Epinephrine-induced Metabolic Acidosis during Orthognatic Surgery: A case report

Epinephrine has a variety of clinical uses one is its use as a topical hemostatic agent on bleeding surfaces, such as in the mouth. We report a temporal association between the administration of topical epinephrine and the development of metabolic acidosis during general anesthesia. A 21 year-old patient, with facial asymmetry, had undergone orthognatic surgery. During the operation, serial blood gas analysis revealed the onset of a metabolic acidosis following the local infiltration (0.036 mg) and topical application of a high dose of epinephrine-BosminⓇ (1:1,000 epinephrine). The metabolic acidosis resolved within 5 hours.ope

Effect of BMI and patient positioning on airway pressures and respiratory compliance during laparoscopic surgery

BACKGROUND: Conventional laparoscopic surgery requires a pneumoperitoneum with CO2 and a change in the patient positioning. Because of the pneumoperitoneum, the peak and plateau airway pressure and respiratory compliances can change compared with initial value. Obesity also affects the patient's respiratory mechanics. The aim of this study was to determine the correlation between the patient's positioning and a pneumoperitoneum with the changes in the respiratory mechanics, and to examine the relationship between the patient's BMI and the changes in therespiratory mechanics. METHODS: Fifty patients undergoing a laparoscopic cholecyctectomy and had no pulmonary pathology were enrolled in this study. The patient's basic data were obtained and the Body Mass Index (BMI) was calculateed. Conventional induction and maintenance of anesthesia were carried out, and each patient was fully relaxed with a rocuronium during the procedure. The change in the respiratory mechanics was checked 5 minutes after induction, the time that the pneumoperitoneum had been induced, and the end of surgery with the supine and 10° tilting of the Trendelenburg and reverse Trendelenburg position. RESULTS: There was approximately a 30% reduction in dynamic compliances before and after inducing pneumoperitoneum with CO2 at each position and a negative correlation between the BMI and the dynamic compliance. There were no significant differences in the respiratory mechanics withe the different patient positions. CONCLUSIONS: The respiratory mechanics are influenced by an increase in the patient's BMI and induced pneumoperitoneum but not by a 10° tilting of the reverse Trendelenburg and Trendelenburg position.ope

In vivo study on the biocompatibility of new resin-based root canal sealers 신개발 레진 계열 봉함제의 생체친화성에 관한 연구 :

