• Proceedings of the KIEE Conference
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• 2015.07a
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• pp.1433-1434
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• 2015

의료기기 무선통신 기능을 포함한 유헬스케어형 기기들이 지속적으로 개발됨에 따라 전기 및 기계적 안전에 관한 공통기준규격 IEC 60601-1(3rd)과 개별규격에 더불어 추가적인 안전성 시험 항목이 요구되고 있다. 유헬스케어형 의약품주입펌프의 적합성을 평가하기 위하여 IEC60601-1-11와 IEC60601-2-24 규격을 기반으로 하여 부품 및 분류방법, 필수성능에 대한 시험항목을 도출하였다. 본 연구에서는 국제규격에 기반하여 적합성 평가기술을 개발하여 헬스케어형 의료기기의 안전성 확보와 선도적 평가기술 방안을 마련하였다.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.297-300
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• 2014

This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.55-59
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• 2016

Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

• Journal of The Korean Dental Society of Anesthesiology
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• v.1 no.1 s.1
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• pp.16-20
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• 2001

연구배경: 일반적으로 자가통증조절기가 자가진정조절을 위해 적합한 것으로 알려져 있다. 그러나 이 장치들은 몇몇 진정제 투여 시 너무 긴 최소 폐쇄간격을 가지고 있다 WalkMed사(Medex inc, USA)의 자가통증조절기는 폐쇄간격을 0으로 설정할 수 있으며 30 ml/h로 추가용량을 투여할 수 있다. 이번 연구에서는 환자 개개인의 요구에 맞추어 환자의 진정을 조절하기 위하여 위장치를 이용한 propofol 자가진정조절기의 가능성를 조사하였다. 방법: Propofol과 전산 프로그램된 WalkMed 주입장치를 이용한 자가진정조절법이 치과치료를 받는 24명의 건강한 환자에게 시행되었다. Propofol 지속 주입량은 2 mg/kg/h로, 추가용량은 5 mg으로 조절되었으며 치소 폐쇄간격은 0으로 설정하였다. Ketoloac 30 mg이 통증 조절을 위하여 진정법 시행 전에 근주되었다. 결과: 진정법 시행 동안 주입된 propofol의 평균량은 3.4 mg/kg/h이었으며 평균 추가용량은 1.6 mg/kg/h이었다. 시간 당 추가용량에는 많은 변이가 있었다(0-32). 모든 환자는 진정법 시행 동안 완전한 각성상태였으며 이러한 진정 법에 만족하였다. 진정 법과 관련된 주요한 합병증은 관찰되지 않았다. 결론: WalkMed사의 자가통증조절기를 이용한 propofol 자가진정조절법이 치과 치료를 받는 환자들에게 유용하게 사용될 수 있다.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.141-147
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• 1993

A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5％, perioperative myocardial infarction in 25.0％ and perioperative arrhythmia in 17.5％. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).

• The Korean Journal of Physiology
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• v.16 no.2
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• pp.177-186
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• 1982

The effect of ethacrynic acid (EA) on the renal secretion of PAH was examined in cat kidney. $C_{PAH}$ and $T_{PAH}$ were measured before and after infusion of EA $(0.5{\sim}50mg/kg)$ through the femoral vein. The following results were obtained: 1) In the dosage range of 0.5 to 25 mg/kg, EA increased the urine flow, and sodium and potassium excretion in dose-dependent manner, but the glomelular filtration rate was decreased as the dosage of EA was increased. 2) $C_{PAH}$ and $T_{PAH}$ were decreased by EA in the dosage range of 3 to 25 mg/kg and 1 to 50 mg/kg, respectively, in dose·dependent manner with the dosage to cause 50% inhibition of about 5 mg/kg. 3) With dosage of 0.5mg/kg, EA appeared to exert a great effect on diuretic response without the influence on $T_{PAH}$. At 10min after infusion of EA, a potent diuretic effect appeared, while $T_{PAH}$ did not show a significant change. These results suggest that the action mechanism of EA on tubular secretion of PAH may be different from that on natriuresis. 4) With dosage of 5 mg/kg, EA did not inhibit the Na-K-ATPase activity in microsomal fractions from both cortex and medulla. 5) The double reciprocal plot ($l/T_{PAH}$ versus $l/P_{PAH}$) suggested that EA inhibited the P AH secretion by a competitive pattern. However, probenecid, a prototypic inhibitor of the organic acid pump, had no influence on both the inhibitory effect of $T_{PAH}$ and the natriuretic effect by EA. These results suggest that in vivo EA altered tubular secretion of P AH through interactions with receptors that are not identical with the Na-K-ATPase.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.139-144
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• 2014

Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.1
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• pp.1-7
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• 2013

Background: Intravenous sedation is effective for dental patients who are anxious. Recently, target-controlled infusion (TCI) has begun to be used widely to administer and titrate propofol and remifentanil during sedation. To investigate the effect and safety of the pharmacologic agents used in anesthetic department, we performed a retrospective study. Methods: Retrospective study of a series of dental procedure under intravenous sedation performed in department of anesthesiology in Dental Hospital of Dankook University was carried out with propofol or propofol/remifentanil between January and August 2011 and January and April 2012. All patients received oxygen by nasal cannula. The average propofol and remifentanil target was 0.5 ${\mu}g/ml$ and 1.0 ng/ml, respectively using a TCI pump. The average peripheral oxygen saturation ($SpO_2$), heart rate, blood pressure, respiratory rate, nasal end-tidal $CO_2$ were recorded at 5-10 minute intervals. The age, gender, weight, procedure and sedation time, type of procedure were also recorded. Results: We included 22 cases of 19 adults (group A) and 6 cases of children (group B). In group A, 4 patients received propofol (group A-P), and 15 patients received propofol with remifentanil (group A-PR). In group B, 6 patients received propofol only. The mean age of group A was 41.1 years old and that of group B was 9.5 years old. No clinically significant complications were noted. There were no case of de-saturation <90%. The median respiratory rate was 13.1 (range 6 to 36) in group A and 19 (range 13 to 25) in group B. The median end tidal $CO_2$ was 36.7 mmHg(range 8 mmHg to 56 mmHg) in group A and 41.7 mmHg (range 30 mmHg to 53 mmHg) in group B. Conclusions: Based on our results, dental sedation using propofol/remifentanil in adult and propofol in children with TCI pump seems to appear as a safe and effective procedure while performing dental procedure.

• Journal of Digital Convergence
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• v.19 no.1
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• pp.211-216
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• 2021

This study was carried out to evaluate the effects of disinfection using environmental disinfectant after having assessed the extent of contamination through microbial culture testing and the Adenosine Triphosphate Bioluminescence method among the environmental management evaluation methods used for the environment in the hospital ward of patients infected by multidrug-resistant organisms. This study was conducted with the patient wards isolated due to multidrug-resistant organisms as the environmental surface. Specimens were collected from five locations including infusion pumps, IV poles, bedside cabinets, bed railings, keyboards, and blood pressure measurement cuffs. ATP and microbial culture testing were executed prior to, immediately after, and five minutes post-disinfection. According to the result contamination of the infusion pumps was statistically significantly reduced after disinfection. In addition, the bacteria before and after disinfection reduced in IV pole, bed railing, and keyboard. That is, regular environmental surface disinfection can provide safer environments to patients against infection. Therefore, it is necessary to establish guidelines including disinfection methods and intervals for environmental surfaces by evaluating the persistence of disinfectants at various institutions in the future.

• Journal of Environmental Health Sciences
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• v.32 no.1 s.88
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• pp.60-66
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• 2006

Bisphenol A(BPA) was known as an endocrine disrupting chemical. This study was conducted to assess the effect of BPA, weaker estrogen, on the preneoplastic and neoplastic lesions induced by diethylnitrosamine (DEN). One hundred male F344 rats were divided into four groups which were treated with DEN followed by BPA. To make liver tumor early, we conducted that DEN containing osmotic pump implanted into rat abdominal cavity. Then diet containing BPA were fed to the rats. All animals were sacrificed at 10 and 18 weeks. Body weights were significantly decreased in 4000ppm at 18 weeks. Relative Liver weights of 4000 ppm BPA treated group were significantly increased compared to that of DEN alone group at 18 weeks. There were no significant differences of liver tumor incidences. Sum area of GST-P positive foci and BrdU labeling indices of BPA treated group were not significantly different compared to those of control group. These results suggest that BPA have no effects in preneoplastic and neoplastic lesions on DEN-induced hepatocarcinogenesis.