일부 지역 초등학생의 정서 ․ 행동문제와 적응유연성

조삼순,홍미순 전남대학교 간호과학연구소 2013 Nursing and Health Issues(NHI) Vol.18 No.1

Purpose: This study was to investigate the correlation between emotional-behavior problems and resilience among high-grade elementary students. Methods: The participants were 303(boys 164, girls 139) 5th, and 6th grade students. Data were collected by Korea-Youth self-Report(K-YSR) questionnaire for emotional-behavior problem(68 items) and Jung's self-Report questionnaire for resilience(19 items). The collected data were analyzed by t-test, ANOVA, Scheffe test, Pearson correlation coefficients using SPSS 18.0 program. Results: The mean score of emotional-behavior problems was 20.7 out of 136. The mean score of resilience was 57.4 out of 76. The following resilience were orderly showed high score self-efficacy, problem-resolve, relationship. The interrelation between emotionalbehavior problem and resilience showed a significant negative correlation. There were significant differences between emotional-behavior problem and resilience for gender, grade, problems arising from computer use, and economical level. Significant difference in emotional-behavior problem and resilience were found for family related characteristics of relationship with father, mother, and sibling, communication with family, and feeling of togetherness among family. And also there were significant difference in school related characteristics with level of school performance, satisfaction in school life, relationship with peer, and the number of good friend. Conclusion: The more resilient students showed fewer emotional-behavior problems. Therefore it is important to recognize their emotional-behavior problems through resilience program which is suitable for personal developmental stage and to improve their ability to control the problems.

일부 지역 초등학생의 정서 ․ 행동문제와 적응유연성

조삼순(Cho Sam Soon),홍미순(Hong Mi Soon) 전남대학교 간호과학연구소 2013 Nursing and Health Issues(NHI) Vol.18 No.1

Ⅰ. 서 론 Ⅱ. 연구방법 Ⅲ. 연구 결과 Ⅳ. 논 의 Ⅴ. 결론 및 제언

고양이에서 출혈성 쇽 및 수액소생시 소화관내 산소투여가 소화관 점막 산소화에 미치는 효과

이유미,박평환,김종욱,조삼순 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.4

Background: This study was purposed to study the therapeutic value of intraluminal oxygen insufflation on the oxygenation of gut mucosa in a feline model subjected to a hemorrhagic shock followed by reperfusion. Methods: Eighteen cats were divided into three groups: For group 1, 6 cats were subjected to sham operation as a control group; for group 2, 6 cats were subjected to a hemorrhagic shock for 2 hours prior to reperfusion as a hemorrhagic shock(HS) group; for group 3, 6 cats were subjected to a simultaneous insufflation of intraluminal oxygen, continued during the shock and reperfusion periods as a oxygenated hemorrhagic shock(OHS) group. Mesenteric PvO₂, mesenteric venous arterial(v-a) lactate difference, mesenteric P(v-a)CO₂ and mesenteric pH(a-v) were measured for every 30 minutes during the shock and reperfusion. Results: The lactate(v-a) was increased during the shock. For group OHS, the lactate(v-a) returned to the baseline value after reperfusion, but for group HS, it did not return. The values pH(v-a) and P(v-a)CO. were increased during the shock and returned to the baseline value for group OHS, but for group HS, the increase was greater than group OHS(p$lt;0.05), but not returned to the baseline value after reperfusion. For both pH(v-a) and P(v-a)CO₂, there were statistically significant differences(p$lt;0.05) between group HS and group OHS during the shock and reperfusion. Conclusions: We conclude that the insufflation of intraluminal oxygen improves the oxygenation of gut mucosa in the feline model undergone a hemorrhagic shock followed by reperfusion.

