Bispectral Index Monitoring during Anesthesiologist-Directed Propofol and Remifentanil Sedation for Endoscopic Submucosal Dissection: A Prospective Randomized Controlled Trial

박우영,최용선,신양식,이상길,김소연,이태경 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.5

Purpose: Endoscopic submucosal dissection (ESD) is a technically difficult and lengthy procedure requiring optimal depth of sedation. The bispectral index (BIS) monitor is a non-invasive tool that objectively evaluates the depth of sedation. The purpose of this prospective randomized controlled trial was to evaluate whether BIS guided sedation with propofol and remifentanil could reduce the number of patients requiring rescue propofol, and thus reduce the incidence of sedation- and/or procedure-related complications. Materials and Methods: A total of 180 patientswho underwent the ESD procedure for gastric adenoma or early gastric cancerwere randomized to two groups. The control group (n=90) was monitored by the Modified Observer’s Assessment of Alertness and Sedation scale and the BIS group (n=90) was monitored using BIS. The total doses of propofol and remifentanil,the need for rescue propofol, and the rates of complications were recorded. Results: The number of patients who needed rescue propofol during the procedure was significantly higher in the control group than the BIS group (47.8% vs. 30.0%, p=0.014). There were no significant differences in the incidence of sedation-and/or procedure-related complications. Conclusion: BIS-guided propofol infusion combined with remifentanil reduced the number of patients requiring rescuepropofol in ESD procedures. However, this finding did not lead to clinical benefits and thus BIS monitoring is of limited use during anesthesiologist-directed sedation.

정량적 위험성 평가에 기반한 간이 주유취급소 시설기준에 대한 연구

박우인(Wooin Park),구재현(Jae-Hyun Ku),송용선(Yong-Sun Song) 한국가스학회 2014 한국가스학회지 Vol.18 No.3

높은 지가로 인해 초기 설치투자비가 많이 필요한 수도권의 경우 간이 주유취급소는 광범위하게 보급할 수 있는 큰 잠재력을 가지고 있다. 본 연구에서는 향후 국내에 설치?보급될 수 있는 간이 주유취급소에 대하여 편의성 및 안전성을 갖는 합리적인 시설기준을 제시하고자 하였다. 이를 위해 현실적으로 간이 주유취급소에서 발생할 수 있는 상황을 고려한 누출 시나리오를 선정하고, 피해예측 프로그램인 PHAST v.6.5를 이용하여 화재 및 폭발 사고의 피해범위를 산출하고, 그 피해영향을 해석하였다. 위험성 평가결과를 바탕으로, 간이 주유취급소의 주유공지, 전용탱크 상한용량, 고정주유설비 설치위치 및 방화벽 높이에 대한 기준을 현행 위험물안전관리법상의 일반 주유취급소와 비교하여 제안하였다. Small petrol stations have great potential for a wide distribution in metropolitan area in which the land value possesses primary installation cost of the facility. The objective of the present study is to propose appropriate facility regulations of small petrol stations in Korea that can be popularly installed in the future in terms of securing safety in addition to serviceability. The hazard analysis and damage prediction from the possible fire and explosion accidents were performed using a software, PHAST v.6.5. As essential components of the facility regulations proposed in this study, the regulations about the refueling lot, maximum capacity of underground tank, location of fixed refueling facilities, height of firewall for small petrol stations were subsequently compared with those for regular-sized petrol stations.

1P-315 New bipolar host materials with carbazole and dipyridylamine groups for blue PHOLEDs

