슬골관절염 환자에서 관절내 리도카인과 아스피린이 혼합주사에 의한 진통 효과

양내윤(Nae Yun Yang),서재현(Jae Hyun Suh) 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.1

N/A Arthritis is one of the most common disease of mankind. Major of arthritis is osteoarthritis (OA), but the cause is not clear and the characters are chronic and often progressive. So the management and the pain control of OA are very difficult and adequate ways of controlling it have not been discovered. In the present study we investigated the effects of Knee Intra-articular Iniection(KII) of lid- ocaine with aspirin on OA of the knee. Thirty OA patients with Visual Analogue Scale(VAS) above 8 were studied and they were di- vided into two groups as follows, Group I(n=15), KII with 1% lidocaine 5 ml Group II(n =15#); KII with 2% lidocaine 2 ml and aspirin 2 ml(180 mg, diluted with normal sa- line) In two groups, KII was done 2 times a week for 4 weeks and we compared the changes of VAS between two groups. The results were as follows, 1) Before the KII, initial mean VAS of group I and II was 8.8 and 8.9. After KII 2 times, VAS of group I and II was 6.6 and 6.4. These deceases were statistically significant, but there was no significant difference of VAS between two groups. 2) After KII 4 times, VAS of group I and II was 6.3 and 5.5, significant decrease was observed in group II. 3) After KII 6 times and 8 times, VAS of group I and II was not decreased anymore, but the VAS of group II was maintained in significant decreased state than that of group I. We experienced that KII of lidocaine with aspirin was more effective than that of lidocaine only. So we suggest that KII of mixed solution of lidocaine and apsirin may be one of treat- ments for OA of the knee.

경막외강에 Morphine과 동반 투여한 Midazolam의 진통효과

양내윤(Nae Yun Yang),문동언(Dong Eon Moon),심재용( 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.2

N/A Background: Preoperative blocking of surgical nociceptive inputs may prevent sensitization of CNS and reduce postoperative pain. The stress responses to surgical trauma consist of increase in catabolic hormones and decrease in anabolic hormones. We studied whether preoperative intravenous morphine could affect postoperative pain and change plasma cortisol and serum glucose levels. Methods: Thirty eight patients undergoing total abdominal hysterectomy were randomly assigned to one of three groups. Control group (n=11) did not received intravenous morphine, preoperative group (n=13) received intravenous morphine (0.1 mg/kg as a bolus 10 min before operation and followed by 1.5 mg/hr for 10 hours), postoperative group (n=14) received the same doses and method of intravenous morphine of preoperative group postoperatively. Postoperative pain relief was provided with i.v. fentanyl through Patient-Controlled-Analgesia Pump. Postoperative visual analogue scores (VAS), analgesic re- quirement (first request time, total amounts used), side effects, plasma cortisol and serum glucose levels were compared. Results: VAS were different between control group and the other two goups, but were not different between preoperative and postoperative group. Total amounts of used fentanyl were not different among groups, but first request time were significantly delayed in the preoperative group compared with the other two groups (66.2+33.9 vs 39.0+15.4 and 45.0+14.9 min respectively, p<0.05), Plasma cortisol and serum glucose levels were not different among groups. Conclusions: Above dosage of preoperative and postoperative morphine has analgesic effect, but could not block surgical stress induced plasma cortisol and serum glucose increase.

척수손상환자의 변비에 있어서 성상신경절 차단의 효과 - 2예 보고 -

양내윤(Nae Yun Yang),문동언(Dong Eon Moon),서재현( 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.2

In the patients having constipation or irritable bowel syndrome, stellate ganglion block is commonly used in many pain clinics because of its excellent effects. But in the case of patients having spinal cord injury complain constipation, its management is very difficult and there is no report about the effects of stellate ganglion block in this case. We experieced good results that stellate ganglion block was very effective in the patients having spinal cord injury com- plaining severe constipation and other symptoms.

