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국소마취 하 이비인후과 수술 시 자가진정조절에서 Alfentanil과 Remifentanil의 비교
최주연,최홍석,강효석,강훈 대한마취통증의학회 2009 Korean Journal of Anesthesiology Vol.56 No.5
Background: This study was conducted to compare the effects of alfentanil and remifentanil on patient controlled sedation (PCS). Methods: 60 patients scheduled for ear, nose and throat surgery under local anesthesia were randomly allocated to Group P (n = 20, propofol 10 mg/ml), Group A (n = 20, propofol 10 mg/ml with alfentanil 500μg/ml) and Group R (n = 20, propofol 10 mg/ml with remifentanil 10μg/ml). Without a basal rate, bolus was set to 2 ml with one minute of lockout time. Results: A total of 57 patients were included in this study. Group A was found to have a lower blood pressure and pulse rate than group R. Group R showed a lower PCS dose upto an OAA/S (Observer’s Assessment of Alertness/Sedation Scale) value of 4 and a higher OAA/S prior to surgery than group P. Group P was found to have a higher blood pressure and respiration rate than Group A. During PCS, patient anxiety was significantly decreased in all groups. In addition, there was no differences among groups in the level of pain during the perioperative period, delivery/attempt ratio, satisfaction of the patient and surgeon, and number of patients required to undergo the same PCS technique again. The frequency of side effects of PCS, which included pain on injection, transient hypertension, hypotension, desaturation and oversedation, were similar among groups. Conclusions: Evaluation of patients who underwent ear, nose and throat surgery under local anesthesia using PCS with propofol alone or alfentanil or remifentanil revealed no differences in safety, effectiveness, complications or satisfaction of the patients and surgeons. Background: This study was conducted to compare the effects of alfentanil and remifentanil on patient controlled sedation (PCS). Methods: 60 patients scheduled for ear, nose and throat surgery under local anesthesia were randomly allocated to Group P (n = 20, propofol 10 mg/ml), Group A (n = 20, propofol 10 mg/ml with alfentanil 500μg/ml) and Group R (n = 20, propofol 10 mg/ml with remifentanil 10μg/ml). Without a basal rate, bolus was set to 2 ml with one minute of lockout time. Results: A total of 57 patients were included in this study. Group A was found to have a lower blood pressure and pulse rate than group R. Group R showed a lower PCS dose upto an OAA/S (Observer’s Assessment of Alertness/Sedation Scale) value of 4 and a higher OAA/S prior to surgery than group P. Group P was found to have a higher blood pressure and respiration rate than Group A. During PCS, patient anxiety was significantly decreased in all groups. In addition, there was no differences among groups in the level of pain during the perioperative period, delivery/attempt ratio, satisfaction of the patient and surgeon, and number of patients required to undergo the same PCS technique again. The frequency of side effects of PCS, which included pain on injection, transient hypertension, hypotension, desaturation and oversedation, were similar among groups. Conclusions: Evaluation of patients who underwent ear, nose and throat surgery under local anesthesia using PCS with propofol alone or alfentanil or remifentanil revealed no differences in safety, effectiveness, complications or satisfaction of the patients and surgeons.
唐代 瑞獸葡萄紋鏡의 제작시기와 韓・日로의 전래양상 검토-당대 기년명 묘 출토 서수포도문경을 중심으로-
최주연 한국고대사탐구학회 2024 한국고대사탐구 Vol.48 No.-
