실험연구 : 잡견에서 Bupivacaine의 주입에 의한 심장 독성 발생 시 시행한 심폐소생술에서 인슐린 부가 효과의 연구

함태수 ( Tae Soo Hahm ),신병섭 ( Byung Seop Shin ),김정수 ( Chung Su Kim ),이상민 ( Sang Min Lee ),여진석 ( Jin Seok Yeo ),황희윤 ( Hee Youn Hwang ),이국현 ( Kook Hyun Lee ),조현성 ( Hyun Sung Cho ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5

Background: Because of the difficulty of resuscitation caused by bupivacaine-induced cardiotoxicity, the choice of resuscitation medication is still unclear. We investigated whether insulin can improve outcomes of resuscitation by epinephrine from bupivacaine-induced cardiovascular collapse. Methods: Twenty-four mongrel dogs were randomly allocated to one of the two groups: an EPI group (n = 12), and an EPI + RI group (n = 12). Sixty minutes after induction of general anesthesia, baseline measurement of hemodynamic parameters and arterial blood gas tension was performed. Bupivacaine infusion was started at a rate of 0.5 mg/kg/min and kept until mean arterial blood pressure fell below 40 mmHg and heart rate 40 beats per minute. At this point, bupivacaine infusion was stopped and resuscitation was started, with epinephrine in EPI group and epinephrine combined with regular insulin in EPI + RI group. Results: Bupivacaine infusion caused significant decreases in mean arterial blood pressure, heart rate, cardiac output, and systemic vascular resistance and increases in mean pulmonary blood pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance, and central venous pressure. The recovery rate of EPI + RI group (8/12) was higher than that of EPI group (2/12). Conclusions: Combined administration of epinephrine and regular insulin improves outcomes of resuscitation of bupivacaine-induced cardiovascular collapse. Therefore, we believe that prompt administration of insulin should be strongly considered in case of bupivacaine-induced cardiotoxicity. (Korean J Anesthesiol 2006; 50: 579~84)

임상연구 : 마취 중 H1-수용체 길항제 투여에 의한 혈역학적 변화에 대한 고찰

함태수 ( Tae Soo Hahm ),김정수 ( Chung Soo Kim ),구명신 ( Myong Shin Koo ),신병섭 ( Byung Seop Shin ),황희윤 ( Hee Youn Hwang ),이상민 ( Sang Min Lee ),조현성 ( Hyun Sung Cho ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.4

Background: Antihistamine agents are one of the most common drugs used during perioperative periods. As histamine can cause various hemodynamic reactions, administration of antihistamine can also result in unexpected responses. Therefore, we investigated what kind of hemodynamic changes might occur after the administration of antihistamine. Methods: We prospectively performed this study on 12 patients who underwent lung surgery. After induction of anesthesia, Swan-Ganz catheter was introduced and continuous arterial blood pressure was checked via radial arterial catheterization. Initial hemodynamic parameters were checked. Based on these parameters, we calculated systemic vascular resistance (SVR), pulmonary vascular resistance (PVR). After administration of chlorpheniramine maleate 8 mg, hemodynamic parameters were checked and calculated at 2, 4, 6, 8, 10, 12, and 15 minute. Then, we made comparisons of these values with initial values. It is commonly recommended to maintain hemodynamic values within 20% of baseline for safe use of a drug. Results: SVR and PVR failed to show statistically significant changes. Heart rates were increased only at 2 minute after administration of chlorpheniramine maleate. Blood pressures were increased but returned to basal level within 4 minutes. Cardiac output showed statistically significant increase until 8 minutes. However, the changes of hemodynamic values were maintained within 20% of basal levels. Conclusions: Chlorpheniramine maleate is observed to cause statistically significant hemodynamic change after intravenous administration during anesthesia. But the changes were within 20% of basal levels, and we can safely use chlorpheniramine maleate 8 mg IV in the view of hemodynamic changes. (Korean J Anesthesiol 2006; 51: 395~9)

도축돈에서 Pasteurella multocida의 분리, 분리주에 대한 미생물학적, 혈청학적성상 및 항생물질의 감수성조사와 돈폐에 대한 병리학적 관찰에 관하여

이학철,함태수,정유열,조성룡,이재현,Lee Hak-Cheol,Ham Tai-Soo,Chung Yoo-Yeol,Cho Seong-Lyong,Lee Jag-Hyeon 한국임상수의학회 1989 한국임상수의학회지 Vol.6 No.2