Midazolam과 Baclofen 투여에 의한 난치성 딸꾹질 환자의 치료 경험

양내윤(Nae Yun Yang),문동언(Dong Eon Moon),박철주( 대한통증학회 1997 The Korean Journal of Pain Vol.10 No.2

Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term intractable is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve blocks including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

한국어ㆍ영어ㆍ중국어모어화자의 일본어 문말표현 습득 양상 - noda형식과 종조사를 중심으로 -

양내윤 ( Yang Nae-yun ),이길용 ( Lee Kil-yong ) 韓國外國語大學校 外國學綜合硏究센터 日本硏究所 2016 日本硏究 Vol.0 No.70

본 연구에서는 정중체 회화문 자료인 KY코퍼스를 사용하여 한국어ㆍ영어ㆍ중국어모어화자를 대상으로 일본어 문말표현의 사용 실태에 대해, noda형식과 종조사를 중심으로 분석하였다. 한국어모어화자뿐 아니라 영어 및 중국어모어화자를 분석 대상으로 삼아 모어의 차이를 초월한 보편적 특징과 모어가 영향을 미치는 개별성에 대해 고찰하였다. 그 결과는 다음과 같이 요약된다. 우선 한국어ㆍ영어ㆍ중국어모어화자 모두 일본어 문말표현 습득 과정의 초기 단계에서 noda형식을 사용하는 것으로 밝혀졌다. 이는 부정 및 과거 등 초점이 되는 정보를 우선하여 배치하고 정중함을 나타내는 모달리티형식은 문말에 배치하는 일본어 회화체의 보편적 특성과 일치한다. 다음으로 한국어모어화자뿐 아니라 영어 및 중국어모어화자에서도 동일하게 noda형식과 동사술어문의 친화성이 인정된다. 학습자가 활용이 어려운 동사술어문의 정중체에서 형태적으로 활용 절차가 복잡한 `masu`형식을 회피하고 보통체에 기계적으로 `n-desu`를 붙이는 간략화를 추구하는 것으로 판단된다. 또한 한국어모어화자는 영어 및 중국어모어화자에 비해 noda형식을 많이 사용하는 것으로 드러났다. 이에 대해서는 일본어와 한국어가 언어적으로 유사하기 때문이라는 언어내적 요인보다, 격식적인 상황에서 정중체의 사용이 강하게 요구되는 한국어의 사회언어적 규범의 전이라는 언어외적 요인이 크게 영향을 미치는 것으로 보인다. In the current study, we analyzed Japanese sentence final expression usage patterns in Korean, Chinese and English speaking learners specifically focusing on noda form and sentence final particles of Japanese polite forms found in KYcorpus (oral speech data). We analysed common features of learners who have different mother tongues. The results are summarized as follows. Usage of noda form by Korean, Chinese and English speaking learners occurs in the early stage of the Japanese sentence final expression learning process. These results suggest that conveying focused information, such as negative and past, is a priority, while the modality type related to politeness is disposed in the final sentence showing common features of conversational Japanese. Next, the affinity between noda form and verbal predicate is commonly recognized in Chinese and English speaking learners as well as in Korean learners. Learners tend to avoid the morphologically complex masu type in difficult verbal predicates in a polite form system and instead pursue a simplified tagging n-desu mechanically. Furthermore, Korean learners tend to use noda form more than English and Chinese learners. We speculate that these results relate to transfer of Korean sociolinguistic norms, which demand the use of a polite form system, rather than linguistic similarity between Japanese and Korean.

