화학적 요부 교감신경절 차단에서 한 분절 차단과 두 분절 차단의 비교

김종일,이규종,이상곤,민병우,반종석,문철준 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Chemical Lumbar Sympathetic Block: Comparison of One- Versus Two-needle Techniques Chul-Jun Mun, M.D., Kyu-Jong Lee, M.D., Sang-Gon Lee, M.D., Jong-Il Kim, M.D.^* Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Fatima Hospital, Daegu, Korea ^*Kim Jong Il Pain Clinic, Daegu, Korea Background: It was frequently noticed in the course of performing a two-needle sympathectomy, that satisfactory spread of contrast solution could be produced by injection through only one of the needles. This led to a closer examination of the merits of single-needle technique. Methods: Forty patients were randomized into two groups. Patients in the single-needle group (n = 20) were injected at the second or third lumbar sympathetic ganglia, while patients in the two-needle group (n = 20) were injected at the second and thired lumbar sympathetic ganglia. Lumbar sympathetic blocks were performed using 3 ml of alcohol and the spread of injectate was verified with C-arm fluoroscopy. The indicators of a successful sympathetic block are increasing skin temperature, decreasing pain, and anhidrosis in the distal extremity. Results: The duration of anhidrosis was 12.2 ?? 2.6 months (mean ?? SD) in the single-needle group versus 13.6 ?? 3.6 months (mean << SD) in the two-needle group. Conclusions: As these results were not significantly different from those obtained in patients having considered to be effective for a neurolytic ;i,bar sympathectomy. (korean J Anesthesiol 2001; 41: 439~443)

Ropivacaine 을 이용한 경막의 마취시 Clonidine 병용의 효과

김종일,조영훈,이상곤,민병우,이지향,반종석 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Effects of Clonidine Added to Ropivacaine in Epidural Anesthesia Young-Hoon Cho, M.D., Ji-Hyang Lee, M.D., Sang-Gon Lee, M.D., Jong-Il Kim, M.D.^*, Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Daegu Fatima Hospital, Daegu, Korea ^*Kim Jong Il Pain clinic, Daegu, Korea Background: Clonidine has been regarded as an adequate supplementary anesthetic during epidural anesthesia and has been used with local anesthetics such as bupivacaine or lidocaine to support the effects of these anesthetics. The authors would examine whether clonidine is an adequate supplementary anesthetic when it is used with ropivacaine during epidural ane-sthesia. Methods: Thirty-two healthy patients undergoing a hip or lower limb surgery were diveded into two groups. In group 1, 0.5% ropivacaine 15 ml was administered. In group 2, 0.5% ropivacaine 15 ml combined with clonidine 150 ㎍ was administered. Onset, duration and maximal height of sensory block were assessed. Sedation score, blood pressure and heart rate were measured. Results: Duration of sensory block of group 2 was significantly longer than that of group 1. Sedation score of group 2 was significantly higher than that of group 1. Blood pressure of group 2 was sig-nificantly lower thatn that of group 1 at 50 min, 70 min and 90 min after epidural injection. No significant differences were observed in onset of sensory block and heart rate between the two groups. Conclusions: The addition of clonidine to ropivacaine during epidural anesthesia prolonged duration of sensory block and produced useful sedation. It caused relatively stable hemodynamic changes. These results suggest that clonidine is an adequate supplementary anesthetic when it is used with ropivacaine during epidural anesthesia. (Korean J Anesthesiol 2001; 41: 428~433)

