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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)
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)
제금련,윤미옥,이수정,최현철,김호정,김효진 식품의약품안전청 2000 식품의약품안전청 연보 Vol.4 No.-
근적외분광분석법(HRS)은 800~2500 nm 영역에 해당하는 전자기복사선의 흡수를 이용하는 분석벌으로 시료의 전처리가 거의 괼요없는 비파괴 분석방법이다. t980 년대 이후 컴퓨터와 Chemometfcs등의 올달로 인해 HIRS의 효용성은 크게 증가하고 있다. 본 연구에서는 NIRS를 이용하여 의약품의 쭘질관리를 효을화할 수 있는 함량시험댑을 개발하고자 하였다. 얄효성분이 같고 유사한 부형제를 함유하고 있는 개 회싸 페노바르비탈정을 가지고 투과방식의 NIR르와 PLSR(Partial Least 르rluares Regression)범을 이용·;차여 페노바르비탈 함량시험을 위한 겅랑식 모델을 개발하고 이를 검증하였다. 직선성, 정량범위, 병행정도, 실내재현정도 등을 평가하여 양호한 결과를 얻었다. Near-infrared spectroscop17(NIRS) is a rapid technique involving the absorption of electroiilagnetic radiation in the range 800~2500 nm. Recently NIRS is highly favored inQuality control testing because quick and accurate measurements can often be made f·ithoutdestroying the sample. The objective of this work was the development and validation of aNR quantitative method for the analysis of a commercially available pharmaceutical preparation.NR transmitance spectroscopy was used to determine nondestructively the content ofphenebarbital in intact tablets by collecting NIR spectra in the range t100 ~aioo nm and usingf PLS regression method. The developed NR method gave results corrlparable to the HPLCassay procedure, the standard error of calibration and prediction being 0.18 % and 0-39 %(wJw), respectively. The developed method was validated for use in routine analysis, and forthis purpose the lineafty, repeatability, intrmediate precision of the active principle quantitauonIvas assessed.