예방적으로 투여한 Dolasetron과 마취 유도제로 사용한 Propofol이 갑상선 절제술 후 오심과 구토에 미치는 영향

조한범 ( Han Bum Joe ),박은정 ( Eun Jung Park ),박선경 ( Sun Kyung Park ),김은진 ( Eun Jin Kim ),박재홍 ( Jae Hong Park ),최정웅 ( Jeong Woong Choi ),김진수 ( Jin Soo Kim ),이숙영 ( Sook Young Lee ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.3

Background: Postoperative nausea and vomiting (PONV) is a common problem in patients undergoing thyroidectomy. In this study we evaluated the effects of prophylactic dolasetron and/or induction with propofol on PONV. Methods: Two hundred three patients scheduled thyroidectomy under general anesthesia with sevoflurane were included and were randomly allocated to one of four groups. In control (group C) and dolasetron groups (group D), the patients received thiopental sodium 4-5 mg/kg intravenously for the induction of anesthesia, and the patients in group D received prophylactic intravenous dolasetron 210 μg/kg. In propofol (group P) and dolasetron+propofol groups (group D+P), the patients received propofol 2 mg/kg intravenously for the induction of anesthesia, and the patients in group D+P received prophylactic intravenous dolasetron 210 μg/kg. The incidence and severity of PONV, the need for rescue antiemetics, adverse events were assessed during 0 to 1 hour and 1 to 24 hours postoperatively. Results: During the first 24 hours after anesthesia, the incidences of PONV and postoperative vomiting were significantly reduced in group D+P compared with group C (P<0.05, respectively). There were no significant differences in postoperative nausea, need for rescue antiemetics, severity of PONV, and adverse events of antiemetics among the four groups. Conclusions: In patients with thyroidectomy, combination of prophylactic dolasetron administration and induction with propofol was found to reduce the incidence of PONV during the first 24 hours after anesthesia, compared with that of routine induction with thiopental sodium. (Korean J Anesthesiol 2009;57:320∼6)

Epigenetic insights into colorectal cancer: comprehensive genome-wide DNA methylation profiling of 294 patients in Korea

Soobok Joe,Jinyong Kim,Jinyoung Lee,Jongbum Jeon,Iksu Byeon,Sae-Won Han,Seung-Bum Ryoo,Kyu-Joo Park,Sang-Hyun Song,Sheehyun Cho,Hyeran Shim,Hoang Bao Khanh Chu,Jisun Kang,Hong Seok Lee,DongWoo Kim,You 생화학분자생물학회 2023 BMB Reports Vol.56 No.10

DNA methylation regulates gene expression and contributes totumorigenesis in the early stages of cancer. In colorectal cancer(CRC), CpG island methylator phenotype (CIMP) is recognizedas a distinct subset that is associated with specific molecularand clinical features. In this study, we investigated the genomewideDNA methylation patterns among patients with CRC. The methylation data of 1 unmatched normal, 142 adjacentnormal, and 294 tumor samples were analyzed. We identified40,003 differentially methylated positions with 6,933 (79.8%)hypermethylated and 16,145 (51.6%) hypomethylated probesin the genic region. Hypermethylated probes were predominantlyfound in promoter-like regions, CpG islands, and N shore sites;hypomethylated probes were enriched in open-sea regions. CRC tumors were categorized into three CIMP subgroups, with90 (30.6%) in the CIMP-high (CIMP-H), 115 (39.1%) in theCIMP-low (CIMP-L), and 89 (30.3%) in the non-CIMP group. The CIMP-H group was associated with microsatellite instabilityhightumors, hypermethylation of MLH1, older age, and rightsidedtumors. Our results showed that genome-wide methylationanalyses classified patients with CRC into three subgroupsaccording to CIMP levels, with clinical and molecular featuresconsistent with previous data.

