정맥내 통증자가조절법을 이용한 Nalbuphine-Ketorolac과 Butorphanol-Ketorolac의 술후 진통효과 비교

윤석화,이원형,손수창,신용섭,김윤희,양신영 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

This study aimed to compare analgegic efficacy, satisfaction score and side effect of nalbuphine-ketorolac and butorphanol-ketorolac by using intravenous patient controlled analgesia(IV-PCA) for postoperative anlgesia following a gastrectomy for stomach cancer. Ninety patients who had undergone gastrectomy for stomach cancer under general anesthesia were randomly divided into two groups. Each group recieived nalbuphine 50mg with ketorolac 150mg(Group 1, n=45) and butorphanol 5mg with ketorolac 150mg(Group 2, n=45) by using IV-PCA during postoperative 48hrs. Assessments for pain with numerical rating scale(NRS), and side effects were evaluated at 2hr, 6hr, 12hr, 24hr, 36hr and 48hr after the operation. There were no significant difference in NRS for pain during rest, but Group 2 requested significantly greater amount of supplementary diclofenac during first 24 hours. Side effects were higher Group 1 in pruritus, nausea and vomiting and Group 2 in sedation, nausea and vomiting. This study suggests that adding ketorolac with intravenous nalbuphine or butrophanol in using an intravenous PCA can decrease analgesics requirement and improve analgesic property without the major morbidity like respiratory depression, but needs for the careful observation and treatment on the side effects like nausea. vomiting, pruritis and sedation...

Midazolam의 백서 기관평활근 이완효과와 Flumazenil의 길항작용

윤석화,신용섭,손수창,이원형,김혜자,최세진 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

Midazolam have been used widely as adjuvants in both regional and general anesthesia and in high risk patients in the intensive care unit. In the present study we evaluated the effect of midazolam and antagonistic effect of flumazenil on isolated rat tracheal preparations mounted for recording isometric contractile force. Trachea smooth muscle were contracted with acetylcholine (10^-5M, Ach) and potassium chloride (40mM KC1). Midazolam 5x10 exp (-6)M and 5x10 exp (-5)M produced dose-dependent relaxation and flumazenil (3.2 x 10 exp (-7)M), central antagonist of benzodiazepine, pretreatment had no significant change midazolaminduced relaxation. Midazolam probably did not relax airway smooth muscle by activatong central benzodiazepine receptors, as flumazenil did not block the concentration-related relaxation of midazolam. Our study suggests that flumazenil may be used satety for asthmatic patients who have been with midazolam, as flumazenil did not antagonize airway relaxation elicited by midazolam.

Urapidil, Labetalol의 투여가 기관내 삽관시 심혈관계에 미치는 영향

신용섭,윤석화,손수창,이원형,이정은,황원재,김만수,김영주,김혜자,최세진 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

We have examined the comparative efficacy of small doses of intravenous urapidil and labetalol in blunting hemodynamic response to endotracheal intubation and surgical incision in 30 patients without cardiovascular diseases. After intravenous urapidil 0.2 mg/kg or labetalol 0.2 mg/kg anesthesia was induced with thiopental 5mg/kg. Endotracheal intubation was facilitated by vecuronium 0.15 mg/kg with priming principle and anesthesia was maintained with enflurane and nitrous oxide in oxygen. Systolic, diastolic and mean arterial pressure and heart rate were measured before administration of the drugs, 5 minute after administration, just prior to endotracheal intubation and 1, 3, 5, 10 minute after intubatin. Also the peak blood pressures and heart rate within 10 minutes after surgical incision were measured. Endotracheal intubation and surgical stimulation were associated with significant increases in blood pressures and heart rate in both urapidil and labetalol group. Comparison of the changes in systolic, diastolic, and mean artrial pressures and heart rate between urapidil and labetalol group showed no significant difference except peak systolic pressure after surgical incision. It is concluded that the pressor response to endotracheal intubation and surgical stimulation are not influenced significantly by urapidil 0.2 mg/kg or labetalol 0.2 mg/kg. However, urapidil and labetalol preloading may be similarly effective in the blunting of the increases in blood pressures with larger doses of the durgs during anesthetic induction.

