak와 실제 측정된 Cpeak를 비교하였다. CPS 업무에 대해 6-Sigma 기법을 사용하여 개선이 필요한 사항을 파악하고 이에 대한 개선활동을 한 후, 개선 활동 전과 후의 CPS 업무의 신속성과 정확성의 σ 수준을 각각 측정하여 이의 향상 정도를 잠재적인 경제적 이익으로 환산하였다. 결 과 : 신속성은 제 1차 자료수집 기간(대조군, 현황 파악 기간) 중 총 소요시간은 평균 930.6±583.2이었으며, 채혈-검체 접수 : 140.4±8705분, 검체접수-약물농도 결과보고: 48.4±23.1분, 결과보고-CPS 보고서 작성 : 741.8±510.6분으로 측정되었다. σ 수준은 총 소요시간의 경우는 0.56σ, 단계별로는 각각 0.45σ, 5.70σ, 0.30σ이었다. 제 2차 자료수집 기간(개선군, 개선활동 평가 기간) 중 총 소요시간은 평균 659.1±344.1분이었고 단계별로는 각각 92±66.2분, 48±28.0분, 518.9±340.7분이 소요되었다. σ 수준은 총 소요시간은 1.75σ이고, 단계별로는 1.32σ, 4.70 σ, 1.10σ로서 총 소요시간과 단계별 소요시간이 1차 자료수집기간에 비해 향상되었다. 정확성 측면에서는, 대조군의 경우, 예측 Cpeak와 실측 Cpeak의 차이는 평균은 0%, 분산 ±27.10%, σ 수준은 -0.56σ이었고 개선군의 평균과 분산 그리고 σ 수준은 각각 0%, ±15.10%, 0.14σ로 향상되었다. CPS 신속성, 정확성 향상으로 인한 경제적 이익은 정확성 측면에서 380만원/년, 신속성 측면에서 1350만원/년으로 총 1730만원/년의 비용절감 효과가 있었다. 결 론 : CPS 업무 흐름에 따라 CPS 효율성에 영향을 미치는 요인을 분석한 결과 CPS 효율성 향상을 위해서는 투약관련 의무 기록의 정확성, 임상병리 검사의 정도관리 향상, 그리고 관련 부서와의 원활한 업무 협조가 가장 중요하였다. The effectiveness of CPS (Clinical Pharmacokinetics Service), one of pharmacist's clinical services, was emphasized by many studies since 1985 it was introduced Korea about. But in the view of clinicians (medical doctors), customers, it's convenience or reliability was not properly evaluated for applying it to patient's care. To improve quality of Clinical Pharmacokinetics Service (CPS), the speed and the accuracy of CPS, the key points of efficiency in CPS, were evaluated by using 6-Sigma method. The speed of CPS was evaluated using total hours it took from blood sampling by a nurse to sending a CPS report to the patient's chart by a clinical pharmacist. Total hours were divided into blood sampling-to-sampling registering, sampling registering-to-C_(peak) result reporting, and C_(peak) result reporting-to-pharmacist's CPS report. The accuracy of CPS was evaluated by the difference between expected C_(peak) and measured C_(peak). Then the speed and the accuracy of CPS were expressed as σ level. After the campaign for improvement by Six Sigma method, the speed was improved by 1.19σ (before and after the campaign; 0.56σand 1.75σ, respectively) and the accuracy was improved by 0.7σ (before and after the campaign, -0.56σand 0.14σ, respectively). Exact recordings of dosing time, drug infusion hours and blood sampling time were shown to have profound effect on the accuracy of CPS. The improvement in the speed and the accuracy of CPS could produce potential financial benefit of U.S.$ 15,300 a year. There have not been studies on evaluating and objectifying as numerical value for the speed and the accuracy of CPS; thus, 6-Sigma method for improving efficiency in manufacturing process was applied to CPS process by expressing as σlevel. The speed and the accuracy of CPS could be improved by tightly controlling many factors related to CPS efficiency.