양측 자궁동맥 색전술을 이용한 자궁근종의 치료

최정범 ( Jeong Bum Choi ),유지훈 ( Ji Hoon Yoo ),김신혜 ( Shin Hye Kim ),박승준 ( Seung Jun Park ),조환성 ( Hwan Sung Joe ),한효상 ( Hyo Sang Han ),황인철 ( In Cheol Hwang ),최규연 ( Kyu Yeon Choi ),양승부 ( Seung Boo Yang ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11

목적: 자궁근종 환자들을 대상으로 하여 수술을 피하고 싶은 환자, 가임 여성으로 자궁을 보존하고 싶은 환자들을 대상으로 양측 자궁동맥 색전술을 시행하여 양측 자궁동맥 색전술이 자궁근종 증상 및 근종의 크기를 얼마나 감소시킬 수 있는지를 평가하고자 하였다. 연구 방법: 2003년 1월부터 2005년 6월까지 2년 6개월 동안 본원 산부인과 외래에서 초음파로 자궁근종으로 진단 받은 환자들을 대상으로 하여 수술을 원치 않거나, 가임기 여성으로 임신을 위해 자궁을 보존하고 싶어하는 증상이 있는 환자들을 대상으로 하였다. 시술 전에 질식초음파와 MRI를 이용하여 자궁근종의 크기를 다시 정확히 측정하였으며, 시술 후 2, 6, 12주 후에 질식 초음파를 통하여 근종 크기의 감소 여부를 측정하였고, 증상의 호전 여부에 대하여 많이 호전, 약간 호전, 호전 없음, 약간 악화, 많이 악화로 구분하여 조사, 평가하였다. 결과: 환자군의 평균연령은 24세 에서 50세로 평균 36.3±7.9세였고, 근종의 평균 직경은 4.8±2.5 cm이었고, 평균 부피는 55.4 (46.3-67.4) cm3이었다. 근종의 형태는 간질 또는 근층내 근종이 9예, 점막하근종이 6예였고, 장막하 또는 복막하 근종 및 유경성 근종, 광간막 근종은 없었다. 평균자궁근종 용적감소는 시술 후 2주 후, 6주 후, 12주 후에 58.6±9.7%, 77.5±12.3%, 86.8±23.5%으로 자궁근종의 크기가 의미 있게 감소한 것을 확인할 수 있었다. 질출혈이나 하복부 통증의 증상은 시술 12주 후 많이 호전된 경우가 60%, 약간 호전된 경우가 40%였으며, 호전이 없거나 악화된 경우는 없었다. 대부분의 연구 대상자에 있어서 증상의 호전을 보였다. 자궁동맥 색전술 시행 후 전자궁 절제술이나, 자궁근종 절제술 등의 수술을 시행 받은 경우는 없었으며, 자궁근종 크기의 증가나, 증상의 악화를 보인 경우도 없었다. 시술 후 합병증으로는 시술 후 복부통증이 모든 환자에게서 발생하였으나, 감염, 자궁괴사, 난소기능저하, 재출혈, 혈종 등의 합병증은 없었다. 결론: 따라서, 자궁동맥 색전술을 이용한 자궁근종의 치료는 수술로 인한 출혈이나 감염, 요관손상 등의 부작용을 최대한 줄일 수 있으며, 덜 침습적인 치료방법으로, 무엇보다도 자궁내막 손상이 거의 없어 가임 여성에서 생식능력을 보존할 수 있다는 장점을 가진 유용하고 안전한 치료방법이 될 것이다. Objective: The purpose of this study is to evaluate the effectiveness and safety of uterine artery embolization for the treatment of symptomatic leiomyomas in the patients who want to preserve uterus, want fertility or feel fear for operation. Methods: From January 2003 to June 2005, among the patients with symptomatic uterine leiomyoma, fifteen women who wanted to preserve uterus or wanted fertility or had fear for operation were included in this retrospective study. Bilateral Uterine artery embolization (UAE) was performed. At the preprocedure and at 2, 6, and 12 weeks of postprocedure, transvaginal ultrasonography was performed for all patients. Clinical symptoms and follow-up information for each patient were evaluated. Results: 15 leimyomas were treated with UAE. The initial mean volume of leiomyomas was 55.4 (46.3-67.4) cm3. The mean volume decrease was 58.6±9.7%, 77.5±12.3%, 86.8±23.5% at 2, 6, 12 weeks. The outcome of clinical symptoms were as followed; `much improved` 20% (3/15), `somewhat improved` 60% (6/15), `no improvement` 20% (3/15), `somewhat worsen`s 0% (0/15), and `much worsen` was 0% (0/15). There was no case of hysterectomy or myomectomy after UAE. And also no case of increasement of volume nor worsening of clinical symptoms were found. Lower abdominal pain was the most common symptoms after UAE, but complications were not detected. Conclusion: In this study, UAE to treat patients with uterine leiomyoma is proved to be effective not only in volume reduction, but also in symptom improvement. And it is a relatively less-invasive procedure which decreases the risk of side effects of operation. Above all things, it preserves fecundity in young women. Therefore, UAE is very effective and safe procedure in the treatment of symptomatic uterine leiomyoma.

