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조영례,박정출,이경천,김홍순 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.5
This report is concerned with our clinical experience of 150 cases of anesthesia for open heart surgery at department of anesthesiology, In chon Gil hospital from Februry, 1990 to April, 1993. The results were as follows ; 1) Among 150 cases, 68 cases (45.3%) were congenital heart disease and 82 cases (54.7%) were acquired heart disease. 62 cases (41.3%) were males and 88 cases (58.7%) were females. 2) Glycopyrrolate, diazepam, morphine, were used as premedicants. 3) Fentanyl, ketamine, diazepam, thiopental sodium were used as induction agents and injected singly or in combination. 4) In congenital cyanotic heart diseases, ketamine was used as main anesthetic agent. In other heart diseases, fentanyl, isoflurane, diazepam were used. 5) Vecuronium was used for intubation and maintenance of muscle relaxation. 6) Overall mortality rate was 3.3% (5 cases) and the causes of death were low cardiac output, respiratory insufficiency, mediastinal infection.
제왕절개술시 전신마취유도제로서 Thiopental Sodium 과 Ketamine 의 비교연구
조영례,박정출,이경천 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.5
This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; 1) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group
선천성 심기형 수술 후 흉입 산화질소 중단시 발생한 반동성 폐동맥 고혈압
박희권,장영진,김지희,조영례,박정출,이현우,이경천,임유택,박국양 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3
Background : Inhaled nitric oxide (NO) therapy causes selective pulmonary vasodilation in patients with pulmonary hypertension. However, attempts to discontinue inhaled NO may be complicated by abrupt life-threatening rebound pulmonary hypertension (RPH). The purpose of this study was to deter- mine the risk factors to develop RPH and to present the adequate weaning methods. Methods : We studied 19 consecutive children who were treated with inhaled NO because of pulmo- nary hypertension after surgery for congenital heart disease. We compared the dose of NO at the time of start and withdrawal, the duration of weaning and treatment, hemodynamic data, and blood gas analysis before inhaled nitric oxide withdrawal, between patients without (group I, n =13) and with RPH (group II, n =6). Results : Compared with group I, group II patients were older in age (1204 ± 1688 versus 546 ± 1654 days, P $lt; 0.05), had a lower NO concentration just befote withdrawal (3 ± 1.6 versus 5 ± 2.6 ppm, P $lt; 0.05), a shorter dura of NO weaning period (4 + 3.3 versus 15 + 13.4 hours, P $lt; 0.05) and received NO therapy for a shorter duration (26 ± 11.6 versus 57 ± 46.0 hours, P $lt; 0.05). Conclusions: We recommend a progressive withdrawal of inhaled nitric oxide to avoid life-threatening RPH observed in the sudden discontinuation. (Korean J Anesthesiol 2000; 38: 457~462)
선천성 심질환 수술 후 폐동맥 고혈압에 대한 흡입 산화질소의 효과
장영진,김지희,조영례,박정출,이경천,임유택 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.6
Background : Congenital heart disease may be complicated by pulmonary hypertension. We assessed whether inhaled nitric oxide would produce selective pulmonary vasodilation in pediatric patients with congenital heart disease and pulmonary hypertension. Methods : Inhaled low dose (10 20 ppm) nitric oxide was administrated in patients who were at risk of pulmonary hypertension after operations for congenital heart disease. To identify the nitric oxide effects, we evaluated hemodynamic and ABGA data before (T0) and after (T1) inhaled nitric oxide and just before (T2) decreasing concentration of inhaled nitric oxide. Results : Inhaled nitric oxide decreased pulmonary arterial pressure and increased PaO2/FiO2 without decreasing systemic arterial pressure. Conclusions : Inhaled nitric oxide selectively decreased pulmonary arterial pressure in patients with congenital heart disease complicated by pulmonary artery hypertension. (Korean J Anesthesiol 1999; 37: 1084∼1088)
골반경 수술시 골반내 도포한 Morphine, Morphine-Bupivacaine의 술 후 진통 효과
박희권,이은주,장영진,이소영,김지희,조영례,박정출,김흥순,이경청,김용옥 대한통증학회 2000 The Korean Journal of Pain Vol.13 No.1
Background: Evidence has accumulated that opioids can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. Bupivacaine has a potent analgesic effect with early peak onset in the postoperative period. The combination of intrapelvic bupivacaine and morphine has been suggested as an ideal analgesic after endoscopic pelvic surgery. Methods: Sixty patients scheduled for endoscopic pelvic surgery under general anesthesia were allocated randomly to three groups. Group 1 received normal saline 20 ml, group 2 received morphine 5 mg in normal saline 20 ml, and group 3 received morphine 5 mg in 0.25% bupivacaine 20 ml into the pelvic cavity. Postoperative pain was assessed using the visual analogue scale at 1, 2, 4, 8, and 24 hours after the intrapelvic instillation. Supplemental analgesic requirements, vital signs, and side effects were recorded for 24 hours. Results: Intrapelvic morphine and bupivacaine produced significant analgesia after endoscopic pelvic surgery. The patients in group 3 bad lower pain scores than those in the group 1 and 2 at 1, 2 and 4th hours. There were no significant differences in the pain scores at 8 hours and 24 hours postoperatively between group 2 and 3. Supplemental analgesic requirements were significantly greater in the groups 1 and 2 than the group 3 for 24 hours. No significant side effects occurred. Conclusion: The intrapelvic instillation of morphine and bupivacaine is effective for the postoperative pain control in patients undergoing endoscopic pelvic surgery.
자동변속기의 구동손실 저감을 위한 체인 커버 형상 설계
우희철(Heechul Woo),이현환(Hyunhwan Lee),大村智洋(Tomohiro Oomura),井出篤幸(Atsuyuki Ide),박진수(Jinsu Park),윤용훈(Yonghun Yoon) 한국자동차공학회 2014 한국자동차공학회 학술대회 및 전시회 Vol.2014 No.11
Automatic Transmission is controlled by pressure of ATF(Automatic Transmission Fluid), and is composed by many rotating components. Part of components is under ATF and it causes rolling resistance when it is rotating. Also collision between ATF and rotating components makes the air bubbles which are included in ATF, so they increase the oil level and driving loss. In this study, shape design of the Oil Pump Chain Cover was performed to improve the oil flow and reduced the air content. Finally, decreased air content was confirmed by experimental measurements and reduced driving loss was evaluated.