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전재규,지대림,김성기,박준만 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.6
Background: This study examined hemodynamic variables, oxygen delivery, extraction, and consumption in response to acute progressive hypoxia and hypercarbia in the setting of apnea. Methods : Apnea was induced in 9 healthy mongrel dogs by disconnecting animals from mechanical ventilation of 30 minutes with pure oxygen. Hemodynamic variables, oxygen transport, extraction, and consumption were rapidly and repeatedly measured using pulmonary arterial and arterial catheters until cardiac output was undetectable. Results : The baseline PaO2, PaCO2, pH, base excess were 318±137 mm Hg, 36±3.5 mm Hg, 7.30±0.06, 6.81±2.65 mmol/l respectively. Hypercarbia and hypoxemia(76±33 mm Hg) was first noted at 1 and 4 minute respectively. Base excess was not changed. Indices of preload(PCWP and CVP) were increased early in the time course(P<0.05). In contrast, indices of afterload(SVR) increased later, just before cardiac decompensation began(P<0.05). No significant reduction of cardiac output, oxygen delivery, extractd consumption was detected just until abrupt cardiac decompensation started, 5 minute. Conclusions : These data suggest that the early increase in preload was primarily due to hypercarbia whereas the late increase in afterload was due to hypoxemia, but the main cause of acute cardiac decompensation was a critical decrease in arterial oxygen tension with some contribution of increased preload and afterload. (Korean J Anesthesiol 1997; 33: 1020∼1028)
전재규,지대림 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.6
To identify the epidural space various methods have been recommended and the methods are divided into two major categories, either loss of resistance or negative pressure technics. A syringe technic to feel loss-of-resistanse is now widely used clinically due to its reliability and simplicity. However, in some instances, it is very difficult to recognize the epidural space despite using the above methods so that the need for a more safe and easier one is required. After the patient is placed in a sitting flexed position, an 18 gauge Tuohy needles is inserted epidurally at the lumbar area with a saline filled CVP manometer connected via a 3-way stopcock, then a sudden drop of pressure is usually observed and a fluctuation of the pressure can be observed in the water column of the manometer according to the changes in positions, respiration and heart beat. Although this method can be criticized because the technique is somewhat cumbersome and is difficult for retrial when the dura has been punctured, the authors appreciate the experimental values of the technic and suggest its aduantanges as follows: 1) it is a visual thchnic. 2) the measurement of epidural pressure is possible. 3) it prevents back-drip of local anesthetic solution with a 3-way stopcock. 4) it is useful as an index for determination of local anesthetic volume to be injected.
전재규,지대림,황정한 대한마취과학회 1992 Korean Journal of Anesthesiology Vol.25 No.6
Surgery and anesthesia-related ipsilateral reexpansion pulmonary edema has been seldom reported. The pathogenic mechanism of this rare complication is not clearly understood. A 23 year-old male had a decortication for left lung empyema under one-lung anesthesia. It took 6 hours to finish the scheduled operation. The patient came back to surgery again because of postoperative bleeding and he developed an ipsilateral pulmonary edema during the reexpansion of the collapsed lung. Fortunately, he was well tolerated with the developed edema which was resolved gradually without any specific management. The most likely mechanism is the increased pulmonary capillary permeability due to capillary injury resulting from hypoxia, oxygen free radicals, stretching, or surgieal manipulation. Secondly, the rise of the pulmonary capillary transmural pressure gradient and decreased lymphatic pump activity might also be involved as well.
서대웅(Dae Woong Seo),성노천(No Cheun Sung),성재호(Jae Ho Sung),최도석(Do Seok Choi) 대한설비공학회 2018 대한설비공학회 학술발표대회논문집 Vol.2018 No.11
냉난방 설비의 존치/교체는 성능을 측정하여 제안하는 것이 가장 이상적이다. 측정하는 냉난방 설비가 늘어날수록 많은 인력이 필요하기 때문에, 낮은 단가로 수행되는 에너지진단에서 모든 장비를 측정하는 것은 현실적으로 어렵다. 만약, 공공건물의 운영자를 통해 측정이 필요한 장비가 선별된다면, 현장조사 시간을 절약할 수 있다. 그러나 공공건물의 운영자가 진단에 대한 전문지식이 없는 경우가 대부분이기 때문에, 공공건물의 건물 운영자 수준에서 작성할 수 있는 냉난방 설비의 사전 문진표를 정립하고자 하였다. 냉난방 설비별로 진단해야할 주요 인자는 내구연한, 관리수준, 장비상태, EPI 수준(또는 고효율 전동기 사용 유무)으로 선정하였으며, 설문 결과 인자별 중요도는 평균적으로 내구연한 30%, 관리수준 25%, 장비상태 30%, EPI 수준(또는 고효율 전동기 사용 유무) 15%로 나타났다. 본 사전 문진표를 통해 운영자는 자체적으로 간이 진단을 수행할 수 있고, 진단기관은 결과를 참고하여 현장진단 시간을 줄일 수 있을 것으로 기대한다.