Thesis (master`s)--서울대학교 대학원 :치의학과 치과보존학전공,2002.Maste

(The) study for the velocity measurement of the horizontal saccadic eye movement

의학과/석사[한글] Saccade 안구운동은 속도-진폭의 특징으로 정의될 수 있다. Saccade 최대속도 측정의 중요성에도 불구하고 그 속도-진폭관계는 일반적으로 일정한 측정값이 나오지 못하고 있 으며, 특히 saccade의 운동방향에 대한 속도-진폭측정값은 더욱 다양한 측정값이 보고되 고 있다. 이와같은 다양한 측정값은 어느 정도는 표본크기에 관계가 있으나 가장 중요한 요인은 사용된 기록방법이 다르기 때문으로 생각된다. 본 연구의 목적은 saccade 운동방향이 수평 saccade 최대속도에 영향을 미칠 수 있는가 를 추구한 것이다. 이를 위하여 수평 saccade 운동에 6가지 기본방식을 정하고 각변위 10 °에 대하여 이 기본방식의 방향과 속도를 기록하여 고찰했다. 안구운동을 측정하기 위하여 안구운동 모니터, 시표발생장치, 기록기 기타 각종 고정장 치와 부대장치로 측정체계를 구성하고 3명의 건강한 한국성인을 피검자로 선정하여 4주동 안 암실에서 실험을 실시했다. 기록지에서 saccade 위치, 최대속도를 면밀히 관찰했고, 자료는 통계적으로 처리했으며, t-검정을 거쳐 5%의 의미있는 레벨을 구하여 다음과 같은 실험결과를 얻었다. 1. 각변위 10°에 대하여 saccade 안구운동은 최종위치미달이나 수정운동의 발생율이 낮았으며 거의가 정상 안구운동형태를 나타냈다. 2. Saccade 최대 속도의 대푯값은 295.6deg/sec이다. 3. 이측과 비측방향의 운동에 대하여 saccade 평균최대속도값은 비측이 약간 더 빠르나 통계적으로 유의미한 변화는 아니다. 4. 중심시, 이심시, 중심통과대칭시 운동사이에 saccade 평균최대속도값은 비측이 약간 더 빠르나 통계적으로 유의미한 변화는 아니다. 5. 본 연구의 결과를 종합하면, 각변위 10°운동에 대하여 saccade 평균최대속도는 방 향에 따라 변화가 없다. 본 연구의 결과는 신경계와 관계된 안과질환의 진단과 연구에 유용하게 이용될 수 있으 리라고 생각되며 이를 위하여 앞으로 보다 광범위한 각변위에 대한 표준치의 확립이 필요 하다. [영문] Saccadic eye movement may be defined entirely on the basis of velocity-amplitude characteristics. Despite the obvious importance of saccadic peak velocity measurements, there is lack of agreement about saccadic velocity-amplitude relationships in general and particularly with regard to the direction of movement. The variability of the results is attributed mostly to different recording techniques used and partly to the sample size. The aim of this study is to investigate the effect of saccadic direction for the determination of their possible influence upon the horizontal saccadic peak velocity. Therefore, six basic patterns of horizontal saccadic movement were determined and the direction and velocity of these basic patterns of the angular distance of 10 degrees were recorded and discussed. The experimental apparatus consisted of Biometrics Eye Movement Monitors, target function generators, oscillographic recorders and the other fixation devices. The experimental subjects were three Korean adults. All experiments had been performed in the dark room for 4 weeks. The position and peak velocity of saccadic eye movement in the records were carefully observed and the data were analyzed statistically for significant change with the use of t-test at the 5 per cent level and the main results are as follows: 1. In the horizontal saccadic eye movement in the angular distance of 10 degrees, the production rate of undershoot or corrective movement is low and most of the saccadic eye movement are normal. 2. The mean of the saccadic peak velocity is 295.6 deg/sec in the angular distance of 10 degrees. 3. The mean horizontal saccadic peak velocity is faster in the nasal direction, as compared with the temporal direction, but the difference is not statistically significant. 4. The mean saccadic peak velocity is greater in the nasal than in the temporal direction among the velocities of the centering, decentering and symmetry but the difference is not statistically significant. 5. The analysis of the results showed that the mean horizontal saccadic peak velocity has no statistically significant difference between the nasal and the temporal direction in the angular distance of 10 degrees. Author feels that the methods and results of this study may be useful tools in the diagnosis and research of eye disease related to the nervous system and that further study to establish the standard data of saccadic peak velocity should be performed at the various angular distances.restrictio

Effects of fatty acids on the activity of K+-channels in vascular smooth muscle cells

