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임상연구 : 관상동맥우회술 시 흉부 경막외 Lidocaine 주입이 이식된 관상혈관의 혈류량에 미치는 영향
심지연 ( Ji Yeon Sim ),임연주 ( Yeon Ju Leem ),김동욱 ( Don Guk Kim ),고원욱 ( Won Wook Ko ),최인철 ( In Cheol Choi ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1
Background: Thoracic epidural anesthesia (TEA) is increasingly used to reduce stress response, pain and pulmonary complication of patients under coronary artery bypass graft (CABG). However, effects of TEA on blood flow of grafted coronary artery are scarcely noticed. Imbalance between blood flow of grafted coronary artery and myocardial oxygen demand can bring about perioperative myocardial ischemia. Thus we evaluated the effect of TEA on blood flow of coronary grafts. Methods: Twenty seven patients with triple-vessel coronary artery disease under CABG were recruited. Left internal mammary artery, radial artery, and great saphenous vein were anastomosed to left anterior descending artery, obtuse marginalis, and posterior descending artery, respectively. Before surgery, an epidural catheter was inserted. Total intravenous anesthesia was undertaken using fentanyl, midazolam and vecuronium. After grafts anastomosis, blood flow of grafted coronary artery was measured using transit-time flowmeter (TTFM) before weaning from CPB. And then, mixture of 2% lidocaine 10 ml, fentanyl 50μg and bicarbonate 1 mEq was injected via epidural catheter. Under the constant pump flow, the blood flow of grafted coronary artery before, 10 and 20 minutes after drug administration were measured using TTFM. Results: The blood flow of coronary artery grafts was similar in three time interval, irrespective of grafted artery. There are no significant differences in changes in coronary blood flow associated with epidural lidocaine injection among 3 types of grafted artery. Conclusions: The present study shows that there are no significant effects of TEA on blood flow of newly grafted coronary artery after CABG. (Korean J Anesthesiol 2007; 52: 42~8)
설태경 ( Tai Kyung Seol ),심지연 ( Ji Yeon Sim ),박희연 ( Hee Yeon Park ),안원식 ( Won Sik Ahn ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.5
We report a case of awakening during general anesthesia due to a vaporizer malfunction. The sevoflurane vaporizer had a hole through which approximately 20% of fresh gas escaped. The gas in the common gas outlet contained only 60% of the sevoflurane stated on the vaporizer setting. Moreover, the gas monitor module was out of order, and the heart rate and blood pressure were stable. As a result, we were unaware of the low sevoflurane concentration. The leakage through the hole could not be detected with the commonly used low-pressure system leak checking method. The implication of this case is that unexpected awakening can occur in patients with stable vital signs with an inhalation anesthesia. Therefore, more attention is needed to detect the level of patient awareness. (Korean J Anesthesiol 2007; 578~81)
임상연구 : 국내 마취과학 임상연구의 임상윤리위원회 심의여부와 동의서의 실태조사
고원욱 ( Won Uk Koh ),심지연 ( Ji Yeon Sim ),안원식 ( Won Sik Ahn ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6
Background: All medical research requires approval of the institutional review board (IRB) and informed consent from the research participants in advance. But there are reports of low rates of IRB approval in major anesthesia journals. The purpose of the study is to investigate IRB approval and informed consent rates of Korean anesthetic field researches and provide suggestion. Methods: We reviewed 11 years data from Korean journal of anesthesiology and obtained the number and percentage of IRB approved papers, informed consents and verbal consents. Results: The total number and percentage of IRB approved papers has increased to 60% and so as cases with informed consents over the past 11 years. But the ratio is still under 25%. The ratio of informed consent against verbal consent is also increasing. Conclusions: The number of IRB approved and informed consented papers have increased. But the proportion is still not satisfying or low. Changes in understandings of the clinical researchers with education of research ethics and systemic establishment are needed. (Korean J Anesthesiol 2007; 53: 753~8)
최병문 ( Byung Moon Choi ),진지현 ( Ji Hyun Chin ),김영국 ( Young Kug Kim ),함경돈 ( Kyung Don Hahm ),심지연 ( Ji Yeon Sim ),최인철 ( In Cheol Choi ),황규삼 ( Gyu Sam Hwang ),한성민 ( Sung Min Han ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.2
