• 수면정신생리
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• 제13권1호
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• pp.5-10
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• 2006

Alcohol has extensive effects on sleep and daytime sleepiness. Alcohol has a sleep inducing effect and the effect of increased non-REM sleep and suppressed REM sleep during the first half portion of night sleep, but alcohol induces the effect of decreased non-REM sleep and increased light sleep and frequent awakenings and REM rebound during the second half portion of night sleep. Alcohol provokes chronobiological change such as the changes of amplitude or the phase shifts of hormones or core body temperature. The sleep disruption resulting from alcohol drinking may lead to daytime fatigue and sleepiness. The elderly are at particular in the increased risk of alcohol-related sleep disorders because they achieve higher levels of alcohol in the blood and brain than do younger adults after consuming an equivalent dose. Bedtime alcohol consumption among older adults may lead to unsteadiness if walking is attempted during the night, with increased risk of falls and injuries. Continued alcohol use for sleep induction often induces aggravation of insomnia, alcoholism or sleep related breathing disorders such as obstructive sleep apnea. Alcohol should not be used as substitution of sleep pill because of the dependence and tolerance for sleep inducing effect, and the sleep disruption produced by alcohol withdrawal.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.116-120
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• 2016

Congenital hyperinsulinism (CHI) is a rare condition that can cause irreversible brain damage during the neonatal period owing to the associated hypoglycemia. Hypoglycemia in CHI occurs secondary to the dysregulation of insulin secretion. CHI has been established as a genetic disorder of islet-cell hyperplasia, associated with a mutation of the ABCC8 or KCNJ11 genes, which encode the sulfonylurea receptor 1 and the inward rectifying potassium channel (Kir6.2) subunit of the ATP-sensitive potassium channel, respectively. We report the case of a female newborn infant who presented with repetitive seizures and episodes of apnea after birth, because of hypoglycemia. Investigations revealed hypoglycemia with hyperinsulinemia, but no ketone bodies, and a low level of free fatty acids. High dose glucose infusion, enteral feeding, and medications could not maintain the patient's serum glucose level. Genetic testing revealed a new variation of ABCC8 mutation. Therefore, we report this case of CHI caused by a novel mutation of ABCC8 in a half-Korean newborn infant with diazoxide-unresponsive hyperinsulinemic hypoglycemia.

• The Korean Journal of Physiology
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• 제13권1_2호
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• pp.35-40
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• 1979

The present study was undertaken to investigate effect of water extracts of the mulberry leaves (MWE) on arterial blood pressure and respiration in cats. And also studied were depressor responses to intravenously administered MWE in the animals pretreated separately with atropine(2.5 mg/kg), propranolol(2 mg/kg), dibenamine (15 mg/kg), and hexamethonium (1.5 mg/kg) in order to find out the mechanism of depressor activity of MWE. The results obtained were as follows; 1) Following intravenous administration of 0.25 ml/kg and 0.5 ml/kg of MWE into the cat the maximum depressor responses observed were $60.2{\pm}2.3\;mmHg$ and $72.3{\pm}1.7\;mmHg$ respectively. 2) Since depressor responses to intravenously administered MWE were partially inhibited by hexamethonium and markedly by atropine, it is strongly suggested that depressor activity of MWE mainly results from its vagal effects. 3) After administration of MWE respiratory rate was invariably increased following a short period of apnea.

• The Korean Journal of Pain
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• 제9권1호
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• 한국임상수의학회지
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• 제15권2호
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• pp.394-398
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• 1998

This study was performed to assess clinical signs, sedative effect and clinicschemical profile of a mixture of fentanyl-azapemne-xylazine(Fentazine$^{(R)}$) in formed elk Twelve male elk(Cervus canadensis) were immobilized with Fentazine, and blood samples were taken of femoral venous blood. Samples were analyzed in the conditions of 10- and 30-minute after administration of the drug. Heart rates, respiratory rates, and body temperatures were in normal ranges during Fentazine anesthesia. After iqiection of Fentazine, most of elk were recumbency and did not respond to needle prick In young adult(3.5.4.5 years old) elk a high dose(>3.0 ml/head) of Fentazine does not result in more sedation, but it does prolong the duration of sedative effect. Fentazine induced sufficient analgesia far velvet antler removal and hoof trimming in elk Salivation, urination, intermittent apnea and mild bloat were observed in elk Globulin, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, calcium, magnesium and phosphorus values were in normal ranges for at least 30 minutes after Fentazine administration. Total protein, albumins cortisol and prothrombin values were slightly increased during sedation(p<0.05). It was concluded that Fentazine is effective analgesic drug being useful for velvet antler removal and hoof trimming.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1132-1138
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• 1995

