• The Korean Journal of Pain
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• 제28권3호
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• pp.210-216
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• 2015

Background: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results: Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions: The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.

• Biotechnology and Bioprocess Engineering:BBE
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• 제10권1호
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• pp.9-15
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• 2005

A bioartificial liver (BAL) is a medical device entrapping living hepatocytes or immortalized cells derived from hepatocytes. Many efforts have already been made to maintain the functions of the hepatocytes in a BAL device over a long term. However, there is still some uncertainty as to their efficacy. and their limitations are unclear. Therefore, it is important to quantitatively evaluate the metabolic functions of a BAL. In previous studies on in vitro BAL devices, two test methods, an initial bolus loading and constant-rate infusion plus initial bolus loading, were theoretically carried out to obtain physiologic data on drugs. However, in the current study, the same two methods were used as a perfusion model and derived the same clearance characterized by an interrelationship between the perfusate flow rate and intrinsic clearance. The interrelationship indicated that the CL increased with an increasing perfusate flow rate and approached its maximum value, i.e. intrinsic clearance. In addition, to set up an in vivo BAL system, the toxic plateau levels in the BAL system were calculated for both series and parallel circuit models. The series model had a lower plateau level than the parellel model. The difference in the toxic plateau levels between the parallel and series models increased with an increasing number of BAL cartridges.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.129-137
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• 2021

Background: Inappropriate use of intravenous and inhaled anesthetics may be dangerous in infants undergoing facial cleft surgeries. This study primarily aimed to compare the effect of infraorbital nerve block on sevoflurane requirement in infants undergoing cheiloplasty. Intraoperative opioid consumption, hemodynamics, blood glucose levels, extubation time, and delirium were also compared. Methods: This prospective, randomized, double-blinded study was conducted in 34 infants undergoing cheiloplasty under general anesthesia. After induction, group A received bilateral infraorbital nerve block with 0.5 mL of 0.5% bupivacaine and group B 0.5 mL saline. An increase in heart rate or blood pressure > 20% was managed by increasing sevoflurane by 2-2.5%, followed by fentanyl 0.5 ㎍/kg bolus. The chi-square test and independent-sample t-test were used where applicable. Results: Demographics, duration of surgery, and intravenous fluids used were comparable between the groups. Compared to group A, patients in group B had significantly higher consumption of fentanyl (14.2 ± 4.4 ㎍ vs. 22.1 ± 6.2 ㎍) and sevoflurane (14.2 ± 4.8 mL vs. 26.8 ± 15.6 mL). Intraoperative hemodynamic parameters were significantly lower in group A, the number of times increases in hemodynamic parameters occurred, and fentanyl supplemental bolus was required remained significantly lower in group A than in group B. Intraoperative glycemic levels remained higher in group B, and the extubation time was significantly shorter in group A than in group B (4.40 ± 1.60 min vs. 9.2 ± 2.18 min). Group A had a lesser occurrence of postoperative delirium. Conclusion: Supplemental infraorbital block in infants undergoing cheiloplasty under general anesthesia resulted in significantly decreased anesthetic requirements and optimal hemodynamic and glycemic levels with faster extubation and lesser delirium.

• 대한방사선기술학회지:방사선기술과학
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• 제39권1호
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• pp.59-69
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• 2016

Computed tomographic angiography (CTA)의 (조영제 집적 정점시간에 영향을 미치는 특성 인자를 분석하여: analyzing factors influencing on the integrated bolus peak timing in contrast-enhanced) 개인별 정점 시간을 계량적(Systems analysis)으로 산정해 검사에 직접 적용함으로써 예비검사(monitoring scan)에 의한 불필요한 방사선 피폭을 예방하는데 목적이 있다. CTA의 예비검사(monitoring scan)을 통해 얻은 조영제 집적 정점시간과 개인별 측정치들 간의 상관관계분석을 통해 영향인자를 파악한 다음, 다중선형회귀분석에 의한 회귀식으로 적정시간을 산출하였다. 결과로는 CTA의 평균 방사선 노출량은 $716.53mGy{\cdot}cm$였고, 예비검사(monitoring scan) 15.52 mGy (2 ~ 34 mGy)로 나타났다. 장기별 변환요소(conversion factor)를 적용한 결과, 전체 선량은 평균 1.5 mSv였고, 예비검사 선량은 0.23 mSv로 나타났다. 특성인자의 측정치와 조영제 정점시간의 상관관계분석 결과, 남성은 심박동수에서, 여성은 심박동수와 최저혈압, 혈당에서 음의 상관관계를 보였으며, 통계적으로 매우 유의하였다(p<.01). 회귀분석결과, 남성은 심박동수가 한 단계 증가할 때마다 -0.160배로, 여성은 최저혈압과 심박동수, 혈당에 따라 각각 -0.004, -0.174, -0.006배로 유의하게 감소하였다. 실측한 조영제 정점시간과 회귀식에 의해 산출된 정점시간의 일치도 검사에서 남여 대상자 모두에서 일치도가 매우 높았다. 본 연구에서는 검사 전에 환자 개인별 조영제 집적 정점시간을 산정하여 적용하면 예비검사를 생략함으로써 불필요한 방사선피폭을 예방할 수 있을 것으로 사료된다.