한국 통증치료실의 현황

문동언(Dong Eon Moon),양내윤(Nae Yun Yang),최영국( 대한통증학회 1998 The Korean Journal of Pain Vol.11 No.2

N/A Background: Twelve years have passed since the Korean Pain Society was organized. Nowadays, there are so many problems to be solved in pain clinics including health insurance, pain education and public information etc. in Korea. The present study was designed to evaluate the current status of pain clinics in Korea. Methods: Eight hundred twenty regular members of Korean Pain Society were surveyed by questionnaire in October 1997. We compared the general characteristics, contents of diseases in pain clinic, treatment methods, patients satisfaction, pain educations, problems in pain treatments, requests to Korean Pain Society among the 138 respondents. Results: Thirty seven percents of the respondents worked at university hospitals, 39% at non-university hospitals and 24% at private pain clinics. The most common diseases treated in pain clinics was low back pain(32% in university and non-university hospital and 28% in private pain clinic respectively). However, cancer pain was 10% in university and non-university hospital and 0.7% in private pain clinic, Epidural block was the most frequently used procedure in chronic pain treatments. And 74.6% of the respondents were studied and learned in Korea and Japan. And then, current problems in pain mana- gement and requests to Korean Pain Society were medical insurance problems, pain education and public information of pain clinics. Conclusions: These results suggest that the Korean Pain Society should make an effort to solve these current problems in order to activate pain medicine and increase the quality of life for those suffering from pain.

日本語學習者におけるノダ形式および終助詞の習得と維持 -クラッシェンのインプット反說の觀点から-

이길용 ( Lee Kil-yong ),양내윤 ( Yang Nae-yun ) 한국일어교육학회 2016 일본어교육연구 Vol.0 No.36

本硏究では、韓國語母語話者4名の日本語によるフォ一マルな談話資料を材料として用いて、文末のノダ形式と終助詞の習得の樣相を分析した。その後、學習者HT氏に焦点を絞り、習得期(2001年-2002年)の談話資料と、歸國後の約10年經った維持期(2012年-2014年)の計6回の談話資料を分析し、習得と維持の兩面について、クラッシェンのインプット反說の觀点から分析した。その結果は、次のようにまとめられる。まず、學習者は、日本語の文末表現を「言い切りの文→終助詞付加文→ノダ形式付加文→ノダ形式と終助詞付加文」の順序で積み上げ式の習得を行い、特にノダ形式付加文は過去形に接續して用いる。それは李吉鎔(2010)が明らかにした、丁寧體において活用が難しくなる環境で形態的手續きの複雜な〈マス形式〉を回避し、普通形に機械的に〈ンデス〉をつけていくといった簡略化の結果である。次に、HT氏についてクラッシェンのインプット反說を參照すると、〔習得期〕は「i+1」の途中にあり、「+1」を積極的に使用する段階であると考えられる。HT氏の〔習得期〕における「i」は、言い切りの文とノダ形式付加文であり、「+1」は終助詞付加文と、ノダ形式と終助詞付加文であると考えられる。そして、新しい習得が行われないHT氏の〔維持期〕においては、「i」は言い切りの文とノダ形式付加文、終助詞付加文とノダ形式+終助詞付加文のすべてであり、「+1」の事象は存在しないことになる。最後に、第2言語の維持や摩滅の觀点からは、HT氏の〔維持期〕は磨滅が起こっていると考えれば、「i-1」の狀態になる。ここで「-1」は終助詞付加文と、ノダ形式と終助詞付加文である。HT氏の〔習得期〕は、ノダ形式と終助詞付加文の過剩般化による獨自體系の構築期(+1の段階)にあたるため、〔維持期〕においては獨自體系の構築が緩和されたものと考えられる。 This research analyzes the acquisition of noda and other final particles in Japanese observed in formal speech of four Korean learners. In this paper, we will particularly focus on one of these learners (HT), analyzing speech collected during the language acquisition stage (2001-2002) and during the maintenance stage (2012-2014), 10 years after his return to Korea. The analysis is based on Krashen’s Input Hypothesis. Based on the data, we can say that final particles were acquired in the following order: bold sentences → sentences ending with final particles → sentences ending with noda → sentences ending with noda and final particle. It was observed that noda was added specially to the past tense of the verbs. This result was mentioned in Lee (2010). Since in the past tense the use of polite style (masu) added to the verb is more complex than the use of verb+ndesu, it is supposed that the learner avoided the first form and often used ndesu added to the plain form of the verb. This was seen as a simplification. According to Krashen’s Input Hypothesis, the [i+1] pattern is observed during the learning stage. In HT data, the occurrence of bold sentences (sentences with no final particle) and noda sentences were seen as [i], while final particle sentences and noda+final particle sentences were seen as [+1]. During the maintenance stage, we observed the [i-1] pattern since the use of final particles sentences and noda+final particle sentences decreased considerably. In conclusion, we can state that HT’s data shows overuse of noda+final particle sentences during the learning stage. In the maintenance stage, however, this phenomenon is reduced.