최용선,김수미,박소라,서민철,이지훈 한국공업화학회 2017 한국공업화학회 연구논문 초록집 Vol.2017 No.0

인공수정체 공막 봉합고정술 후 굴절력의 변화

안용선,박율리,김현승 대한안과학회 2015 대한안과학회지 Vol.56 No.4

목적: 인공수정체 공막 봉합고정술 후 전방 깊이, 인공수정체의 기울어짐과 중심이탈에 따른 굴절력 변화를 알아보고자 한다. 대상과 방법: 인공수정체 공막 봉합고정술을 시행한 17안 중 6안은 무수정체안, 5안은 인공수정체 탈구, 6안은 수정체 탈구 상태였다. 12안에는 아크릴레이트 재질(MN60ACⓇ), 5안에는 PMMA 재질(CZ70BDⓇ)의 인공수정체를 모두 각막 윤부로부터 1.0 mm 뒤쪽 공막에봉합고정하였다. 그리고 후향적 의무기록 분석을 통해 이들의 수술 후 2주, 1개월, 2개월째 전방 깊이, 인공수정체의 기울어짐과 중심이탈, 현성 굴절력, 굴절오차 그리고 각막 내피세포 검사를 확인하였다. 결과: 수술 후 2주, 1개월, 2개월째 전방 깊이는 3.36 ± 0.11 mm, 3.30 ± 0.12 mm, 3.27 ± 0.13 mm로 낭내삽입술군에 비해 유의하게 더 얕았다. 인공수정체의 기울어짐은 4.61 ± 0.12o, 4.65 ± 0.14o, 4.60 ± 0.12o, 중심이탈은 0.43 ± 0.01 mm, 0.45 ± 0.01 mm, 0.45± 0.01 mm로 낭내삽입술군에 비해 유의하게 더 컸다. 굴절오차는 ‐0.55 ± 0.27D, ‐0.63 ± 0.24D, ‐0.69 ± 0.19D로 낭내삽입술군에 비해 유의하게 더 근시화되는 경향을 보였다. 결론: 본 연구의 결과로는 각막 윤부로부터 1.0 mm 뒤쪽에 인공수정체 공막 봉합고정 시 예측보다 약 0.75D 원시를 목표로 도수를 선택하면 원하는 목표 굴절력에 근접할 수 있다. 하지만 수술 후 굴절력은 절개창, 고정 위치, 봉합사 장력 등 술자 요인에도 영향을받으므로 수술 시 이를 고려하여야 할 것이다. Purpose: To evaluate the anterior chamber depth (ACD), extent of intraocular lens (IOL) tilt, and decentration and refractive error after transscleral fixation of IOL. Methods: We retrospectively reviewed the medical records of 17 cases with transscleral fixation of IOL (6 with aphakia, 5 with IOL dislocation, and 6 with lens subluxation). The acrylic IOL (MN60AC??) was fixated in 12 eyes and the polymethylmethacrylate IOL (CZ70BD??) was fixated in 5 eyes at 1.0 mm posterior from the limbus. We analyzed the ACD, extent of IOL tilt and decentration,manifest refraction, refractive error, higher order aberration, and corneal endothelium at 2 weeks, 1 month and 2 months postoperatively. Results: The mean ACD was 3.36 ± 0.11 mm, 3.30 ± 0.12 mm, and 3.27 ± 0.13 mm, the mean extent of IOL tilt was 4.61 ± 0.12°,4.65 ± 0.14°, and 4.60 ± 0.12° and the mean extent of IOL decentration was 0.43 ± 0.01 mm, 0.45 ± 0.01 mm, and 0.45 ± 0.01mm at 2 weeks, 1 month and 2 months postoperatively, respectively in eyes with transscleral fixation of IOL. The ACD was shallower and the extent of IOL tilt and decentration was greater than with IOL in-the-bag insertion patients. The mean refractive errors were -0.55 ± 0.27 D, -0.63 ± 0.24 D, and -0.69 ± 0.19 D at the same period, respectively. Conclusions: Although postoperative refractive error is influenced by surgeon factors such as incision size, distance of fixation suture from limbus, and tightness of suture material, according to our results, an IOL 0.75 D more hyperopic than predicted should be selected in transscleral fixation of IOL at 1.0 mm posterior from the limbus. Additionally, each surgeon should assess their specific results and modify the lens calculations accordingly.

교통사고 환자 35예에 대한 한방의료 서비스 만족도 조사

박단서 ( Darn Seo Park ),필감흔 ( Chien Hsin Pi ),이정한 ( Jeong Han Lee ),공재철 ( Jae Cheol Kon ),백동기 ( Dong Gi Baek ),송용선 ( Yung Sun Song ),권영미 ( Young Mi Kwon ) 한방재활의학과학회 2008 한방재활의학과학회지 Vol.18 No.3

