• 제목/요약/키워드: Sung ChunHyang

검색결과 156건 처리시간 0.024초

Baxter $Infusor^{(R)}$를 이용한 경막외 진통제 지속 주입 (Clinical Experience of Continuous Epidural Analgesia Using Baxter $Infusor^{(R)}$)

  • 배상철;이장원;김일호;송후빈;박욱;김성열
    • The Korean Journal of Pain
    • /
    • 제4권2호
    • /
    • pp.127-132
    • /
    • 1991
  • Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

  • PDF

덱사메타손과 에피네프린의 이중 전처치가 횡복직근피판 생존에 미치는 영향 (Dual Preconditioning Effect of Dexamethasone and Epinephrine on TRAM flap Survival in Rats)

  • 김재우;김준혁;안형식;신호성;최환준;이영만
    • Archives of Plastic Surgery
    • /
    • 제34권2호
    • /
    • pp.163-168
    • /
    • 2007
  • Purpose: The flap delay is a widely used technique to increase the flap survival. Dexamethasone is a well-known drug to have a positive impact on the flap survival. The objective of this study is to investigate the dual synergic effect of epinephrine as a chemical delay agent plus dexamethasone on the TRAM flap survival in rat model. Methods: Forty Sparague-Dawley rats were divided into 4 groups evenly and a right inferior epigastic vessel pedicled TRAM flap, sized $5.0{\times}3.0cm$, was elevated on each upper abdomen. In the control group(N=10), 2 ml saline was injected on transverse abdominis muscle for a week before the flap elevation. In surgical delay group(N=10) all superior pedicles and left inferior pedicle were ligated a week before the flap elevation. In epinephrine group (N=10), 1 : 50000 epinephrine mixed saline was injected to transverse abdominis muscle every day for a week before flap elevation. In epinephrine plus dexamethasone group (N=10), the same procedure as that of epinephrine group was conducted for a week and 2.5 ml/kg dexamethasone was injected transverse abdominis muscle 2 hours before the flap elevation. On the seventh day after flap elevation, the survival area of flaps were measured and the vessel numbers in upper dermis of flap were counted through histologic slides. Results: The results were as follows: the mean percentage of the flap survival area of surgical delay group ($60.5{\pm}2.44%$), epinephrine group ($75{\pm}4.43%$), and epinephrine plus dexamethasone group ($87{\pm}1.94%$) were higher than that of the control group ($35{\pm}6.06%$) significantly(p<0.05). In case of the vessel number though histologic slides, epinephrine group ($79.3{\pm}5.57$) and epinephrine plus dexamethasone group ($96.3{\pm}14.05$) were higher than that of the control group ($44.8{\pm}8.82$) significantly(p<0.05), but the surgical delay group ($54{\pm}4.23$) showed no significant difference (p>0.05) compared to that of the control group. Conclusion: The results indicated that epinephrine plus dexamethasone injection before the flap elevation could be used to increase the TRAM flap survival area in rat model.

두부손상으로 응급실에 내원한 환자의 두피손상 양상, 크기와 두개내 손상과의 관련성 (The Relationship Between Type and Size of Scalp Injury and Intracranial Injury Among Patients who Visited the Emergency room due to head Trauma)

  • 김용성;임훈;;김호중
    • Journal of Trauma and Injury
    • /
    • 제19권1호
    • /
    • pp.8-13
    • /
    • 2006
  • Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.

Outcomes of dental implant treatment in patients with generalized aggressive periodontitis: a systematic review

  • Kim, Kyoung-Kyu;Sung, Hun-Mo
    • The Journal of Advanced Prosthodontics
    • /
    • 제4권4호
    • /
    • pp.210-217
    • /
    • 2012
  • PURPOSE. The purpose of this study was to analyze the current literatures and to assess outcomes of implant treatment in patients with generalized aggressive periodontitis. MATERIALS AND METHODS. Studies considered for inclusion were searched in Pub-Med. The literature search for studies published in English between 2000 and 2012 was performed. Our findings included literature assessing implant treatment in patients with a history of generalized aggressive periodontitis (GAP). All studies were screened according to inclusion criteria. The outcome measures were survival rate of superstructures, marginal bone loss around implant and survival rate of implants. All studies were divided into two follow-up period: short term study (< 5 years) and long term study (${\geq}5$ years). RESULTS. Seven prospective studies were selected, including four short-term and three long-term studies. The survival rates of the superstructures were generally high in patients with GAP, i.e. 95.9-100%. Marginal bone loss around implant in patients with GAP as compared with implants in patients with chronic periodontitis or periodontally healthy patients was not significantly greater in short term studies but was significantly greater in long term studies. In short term studies, the survival rates of implants were between 97.4% and 100% in patients with GAP-associated tooth loss, except one study. The survival rates of implants were between 83.3% and 96% in patients with GAP in long term studies. CONCLUSION. Implant treatment in patients with GAP is not contraindicated provided that adequate infection control and an individualized maintenance program are assured.

