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흡입마취시 Neostigmine 과 Pyridostigmine 이 심혈관 반응에 미치는 영향
강효석,이춘희,이귀용 대한마취과학회 1990 Korean Journal of Anesthesiology Vol.23 No.6
At the end of the operation, residual neuromusular blookade may be antagonized by anticholines-terase (edrophonium, neostigmine and pyridostigmine). Neostigmine is probably commonly used antagonist of nondepolarizing neuromuscular blocking agents. But, because of an apparent longer duration of action and lesser muscarinic effects, pyridos- tigmine has been suggested as possibly superior to neostigmine as an antagonist of nondepolarizing neuromuscular blockade. Accordingly, present study observed the heart rate, systolic and diastolic blood pressure changes following equipotent doses of pyridostigmine and neostigmine given with glycopyrrolate in inhalation anesthesia (halothane and enflurane). Eighty patients were randomly divided in four groups as follows: Group I: halothane, glycopyrrolate + neostigmine Group II: halothane, glycopyrrolate + pyridostigmine Group IIl: enflurane, glycopyrrolate + neostigmine Group IV: enflurane, glycopyrrolate +pyridostigmine The results were as follows: 1) In halothane and enflurane anesthesia, the changes in heart rate were significant in each group after 4 minutes and especially, the group I, III showed more decrease than the group II, IV. 2) Tachycardia were observd until 6 minutes after administration of anticholinesterase in each group. Bradycardia were appeared at 6 minutes in the group I, IIl and at 14 minutes in the group II, IV and, each group showed bradycardia which continued over 20 mintes. 3) Even though the decrease of systolic and diastolic blood pressure showed transiently with time, there were no significant difference in the changes in ach group. 4) When the same anticholinesterase was administered, the cardiovascular responses were no significant difference between the halothane and enfurane anesthesia. In conclusion, pyridostigmine with glycopyrrolate seems to produce minimal changes in the cadiovascular responses in halothane and enflurane anesthesia.
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Current therapeutic agents and anesthetic considerations for diabetes mellitus
강효석 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.63 No.3
As the incidence of diabetes mellitus (DM) continues to increase worldwide, more diabetic patients will be presented for surgery and anesthesia. This increase of DM is a consequence of the rise in new patients of type 2 DM, and is likely attributable to rapid economic development, improved living standards, aging population, obesity, and lack of exercise. The primary goal of management in DM is to delay, or prevent the macro- and microvascular complications by achieving good glycemic control. More understanding of the pathophysiology of DM has contributed to the advance of new pharmacological approaches. In addition to the conventional therapy for DM, glucagon-like peptide-1 (GLP-1) mimetics, dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), and insulin analogues are currently available effective hypoglycemic agents for the management of the patients with DM in the perioperative period and also consider the adverse effects of newly introduced agents that need more clinical observations.
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자궁경 자궁내막절제술 후 발생한 뇌교외수초용해증의 완전 회복
강효석,오인영,김영주,조춘규,이수경,양신영,권용임,최환영,양윤석 대한마취통증의학회 2006 Korean Journal of Anesthesiology Vol.50 No.1
Transcervical resection of endometrium is under-utilized in the treatment of dysfunctional uterine bleeding, uterine myoma and menorrhagia. The procedure is similar to transurethral resection of prostate in men with a possibility of substantial absorption of irrigation fluid. Absorption of a large volume of fluid can cause excessive intravascular volume, hyponatremia, cerebral edema and death. Severe hyponatremia leading to extrapontine myelinolysis is an extremely rare complication of this procedure. So, We report a case of developed extrapontine myelinolysis after hysteroscopic myomectomy which, however, showed complete recovery. (Korean J Anesthesiol 2006; 50: 94~8)
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강효석,서재웅 한국재무학회 2011 한국재무학회 학술대회 Vol.2011 No.05
본 연구는 2000년 1월 1일부터 2009년 12월 31일까지 한국증권선물거래소에 상장된 기업을 대상으로 운전자본관리가 자본적지출에 미치는 영향을 분석하였 다. 분석결과는 다음과 같다. 첫째, 일반적인 운전자본관리 관점에서 자본적지출을 줄이는 방법은 매출채권 변화율과 재고자산변화율은 줄이고, 매입채무변화율은 비중을 늘인다. 재고자산 변화율, 매입채무변화율, 매출채권변화율의 순으로 조정하는 것이 효과적인 것으 로 실증분석되었다. 둘째, 표본기업이 속한 시장에 따라 운전자본의 주요요소인 매출채권변화율, 재 고자산변화율, 매입채무변화율이 자본적지출에 미치는 영향은 다르게 나타났다. KOSPI시장에서는 재고자산변화율만이, KOSDAQ시장에서는 매출채권변화율, 재 고자산변화율, 매입채무변화율이 모두 유의한 결과를 나타내었다. 셋째, 표본기업의 규모에 따라 매출채권변화율, 재고자산변화율, 매입채무변화 율이 자본적지출에 미치는 영향은 다르게 나타났다. 대기업은 재고자산 변화율 만이, 중소기업에서는 매출채권변화율, 재고자산변화율, 매입채무변화율이 유의 한 결과를 나타내었다. 결론적으로, 한국증권선물거래소 상장된 기업들은 시장의 역사가 오래되고 규 모가 클수록 재고자산변화가 자본적지출에 미치는 영향이 컷고, 시장의 역사가 비교적 짧고 규모가 작을수록 매출채권, 재고자산, 매입채무변화가 자본적지출에 미치는 영향이 컷다. 바꾸어 말해, 이는 기업들이 시장과 규모에 따라 운전자본 관리를 취하는 방법이 다름을 시사한다.
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자발성 지주막하출혈 환자의 계절별 발생 분포 양상과 기후 요소의 영향에 관한 분석
강효석,홍대영,김종원,이경룡,박종호,박상오,백광제 대한응급의학회 2015 대한응급의학회지 Vol.26 No.3
Purpose: The aim of this study was to determine whether there are monthly and seasonal variations of incidence of subarachnoid hemorrhage (SAH) in Seoul. Methods: We conducted a cross-sectional, retrospective study on the incidence of SAH using the National Emergency Department Information System (NEDIS) of Korea, a nationwide electronic emergency medical care database. Meteorological data (daily and monthly mean sea level air pressure, daily and monthly mean air temperature, daily temperature range) between January 2010 and December 2010 in Seoul were acquired from the Korea Meteorological Administration. The incidence of SAH in patients visiting the ED was defined as those assigned the following codes of the Korea Standard Classification of Disease, 6th Revision (KCD-6codes): I600-I609. Results: The diurnal variation of the onset of SAH showed two broad peak times from 10 a.m. to 2 p.m. and from 4 p.m. to 7 p.m. There was a clear seasonal variation in the occurrence rate of SAH, which was higher in winter than in any other season. Daily temperature (mean, maximum, and minimum) and mean sea-level barometric pressure were not associated with the occurrence rates of SAH. Univariate analysis showed no significant difference between bleeding days and non-bleeding days for the number of SAH patients. In multivariate analysis, the monthly mean temperature showed significant correlation with the occurrence of SAH. Conclusion: This study showed seasonal variation in the onset of SAH. Conduct of further population-based study would be required in order to obtain more precise and valuable information.
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