한번의 간질발작 후 혈청 Neuron-Specific Enolase 농도 변화

최승호,박영춘,이장준,임정근,김지언,이상도 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.4

An increase in neuron-specific enolase (NSE) levels in serum and CSF has been shown to be an useful marker of brain damage after stroke, global ischemia, and coma. We report the changes of serum NSE levels after seizure attacks in epileptic patients compared with the levels in normal controls and epileptic patients without seizure attack at least 7 days (epileptic controls). Twenty-four seizures were included in this study. Blood was drawn within 1 hour, at 12 hour, 24 hour, and 48 hour after seizure attack. Serum NSE levels were measured with radioimmunoassay. The mean NSE levels for normal controls and epileptic controls were 6.94 ng/ml and 7.46 ng/ml, respectively. There were significant increase in level of serum NSE measured within 1 hour after seizure attack in epileptics compared with the level in normal controls (15.10ng/ml versus 6.94ng/ml, p<0.05) and epileptic controls (15.10ng/ml versus 7.46ng/ml, p<0.05). Serum NSE measured at 12 hours after seizure also increased compared with normal controls (12.32ng/ml versus 6.94ng/ml, p<0.05) and epileptic controls (12.43ng/ml versus 7.46ng/ml, p<0.05). Between normal controls and epileptic controls, there were no significant difference in serum NSE levels. We conclude that serum NSE level was elevated in epileptic patients who had seizure attack within 12 hours. Serum NSE levels can be useful marker for seizure within 12 hours after onser. The elevated serum NSE level after single seizure attack may suggest that the brain was injured in single seizure.

Chitosan을 이용한 Levan Fructotransferase의 고정화

임승,이기영,최춘순 전남대학교 촉매연구소 2001 觸媒硏究 論文集 Vol.22 No.-

The condition for the immobilization of the partially purified levan fructotransferase and the properties of the immobilized enzyme was investigated. Levan fructotransferase was immobilized on chitosan with glutaraldehyde, crosslinking agent. The optimum activity of immobilized enzyme was obtained at 0.125%(v/v) glutaraldehyde concentration. The immobilized enzymes had 40% higher relative activity than free enzyme. The optimal temperature and pH were 55℃ and 6.0 or 5.5 for the immobilized and free enzyme. The conversion ratio of free enzyme and immobilized enzyme was 45% and 36% respectively at 24hr.

복어중독에 의한 가사 상태에서 소생한 1예

송승찬,신진호,강석우,박경남,최호순,박근태,문희식,기춘석,이성희,윤병철,노우균,조균석,이민호 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.3

Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cation. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it deminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.

완전뇌허혈후 재관류시에 국소뇌혈류, 체성감각유발전위 및 신경학적 회복에 대한 Mannitol과 Thiopental의 효과

박춘근,이상원,박영섭,최승진,허필우,정동섭,강준기,최창락 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

The cardiopulmonary bypass or cerebral circulation arrest is often used in the treatment of complex aneurysm or of arteriovenous malformation to decrease the risk of intraoperative aneurysm rupture. Although experimental studies have suggested that some drugs may protect the brain from ischemic injury, there are limitations in maintaining cerebral perfusion arrest without incurring neurologic deficits due to the initiation of detrimental processes including excitotoxic neuronal injury, activation of phospholipases, influx of calcium, and generation of damaging free radicals. The purpose of this study is to determine wheter mannitol or thiopental has any favorable effects on the recovery of neurologic deficits and on the regional cerebral blood flow(rCBF), somatosensory evoked potential(SEP) and electroencephalogram(EEG) in cats which underwent 15 minutes-complete global ishcemia-reperfusion. The complete global ischemia was produced in 38 cats by temporary intrathoracic occlusion of the innominate artery and the subclavian artery following ligation of bilateral mammary arteries and simultaneous induction of hypotension. The cats were allocated randomly to one of 4 treatment groups : (1) control group, 8 cats received equal volume of saline solution : (2) thiopental group, 10 cats received 45㎎/㎏ thiopental intravenously, (3) mannitol group, 10 cats received 2g/㎏ mannitol intravenously, (4) combined mannitol and thiopental group, 10 cats received equal dose of mannitol and thiopental intravenously. The drugs were administrated in a equally divided dosage before and after the ischemic episode. The results were as follos : 1) Eight animals which received saline showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia. 2) Ten thiopental-treated animals also showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours the ischemia. 3) Both mannitol-and combined treated groups showed early recovery of EEG, good recovery of SEP and EEG without the severe postischemic hypoperfusion, and 7 of 10 mannitol-treated animals and 8 of 10 combined treated animals were significantly recovered in all parameters. There were not significant differences in all parameters between the mannitol-and combined treated groups. 4) Thirty-four of 38 animals involved in this 15 minutes-ischemia resulted in the severe neurologic deficits inspite of treatment with mannitol, thiopental or both of them. These results suggest that, in cats, mannitol treatment is effective but not thiopental in preventing severe neurologic injury following complete global ischemia and the duration of complete ischemia should be far less than 15 minutes.