An inguinal hernia shows that the protruding viscus exits from the endoabdominal fascial sac through the internal inguinal ring. Because an inguinal hernia is usually associated with incarceration, obstruction and even strangulation, it must be quickly treated whenever observed. Although there are several predisposing factors of the development of inguinal hernia, relatively little is a case report of the inguinal hernia developed by the increased intra-abdominal pressure during general anesthesia. In this case, we report a patient who developed the unexpected recurrence of left inguinal hernia following lumbar spinal surgery in prone position by increasing intra-abdominal pressure. After manual reduction was performed promptly by general surgeon, the patient was discharged without any complication on the eighth postoperative day. (Korean J Anesthesiol 2006; 51: 239~42)
진민령 ( Jin Min-ryeong ),정명석 ( Jeong Myeong-seok ),심지연 ( Sim Ji-yeon ),이혜숙 ( Lee Hye-suk ),이경미 ( Lee Kyung-mi ),진혜영 ( Jin Hye-yeong ) 한국전통조경학회(구 한국정원학회) 2020 한국전통조경학회지 Vol.38 No.4
본 연구는 민가정원의 기록화를 목적으로, 전라도 지역 문화재 지정 민가정원의 역사적 가치, 입지, 공간구성 및 건축물 배치, 정원구성요소 등을 검토하여 현재 민가정원의 모습을 고찰함으로써 향후 지속적인 유지관리·보존을 도모하고, 가치를 제고하고자 하였다. 연구의 결과는 다음과 같다. 첫째, 대부분 조선후기에서 근대에 조성된 민가정원의 조성시기와 궁궐·일본·서양의 양식에 영향을 받은 정원구성요소 등을 통해 농·상업 발달의 확산 등 시대적 흐름 속에 영향을 받아온 것을 알 수 있다. 두째, 입지한 지형에 따라 민가정원의 공간구성과 후원 처리 방식에 차이가 있다. 입지한 지형을 평지와 경사지로 구분하였을 때 평지에 입지한 민가는 담장으로 공간을 구획하고 후원 주변으로 담장을 두르고 화계 및 석단을 조성하였다. 경사지에 입지한 민가는 2~3단의 단차를 두어 공간을 구획하고, 후면의 구릉과 접한 후원에 담장을 조성하지 않고 수목 식재, 화계 및 석단 조성 등을 통해 배경림과 자연스럽게 이어지도록 하였다. 셋째, 가옥의 규모 및 정원구성요소가 일부 소실·훼손·변화되었으며, 변화과정에 대한 기록이 부족한 경우 도면으로 기록하는 것에 한계가 있다. 시대적 흐름과 수요의 변화에 따라 소실 또는 훼손된 건축물 및 정원구성요소가 많았으며, 기록이 남지 않은 일부는 소유주 및 관리자의 기억에 의존해야하는 실정이다. 넷째, 전라도 기후적 특성을 반영한 난대성 수종의 식재가 이루어졌으며, 전통수종이 아닌 외래수종이 많은 부분 도입되었다. 다섯째, 현대의 편의를 고려한 공간 기능과 식재 수종의 변화에 대비하기 위한 세분화된 수목 관리 기준이 필요하다. For the purpose of recording Folk House Garden, this study was to review the historical value, location, space composition, Placememnt of the Building, garden composition, and management status of Folk House Garden designated as a cultural asset in Jeolla-do and to promote continuous maintenance and preservation in the future and enhance its value. The results of the study are as follows. First, most of them have been influenced by the trend of the times, such as the creation of a modern private garden and the spread of agricultural and commercial development through the garden components influenced by the royal, Japanese, and Western styles. Second, there are differences in the spatial composition of private households and the way they handle sponsorship, depending on the geographical location. When the geographical features were divided into flat and sloping areas, private houses located on flat land were divided into walls, walls were placed around the support area, and flower systems and stone blocks were created. The private houses located on the slope were divided into two to three tiers of space, and the wooden plant, flower bed, and stone bed were naturally connected to the background forest without creating a wall at the rear hill. Third, the size of the house and the elements of the garden have been partially destroyed, damaged, and changed, and if there is a lack of records of the change process, there is a limit to the drawing floor plan. There were many buildings and garden components that were lost or damaged due to changes in the trend and demand of the times, and some of them without records had to rely on the memory of owners and managers. Fourth, the species in Warm Temperate Zone, which reflects the climatic characteristics of Jeolla-do, was produced, and many of the exotic species, not traditional ones, were introduced. Fifth, fine-grained tree management standards are needed to prepare for changes in spatial function and plant species considering modern convenience.
Wook Jong Kim,Jin-Young Oh,Hyo Jung Son,심지연,Dae Kee Choi,Eun Ho Lee,Ji Yeon Sim,최인철 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.5
Little is known about the prophylactic use of recombinant factor VIIa (rFVIIa) in patients undergoing surgery for a bleeding aorta employing cardiopulmonary bypass. We report the successful use of rFVIIa in a patient undergoing hypothermic circulatory arrest and prolonged cardiopulmonary bypass for repair of a DeBakey type III aortic dissection.