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- 저자 : Myung Kul Yum (검색결과 32 건)
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강종만,김종성,김희수,염명걸 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4
Correlation between Respiratory Rates and the Degree of Bradycardia in Strabismus Surgery in Children Jong-Man Kang, M.D., Hee-Soo Kim, M.D., Chong0Sung Kim, M.D. and Myung-Kul Yum, M.D.^* Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, and ^*Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea Background: Strabismus surgery is frequent in pediatric ophthalmic surgery. Traction on the extra-ocular muscles can trigger an oculocardiac rdflex. We investigated the correlation between respiratoy rates and the degree of bradycardia to find another management for preventing oculocardiac reflex. Methods: NO premedications were administered. They were induced with thiopental and vecuronium and maintained with O_@-enflurane-N_2O. The tidal volume was 10 ml/kg. Respiratory rate of group 1 (n = 18) was fixed at 24 bpm, group 2 (n = 18) at 20 bpm, and group 3 (n = 19) at 16 bpm. We measured the mean heart rate from intubation to the beginning of surgery and defined this as the basal heart rate. We defined the lowest heart rate after traction of the extraocular muscles as the minimal heart rate. We calculated the correlation coefficient between the respiratory rate and basal heart rate, minimal heart rate, the change of heart rates and E_tCO_2. Results: There was a positive correlation between the respiratory rate and the basal heart rate, and minimal heart rate. There was no correlation between the respiratory rate and the change of heart rate. There was no difference in E_tCo_2 among the 3 groups. Conclusions: Can be increased both basal heart rate in anesthetized patients and minimal heart rate induced by oculocardiac reflex by making the respiratory rate more rapid if there is no significant difference of E_tCO_2. The oculocardiac reflex may be reduced by making respiratory rate more rapid if there is no significant influence on minute ventilation. (Korean J Anesthesiol 2001; 41: 450~454)
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이홍기,염명걸,김수찬 대한혈관외과학회 1999 Vascular Specialist International Vol.15 No.1
Background: There are two methods to understand a periodic signal. One is describing it in the time domain, and the other is in the frequency domain. Various methods have been described for analysis of Doppler signals in terms of velocities and they need to be further characterized. Frequency domain analysis involves conventional Fourier transformation and analysis by modeling. In 1980' s, Skidmore et al. applied Laplace transformation analysis to the femoral and ankle Doppler waveforms and described the waveforms in terms of damping, stiffness and distal impedance. However, few subsequent studies have been reported by other authors. Further, an appealing feature of frequency function analysis is that it can be used for modeling of the resistive and/or storage property of the circuit. Purpose: The purpose of study is to analyze the Doppler waveforms of lower extremity in frequency domain and compare the results with the currently known parameters of pusatility in the time domain. Methods: This study includes 119 Doppler waveforms from 7 non-symptomatic limbs and from 18 limbs with symptoms of chronic low extremity ischemia. Each five representative beats of Doppler waveforms were curve-fitted by third-order AR (auto-regressive) model and z-transformed resulting in three representative roots in the z-plane. Maximum velocity (Max), minimum velocity (Min), maximum excursion of the waveform (Max-Min; MaxE), mean velocity (Avg), pulsatility index (PI) and resistive index (RI) were calculated and compared with the values of the roots. Results: Mostly, the poles of the transfer function were two imaginary and one real poles. Severely diseased waveforms had all three poles in real axis or the imaginary poles approached toward the realaxis. The average value of the three poles (Rmean) was 0.5096 (±0.0967 S.D.) (range: 0.2193 ∼0.7197). The real value of the first pole (R1real) was 0.8957 (±0.067 S.D.) (range: 0.5964 ∼0.97). The absolute value of imaginary value of the first pole (R1imag) was 0.0998 (±0.0713 S.D.) (range: 0 ∼0.2336). Significant correlation was observed between 1) Rmean and MaxE (r=0.769), Max (r=0.7498), Avg(r=0.3106), RI (r=0.4378), 2) R1real and MaxE (r=0.5382), Max (r=0.4732), RI (r=0.3629), and 3) R1imag and MaxE (r=0.4785), Max (r=0.3333), Min (r= 0.3703), RI (r=0.5611). Conclusion: The position of roots of third-order transfer function of Doppler waveforms seems to correlate with the known parameters of velocity. In addition to these parameters of velocity, transfer function analysis appears to be a useful tool to evaluate the Doppler waveforms. Further studies are needed in relation to clinical manifestation.$quot;
