X-ray Crystal Structure of Hetaryl Leuco-TAM Dyes, (2Z,2'E)-2,2'-(2-Phenyl Propane-1,3-diylidene) Bis(1,3,3-trimethyl indoline) Derivatives

Keum, Sam-Rok,Roh, Se-Jung,Kim, Young-Nan,Im, Do-Hyuck,Ma, So-Young Korean Chemical Society 2009 Bulletin of the Korean Chemical Society Vol.30 No.11

The unequivocal solid-state structure and stereochemistry of the hetaryl leuco-TAM dye, 2,2’-(2-phenyl propane- 1,3-diylidene) bis(1,3,3- trimethylindoline) derivatives were established using X-ray single crystal analysis. The X-ray crystal analysis showed that the (Z, E)-isomers only formed stereoselectively, with a so-called “threebladed propeller” conformation, from the reaction of a Fischer base and benzaldehyde derivatives. These isomers were stacked in a juxtaposition to form a dimer or a double dimer, adopting either a triclinic, with P-1, or monoclinic crystal system with a space group P21/n in the unit cell of the crystal.

Rocuronium 정주시 통증에서 Ondansetron 전처치에 따른 효과

소금영,기형섭 朝鮮大學校 附設 醫學硏究所 2003 The Medical Journal of Chosun University Vol.28 No.2

Background: Intravenous rocuronium produces intense discomfort at the injection in conscious patients. The purpose of this study was two fold; first, to determine the incidence and severity of pain associated with IV injection of rocuronium in conscious patients; and second, to determine the efficacy of IV ondansetron in minimizing injection pain. Methods: We evaluated 60 inpatients undergoing various elective surgery. The patients were randomized into three groups of 20 patients in double blinded prospective study. After tourniquet application on forearm, the patients were given saline (4 ml) (Group I, n=20), ondansetron 6 mg (Group II, n=20), ondansetron 8 mg (Group III, n=20). The occlusion was released after 20 seconds and rocuronium 0.6 mg/kg was injected over 10 seconds. The patients were observed and asked immediately if they had pain in the arm, and the response was assessed. Thirty seconds after the administration of the rocuronium, 5 mg/kg of thiopental was administered intravenously. Results: We observed that the incidence of moderate to severe pain was 85 % in the group 1 and were significantly decreased to 45 % in the group 2, 5 % in the group 3. Conclusions; The doses of 6 mg and 8 mg ondansetron was effective in relieving the pain of rocuronium.

하지수술에서 희석된 고비중 Bupivacaine의 효과

소금영,양인호,안태훈,이준영 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Background: Although lidocaine seems to be one of the most suitable spinal anesthesias for ambulatory surgery, the safety of lidocaine spinal anesthesia has been called into question by report of both permanent and transient neurologic toxicity. The purpose of this study is to investigate the possibility of adapting the longer acting spinal bupivacaine in short duration of lower extremity operation. Methods: Forty five patient were randomly assigned to three groups for spinal anesthesia, Group Ⅰ (15㎎ bupivacaine), 3㎖ of 0.5% spinal bupivacaine in 8% dextrose; Group Ⅱ (10㎎ bupivacaine), 2㎖ of the 0.5% spinal bupivacaine +1㎖ saline; Group Ⅲ (7.5㎎ bupivacaine), 1.5㎖ of the 0.5% spinal bupivacaine +1.5㎖ saline. Dural puncture were performed at the L3-L4 with 25 gauge needle in lateral position after which the patients were turned to the supine horizontal position. We checked peak sensory level and height, time to two segment regression and S2 sensory regression via pin-prick test and motor block level by modified Bromage scale. Results: There were significantly difference with regard to peak sensory level and height, time to two segment regression and S2 regression, and motor blockade level between Group Ⅰ, Ⅱ and Group Ⅲ. Conclusions: Dilute Bupivacaine in spinal anesthesia provided the combination of adequate depth of anesthesia and rapid recovery. We conclude that 0.5% bupivacaine 7.5㎎ with normal saline 1.5㎖ is effective in spinal anesthesia for short-duration lower extremity surgery.

척수강내 Bupivavacain에 첨가한 소량의 Neostigmin의 진통효과와 부작용

소금영,정종달,김병철,유벙식,안태훈,김훈정,임경준 조선대학교 2000 The Medical Journal of Chosun University Vol.25 No.2