From 1991 to 1994, we experienced 24 cases of neonatal pneumothorax who were admitted to the Neonatal Intensive Care Unit[NICU , Chosun University Hospital. The Following results were obtained.1 The incidence of neonatal pneumothorax was 0.70%, and there were 8 spontaneous pneumothoraces and 16 secondary pneumothoraces. 2 The clinical manifestation of neonatal pneumothorax was as followed. Male infant was dominant[M:F=2:1 , the onset was within 24 hours in the majority[83% , and the right side[62% was more frequent than the left side. The gestation duration and birth weight show no correlation with underlying neonatal pneumothorax. The pulmonary diseases were meconium aspiration syndrome and hyaline membrane disease, and the incidence of those was 58%. Meconium aspiration syndrome occurred earlier than hyaline membrane disease. Symptoms and signs were tachypnea[46% , cyanosis[21% , irritability[13% , chest retraction[8% and apnea[8% .3 The treatments performed were oxygen therapy[17% , thoracentesis[4% and closed thoracostomy with underwater seal drainage[79% . The Mean duration of air leakage was 11.7 hours, and the mean drainage time was 4.35$\pm$1.3day. 4 The overall hospital mortality was 33%, and the rate of complication was 46%. The complications were metabolic acidosis, atelectasis, pleural effusion, pulmonary hemorrhage and pneumonia. We concluded that the prognosis was related to the underlying pulmonary disease.

• 대한유전성대사질환학회지
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• 제14권1호
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• pp.10-18
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• 2014

Recent advances in the diagnosis and treatment of inborn errors of metabolism have improved substantially the prognosis of many of these diseases, if diagnosed early enough before irreversible damage occurs. This makes it essential that the practicing pediatrician, especially neonatologists be familliar with the clinical presentations and systematic approaches of these disorders. Characteristic clinical presentations, methods of systematic approach and typing of various disorders is discussed in this review. The signs of neurological dysfunctions of many IEMs manifesting in the neonatal period is very nonspecific, such as poor feeding, poor sucking, apnea or tachypnea, vomiting, hypertonia, hypotonia, seizure, letharginess, consciousness change and coma. Many other non-metabolic severe disorders of neonatal period such as neonatal sepsis and intracerebral hemorrhage share these nonspecific symptoms. Hyperammonemia, metabolic acidosis, ketosis and hyperlatic acidemia are observed in many of these conditions but there are exceptions in which conditions all basal laboratory tests are normal, such as NKH, sulfite oxidase deficiency and peroxisomal disorders. According to the results of basal laboratory tests, IEMs in the neonatal period can be categorized in to 6 types. Grouping of IEMs into 6 types will make confirmatory tests and early emergency treatment more efficient.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.22-26
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• 1998

Uvulopalatopharyngoplasty(UPPP) is one of the most popular surgical procedure for the treatment of obstructive sleep apnea syndrome(OSAS) occurring at the level of oropharynx. However, voice changes after UPPP have been a challenging issue for the professional voice users, because even minor changes in voice quality or articulation may be critical to professional singers, teachers, and so on. Several acoustic changes after UPPP have been proposed. However, based on the authors understanding, there is no report about voice changes after UPPP in Korean. We measured the first, second and third formant frequencies of /a/, /i/, /u/ phonations in 20 adult male patients who had undergone UPPP surgery, and the nasalances of Rabbit, Baby, and Mama passages. These parameters were measured preoperatively, at 1 month and 3 months after the operation. Any subjective voice changes were asked to be reported at the posto-perative visits. The third formant(F3) of /u/ phonation was significantly reduced at postoperative 1 month measurement. The nasalance of Mama passage was singnificantly increased at postoperative 3 months measurement. No one complained of subjective changes in voice quality, timbre, articulation or speech. Even though there are no complaints about postoperative voice changes subjectively, significant changes in the formant characteristics of certain vowel and changes in the nasality after UPPP require the clinicians to be mort cautious and careful in deciding UPPP for the professional voice users.

• 대한기관식도과학회지
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• 제1권1호
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• pp.129-135
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• 1995

The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.

• 한국임상수의학회지
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• 제14권2호
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• pp.151-160
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• 1997

This study was performed to assess clinical signs, sedative and physiologic effects of a combination of fentanyl, azaperone and xylazine (F-A-X). The experiments were divided into four groups; xylazine 0.1mg/kg (X 0.1), F-A-X 0.05 MG/KG (F-A-X 0.05), F-A-X 0.1 MG/KG (F-A-X 0.1) and F-A-X 0.2mg/kg (F-A-X 0.2). Heart rates were decreased in all groups. Respiratory rates were decreased in other groups, but increased in F-A-X 0.2. Body temperatures were in normal ranges. After administration of F-A-X, most of cattle were recumbency and did not respond to needle prick. Duration of sedation was prolonged with increasing dosages. F-A-X did not induce sufficient analgesia for dehorning. Side effects were salivation and urination in all, but they were much less in F-A-X groups than those in X 0.1. Intermittent apnea and bloat were observed in F-A-X 0.2. Serum chemistry values were in normal ranges exvept for hyperglycemia invreased thorough experimental time. Based on above results, it may be concluded that F-A-X is effective preanesthetic with low dosage of 0.05~0.1 mg/kg being useful for immobilization or manipulation without tissue incision in cattle.