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임상연구 : 체외순환 없는 관상동맥우회술을 시행 받는 환자에서 수술 전 안지오텐신 전환효소 억제제 중단이 혈역학에 미치는 영향
이용경 ( Yong Kyung Lee ),나성원 ( Sung Won Na ),남순호 ( Soon Ho Nam ),남성범 ( Sang Boem Nam ),채영근 ( Young Keun Chae ),송하나 ( Ha Na Song ),곽영란 ( Young Lan Kwak ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1
Background: Angiotensin-converting enzyme inhibitors (ACE-I) have been widely used for cardiac patients. This study investigated the effect of omitting ACE-I medication on hemodynamics during induction of anaesthesia and operation in patients chronically treated with ACE-I undergoing off pump coronary artery bypass graft surgery (OPCAB). Methods: Sixty patients scheduled for OPCAB were included in this study. Patients not treated with ACE-I were included in control group (Group I, n = 20). And then, patients treated with ACE-I more than 4 weeks were randomly divided into two groups: continuing group including patients who continued ACE-I medication until the morning of surgery (Group 2, n = 20) and discontinuing group including patients who discontinued ACE-lone day before the surgery (Group 3, n = 20). Norepinephrine (8㎍/ml) was infused when systolic blood pressure decreased below 90 mmHg during induction and operation. Amount of norepinephrine infused and hemodynamic data were recorded. Results: Significantly larger amount of norepinephrine was infused in Group 2 than in other two groups during obtuse marginal artery anastomosis. Total amount of norepinephrine infused during the all coronary anatsomosis was significantly larger in Group 2 than those values in other two groups. Conclusions: Continuing ACE-I treatment until the morning of surgery significantly increased the use of norepinephrine during the anastomosis. In contrast, there was no significant difference in the use of norepinephrine between Group I and Group 3. Discontinuing ACE-I before the surgery may helpful to maintain hemodynamics stable during coronary anastomosis in OPCAB. (Korean J Anesthesiol 2007; 52: 34~41)
김용호 ( Yong Ho Kim ),민진혜 ( Jin Hye Min ),최영순 ( Young Soon Choi ),이우경 ( Woo Kyung Lee ),이용경 ( Yong Kyung Lee ),이현민 ( Hyun Min Lee ),채영근 ( Young Keun Chae ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Background: Many studies have suggested that propofol in combination with remifentanil may provide adequate conditions for tracheal intubation without the use of muscle relaxants. Other hypnotic drugs have not been thoroughly investigated in this regard. The goal of our study was to evaluate the effect of thiopental, propofol or etomidate on tracheal intubating conditions and hemodynamic changes using remifentanil in the absence of muscle relaxants. Methods: A total of 45 healthy adults were divided randomly into three groups. After iv lidocaine 1.5 mg/kg, thiopental 5 mg/kg (thiopental group) or propofol 2.5 mg/kg (propofol group), or etomidate 0.4 mg/kg (etomidate group) were injected. After the injection of study drugs, remifentanil 2 mcg/kg was administered. Ninety seconds after the administration of remifentanil, laryngoscopy and intubation were attempted. Intubating conditions were assessed and the mean arterial pressure and the heart rate was measured. Results: There were no significant differences in intubating conditions between patients in the three groups. The heart rate was significantly lower in the propofol and etomidate group patients when compared to the thiopental group patients after anesthetic induction. The mean arterial pressure was significantly lower in the propofol group patients when compared to the thiopental and etomidate group patients. Both heart rate and mean arterial pressure after tracheal intubation were significantly elevated in etomidate group patinets when compared to their preintubation value. Conclusions: The use of thiopental 5 mg/kg, propofol 2.5 mg/kg, and etomidate 0.4 mg/kg did not differ in effect under intubating conditions for tracheal intubation using remifentanil in the absence of muscle relaxants. Thiopental provided the best hemodynamic conditions. (Korean J Anesthesiol 2007; 53: 61~6)
Desflurane 흡입 마취 유도 시 기도 과민성에 대한 Lidocaine과 Fentanyl의 효과
최인규 ( In Gyu Choi ),최영순 ( Young Soon Choi ),민진혜 ( Jin Hye Min ),김용호 ( Yong Ho Kim ),채영근 ( Young Keun Chae ),이우경 ( Woo Kyung Lee ),이용경 ( Yong Kyung Lee ),이애리나 ( Ae Re Na Lee ),조형래 ( Hyong Rae Cho ),채홍석 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.6
