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김장만,염철호 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2
Central hemodynamic actions of bradykinin were studied in anesthetized rats in order to investigate its mode of action in the central nervous system. Bradykinin(0.5~10 nmoℓ) was administered into the right lateral ventricle, while blood pressure and heart rate were monitored continuously. Effects of various drugs including phentolamine(2 ㎎/㎏), hexamethonium(2.5 ㎎/㎏/min), reserpine (2 ㎎/㎏/day), indomethacin(10 ㎎/㎏) and sara1asin(20 ㎍/㎏/min) on the hemodynamic effects of bradykinin were also examined. The results obtained were as follows: 1. Administration of bradykinin into the lateral ventricle, elicited an increase in mean arterial pressure without significant changes in heart rate. 2. Bradykinin, doses ranging from 0.5 to 10 nmoℓ, produced a dose-dependent increase in mean arterial pressure. The maximum increase in blood pressure was noted at 5 nmoℓ, 3. Central pressor responses to bradykinin were attenuated by pretreatment with phentolamine or hexamethonium. Reserpine, indomethacin and saralasin did not affect the pressor response to bradykinin. 4. These results suggest that the central pressor effect of bradykinin is, at least in part, due to excitation of the autonomic nervous activity. Mechanisms other than the enhanced sympathetic nervous activity cannot be ruled out completely in the central action of bradykinin.
김순일,조홍래,배수동,김주섭,정중기,박찬흔,임동현,김장만,이석구 대한소화기학회 1992 대한소화기학회지 Vol.24 No.1
This is a clinical analysis of 45 patients with traumatic hepatic injuries treated at the General Surgery Department of Hallym University's Kangdong Sacred Heart Hospital from December 1986 through December 1989. Of the 45 patients, 32 have undergorge surgical operations, while 13 underwent conseervative treatment. Followings are relevant clinical results; 1) Regarding age groups; 14 patients (31%) were in their twenties, followed by 10 years or younger age group and the age group of the thirties. 2) Ratio between male and female was 4 to 1, i.e., 36 male patients (80%) and 9 female patients (20%). 3) Blunt trauma was the most frequent cause of the hepatic injury whereby 35 patients were suffering. Of these 35, 27 patients (77%) were due to traffic, accidents, 3 (9%) Patients were hospitalized because of fall-down and 5 (14%) were caused by street violences. And, 10 patients were stabbed to be penetrated in the liver. Of the traffic accident victims, there were 13 pedestrians and, 14 passengers of various vehecles. 4) Of the 35 patients with blunt trauma, 22 patients (63%) have undergone surgical operations while the remaining 13 received conservative treatment. All 10 patients with penetrating injury have undergone surgical operations. 5) In the cases of abdominal blunt trauma, patients were classified by 5 different categories which ranged class 1 through class 5. Of the class I patients, 8 out of 12 patients revealed abnormality (average 367/290) as to the SGOT/SGPT. Fifteen patients in class Ⅱ as well as 7 patients in class Ⅲ showed abnormality as to the SGOT/SGPT, whose respective average were 229/120 and 553/232. The average time span required for them to recover normal SGOT/SGPT were approximately 10 days. 6) 6 out of 12 class Ⅰ patients have undergone surgical operations, 8 out of 15 class Ⅱ patients and all 7 class Ⅲ patients have undergone surgical operatiovas as well. Surgical operations applied to class Ⅰ and Ⅱ patients were primary closure and dranages. 7) Also, of the 35 blunt trauma patients, 27 patients (77%) received associated injuries. And, 17 of these 27 have undergone surgical operation while 10 patients received conservative treatment, As to the associated injuries, most frequent cases were associated with fractures in the chest or ribs. Three out of 10 patients who suffered head injury died. 8) Five put of 10 patients with penetrating injury revealed associate injury of durable nature. And, of such patients, 3 suffered penetrations in the chest. 9) Molt popular surgical operation employed was primary closure and drainage method (22 cases, 69%). There were 4 cases of drainage method, 3 of hepatic A. ligation and, 2 hepatic resections. 10) Of the surgical operations, 10 patients suffered complications and, the most common complication was pulinonary complications. 11) Mortalities were higher where there was less TS, higher IS or lower TRISS. And, where there was higher TRISS, mortality decreased. It is considered that TS, IS and TRISS shall be applied as index fox the evaluation and transfer of the trauma patient.