Lee, Chul,Kwun, Oh-Cheun,Jung, Dae-Il,Lee, Ihn-Chong,Kim, Nak-Bae Korean Chemical Society 1986 Bulletin of the Korean Chemical Society Vol.7 No.6
A number of Korean potsherd samples has been classified by Fisher's discriminant method for the training set of Kyungki, Koryung and Kyungnam groups. The Koryung samples have been further classified for the training set of Koryung A, B and C subgroups. The training sets have been used to define classification of unknown samples and clay samples so as to find out some similarity between clay samples and certain potsherd groups.
마취유무에 따른 무호흡후의 혈역학 및 산소 이용률의 비교
장영호,송대규,전재규,배정인 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.3
Background : Acutely induced hypoxia causes an increase in the mean arterial pressure, cardiac output and oxygen consumption. However, comparisons of hemodynamic changes and oxygen consumption between subjects with and without anesthesia are rare. The purpose of this study was to examine and compare the hemodynamic changes and oxygen availability after acute apnea between the dogs with and without anesthesia. Methods : Apnea was induced to 19 healthy mongrel dogs. Group 1(N=10) constituted dogs with anesthesia and group 2(N=9) constituted dogs without anesthesia. Hemodynamic data and oxygen levels were rapidly measured with 1 minute intervals. Results : The survival time of group 1 was longer than that of group 2. The mean arterial pressure increased in group 1. Although the cardiac outputs in both groups increased at the same time course in early phase of apnea, the preload values increased more rapidly in group 1. Systemic vascular resistance decreased at 2 and 3 minutes of apnea in group 1 but not in group 2. The oxygen extraction ratio increased significantly at 4 and 5 minutes of apnea in group 2. Conclusion : In this study the dogs with anesthesia had a prolonged survival time compared to the dogs without anesthesia. Most hemodynamic values did not differ significantly between the two groups, except for an increased mean arterial pressure and decreased systemic vascular resistance in the dogs with anesthesia. It was suggested that the cause of early death in the dogs without anesthesia was decreased oxygen delivery. (Korean J Anesthesiol 1997; 33: 407∼415)
할로탄 마취하 무호흡에 의한 혈역학 및 산소 이용률의 변화
장영호,송대규,전재규,정정길 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.34 No.2
Background : Varying results of hemodynamic and oxygen parameters in response to hypoxia and/or hypercarbia have been reported. In this study, the effects of apnea on the hemodynamic parameters and oxygen availability were evaluated using ten healthy mongrel dogs. Methods : After full oxygenation, apnea was induced by disconnecting animals from mechanical ventilation. Hemodynamic parameters, oxygen delivery, consumption and extraction ratio were measured at one minute intervals until the cardiac output was undetectable via the thermodilution method. Results : Blood pressure(BP) increased continually following apnea. Cardiac output(CO) increased during the early of apnea(2 and 3 minute) but decreased thereafter. Systemic vascular resistance(SVR) decreased in the early phase of apnea but subsequently declined. The indices of preload increased steadily following apnea. Changes in heart rate(HR) were compared with changes in CO and oxygen delivery, and was found to increase during the early phase of apnea (2∼3 minutes) and decrease thereafter. The oxygen extraction ratio did not change significantly and remained steady 6 minutes after apnea but increased and became irregular thereafter. Conclusions : These data suggest that early reflex responses such as increased BP were primarily due to increased CO, whereas the late increase in BP was due to the increase of SVR. We conclude that BP is not meaningful variables in evaluating critical hypoxic condition such as apnea, and bradycardia might be caused by decreased CO and severe hypoxemia. (Korean J Anesthesiol 1998; 34: 280∼293)