기관내 삽관시 Slow induction과 Fentanyl 정주가 심혈역학적 변화에 미치는 영향

윤재천,채종한,조남수,정종달,김용일 朝鮮大學校 附設 醫學硏究所 1991 The Medical Journal of Chosun University Vol.16 No.2

Tracheal intubation is accompanied by varying degrees of sympathetic stimulation as reflected by increases in blood pressure and heart rate. Several clinical trials to reduce these effects by deepening anesthesia, using pharmacologic agents such as alpha and beta blockers,calcium channel blockers, fentanyl and lidocaine have been reported. To evaluate the effects of slow induction and fentanyl on responses of cardiovascular system induced by endotracheal intubation, we administered thiopental sodium 5㎎/㎏ (group Ⅰ), slow induction with O_(2)-N_(2)O-halothane( group Ⅱ), fentanyl 3uμ/㎏ with thiopental sodium 4㎎/㎏(group Ⅲ) for induction of anesthesia, and measured systolic and diastolic pressures, and heart rates before induction, and at 1,2,3,4, and 5 minutes after intubation. 1) In group Ⅰ, intubation caused a significant increase in systolic pressure (10%) diastolic pressure (15%) and heart rate (28%) at 1 min. after intubation but each parameter returned to the normal level within 5 min. 2) In group Ⅱ, increases in systolic pressure (12%), diastolic pressure (22%) and heart rate (23%) at 1 min. after intubation but there were no significant differences compared to group Ⅰ. 3) In group Ⅲ, the increase in systolic and diastolic pressure induced by intubation was abolished by fentanyl and showed significant decrease compared to group Ⅱ, increase in heart rate (4%) at 1 min. after intubation but were of no significance, and showed significant decrease compared to group Ⅱ but not at 3 min., 4 min. after intubation. These results suggested that a low dose of fentanyl significantly blunts postintubation hypertenion and tachycardia when used as an adjunct to thiopental sodium.

지지방식에 따른 흙막이벽의 변형거동과 안정성

남정만,윤중만,이용두 제주대학교 해양연구소 2000 해양자원연구소연구보고 Vol.24 No.-

An extensive instrumentation systems are designed on twenty-one anchored excavation sites and twelve braced excavation sites to observe the deformation behavior of the earth retention walls. The excavation sites are divided two cases by construction conditions: one is a stable construction site and the other is an unstable construction site. In this excavation sites. the anchor. strut load and the horizontal displacement of walls were measured from load cell and inclinometer. The different behavior of anchored and braced walls are precisely investigated on the basis of field measurements. And an empirical construction criterion is established to judge and ensure the stability of earth retention wall by the relationship between the earth pressure and the horizontal displacement of wall measured from both stable and unstable construction sites.

지지방식에 따른 흙막이벽의 변형거동과 안정성

남정만,윤중만,이용두 제주대학교 해양연구소 2000 해양과환경연구소 연구논문집 Vol.24 No.-

An extensive instrumentation systems are designed on twenty-one anchored excavation sites and twelve braced excavation sites to observe the deformation behavior of the earth retention walls. The excavation sites are divided two cases by construction conditions: one is a stable construction site and the other is an unstable construction site. In this excavation sites, the anchor, strut load and the horizontal displacement of walls were measured from load cell and inclinometer. The different behavior of anchored and braced walls are precisely investigated on the basis of field measurements. And an empirical construction criterion is established to judge and ensure the stability of earth retention wall by the relationship between the earth pressure and the horizontal displacement of wall measured from both stable and unstable construction sites.

