Ketamine 이 Fentanyl 과 Diazepam 의 병용에 의한 혈역학 억제 효과에 미치는 영향

정성수,임웅모,위금량,정선민 대한마취과학회 1991 Korean Journal of Anesthesiology Vol.24 No.2

To investigate the effects of ketamine on the hemodynamics decreased by fentanyl-diazepam, twenty-five patients were randomly assigned to three groups. In all patients fentanyl (10 ug/kg) diazepam (0.2 mg/kg) was intravenously administered, and then patients in group 1 recevied saline only, group 2 and group 3 recevied 1 and 2 mg/kg of ketamine, respectively. Hemodynamic parameters were obtained before and 5 minutes after durg in each group. In group 1, fentanyl-diazepam produced a decrease in heart rate (HR:17%), mean arterial pressure (MAP:27%), cardiac index (CI:40%) and sroke volume index (SVI:14%), and a increase in mean pulmonary arterial pressure (MPAP:27%) and pulmonary capillary wedge preasure (PCWP;25%), but no significant change in central venous pressure (CVP) and systemic vascular resistance index (SVRI). Patients in group 2 had decreases in HR(16%), MAP(10%), CI(10%) and SVI(16%), and decrease in MPAP(21%), PAWP(21%), PCWP(26%), CVP(58%) and SVRI(24%), but theae hemodynamic changes were no significant difference compared to those of group 1 except a bit increase in CVP and SVRI. In group 3, HR(11%), MAP(11%), CI(23%), and SVI(13%) were decreased, but MPAP(14%), PCWP(14%), CVP(69%) and SVRI(26%) were increased and these values were no difference compared to those of group 2. These results demonstrated that ketamine did not significantly affect the hemodynamics decreased by fentanyl-diazepam except CVP and SVRI were increased by ketamine. Base on this study, the author suggeeted that the mechanism of cardiovascular depression caused by diazepam-fentanyl might to be the result of myocardial depression, ketamine produced its sympathomimetic actions primarily by direct stimulation of central nervous system, and ketamine might to be unuseful to improve the hemodynamics to patients with cardiovaseulsr depreseion caused by fentanyl-diazepam.

의과대학생을 위한 진로개발: 프로그램 개발과 운영 시 고려할 것은?

정성수,Sung-soo Jung 연세대학교 의과대학 2024 의학교육논단 Vol.26 No.1

수술환자에서 전신마취중 인지빈도, 기관내삽관의 용이성 및 마취후 합병증의 평가

정성수,임웅모,임성진 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.4

Randomly selected 193 patients who received elective operation under general anesthesia and were able to communicate with anesthesiologists and follow up for 5 days between May and September 1994 at Chonnam University Hospital, were interviewed and evaluated on the night before, 2 and 5 days after their operation. Distribution of physieal status by ASA was that more than half the total patients belongs to class I and 36.8% of patients were under class II. Sedation scores did not chang between on the night before and the day of operation. A significant correlation existed among the visibility of pharyngeal structures, the exposure of glottis by laryngoscopy, and the degree of difficulty with intubation. About 83% of patients was readily intubated, and none of patient was impossible to intubate. All of the patients lost consciousness during induction of anesthesia, and did not recall during operation. Postanesthetic complications were sore throat(30%), nausea and vomiting(28%), lumbago(15%), urticaria(3%), and dizziness(3%).

Glycopyrrolate(Robinul)가 Scopolamine 의 서맥에 미치는 영향

정성수,정창영,하인호,하정성 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.4

Glycopyrrolate, a synthetic quarternary ammonium compound, has a similar pharmacologic property to that of acopolamine, a belladonna alkaloid. Since glycopyrrolate, a quarternary ammonium compound, does not readily cross the blood brain barrier, it has less central effect than that of scopolamine, a tertiary-amine compound. The authors administered a small dose of scopolamine and glycopyrrolate to human volunteers, and examined the effect on the heart rate for both drugs. The results were as follows; 1) A small dose of scopolamine (0.1 mg) showed significant decrease in the heart rate. 2) A small dose of glycopyrrolate (0.1 mg) induced littel change in the heart rate. 3) A small dose of glycopyrrolate (0.1 mg), 10 minutes after glycopyrrolate (0.1 mg), showed marked increase in the heart rate. 4) A small dose of scopolamine (0.1 mg), given 10 minutes after glycopyrrolate (0.1 mg), showed tendency for decrease in heart kate. 5) A small dose of glycopyrrolate (0.1 mg), 10 minutes afterscopolamine (0.1 mg), showed significant increase in the heart rate. 6) Scopolamine induced bradycardia was suppressed by an additional dose of glycopyrrolate and a preceding dose of glycopyrrolate.