경막외강에 투여한 Lidocaine HCI 이 Vecuronium 의 신경근 차단 작용에 미치는 영향

양내윤,서재현 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.6

Most local anesthetics intravenously administered inhibit neuromuscular transmission or enhance the neuromuscular block of both nondepolarizing and depolarizing musde relaxants. Local anesthetics used to treat cardiac arrhythmias intraoperatively or postoperatively may, therefore, greatly augment a residual neuromuscular block. To obtain adequate balanced anesthesia and postoperative analgesia, general anesthesia with epidural anesthesia is frequently selected. In the present study we investigated the effects of lidocaine HC1 administered into epidural space on the neuromuscular blocking action of vecuronium. Eighty adult gynecological patients of ASA class I or II were studied. Patients were divided into four groups as follows ; Group I (n=20); vecuronium 0.1 mg/kg iv administered only Group II(n=20); vecuronium 0.1 mg/kg iv and lidocaine 6 mg/kg administered into epidural space Group III(n=20); vecuronium 0.1 mg/kg iv and lidocaine 8 mg/kg administered into epidural space Group IV(n=20); vecuronium 0.1 mg/kg iv and lidocaine 10 mg/kg administered into epidural space Patients of experimental groups II, III and IV were anesthetized by epidural block with 2 % lidocaine followed by general anesthesia 15 minutes later. Before induction with fentanyl(3 ug/kg), droperidol(0.04 mg/kg), thiopental sodium (5 mg/kg) and vecuronium(0.1 mg/kg) iv, neuromuscular monitoring was set by using ABM(Anesthesia and Brain activity Monitor, Datex Co, Finland) which stimulating ulnar nerve at the wrist with supramaximal stimuli at a frequency of 2 Hz and 20 seconds interval. The electromyographic response of hypothenar muscles was recorded. Following stabilization of the control twitch height, vecuronium(0.1 mg/kg) was intravenously injected, and tracheal intubation was performed when the first twitch height of the train of four twitch response(T1) was 5 % of the controL Anesthesia was maintained with O2 (2 L/min) and N2O (4 L/min). The time of onset of action (time from vecuronium iv to 0 % of T1), time of maximal twitch depression (time from loss of T1 to reappearance of T1), Recovery index (time from recovery of 25 % of T1 to 75 % of T1) and T4 ratios (ratio of the height of the fourth twitch to T1) at 25 %, 50 % and 75% of T1 were measured and compared among the groups. The results were as follows ; 1. The time of onset of action was 3.99±0.92 minutes in the control group and 2.94±0.89 minutes in the lidocaine 10 mg/kg administered group(P$lt;0.05). 2. The time of maximal twitch depression was 19.055.46 minutes in the control group and 24.02±6.94, 25.33±5.84, 27.07±5.26 minutes in the lidocaine 6 mg/kg, 8 mg/kg, 10 mg/kg administered groups(P$lt;0.05). 3. Recovery index was 14.76±5.40 minutes in the control group and 20.39±4.56, 22.36±7.98 minutes in the lidocaine 8 mg/kg, 10 mg/kg administered groups(P$lt;0.05). 4. The lidocaine administered into epidural space has little effect on the recovery of T4 compared with that of T1(P$gt;0.05). These results suggest that the effect of lidocaine HC1 administered into epidural space on the neuromblocking action of vecuronium showed prolonged depression and recovery time, and reduced time of the onset of action with dose larger than lidocaine 8 mg/kg.