하지 수술을 위한 경막외 마취시 Ropivacaine 과 Bupivacaine 의 비교

이상곤,민병우,반종석,문철준 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Comparison of Epidural Ropivacaine and Bupivacaine in Patients Undergoing Lower Extremity Surgery Chul-Jun Mun, M.D., Sang-Gon Lee, M.D., Jong-Suk Ban, M.D. and Byung-Woo Min, M.D. Department of Anesthesiology, Fatima Hospital, Daegu, Korea Background: Ropivacaine is an amide local anesthetic structurally related to bupivacaine. A ran-domized, double-blind study was performed to compare the clinical effectiveness of ropivacaine and bupivacaine in patients undergoing lower-extremity surgery. Methods: Forty-nine patients (ASA Ⅰ-Ⅱ) were randomized to receive 15 ml of 0.5% ropivacaine or bupivacaine. Twenty patients received 15 ml of ropivacaine and 20 patients received 15 ml of bupiva-caine at the L3,4 or L4,5 interspace. Parameters measured were the onset time, duration and spread of sensory block, the onset time, duration and degree of motor block, the quality of anesthesia and the heart rate and blood pressure profile during the block onset. Results: Demographic characteristics were similar among the groups. Seven patients were excluded from the study due to technical failure of the block, two patients were excluded due to insufficient data. The onset and duration of analgesia at T10 dermatome (mean ?? SD) was 18.9 ?? 7.0 minutes and 187.5 ?? 34.6 minutes respectively for ropivacaine, and was 15.2 ?? 8.8 minutes and 187.8 ?? 40.0 minutes respectively for bupivacaine. Maximum block height (mean ?? SD) was T6.5 ?? 2.0 for ropivacaine and T6.4 ?? 2.0 for bupivacaine. The incidence of complete motor block (Bromage scale 3) was low in the ropivacaine group, being 3/20 for ropivacaine and 12.20 for bupivacaine. Conclusions: The sensory blockade profile of ropivacaine, administered epidurally, is similar to that obtained with an equal dose of bupivacaine. However motor blockade with ropivacaine is less intense, less frequent, and of shorter duration than with bupivacaine. (Korean J Anesthesiol 2001; 41: 434~438)

식중독균 항원(Salmonella typhimurium)에 의하여 생성된 계란항체(IgY) 특성과 항균 효과

백반석,한준표,배만종 동아시아식생활학회 1999 동아시아식생활학회지 Vol.9 No.2

This study was carried out to get a industrial information about a possibility of IgY antibody production, antimicrobial activity and properties of IgY antibody in egg yolk. The residual antibody activities of IgY were 91.5% after heating for 30min at 60℃. At the same time, these activities, were 73.2% after heating 15min at 65℃ and decreased vapidly at 70℃ and little antibody activity was left after heating for 15min at 80℃. When the prepared IgY was incubated at various pH ranges from 7 to 2 for 5hr at 37℃, the antibody activity was stable from pH 7 to 4 and remained to 69.8% at pH 3.

식중독균 항원(Escherichia coli)에 의한 계란항체(IgY)생산성과 항체특성

백반석,배만종 경산대학교 생명자원개발연구소 2000 생명자원과 산업 Vol.4 No.-

식중독 균인 Escherichia coli를 항원으로 하여 산란계에 면역시켜 계란 항체(IgY)의 생산성과 항체의 특성을 조사하고자 실시하였다. 최초 면역후 형청내의 IgG는 1주부터 생성되기 시작하였으나, 난황내의 IgY는 2주부터 생성되기 시작하였다. 이것은 모체인 산란계에서 먼저 항체가 생성된 후 계란의 난황에 이행되어 농축되는 것으로 IgY의 생성과정을 확인하는 결과였다. 또한 혈청 및 난황내의 단백질 함량도 일반 대조군에 비해 다소 높은 경향을 보여 면역단백질의 증가를 뒷받침하였다. 본 실험에서 생산된 IgY는 65℃까지는 다소 안정된 경향을 나타내었으나, 70℃에서는 활성이 급격히 떨어지는 것으로 나타났다. pH에 대한 안정성은 비교적 안정하여 pH4에서도 90% 이상의 활성을 유지하였다. 이러한 결과로 볼 때 계란을 이용한 항체의 생산은 대량생산이 가능할 뿐만 아니라, 항원에 대한 특이성을 이용한 진단 kit제조, 의약품등 다양한 분야에 응용될 수 있으리라 기대된다. This study was investigated to make industrial base from discussion about production possible of IgY antibody, properties of IgY antibody in egg yolk. Immunoglobulin Y in egg yolk and immungoglobulin G in serum were obtained from hens which were immunized with Escherichia coli(ATCC 11775). The antibody titer were evaluate in serum and egg yolk by ELISA. After the initial immunization, the anti-Escherichia coli IgY antibody level in egg yolk increased from the two week, reaching its peak in the fifth week. On the other hand, the antibody level in the serum began to increase from the first week, reaching its peak in the eighth week. The residual antibody activities of IgY after heating at 60℃ for 30min and at 65℃ for 15min were 92%, 70% respectively, and decreased sharply at 70℃ and little antibody activity was left after heating at 80℃ for 15min. When the IgY preparation was incubated at various pHs ranging from 7 to 2 at 37℃ for 5hr. With result that the antibody acivity was stable from pH 5 to 4 and remained to 99% and 90% respectively.