Durable Press 加工에 있어서 遊離포름알데히드의 捕捉效果

李廷玟,裵基瑞,李哲鎬 忠南大學校 産業技術硏究所 1986 산업기술연구논문집 Vol.1 No.2

This study was investigated on the effects of scavenger treatment for low formaldehyde release from durable press finished cotton fabrics using saturation pad method. And possibility of foam application in durable press cotton fabrics was investigated. Cotton cellulosic fabric was crosslinked with DMDHEU in the presence of magnesium chloride as a catalyst and polyhdroxy alcohols as a formaldehyde scavenger. Optimum concentration of formaldehyde scavengers on the durable press finished cotton fabrics were about 4%. Most favourable pH of the pad solution and wash water were about 5. The glycols and glycerol were the most effective formaldehyde scavenger. The glycol class of polyhydroxy alcohol is water soluble and is compatible and effective with crosslinking agent.

Color CRT의 색관리 기술

배기서,이래연,이정민,김청섭 忠南大學校 産業技術硏究所 1998 산업기술연구논문집 Vol.13 No.2

The purpose of this study was to develope the color matching technic between fabrics and color CRT which is a commonly used color matching machine. The former researchers had focused on the theoretically color matching technic between CIE and RGB color co-ordinates, but in this study we tried simulating the colors obtained from fabrics on the color CRT by using experimental method.

베체트병 환자에서 Azathioprine으로 유발된 급성 췌장염 1례

김기향,권민정,김동기,김애란,김윤정,박지훈,이영태,박보민,김동욱 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Although many drug are thought capable of initiating acute pancreatitis, following azathioprine administration represents the 5% incidence by far the highest recorded incidence to date. We report a 35-year-old male who developed acute pancreatitis in the course of treatment with azathioprine for Behcet's disease. He was admitted due to abdominal pain, diarrhea, and fever for 10 days. Serum amylase and lipase levels were 510U/L and 3702U/L respectively. The abdominal CT scan revealed diffuse enlargement of the pancreas. There was no history of alcohol use or gall bladder disease. We considered drugs, especially azathioprine, as the cause of acute pancreatitis. We diagnosed it as acute pancreatitis. The patient was treated conservatively with hydration and analgesics. The symptom subsided within four days. Five days later, azathioprine was resumed. And the patient complained of abdominal pain. The elevated levels of serum amylase and lipase confirmed the recurrence of pancreatitis. His symptom subsided when azathioprine intake the stopped, and the serum amylase and lipase levels returned to normal level within five days.

W^(sh)/W^(sh) 마우스 고환에서 Protein Kinase C(PKC)와 c-kit의 발현 양상

곽현정,최병민,서기석,임정식,정헌택 大韓免疫學會 1996 大韓免疫學會誌 Vol.18 No.3

Protein kinase C (PKC) is a multigene family of at least nine serine/threonine kinases that are central to many signal transduction pathways. And the expression of PKC gene is strictly con-trolled by developmental stage. Mutation of the W (c kit) gene, which encodes a transmembrane tyrosine kinase receptor, affect the development and differentiation stem cells. Most homozygous W mutant mice are sterile, due to a lack of germ cells arising during embryonic development, but one of notable exception is W */Wh mice, which are fully fertile in both sexes. In order to elucidate the biological functions of PKC S and c-kit in the testes, we have examined the expression of PKC b mRNA and c-kit mRNA in While mouse testes by means of Northern blotting. North-em blot results was demonstrated that only PKC 8, 4, 8 mRNA can be detected in normal mouse testes. PKC, 8 mRNA was weakly expressed in 7 and 8-week-old mice and highly ex-pressed by 12 weeks. The PKC 8 mRNA and the c-kit mRNA was detectable in the testes of Whl Wh mouse. These results indicated that the function of the PKC a gene is necessary for the development and the W (c-kit) gene is important for the transmission of signal in testes.

