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임상연구 : 신선가스유량의 변화가 흡입마취제의 흡기가스농도에 대한 호기가스농도 비율에 미치는 영향
신원정 ( Won Jung Shin ),최규택 ( Kyu Taek Choi ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6
Background: One way to make rapid increase in alveolar anesthetic concentration includes using high fresh gas flow rates. Fresh gas flow rates should be increased to compensate the amount of uptake either. This study was performed to elucidate optimal fresh gas flow rates for rapid induction by comparison of changes of ratio of expired to inspired concentration. Methods: The study population was composed of 107 patients undergoing thyroidectomy. Patients were randomly allocated to one of three groups who received desflurane or sevoflurane or isoflurane. Each group was randomly subdivided into three groups who received one of the fresh gas flow rate: 2, 5 or 10 L/min. Inspired anesthetic concentration (Fi) and expiratory anesthetic concentration (Fe), delivered concentration (FD) were recorded. Results: With same fresh gas flow rates, there were significant differences between Fe/Fi of desflurane, sevoflurane, isoflurane. With same anesthetics, Fe/Fi of desflurane and sevoflurane were not influenced by fresh gas flow rates. But Fe/Fi of isoflurane at 2 L/min was significantly lower than 5 L/min and 10 L/min. Fi/FD of desflurane at 10 L/min did not differ from sevoflurane. At 2 L/min and 5 L/min, Fi/FD of desflurane was highest and then sevofluane, isoflurane in that order. Conclusions: Because rates of Fe/Fi of desflurane and sevoflurane were not influenced by fresh gas flow rates, 2 L/min of fresh gas flow rates could be selected. However, considering the wash-in time in circuit, optimal choice of fresh gas flow rate for desflurane and sevoflurane could be 5 L/min, that of isoflurane be 10 L/min. (Korean J Anesthesiol 2006; 50: 629~36)
증례보고 : 목동맥 내막 절제술 재관류 시 생긴 저혈압에 대한 목동맥 팽대신경 차단의 혈역학적 효과
강수진 ( Su Jin Kang ),신원정 ( Won Jung Shin ),황규삼 ( Gyu Sam Hwang ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.5
Carotid sinus nerve blockade (CSNB) has been shown to be effective for management of post-carotid endarterectomy (CEA) hypotension. The underlying hemodynamic changes are unknown. We retrospectively analyzed a recorded arterial blood pressure (ABP) waveform using a Modelflow technique. After declamping, total peripheral resistance (TPR) decreased (-65% of predeclamping value), but cardiac output (CO) and stroke volume (SV) increased (+60 and +57% of predeclamping value, respectively). CSNB abruptly increased blood pressure (BP) and TPR (75 and 95% of nadir, respectively), while CO and SV gradually decreased to -21 and -16% of maximum value, respectively). In conclusion, we found that severe decline of TPR was a cause of severe hypotension after declamping and CSNB increased BP mainly through increase in TPR, with little change in CO and SV. (Korean J Anesthesiol 2006; 51: 651~4)
임상연구 : Ketamine 마취유도가 압반사의 심박수 조절에 미치는 영향
송준걸 ( Jun Gol Song ),신원정 ( Won Jung Shin ),전인구 ( In Gu Jun ),강수진 ( Su Jin Kang ),최병문 ( Byung Moon Choi ),윤미옥 ( Mi Ok Youn ),김태희 ( Tae Hee Kim ),김영국 ( Young Kug Kim ),허인영 ( In Young Huh ),강성식 ( Seong S 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.5
Background: It is reported that ketamine increases central sympathetic activity as well as catecholamine reuptake inhibition. However, little has been known about baroreflex control of heart rate in ketamine anesthetized humans. Thus, the aim of this study was to analyze the effect of ketamine on spontaneous baroreflex sensitivity (BRS) during ketamine induction of anesthesia. Methods: Beat-by-beat arterial blood pressure and electrocardiogram at 5 min before and 10 min after ketamine administration (2 mg/kg) were recorded in twenty healthy living liver transplant donors. Spontaneous BRS was assessed by sequence method and transfer function analysis method. Results: Spontaneous BRS assessed by sequence method, BRSsequence, decreased from 13.7 ± 6.3 to 7.8 ± 4.5 ms/mmHg (P < 0.001). Spontaneous BRS assessed by low frequency transfer function method decreased from 10.9 ± 5.4 to 7.0 ± 4.1 ms/mmHg and by high frequency transfer function method from 14.8 ± 9.2 to 8.7 ± 8.8 ms/mmHg, respectively (P < 0.05). Conclusions: The spontaneous BRS was decreased during ketamine induction of general anesthesia. These results suggest that anesthesia induction with ketamine impairs baroreflex control of heart rate, which may provoke hemodynamic instability. (Korean J Anesthesiol 2006; 51: 528~34)
