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5-HT3A receptor, ondansetron, polymorphism, PONV, Pro16Ser.
곽인숙 대한마취통증의학회 2008 Anesthesia and pain medicine Vol.3 No.4
Background: Major burns can alter the hemodynamic effect caused by anesthesia. Total intravenous anesthesia induces little hemodynamic change and desflurane has a rapid induction advantage among the different kinds of inhalation anesthesia. The study compared propofol and remifentanil anesthesia with desflurane anesthesia during induction and maintenance anesthesia. Methods: Forty patients, who were scheduled for burn surgery, were randomly assigned to either Group 1 (n = 20) or Group 2 (n = 20). Group 1 was induced and maintained with an infusion of propofol and remifentanil. After inducing anesthesia with propofol and rocuromium, group 2 was maintained with desflurane. The heart rate and mean arterial pressure, and cardiac index were measured in the operation room, after induction (AI), after intubation (AT) and at 5, 10, 15 and 20 minutes after intubation. Results: There was a significantly lower heart rate in group 1 than in group 2. The heart rate of group 2 showed a significant increase at AI, AT, 5, 10, 15 and 20 minutes after intubation. There was no significant difference in the mean arterial blood pressure and cardiac index between the two groups. Conclusions: During burn surgery, total intravenous anesthesia was effective in attenuating the hemodynamic effects.
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중화상 환자들에서 비선형 혼합효과 모델을 이용한 프로포폴의 인구약동학
곽인숙 대한마취통증의학회 2007 Anesthesia and pain medicine Vol.2 No.4
Background: Major burns can alter the pharmacokinetics of the commonly used drugs during the perioperative period. This study was carried out to define the population pharmacokinetics of propofol in the burned patients during the subacute hyperdynamic phase of the injury. Methods: Twenty adults, aged 43.7 ± 2.3 years, with total body surface area burn of 44.0 ± 22.2%, were examined at 14.1 ± 2 days after the injury (mean ± SD). Age and sex gender matched unburned patients served as controls. Propofol 2 mg/kg was given intravenously over 10 seconds as a single bolus in both groups. Blood samples (n = 20) were collected at predetermined intervals. Nonlinear mixed effect modeling was used for the pharmacokinetic analyses of the propofol concentrations, which were determined by HPLC. The cardiac index was measured by esophageal echocardiography. Results: The burns patients had a significantly higher cardiac index (CI). Propofol population pharmacokinetics has shown that clearance (Cl) and total volume of distribution (Vd) of propofol were higher in the burned patients. The significant model influencing covariates are the history of burn injury, extent of the injury and body weight. Conclusions: There is a large increase in Vd and Cl in the burns patients compared to with the controls. Therefore, the initial bolus dose and short duration infusion may have to be increased in the burns patients, provided the pharmacodynamic sensitivity is unaltered.
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중화상에서 Sevoflurane 흡입마취와 Propofol-Remifentanil 정맥마취가 중심체온에 미치는 효과
곽인숙 대한마취통증의학회 2008 Anesthesia and pain medicine Vol.3 No.2
Background: The ability of the body to maintain its temperature is evidently decreased in patients with thermal injury. The aim of this study is was to evaluate the effect of inhaled sevoflurane and intravenous propofol with remifentanil on core body temperature in burn patients. Methods: Sixty patients scheduled for burn surgery were divided into 4 groups. Within the major burn patients, intravenous propofol and remifentanil group (group I) followed by a continuous infusion of propofol and remifentanil. In inhaled sevoflurane group (group II), propofol 2 mg/kg was given intravenously over 10 seconds as a single bolus and was maintained with nitrous oxide and oxygen and 2−2.5% sevoflurane. In minor burn patients, the intravenous propofol and remifentanil group (group III) and inhaled sevoflurane group (group IV) were treated in the same manner. After induction of anesthesia, esophageal stethoscope was placed to monitor the core temperature every five minutes in all patients. Results: During operation, the core temperature of major burn patients was about 0.7−1.0oC greater than that of minor burn patients. Until 95 minutes after induction of anesthesia, this difference showed statistical significant. However, there was no statistical significance after 100 minutes (P < 0.05). There were no statistically significant differences between group I and group II and group III and group IV for burn patients as well. Conclusions: Compared to minor burn patients, the core temperature of major burn patients was greater, and anesthetics type and administration route during operation had no effect on the core temperature in these patients.
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곽인숙,이경희,홍성희 대한가정학회 2003 Family and Environment Research Vol.41 No.12
The purpose of this study were (1) to examine the level of housewives' pre environmental behavior, and (2) to analyze the effect of the selected variables on pro-environmental behavior. 941 sample were selected from housewives living in urban area. For the analysis of data, frequencies, means, one-way ANOVA, DMR test, Chisquare test, and multiple regression analysis were used. The major findings were as follows : 1. The level of housewives' pro-environmental behavior was lower than that of pro-environmental attitude. 2. The level of housewives' pro-environmental behavior was mainly affected by their environment-related variables, for example, pro-environmental attitude, and experience of environmental education. Most of socio-demographic variables and family-related variables didn't have significant effects on the level of pro-environmental behavior.
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곽인숙 又石大學校 1989 論文集 Vol.11 No.-
The purpose of this study is to analyse the influence of family life cycle on the pattern of housing consumption and residental mobility. For this purpose, 956 housewives were sampled from the households in Seoul. The data were analysed by such statistical methods as crosstabulation, X^2-test, and T-test. The main results obtained are as follows. 1. The majority of significant difference occur between stage 1 and 2 in housing consumption(persons per room) because the arrival of children. 2. Between stages 2 and 3 we find significant differences. The existence of school children increase in number of room, persons per room and housing satisfaction. 3. Between stages 3 and 4, 4 and 5, 5 and 6 we find few significant difference. The development of children does not generate an increase in number of rooms and persons per room. 4. In stage 4, the family consider good schools and education environment seriously to chose their residential location. In further study it should be analyse that influence of household income and wealth on housing comsumption and residential mobility over the family life cycle.
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중화상환자에서 6% Hydroxyethyl Starch Solution 투여가 혈액 응고 기능에 미치는 영향
곽인숙,배지영,김광민 대한중환자의학회 2008 Acute and Critical Care Vol.23 No.2
Background: Patients with major burns require replacement of intravascular volume. Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. Dilution with crystalloids or colloids and corresponding platelet dysfunction are known causes of perioperative bleeding tendencies. The aim of the current study was to evaluate the effect of crystalloid and colloid solutions on platelet function in patients with major burns. Methods: Forty patients scheduled for burn surgery were divided into 4 groups. The infusion was started with a Hartman solution infusion (group 1) from 7 A.M. until surgery. HES (6%, Voluven(R)) was infused in the following concentrations: 7 ml/kg (group 2), 10 ml/kg (group 3), and 15 ml/kg (group 4). The bleeding time (BT), prothrombin time (PT), prothrombin time international ratio (PT INR), activated partial thromboplastin time (aPTT), hemoglobin (Hb), platelet function analyzer-100 closing time (PFA CT), and platelet count (Plt) were measured. Results: Hartmann solution and HES had no significant effect on the BT, PT, PT INR, a PTT, Hb, and Plt. The post-operative PFA CT was significantly higher in group 4 than in group 3. In group 4, the PFA CT was significantly higher post-operatively compared to pre-operatively. Conclusions: The use of high dose HES may increase the risk of bleeding tendencies in burn patients.
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