Objectives : This study aimed to understand the satisfaction degree of patients due to traffic accident(TA) in order to provide basic data which would give help not only to improve the quality of services, but also to strengthen the competitiveness of oriental medical hospitals on sequela of TA patients. Methods : The data were collected from inpatients and outpatients who answered a self-report questionnaire. Independent t-test, analysis of variance(ANOVA), X2-test, correlation analysis were used for data analysis. Results : According to the research on medical satisfaction degree, the overall satisfaction degree was 4.141. On each field, satisfaction degree related to the doctor service recorded the highest degree among others(4.474). Satisfaction degree related to the appropriateness of service was the second(4.091). On the other hand, satisfaction degree of using procedure was the lowest degree(3.857). On the difference of degrees of satisfaction by general characteristics, patients who were unemployed·houseworker group showed lower doctor service satisfaction degree than that of other groups. However, on the difference of degrees of satisfaction related to other general characteristics, there were no signigicant differences(p<0.05). Conclusions : The service distribution of oriental medical hospital was almost equal without concentrating on specified social classes.

동의보감(東醫寶鑑) 중(中) 오미자(五味子)가 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察)

박양구,최용선,이장천,윤용갑,Park, Yang-Ku,Choi, Yong-Sun,Lee, Jang-Cheon,Yun, Ypung-Gab 대한한의학방제학회 2005 大韓韓醫學方劑學會誌 Vol.13 No.1

This report describes 47 studies related to the use of Fructus Schisandra main blended prescriptions from Donguibogam. The following conclusions were reached through investigations on the prescriptions that use Fructus Schisandra as a key ingredient. 1.34% of a cough, 10.6% of a consumptive disease, recorded the largest number of clinical frequency of the prescriptions in therapeutic use when Fructus Schisandra was taken as a monarch drug in prescriptions 2. Prescriptions that utilize Fructus Schisandra as the main ingredient are used in the treatmeant of a cough, a consumptive disease, an exogenous febrile disease, a carbuncle, and cellulitis, and they are also used for treating 11 different types of diseases. 3. The prescriptions are compounded with Fructus Schisandra as a monarch drug can apply to a deficiency syndrome of the lung a deficiency syndrome of both the lung and the stomach, a deficiency syndrome both the spleen and the lung a deficiency syn-drome of the kidney, a hypofunction of the bladder with cold syndrome, a cold of insufficiency type, a deficiency syndrome of the heart, a heat syndrome of the stomach, an affective by cold, an invasion by wind, a consumptive disease. 4. The dosage of Fructus Schisandra is 5pun(about 1.88g) to 5jeon(about 18.75g), however 1jeon(about 3.75g) has been taken the most for clinical application. 5. When Fructus Schisandra is combined with base prescriptions such as Ijintang Chungliongsan, Saengmaksan, it applies symtoms of cough. In addition, when Fructus Schisandra is combined with base prescriptions such as Liukmizihwangtang, Ssangbohwan, Sipjeondaebotang, it utilizes a consumtive disease.

혈청 neuron specific enolase를 이용한 심정지후 신경학적 예후의 예측

강용선,정성필,박기일,김승환,김태승,이한식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: The purpose of this study was to determine that the assessment of serum neuron specific enolase(NSE) could provide a reliable early predictor of neurologic outcome after cardiac arrest. Methods: Prospective, observational study was performed from April 1996 to March 1998 at a university teaching hospital ED. Serum NSE concentrations were analysed twice at 24 and 48 hours after return of spontaneous circulation(ROSC). Neurologic outcome was categorized using cerebral performance category(CPC). Results: Twenty-nine patients(16 were men) were enrolled during the study period. The mean age was 50.8 years. Nine(31%) of them showed good outcome defined as CPC 1-3, and 20(69%) patients showed bad outcome defined as CPC 4-5. In the good outcome group, the serum NSE was revealed 33.8±9.3 ng/ml at 24 hours, 34.0±4.73 ng/ml at 48 hours. While in the bad outcome group, it was 99.5±11.7 ng/ml and 114.6±15.8 ng/ml. The NSE at 48hr after ROSC was more prescise than that of 24hr. When the cutoff value of 50 ng/ml at 48hr, the sensitivity was 82%, and specificity was 93%. Conclusion: This study suggest that the serum NSE may represent a valuable, noninvasive, and useful clinical tool for prediction of neurologic outcome after cardiac arrest.