위암세포주에서 Recombinant Human Interferon-r와 Adriamycin의 투여순서가 항암효과에 미치는 영향

홍원선,손영숙,김창민,강윤구,이춘택,김유철,임영혁,남현석,이진오,강태웅 大韓免疫學會 1993 大韓免疫學會誌 Vol.15 No.-

Numerous previous studies, both in vitro and in vivo, have demonstrated that the cytotoxicity can be enhanced by the combination of chemotherapeutic agent and interferons(IFNs) in various types of cancer cells. We have previously reported that combined treatment of MKN-45, human gastric adenocarcinoma cells, with adriamycin(ADM) and recombinant human interferon-r(rh-IFN-r) increased in the cytotoxicity. In this study, the effects of combination timing of rh-IFN-r and ADM on the cytotoxicity against MKN-45 were investigated using MTT assay. MKN-45 was treated with rh-IFN-r and ADM in vitro on three schedules : Treat A ; rh-IFN-r and ADM were treated simultaneously, Treat B ; rh-IFN-r was treated 24 hours after the treatment with ADM, Treat C ; rh-IFN-r was treated for 72 hours and followed by the treatment with ADM. The survival of MKN -45 was inhibited by ADM dose-dependently. 102 and 103U/ml of rh-IFN-r significantly inhibited the survival of MKN-45(% survival : 35.1 ±-1.2% and 34.4 ±1.1% in Treat A and 42.5 ± 2.1% and 45.9-±2.5% in Treat C, respectively). However no difference in the survival was observed between 102 and 103U/ml of rh-IFN-r. Combined treatment with rh-IFN-r and ADM significantly augmented the cytotoxicity at low concentrations of ADM. Combined effects of rh-IFN-r and ADM were evaluated using IC30(,ag/ml) to ADM. IC30s of MKN-45 in Treat A, B and C at 102 U/ml of rh -IFN-r _ were 0.019 -?- 0.003, 0.045 :I:0.001 and 0.054 ± 0.012, respectively, while IC30 of MKN-45 treated with ADM alone was 0.052±0.004. IC30s of MKN-45 in ADM alone group, Treat A, Treat B and Treat C at 103U/ml of rh-IFN-r were 0.047 ±0.003, 0.004 -±0.001, 0.031 ±0.004 and 0.056 0.008, respectively. These results indicate IC30s of Treat A and B were significantly lower than those of ADM alone(p<0.05) and IC30s of Treat A was significantly lower than those of Treat B(p <0.01). IC30s of Treat C, however, were not different from those of ADM alone. From these results demonstrating that cytotoxic effects were increased by the combination of rh-IFN-r and ADM in the order, Treat A > Treat B> Treat C, it can be concluded that the simultaneous administration of rh-IFN-r and ADM may be the most effective method to combine these two therapeutic modalties.

서울의 Penicillinase Producing Neisseria gonorrhoeae 발생빈도(1998)

김재홍,김준호,반재용,이정우,황성주,정준규,정성태,강진문,조흔정,홍창의,정혜신,이한승,김이선,이봉길,이종호,선영우,한기덕,윤성필,이성훈,안종성,박석범,문승현,조항래,김형섭,류지호,황재영,박준홍,손상욱 한양대학교 의과대학 2001 한양의대 학술지 Vol.21 No.1

In recent years, gonorrhea has been pandemic and remains one of the most common STDs in the world, especially in developing countries. For the detection of a more effective therapeutic regimen and assessing the prevalence of Penicillinase Producing Neisseria gonorrhoeae(PPNG), we have been trying to study the patients who have visited the Venereal Disease Clinic of Choong-Ku Public Health Center in Seoul since 1980 by menas of the chromogenic cephalosporin method. In 1998, 93 strians of N. genorrhoeae were isolated, among which 60(64.5%) were PPNG. The prevalence of PPNG in Seoul, which had been decreased to 39% in 1996 after a peak of 74.3% in 1993, is increased to 64.5% in 1998.

Diagnostic Performance of Rectal CT for Staging Rectal Cancer: Comparison with Rectal MRI and Histopathology

Seok Yoon Son,Yun Seok Seo,Jeong Hee Yoon,Bo Yun Hur,Jae Seok Bae,Se Hyung Kim 대한영상의학회 2023 대한영상의학회지 Vol.84 No.6

Purpose To compare the diagnostic performance of rectal CT with that of high-resolution rectal MRI and histopathology in assessing rectal cancer. Materials and Methods Sixty-seven patients with rectal cancer who underwent rectal CT with rectal distension using sonographic gel and high-resolution MRI were enrolled in this study. The distance from the anal verge/anorectal junction, distance to the mesorectal fascia (MRF), extramural depth (EMD), extramesorectal lymph node (LN) involvement, extramural venous invasion (EMVI), and T/N stages in rectal CT/MRI were analyzed by two gastrointestinal radiologists. The CT findings of 20 patients who underwent radical surgery without concurrent chemoradiotherapy were compared using histopathology. Interclass correlations and kappa statistics were used. Results The distance from the anal verge/anorectal junction showed an excellent intraclass correlation between CT and MRI for both reviewers. For EMD, the distance to the MRF, presence of LNs, extramesorectal LN metastasis, EMVI, T stage, and intermodality kappa or weighted kappa values between CT and MRI showed excellent agreement. Among the 20 patients who underwent radical surgery, T staging, circumferential resection margin involvement, EMVI, and LN metastasis on rectal CT showed acceptable concordance rates with histopathology. Conclusion Dedicated rectal CT may be on par with rectal MRI in providing critical information to patients with rectal cancer.