포도당 용액이 쥐의 적출된 좌골신경전도에 미치는 영향

박재홍,최윤,전희정,이청,조삼순 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.5

Background: When performing spinal anesthesia, glucose is frequently added to control the extent of the anesthesia by increasing the specific gravity of the local anesthetic solution. It is not clearly known whether the added glucose directly affects the nerve blockade or not. The purpose of this study is to examine the effect of glucase solution on isolated nerve fibers in vitro. Methods : Compound actioa potentials (CAPs) of A-fiber range were recorded from isolated nerves of adult Sprague-Dawley rats (300 ― 400 gm), Tonic (0.5 Hz) and phasic (30 Hz) supramaximal stimuli were repeatedly applied to one end of the nerves and the recordings were made on the other end. Nerves were perfused with modified Krebs solution for 45 minutes initially to get baseline data and then perfused with test solutions containing different concentrations of glucose (2.5%, 5%, 7.5%) for 30 minutes. The same experiments were repeated with mannitol at the same osmolality as the glucose. Results : Glucose produced a decrease in he amplitude of CAPs in a dose-dependent manner (79.2 ± 3.4, 50.3 ± 3.7, 34.6 ± 4.0 for 2.5%, 59o, 7.5% glucose solutions, respectively). At each of the same concentration levels, the degree of nerve conduction blockade did not have any significant difference within the glucose groups and mannitol groups. Conclusions: Glucose, in clinically employed concentration range, directly depressed peripheral nerve conduction in vitro, probably via osmotic effect. (Korean J Anesthesiol 2000; 3S: 871~876)

당뇨병 환자의 자율신경기능 이상은 관상동맥 우회술시 혈역학적 변화에 영향을 주는가 ?

최인철,전희정,심지연,조삼순,권은하 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3

Background : In this study, we examined diabetic patients scheduled for elective coronary artery bypass surgery to determine whether there is an association between autonomic dysfunction and intraoperative hemodynamic instability, and if perioperative autonomic function tests are effective predictors for diabetic patients at greatest risk for hemodynamic events during the intraoperative period. Methods : We examined 52 patients, 25 without diabetes (nonDM group) and 27 with diabetes (DM group). Preoperative autonomic function tests included are the valslava maneuver (valsalva ratio, valsalva index, strain response), change in heart rate with deep breathing 0/E ratio), change in heart rate (30: 15 ratio, stress response) and diastolic blood pressure (L-S(d)) while standing. Anesthesia was established with midazolam, fentanyl, isoflurane and vecuronium. Several hemodynamic variables such as heart rate (HR), mean arerial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance index (SVRI), pulmo- nary vascular resistance index (PVRI), cardiac output (CO), and cardiac index (C0 were obtained at the following times: before induction; after induction; after intubation; after skin incision and after sternotomy. Results: The DM group had a significantly diminished response compared with the nonDM group in the valsalva ratio, valsalva index, 30: 15 ratio, and L-S(d). The remaining tests (I/E ratio, strain response, stress response) showed similar but nonsignificant diminished trend response in the DM group. Most patients had one or more abnormal test results in this group (76%), whereas in the control group most patients did not show any abnormal test results (74.1%). The comparison of hemodynamic response between the DM group and non-DM group reveal a significant difference between times within each group but not between groups. Conclusions: This study indicates that increased hemodynamic instability during the intraoperative period is not an obligatory association with diabetes and autonomic dysfunction and is not detected by preoperative autonomic function tests in patients with coronary artery disease and diabetes mellitus when anesthesia is induced and maintained with a large dose of opiod and anesthetic agent which has minimal hemodynamic effects, (Korean J Anesthesiol 2000; 38:440~449)