Background : Spinal cholinergic receptor has been shown to have a antinociceptive action, an effect that can be mimicked by spinal cholinesterase inhibitor. Intrathecal injection of neostigmine cause analgesia and adverse effect in a dose-dependent pattern in the patients. The purpose of this study was to determine whether small doses of intrathecal neostigmine (10, 25 and 50 ㎍) produce analgesia and any side effects. Method : After getting informed consents, 60 patients scheduled for orthopedic surgery of lower extremities under spinal anesthesia were randomly assigned to one of four groups. Using dose-ranging design, patients received either normal saline or neostigmine l0, 25 or 50 ㎍ in a 1-㎎ solution of 5% glucose in normal saline with heavy bupivacaine 12 ㎎. Heart rate, blood pressure, degree of motor and sensory block were recorded. The assessment of postoperative analgesia included time to first rescue, total number of rescue medication and pain score on visual analog scale (VAS) at 1, 3, 6, 9, 12, 24 hour. Nausea and vomiting were assessed by using the visual analog scale at 24 hr postperatively and the incidence of them was recorded postoperatively. Result : There were no significant differences among the four groups in characteristics of spinal blocks. Compared to saline, neostigmine groups significantly prolonged time to first rescue medication and decreased total number of rescue medication and pain visual analog scale score, but incidence of nausea and 24hr nausea VAS score were not increased in neostigmine group compared to control group. Conclusion : These data in patients injected intrathecal neostigmine suggest that analgesia may occur at doses less than neostigmine 50 ㎍ and neostigmine 50㎍ has a better analgesia effect with fewer side effects than other doses for postoperative analgesia.

소아에서 편도절제술 시행시 진통효과 : Tramadol과 Meperidine의 비교

소금영,식홍림,임시경,안태훈,임태승 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.3

Background: Pain is major problem regarding quality of life in children undergoing tonsillectomy. Preemptive analgesia by medicine given before commencement of surgery is a new recommended for relief of pain during and after operation. We compared intra-and postoperative analgesic and recovery characteristics of tramadol, meperidine given at induction of anesthesia in 40 ASA I or II children undergoing tonsillectomy with or without adenoidectomy. Materias and Methods: Fourty children aged 4-7 years undergoing tonsillectomy with or without adenoidectomy were randomly assigned to receive either tramadol 2 mg/kg (group 1) or meperidine 1 mg/kg (group 2) at induction of anesthesia. Thiopental sodium (5 mg/kg) and rocuronium (0.6 mg/kg) were used for the induction of anesthesia, and it was maintained with sevoflurane in N₂O/O₂50/50 via an endotracheal tube. Pain assessment was done by facial pain scale. Agitation scores, time to recovery of spontaneous respiration and the incidence of postoperative nausea and vomiting. Heart rate and mean arterial pressure was recorded at regular intervals. Results: Facial pain scale scores were increased in group 1 at 10 and 20 min in recovery room. There was no difference for agitation scores in the two groups. Intraoperative mean arterial pressure (15th min) were found to be higher in group 1. The time to recovery of spontaneous respiration was delayed with group 2 compared with group 1. The incidence of nausea and vomiting was not statistically differed between groups. Conclusions: Meperidine was more effective for pain relief than tramadol after tonsillectomy in children.

섬유강화형 포스트를 이용한 치관-치근 파절의 치료: 증례 보고

임화신,라지영,이광희,안소연,김윤희,금기석,이상봉 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

The crown-root fracture is defined as a fracture of tooth that contains enamel, dentin and cementum with or without pulp exposure. Generally the fracture lines place obliquely from labial surface, between incisal edge of the crown and marginal gingiva, to palatal surface subgingivally. If the fracture line is located supragingivally, the removal of tooth fragment and supragingival restoration can be performed. In subgingival fracture line, the surgical exposure, orthodontic eruption or surgical eruption can be considered. If the fracture line is too deep to restorate, extraction or decoronation can be selected. In children and adolescents, the extraction should be the last option. Another option to select before extraction is the restoration using fiber-reinforced post and the reattachment of tooth fragment. The fiber-rainforced post enhances the retention and the durability of tooth fragment. The reattachment of crown fragment using resin adhesive system is considered minimal invasive treatment biologically. This case reports the treatment of crown-root fracture using the reattachment of crown fragment and the insertion of fiber-reinforced post. 치관-치근 파절은 법랑질, 상아질, 백악질이 모두 포함된 치아의 파절로, 파절선이 대부분 절단연이나 순측의 변연부 치은 에서 구개측 치은열구 하방으로 사선으로 진행된다. 파절선의 위치가 치은 연상이라면 파절편의 제거 및 치은연상 수복을 시 행하고, 치은 연하라면 파절면의 외과적 노출술, 교정적 정출술, 외과적 정출술을 이용한 치아의 수복이 이루어진다. 그 외에 섬유 강화형 포스트를 삽입하여 치관 수복물의 유지력을 높이고, 레진 접착 시스템을 사용하여 치관 파절편을 재부착함으로 써 생물학적으로 최소한으로 침습적인 치료를 하는 방법도 있다. 만약 파절의 정도가 치은 연하로 깊은 경우 발치나 치관절제 술을 이용한 치근의 유지 등을 고려할 수 있다. 본 증례는 치관-치근파절로 내원한 12세 환아로 섬유강화형 포스트를 사용하여 치관 파절편 재부착을 시행하였으며 양호 한 경과를 보여 이를 보고하는 바이다.