Midazolam 병합투여가 Propofol 정주에 의한 마취유도 및 각성에 미치는 영향

최종호,심재용,김창성,김은성,유건희,이재민,양내윤,서소운 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.2

Background: Previous reports have demonstrated the synergistic interaction of midazolam and propofol in the induction of hypnosis. But there haer been some different views expnrsscd as to whether the synergism extended to hemodynamic effects. So we studied the effect of the co-administration of midazolam on induction dose, hemodynamic response, and recovery with the use of continuous infusion of propofol for induction, and the maintenance of anesthesia. Methods: Thirty-five patients undergoing elective surgery within 2 hours were randomly assigned to one of two groups formed according to the induction agents: Group P (continuous propofol infusion 1,200 mg/h), Group MP (midazolam 2 mg followed by continuous propofol infusion 1,200 mg/h). After induction, anesthesia was maintained with fentanyl (50 ㎍), N_2O (70%), andpropofol (5-15 mg/kg/h). Outcome measures were propofol doses (induction and maintenance), hemodynamic responses (heart rate, blood pressure) during the induction period, emergence time (eye-opening to command), postoperative nausea and dizziness. Results: The induction dose of propofol was 29% less in Group MP compared to Group P but there was no significant difference in maintenance doses between the two groups. Heart rates showed no differences between the two groups, but the changes of mean arterial pressures from base line at 30 sec, 2 min and 5 min after intubation were greater and the emergence time was delayed in Group MP compared to Group P (P < 0.05). Conclusions: Midazolam potentiates the hypnotic action of propofol synergistically, but there was no evidence that the synergism extended to the blunting effect of propofol against the hypertensive response to intubation. (Korean J Anesthesiol 1999; 37: 193~198)

흰쥐의 절개 통증모델에서 척수강내로 투여한 Magnesium Sulphate 의 효과

박종민,최종호,이재민,김창성,이해진,권오경,이윤기,양내윤,박수석,문동언 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.39 No.6

3384001224 Background: The mechanical hyperalgesia that follows peripheral tissue injury results from peripheral and central sensitization. Central sensitization is initiated and maintained by windup that can be prevented by N-methyl-D-aspartate(NMDA) antagonists. NMDA antagonists, therefore, have the potential to pre-vent and treat pain, although clinical uses are limited because of their side effects. This study was designed to evaluate the analgesic action of intrathecal (IT) magnesium sulphate in a rat model of postoperative pain and investigate the analgesic mechanism of magnesium. Methods: Forty-two Sprague-Dawley rats (300 ± 20 g) were prepared with a chronic IT catheter. Under brief enflurane anesthesia, a 1-cm incision including skin, muscle and fascia was made in the plantar aspect of the hind paw and closed. Normal saline, magnesium (30, 100, 300, 600 ㎍), NMDA 50 ng or NMDA 50 ng with magnesium 300 ㎍ was administered via the IT catheter after recovery. Response frequency, using Von Frey filaments, cumulative pain scores and motor deficits were assessed. Results: The mechanical hyperalgesia and nonevoked pain behaviors decreased significantly at 1 h or 1 h and 3 h after IT injection of magnesium 100 ㎍ or 300 ㎍ compared to the saline group without profound motor deficits in a rat model of postoperative pain. However, the rats administered with magnesium 600 ㎍ were lethargic due to severe motor weakness. Effective duration of magnesium decreased significantly in the group of NMDA 50 ㎍ with magnesium 300 ㎍ compared to that of magnesium 300 ㎍ administered alone, but the initial effects were similar between the two groups. Conclusions: We conclude that IT magnesium sulphate can modulate nociceptive processing after tissue injury and the analgesic mechanism of magnesium is involved in NMDA receptors. Magnesium,