Background: Inhalation induction with desflurane can cause airway irritability and sympathetic stimulation. The aim of this study was to investigate whether lidocaine and fentanyl could reduce these unwanted reactions. Methods: Seventy-five patients who had premedication with midazolam were randomly allocated to one of three groups to receive intravenous saline (S group), lidocaine 1.5 mg/kg (L group), fentanyl 1 μg/kg (F group), respectively, before tidal volume induction with desflurane in oxygen and nitrous oxide. We recorded airway irritability such as cough, apnea, laryngospasm and excitatory movement and hemodynamic changes. Results: Airway irritability was not significantly different between the groups. In F group, mean blood pressure at LOC ver and LOC BIS and heart rate at LOC ver, LOC BIS and just before intubation were lower than those of S group (P<0.05). Other results were not significantly different. Conclusions: The results of the study showed that intravenous fentanyl and lidocaine had no beneficial effects to reduce airway irritability, but intravenous fentanyl could significantly reduce hemodynamic stimulation during inhalation induction with desflurane in the patients who were premedicated with midazolam. (Korean J Anesthesiol 2009; 57: 693∼7)
주정흔 ( Jung Hun Ju ),이용경 ( Yong Kyoung Lee ),손경희 ( Kyung Hee Son ),이정표 ( Jeong Pyo Lee ),김진호 ( Jin Ho Kim ),임채형 ( Chae Hyung Lim ),홍순근 ( Soon Keun Hong ),권태린 ( Tae Rin Kwon ),장미 ( Mi Chang ),김동섭 ( Dong 한국동물실험대체법학회 2010 동물실험대체법학회지 Vol.4 No.1
Phototoxicity is an acute toxic response induced by skin irradiation after the systemic or local administration of a chemical and subsequent exposure to light. Thus, it is necessary to evaluate phototoxicity of chemicals or products that are applied to the skin. Although the previous studies on the assessment of phototoxicity have been done using animals, it is necessary to establish alternative test methods, as EU ban animal-tested cosmetic ingredients or products. In vitro 3T3 NRU PT is an alternative method for identification of phototoxicity hazard chemicals as it compares cytotoxicity between UV irradiation and non-irradiation groups. Accordingly the accumulated information of phototoxicity assessment and its data has been found to be insufficient in Korea. Thus, we tested ten phototoxic and three non-phototoxic chemicals, and assessed two UV filter ingredients using in vitro 3T3 NRU PT mehtod. As a result, we identified that this method can be used to predict phototoxicity of chemicals. However, Eusolex 9020, UVA filter ingredient, was misclassified in vitro as a false positive compared with in vivo result. It suggests that other adequate test methods should be accompanied in order to enhance accuracy of phototoxicity prediction.
연구논문 : 3T3 세포를 이용한 광독성 대체시험법 확립
주정흔 ( Jung Hun Ju ),이용경 ( Yong Kyoung Lee ),손경희 ( Kyung Hee Son ),이정표 ( Jeong Pyo Lee ),김진호 ( Jin Ho Kim ),임채형 ( Chae Hyung Lim ),홍순근 ( Soon Keun Hong ),권태린 ( Tae Rin Kwon ),장미 ( Mi Chang ),김동섭 ( Dong 한국동물실험대체법학회 2010 동물실험대체법학회지 Vol.4 No.1
Phototoxicity is an acute toxic response induced by skin irradiation after the systemic or local administration of a chemical and subsequent exposure to light. Thus, it is necessary to evaluate phototoxicity of chemicals or products that are applied to the skin. Although the previous studies on the assessment of phototoxicity have been done using animals, it is necessary to establish alternative test methods, as EU ban animal-tested cosmetic ingredients or products. In vitro 3T3 NRU PT is an alternative method for identification of phototoxicity hazard chemicals as it compares cytotoxicity between UV irradiation and non-irradiation groups. Accordingly the accumulated information of phototoxicity assessment and its data has been found to be insufficient in Korea. Thus, we tested ten phototoxic and three non-phototoxic chemicals, and assessed two UV filter ingredients using in vitro 3T3 NRU PT mehtod. As a result, we identified that this method can be used to predict phototoxicity of chemicals. However, Eusolex 9020, UVA filter ingredient, was misclassified in vitro as a false positive compared with in vivo result. It suggests that other adequate test methods should be accompanied in order to enhance accuracy of phototoxicity prediction.