의학과/박사[한글] 임상적으로 허혈 상태에 빠진 경우 관상 동맥의 혈류량이 현저히 증가하는 것이 많은 연구자들에 의해 보고되었으며, 이같은 혈류량 증가 현상은 허혈시 증가하는 대사물질(is chemic metabolites)들이 관상동맥의 긴장도를 감소시켜 나타나는 것으로 생각되고 있으 나 아직 그 기전은 명확치 않다. 이같은 허혈성 대사물질 중의 하나인 유리지방산은 여러 종류의 ion channel 활성 조절 에 중요한 역할을 하고 있으며, 특히 세포의 막전압을 과분극시켜 주는 ion channel의 활 성은 증가시켜주나 막전압의 탈분극을 초래하는 ion channel의 활성은 억제하는 것이 많 은 연구자들에 의해 보고되었다. 그런데 말초 조직으로의 혈류량은 관류압이 일정한 경우 혈관의 긴장도에 의해 조절되게 되며, 이같은 혈관의 긴장도는 혈관 평활근 세포의 막전 압의 크기에 커다란 영향을 받게 된다. 혈관 평활근 세포의 막전압은 여러 인자들에 의해 조절되고 있으며, 특히 혈관 평활근세포막에 널리 존재하는 Ca**++ -activated K**+ -ch annel의 활성 정도에 따라 크게 영향을 받게 된다. 따라서 허혈시 증가하는 arachidonic acid 및 기타 유리 지방산이 토끼 관상 동맥 평활 근 세포의 Ca**++ -activated K**+ -channel의 활성에 미치는 영향을 patch clamp 방법으 로 측정하여 다음과 같은 결과를 얻었다. 1. 본 실험 조건에서 관상 동맥 혈관 평활근 세포에서 주로 관찰되는 ion channel은, 세포내 Ca**++ 농도 및 막전압의 탈분극에 비례하여 그의 활성이 증가되는 large conduct ance K**+ -channel(BK channel)이 주로 관찰되었다. 2. 관류액에 유리지방산을 첨가한 경우 BK channel의 활성이 현저히 증가하였으며, 이 같은 증가 효과는 유리지방산의 용매로 사용한 dimethylsulfoxide(DMSO)와는 무관하였다. 3. 유리지방산의 농도를 0.5μM에서 4μM까지 증가시킨 경우 투여 농도에 비례하여 BK channel의 활성이 증가하였으며, 유리 지방산의 농도를 10μM까지 증가시킨 경우에는 오 히려 BK channel의 활성이 감소하였다. 4. 유리지방산의 BK channel 활성 증가 효과는 그의 탄소수가 큰 경우 더욱 현저하였으 며, 포화 여부는 커다란 영향을 끼치지 못하였다. 5. 관류용액내 ^^Ca++ 농도 및 ^^Mg++의 존재 여부는 유리지방산의 BK channel의 활성 증가효과에 별다른 영향을 끼치지 못하였다. 6. 유리지방산은 BK channel의 활성 증가 효과이외에 small conductance K**+ -channel 의 활성 역시 증가시켜 주었다. 이상의 실험 결과로 보아 유리지방산은 혈관 평활근의 BK channel의 활성 조절에 관여 하는 endogenous regulator로 작용하며, 특히 허혈상태와 같이 세포내 유리지방산의 농도 가 증가하는 경우 혈관 긴장도 조절에 중요한 역할을 할 것으로 생각된다. [영문] A variety of fatty acids regulate the activity of ion channels in a different preparations, and the concentration of fatty acid is greatly increased during myocardial ischemia. These reports suggest that fatty acid may contribute to the ischemic regulation of coronary blood flow. To test this possibility, we studied the effect of fatty acid on the Ca**++ -activated K**+ -channel(BK channel) from rabbit coronary smooth muscle cells by using a patch clamping method. Arachidonic acid dissolved in DMSO activated BK channel in a dose-dependent manner(from 0.5 to 10μM), and DMSO(0.1%) alone had no effect on the activity of BK channel. The effect of arachidonic acid were also examined in both cell-attached and excised, inside-out patch. Arachidonic acid activated BK channel in both cell-attached and inside-out patches, but onset and recovery of this effect were slower in cell-attached patch configuration. BK channel activity was also increased by other fatty acids, including myristic acid, linoleic acid, palmitoleic acid and palmitic acid. Long chain fatty acids were more effective than short chain fatty acid(myristic acid), and there is no stastical difference between saturated(palmitic acid) and unsaturated fatty acid(palmitoleic acid) on BK channel activity. The concentration of Ca**++ and Mg**++ in the bathing solution had no appreciable effect on the arachidonic acid-induced increase of BK channel activity. From the above results, it may be concluded that fatty acid act as an "endogenous regulator" of BK channel and also contribute to the ischemic coronary vasodilatation by increasing the activity of BK channel in coronary smooth muscle cells.restrictio

자궁경부암에서 Bcl-2, Bax, VEGF, PCNA 단백의 발현 및 Apoptosis 양상과 선행항암화학요법 반응도와의 상관관계에 관한 연구

학위논문(석사)--서울대학교 대학원 :의학과 산부인과학전공,2000.Maste

대두 가공 식품으로부터 친화 크로마토그래피를 이용한 CP4 5-enolpyruvylshikimate-3-phosphate의 검출

Thesis (master`s)--서울대학교 대학원 :농생명공학부,2003.The Round-up Ready£¿ soybean, which has the tolerance against an herbicide, glyphosate, is widely used for soybean processing. Recently, detection of genetically modified (GM) food becomes more important because of mandatory labeling. In general, there are two quantitation methods of genetically modified soybean in soybean food products; one is based on PCR analysis at DNA level and the other is an immunoassay for the CP4 5-enolpyruvylshikimate-3-phosphate synthase (CP4 EPSPS) at protein level. However, these two methods have limitations when GM soybean is processed to Korean traditional foods. Therefore, development of a new detection method is needed for soybean food products. Affinity chromatography could be a possibility as an alternative detection method at protein level using the shikimate 3-phosphate as a ligand. Especially, because CP4 EPSPS is intact after the heat-treatment for 90 min at 95 ¡ÆC, tofu can be applied onto affinity chromatography. An affinity chromatography column was made by immobilizing shikimate 3-phosphate to the beaded agarose gel through the carbodiimide condensation. Since the shikimate 3- phosphate was not available commercially, it was synthesized enzymatically by shikimate kinase II and purified by ion exchange chromatography. The protein samples isolated from GM soybean were applied to an affinity chromatography column and CP4 EPSPS was analyzed by SDS-PAGE. It seemed that CP4 EPSPS was adsorbed onto affinity chromatography column. However, Because shikimate 3- phosphate was purified with low level, the efficiency of affinity chromatography column was not good. To prepare a large quantity of shikimate 3-phoshate, an affinity chromatography can be a successful detection method for CP4 EPSPS from GM soybeans and its food products. For the better analysis of CP4 EPSPS, the changes of ligand immobilizing method and protein elution condition should be considered.Maste