• 대한핵의학회지
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• 제27권2호
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• pp.233-238
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• 1993

Esophageal motility was evaluated from the analysis of 10 consecutive swallows using liquid bolus containing 0.5 mCi of $^{99m}Tc$ tin colloid. We have reviewed our experience of esophageal transit study in the 20 normal volunteers and 55 patients with dysphagia that was not related to mechanical obstruction. The purpose of this study is to measure the esophageal transit in normal subjects and in patients with various esophageal motility disorders. The overall sensitivity and specificity of radionuclide esophageal transit study in detecting esophageal motor abnormality were compared with manometric results as a gold standard, which were 80% and 100% respectively. Radionuclide transit study is a safe, rapid, noninvasive test and suitable as a screening test for esophageal motor disorders.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.786-792
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• 2013

본 연구는 조영제 peak time에 영향을 주는 주된 생체 요인를 분석하여 검사에 적용함으로써 추가적인 조영제 주입에 따른 부작용을 최소화 하고 고해상도의 혈관영상을 유지하는 방안을 모색하고자 하였다. 시험적조영제주입법을 이용한 48명의 환자를 대상으로, 검사 전과 검사 중 환자의 생체 요인을 측정한 후, 조영제 peak time과 상관관계를 알아보고, 회귀식을 이용해 산출한 조영제 peak time이 측정된 조영제 peak time과 일치하는지 Bland-Altman plot를 통해 평가하였다. 연구결과, 검사 시 최저혈압과 심박동수가 조영제 peak time과 유의한 음의 상관관계를 보였고, 1단계 증가할 때마다 평균적으로 조영제 peak time은 -0.018과 -0.159로 유의하게 감소하였으며, 일치도가 상당히 높아 두 방법의 차이가 없음을 알 수 있다. 결론적으로 본 연구의 회귀식을 이용하면 우수한 화질을 유지하면서 환자에게 투여되는 조영제 사용량을 줄일 수 있어 기존의 방법을 대체할 수 있으리라 사료된다.

• Archives of Pharmacal Research
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• 제21권4호
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• pp.411-417
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• 1998

In order to investigate the effect of the pretreatment with various doses of diltiazem (DTZ) on the pharmacokinetics of indocyanine green (ICG) at steady state, especially the hepatic blood clearance due to the change of hepatic blood flow, the following experiments were carried out with ICG, a hepatic function test marker, not metabolized in liver and only excreted in bile. The intravenous bolus injection ($3,780\mu\textrm{g}$/kg) and the constant-rate infusion ($10,100\mu\textrm{g}$/kg/hr) of ICG into the left femoral vein were made in order to check the steady-state plasma concentration ($C_{ss} of $10\mu\textrm{g}$/ml) of ICG at 20, 25 and 30 min. Following a 90-min washout period, the intravenous bolus injection (108, 430, 860 and $1,720\mu\textrm{g}$/kg) and the constant-rate infusion (108, 433, 866 and $1,730\mu\textrm{g}$/kg/hr) of DTZ into the right femoral vein were made and the achievement of the steady-state plasma levels ($C_{ss} of 50, 200, 400 and 800 ng/ml) of DTZ were conformed at 60, 70 and 80 min. During the steady state of DTZ, the intravenous bolus injection ($3,780\mu\textrm{g}$/kg) and the constant-rate infusion ($10,200\mu\textrm{g}$/kg/hr) of ICG into the left femoral vein were made and also the steady-state plasma concentration of ICG was checked at 20, 25 and 30 min. The plasma concentrations of DTZ and ICG were determined using a high performance liquid chromatographic technique. At the steady state, the hepatic blood clearance of ICG was obtained from the plasma concentration and blood-to-plasma concentration ratio ($R_B$) of ICG. The pretreatment with various doses of DTZ did not influence the plasma concentrations, $R_B$ and plasma free fraction ($f_p$) of ICG. So the hepatic blood clearance of ICG was independent of concentration of DTZ. The hepatic blood clearance of ICG could be affected by both hepatic bood flow and hepatic intrinsic clearance. But there was no change of the hepatic blood clearance of ICG between the control and the DTZ-pretreated rats in this study. So it may be suggested that DTZ does not influence hepatic blood flow.