The Role of Radiation Therapy for the Extramammary Paget’s Disease of the Vulva ; Experience of 3 Cases

Seok-Hyun Son,Jung-Seok Lee,Yeon-Sil Kim,Mi-Ryeong Ryu,Su-Mi Chung,Sung-Eun Namkoong,Gu-Taek Han,Hee-Jeong Lee,Sei-Chul Yoon 대한암학회 2005 Cancer Research and Treatment Vol.37 No.6

We have experienced three cases of extramammary Paget's disease (EMPD) of the vulva that received radiation therapy (RT). Here, we analyze the efficacy of RT and include a literature survey. Three patients with EMPD of the vulva were treatedwith curative RT between 1993 and 1998. One of the patients had associated underlying adenocarcinoma of the vulva. The total doses of radiation administered were 54∼78 Gy/6∼8 weeks. Radiation fields encompassed 2 to 3 cm outer margins free from all visible disease including or not including the inguinal area using a 9 MeV electron or a 6 MV photon beam. Follow-up durations after radiotherapy were 0.6∼11 years. Complete response was obtained in all three patients. Marginal failure occurred in one patient, and another patient withunderlying adenocarcinoma treated by vulvectomy with bilateral inguinal lymph node dissection followed by external RT showed no relapse. Radiation induced sideeffects were transient acute confluent wet desquamation in the treated area resulting in mild late atrophic skin changes. Although surgery is currently considered the preferredprimary treatment for EMPD, it has a high relapse rate due to the multifocal nature of the disease. We conclude that RT is of benefit in some selected cases of EMPD.

경로지연고장의 효율적인 동시성 고장시뮬레이션

손윤식(Yoon-Sik Son),이인학(In-Hack Lee),박준(Joon Park),류근장(Keun-Jang Ryoo),신재흥(Jae-Heung Shin),허용민(Yong-Min Hur),김윤홍(Yoon-Hong Kim),한석붕(Seok-Bung Han),임인칠(In-Chil Lim) 한국정보과학회 1993 한국정보과학회 학술발표논문집 Vol.20 No.2

본 논문에서는 조합논리회로의 경로지연고장을 위한 효율적인 고장시뮬레이션 알고리즘을 제안한다. 제안하는 고장시뮬레이션 알고리즘은 동시성 고장시뮬레이션 방식을 사용하며 시뮬레이션수행시 각 경로들에대한 정보들을 효율적으로 저장하기위한 경로트리를 구성하여 메모리의 낭비를 줄인다. 활성화되는 경로의 로버스트 테스트용이도를 정의하고, 단계적 역추적(stepwise backtracing) 알고리즘을 제안하여 역추적 과정중의 불필요한 계산과정을 줄이고 팬아웃이 많은 회로의 경우에 중복되는 계산과정을 줄임으로서 시뮬레이션 속도를 향상시킨다.

National Survey Regarding the Management of Difficult Bile Duct Stones in South Korea

Lee Yoon Suk,Jeon Tae Joo,Paik Woo Hyun,Ahn Dong-Won,Chung Kwang Hyun,Son Byoung Kwan,Song Tae Jun,Moon Sung-Hoon,Lee Eaum Seok,Lee Jae Min,Yoon Seung Bae,Paik Chang Nyol,Lee Yun Nah,Park Jin-Seok,Lee 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.3

Background/Aims: This study aimed to investigate the patterns of preferred endoscopic procedure types and techniques for managing difficult common bile duct (CBD) stones in South Korea. Methods: The Committee of Policy and Quality Management of Korean Pancreatobiliary Association (KPBA) conducted a survey containing 19 questions. Both paper and online surveys were carried out; with the paper survey being conducted during the 2019 Annual Congress of KPBA and the online survey being conducted through Google Forms from April 2020 to February 2021. Results: The response rate was approximately 41.3% (86/208). Sixty-two (73.0%) worked at tertiary hospitals or academic medical centers, and 60 (69.7%) had more than 5 years of endoscopic retrograde cholangiopancreatography experience. The preferred size criteria for large CBD stones were 15 mm (40.6%), 20 mm (31.3%), and 30 mm (4.6%). For managing of large CBD stones, endoscopic papillary large balloon dilation after endoscopic sphincterotomy was the most preferred technique (74.4%). When performing procedures in those with bleeding diathesis, 64 (74.4%) respondents favored endoscopic papillary balloon dilation (EPBD) alone or EPBD with small endoscopic sphincterotomy. Fifty-five respondents (63.9%) preferred the doubleguidewire technique when faced with difficult bile duct cannulation in patients with periampullary diverticulum. In surgically altered anatomies, cap-fitted forward viewing endoscopy (76.7%) and percutaneous transhepatic cholangioscopy (48.8%) were the preferred techniques for Billroth-II anastomosis and total gastrectomy with Roux-en-Y anastomosis, respectively. Conclusions: Most respondents showed unifying trends for the management of difficult CBD stones. The current practice patterns could be used as basic data for clinical quality improvements in the management of difficult CBD stones.

Winged bean(Psophocarpus tetragonolobus(L.)DC)의 生育에 따른 植物體, 綠 및 種의 成分變化

Seong-Tak Yoon,Moon-Kap Joo,Seok-Yeong Son 한국국제농업개발학회 1994 韓國國際農業開發學會誌 Vol.6 No.1