전립선에 발생한 Malacoplakia 1례

이국현,허만우,문기혁,김대중,전윤수,이남규 大韓泌尿器科學會 1998 Korean Journal of Urology Vol.39 No.5

술후 환자에서 산소공급장치에 의한 동맥혈 산소분압의 상승효과

이국현,정남영 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.4

Arterial hypoxemia in the postoperative period is of particular importance hecause it may delay recovery, exacerbate organ dysfunction, and contribute to motality. Oxygen supply during recovery period is to prevent the complications attributed to hypoxemia, including confusion, cardiac arrythmia, reactive pulmonary hypertension, lactic acidosis and tissue death. A low flow oxygen supply device, O₂-Cap, is used to supply oxygen in postoperative patients. However, it was hypothesized that increase of inspired oxygen fraction (F₁O₂) in an O₂-Cap is less than that in a T-Piece with an expiratory limb served as a reservoir. The purpose of this study was to compare the effects of O₂-Cap and T-Piece on the increase of arterial tension (PaO₂) during early postoperative period. In a prospective study, we measured vital signs, PaO₂, and arterial carbon dioxide tension (PaCO₂) in 24 adult patients (ASA class I or II) breathing room air in the operation room. After aMominal surgery, they were transferred to the recovery room with the endotracheal tube (intemal diameter, 7.5 mm) whose cuff is deflated. We devided the patients into two groups in the same number. Group C received O₂ of 5 1/m via an O₂-Cap and group T via a T-piece. Postoperative values were obtained at 5 min, 30 min, and 60 min in the recovery room and were compared between two groups. Preoperative values were served as controls in each group. Vital signs were similar in the two groups. PaCO₂ in both groups maintained normal ranges. PaO₂ in group C increased significantly to 132.5±28.1 mmHg, 134.7±26.8 mmHg, and 136.7±23.6 mmHg at 5 min, 30 min, and 60 min after operation, respectively, compared with preoperative value, 99.7±10.0 mmHg (p$lt;0.05). Group T also showed a significant increases in PaO₂ from 102.4±18.2 mmHg, preoperatively to 223.1±56.1 mmHg, 267.0±90.0 mmHg, and 249.8±76.5 mmHg at 5 min, 30 min, and 60 min after operation, respectively (p$lt;0.05). PaO₂ in group T increased more than that in group C during the same period after the operation. It is concluded that T-Piece with a reservoir increases PaO₂ more than O₂-Cap andmaintains normal range of PaCO₂ without hemodynamic instability. Therefore it is expected that T-Piece with reservoir of 70 ml is safe and effective in spontaneously breathing intubated patients for oxygen supply during postoperative period.

최적의 기본마찰각 측정법에 관한 실험적 연구

이국현,장현식,장보안 대한지질공학회 2019 지질공학 Vol.29 No.4

Basic friction angles of Hwangdeung granite, Berea sandstone, Jeongsun marble, Hongcheon gneiss, Pungam shale and Eumseong sandy shale were measured by direct shear test, tilt test and pull test. Characteristics of basic friction angle and the accuracy of test methods were compared and the optimal method in measuring basic friction angle was suggested. Although basic friction angles might be measured accurately by direct shear test, the test apparatus is expensive and procedures are complicated. Tilt tests which is the suggested method for measuring basic friction angle by International Association for Rock Mechanics also provided similar basic friction angles measured by direct shear test. However, the error measured for the same rock type is higher than 7° and values by repeated measurements in one sample show different trends, such as increasing or decreasing or almost constant as measurements continued. The difference measured in one gneiss sample is higher 12°, indicating that tilt test may be not a reliable method for measuring basic friction angle. Not only pull test provided accurate and consistent results under low normal stresses, but also test apparatus is simple and inexpensive and procedure is not complicated, indicating that pull test may be the optimal method for measuring basic friction angle. 황등 화강암, Berea 사암, 정선 대리암, 홍천 편마암, 풍암 셰일 및 음성 사질 셰일의 여섯 종류의 암석에대하여 직접전단시험, 기울임시험 그리고 당김시험을 이용하여 기본마찰각을 측정하고, 암종에 따른 기본마찰각의 특성, 시험방법의 정확성을 비교, 검토하여 기본마찰각 측정에 가장 정확하고 효율적인 시험방법을 제시하였다. 기본마찰각은 직접전단시험을 이용하면 정확하게 측정되지만, 비싼 장비와 복잡한 시험절차가 필요하다. 국제암반역학회에서 표준시험법으로 제안한 기울임시험은 직접전단시험에서측정된 기본마찰각과 유사한 값을 제시하나, 동일한 암석으로 제작된 3개의 시료에서 측정된 기본마찰각은 최대 7° 이상의 오차를 보이고, 1개의 시료에서 5회 측정된 미끄러짐 각 또한 시료에 따라서 증가하거나, 감소하거나, 유사한 값을 보이는 등 일정한 패턴을 보이지 않고 변할 뿐만 아니라, 편마암에서는 최대 12°의 오차를 보여 시험의 신뢰성에 상당한 의문이 든다. 간단한 시험장비와 비교적 낮은 수직응력하에서 실시되는 당김시험은 직접전단시험에서 구한 기본마찰각과 매우 유사한 값을 제공하고, 측정된 값들이 일관성을 보이고 시험절차 또한매우 간단하여 기본마찰각 측정에 가장 유용한 시험 방법으로 판단된다.