거대 관동맥류에 병발한 급성 심근 경색증 1예

윤혁준,김기식,허승호,박남희,조용원 대한순환기학회 2002 Korean Circulation Journal Vol.32 No.8

항갑상선제로 치료한 그레이브스병 환자의 관해예측인자

남일송,윤여일,김선규,김용현,이주영,목지오,윤석기,김철희,김영선,변동원,서교일,유명희 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background: Most cases of Graves' disease have been treated by antithyroid drugs in Korea. The major drawbacks of antithyroid drugs are the relative high rate of relapse and the inconvinience of long term therapy. Measurement of TBII and TRH stimulation test have been considered as the most reliable tests predicting relapse, but the predictive power is not high enough to use in clinical situation. This study was performed to find good prognostic indicators in Graves' disease patients after the discontinuation of antithyroid drug therapy. Subjects and methods : We restrospectively evaluated 96 patients with Graves' disease who showed normal TRH test at the end of antithyroid drug therapy and were followed for more than one year. Serum T3, T4, T3/T4 ratio, TBII, Anti-TPO Ab and TGAb levels were measured at the time of diagnosis and at the end of therapy. Two to three months after withdrawal of antithyroid medication, serum TSH and free T3 responses to TRH were examined. These parameters were compared between the relapse group and the remission group. Results : Among the 96 patients, 22 patients(22.9%) relapsed(Group Ⅱ) and 74 patients(77.1%) remained in remmision(Group Ⅰ). No significant difference was observed between the relapse and the remission group in clinical parameters, serum T3, T4, TSH, T3/T4 ratio, TBⅡ and Anti-TPO Ab determined before and after treatment. Serum TSH and free T3 levels measured after TRH stimulation were also similar in both groups. Serum TGAb levels determined at the end of treatment were significantly higher in the remission group(p<0.05). Relapse following the discontinuation of therapy occured within 24 months in 72.7% of the relapsed cases. After 24 months, relapse rate was reduced significantly. Conclusion : These results suggest that high serum TGAb levels could be a favorable prognostic indicator for the long term remission of Graves' disease treated with antithyroid drugs, and may suggest that Hashimoto's thyroiditis is combined with Graves' disease in those patients.

시골 지역 청원에서 관측한 이산화황 농도의 변동 경향 특성

남윤희,정용승 한국교원대학교 환경과학연구소 2004 환경연구논문집 Vol.- No.8

We analyzed hourly integrated measurements of SO₂ concentrations obtained from a rural monitoring site located in Chongwon, Korea to investigate the characteristics of temporal variations during the period from 1994 to 2001. The annual, seasonal, and diumal variations of observed SO₂ concentrations are discussed and the characteristics of rural concentration variations are addressed associated with the effects of meteorological variables such as wind speed, wind directions and temperature. The results indicate that the annual variation of mean SO₂ concentrations show a significantly decreasing trend and the amplitude of monthly variations are also found to decrease with time. The diumal variations of SO₂ concentrations show maximum in the morning around at 0800-1000 LST and secondary maximum at around 1900-2100 LST, but the amplitude of diumal variation of SO₂ concentration has decreased. Although the urban and industrial cities such as Chongju are located in the eastern part of Khangnae, Chongwon, the analyzed result in association with wind directions shows that relatively lower SO₂ concentrations are found in the directions of ENE rather than WSW cases. This is implying the importance of topography located in south-north direction over the eastern Chongwon area where a blocking of air pollutants from the eastern emission area plays a certain role on the characteristics of SO₂ levels in Chongwon. On the other hand the SO₂ concentrations from the WSW-W area (i.e., Daejun and Chochiwon) are found to be relatively higher than from other directions due to more effective medium and large scale transport of pollutions from upstream regions.

