전신마취 후 발생한 악성고열증 환자의 치료 경험

이근무,정승환,이정한,정순호,최영균,김영재,신치만,박주열,이영민 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Malignant hyperthermia is the disorder of calcium regulation within skeletal muscle associated predominantly with anesthesia. It is triggered by volatile anesthetics and depolarizing neuromuscular blocking agents. We experienced a case of malignant hyperthermia. 50 years old female patient was transferred to our emergency room that she was developed tachyarrhythmia and high fever. She was taken arthroscopic examination under the general anesthesia with enflurane and succinylcholine. We suspected malignant hyperthermia and promptly treated her with dantrolene sodium. She was developed disseminated intravascular coagulopathy and acute renal failure then we were intensive care to her. She was discharged without sequela. We experienced successful management of malignant hyperthermia.

복강경하 대장절제술을 시행 받는 환자에서 라모세트론과 온단세트론외 술 후 오심 및 구토 예방 효과 비교

김효중;어전영;어근무;어정한;엄세훈;조광래;김명훈 인제대학교 2011 仁濟醫學 Vol.32 No.-

Objectives : We evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) in laparoscopic colectomy. Methods and Materials : Eighty patients who received laparoscopic colectomy were randomly divided into two groups: R group (ramosetron 0.1mg PO) and O group (ondansetron 4mg twice IV). Injection or oral medication was administered before the induction of anesthesia in each group. Injection was administered at the end of surgery in O group. General anesthesia was induced using propofol and rocuronium, and maintained with sevoflurane, remifentanil and air (FiO2 0.5), We investigated the incidences of PONV in each group by the Rhodes index of nausea, vomiting and retching (RINVR) at postoperative 6 and 24 hours. Results : The incidence of PONV was not different between group at each time points after surgery (at postoperative 6 hours: 20% in group R, 17.5% in group 0, at postoperative 24 hours; 12.5% in group R, 7.5% in group 0). There was no difference in the severity of PONV, satisfaction, rescue drug usage. Conclusion : Prophylactic therapy with ramosetron is as effective as conventional prophylactic therapy with ondansetron for preventing PONV in general anesthesia for laparoscopic colectomy.

Rocuronium의 애별투여방법이 모지내전근의 이완에 미치는 영향

최영균,김승수,이원진,조광래,이상은,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 인제대학교 2009 仁濟醫學 Vol.30 No.-

Objective : There are controversies in pnmmg technique of rocuronium whether it can or can't shorten the onset time. We want to compare the effects of two different priming doses and intervals of rocuronium. Materials and Methods : After giving propofol, 50 patients were randomly assigned to 5 groups. Group I received a placebo, followed 3 min later by rocuronium 0.6 mg/kg. Priming doses and intervals of Group II, Ill, N, V were 0.06 rng/kg and 2 min, 0.12 mg/kg and 2 min, 0.06 rug/kg and 3 min, 0.12 mg/kg and 3 min, respectively. Total dose of rocuronium was 0.6mg/kg. Train of four (TOF) count or ratio and 1st twitch height of TOF (T1) were monitored with 15 secondsintervals. TOF ratio of each groups just before bolus injection, duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were compared. Results : Duration for TOF count to reach zero and duration for Tl to reach 95% depression after bolus injection were decreased in priming groups compared to Group 1 (P < 0.01) In group V, significant depression of TOF ratio just before bolus injection was seen (P < 0.05). Conclusion : Priming technique with rocuronium is effective method to shorten the onset of neuromuscular block. But priming dose of rocuronium itself could cause hypoxia and aspiration in awake patients and should be used carefully. Priming dose of rocuronium 0.06 mg/kg and 2 minutes interval maybe relatively safe method.