복식전자궁적출술 후 경막외 통증 관리시 0.1% Bupivacaine/Morphine과 0.1% Ropivacaine/Morphine의 비교

임일환,문철준,반종석,민병우 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: Local anesthetics combined with an opioid are frequently used as a postoperative epidural analgesia, to minimize individual doses and to reduce unwanted side effects. The aims of this study were to compare analgesic effectiveness, occurrence of motor block and other side effects of a 48 hr postoperative continuous epidural infusion of 0.1% bupivacaine/morphine or 0.1% repivacaine/morphine. Methods: Forty female patients scheduled for an elective total abdominal hysterectomy under general anesthesia were randomized in a double-blind fashion to receive either 0.1% bupivacaine with 0.02 mg/ml morphine or 0.1% ropivacaine with 0.02 mg/ml morphine using a continuous epidural analgesia pump at a rate of 4 ml/hr during the postoperative 48 hours. After toe operation, we assessed the blood pressure, heart rate, visual analog scale (VAS), side effects, additional analgesic requirement and time to ambulation for 48 hours in 12-hour intervals. Results: There were no significant differences in VAS on rest and cough between the groups, but VAS on deep breathing and position change were significantly lower in the bupivacaine group compared to the ropivacaine group. Side effects were similar in both groups except paresthesia. Time to ambulation was earlier in the ropivacaine troup compared to the bupivacaine group. Conclusions: Both the postoperative continuous epidural infusion of 0.1% bupivacaine with morphine and 0.1% ropivacaine with morphine provided similar pain relief and side effects. However, earlier recovery of ambulation in patients receiving ropivacaine/morphine will improve outcome after abdominal surgery. (Korean J Anesthesiol 2002; 43: 633~639)

하지수술시 Fentanyl과 병용한 0.75% 등비중 Ropivacaine을 이용한 척추마취

임일환,이상곤,반종석,민병우 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: Opioids and local anesthetics administered together intrathecally have a potent synergistic analgesic effect and less hypotention using a minidose of local anesthetic. This study was designed to investigate the safety and efficacy of two doses of intrathecal isobaric ropivacaine/fentanyl in patients undergoing an operation of the lower extremities. Methods: Thirty patients undergoing an elective orthopedic surgical operation of the lower extremities were randomly assigned to two groups for spinal anesthesia. Patients in group Ⅰ (n = 15) received 0.75% ropivacaine 14 mg/fentanyl 20㎍, and patients in group Ⅱ (n = 15) received 0.75% ropivacaine 16 mg/fentanyl 20㎍. After spinal anesthesia, we measured the time to T10, peak dermatomal level, time to peak sensory level, time to maximum motor blockade, duration of complete motor block and duration of complete sensory block using the pin prick test and Bromage motor scale. Also circulatory variables were monitored every 5 min and side effects were measured for 3 day after spinal anesthesia. Results: There were no significant differences between the groups in time to T10, peak dermatomal level, time to peak sensory level, time to maximum motor blockade and duration of complete motor block, but duration of complete sensory block was significantly longer in the 0.75% ropivacaine 16 mg/fentanyl 20㎍ group than the 0.75% ropivacaine 14 mg/fentanyl 20㎍ group. Conclusions: Intrathecal 0.75% ropivacaine 14 mg/fentanyl and 0.75% ropivacaine 16 mg/fentanyl were equally suitable for a lower extremity operation. (Korean J Anerthesiol 2002; 43: 600~605)