In recent years much attention has been paid to swine respiratory infection caused by Pasteurella(P) multocida with rapid expansion of pork Industry in Korea. The present study was performed to observe the etiologic situation of P. multocida infection by bacteriological, serological(serotyping) and pathological examinations with the lungs respectively. In addition antibiotic susceptibility test was carried out against the isolated strains of P. multocida. The results obtained are as follows : 1. Eighteen strains(12.8%) wert isolated from the 140 cases of swine lungs examined, and biological and biochemical characteristics of the isolates were the sam as those in the references of other workers, whereas some differences were observed in sugar fermentation and enzyme activity according to the strain of isolates. 2. Capsular serotyping performed on 18 P. multocida revealed that 13 strains(72.2%) were A type and 5 strains(27.8%) were D type, respectively. 3. When serotyping was performed against somatic antigen on 18 strains capsular types of which were identified as described above 9(50%), 3(16.7%) and 4(22.2%) strains belong to 1:A, 3:A and 2:D, respectively, but untypable 2 strains(11.1%) were observed. 4. Antibiotic susceptibility test by employing disc method for 24 kinds of drugs revealed that 15 kinds of antibiotics were sensitive to 18 strains of P. multocida isolated such as ampicillin(l00%), penicillin(100%), cloxacillin(56%), piperacillin(70%), cefotaxime(30%), minocycline(60%), chloramphenicol(95%), erythromycin(39%), kanamycin(17%), gentamicin(70%), amikasin(30%), colistin(78%) and nalidixic acid(5%), respectively, but resistant to 9 kinds of antibiotics such as sulpenicillin, cefazolin, cephalothin, cefametazol, cefoperazone, kitasamycin, oleandomycin. lincomycin and bacitracin. 5. Pathological features of 60 cases of swine lungs indicated that pneumonic .lesions were observed in 38 cases(63.3%) examined by macroscopic finding, in which lesions of 8 cases(13.4%) would correspond to those of mycoplasmal infection, and 30 cases(50%) were similar to viral infection by histopathological finding, whereas 22 cases(36.7%) were considered to be normal by ecropsy or histopathological finding.

Effect of Combined Single-Injection Femoral Nerve Block and Patient-Controlled Epidural Analgesia in Patients Undergoing Total Knee Replacement

Ae-Ryung Lee,Sangwook Ko,최덕환,최수주,함태수,김가현,문영완 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.1

Purpose: Total knee replacement is one of the most painful orthopedic procedures, and effective pain relief is essential for early mobility and discharge from hospital. The aim of this study was to evaluate whether addition of single-injection femoral nerve block to epidural analgesia would provide better postoperative pain control, compared to epidural analgesia alone, after total knee replacement. Materials and Methods: Thirty-eight patients received a single-injection femoral nerve block with 0.25% levobupivacaine (30 mL) combined with epidural analgesia (femoral nerve block group) and 40 patients received epidural analgesia alone (control group). Pain intensity and volume of patient-controlled epidural analgesia medication and rescue analgesic requirements were measured in the first 48 hours after surgery at three time periods; 0-6 hours, 6-24 hours, and 24-48 hours. Also, side effects such as nausea,vomiting, and pruritus were evaluated. Results: Median visual analog scale at rest and movement was significantly lower until 48 hours in the femoral nerve block group. Patient-controlled epidural analgesia volume was significantly lower throughout the study period, however, rescue analgesia requirements were significantly lower only up to 6 hours in the femoral nerve block group. The incidences of nausea and vomiting and rescue antiemetic requirement were significantly lower in the femoral nerve block group up to 6 hours. Conclusion: The combination of femoral nerve block with epidural analgesia is an effective pain management regimen in patients undergoing unilateral total knee replacement.

Serranidae (Coreoperca herzi) 췌장 내분비세포에 대한 면역조직화학적 연구

이재현,구세광,이형식,함태수,Lee, Jae-hyun,Ku, Sae-kwang,Lee, Hyeung-sik,Ham, Tae-su The Korean Society of Veterinary Science 2003 大韓獸醫學會誌 Vol.43 No.3