건축 시공현장에서의 품질관리가 원가에 미치는 영향에 대한 연구

박주석,안용선 대한건축학회지회연합회 2012 대한건축학회연합논문집 Vol.14 No.1

품질관리는 프로젝트가 요구하는 사항을 만족시키며, 프로젝트의 안전성 및 신뢰성을 확보, 보장하기 위해 품질 목표를 설정하고 목표달성을 위해 수행하는 종합 품질보증체제를 구축하는 것으로 품질의 방침, 목표, 책임과 수행을 결정하는 관리기능의 모든 행위를 포함한다. 또한 품질은 원가, 공정과 서로 영향을 주고 받기 때문에 결국 기업의 입장에서 생산 경영자가 이들을 유기적으로 관리하여야 한다. 품질관리에 투하되는 비용은 예방비용, 평가비용, 실패비용으로 구분되는데 각 비용이 상호적으로 잘 적용되면, 효율적인 품질관리가 이루어지게 되는데 이러한 효과적인 관리는 결국 원가절감효과를 거두게 된다. 체계적인 품질관리를 통한 하자율 0%달성은 정량적으로는 총공사비의 0.5%절감 효과가 있으며, 이러한 원가절감의 효과 이외에도 품질수준의 향상으로 인한 기업이미지의 향상과 입주자의 만족 등 부가이익을 취할 수 있다. 이에 점점 더 초고층화, 복잡화, 심대화, 과밀화 되고 무한경쟁 시대로 가는 건설업계의 추세와 사회의 흐름에 맞추어 볼 때, 체계적이고 전문화된 품질관리 활동을 기반으로 최고경영자에서부터 건설현장의 작업자까지 품질관리 활동에 적극적인 참여와 품질관리 의식의 제고가 요청되는 시점이다.

열적특성이 우수한 벤조퀴놀린 유도체를 이용한 신규 인광호스트의 OLED 특성과 DFT계산을 통한 전하이동특성 분석

최용선,신성준,박소라,서민철,이지훈 한국공업화학회 2018 한국공업화학회 연구논문 초록집 Vol.2018 No.0

OLED는 시안성과 빠른 응답속도, 우수한 색 재현, 고효율의 빛 방출 등 다양한 장점을 가지고 있으며, 많은 연구가 진행되고 있다. 하지만 디스플레이 소자를 구동할 때 발생하는 구동열로 인해 Morphology가 변할 수 있고 이에 따라 소자의 수명감소, 특성 저하 등의 결과를 초래할 수 있다. 본 연구에서는 이와 같은 문제점을 해결 하기 위해 열적특성이 우수한 벤조퀴놀린을 도입하여 분자구조를 설계 하였으며, 치환기 개수에 따른 물성과 EL 특성을 비교하고, 소자 수명 향상을 기대하였다.

생체외 류마토이드 관절염 실험 모델에서 청열사습탕(淸熱瀉濕湯)의 효과

박진상 ( Jin Sang Park ),한명금 ( Myeng Gum Han ),임양의 ( Yang Eui Lim ),이수경 ( Su Kyung Lee ),신병철 ( Byung Cheul Shin ),권영달 ( Young Dal Kwon ),송용선 ( Yung Sun Song ) 한방재활의학과학회 2004 한방재활의학과학회지 Vol.14 No.2

Objective: This study was designed to understand the mechanism of action of Cheongyeolsaseup-tang(Qingrexieshi-tang) (CYSST) leading to control of mast cells on inflammatory condition like RA. Methods: Viability of cells was evaluated by MTT colorimetric assay for 8 h incubation after stimulation of PMA plus A23187. HMC-1 cells (3×105 cells/㎖) were stimulated for 8 hour incubation with PMA plus A23187, we investigated the effect of CYSST on the production of cytokines by activated human mast cell line HMC-1. Results: When CYSST (1 mg/ml) was added, the production of tumor necrosis factor (TNF)-α, interleukin (IL)-6 was significantly inhibited by 37% and 33.6%, respectively in phorbol 12-myristate 13-acetate plus calcium ionophore A23187-stimulated HMC-1 cells. RA is an aggressive inflammatory disease in which chemokines are thought to recruit leukocytes and induce angiogenesis. CYSST also inhibited by 48% the production of IL-8 in HMC-1 cells. In addition, CYSST inhibited the expression of Nuclear factor-κB(NF-κB) in HMC-1 cells. Conclusions: When CYSST was added, the production of TNF-α, IL-6, IL-8 was significantly inhibited. These results imply that CYSST has a critical role on the treatment of the bone damage associated with rheumatoid arthritis.