폐 섬유 보강 복합재의 제조와 마찰특성

차준용,이정민,모상영,이재달,배기서,홍영기 忠南大學校 産業技術硏究所 1996 산업기술연구논문집 Vol.11 No.2

Fiber-reinforced composite materials are used in a wide variety of applications in the advanced field of industries such as electric clutch, motor, car, space and aviation etc. It is well known that the brake lining made of fiber-reinforced composites show excellent friction and wear properties compared to the conventional asbestos brakes and also are known to have high absorption energy and excellent high temperature properties in braking. In order to endow high friction and wear stability to the commercial brake lining, the waste fiber such as cotton, PAN, PET, nylon,kevlar, glass and it's binary mixture fibers were used the fiber reinforcements. The fiber/phenolic resin system has been carried out by preform molding method. The friction tester was especially designed and prepared for evaluation of frictional properties such as friction coefficient and stability. The physical properties of fiber reinforced composites were investigated in terms of the 3-point bending strength, the properties of friction, and morphology. The results obtained from the work are as follows ; 1. The friction properties of the cotton fiber reinforced composites were similar to those of the commercial brake linings, but in the cases of reinforcement of kevlar, glass. we can improve those properties, 2. The proper amount of organic and inorganic fiber mixtures can improve the properties of friction and the mechanical properties, 3. It is more desirable to manufacture hybrid fiber reinforced composites because single cotton or synthetic fiber reinforced composites aren't improved frictional properties, and 4. On evaluating frictional properties of waste fiber reinforced composites, frictional properties of waste fiber reinforced composites are superior to commercial disc lining. Therefore we can confirm practical possibility of waste fiber reinforced disc lining.

대전광역시 양축농가의 축분뇨 관리 실태 및 VOCs 농도 조사

이봉덕,이수기,오홍록,허정민,정기철,김성복 충남대학교 농업과학연구소 2005 농업과학연구 Vol.32 No.1

This study was carried out to investigate the style of livestock house, concentration of malodorous substances of livestock feces and livestock houses in Daejeon area. Among the livestock houses investigated, as most of cow pens(94.5%) have sawdust or chaff on the bottom, there was no leakage of feces out of pen. Most pig pens adopted slury style, but some of them currently use buffering material on the bottom. It is thought that there will be no possible contamination leakage. When it comes to hen house, all the broiler house use litters on the bottom and all the layer house use scrapper. It is also thought that there will be no possible contamination leakage. 3 out of 12 deer pens used buffering material on the bottom, 10 places were maintained in a traditional method, and 7 places left possibility of contamination leakage considering whether the roof was installed or not. The contents of ammonia, amine and volatile fatty acid in fresh feces were lower compared to rotten feces, but the concentration of sulfur-containing matter - hydrogen sulfide, methylmercapthan and ethylmercapthan were higher compared to rotten feces. In the case of malodorous ingredient in livestock houses, only small amount of ammonia and hydrogen sulfide were detected in pig pen and hen house, and other ingredients were not detectable. And those who are engaged in animal husbandry reacted negatively to the use of feed additives for decreasing malodor. In conclusion, it is not worrisome that contamination can be leaked out of animal raising facilities. But if we take into consideration that the point of investigation time is wintry season, there should be more considerate attitude. And feed additives for decreasing malodor need establishing criteria in the manufacturing process.

대퇴골 전자부 골절에서 압박고 나사 고정과 Captured 고나사 고정 및 감마정 고정의 비교

정의섭,최경수,김민기,이종봉 예수병원 1997 예수병원학술지 Vol.18 No.-

Neuropeptide Y improves cisplatin-induced bone marrow dysfunction without blocking chemotherapeutic efficacy in a cancer mouse model

( Min Hee Park ),( In Kyung Jung ),( Woo-kie Min ),( Jin Ho Choi ),( Gyu Man Kim ),( Hee Kyung Jin ),( Jae-sung Bae ) 생화학분자생물학회(구 한국생화학분자생물학회) 2017 BMB Reports Vol.50 No.8

Cisplatin is the most effective and widely used chemotherapeutic agent for many types of cancer. Unfortunately, its clinical use is limited by its adverse effects, notably bone marrow suppression leading to abnormal hematopoiesis. We previously revealed that neuropeptide Y (NPY) is responsible for the maintenance of hematopoietic stem cell (HSC) function by protecting the sympathetic nervous system (SNS) fibers survival from chemotherapy-induced bone marrow impairment. Here, we show the NPY-mediated protective effect against bone marrow dysfunction due to cisplatin in an ovarian cancer mouse model. During chemotherapy, NPY mitigates reduction in HSC abundance and destruction of SNS fibers in the bone marrow without blocking the anticancer efficacy of cisplatin, and it results in the restoration of blood cells and amelioration of sensory neuropathy. Therefore, these results suggest that NPY can be used as a potentially effective agent to improve bone marrow dysfunction during cisplatin-based cancer therapy. [BMB Reports 2017; 50(8): 417-422]