내분비기관으로서의 심방의 형태학적 특징에 관한 연구 - Ⅱ. 흰쥐의 심방 내강 및 내표면 구조

이무삼,두홍서,고병문,강경진,정우송,박병건,이창현 대한해부학회 1994 Anatomy & Cell Biology Vol.27 No.2

췌장암 환자에서 알코올 내장신경 신경파괴블럭 후 발생한 간염

이상은,최석환,김영환,임세훈,이정한,이근무,정순호,최영균,김영재,신치만 인제대학교 2008 仁濟醫學 Vol.29 No.-

Splanchnic neurolytic block(SNB) with alcohol improves the management of pancreatic cancer pain. Adverse effects of alcohol SNB which include regional pain, hypotension, diarrhea, and acute alcohol intoxication are common, but acute hepatitis caused by alcohol neurolytic block is rare. A 63-year-old patient with pancreatic head cancer and liver metastasis had complete pain relief after both retrocrural tansdiscal SNB with 100% alcohol 10 ml. But, 1 day later, liver function test showed a high elevation in the aspartate aminotransferase (AST, 2182 IU/L) and alanine aminotransferase (ALT, 1807 IU/L). The patient had slight jaundice, general weakness, chilling, nausea and vomiting after SNB. Both AST and ALT decreased to 46 and 119 IU/L within 10 days with only supportive therapy. But, 19 days later, the patient died due to pneumonia. Our case illustrates the importance of clinical surveillance especially in patient with hepatic disease after alcohol SNB.

알코올 금단 발작 환자에서 진전 섬망 예방에 대한 Nimodipine과 Chlordiazepoxide의 효과 비교

정두신,양광익,이보람,방차옥,이태경,성기범,안무영,박형국 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background & objectives : An increase of calcium influx during alcohol withdrawal state may contribute to neuronal hyperexitability, which cause delirium tremens(DT). Some investigators have found calcium channel blockers effects in prevention of DT in experimental animals. Therefore we evaluated the preventive effects of calcium channel blocker(nimodipine) and benzodiazepine(chlordiazepoxide) on the development of DT in alcohol withdrawal seizure(AWS) patients. Method : A total 59 patients with AWS were divided into three groups according to the management nimodipine-treated, chlordiazepoxide-treated, and control(no specific medication) groups. We compared the incidence rates of DT in the three groups. Results : Total incidence rate of DT was 30.5%(18 of 59 patients). There were 6 DTs of 18 patients(33.5%) in nimodipine-treated group, 4 of 21 patients(22.5%) in chlordiazpoxide-treated group, and 8 of 20 patients(44.0%) in control. Conclusion : The control group(44.0%) showed the highest incidence rate of DT. And nimodipine-treated(33.5%) and chlordiazepoxide-treated group(22.5%) were followed. However, this result failed to demonstrated statistically significant differences due to small numbers size.

대장암종에서 암관련 유전자들의 Promoter Methylation과 암종 발생 및 진행과의 관게에 대한 연구

정동준,이정은,민영기,조성우,백무준,양승하,김의한,김창진 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

The colorectal corcinoma is one of the most common malignant tumor in Korea and its carcinogenic mechanism has not been elucidated exactly yet. So far, the most common carcinogenic mechanism has been known to be multiple genetic changes. But, the CpG island hypermethylation has been revealed to be one of the most important carcinogenic mechanism second to the genetic changes. The epigenetic changes characteristically imprint and transfer to the next generation without changes of nucleotide sequences. When the CpG island of promoter or 5'- exon 1 of a specific gene is methylated by DNA methyltrasferases (DNMTs), the gene expression is inhibited. Carcinogenic mechansisms by promoter methylation has been well known, but the progression of the cancer has not been elucidated yet. The molecular researches on the carcinogenic mechanisms largely depended on the tumor tissue containing various components of cell, due to difficulties in harvesting pure homogeneous tumor cells. Promoter methylatonof the cancer related genes as APc, hMLH2, p16, DAP-K and MGMT in 50 cases of sporadic colorectal carcinoma was studied. The pure normal colorectal epithelial cells, and cancer cells from superficial and deep invasive portion were harvested respectively by laser captured microdissection(LCM), and DNA was extracted from them. The promoter methylation was studied by methylation specific poymerase reaction (MSP) after bisulfite modification of the DNA and the expression of the genes by immunohistochemistry. The results suggests that promoter methylation of the cancer related genes are closely related with the colorectal carcinogenesis and it occurrs from early phase of carcinogenesis, progressing constantly to the late stage. And the promoter methylation of normal epithelial cells increased by age. The p15, known to be the genes related to hematologic malignancy, was closely related to the colorectal carcinoma as well.