서수포도문경은 중국 고대 상서로운 동물 서수와 새롭게 유입된 포도가 문양으로 구성된 것이 특징이며, 당경 중에서도 가장 화려하고, 유행했던 동경이다. 본고는 당대 제작된 서수포도문경 중 기년명 당묘에서 출토된 사례를 통한 제작시기와 한・일로의 전래양상을 검토한 연구이다. 당대 서수포도문경은 전형적 동경 형태를 따르고 있지만, 내, 외구를 표현한 문양은 이전과 다른 양상을 보이는데, 화려한 문양을 고부조로 뒷면 가득 빈틈없이 채운 것이 특징이다. 이러한 서수포도문경은 서수와 포도문의 위치, 뉴의 형태, 기타 문양 배치 등의 요소들을 바탕으로 Ⅰ, Ⅱ유형으로 분류했다. Ⅰ유형은 내・외구에 서수가 표현되어 있고, 중앙에 원형 뉴가 있다. Ⅱ유형은 문양구성이 복잡해지는 공통점을 갖고 있고, 뉴가 서수형으로 변화한다. 2가지 유형을 바탕으로 분석한 서수포도문경은 기년명 당묘 출토품을 중심으로 그 제작시기를 살펴보았다. 3기로 구분되는 시기는 발전기, 전성기, 쇠락기로 나눴고, 당묘 출토 서수포도문경은 대다수가 Ⅱ기에 제작되었다. 당대 성행한 서수포도문경은 주변 인접국가인 한국과 일본에도 전래되었다. 두 국가는 당에서 서수포도문경을 받아들였지만, 그 양상은 달랐다. 한국은 마로산성 출토 서수포도문경을 제외하면 주조상태가 좋지 않은 예들이 남아 있어 중국에서 답반주조된 동경류가 유입되었거나, 국내에서 주조하였을 가능성이 있다. 반면, 일본은 대표적 예로 정창원에 서수포도문경 4점이 소장되어 있는데, 주조상태가 양호하며, 정교하고 세밀한 문양표현이 이루어져 있다. 당시 흔하지 않은 양질의 동경은 일본에서 당으로 파견한 견당사에 의해 일본으로 전해진 것으로 판단되며, 그 시기는 문화적 요소를 받아들이는 것에 치중했던 8세기 전반으로 보았다. 따라서 당대 서수포도문경은 제작이 성행했던 8세기에 주변 국가로 전파되었던 당의 대표적 동경 중 하나로 꼽을 수 있다. Auspicious Animals (mirror with images of auspicious animals and grapes) is characterized by the patterns of ancient Chinese auspicious animal character and newly introduced grapes, and it is the most colorful and popular bronze mirror among the Tang’s bronze mirror. The study on the production period and the transmission of Korea-Japan through cases excavated from articles with Chronograms from the Tang tombs among the pattern of Auspicious Animals Grapes produced at the time. The Auspicious Animals and Grapes Bronze Mirror of the time follows a typical bronze mirror form, but the pattern expressing the inner and outer parts shows a different pattern than before, and is characterized by filling the back of a high relief structure with ornate patterns. These Auspicious Animals and Grapes Bronze Mirror views were classified into types I and II based on elements such as the position of the auspicious animals and grape patterns, the shape of New, and other pattern arrangements. Type I features auspicious animals expressed in the inner and outer parts, and there is a circular New. Type II has a common point where the pattern composition becomes complicated, and the New changes to the auspicious animals. The Auspicious Animals and Grapes Bronze Mirror, which was analyzed based on the two types, reviewed the production period of the excavated articles with Chronograms from the Tang tombs. The period divided into the third period was divided into the period of development, the period of prime time, and the period of decline, and most of the The Auspicious Animals and Grapes Bronze Mirror excavated from the Tang Dynasty was produced during the period II. The Auspicious Animals and Grapes Bronze Mirror, which was popular at the time, was also introduced to neighboring countries such as Korea and Japan. The two countries accepted the Auspicious Animals and Grapes Bronze Mirror from a country called Tang, but the aspect was different. Except for the The Auspicious Animals and Grapes Bronze Mirror excavated from Maro mountain fortress(馬老山城), Korea is presumed to have introduced the eastward trend that was cast from China as there remain examples of poor casting. On the other hand, in Japan, four Auspicious Animals and Grapes Bronze Mirror are held in Shosoin(正倉院), and they are in good casting condition and have elaborate and detailed pattern expressions. This particular example is believed to have been handed down to by Japanese missions to Tang China dispatched to Tang from Japan at the time, and the period was considered to be the first half of the 8th century, when it was focused on accepting cultural elements. Therefore, it can be seen that The Auspicious Animals and Grapes Bronze Mirror of the Tang Dynasty was one of the representative admiration that spread to surrounding countries in the 8th century, when production was popular.