위 편평선종 및 조기위암에서 내시경적 점막절제술 후 절제부위에서 발생한 융기형 병변에 관한 임상적 고찰 (A Clinical Study of Protruding Lesions That Arise at the Scar of an Endoscopic Mucosal Resection for an Early Gastric Carcinoma and a Gastric Flat Adenoma)

  • 천영국;유창범;고봉민;김진오;조주영;이준성;이문성;진소영;심찬섭
    • Journal of Gastric Cancer
    • /
    • 제1권1호
    • /
    • pp.55-59
    • /
    • 2001
  • Purpose: Several studies of an endoscopic mucosal resection(EMR) have been reported, but reports about benign protruding lesions that arise at the scar of EMR for early gastric cancer (EGC) or a gastric adenoma are rare. The purpose of this study was to elucidate endoscopic and histological characteristics of benign protruding lesions which arise at the scar of an EMR for EGC and a gastric flat adenoma. Materials and Methods: In 101 lesions (73 gastric flat adenomas and 28 EGCs) from 96 patients, 16 lesions developed new protruding lesions that arose at the scar of the EMR. We retrospectively analyzed the endoscopic findings of initial and protruding lesions, and several other clinical factors (H. pylori infection, eradication therapy, and proton pump inhibitor (PPI) or H2-blocker use). Results: 1. The mean duration until detection of the protruding lesion was 8.9 months ($1.5\∼27$). Protruding lesions arose at the scar of the EMR in 1 of 28 EGCs ($3.6\%$) and from 15 of 73 gastric flat adenomas ($20.5\%$). All of the patients were men. 2. With respect to the endoscopic findings, the shapes of the protruding lesions were as follows: 10 Yamada (Y) I, 4 Y-II, 1 Y-III, and 1 flat lesion. Histological examination of the protruding lesions revealed regenerating hyperplasia in 5 lesions, intestinal metaplasia in 5, and both in 6. 3. The incidence of these lesions was higher in cases of tubular adenomas with focal high-grade dysplasia than in cases of tubular adenomas without dysplasia (p<0.05). 4. The incidence of H. pylori infection was higher in patients ($81.7\%$) who developed a protruding lesion than in those ($51.8\%$) who did not develop (p=0.029); also, the incidence of use of PPI was higher in those patients (p=0.045). However, eradication therapy for H. pylori and duration of use of PPI or H2-blocker showed no difference between groups. Conclusions: It may be possible that the potential hyperplasia that may reside in normal mucosa surrounding EGC or a gastric adenoma might awaken during the healing process of the EMR ulcer and develop to benign protruding lesions. And, H. pylori and PPI might also be related to the development of the protruding lesions.

  • PDF

확장성을 제공하는 안전한 멀티캐스트 키 관리 구조에 관한 연구 (A Study on Scalable Secure Multicast Key Management Structure)

  • 박희운;이임영;박원주;이종태;손숭원
    • 한국정보처리학회:학술대회논문집
    • /
    • 한국정보처리학회 2000년도 추계학술발표논문집 (상)
    • /
    • pp.821-824
    • /
    • 2000
  • 통신 및 컴퓨터의 보급 발전을 통해 공개 네트워크 상에서 그룹에 기반한 통신 응용 서비스의 요구가 증가하고 있다. 이러한 필요성에 따라 멀티캐스트 기반 구조에 대한 연구가 활발히 진행되고 있다. 하지만 멀티캐스트 구조에 대한 안전성과 효율성 및 확장성 부분에 대한 해결책은 아직 미비한 상태이다. 본 연구에서는 기존의 대표적인 멀티캐스트 키 관리 구조를 고찰함과 동시에 안전성과 효율성 및 확장성을 분석한다. 이에 기초해 확장성을 제공하는 안전한 멀티캐스트 키 관리 구조를 제안하고 기존 방식과 비교 분석한다.

  • PDF

엔드밀 가공시 공구 변형에 관한 유한요소해석 (Finite Element Analysis of Tool Deformation in End-Mill Process)

  • 정성찬;김국원
    • 한국산학기술학회:학술대회논문집
    • /
    • 한국산학기술학회 2004년도 추계학술대회
    • /
    • pp.90-92
    • /
    • 2004
  • 본 연구에서는 절삭 가공시 공구가 받는 절삭력과 칩-공구 사이에서 발생하는 절삭 열에 의한 공구의 변형을 예측하였다. 3D CAD를 이용하여 공구를 모델링 하였으며 절삭력과 절삭 열을 하중조건으로 부여하여 유한요소해석을 수행하였다. 하중조건으로 사용한 절삭력과 절삭 열은 절삭이론을 이용한 절삭력 모델을 사용하여 예측하였으며 실험을 통해 모델의 타당성을 검증한 결과이다. 그러므로 본 연구는 어떠한 사전 실험도 없이 절삭조건과 재료 물성치 그리고 공구 형상만을 알면 이에 따른 절삭력성분 및 절삭열 등을 얻을 수 있고, 이를 이용하여 절삭 가공시 공구의 변형을 예측할 수 있다.

  • PDF

Propylene Oxide와 Cyclohexene Oxide와 CO2의 삼원 공중합체의 합성 (Synthesis of the Terpolymers of Propylene Oxide, Cyclohexene Oxide, and Carbon dioxide)

  • 이윤배;성언경;박희경
    • 한국산학기술학회논문지
    • /
    • 제12권2호
    • /
    • pp.1027-1031
    • /
    • 2011
  • 온실가스 가운데 하나인 이산화탄소를 활용하기 위한 연구의 일환으로 프로필렌옥사이드와 사이클로헥신옥사이드, 그리고 이산화탄소를 원료로 하고 zinc glutarate를 촉매로 하여 여러가지 조성의 삼원공중합체가 합성되었다. 이고분자는 FT-IR, $^1H$-NMR, DSC을 이용하여 분석되었고, 이들의 유리전이온도는 poly(alkylene carbonate)의 두성분의 질량비와 일정한 관계를 가지며 Fox식과 비교적 일치함을 확인하였다.

고리 금속판을 이용한 망치 손가락의 수술적 치료법 (Surgical treatment of Mallet finger deformity with Hook plate)

  • 최석민;정성균;신호성;박은수;김용배
    • Archives of Plastic Surgery
    • /
    • 제36권3호
    • /
    • pp.318-321
    • /
    • 2009
  • Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.