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Yum, Myung-Kul,Kim, Chang-Ryul,Park, Eun-Young,Kim, Jong-Hwa,Park, Ki-Jong Taylor Francis 2006 Clinical and experimental hypertension Vol.28 No.2
<P>Fetuses with intrauterine growth restriction (IUGR) can be programmed in utero to develop hypertension in adult life. The etiology of IUGR in human fetuses is not uniform. The present study demonstrated that different etiologies of growth restriction, idiopathic cause, and pregnancy-induced hypertension, produce different consistencies in the occurrence of an abnormal local very-short-term nonstationarity of heart rate during intrauterine period. Whether the consistent abnormality that was found in the growth-restricted fetuses associated with pregnancy-induced hypertension is linked to the different risk of later hypertension requires future studies.</P>
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Effect of a ketogenic diet on EEG: Analysis of sample entropy
Yum, Myung-Kul,Jung, Ki-Young,Kang, Hoon-Chul,Kim, Heung Dong,Shon, Young-Min,Kang, Joong-Ku,Lee, Il Keun,Park, Ki-Jong,Kwon, Oh-Young Elsevier 2008 SEIZURE Vol.17 No.6
<P><B>Summary</B></P><P>Although ketogenic diet (KD) is an effective alternative therapy for controlling intractable seizures, the anticonvulsant mechanism still remains unclear. Sample entropy (SampEn) provides a generalized measure of regularity in time-series data. To investigate the potential anticonvulsive mechanism of a KD, we analyzed the SampEn of electroencephalography (EEG) data in patients with intractable pediatric epilepsy before and after treatment with a KD. Seventeen pediatric patients with epilepsy who were treated with KD were enrolled in present study. Patients were classified as good responder and poor responder according to therapeutic responsiveness on KD. Thirty segments of 30-s epochs were selected before and after KD from each patient which were subject to SampEn. The KD increased the SampEn in the whole patient population; the SampEn increased significantly in all electrodes in the good responders, but the change in SampEn varied according to the electrode in the poor responders. Before the KD, the good responders had significantly lower SampEn values than the poor responders, but after the KD, SampEn values were higher in the good responders than in the poor responders. KD may have an anticonvulsive effect by decreasing the regularity of the EEG dynamics.</P>
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이홍기,엄명길 대한혈관외과학회 2001 Vascular Specialist International Vol.17 No.1
Purpose: Although it is well known that the pulsatile Doppler waveforms change in shape with disturbed flow, interpretation of the waveforms has largely been subjective. We aimed to describe the Doppler waveforms of the lower extremity objectively by parameters of Fourier transformation. Method: Sixty-eight Doppler arterial waves were analyzed in this study. They were classified according to the clinical findings; Group I: no ischemic symptoms with ankle pressure$gt;100 mmHg (N=17). Group II: no ischemic symptoms with ankle pressure 80~100 mmHg (N=18). Group III: symptoms of claudication (N=l9). Group IU: rest pain or tissue loss (N=14). The waveforms were Fourier transformed and their amplitudes and phases were compared up to the third harmonics. Result: Both the fundamental and second harmonics were predominant in group I. In contrast, fundamental harmonic was predominant with disturbed flow. The phases of the fundamental and second harmonics were delayed with disturbed flow. Relative phase (difference of phase between higher harmonics and fundamental harmonic) tended to be shortened with disturbed flow. Conclusion: Abnormal waveforms are characterized by predominant amplitude of the first harmonic, phase delay, and shortening of the relative phase. These parameters may be useful for differentiation of Doppler waveforms.
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이철범,염명걸 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.2
Inflammatory pseudotumors(IPT) of the lung are uncommon. These masses resemble carcinoma of the lung or sometimes mediastinal tumor radiographically and are discovered only at time of the histologic review of the resected specimen. A 14 year old girl presented with high fever and iron deficiency anemia had a radiological left upper mediastinal and left upper lung lesion, that was interpreted as an mediastinal tumor. At operation an inflammatory pseudotumor was found in the left upper lobe of the lung, that was projecting across the mediastinum. Left upper lobectomy was carried out. Histological examination confirmed the diagnosis of an IPT. The patient had an uneventful postoperative course and has been free of recurrence for 42 months since her operation.
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