Feasibility of ultrasound-guided posterior approach for interscalene catheter placement during arthroscopic shoulder surgery

신혜원,Jae Hyun Ahn,Hye In Jung,Choon Hak Lim,Hye Won Shin,Hye Won Lee,Hae Ja Lim,Suk Min Yoon,Seong Ho Chang 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.6

Background: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after placement of the catheter. Methods: Forty-two patients undergoing elective arthroscopic shoulder surgery were included in this study and an interscalene catheter was inserted under the guidance of ultrasound with posterior approach. With the inplane approach, the 17 G Tuohy needle was advanced until the tip was placed between the C5 and C6 nerve roots. After a bolus injection of 20 ml of 0.2% ropivacaine, a catheter was threaded and secured. A continuous infusion of ropivacaine 0.2% 4 ml/hr with patient- controlled 5 ml boluses every hour was used over 2 days. Difficulties in placement of the catheter, clinical efficacy of analgesia and complications were recorded. All patients were monitored for 48 hours and examined by the surgeon for complications within 2 weeks of hospital discharge. Results: Easy placement of the catheter was achieved in 100% of the patients and the success rate of catheter placement during the 48 hr period was 92.9%. Postoperative analgesia was effective in 88.1% of the patients in the post anesthetic care unit. The major complications included nausea (7.1%), vomiting (4.8%), dyspnea (4.8%) and unintended vascular punctures (2.4%). Other complications such as neurologic deficits and local infection around the puncture site did not occur. Conclusions: The ultrasound-guided interscalene block with a posterior approach is associated with a success high rate in placement of the interscalene catheter and a low rate of complications. However, the small sample size limits us to draw definite conclusions. Therefore, a well-designed randomized controlled trial is required to confirm our preliminary study.

가마쿠라(鎌倉)시대 불사(佛師)에 관한 고찰 - 특히 게이하(慶派)의 불사를 중심으로

신혜원(Shin Hae Won) 일본어문학회 2007 일본어문학 Vol.36 No.-

디즈니 애니메이션의 젠더 표상과 이데올로기

신혜원(Hae Won Shin),백선기(Seon Gi Baek) 한국방송학회 2014 한국방송학보 Vol.28 No.2

누비를 응용한 의상디자인 연구

신혜원(Hae Won Shin),김정혜(Jung Hye Kim) 한국복식학회 2000 服飾 Vol.50 No.7

Modern clothing is approached in the level of art, and it becomes the means of expressing individuality in modern society uniformed by the development of information society. In this modern society, modern men need the recovery of humanity and expectations of handcrafted skills for the succession of tradition culture, Prior to expressing individuality, we should examine our traditional culture and combine it with western culture. Quit started to be used for practical purpose such as life items, but it is expanded to the fields of art. Used in dress and its ornaments design, quilt is often applied to the addition of aesthetic factors or cubic material feelings by transforming its warming effect. Hereby, this study has a purpose to create high value added modern dress and its ornaments design by expressing the Modern clothing is approached in the level of art, and it becomes the means of expressing individuality ree-dimensional characteristics of quilt, and applying the color combination and the surface of butterfly wings to dress and its ornaments design. The following are the results of this study. 1. The concept of quilt started for practical purposes, but it is expanded to decoration in modern times, and it is confirmed that quilt can be variously applied to handcrafted modern design. 2. Quilt removes the plane character of textile and it riches the three-dimensional material of dress and its ornaments. Applying these characteristics, the expression of transparent wings were possible with 3 transparent layers of textile. 3. The spledid color of butterfly wings are expressed by coloring oganza and felt, and the various colors of felt showed rich color gradation. 4. The form and pattern of butterfly wings are applied as modeling form and line, and the transformation, repetition and expansion of unit forms determined the form of quilting lines. By designing the characteristics of back wings for the composition line of clothing, the form characteristics of a motif could be emphasized. 5. By using felt, oganza, Damdam yarn and ostritch feathers in expressing butterfly wings, the warm material of Linbun is felt, and the tip hair of wings are expressed by croche techniques using Damdam yarn.