The regional distribution and relative frequency of some endocrine cells in the pancreas of the Korean aucha perch, Coreoperca herzi Herzenstein belonging to the family Serranidae in order Perciformis, were observed using specific mammalian antisera against serotonin, insulin, glucagon, somatostatin and human pancreatic polypeptide (hPP) by peroxidase antiperoxidase (PAP) method. The pancreas was divided into four portions (principal and secondary islets, exocrine and pancreatic duct regions). In addition, the pancreatic islet regions were further subdivided into three regions (central, mantle and peripheral regions). Spherical to spindle or occasionally round to oval immunoreactive (IR) cells were demonstrated in the pancreatic islets and exoccrine portions, but no cells were detected in the pancreatic duct portions. In the principal islets, serotonin-IR cells were not detected but most of insulin-IR cells were located in the central regions and they were also demonstrated in the mantle and peripheral regions in moderate and rare frequencies, respectively. Glucagon- and hPP-IR cells were mainly situated in the mantle regions but the cells were also demonstrated in the peripheral regions in relatively lower frequency. Somatostatin-IR cells were evenly distributed in the central and mantle regions in a few frequency and cells were also demonstrated in the peripheral regions in rare frequency. Cell clusters were consisted of hPP-IR cells that were situated in the peripheral to mantle regions. In the secondary islet portions, serotonin-IR cells were randomly distributed throughout the whole pancreatic islet regions but lower frequency was detected in the peripheral regions compared to that in central and mantle regions where cells were detected in a few frequency, respectively. Insulin-IR cells were restricted to the central regions in numerous frequency and glucagon-IR cells were evenly distributed in the mantle and peripheral regions in moderate frequencies, respectively. Somatostatin-IR cells were observed in the central and mantle regions in moderate and a few frequencies, respectively. In addition, hPP-IR cells showed similar distributional patterns to those of glucagon-IR cells except cells were also located in the central regions in rare frequency. In the exocrine portions, only glucagon- and hPP-IR cells were demonstrated in rare and a few frequencies, respectively. In conclusion, the regional distribution and relative frequency of pancreatic endocrine cells of the Korean aucha perch showed general patterns, which were observed in other teleost. However, some species-dependent different distributional patterns and/or relative frequencies were also demonstrated especially to serotonin-IR cells. In pancreas of the Korean aucha perch, insulin-IR cells were the most predominant cell type followed by glucagon-, somatostatin-, hPP- and serotonin-IR cells.

ddY 마우스를 이용한 골다공증 모델에 대한 비교연구: 난소적출 및 신경절단 모델

이형식,홍표원,구세광,이재현,함태수,Lee, Hyeung-sik,Hong, Pyo-one,Ku, Se-kwang,Lee, Jae-hyun,Ham, Tae-Su 대한수의학회 2004 大韓獸醫學會誌 Vol.44 No.4

In order to compare the induced time of osteoporosis between ovariectomized and neurectomized models in ddY mice. Experimental groups were divided into Sham, ovariectomized (OVX group) and neurectomized (NX group) group. The changes of body weight, tibia weight and histomorphometry of epiphyseal regions of tibia that were generally used as criteria index in osteoporosis, were evaluated at 2 and 4 weeks after operations with other generally used index-changes of serum osteocalcin. Also, calcium and phosphorus levels in the ash tibia were demonstrated with their ratio (Ca/P ratio). From the result of this study, evidences which reflect osteoporotic states of animals such as decrease of absolute and relative tibia weight, histomorphometrical index of epiphyseal region of tibia including trabecular bone volume %, and calcium and phosphorous contents in tibia, were generally detected from 4 weeks after ovariectomy and 2 weeks after neurectomy with increase of serum osteocalcin levels. In conclusion, it is considered that more rapid and favorable osteoporosis was induced in neurectomized model compared to that of ovariectomized model.

증례보고 : 성문상 종양에 의한 성문 폐쇄 환자에서의 기관 내 삽관

이숙영 ( Suk Young Lee ),함태수 ( Tae Soo Hahm ),진현승 ( Hyun Seung Jin ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1

Intubation in patients with an obstruction of the glottis due to a large mass may present great challenge to most anesthesiologists. If tracheostomy is not available, flexible fiberscope guided endotracheal intubation is now the part of the standard management in these cases, but difficulty in advancing the tracheal tube over the fiberscope and into the trachea may be encountered. In this case, a 60-year-old male with a huge supraglottic mass was given general anesthesia for laryngomicroscopic surgery and debulking of the mass lesion. We planned an awake flexible fiberoptic intubation but failed to railroad the tube over the fiberscope even after successfully placing the scope inside the trachea. During various attempts to pass the tracheal entrance, the patient coughed and the tube slid into the trachea as mass moved aside and we could successfully secure the airway. (Korean J Anesthesiol 2009;56:87~91)

한우 육증산을 위한 비육촉진제에 관한 연구 3 보 . Monensin 첨가가 한우큰소 비육의 비육능력 및 제 1 위내성상에 미치는 영향

이학철,정근기,손제영,서영석,임경순,함태수 ( H . C . Lee,K . K . Jung,J . Y . Son,Y . S . Sye,K . S . Lim,T . S . Ham ) 한국축산학회 1980 한국축산학회지 Vol.22 No.5