위치-특이적 돌연변이 유도와 N-말단 영역 제거를 통한 Arthrobacter sp. S37 유래의 endoinulinase의 기능 분석

Thesis (master`s)--서울대학교 대학원 :농생명공학부,2003.Endoinulinase from Arthrobacter sp. S37 (EnIAb), a member of family 32 glycosidase, catalyzes hydrolysis of inulin using two catalytic residues, a nucleophile and an acid/base catalyst, as indicated in the bell-shaped pH dependence profile. Sequence alignment of EnIAb with other members of the family followed by a site-directed mutagenesis and the pH dependence studies of mutants proposed a detailed catalytic mechanism. Complete loss of enzyme activity in D460A mutant and noticeable changes in the alkaline limb from 8.8 to 7.0 of pH dependence in D460E mutant revealed that Asp460 residue, a component of the fully conserved RDP (Asn-Asp-Pro) motif among family 32, elevates the pKa of the acid/base catalyst of EnIAb with electrostatic interaction. Together with observations that only a kcat not a Km value was reduced more than 100-fold in E323A, E519A, D460N and D460E mutants, the active site of the enzyme is proposed to be a triad of carboxylate groups Glu323 (nucleophile), Glu519 (acid/base catalyst) and Asp460. Various single residue and truncated mutants of the unique N-terminal domain (residue 1 ~ 240) suggested that the domain has dual roles as a carbohydrate-binding domain and a direct involvement in catalysis. Significant reductions in enzyme efficiency (kcat/Km) were observed in W75K, W141A, and W141K mutants,suggesting these highly conserved aromatic residues W75 and W141 play a key role in substrate binding. In addition, N-terminal truncated mutants Δ15, Δ45, Δ70 as well as Δ240 were almost inefficient in enzyme catalysis, necessitating the structural integrity of the Nterminal domain for catalysis. These results provide a model of the active site common to a family 32 and a unique functional role of the N-terminal domain in EnIAb.Maste

A Study on the Activity of HBV DNA-polymerase and Effect of Adenine Arabinoside-5'-monophosphate (Ara-AMP) Therapy in Chronic HBV Infection