감초 추출물이 면역응답에 미치는 영향

심호기,백반석,황성원,배만종 경산대학교 생명자원개발연구소 1996 생명자원과 산업 Vol.1 No.-

감초에서 분리한 각각의 추출물(HWE, ME, AE)을 BALB/c mouse에 투여하여 탐식작용, 용혈반형성, 용혈소 역가특정 및 Rosette형성 실험을 통해 감초가 면역응답에 미치는 영향을 조사하였다. 1. 탐식능 측정에서 복강침출세포(PEC)와 비장세포(spleen cell)는 CON군에 비하여 가각의 약물투여군이 Candida parapsilosis에 대한 효과가 약간 높은 경향을 나타냈지만 유의성은 없었다. 2. 용혈반 형성 및 용혈소 역가측정에서는 CON군에 비하여 HWE, ME, AE투여 군이 유의성을 나타냈다. 3. Rosette형성에 대한 측정에서는 CON군에 비하여 ME, AE투여 군이 높은 유의성을 나타냈다. 본 실험 결과에서 감초 추출물들은 Candida paraprapsilosis에 대하여 약간의 탐식증진효과를 나타냈으며, 항체생성세포의 용혈반 시험 및 용혈소 역가측정과 Rosette형성측정에서의 유의성을 나타낸 것은 감초가 세포성 면역을 주도하는 T세포를 활성화시킬 뿐만 아니라, 체액성 면역을 주도하는 B세포를 활성화시킨다는 것을 확인 할 수 있다. The inverstigation of effecting immune response on BALB/c mouse was experimented with hot water extract(HWE), 50% methanol extract(ME) and aaceton extract(AE) 〔which was extracted from Glycyrrhiza glabra〕. The experiment was carried out by phagocytosis, hemolytic plaque assay, hemolysin titration and rosette assay. Peritoneal exudative cells and spleen cells in phagocytosis ability; the experimental group has shown a slight increase in Candida parapsilosis(HWE, ME & AE). The experiment shows no relevant correlation. The experiment of hemolytic plaque assay and hemolysin titration was treated by HWE, ME and AE. The experimental group was treated by ME and AE through the measurement of rosette assay. The experimental group has given significant increase compared with the control. As the result, the extracts of Glycyrrhiza glabra (HWE, ME and AE) has effedted slightly to Cnadida parapsilosis in phagocytosis. The reason of effecting the immunocyte in hemolysin titration, rosette assay and hemolytic plaque assay ; Glycyrrhiza glabra has activated the T-cell which controlled cell mediated immunity. Same with B-cell which could also control humoral immunity.

식중독균 항원(Salmonella typhimurium)에 의한 계란항체(IgY) 생산성과 분리 정제

한준표,백반석,배만종 동아시아식생활학회 1999 동아시아식생활학회지 Vol.9 No.2

This study was carried out to get a industrial information about a possibility of IgY antibody production, antimicrobial activity and properties of IgY antibody in egg yolk. After the initial immunization the anti-Salmonella typhimurium IgY antibody level gradually were decreased from firth week to tenth week. On the other hand, the antibody level in the serum were increased from the first week, reaching its peak in the sixth week. Molecular weights of IgY were estimated approximately 72~75KD in a heavy chain and 30~40KD in a light chain by electrophoresis.

고혈압 환자에서 Nicardipine과 Esmolol의 병용 투여가 기관내삽관시 혈압과 심박수에 미치는 영향

김혜경,이지향,이상곤,반종석,민병우 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.5

Background: This study was designed to determine the efficacy of a combined use of esmolol and nicardipine for blunting hypertension and tachycardia after tracheal intubation in hypertensive patients. Methods: Forty-five hypertensive patients were randomly divided into three group: group E (esmolol 0.5 mg/kg, n = 15), group N (nicardipine 30㎍/kg, n = 15), group EN (esmolol 0.25 mg/kg, nicardipine 15㎍/kg, n = 15). All patients received midazolam 0.5 mg/kg, and glycopyrrolate 0.2 mg IM for premedication. Fentanyl 1㎍/kg was injected before induction of anesthesia, and then esmolol, nicardipine, or the mixed drugs were administrated as an IV bolus and immediately followed by the induction drugs: thiopental 5 mg/kg, and succinylcholine 1 mg/kg. Endotracheal intubation was performed 90 seconds after injection of the experimental drugs. Thereafter 50% Nitrous Oxide in oxygen and 2 vol % enflurane were inhaled. BP and HR were recorded at the resting state, before fentanyl injection (base {T0}), after injection test drug (T1), after induction (T2), immediately after intubation (T3), 2 min (T4), 3 min (T5), 4 min (T6), and 5 min (T7) after intubation. Results: There was a significant attenuation in SBP, MBP, DBP after tracheal intubation on the nicardipine & mixed groups compared to the esmolol group. HR was significantly lower in the esmolol and mixed groups than in the nicardipine group after tracheal intubation. Conclusions: Combined administration of esmolol (0.25 mg/kg) and nicardipine (15㎍/kg) was effective in attenuating an increase of BP and HR during tracheal intubation in hypertensive patients. (Korean J Anesthesiol 2002; 43: 581~587)