무증상의 후두개곡 낭종 환자에서 예기치 못한 어려운 기관내 삽관 1례

이상모,최준석,이철승,김원태,박천희 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

Although vallecular cyst is often asymptomatic and harmless to the patient, discovery of large vallecular cyst after induction of anesthesia is a potentially life-threatening problem for thepatient and provides for the anesthesiologist a challenge in airway management. We describe a case of difficult intubation where the laryngeal inlet was obscured by a large vallecular cyst that was discovered during induction of general anesthesia. A 47-year-old man presented for elective laparoscopic colecystectomy due to GB polyp. He had normal mouth opening and neck extension; no mass or distortions of the tongue or neck were observed. Anesthesia and paralysis were induced with 80 ㎎ propofol, alfentanil 0.5 ㎎, midazolam 2.0 ㎎ and rocuromum 50 ㎎. It was noted that ventilation of the lungs via mask was difficult. Despite insertion of an oropharyngeal airway, ventilation proved to be more difficult. Intubation was attempted. Direct laryngoscopy (Macintosh 3 blade) revealed a 3-4 ㎝ tranlucent cyst arising from the left vallecula. The cyst completely obscured the view of epiglottis and vocal cords, preventing intubation despite multiple attempts by three anesthesiologists. StafF anesthesiologist was aspirated cyst using a 16-guage needle, syringe and 20 ㎖ of serous fluid were aspirated from cyst. The epiglottis and vocal cord were then exposed and tracheal intubation was performed easily with a size 7.0 cuffed oral tracheal tube. Anesthesia and the operation then proceeded uneventfully, following laparoscopic colecystectomy, an ENT surgeon removed the cyst.

편도선 절제술 중 Epinephrine 국소침윤에 의한 심정지와 급성 폐부종 1예

안익순,최준석,박천희,이철승,김원태,임경준 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Hemostasis and a clear surgical field are obtained by the local infiltration of a local anesthetic mixed with epinephrine during tonsillectomy. However, epinephrine may in itself, due to its cardiovascular effect, cause arrhythmia, heart failure, Pulmonary edema, and even cardiac arrest. We describe a 22-year-old patient who developed cardiac arrest due to epinephrine infiltration during tonsillectomy. The patient was resuscitated and recovered without any sequele after intensive treatment.

척추병변에 대한 티타늄 기구 고정술 후 핵자기 공명 영상의 진단적 효용성

이관성,박춘근,최승진,이상원,박성찬,지철,조경석,강준기,박영하 대한신경외과학회 1997 Journal of Korean neurosurgical society Vol.26 No.1

N-아세틸시스테인 투여후 발생한 급성 무기폐 : 증례보고

이광범,안용미,이철승,최준석,박천희 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.34 No.1

Causes of atelectasis under general anesthesia are tracheal foreign body, blood clot, aspiration of bronchial secretion, one-lung ventilation and relative predominance of parasympathetic system. N-acetylcysteine is mucolytic agent which improves the capability of sputum drainage. After administration of N-acetylcysteine, an increased volume of liquified bronchial secretions may occur. When cough is inadequate, the airway must be maintained open by mechanical suction. In case that is a mechanical block due to local accumulation, the airway should be cleared by endotracheal aspiration. A 49-year-old female was admitted for bilateral laparoscopic oophorectomy due to ovarian tumors. There was not any problem during a general anesthesia induction. After instillation of N-acetylcysteine into endotracheal tube, acute atelectasis was developed in right lower lung.

Effects of Mannitol and Thiopental on rCBF, SSEP and Neurologic Outcome During Reperfusion Following Complete Global Cerebral Ischemia

Choi, Seung-Jin,Park, Choon-Keun,Kang, Joon-Ki,Lee, Sang-Won,Choi, Chang-Rak CATHOLIC MEDICAL CENTER 1995 Bulletin of the Clinical Research Institute Vol.23 No.1

The purpose of this study is to determine the effect of mannitol and thiopental on the recovery of neurologic deficits and on the regional cerebral blood flow(rCBF), somatosensory evoked potential(SEP) and electroencephalogram(EEG) in cats which underwent 15 minutes-complete global ischemia-reperfusion. The complete global ischemia was produced in 38 cats by induced hypotension and temporary intrathoracic occlusion of the innominate artery and the subclavian artery. After reperfusion, the cats were observed for 6 hours. The drugs, manritol 2g/kg or thiopental 45mg/kg or both, were administrated in a equally divided dosage before and after the ischemic episode. Eight animals which received saline showed the severe postisehemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia. Ten thiopental-treated animals also showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia. Both mannitol-and combined treated groups showed early recovery of EEG, good recovery of SEP and EEG without the severe postischemic hypoperfusion, and 7 of 10 mannitol-treated animals and 8 of 10 combined treated animals were significantly recovered in all parameters. There were not significant differences in all parameters between the mannitol- and combined treated groups. Thirty-four of 38 animals involved in this 15 minutes-ischemia resulted in the severe neurologic deficits inspite of treatment with mannitol, thiopental or both of them. These results suggest that, in cats, mannitol treatment is effective but not thiopental in preventing severe neurologic injury following complete global ischemia and the duration of complete ischemia should be far less than 15 minutes.

소아 갑상선종괴에 관한 임상적 고찰

양승춘(Seung Choon Yang),최승훈(Seung Hoon Choi),황의호(Eui Ho Hwang) 대한외과학회 1986 Annals of Surgical Treatment and Research Vol.31 No.3