Differential Diagnosis of Tremor Disorders

신혜원(Hae-Won Shin) 대한임상노인의학회 2012 대한임상노인의학회지 Vol.13 No.1

임상연구 : Propofol 마취 시 근이완제의 투여가 Bispectral Index에 미치는 영향

이신영 ( Shin Young Lee ),신혜원 ( Hye Won Shin ),이혜원 ( Hye Won Lee ),윤석민 ( Suk Min Yoon ),장성호 ( Seong Ho Chang ),임혜자 ( Hae Ja Lim ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6

Background: There have been some conflicting reports showing that the muscle relaxant affect the level of bispectral index (BIS) during various condition of anesthesia. The purpose of this study was to investigate whether muscle relaxant affects the level of BIS during propofol anesthesia. Methods: Eighty patients (ASA class I or II, 20-55 yrs) scheduled for elective surgery under general anesthesia were randomly assigned to four groups. Anesthesia was maintanined at a BIS level of 60 by propofol target controlled infusion (TCI) with air-oxygen (2 L/min:2 L/min). After maintaining BIS 60 with spontaneous breathing, normal saline 0.05 mg/kg was iv injected in group I and vecuronium bromide 0.1 mg/kg was iv injected in group II. After maintaining at a BIS level of 40 with assisted ventilation, normal saline 0.05 mg/kg was iv injected in group III and vecuronium bromide 0.1 mg/kg was iv injected in group IV. The BIS, mean arterial pressure, and heart rate were measured before anesthetic induction and up to 10 min after normal saline or vecuronium bromide injection in each group. Results: BIS was not changed in group I, but BIS significantly decreased in group II (P < 0.05). In group III and IV, BIS were not changed in both group. There were no hemodynamic changes among the four groups. Conclusions: These result suggest that the effect of muscle relaxant on BIS vary according to the level of BIS during propofol anesthesia. (Korean J Anesthesiol 2006; 50: 611~5)

임상연구 : 반폐쇄식 회로를 이용한 폐쇄회로 마취 시 신선가스 유량이 호흡일에 미치는 영향

유해선 ( Hae Sun You ),서령선 ( Young Sun Seo ),신혜원 ( Hye Won Shin ),이혜원 ( Hye Won Lee ),임혜자 ( Hae Ja Lim ),장성호 ( Seong Ho Chang ),윤석민 ( Suk Min Yoon ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.5

Backgound: The effect of anesthetic techniques, such as closed circuit anesthesia (CCA) using semiclosed circuit system and semiclosed circuit anesthesia (SCCA), on the work of breathing has not been studied yet in detail. This study was purposed to compare the work of breathing according to anesthetic technique (CCA, SCCA). Methods: Thirty patients were assigned to receive either SCCA group or CCA group (n = 15). Anesthesia was induced with propofol 2 mg/kg with 2% lidocaine 1 ml. Two percents isoflurane with O2 and N2O 2 L/min were given for 10 min to patients initially to wash in functional residual capacity and the breathing circuits. In SCCA group, anesthesia was maintained with 2% isoflurane in O2 2 L/min and N2O 2 L/min throughout the surgery. In CCA group, O2 was reduced to 200 ml/min and N2O to 100 ml/min with isoflurane vaporizer setting adjusted to 4% for anesthesia maintenance. When the operation was ended, the vaporizer setting of isoflurane deceased to zero and then O2 was increased to 4 L/min for the arousal of the patient. We measured the inspiratory/expiratory concentration of isoflurane, end-tidal CO2, the hemodynamic parameters, the change of airway pressure, the work of breathing, and compliance at anesthetic induction and emergence in both groups. Results: There were no significant differences in the inspiratory/expiratory concentrations of isoflurane, the hemodynamic parameters, end-tidal CO2, airway pressure, the work of breathing and compliance between the groups. Conclusions: CCA using semiclosed circuit system does not increase the work of breathing compared to SCCA. (Korean J Anesthesiol 2006; 50: 495~500)

무선 인터넷 플랫폼을 위한 XML 기반 Contents Generator System

윤수진 ( Soo-jean Yoon ),신혜원 ( Hae-won Shin ) 한국정보처리학회 2005 한국정보처리학회 학술대회논문집 Vol.12 No.1

최근 들어 무선인터넷 단말기로 보다 효율적으로 인터넷에 접근하여 정보를 제공하고자 하는 연구가 활발히 진행되고 있다. 사용자는 유선 인터넷으로 제공받는 컨텐츠를 휴대가 간편한 무선 이동통신으로 제공받고자 하는 욕구가 점점 늘어나고 있고 이러한 원인으로 다양한 무선 컨텐츠의 제공이 요구된다. 그러나 다양한 무선 단말기의 특성에 따라 컨텐츠를 새롭게 개발하는데는 개발비용, 기간이 많이 들게 되므로 기존의 웹 컨텐츠를 활용하여 무선환경에 맞는 문서변환 기술 연구의 필요성이 대두되고 있다. 본 논문에서는 유선 인터넷상의 컨텐츠를 무선 환경으로 손쉽게 변환할 수 있는 XML(eXensible Markup Language)기술을 활용한 변환기(Generator)구조를 설계하고 이와 관련된 XML Generator, RuleSet Management, Clipping Toolkit 등의 기능을 정의하여 보다 효율적으로 무선 컨텐츠로 변환하는 기술을 소개한다.

