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Effectiveness of milrinone for cardiogenic shock due to massive pulmonary aspiration -a case report-
박정헌,김동희,김석곤,전대근,송재격,지승헌,이관우,강봉진,권민아 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.66 No.6
Pulmonary aspiration of gastric contents is one of the most frightening complications during anesthesia. Although pulmonary aspiration of gastric contents in general surgical patients is not common and resulting long-term morbidity and mortality are rare, severe hypoxemia and other sequelae of pulmonary aspiration continue to be reported. We report a case of massive aspiration of gastric contents during induction of general anesthesia, resulting in cardiac arrest due to severe pulmonary hypertension and myocardial infarction. Sustained cardiac arrest and shock that did not respond the conventional resuscitation was successfully treated using milrinone. The patient was discharged without complications in 20 days.
요추부 추간판 탈출증세와 유사한 골반내 악성종양 증례 보고
박정헌,김태형,심우석,허진산,권민아 대한통증학회 2004 The Korean Journal of Pain Vol.17 No.2
A pelvic bone tumor may produce symptoms such as a herniated intervertebral lumbar disc if it invades the sacrum and sacro-iliac joint. Diagnosis is not always easy, and misdiagnosis due to nerve root compression of the pelvic bone tumor may occur. Herein, the case of a 61-year-old patient, whose diagnosis was more difficult than for a herniated intervertebral lumbar disc due to a lack of symptoms usually associated with malignancy, is described. Unfortunately, the patient underwent an operation for the suspected herniated discs. In such cases, the correct diagnosis often can not be made on the first attempt. In conclusion, it must be remembered that patients who do not respond to the usual forms of treatment in a reasonable period of time should be re-examined both clinically and radiographically.
박정헌,권민아 대한수면연구학회 2021 Journal of sleep medicine Vol.18 No.1
The prevalence of obstructive sleep apnea (OSA) is on the rise worldwide due to an increase in metabolic syndrome, obesity, and aging. Patients with OSA are at higher risk of perioperative complications than those without OSA; however, OSA is often not diagnosed before surgery. For patients diagnosed with OSA or who are judged to be at risk of OSA by various screening tools, safe preparation for respiratory depression or difficult airway is critical. Exaggerated respiratory depression often occurs in response to commonly used sedatives and analgesics, and there is a high risk of hypoxic events due to difficulty in maintaining the airway. Currently, there is insufficient training of health care providers to screen and diagnose patients with OSA, and several screening tools are incomplete. In addition, the guidelines for optimal monitoring and perioperative management of patients with OSA have not yet been clearly established. In the present work, the author aims to explain the latest findings useful to sleep physicians regarding the overall management, including pre-operative evaluation and preparation, intraoperative anesthetic management, and post-operative general care and analgesic strategies, of patients at risk of OSA.
박정헌,김상윤,권민아 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.2
Recently, balanced sedation has commonly been used during procedural sedation. Dexmedetomidine is known for its relative safety to cause “conscious sedation” with little respiratory depression but has some limitations such as frequent awakening and hemodynamic instability during surgery. To facilitate sedation, a small dose of midazolam can be co-administered rather than escalating the dose of dexmedetomidine, especially in elderly patient. Despite the respiratory safety profile of dexmedetomidine, the overall safety of co-administration has not been clarified. We describe the first case of fatal pulmonary aspiration that developed in an elderly patient during balanced sedation with spinal anesthesia for elective femur fracture surgery.
박정헌(Park, Jeong-Heon),홍성근(Hong, Sung-Geun),이광희(Lee, Kwang-Hee),이철희(Lee, Chul-Hee),김철현(Kim, Cheol-Hyun),조원오(Cho, Won-Oh) 한국소음진동공학회 2012 한국소음진동공학회 논문집 Vol.22 No.6
This paper presents a solution of the vibration reduction in the hollow shafts by using magentorehological( MR) elastomer. Proposed active damping structure is built by embedding the MR elastomers whose elastic modulus is controllable by an applied magnetic field. MR elastomers consist of synthetic rubber filled with micron-sized magnetizable particles. For reduction of vibration, dynamic damper of hollow shaft is designed by using MR elastomer and equipped in the hollow shaft for the application to drive shaft. Experiment results are shown through the experiments to confirm the effect of MR elastomer dynamic damper for vibration reduction. Thus, the designed damping structure can be applied to vibration absorber used in drive shafts as well as the propeller shafts.
임상연구 : 진통제와 환자 조절 진통(Patient-Controlled Analgesia)에 대한 수술 전 교육이 수술 후 진통제 사용량에 미치는 영향
박정헌 ( Jeong Heon Park ),권민아 ( Min A Kwon ),구명신 ( Myoung Shin Koo ),김용익 ( Yong Ik Kim ),김순임 ( Soon Im Kim ),김선종 ( Sun Chong Kim ),강진구 ( Jin Gu Kang ),조현성 ( Hyun Sung Cho ),이병달 ( Byung Dal Lee ),김갑수 ( G 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.6
Background: The purpose of this study is to evaluate the patients` general perception about the analgesics and the effects of the preoperative education about analgesics and patient-controlled analgesia (PCA). Methods: One hundred patients scheduled for elective gastrectomy were randomly allocated into two groups. In control group (n = 50), patients were given conventional preanesthetic visit with questionnaire survey on PCA one day before operation. In study group (n = 50), patients were sufficiently explained about postoperative analgesia and PCA by anesthesiologist and given precise explanation sheet about PCA. Total amounts of drug used in PCA as well as rescue analgesics, the pain scores, and side effects were compared. Results: 62.2% of patients had much information from various sources that analgesics effects positively in the recovery phase, but actually 73.7% of patients considered that analgesics do not seem to have any influence on the recovery after operation. There was no difference between the amounts of total PCA used, rescue analgesics, and the pain scores. However, the educated patients complained less dizziness at postoperative days (POD) one. Also, the number of patients excluded from study due to the PCA discontinuation secondary to related side effects was less in educated patients (P = 0.025). Conclusions: Preoperative education about analgesics and PCA failed to demonstrate significant decrease in the amount of analgesics and of pain scores. However, it lowered the incidence of PCA discontinuation due to side effects. (Korean J Anesthesiol 2006; 51: 715~9)
박정헌(Park, Jeong-Heon),이철희(Lee, Chul-Hee),김철현(Kim, Cheol-Hyun),조원오(Cho, Won-Oh) 한국소음진동공학회 2011 한국소음진동공학회 논문집 Vol.21 No.8
This paper presents vibration characteristics of magnetorheological(MR) elastomer, whose elastic modulus are controllable by applied magnetic field. By using this property, the material can be applied to vibration absorber, so that the stiffness of the absorber can be changed and actively controlled according to the magnetic flux density. However, the various performances of MR elastomer depends on different polarized direction of particles by applied magnetic field and dimension during the manufacturing process. In this paper, in order to obtain the optimal characteristics of MR elastomer, MR elastomers with different types and dimensions are prepared for a series tests. Using this test setup, extent of natural frequency shifted against magnetic field at various excitation frequencies can be measured. Specimens are prepared with 3 types, as cylinder samples exposed to magnetic field vertically, horizontally and unexposed during cure, respectively. Also, a set of design variables are considered to produce MR elastomers. Through the modal tests of mass structure with MR elastomer, the optimal design as well as the polarization direction of MR elastomer is obtained among the various dimensions and 3 directional types of MR elastomers.