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기관내 삽관과 d-Tubocurarine이 혈압 및 맥박에 미치는 영향
최세진,길기진 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.2
Transient increase in blood pressure and heart rate following laryngoscopy, endotracheal intubations are common. Tomori and Widdi can be found these response are associated with an increased impulse traffic in the cervical sympathetic efferent nerve fiber. These nervous activities were especially increased by mechanical stimulation of the epi-and laryngopharyngeal region. The present study was undertaken to observe the effect of d-Tubocurarine on the blood pressure and heart rate in endotrachel intubation. d-Tubocurarine is one of the non-deporalizing muscle-relaxants which is commonly used in clinical situation. The most common side effect of d-Tc in a dose-related falls in arterial pressure. Adult patients who had received elective surgery under general anesthesia with endotracheal intubation randomly selected in Chungnam University hospital. Sixty patients were selected for the response of d-Tc following intubation, and these were divided into 4 group each. Group Ⅰ : Served as a control group for intubation(n=15, no intravenous d-Tc) Group Ⅱ : Served as a intravenous d-Tc(3mg) injected group before intubation(n=15). Group Ⅲ : Served as a intravenous d-Tc(6mg) injected group before intubation(n=15). Group Ⅳ : Served as a intravenous d-Tc(9mg) injected group before intubation(n=15). The results were as follow. 1) The elevation of systolic B. P. following intravenous d-Tc injection before intubation was of less magnitude than in control group, (Statistically significant, esp. group Ⅳ). 2) The elevation of diastolic B.P. following intravenous d-Tc injection before intubation was of less magnitude than in control group (Statistically significant). 3) The elevation of heart rate following intravenous d-Tc injection before intubation was not significant compared with control group. It is suggested from the above results that the d-Tc intravenous injection before intubation decrease the magnitude of blood pressure elevation but not decrease the magnitude of H. R. elevation following intubation.
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김헌수,김영돈,이재우,나철,이길홍,민병근,김세철 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.1
The present study was intended to examine the relationship of the MMPI mean scales in the Korean impotent and Beutler's decision rules to acertain the empirical utility of the MMPI in discriminating between organic and psychogenic erectile dysfunction. Subjects served for this study consisted of 451 patients visited to department of neuropsychiatry and urology, Chung-Ang University Medical Center from May 1, 1985 to July 31, 1987. Their age range was between 22 and 84. The actual number of cases put into the analyses was 97 including 53 psychogenic impotents and 43 organic impotents. Statistical methods employed were χ² and T score. Results of the study were presented as follows: 1) The mean overall 4-3/3-4 MMPI profile(17.7%) revealed somatic complaints, depression, conflict with spouse and emotionally unstable personality trait. However, there were no significant relationship of mean T score between psychogenic and organic impotents. 2) Applying the Beutler's rule decision, we found that our hit rate of rule I or rule Ⅱ were 12.3% and 47.2%, respectively. Applying the two rules to 97 cases, the hit rate was 60.4% with nonsignificant Chi square of 0.017. These results revealed no significant differences between psychogenic and organic subjects. Finally, we failed to examine the validity of Beutler's decision rules adapted to our 97 subjects.