전신마취시 경막외강에 투여한 Fentanyl과 Clonidine의 술후 제통효과비교

국종수,소금영,안태훈 조선대학교 부설 의학연구소 1998 The Medical Journal of Chosun University Vol.23 No.2

Epidurally administered clonidine produces analgesia by an alpha 2-adrenergic mechanism and may provide postoperative analgesia without nausea, pruritus and respiratory depression associated with opioid administration. Many studies have shown the benificial effects of epidural clonidine in postoperative pain management. Pre-administered epidural analgesic agent before the skin incision may Prevent the nociceptive input. We provided the pre-emptive analgesia and compared the postoperative analgesic effects of epidural clonidine that of with epidural fentanyl. Thirty gynecologic Patients, ASA (American society of anesthesiologists) Physical status 1, 2, undergoing elective lower abdominal surgery under general anesthesia, were studied. They were not taking any premedications. Before anesthesia, an epidural catheter was inserted at the L<아래첨자>2-3</아래첨자> interspace. Patients were divided into two groups randomly. Group 1 received 100 ㎍ fentanyl in normal saline IS ml through the epidural catether, and group 2 received 150 ㎍ clonidine in normal saline 15 ml. During the operation, we recorded the vital signs and side effects. Just before suturing peritoneum, we injected the corresponding drugs on individual groups through the epidural catheter In the recovery room, the postoperative analgesia was assessed by VAS (visual analogue scale). Vital signs, sedation score and side effects were also checked. VAS and systolic blood pressure were significantly lower in the group 2 than the group 1 at the recovery room. The diastolic blood pressure, heart rate and sedation score were not significantly different between the two groups at the recovery room. Also the vital signs during the operation were not significantly differnt between the two groups The incidence of hypotension was 3 out of 15 in the group 2 Epidural bolus clonidine 150 ㎍ produces more profound and longer postoperative analgesic effects than fentanyl 100 ㎍ at the lower abdominal surgery. But hypotension may occure more frequently. So, if we select the patient cautiously, clonidine is a good alternative analgesic agent for the epidural analgesia.

전정맥마취 동안 tramadol의 수술 중 각성에 대한 영향

김상훈,소금영 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S

Background and Objectives: Tramadol is a central acting, opioid-like analgesic commonly used for analgesia during anesthesia. Previous studies have suggested that the use of tramadol during general anesthesia may be associated with awareness. This study is aimed to investigate the effect of tramadol on the bispectral index (BIS) during total intravenous anesthesia. Materials and Methods: One hundred fifty adults, ASA class 1 and 2 patients, scheduled for general anesthesia for elective surgical procedures were included in this study. None of the patients were premedicated and anesthesia was induced with propofol 2 mg/kg and maintained with air-oxygen (FiO₂ 0.5) and doses for remifentanil and propofol, adjusted to keep the BIS between from 50 and 60. Forty minutes before completing surgery, the subjects were randomly allocated into 3 groups to receive saline (C group), tramadol 1.5 mg/kg (T1 group) or 3.0 mg/kg (T2 group) intravenously. Hemodynamics and BIS values were then recorded every 5 minutes until completion of the operation, during which time the concentrations of desflurane were not modified. Results: The mean BIS values after tramadol administration weren’t significantly different from the control group throughout the period of observation. No significant changes in the hemodynamics were noted, except systolic and diastolic arterial blood pressure in the T1 and T2 groups significantly increased in the first 5 minutes after the tramadol injection. Conclusions: The results indicate that the administration of tramadol during total intravenous anaesthesia with propofol-remifentanil, adjusted to keep the BIS between from 50 to 60, does not modified BIS values. So, we propose that tramadol can be safely administered as preventive analgesia without concern about intra-operative awareness.

견관절경 수술시 혈역학적 변화에 Remifentanil이 미치는 효과

김상훈,소금영 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S

Background: Although the arthroscopic procedure was less painful, we often observed the poorly controlled intra-operative hemodynamics. This study was performed to investigate the effects of remifentanil on hemodynamics during arthroscopic shoulder surgery. Methods: Sixty patients (ASA class 1 and 2) who were scheduled for arthroscopic shoulder surgery were randomly allocated to four groups. After anesthesia was induced with thiopental sodium 5 mg/kg , rocuronium bromide 0.9 mg/kg and maintained with 2 vol% sevoflurane, 50% N₂O, either saline 20 ml/hr, remifentanil 0.06 ㎍/kg/min (Groups C, R respectively) was infused and then the hemodynamics were recorded. Results: The hemohynamics were significantly more stable in Group R than C (P<0.05). Conclusions: Remifentanil 0.06 ㎍/kg/min was effective at controlling the hemodynamic changes induced by shoulder arthroscopic surgery.

Pierre Robin syndrome 환아에서 기관내 삽관 경험 : 증례보고

김상훈,이현영,소금영,유병식,정이남 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S

Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and cleft palate. Neonates with Pierre Robin are at risk of upper airway obstruction and may require surgical fixation of the tongue to the mandible. Such neonates are at high risk of hypoxia and difficult to intubation during induction of anesthesia. We report a case of an 11-day old neonate with Pierre Robin syndrome was intubated in operative room and emergency room. While under general anaesthesia, awake intubation was attempted and facilitated oxygenation. After a 4 day discharge, he revisited to emergency room due to airway obstruction symptom. Repeated attempts at intubation (again with spontaneous breathing) failed. Finally, laryngeal mask airway (LMA) was introduced, and as a result of this ventilation was achieved. The next day, we awake fiberoptic intubation through the laryngeal mask and were easily achieved.