당뇨병환자에서 호흡이 심박수에 미치는 영향

남수현,오용구,박경욱,윤영길 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1

당뇨병환자에서 자율신경 기능장애를 알아내기 위한 검사로서 심호기 심흡기율이 건강인에 비해 떨어져 있음을 심전도를 이용하여 검사하므로서 환자 침대에서 간단하게 그리고 정확하게 검사할 수 있었다. 당뇨병환자는 안정시 정상인에 비해 빈맥이 있으며, 심박수의 감소 또한 유의하게 적었다. 특히 건반사가 이상이 있는 당뇨병환자에서 건반사가 정상인 환자에 비해 심박수의 변화가 유의하게 적었으며 건반사가 이상인 환자에서 심흡기 심호기율이 1.10 이하는 56명중 49명으로 88%나 되었다. Retinopathy가 있는 환자에서 역시 심박수의 변화는 유의하게 적었고 심흡기 심호기 율이 1.10 이하인 예가 47명중 38명으로 78%나 되었다. 또한 단백뇨가 있는 환자에서도 심박수의 변화는 그 정도는 낮았으나 유의하게 적었다. 당뇨병의 병력기간이 길수록 심흡기 심호기율은 더 작아지는 경향은 확실하며 저자의 예에서는 병력기간이 1년이상 5년이하까지는 1.11±0.21 이였고, 5년이 넘어서서 10년 이하에서 1.07±0.03으로 1.10을 하회(下廻)하였다. 이와 같은 성적으로 미루어 보아 심호흡시 흡기 호기의 율을 계산함으로써 외과수술환자의 급성심폐부전에 의한 높은 사망율을 줄이는 데는 많은 도움이 될 것이다. To find a simple and accurate test of autonomic nervous dysfunction in diabetes mellitus, we performed maximal deep breathing procedures while undergoing electrocardiographic recording at bed side. Normal indivisuals at rest show variation in heart rate induced by respiration. During maximal deep breathing these changes are accelltuated and electrocardiographic recording will show the increase in heart rate during inspiration and the decrease during expiration. This variation is reduced or abscent in diabetics with autonomic neuropathy. Forty eight of the 56 with sensory neuropathy(88%) had an DE/Dl ratio below of 1.10. Diabetics with retinopathy also had significantly smallest variation and thirthy eight of the 47 with retinopathy(78%) had an DE/DI ratio below of 1.10. Also diabetics with proteinuria had significantly smaller variation. Relation between duration of diabetics and DE/DI ratio was inverse proportion accurately. For example in diabeticc of duration which above 1 year and below 5 years DE/DI ratio was 1.11±0.21 and in diabtiecs with below 10 years duration was 1.07±0.03. Our study cleary shows that diabetics with sensory neuropathy have a high prevalence of autonomic dysfunction, with may be important clinically. Since sudden cardiorespiratory deaths are common in diabetics with autonomic neuropathy during and after sugery, the determination of the DE/DI ratio might be a suitable preoperative test for those diabetics at risk. Patients with an abnormal ratio should probably be closely monitered in an intensive care unit after operation.

제2형 당뇨병 환자에서 체내 총항산화능 측정의 의의

윤여일,윤석기,김선규,김용현,남일송,차건영,황의원,김영선 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.2

Background: The diabetic patients are at significantly increased risk of developing vascular disease. It's etiology may involve oxidative damage by free radiacals and protection againse such damage can be offered by antioxidants. We investigated that oxidative stress as assessed by measurement of total antioxidant status may play a role in development of diabetes mellitus. Method: We measured total antioxiant status using merchandised kit, glycated hemeglobin(HbA1c) in 46 type 2 diabetes mellitus patients and 50 healthy matched control subjects. Result: The total antioxidant status(TAS) was 2.10(±0.04) mmol/L in uncontrolled type 2 DM patients, 2.60(±0.03) in controlled type 2 DM patients and 2.70(±0.16) in healthy control subjects. TAS was significantly lower(P<0.05) in uncontrolled type 2 DM patients, but no significant association between in controlled type 2 DM patients and healthy control subjects. The TAS was 2.00(±0.17) mmol/L in complicated type 2 DM patients and 2.10(±0.29) uncomplicated type 2 DM patients. There was no significant associations between complicated type 2 DM patients and uncomplicated type 2 DM patients. Conclusion: Poor glycemic control is associated with reduced TAS in type 2 DM patients. TAS was thought indirect index that predict glycemic control of type 2 DM patients.