Task Specific Lingual Dystonia: An Uncommon Cause of Isolated Dysarthria

권미선(Miseon Kwon),신혜원(Hae-Won Shin),김종성(Jong S. Kim) 한국언어청각임상학회 2013 Communication Sciences and Disorders Vol.18 No.2

배경 및 목적: 마비말장애는 다양한 신경학적 질환들로 인해 초래되며 그 특성에 따라 여러 유형으로 분류된다. 과다운동형 마비말장애는 기저를 이루는 불수의적 움직임이 매우 다양하기 때문에 보통 복수형으로 표시하며 그 중에서도 근긴장이상증은, 특히 말산출과 같은 특정과제에서만 나타나는 국소적 혀의 근긴장이상증은, 과다운동형 마비말장애를 일으키는 매우 드문 원인으로 알려져 있다. 사례: 55세 남자 환자가 말을 할 때 혀가 꼬인다는 것을 주소로 병원에 내원하였다. 고혈압이나 기타 의학적 심리학적 질환에 대한 기왕력은 전혀 없었다. 신경학적 검사에서 감각이나 운동이상도 없었으며 뇌 자기공명 영상검사나 근전도검사 등 다른 검사상에서도 이상소견은 보이지 않았다. 그러나 언어평가 결과, 말산출 시와 구강기능평가 시에 입을 벌리고 있는 과제에서 혀의 근긴장이상 증상이 관찰되었고 이러한 증상은 다른 구강기능 평가과제 시나 씹기, 삼키기와 같은 말산출 이외의 활동 중에는 나타나지 않았다. 논의 및 결론: 말산출과 같은 특정과제에서 혀에 단독적으로 나타나는 근긴장이상증은 드문 장애로마비말장애를 일으키는 원인이 될 수 있다. 마비말 장애 이외의 다른 증상이 동반되지 않는 환자의 경우 혀 근긴장이상증의 가능성도 고려해 보아야 할 것이다. Objectives: Dysarthria is a common neurologic symptom and is produced by a variety of neurologic disorders. Hyperkinetic type of dysarthria is indicated as a plural disorder because it includes many heterogeneous involuntary movements including dystonia. Isolated dysarthria due to lingual dystonia is rarely encountered. We describe a patient presenting with isolated dysarthria caused by lingual dystonia. Case: A 50-year-old man visited our hospital due to dysarthria. His medical and psychological history was not remarkable. The results of neurological examinations did not reveal any motor or sensory abnormalities. However, on speech examination, he demonstrated dystonic movements of the tongue aggravated on speaking and during rest with mouth opening. The dystonic movements disappeared when he protruded his tongue and did not occur during chewing or eating behaviors. After exclusion of other causes of tongue dystonia, he was diagnosed as having primary lingual dystonia. Conclusion: We presented a patient with isolated dysarthria caused by dystonia specifically involving the tongue. Our case illustrates that task specific lingual dystonia should be considered as one of the causes of isolated speech disturbances.

임상연구 : 후두 현미경하 미세수술 시 Alfentanil 투여가 혈역학적 반응과 회복양상에 미치는 영향

김지연 ( Ji Yeon Kim ),이신영 ( Shin Young Lee ),신혜원 ( Hye Won Shin ),이혜원 ( Hye Won Lee ),임혜자 ( Hae Ja Lim ),윤석민 ( Suk Min Yoon ),장성호 ( Seong Ho Chang ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.4

Background: Laryngoscopy, tracheal intubation and suspension laryngoscopy may cause acute hemodynamic responses such as hypertension and tachycardia. Thus, anesthetic technique during laryngoscopic surgery should be focused on sufficient anesthetic depth and rapid recovery. We investigated the effects of alfentanil to hemodynamic responses and recovery during laryngoscopic surgery. Methods: Seventy five patients of ASA class 1 or 2 scheduled for laryngoscopic surgery were randomly divided into three groups. Each group received intravenous normal saline 2 ml (control group), alfentanil 10μg/kg (A10 group), alfentanil 20μg/kg (A20 group) respectively and then followed by induction of thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg. The systolic blood pressure, diastolic blood pressure, heart rate were measured at baseline, immediately and 1 minute after intubation, immediately and 1, 2, 3 minutes after placement of suspension laryngoscopy. The time of suction catheter response, eye opening and extubation were evaluated during recovery periods. Results: The hemodynamic responses to tracheal intubation were blocked in the A10, A20 groups compared with control group. But the hemodynamic responses to placement of suspension laryngoscopy were blocked only by A20 group. The time of eye opening and extubation were no significant differences among groups. Conclusions: Alfentanil 20μg/kg effectively alleviate the hemodynamic responses by tracheal intubation and suspension laryngoscopy during laryngoscopic surgery. (Korean J Anesthesiol 2006; 50: 396~401)