전신성 홍반성 낭창

정성수,김성윤 한국의학사 1994 診斷과治療 Vol.14 No.10

Lidocaine 과 Propranolol 이 Ketamine 의 심박수와 혈압에 미치는 영향

정성수,임웅모,정훈 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.6

It is well known that ketamine produces an increase in the heart rate and blood pressure. Lidocaine has a direct myocardial depressant effect with indirect stimulant effects mediated by the autonomic nervous system, and propranolol, beta-adrenergic receptor blockade, has negative chronotropic effects through the beta-adrenergic blockade. In order to investigate the effect of propranolol and lidocaine on the heart rate and blood pressure increased by ketamine, lidocaine, and/or propranolol were administered intravenously in awake patients. The results were as follows. 1) In ketamine(2 mg/kg) receiving group, the heart rate increased 16-19 beats per minute and systolic, diastolic and the mean blood pressure increased significantly. 2) In ketamine(2 mg/kg)-lidocaine(2 mg/kg) receiving group, the heart rate increased l2-14 beats per minute, and the systolic, diastolic and mean blood pressure increased significantly. 3) In ketamine(2 mg/kg)-propranolol(0.02 mg/kg) receiving group, the heart rate increased below 5 beats per minute and systolic, diastolic, and the mean blood pressure increased significantly. 4) In ketamine(2 mg/kg)-propranolol(0.02 mg/kg)-lidocaine(2 mg/kg) receiving group, the heart rate increased only 3-4 beats per minute and systolic, diastolic, and mean pressures increased significantly. From the above results, the chronotropic effect of ketamine was markedly attenuated by propranolol or propranolol-lidocaine but not attenuated by lidocaine, and the pressor effect was not attenuated by lidocaine, or propranolol and propranolol with lidocaine.

少量의 Propantheline (Pro-Banthine^(�))이 麻醉 및 昏睡患者의 心博數에 미치는 影響

丁聖洙,任雄模 全南大醫大 1984 전남의대학술지 Vol.21 No.1

경추부 손상 환자에서 전경추부 연부조직 확장의 진단적 효용성

정성수,이종서,김호 대한척추외과학회 1998 대한척추외과학회지 Vol.5 No.2

Study design : We analysed the pre-vertebral soft tissue measurements in cervical spine trauma patients. Objectives : We tried to determine the sensitivity and specificity of soft tissue measurements in patients with radiographically proven cervical spine fracture and to investigate the diagnostic value of the measurements. Summary of literature review : Widening of the pre-vertebral soft tissue is a well recognized sign in injury of the cervical spine. But the diagnostic value of this widening is still controversial. Materials and methods: Width of the prevertebral soft tissue on lateral cervical spine radiographs was measured for 52 patients with a history of cervical spine trauma and for 53 patients complaining of cervical discomfort without a history of trauma. As a normal Korean adult standard'', 7mm at C2 level, 8mm at C3 level, and 16mm at C6 level were considered the upper limit. Width of the prevertebral soft tissue was measured as a distance between antero-inferior margin of the body of cervical spine and the most posterior border of the larynx and trachea. Results : A C2 prevertebral soft tissue measurement of more than 7mm had a sensitivity of 35% and a specificity of 86%. A C3 measurement of more than 8mm had a sensitivity of 35% and a specificity of 72%. A C6 measurement of more than 16mm had a sensitivity of 30% and a specificity of 80%. Conclusions : The prevertebral soft tissue measurement seems to be of limited diagnostic value. Further study may be required to determine more acceptable limits of normal cervical spine measurement in Korean population.

면역조직형검사로 확진된 피부 T-세포 임파종 1 예

정성수,김인순,이진,한동수,최일영,고윤석,이영열,정태준 대한내과학회 1988 대한내과학회지 Vol.34 No.6

Cutaneous T cell lymphoma (CTCL) is a malignant proliferation of T cells that preferentially infiltrate the skin. The atypical lymphocytes in the cutaneous T cell lymphoma usually express the immunophenotype of mature helper T cell, although cases with abberant phenotypes may occur particularly in advanced disease. We recently experienced a case of CTCL. A 60-year-old woman was admitted brown to violaceous subcutaneous nodule on left lower leg which had been wax and wane for 2 years. In peripheral blood, atypical lymphocytes which had convoluted and hyperchromatic nucleus were found. Histopathologically, specimen from skin showed lymphocytic infiltration and vascular proliferation. By immunophenotyping technigue using anti-T cell monoclonal antibodies, most dermal infiltrate consisted of T lymphocytes, which were mostly helper T cell (CD4 80%) The above clinical, histological, and immunohistochemical findings are compatible to CTCL.

Risk Factors and Comorbidities Associated With the Allergic Rhinitis Phenotype in Children According to the ARIA Classification

정성수,So-Yeon Lee,Jisun Yoon,Hyun-Ju Cho,Young-Ho Kim,Dong In Suh,Song-I Yang,Ji-Won Kwon,Gwang Cheon Jang,Yong Han Sun,Sung-Il Woo,You-Sook Youn,Kang-Seo Park,Eun Lee,Hwa Jin Cho,Myung-Hee Kook,Hye Ryo 대한천식알레르기학회 2020 Allergy, Asthma & Immunology Research Vol.12 No.1

Purpose: Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study. Methods: We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed.Results: The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to Dermatophagoides Pteronyssinus (Der p), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77–15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40–40.74). Conclusions: Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.