손수정 ( Soo Jung Sohn ),차혜진 ( Hye Jin Cha ),이용경 ( Yong Kyung Lee ),염영나 ( Young Na Yum ),한순영 ( Soon Young Han ) 한국동물실험대체법학회 2010 동물실험대체법학회지 Vol.4 No.2
Korean Center for the Validation of Alternative Methods (KoCVAM) was founded in 2009 as part of the Division of Toxicological Screening and Testing, Department of Toxicology Evaluation and Research at the National Institute of Food and Drug Safety Evaluation, affiliated with the Korea Food and Drug Administration. According to the Article five of the Korea Laboratory Animal Act, establishment of policies and their execution on the development and approval of alternative test methods are specified as duty of the commissioner of KFDA. KoCVAM was founded based on this law. The mission of KoCVAM are 1) promoting the 3Rs in regulatory science for the safety assessment, 2) evaluating the usefulness and limitations of alternative test methods, and 3) promoting cooperation both nationally and internationally to achieve international harmonization. In this paper we introduce KoCVAM`s organization and describe KoCVAM`s international activities.
연구논문 : 한국 동물대체시험법검증센터의 설립 및 국제협력
손수정 ( Soo Jung Sohn ),차혜진 ( Hye Jin Cha ),이용경 ( Yong Kyung Lee ),염영나 ( Young Na Yum ),한순영 ( Soon Young Han ) 한국동물실험대체법학회 2010 동물실험대체법학회지 Vol.4 No.2
Korean Center for the Validation of Alternative Methods (KoCVAM) was founded in 2009 as part of the Division of Toxicological Screening and Testing, Department of Toxicology Evaluation and Research at the National Institute of Food and Drug Safety Evaluation, affiliated with the Korea Food and Drug Administration. According to the Article five of the Korea Laboratory Animal Act, establishment of policies and their execution on the development and approval of alternative test methods are specified as duty of the commissioner of KFDA. KoCVAM was founded based on this law. The mission of KoCVAM are 1) promoting the 3Rs in regulatory science for the safety assessment, 2) evaluating the usefulness and limitations of alternative test methods, and 3) promoting cooperation both nationally and internationally to achieve international harmonization. In this paper we introduce KoCVAM`s organization and describe KoCVAM`s international activities.
증례보고 : 자발성 두개내 저압 환자에서 전산화 단층촬영 유도하에 시행된 경추 경막외 혈액봉합술에 의한 치료
민진혜 ( Jin Hye Min ),최영순 ( Young Soon Choi ),김용호 ( Yong Ho Kim ),이우경 ( Woo Kyung Lee ),이용경 ( Yong Kyung Lee ),채홍석 ( Hong Seok Chai ),채영근 ( Young Keun Chae ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.1
Spontaneous intracranial hypotension due to spinal cerebrospinal fluid leakage is uncommon, relatively benign and usually self-limiting. However it is being increasingly recognized as a cause of postural headaches. The treatment options range from conservative supportive measures to an pidural blood patch. We report a 40-year-old woman who developed intracranial hypotention without any preceding events such as lumbar puncture, back trauma, surgical procedures or medical illnesses. The site of the cerebrospinal fluid leakage was identified at between the C1 to C2 level using computerized tomographic myelography. Consequently, the patient underwent a CT-guided autologous epidural blood patch at the C3-C4 level. Her symptoms were relieved immediately without recurrence. (Korean J Anesthesiol 2007; 52: 115~8)