가토를 대상으로 Oleic Acid로 유발한 급성 호흡부전증에서 기관내 폐환기법이 사강과 기도내 압력에 미치는 효과

이국현,이가영,김광우,정성량,강양자 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.32 No.3

Background : Intratracheal pulmonary ventilation (ITPV) was developed to allow a decrease in physiological dead space during mechanical ventilation. To reduce anatomic dead space, a reverse thrust catheter (RTC) is introduced into an endotracheal tube (ETT) through an adapter and positioned just above the carina inside the ETT. ITPV can be combined with pressure control mode of mechanical ventilation to make hybrid ventilation(HV). The effect of HV on the reduction of dead space was compared with that of conventional mechanical ventilation(CMV) in rabbits with acute respiratory failure. Methods : Oleic acid of 0.06 ml/kg was injected to induce acute respiratory failure in 7 rabbits. PaO2 and PaCO2 were measured 30 minutes after the injection. Oleic acid was injected in another 7 rabbits to compare CMV with HV while increasing the respiratory rate(RR). Tidal volume, dead space(VD) and peak inspiratory pressure(PIP) were measured at the same RR. Results : PaO2 decreased significantly from 467± 68 mmHg to 156 6 mmHg at FIO2 1.0 after the injection of oleic acid. In another 7 rabbits, the VD's of CMV were 34± 10 ml, 27 ±10 ml, 20± 6 ml, and 18± 3 ml at respiratory rate of 20/min, 40/min, 80/min and 120/min, respectively. The VD's of HV were 28 ±11 ml, 16± 8 ml, 9± 4 ml, and 7± 3 ml at the same respiratory rates as in CMV. The VD's of HV were lower than those of CMV. The PIP's were lower in HV than in CMV. Conclusion: We conclude that HV, as the modification of ITPV, can be applied to acute respiratory failure to minimize the airway pressures and dead space of CMV. (Korean J Anesthesiol 1997; 32: 360∼365)