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신경차단이 정맥압박에 의한 t - PA 분비에 미치는 영향
홍세용(Sae Yong Hong),양동호(Dong Ho Yang),신현길(Hyun Kil Shin),김순길(Sun Kil Kim),김난숙(Nam Suk Kim),김형미(Hyung Mi Kim),신정순(Jung Sunn Shin) 대한내과학회 1992 대한내과학회지 Vol.43 No.2
N/A Background: Fibrinoiytic response to venous occlusion of the limbs had been regarded as a sensitive and reliable method for assessing the individual fibrinolytic capacity, but the exact mechanism of the increased fibrinolytic activity after venous occlusion is not clear. Methods: In order to investigate the influence of neurotransmitter on t-PA release by venous occlusion, we compared the increase in t-PA and fibrinolytic activity in the euglobulin fraction initiated by cubital venous occlusion (100mmHg for 10mins), in pre-neural block and post-neural block states, in seven cases. In all patients, the supra-clavicular approach was used to obtain a brachial plexus block and venous occlusion was achieved at the cubital levels on the ipsilateral arm. Results: The euglobulin fibrinolytic activity before venous occlusion was 100.9±27,5 BAU in the pre nerve block state and 102.7±29.4 BAU in the post nerve block state (p>0.5). The t-FA antigen level before venous occlusion was 3.5±1.2ng/ml in the pre nerve block state and 4.0±1.0ng/ml in the post nerve block state (p>0.5). The increase in the euglobulin fibrinolytic activity after venous occlusion was 18.0±16.7 BAU in the pre nerve block state, and 18.3±15.6 BAU in the post nerve block state (p>0.5). The increase in the t-PA antigen levels after venous occlusion was 3.0±2.0ng/ ml in the pre nerve block state and 3.0±2.1ng/ml in the post nerve block state (p>0.5). Conelwion: These findings suggest that the peripheral nervous system does not exert any influence on t-PA release during venous occlusion.
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( Kil Hyo Park ),( Soon Ha Kwon ),( Yong Sub Lee ),( Soung Won Jeong ),( Jae Young Jang ),( Sae Hwan Lee ),( Sang Gyune Kim ),( Sang Woo Cha ),( Young Seok Kim ),( Young Deok Cho ),( Hong Soo Kim ),( 대한간학회 2015 Clinical and Molecular Hepatology(대한간학회지) Vol.21 No.2
Background/Aims: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined. We assessed the possible predictive factors of CEUS for the response to TACE. Methods: Seventeen patients with 18 hepatocellular carcinoma (HCC) underwent TACE. All of the tumors were studied with CEUS before TACE using a second-generation ultrasound contrast agent (SonoVue®, Bracco, Milan, Italy). The tumor response to TACE was classified with a score between 1 and 4 according to the remaining enhancing-tumor percentage based on modified response evaluation criteria in solid tumors (mRECIST): 1, enhancing tumor <25%; 2, 25%≤enhancing tumor<50%; 3, 50%≤enhancing tumor<75%; and 4, enhancing tumor≥75%). A score of 1 was defined as a “good response” to TACE. The predictive factors for the response to TACE were evaluated during CEUS based on the maximum tumor diameter, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, presence of a hypoenhanced pattern, and the feeding artery to the tumor. Results: The median tumor size was 3.1 cm. The distribution of tumor response scores after TACE in all tumors was as follows: 1, n=11; 2, n=4; 3, n=2; and 4, n=1. Fifteen tumors showed feeding arteries. The presence of a feeding artery and the tumor size (≤5 cm) were the predictive factors for a good response ( P=0.043 and P=0.047, respectively).Conclusions: The presence of a feeding artery and a tumor size of less than 5 cm were the predictive factors for a good response of HCC to TACE on CEUS. (Clin Mol Hepatol 2015;21:158-164)
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오세문,차희중,최길수,심보성 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.2
Our study was designed for two purposes. The first purpose was to evaluate the incidence of the visualization of the identifiable vessels of the posterior fossa on the vertebral angiography and its significance in the diagnosis of the supra and infratentorial lesions. The second purpose is by measuring the position of the important angiograaphic landmarks of the posterior fossa on the vertebral angiography to obtain their normal value and to investigate the correlation between the change of the position of the landmarks and the supra and infratentorial lesions. 