고양이에서 출혈성 쇽 유발후 투여한 THAM 과 Sodium Bicarbonate 가 소화관 점막 산소환에 미치는 영향

최인철,박평환,최수주,서병태,김종욱,조삼순 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.4

Background: In hypovolemic shock, multiple organ failure is caused by translocation of endotoxins and microorganisms from the ischemic gut mucosa. Therefore, much attention has been paid to the gut mucosa oxygenation in shock resuscitation. The current guidelines on cardiopulmonary resuscitation restrain the use of sodium bicarbonate due to paradoxical intracellular acidosis. Because THAM, CO₂ - consuming agent, does not produce CO₂ and induce intracellular acidosis, THAM has been known as a effective buffering agent. This study was purposed to investigate the effect of THAM and sodium bicarbonate on the gut mucosa oxygenation in cats which were in hemorrhagic shock and resuscitation. Methods: 18 anesthetized cats were subjected to hemorrhage to decrease the mean arterial blood pressure to 35-45 mmHg and this blood pressure was maintained for 120 minutes. After 90minutes, we infused 1.945% hypertonic saline, 2.8% sodium bicarbonate and 0.3M THAM as same volume and osmolality. Mean arterial pressure(MAP), mesenteric arterial-venous pH differences[pH(a-v)], mesenteric venous oxygen tension(PvO₂), mesenteric arterial-venous carbon dioxide tension differences[P(v-a)CO₂], mesenteric arterial-venous lactate differences[Lactate(v-a)] were measured 1, 5, 15, 30 minutes after drug infusion and 30, 60 minutes after reperfusion. Results: There were no statistical significances in MAP, pH(a-v), PvO₂, Lactate(v-a) among the three groups. There were significant differences in P(v-a)CO₂ and ETCO₂ between sodium bicarbonate group and THAM group. Conclusions: This study suggest that THAM and sodium bicarbonate do not have significant effects on the tissue oxygenation and hemodynamic improvement in hypovolemic shock. We suppose that THAM does not produce carbon dioxide but may correct intracellular acidosis.

Airway obstruction by extrinsic tracheal compression during spinal surgery under prone position -A case report-

최락민,윤진선,노재훈,강경오,유상욱,조삼순,정희정 대한마취통증의학회 2010 Korean Journal of Anesthesiology Vol.59 No.-

Tracheal compression by vascular anomalies in adults is uncommon and most related reports are of children. A 79-year-old woman without any respiratory history underwent a lumbar spine surgery under general anesthesia. She suddenly developed airway obstruction after a position change from supine to prone. A fiberoptic bronchoscopy showed the obstruction of endotracheal tube. The obstruction was relieved after we changed the depth of endotracheal tube and supported the patient’s neck with a cotton roll. The surgery ended without any other event and the patient recovered safely. A computed tomography revealed the rightward tracheal deviation and tortuous innominate artery contact with trachea. The patient didn’t manifest any respiratory related symptoms during postoperative period, and she was discharged without any treatment.

흰쥐 횡경막 신경근표본에서 Mivacurium과 Succinyl-choline의 근이완 작용에 대한 Neostigmine, Pyridostigmine, Edrophonium, Galanthamine 및 Pseudocholinesterase의 반전효과

한성민,최윤,양홍석,김성렬,서병태,조삼순,윤시네 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.2

Background: The hydrolysis of mivacurium and succinylcholine is impaired in the presence of defects of pseudocholinesterase. Clinical reports are conflicting as to the utility of anticholinesterases, in the reversal of mivacurium- or succinylcholine- induced paralysis. In this study, the role of exogenous bovine pseudocholinesterases (BpChE) and/or neostigmine, pyridostigmine, edrophonium or galanthamine in the reversal of mivacurium- or succinylcholine-induced paralysis, were investigated with the rat phrenic nerve-diaphragm preparation. Methods: Ninety five Sprague-Dawley rats (200 g, male) were divided into 14 groups (n = 10). The phrenic nerve-diaphragm preparation mounted in a bath containing oxygenated Krebs' solution. Twitch response from diaphragmatic muscle evoked by phrenic nerve stimulation were measured. After stabilization of the twitch responses, mivacurium (0.1 ㎍/mlml) or succinylcholine (0.1 ㎍/ml) was administered incrementally in the preparation to obtain more than 95% twitch inhibition. BpE (0.1, 1.0 u/ml), and/or neostigmine (0.1, 1.0 ㎍/ml), pyridostigmine (0.5, 5 ㎍/ml), edrophonium (0.01, 0.1 ㎍/ml) or galanthamine (0.1, 1.0 ㎍/ml) were added for the reversal of mivacurium- and/or succinylcholine-induced block in each group and the twitch responses (0.1 Hz) were monitored for 60 min. The effect of BpChE (0.1 u/ml), in combination with each of the above four anticholinesterases at lower concentrations also were examined. Twitch heights more than 75% was considered an adequate reversal. Results: BpChE 0.1 and 1.0 u/ml were effective in reversal of mivacurium-induced paralysis. When anticholinestrases were added, there was no effective improvement of twitch height at the end of 60 minutes. In succinylcholine-induced paralysis, BpChE was effective for reversal, but when anticholinesterases were added, BpChE potency was inhibited. Conclusions: BpChE will reverse mivacurium-induced block more effectively than anticholinesterase. BpChE is effective in reversing succinylcholine block. The additionanticholinesterases inhibits the activity of pseudocholinesterase.