두경부 마사지가 중환자실 환자의 수면과 불안에 미치는 효과

김미용,전선영,송윤희,최은진,김재희,김미성,주명순,김남선 병원간호사회 2006 임상간호연구 Vol.11 No.2

Purpose: This study was to apply head and neck massage to patients in intensive care unit and to inventigate the effect of that massage on sleep and state anxiety. Method: The subjects in this study were 27 patients who were admitted in medical intensive care unit. The study was performed from June thru September of 2005 on the One-group pretest-posttest design and the sleep, state anxiety of the subjects were measured before and after head and neck massage. For data analysis, paired t-test and Pearson correlation coefficient were utilized. Result: The first hypothesis that the subjects might have a better sleep after being exposed to head and neck massage was accepted. The second hypothesis that the subjects might feel less state anxiety afrer being exposed to head and neck massage was accepted. The third hypothesis that the sleep of the ICU patients maight be correlated to their anxiety was accepted, as there appeared correlation between their sleep and anxiety. Conclusion: Head and neck massage is identified as one of independent nursing interwentions to improve the sleep of ICU patients and ease their anxiety, and it is necessary to apply it to clinical practices.

이대생의 체력 및 건강도에 관한 조사 연구

강지용,김종선,윤남식,이희순,한성일 梨花女子大學校 韓國生活科學硏究院 1975 韓國生活科學硏究院 論叢 Vol.15 No.-

The following results were obtained from the survey of health status and the measurements of physical fitness of 914 students of Ewha Womans University by means of CMI, which were conducted from October 7 to October 27 for three weeks. The purpose of the research mainly consists in the improvement of university health adiministration and of physical education. A. Survey of Health Status 1. The average Number of Complaints are 26.8 for items A-L, 15.3 for items M-R, and 42.1 for items A-R. In terms of classes, the Numbers of Complaints are revealed on a decreasing scale as follows: sophomores, 44.0, the highest; seniors, 42.6; freshmen, 42.1; and juniors, 40.5. 2. Among all the items, the following figures of average Numbers of complaints per person are conspicuous: the seniors have shown 5.3 for item D, which is the highest; and the sophomores, 0,7, which is the lowest. Among the physiological item, D, which corresponds to the ailments of digestion system, shows the highest rate; and among the items for mental diseases, item M, which corresponds to non­adjustment, is 5.2, the highest. 3. The percentiles on the lower echelons of the Number of Complaints are the following: 26.1% for freshmen is the highest; 22.2% for sophomores, the lowest. The sophomores have shown 27.1%, the highest figure, of students who have Number of Complaints of four or above. 4. The percentile figures of 10 or above of Number of Complaints are displayed by seniors with 2.4% and by sophomores with 1.5%. On the other hand, the percentile figures of 80 or above are revealed by seniors with 5.4% and by sophomores with 5.3%. B. Physical Fitness Measurements The figures for the physical fitness measurements are found as given below: 1. Pull­up Freshmen 18.4 seconds Juniors 9.3 seconds Sophomores 7.5 seconds Seniors 7.0 seconds 2. 100 Meters Dash An approximation of 19 seconds is recorded by freshmen, and the tendency is to be slower as the years go up. 3. Sit­ups The freshmen recorded 13 sit­ups, and the tendency is to be fewer as the years go up. 4. Throwing An approximation of 19 meters is marked by freshmen, and the tendency is to be shorter as the years go up. 5. Long Jump The freshmen marked 249.5 centimeters, and the tendency decreases as the years go up. 6. 800 Meters Run 4'1"8"'(4 minutes 1 seconds 8 points) is obtained for freshmen, and the tendency is to be slower as the years go up. 7. Shuttle Run 12.5 seconds is recorded for freshmen, and the tendency is to be slower as the years go up. 8. Trunk Flexion 18 centimeters is marked by freshmen, and the tendency is to be decreasing as the years go up.