최주연 한국문화사학회 2020 文化史學 Vol.0 No.53
선각불상문경은 거울 표면에 선각으로 부처ㆍ보살, 신장 등 불교의 다양한 도상을 새긴 것으로 중국 선각불상문경이 고려로 전래된 이후 성행했다. 선각불상문경 제작이 활발해진 것은 당시 고려 불교신앙의 변화와 사회적 문제 등이 결부되면서 비롯된 것으로 보았다. 또한 고려시대 선각불상문경 제작발전에는 중국 선각불상문경의 영향을 간과하기 어렵다. 이에 본고에서는 중국의 오월국, 송, 요대 제작된 주요 선각불상문경의 발전양상을 정리해봄으로써 그 특징을 살펴보고자 했다. 고려시대 선각불상문경은 총 28점으로 대부분 앞, 뒷면에 불교 관련 도상을 새겼다. 도상은 크게 아미타, 관음, 신장으로 나눌 수 있으며, 기타 보탑, 공작명왕 등이 표현되어 있다. 이중 새롭게 발견된 선각불상문경과 신장에서 보이는 새로운 요소 중심으로 여래, 보살, 신장의 도상들을 해석하고자 했다. Ⅳ장 고려시대 선각불상문경의 제작요인에 대해 중국 선각불상문경의 유입과 영향, 사회적ㆍ종교적 요인으로 나누어 살펴보았다. 먼저, 중국 선각불상문경 중 요대 방산 운거사 석경탑 사리함 발견 선각불상문경은 그 형태와 표현이 고려 선각불상문경과 유사해 이를 검토해봄으로써 고려시대 선각불상문경의 유입시기를 제시했다. 사회적ㆍ종교적 요인으로 당시 발생한 전염병, 가뭄, 전쟁 등 큰 사건들을 중점으로 보았으며, 이를 해결하기 위한 당시 성행한 불교 신앙인 정토신앙과 다라니신앙을 중심으로 고찰했다. 사회적으로 재난을 극복하기 위한 왕실의 노력은 기복적이고 기양적 성격의 불교를 바탕으로 여러 도량을 설치하였으며, 이때 시행한 의식에서 선각불상문경이 사용되었을 가능성을 생각해보았다. 그리고 종교적 요인에 대해서 당시 성행한 정토신앙, 다라니신앙이 선각불상문경에 새겨진 도상과 긴밀한 관계가 있다고 생각했으며, 이에 대해 문헌기록을 토대로 각 신앙에 따른 요인을 정리했다. Buddhist line-engraved mirror refers to mirrors engraved with various icons of Buddhism, such as Buddha, Bodhisattva, and Guardian on the surface, and began to be produced as Chinese line-engraved mirror was passed down to Goryeo. It prevailed between the end of 12th century~ 13th century, presumably due to the combination of changes in Buddhist faith in Goryeo and social issues. This study aimed to examine the aspect of introduction of Goryeo line-engraved mirror by studying the development and effects of Chinese line-engraved mirror. Chinese line-engraved mirror was produced mainly around Wuyue, Song Dynasty, and Liao Dynasty, and was mostly excavated from graves or pagoda. The study attempted to summarize the developmental aspects of Chinese line-engraved mirror by examining the classic line-engraved mirror of each country. There are total 28 line-engraved mirror from Goryeo Dynasty, which mostly engraved icons related to Buddhism on the front and back. Icons can be divided into Amitabha, Avalokitesvara, and Guardian, along with expressions of Pagoda, Mahamayuri, etc. Interpretations of icons such as Buddha, Bodhisattva, and divinity were attempted based on new elements observed in newly discovered line-engraved mirror and divinity. Chapter IV examined the factors of production of line-engraved mirror in Goryeo Dynasty in terms of the introduction and effects of Chinese line-engraved mirror, social factors, and religious factors. First, the line-engraved mirror discovered in the reliquary of pagoda in Yunju Temple in Fangshan District of Liao, is similar to Goryeo’s line-engraved mirror in terms of form and expression that it was examined to determine the time of introduction of line-engraved mirror in Goryeo Dynasty. In terms of social and religious factors, major events such as infectious disease, famine, and wars that took place at the time, and the Buddhism faiths, the pure land faith and Dharani faith, which prevailed at the time in an attempt to solve such events, were examined. The royal family’s effort to overcome social disaster displayed different generosities based on fortune belief and supplicatory nature of Buddhism, and the possibility of using line-engraved mirror in rituals performed at this time was examined. In terms of religious factor, the pure land faith and Dharani faith that prevailed at the time were thought to be closely related to the icons engraved on line-engraved mirror, and accordingly, factors relevant to each faith were summarized based on literature.
Nanoparticle-based combination drug delivery systems for synergistic cancer treatment
최주연,Raj Kumar Thapa,용철순,김종오 한국약제학회 2016 Journal of Pharmaceutical Investigation Vol.46 No.4
Despite being a leading cause of death worldwide, cancer remains difficult to treat due to the development of drug resistance and severe adverse effects associated with conventional chemotherapy. Hence, combination chemotherapy is theoretically advantageous owing to the synergistic effects of drugs and suppression of drug resistance. Nanoparticle-mediated chemotherapeutic delivery is a promising approach for the effective treatment of various cancers because it may simultaneously enhance therapeutic effects and reduce side effects. The loading of multiple chemotherapeutic agents to these systems could additionally improve the antineoplastic efficacy. This review highlights recent advances in combination chemotherapy using small-molecule chemotherapeutic agents via nanocarrier systems, e.g., liposomes, polymeric micelles, dendrimers, polymer-drug conjugates, and mesoporous silica nanoparticles. Specifically, it emphasizes the unique properties of these systems that make them amenable to optimized treatments with respect to efficacy and safety and clarifies areas in which current therapeutic strategies can be improved.