임상연구 : 건강한 자원자에서 마그네슘 정주에 따른 혈역학 및 자율신경계 변화
김태희 ( Tae Hee Kim ),강수진 ( Su Jin Kang ),상보현 ( Bo Hyun Sang ),신원정 ( Won Jung Shin ),김영국 ( Young Kug Kim ),황규삼 ( Gyu Sam Hwang ),한성민 ( Sung Min Han ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
Background: Magnesium has been used for treatments and preventions of various situations, such as cardiovascular disease and pre-eclampsia. And it also used for decreasing demands of anesthetics and analgesics during anesthesia. Activity of autonomic nervous system has important roles for homeostasis of cardiovascular system, and its dysfunction affects mortality and morbidity. Because there are few reports about effects of magnesium infusion on autonomic nervous system, we investigated effects of magnesium infusion on hemodynamic and autonomic changes using variable autonomic function tests in healthy volunteers. Methods: Hemodynamic parameters, heart rate variability, blood pressure variability, and baroreflex sensitivity were evaluated before and after magnesium infusion of 30 mg/kg during 20 min in twenty healthy volunteers. Cold face test, valsalva maneuver were also performed before and after magnesium infusion. Results: Low-frequency components of blood pressure variability decreased after magnesium infusion (P = 0.026). There were no significant differences in blood pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, heart rate variablility and baroreflex sensitivity between before and after magnesium infusion. Increases of diastolic blood pressure during cold face test decreased significantly after magnesium infusion (P = 0.022). In addition, no significant hemodynamic and autonomic changes were found during valsalva maneuver. Conclusions: Central sympathetic vasomotor tone decreased after magnesium infusion of 30 mg/kg during 20 min in healthy volunteers. However, it had no effects on parasympathetic system and baroreflex sensitivity. (Korean J Anesthesiol 2008; 55: 691~9)
임상연구 : 심박수 변이도, 혈압 변이도 및 압반사 민감도를 이용한 간경화 환자의 심혈관 자율신경계 평가
윤미옥 ( Mi Ok Youn ),강수진 ( Su Jin Kang ),전인구 ( In Gu Jun ),신원정 ( Won Jung Shin ),최병문 ( Byung Moon Choi ),도경준 ( Kyung Jun Do ),조선준 ( Sun Joon Cho ),최재혁 ( Jae Hyuk Choi ),송준걸 ( Jun Gol Song ),허인영 ( In You 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6
Background: Liver cirrhosis is associated with several hemodynamic abnormalities, including an impairment of autonomic nervous system reflexes, but very few have compared the disease severity with cardiovascular autonomic dysfunction assessed by spectral analysis of blood pressure and electrocardiogram. The aim of this study was to investigate the relationship between Child-Turcotte-Pugh (CTP) score and autonomic indices in patients with liver cirrhosis using the heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS). Methods: Fifty patients scheduled for liver transplantation recipients under general anesthesia were enrolled in the study. Beat-to-beat blood pressure and RR interval were measured for five minutes before anesthesia induction. HRV and BPV were estimated by power spectral analysis of RR interval and systolic blood pressure. BRS was estimated by both the sequence method (Sequence BRS) and high frequency (HF) gain of transfer function analysis (HF BRS). Results: Significant inverse correlations between CTP score and Sequence BRS (r = -0.61), HF BRS (r = -0.59), low frequency (LF) and HF power of HRV (r = -0.57, r = -0.46), LF power of BPV (r = -0.37) were found. However, no significant correlations were observed between CTP score and LF/HF ratio of HRV (r = -0.02) and HF power of BPV (r = 0.27). Conclusions: These results showed that autonomic dysfunction assessed by spectral analysis was associated with increasing severity of liver cirrhosis. Further study will be needed to clarify relationship between our findings and hemodynamic fluctuations during anesthesia for liver transplantation. (Korean J Anesthesiol 2006; 50: 655~62)