91 cases of vertebral angiogram performed at Seoul National University Hospital from June 1974 to September i976 were reviewed. The results were as follows: 1. Generally the vessels of the injected site showed better visualization than the vessels of the opposite site on the Towne's projection and the lateral projection showed better visualization than the Towne's projection with respect to each vessel of the injected site. 2. Reflux of contrast media down the contralateral vertebral artery was seen in about 33% of cases. On the lateral projection, posterior inferior cerebellar artery, precentral cerebellar vein and inferior vermian vein showed high incidence of visualization, which were important in the diagnosis of the posterior fossa lesions. On the Towne's projection posterior choroidal artery, posterior pericallosal artery, precentral cerebellar vein, superior vermian vein and anterior pontomesencsphalic vein showed very low incidence of visualization. 3. For the better visualization of the vessels of the posterior fossa, injection with constant and high pressure, precise serialogram, subtraction and magnification techniques were needed. 4. On the lateral projection the normal value of the distance between the dorsum sellae and the basilar artery was 6.0㎜ (3.0㎜-10.0㎜), and the distance between the midpoint of the clivus and the basilar artery was 3.5㎜ (1.5㎜-10.0㎜), and the distance between the anterior rim of the Foramen Magnum and the vertebral artery was 9.5㎜ (1.0㎜-19.0㎜). In some cases of craniopharyngioma the tip of the basilar artery was displaced posteriorly and in the most cases of the space occupying- lesions of the posterior fossa the basilar artery was displaced anteriorly and compressed to the clivus. 5. On the lateral projection normal value of the distance between the choroidal point and the clivus/IOP line was 9.5㎜ (1.0㎜-19.0㎜). Normal value of the proportion of the distance between the anterior rim of the Foramen Magnum and the point on the clivus/IOP line crossed by a perpendicular line from the choroidal point to the length of the clivus/IOP line was 39% (28%-49%) and in 78% of cases within the range of 35%-43%. Generally in the most cases of the space occupying lesions of the posterior compartment of the posterior fossa the choroidal point was displaced anteriorly, and in the most cases of the space occupying lesions of the anterior compartment of the posterior fossa the choroidal point was displaced posteriorly, and in the most cases of the supratentorial space occupying lesions the choroidal point showed no change. 6. On the lateral projection distance between the copular point and the clivus/IOP line was 7.5㎜ (1.0㎜~11.5㎜). In the most cases of the space occupying lesions of the posterior fossa it was over 11. 5㎜. 7. On the Towne's view the normal position of the bifurcation point of the basilar artery was 0.3㎜ left from the midline and its normal range was 3㎜ left and right from the midline. In the most cases of the cerebellopontine angle tumors and some cases of large cerebellar hemispheric tumors the bifurcation point of the basilar artery was displaced to the opposite of the tumors. 8. On the Towne's projection the maximal width of the ambient segments of the posterior cerebral arteries was 41.0㎜(32.0㎜∼52.0㎜) and the minimal width of the quadrigeminal segments of the posterior cerebral arteries was 17.0㎜ (6.0㎜∼28.0㎜). In the cases of brain stem tumors the widths of the both ambient and quadrigeminal segments were widened, and in the most cases of posterior fossa lesions showing the upward supratentorial herniation and in the all cases of the pineal tumors the width of the quadrigeminal segments of the posterior cerebral artery was widened. 9. On the lateral projection the normal value of the distance between the C-C point and the Twining's line was 11.2㎜ (5.0㎜∼17.0㎜). The normal value of the proportion of the distance between the tuberculum sellae and the the point on the Twining's line crossed by a perpendicular line from the C-C point to the length of the Twining's line was 50% (45%∼54%) and in 76% of cases within the range of 49%∼51%. In the most cases of the pineal tumors, thalamic tumors and the tumors of the anterior compartment of the posterior fossa the C-C point was displaced posteriorly, and in the most cases of the tumors of the posterior compartment of the posterior fossa, the C-C point was displaced anteriorly. 10. On the Towne's projection the normal value of the angle between the midline and the line connecting the torcular Herophili and the copular point was 11˚(6˚∼20˚). In the most cases of the cerebellopontine angle tumors and some cases of the cerebellar hemispheric tumors the angle was closed, and in some cases of the cerebellar vermis tumors the angle was opened. 11. In the most cases of the vascular diseases of the posterior fossa the values of the measurements of the anatomical landmarks of the posterior fossa were within normal limit.
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