The pervious studies evidenced the marked effects of monensin on feedlot performance of growing-finishing male cattle. Thus, the effects of monesin on feedlot performance of finishing bulls with initial body weight of over 300 ㎏ in Korean native cattle were studied, and also volatile fatty acids production in the rumen was observed. Eight bulls of Korean native cattle averaging 318.7 ㎏ were randomly divided into two groups of four animals for 161-day experiment. The bulls were fed ad libitum rations containing monensin at 0 or 30 ppm with rice straw as roughage. The rice straw was cut to length of 3-5㎝ and mixed with the concentrates at the rate of 10%. Average daily gain, concentrate consumption, and concentrate conversion were 1.05, 9.00, 8.55 ㎏ for the control group and 1.20, 9.13, 7.5 ㎏ for the monensin group, respectively. Monesin improved daily gain by 14.3% and concernrate conversion by 11.2%. Also, monensin made an improvement of 10.6% and 11.4% in DCP and TDN per ㎏ gain, respectively. Ruminal pH and total VFA concentration were not largely changed by monensin, but monensin group tended to slightly increased the total VFA concentration. Molar percent of propionate was significantly increased (p$lt;.01). As a result, acetate to propionate ratio was greatly decreased (p$lt;.01). Monensin did not influence carcass characteristics, but monensin group tended to have lower dressing percent. Rumen parakeratosis, abomasum erosion and ulcer were observed in the control and the monensin groups. However, the control group showed more pathological changes including abomasum hemorrhage and urinary calculi in the bladder than the monensin group. These results suggest that monensin is valuable to increase beef production of Korean native cattle.

한우 육증산을 위한 비육촉진제에 관한 연구 1 보 . Monensin 첨가가 홀스타인 비거세우의 비육능력 및 제1 위내성상 ( 胃內性狀 )에 미치는 영향

정근기,이학철,손제영,서영석,임경순,함태수 ( K . K . Jung,H . C . Lee,J . Y . Son,Y . S . Sye,K . S . Lim,T . S . Ham ) 한국축산학회 1980 한국축산학회지 Vol.22 No.5

Eight holstein bulls averaging 244.1 ㎏ in initial body weight were utilized in two treatments to study the effects of monensin on growth rate, feed efficiency, carcass characteristics and ruminal volatile fatty acids production in an outdoor drylot conditions. The treatment groups were fed ad libitum either 0 or 30 ppm monensin supplemented in concentrates, for 280-day feeding period. The cut rice straw as a only roughage was mined with the concentrates at the rate of 10%. During 112 days of the first stage, monensin improved daily gain 17%.(p$lt;.05), feed conversion 9%, and 11% and 10% in DCY and TDN per ㎏ gain, respectively. Throughout 280 days of tire entire period, monensin group showed 8% improvement in gain but had no improvement io feed conversion and DCP and TDN per ㎏ gain. Feed consumption tended to be higher as tire fattening stages progressed. Ruminal pH and total VFA concentration were unchanged by monensin, Molar percents of acetate and butyrate were reduced and that of propionate increased markedly with monensin. As a result, the acetate to propionate ratio was narrowed.

한우 육증산을 위한 비육촉진제에 관한 연구 2 보 . Monensin 첨가가 한우비거세우의 비육 능력 및 제 1 위내 성상에 미치는 영향

정근기,이학철,손제영,서영석,임경순,함태수 ( K . K . Jung,H . C . Lee,J . Y . Son,Y . S . Sye,K . S . Lim,T . S . Ham ) 한국축산학회 1980 한국축산학회지 Vol.22 No.5

This experiment was conducted to determine the effects of monensin on feedlot performance and volatile fatty acids production in the rumen of fattening bulls of Korean native cattle. Twelve bulls of Korean native cattle averaging 235 ㎏ initially were randomly assigned in groups with 6 animals per pen (9m x 10m) for 280-day experiment. The bulls were fed ad lithium concentrate rations with and without 30 ppm monensin, and the cut rice straw as roughage was mixed with the concentrates at the rate of 10%. Average daily gain for the first stage (112 days), the second stage (168 days), and for the entire period (280 days)was improved by 19.8, 20.5, and 20.2%, respectively, by monensin. Feed conversion for the first stage, the second stage, and the entire period was improved by 16.8, 15.3, and 15.5%, respectively, by monensin. Also, DCP and TDN per ㎏ gain were improved with monensin by 17.6 and 16.8 for the first stage, 15.0 and 15.2% for the second stage, 15.4 and 15.4% for the entire period, respectively. Feed consumption of monensin group tended to be increased slightly compared that of non-monensin group regardless of fattening stages. Ruminal pH and total VFA concentration were not affected by monensin. Molar percent of propionate was greatly increased (p$lt;.01) with monensin feeding and acetate (p$lt;.01) and butyrate decreased markedly. As a result, acetate to propionate ratio was decreased to 32.5%. Monensin did not greatly influence carcass characteristics. However, monensin group tended to have somewhat lower dressing percent, more marbling score, and larger rib-eye area. Rumen parakeratosis, abomasum erosion, and urinary calculi in the bladder were found in all groups. Although there was no large difference between both groups. more urinary calculi were observed in the control than the monensin group. These results indicate that monensin in of positive value as a feed additive in fattening hull rations for Korean native cattle.