사물 인터넷을 위한 지능형 주차 시스템

이충산(Chung-san Lee),한영탁(Young-Tak Han),조영태(Young-Tae Joe),전수빈(Soo-Bin Jeon),최진섭(Jin-Seop Choi),정인범(In-bum Jung) 한국정보과학회 2014 한국정보과학회 학술발표논문집 Vol.2014 No.6

Accuracy of cardiac output measurements during off-pump coronary artery bypass grafting: according to the vessel anastomosis sites

Sung Yong Park,Dae Hee Kim,Han Bum Joe,Ji Young Yoo,Jin Soo Kim,Min Kang,Yong Woo Hong 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.5

Background: During beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites. Methods: This study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO. Results: CO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques. Conclusions: In the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB. Background: During beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites. Methods: This study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO. Results: CO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques. Conclusions: In the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB.

Case Report : Occlusion of the right subclavian artery after insertion of a transesophageal echocardiography probe in an adult with a vascular ring -A case report-

( Sung Yong Park ),( Dae Hee Kim ),( Han Bum Joe ),( Sun Kyung Park ),( Ji Hoon Hwang ),( Yong Woo Hong ) 대한마취과학회 2010 Korean Journal of Anesthesiology Vol.59 No.4

Intraoperative transesophageal echocardiography (TEE) has become an important monitoring device for patients undergoing cardiac or noncardiac surgery. Complications associated with TEE are unusual, but the potential for TEE probe compression of the posterior vascular structures has been reported in pediatric patients. We present here a case of occlusion of the right subclavian artery in an adult patient with a vascular ring after insertion of a TEE probe. (Korean J Anesthesiol 2010; 59: 283-285)

자궁 동맥색전술 후 자궁벽내근종의 경질구축

박승준 ( Seung Jun Park ),김지영 ( Gi Young Kim ),한상확 ( Sang Hwak Han ),최정범 ( Jeong Bum Choi ),김신혜 ( Sin Hye Kim ),유지훈 ( Ji Hoon Yoo ),조환성 ( Hwan Sung Joe ),한효상 ( Hyo Sang Han ),황인철 ( In Cheul Hwang ),양승부 ( 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11

Uterine artery embolization for the treatment of uterine leiomyomas is gaining acceptance as an effective alternative to surgical treatment in preserving uterus and reducing symptoms. Vaginal expulsion of leiomyomas after UAE is uncommon, and has been regarded as a side effect of the procedure, as well as a natural phenomenon of treatment response. A-28-year-old unmarried woman who has been suffered from menorrhagia underwent UAE. MRI revealed the remnant leiomyomas were reduced in size and volume and also symptoms of leiomyomas were much improved. After 6 month, We`ve made sure about non-visualization of leiomyoma on follow-up pelvic dynamic MRI. We report this rare case of vaginal expusion of intramural leoimyoma with a brief literature.