기관내 폐환기법의 물리학적 성질 규명에 관한 연구

이국현,손주태 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.1

기관내 폐환기법(intratracheal pulmonary ventilation ; ITPV)은 기계적 인공환기를 실시할 때 폐장내의 해부학적 사강을 감소시키기 위하여 개발되었다. 미국 국립보건원의 Kolobow 박사에 의하여 개발된 ITPV는 종래의 기관내 튜브(endotracheal tube ; ETT)의 선단에 역분사 카테타(reverse thrust catheter ; RTC)를 위치시키며, RTC를 통하여 신선가스를 공급하여 RTC의 선단에서 역으로 분사되는 빠른 속도의 가스가 venturi 효과를 유발시키게 된다. 호기회로에 장치된 호기 밸브의 개폐에의하여 RTC에서 분사되는 가스는 방향이 바뀌게 되어, 흡기시에는 1회 환기량으로 폐포내로 이동되고, 호기시에는 분기즐(carina) 하방의 호기가스를 유입(entrainment)시키는 작용을 한다. 따라서 호기말에는 기관내 튜브의 내부는 신선가스로 충만하게 되고, 능동적인 호기가 가능하게 되어 결과적으로 생기학적 사강의 감소를 초래하게 되다. RTC에 의하여 ETT 내로 유입되는 가스의 양은 ETT내의 단면적에 의하여 좌우되리라는 가정을 하여고, ETT의 내경의 변화에 따른 RTC의 가스유입 효과를 알아보고자 하였다. 먼저, RTC 삽입에 따른 ETT의 저항의 증가를 알아보기 위하여, 4.5와 5.0 ETT를 수평으로 고정시키고, RTC 삽입전과 삽입후의 저항의 차이를 ETT내를 흐르는 가스유량과 물기둥에 의하여 측정하였다. ETT내의 단면적이 일정할때, RTC 선단 구멍(orifice)의 크기에 따른 가스유입 효과를 RTC내를 흐르는 가스유량(ITPV flowrate)과 발생되는 음압(sunction pressure) 그리고 유입되는 가스유량(entrained flowrate)을 비교하여 추정하였다. 그리고, 내경이 다른 여러가지 ETT를 이용하여 RTC의 가스유입 효과를 동일한 방법으로 측정하였다. ETT의 저항은 내경이 작을수록 크고, RTC를 삽입하였을때 저항이 급격히 증가하였다. RTC선단의 구멍이 작을수록 높은 음압이 발생하고, 가스유입량이 많아지지만 동일한 가스를 유입시키는데 필요한 음압의 양은 동일하였다. 일정한 RTC를 사용할 때 내경이 큰 ETT에서 작은 음압으로 많은 양의 가스가 유입됨을 확인하였다. 따라서 ITPV를 사용할 때 ETT내의 저항은 가스유입을 결정하는 주된 요소이고, 장래의 ITPV장치의 설계에는 ETT의 단면적을 최대한으로 보장할 수 있는 새로운 방법이 모색되어야 할 것으로 결론한다.

술후 회복기환자에서 기관내 튜브의 기낭 사용 여부에 따른 동맥혈 가스 분석치의 비교

이국현,이가영 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.1

An endotracheal tube (ETT) may be thought of as a mechanical burden to a spontaneously breathing patient because increases in airway resistance might result in increases in the work of breathing,when diameter of airway is decreased in the intubated patient compared with his own tracheal diameter. We hypothesized that air removal from ETT cuff would permit the airflow between ETT and tracheal wall and could make the airway resistance decrease. Postanesthetic patients after abdominal surgery were divided into two groups. ETT cuff was inflated in group 1 (n=25) and deflated in group 2 (n=25), while 5 l/min of oxygen was delivered through the ETT via a simple oxygen supplement device without a gas reservoir. The effects of balloon on gas exchange and respiratory pattern were evaluated at 5 and 30 minutes after admission to the recovery room. Postanesthetic PaO₂ was increased compared to preanesthetic value with oxygen supply. PaCO₂ values revealed no significant changes in preanesthetic and postanesthetic periods. Postanesthetic respiratory rate was increased significantly but there was no difference between two groups. However, there were three hypoxemic patients whose PaO2 were below 70mmHg in group 1. It was concluded that the use of balloon of ETT in postanesthetic recovery period might contribute to airway resistance and the work of breathing. Although almost of patients could make compensations to overcome the effects of balloon, there is a risk of postoperative hypoxemia if compensated inadequately.

전부 요도손상 환자에서 초기 치료 방법에 따른 결과의 비교

이국현,이남규,박영호 大韓泌尿器科學會 1999 Korean Journal of Urology Vol.40 No.7

실(實)_조부장의 직장인 백서 : 조(助) 부장

이국현 한국지방재정공제회 2015 지방재정 Vol.2015 No.2

부갑상선 증식증의 수술적 치료경험

이국현,정파종 대한외과학회 1996 대한외과학회 학술대회 초록집 Vol.1996 No.11

실험동물 시설의 운영 및 관리

이국현 주식회사 녹십자 2000 녹십자의보 Vol.28 No.5