임상연구 : Sevoflurane 흡입마취유도 시 동맥압 변화의 기전 평가: Modelflow 방법을 이용한 혈역학 변수의 Beat-to-Beat 분석
김영국 ( Young Kug Kim ),윤미옥 ( Mi Ok Youn ),서형석 ( Hyung Seok Seo ),최재혁 ( Jae Hyuk Choi ),최병문 ( Byung Moon Choi ),신원정 ( Won Jung Shin ),도경준 ( Kyung Jun Do ),조선준 ( Sun Joon Cho ),강수진 ( Su Jin Kang ),전인구 ( 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.1
Background: A modelflow method provides beat-to-beat analysis of cardiovascular variables based on arterial pulse pressure analysis. In this study, we assessed the mechanism of arterial blood pressure (ABP) change during sevoflurane induction by the analysis of beat-to-beat hemodynamic changes using a modelflow method. Methods: Beat-to-beat ABP was measured during a stable conscious state (baseline) and vital capacity induction with sevoflurane 6 vol% and oxygen 8 L/min in 18 healthy living liver transplant donors. Alterations of beat-to-beat systolic ABP, mean ABP, diastolic ABP, heart rate (HR), stroke volume (SV), cardiac output (CO), and total peripheral resistance (TPR) by sevoflurane induction were estimated noninvasively using a modelflow method simulating aortic input impedance from an ABP waveform. Results: After sevoflurane induction, ABP, SV, CO, and TPR decreased significantly (all P < 0.05), but HR did not change significantly. After tracheal intubation, ABP, CO, and TPR did not change significantly compared with baseline, but HR increased and SV decreased significantly (both P < 0.05). Conclusions: Using a modelflow beat-to-beat analysis of cardiovascular variables, we found that ABP did not change significantly compared to baseline after tracheal intubation during sevoflurane induction, indicating the counteraction of increased HR and decreased SV, and that the reduction of SV by tracheal intubation suggests the suppression by increased HR and TPR compared with that after sevoflurane induction. (Korean J Anesthesiol 2006; 51: 17~23)
스크린 골프 이용자들의 참여 동기가 여가만족도에 미치는 영향
허남양,신원정 龍仁大學校 體育科學硏究所 2011 體育科學硏究論叢 Vol.21 No.1
The purpose of this study was to closely examine the influence of screen golf users' motivation on leisure satisfaction so that the finding from this study can be used as baseline data necessary for the prosperity and popularization of screen golf industry. Study data were collected from Questionnaire given out to 240 screen golf users from 5 different areas in Seoul-Gyeonggi Province(Gwanak-Gu, Youngdeungpo-Gu, Kangnam-Gu, Sungbuk-Gu, Gwacheon). Various analytical methods were perform on the data such as t-test, one-way ANOVA, correlation analysis, and multiple regression analysis using Windows SPSS 15.0 version. The results of the analysis were summarized as follows. First, significant difference was found in age factor on motivation according to demographic characteristic of screen golf users. The 50 and above age group showed highest intrinsic and extrinsic motivation among the sub-variables of motivation. No motivation was most found in the 40's age group. Second, significant difference was found in age and monthly income factors on leisure satisfaction according to demographic characteristic of screen golf users. 50 and above age group and a group with monthly income exceeding 3 million won showed the highest satisfaction level. Third, as a result of examining the relationship between screen golf users' motivation and leisure satisfaction, among the motivation sub-variables, intrinsic and extrinsic motivation had positive correlation with leisure satisfaction, and no motivation had negative correlation with leisure satisfaction.