고선량 방사선 조사후 치아수복재의 특성변화

이용근,이건일,이성재,박수아,허정무 원광대학교 생체재료·매식연구소 1996 원광생체재료·매식 Vol.5 No.2

To investigate the effect of high dose irradiation on the Vickers hardness number(VHN), color change and wear rate of dental filling materials, esthetic filling material specimens were studied. Six kinds of composite resins and two kinds of glass ionomers(GI) were used. One(CLF) was chemically cured composite resin, and five(HCX, HPL, PHB, POF, PRT and RZI) were light cured composite resins. One(FJT) of GI was chemically cured GI and one(FLC) was light cured GI. The filling material specimens were made according to the manufacture's instructions and were finally polished with Microcloth(Buehler). Half of the specimens were irradiated with 100 Gy radiation using a linear accelerator(Mitsubishi, 6 MV). VHN and CIELAB color were measured before and after irradiation, and wear test were performed for nonirradiated specimens by brushing with toothpaste, From the experiment , the following results were obtained. 1. The CIELAB color difference was significantly different depending on the material(p<0.01), and FLC showed the highest color difference (CIELAB ΔE) of 9.452 and CLF showed the lowest value of 3.642. 2. The VHNs of nonirradiated specimens were 12.22∼73.58 and those of irradiated specimens were 25.53∼84.53. The VHNs of irradiated specimens were significantly higher than those of nonirradiated specimens(p<0.05) except RZI, FJT and FLC. 3. The wear rate of irradiated specimens of RZI, FLC were significantly lower than those of nonirradiated specimens(p<0.05). 4. The color difference after brushing of irradiated specimens were higher than those of nonirradiated specimens except CLF.

방사선 치료 중인 암환자의 정신병리, 자아존중감 및 삶의 질

정찬영,양종철,신일선,최영,윤진상,이무석,이형영,나병식 한국정신신체의학회 2002 정신신체의학 Vol.10 No.2

腎臟組織에서 백강잠 抽出物의 抗酸化 作用에 關한 硏究

李武炯,尹哲浩,鄭智天 동국대학교 한의학연구소 1998 東國韓醫學硏究所論文集 Vol.7 No.1

白彊蠶 추출물이 신장조직에서 반응성 산소기들에 의한 지질의 과산화와 세포 손상을 방지하는지를 관찰하기 위하여 정상조직과 t-BHP를 처리한 조직에서 白彊蠶 추출물의 효과를 조사하였다. 지질의 과산화와 LDH 유출은 t-BHP의 농도에 비례하여 증가되었으나, 白彊蠶 추출물의 첨가로 유의하게 억제되었다. 그리고, t-BHP에 의한 지질의 과산화 및 LDH 유출은 白彊蠶 추출물의 농도에 비례하여 억제되었다. 또한, 白彊蠶 추출물은 oxidant를 처리하지 않은 정상조직에서도 지질의 과산화 및 LDH 유출을 유의성 있게 감소시켰다. 그리고, catalase 활성에는 영향이 없는 반면, 정상 조직과 t-BHP를 처리한 조직에서는 glutathione peroxidase 활성을 유의성 있게 증가시켰다. 한편, 반응성 산소기의 발생은 白彊蠶 추출물의 농도에 비례하예 억제되었다. 이러한 결과로 볼 때, 白彊蠶 추출물은 신장 조직내 항산화 효소의 활성을 증가시킴과 동시에 직접 반응성 산소기의 발생을 억제하므로 신장 조직에서 지질의 과산화와 세표손상을 방지하는 효과가 있을 것으로 여겨진다. This study was undertaken to determine whether Bombycis Corpus extract (Bom) has antioxidant action. Kidney tissues were exposed to t-butylhydroperoxide (t-BHP) to induce oxidative stress. Lillid peroxidation was estimated by measurimg rnalondialdehyde, a product of lipid peroxidation, and cell injury was estimated by measuring lactate dehydrogenase (LDH) release in rabbit renal cortical slices, t-BHP increased lipid peroxidation and LDH release in a dose-dependent manner over the concentration range of 0.1-1 mM. Such effects of t-BHP on lipid peroxidase and LDH release were prevented by 0.5% Bom. When tissues were treated with t-BHP in the presence of various concentration of Bom, lipid peroxidation and LDH release were dose-dependently inhibited by Bom. Bom at 1 and 2% concentrations inhibited lipid peroxidation and LDH release in normal tissues. Bom at 2% concentration increased glutathione peroxidase activity in tissues treated or untreated with 1.0 mM t-BHP. However, catalase activity was not altered by addition of Bom. Bom inhibited generation of reactive oxygen species. These results indicate that Born inhibits lipid peroxidation and cell injury in tissues treated with or without oxidant and effect is, at Ieast in part, attributed to increased activity of glutathione peroxidase and a direct sacvenging action.