의학과/석사[영문] [한글] Hirschman 등 (1971)이 Australia 항원 양성인 환자의 혈청에서 DNA-polymerase의 존재 를 보고한 이래 DNA-polymerase의 활성도가 하나의 B형 간염바이러스의 표식자로서 바이 러스의 증식정도를 반영하고 e항원의 양성여부와 밀접한 연관성을 가지는 예후인자로 보 고되고 있다(Hindman, 1976). 또한 근래까지 대증적 및 보전적 치료에만 의존해오던 만성 활동성 간염의 치료로서 최근 항바이러스제인 adenine arabinoside 5'-monophosphate ( 이하Ara-AMP로 약함)가 간염 바이러스 표식자의 소실 내지는 저하에 효과가 있다고 보고 되고 있으며 (Pollard등, 1976; Bassendinee 등, 1978) 이 약물이 clfydhy과의 경가에 DN A-polymeass의 활성도가 가장 민감하다고 알려져 있다(Scullard 등, 1981). 저자는 1985년 1월부터 1986년 5월까지 연세대학교 의과대학 영동세브란스병원에 입원 하였던 HB^^s Ag 양성이며 복강검사를 측정하였으며 그중 e 항원이 양성이 만성 활동성 간염, 만성 지속성 간염 및 간경변증으로 확진된 환자 80예를 대상으로 DNA-polymerase의 활성도를 측정하였으며 그중 e 항원이 양성인 만성 활동성 간염환자 37예를 대상으로 Ar a-AMP를 투여한 후 장기간 주기적으로 DNA-polymerase의 활성도를 측정하여 다음과 같은 결과를 얻었다. 1) 혈청 e 항원이 양성이었던 환자군의 DNA-polymerase의 활성도는 4994.3±789.8 dpm/ ml였고 음성이었던 환자군은 606.2±190.1 dpm/ml로서 양군사이에 통계학적으로 유의한 차이를 보였다(p<0.05). 2) 만성 활동성 간염, 만성 지속성 간염 및 간경변증 환자군의 DNA-polymerase의 활성 도는 각각 4889.6±930.6 dpm/ml, 5040.9±1449.3 dpm/ml 그리고 1895.6±1075.8 dpm/ml 로서 각군 사이에 통계적 유의성은 보이지 않았다(p>0.05). 3) Ara-AMP로 치료한 구에서의 DNA-polymerase의 활성도는 치료후 1주째부터 의의있게 감소하기 시작하여 24주이상 추적이 가능했던 16명의 경우에서 10예(62.5%)는 정상범주의 DNA-polymerase의 활성도를 나타냈으며 그중 6예가 e 항원이 음전되었고, DNA-polymeras e의 재상승을 보였던 나머지 6예 (37.5%)는 대조군에서와 같이 1예만이 e 항원의 음전을 보였다. 4) Ara-AMP의 부작용으로는 37예중 식욕부진이 8예(21.6%)로 가장 많았고 오심과 무기 력감이 각각 6예(16.2%)였으며 1예(2.7%)에서 지각이상, 과립백혈구 감소증 및 혈소판감 소증을 동시에 보였으나 투약중지후 정상으로 회복되었다. 이상의 결과 DNA-polymerase의 활성도는 e항원의 양성여부와 연관성을 보이며 만성 활 동성 간염환자에게 Ara-AMP로 4주간 단기치료를 시행함으로서 B형 간염바이러스의 증식을 효과적으로 억제할 수 있었다. A Study on the Activity of HBV DNA-polymerase and Effect of Adenine Arabinoside-5'-monophosphate (Ara-AMP) Therapy in Chronic HBV Infection Yong Bum Kim, M.D. Department of Medical Science The Graduate School, Yonsei University (Directed by Prof. Jin Kyung Kang, M.D.) Since the presence of DNA-polymerase has been reported by Hirschman et al. in concentrated preparations containing Au antigen, the activity of DNA-polymerase has been used as the index of degree of the viral replication and as the most sensitive marker for the effects of antiviral therapy. The activity of DNA-polymerase was measured through radiological assay in 80 patients with HBaAg positive chronic HBV infection (57 patients with chronic active hepatitis, 12 with chronic persistent hepatitis and 11 with liver cirrhosis) and serially checked for about one year in 37 patients with HBeAg positive chronic active hepatitis, who received 4 weeks Ara-AMP there apy. The following results were obtained 1. The mean DNA-polymerase activity of the HBeAg positive chronic hepatitis patients was significantly higher than that of the HBeAg negative patients (p<0.05) but differences of the SGOT and SGPT levels between the both groups were not significant (p>0.05). 2. The differences of mean DNA-polymerase activities among the chronic active hepatitis, chronic persistent hepatitis and liver cirrhosis were not significant(p>0.05). 3. During the 4 weeks of Ara-AMP therapy, the mean levels of DNA-polymerase activity, SGOT and SGPT fell dramatically. 10 of 16 patients who could follow up for over 24 weeks maintained DNA-polymerase activity normal however, remaining 6 relapsed. From 1 to 9 months after therapy, 7 of 16 patients became HBeAg negative, while only one of 6 controls became HBeAg negative. 4. Side effects of Ara-AMP such as anorexia (21.6%), nausea(16.2%), general weakness(16.2%), paresthesia(2.7%), granulocytopenia(2.7%), and thrombocytopenia(2.7%) were observed. In conclusion, the measurement of DNA-polymerase activity will be helpful in evaluation of infectivity of chronic viral hepatitis and effect of antiviral therapy. More work is needed to determine whether the use of Ara-AMP in more prolonged or repeated courses, or both, and application earlier in the course of the iliness might be more effect in the eradication of virus and in stopping progression of chrniceliver disease. Alternatively, Ara-AMP may be more effective when combined with other antiviral agents, and controlled studies to evaluate various combination regimens are required.restrictio

The U.S. Antitrust Policy of Telecommunications:1974~1984 AT&T antitrust divestiture

학위논문(석사) --서울대학교 대학원 :외교학과,2007.Maste