고양이에서 저산소혈증후 대기 혹은 100 % 산소소생시 뇌에너지 대사의 변화:생체내 31P 자기공명분광법을 이용한 연구

이정희,이대근,박평환,최수주,임태환,김종욱,조삼순 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.5

Background: This study was purposed to study the effect of reoxygenation with room air as compared to FiO₂ 1.0 in a feline model subjected to hypoxemia followed by reoxygenation. Changes in the brain energy metabolism were investigated by P magnetic resonance spectroscopy(P MRS). Methods: Twelve cats were employed for this study and divided into two groups(6 cats each). Both groups were subjected to hypoxemia for 1 hr with FiO₂ 0.07 followed by reoxygenation for 2hrs. For group I, the reoxygenation was done by FiO₂ 1.0 and for group 2, by room air. Brain intracellular pH and the ratio of Pcr/Pi(phosphocreatine/inorganic phosphate) were calculated from the spectra acquired every 15 mimutes of the hypoxemia and reoxygenation periods. Results: The intracellular pH of the baseline were 7.07±0.01 and 7.04±0.01 for group 1 and group 2, respectively, and dropped to 6.89±0.04 and 6.83±0.06 during hypoxemia. For both groups, the intracellular pH returned to baseline values after 30 minutes of reoxygenation. The of Pcr/Pi of the baseline were 2.41±0.21 and 2.47±0.15, for group 1 and group 2, and dropped to 0.77±0.10 and 0.70±0.11, respectively, during hypoxemia and recovered to the baseline values after 30 minutes of reoxygenation for both groups. For both pH and the ratios of Pcr/Pi, the differences between the groups were statistically insignificant. Conclusion: From this study, we can conclude that reoxygenation by room air is as effective as FiO₂ 1.0 in the feline model of hypoxemia investigated by P MRS.

증례보고 : 척추마취하 치핵 절제술 종료 직후에 발생한 스트레스성 심근병의증

최락민 ( Rak Min Choi ),윤진선 ( Jin Sun Yoon ),노재훈 ( Jae Hoon Noh ),강경오 ( Kyoung Oh Kang ),김민석 ( Min Suk Kim ),조삼순 ( Sam Soon Cho ),전희정 ( Hee Jung Jun ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4

A 48-year-old healthy woman was admitted in our hospital for elective hemorrhoidectomy. She developed sudden headache and chest pain, and showed sinus bradycardia, arrhythmia and hypotension forty minutes after spinal anesthesia with 0.5% hyperbaric bupivacaine. An EKG showed ST depression and an transthoracic echocardiogram performed in PACU demonstrated mild LV dysfunction with hypokinesia of LV inferolateral wall. An coronary angiography on postoperative day 1 revealed normal coronary vessel and akinesia of LV inferior wall. Levels of CK-MB and Troponin I were mildly elevated. With medical therapy, the patient`s symptoms improved and recovered without any complication. (Korean J Anesthesiol 2009;56:470~3)