• The Korean Journal of Pain
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• 제33권2호
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• pp.166-175
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• 2020

Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.

• 한국융합학회논문지
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• 제6권5호
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• pp.287-294
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• 2015

본 연구의 목적은 급성기 허혈성 뇌졸중 환자의 뇌 관류 CT검사 시 피폭선량을 알아보고자 하였다. 특히, 방사선 감수성이 높은 장기들의 장기선량(Organ dose)을 팬텀과 유리선량계를 이용하여 실측해보고, 제조사가 제시한 기존 프로토콜(고정시간기법)과 새로 제시한 융합 프로토콜(조영제 추적기법)을 적용하여 선량을 측정하여 보고, 피폭선량 저감화 방안을 마련하고자 하였다. 분석결과 기존 프로토콜과 비교하여 새로 제시한 융합 프로토콜에서 최고 39.8 %, 최저 5.8 % 장기선량이 감소하였고, 검사 피폭선량인 $CDTI_{vol}$과 DLP 값은 각각 25 % 감소하였으며, 권고 선량 이하로 측정되었다. 위의 분석결과를 바탕으로 기존에 제시된 프로토콜을 점검해보고, 새로 제시한 융합 프로토콜을 적용하여 피폭선량을 감소시켜 국민보건향상에 이바지 해야 할 것이며, 다른 검사에서도 최적의 프로토콜을 찾기 위한 연구가 계속되어져야 할 것으로 사료된다.

• 대한치과보철학회지
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• 제36권2호
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• pp.389-423
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• 1998

This investigation was designed to determine the effectiveness of the posterior occlusal schemes on masticatory activity during mastication in complete denture. Twelve edentulous subjects were selected for this study. All subjects had no past history and no functional abnormality on masticatory system and TMjoint. And, they had residual ridge of favorable morphology, firm mucosa and Class I skeletal jaw relationship, Twelve experimental denture with interchangeable occlusions(0-degree teeth, 30-degree teeth, Levin teeth and S-A teeth) were constructed for this study. The masticatory performance was analyzed by means of standard sieve(10, 16, 20, 30sieve), and the electrical activity from selected muscles(Temporalis and Masseter muscle) was recorded simultaneously with electromyography (Bio-Pak system) as the subject masticated test foods (rice, peanut and gum) with four different occlusal schemes. Mandibular movement was, also, measured with Sirognathography(Bio-Pak system). These recordings were performed in immediately, after 1 week and after 2 weeks of insertion of complete denture. The results were as fellows; 1. The average masticatory performance of 0-degree artificial teeth was higher than any other artificial teeth. 2. Masticatory performance in denture wearer was affected preferentially by food and artificial occlusal schemes. 3. During chewing, there was a statistical difference of EMG activity between masseter and temporal muscle(p<0.01). Especially, EMG activity of working masticatory muscle was highly affected by food rather than by artificial occlusal schemes. 4. In denture wearer, the velocity of opening was not affected by food, whereas, the velocity of closing was faster in soft food chewing than in hard food chewing, and the amount of vertical displacement was grater in chewing of soft and large bolus than in chewing of hard and small bolus. However, the amount of lateral displacement showed conversely(p<0.05). 5. It was considered that masticatory performance in denture wearer is not affected by the condition of residual ridge. the history of denture wear, the preference, the adaptation to artificial teeth and the total mesiodistal length of artificial posterior teeth.