http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Naloxone 이 저혈량성 Shock 에 미치는 영향
이춘희,이귀용 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.1
The effects of morphine in 'bringing sleep and an end to pain' have been known from the beginning of recorded history. But the existence of endogenous opiates(endorphins) has been demonstrated only in the last decade. Endorphins bind to opiate receptora and exhibit potent opiate-like activity. In the corticotroph cells of the anterior lobe of pituitary, ACTH and B-endorphin are synthesized simultaneously. There is a hypothalamic releasing factor which causes the secretion both B-endorphin and ACTH, but ACTH and B-endorphin are also released simultaneoulsy by stress. Endorphins adversely affect the circuraltory status and these effects are reversed by the intravenous injection of the narcotic antagonist, naloxone. The author studied Dirksen's hypothesis that endorphins may be involved in the pathophysiology of hemorrhagic shock. In this experiment, the author dividd laboratory animals into 3 groups and administered normal saline, salicylate or hydrocortisone, respectively. Ⅰ. normal saline pretreated group Ⅱ. salicylate pretreated group Ⅲ. hydrocortisone pretreated group Each group was them divided into 4 subgroups and treated as follows: 1) hypovolemic shock+normal saline 2) hypovolemic shock+naloxone 3) hypovolemic shock+hydrocortisone 4) hypovolemic shock+PGE_1 The following results were obtained: 1) MAP was significantly increased after naloxone and PGE_1 administration in the normal saline pretreated group. 2) MAP was not changed in the salicylate pretreated group. 3) MAP was significantly increased after naloxone and PGE_1 administration in the hydrocortisone pretreated sgroup. 4) Pulse pressure was significantly increased after naloxone, hydrocortisone and PGE_1 administraition in the normal saline and hydrocortisone pretreated groups. Form the above experiment, it may be inferred that endorphins and prostaglandia may play a role in the pathophusiology of hypovolemic shock.
李春姬 열상고전연구회 2008 열상고전연구 Vol.27 No.-
明나라 문인 王世貞은 18세기 조선 문단에서 별로 환영 받지 못했으며, 그의 문학사상 역시 추종(推從)하는 이가 드물었다. 이러한 문단의 분위기를 고려할 때, 왕세정의 문학사상을 준거로 삼았던, 18세기 중반에 활약한 李彦의 문학실천은 독특하다. 과연 이언진은 왕세정의 문학사상을 어떤 방식으로 수용했으며, 또한 그것을 토대로 자신만의 문학세계를 어떻게 구축해 놓았을까? 이러한 문제의식을 가지고 왕세정의 문학사상과 만년의 변화, 이언진의 문학취향과 왕세정, 이언진 한시의 특징 등을 고찰했다. 결과적으로 이언진은 왕세정의 문학사상이 만년에 와서 자아교정을 거쳐 자아완성으로 나아갔던 점을 이어받았으며, 그것을 한시 창작으로 실천했음을 발견할 수 있었다. 이러한 고찰은 이언진의 독특한 문학의 본질에 접근하기 위한 작업으로, 18세기 조선 문단에 존재했던 다양한 흐름을 보다 입체적으로 인식하는 데 보탬이 되지 않을까 한다.
이춘희,김유희 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.12
Pulse oxymetry noninvasively estimates arterial oxygen saturation (SaO₂) spectrophoto- metically by processing a pulse added light absorbance signal from transilluminsted tissue and provides continuous information. So the device is rapidly becoming a standard in clini- cal monitoring. Preganglionic sympathetic denervation during spinal and lumbar epidural anesthesia causes dilatation of both resistance and capacitance veasels of the lower limbs, with a reflex increase in efferent sympathetic activity above the level of the block. Skin temperature elevation corresponds with the upper limit of diminished sympathetic activity and is in agreement with the view that skin temperature increase is a useful indicator of sympathetic blockade. Pulse oximetry is dependent upon the presence of a pulsating vascular bed. The signal detection will be impaired in the presence of vasoconstriction or venous congestion, conditions which occur in spinal and lumbar epidural anesthesia. We compared the oximetric measurements (SpO₂) at the hand and the foot with arterial oxygen saturation (SaO₂) during spinal and lumbar epidural anesthesia. After administration of a crystalloid solution, 10 patients recieved 7-10mg of 0.5% tetracaine into the subarachoid space and 10 patients recieved 10-20ml of 2% lidocaine into the lumbar epidural space in 20 adult patients, scheduled for operation. Two temperature probes and two pulse oximeter probes were applied to the finger snd toe of the patients, and the temperature and SpO₂, values were recorded continuously. Arterial oxygen saturation (SaO₂) was measured using M288 before and 30 min after the onset of sensory block. In all patients, intraoperative decreasing of heart rate and arterial blood pressure was 15% from baseline. During anesthesia, the decreasing of temperature reeorded from sympathetically unaffected areas could be related to vasoconstriction, counterbalancing sympathetic block. But no significant differences were detected between SaO₂, and SpO₂, basal values recorded from the hand and foot before anesthesia. After the onset of spinal and lumbsr epidural anesthesia, SpO₂, values recorded from tbe hand were not changed aignificantly. Otherwise significant differences in SaO₂ were detected between two groups before and 30 min after anesthesis, because the age in lumbar epidural group (63.8±90.1) was older than the age in spinal group (44.6±121.1). Therefore, we concluded that SaO₂ must be confirmed when there are clinically significant changes during spinal and lumbar epidural anesthesia, although SpO₂ in hand are neither changed nor decreaaed below normal range.
Propofol 로 마취유도시 Lidocaine, Fentanyl, Esmolol 의 전투여가 기관내 삽관에 의한 혈압 및 심박수 변동에 미치는 영향
이춘희,최희령,이귀용 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.2
Background: Laryngoscopy and endotracheal intubation for general anesthesia cause tachycardia and hypertension due to sympathetic stimulation. The purpose of this study is comparison of effects of lidocaine, fentanyl, and esmolol on blood pressure and heart rate changes owing to tracheal intubation during propofol induction. Methods: Pateints were randomly received one of the following study drug intravenously prior to induction: Group 1(normal saline 5 ml, n=20); Group 2(lidocaine 1.5 mg/kg, n=20); Group 3(fentanyl 2 ㎍/kg, n=20); Group 4(esmolol 1.0 mg/kg, n=20). Anesthesia was induced with propofol 2.5 mg/kg IV and then maintained with 50% nitrous oxide in oxygen and 1.0vol% isoflurane. Systolic and diastolic blood pressure and heart rate were measured preinduction, after induction, immediately after intubation, and 1, 3, 5, 7, 9, ll minutes following intubation. Results: After intubation, the increase in systolic blood pressure and heart rate were blunted significantly compared with the control group in he group 3(p$lt;0.05). In the group 4, the increase in blood pressure was not suppressed but modified and tachycardia was not prevented after intubation. Conclusions: Fentanyl 2 ㎍/kg was suppressed blood pressure changes and effective in attenuating tachycardia during propofol induction compare with control and lidocaine groups. Esmolol 1.0mg/kg was effective in attenuating blood pressure changes owing to tracheal intubation.