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Enflurane 과 Halothane 마취제가 간기능에 미치는 영향의 임상적 비교 연구
김완식,박동호,심재철,서정국,김유재,서병태,황영희,정창우,강귀빈,유희구 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.1
Halothane was introduced in 1956. It has been used worldwidelr as a relatively safe inhalation anesthetic but it Is generally accepted that it can causu decrease of liver function. But the causative factor has not yet been pinpointed. Enflurane also seems to decrease liver function but the exact cause is not yet known. In order to study the effects of enflurane and halothane on liver function, we used 10 cases of spinal anesthesia as a control group, and 20 cases each of enflurane and halothane anesthesia respectivly as experimental groups. We then checked serum GOT, GPT, total bilirubin, alkaline phosphatase, and eosinophil count in peripheral venous blood before operation and 6 days after operation and looked for the existence of high fever of more than 99"C. 3 daya postoperatively. The results are as fellows : 1) We found statistical significant change of serum GOT, GPT, total bilirubin, alkaline phosphatase and eosinophil count in spinal, enflurane, or halothane anesthesia before and after operation. There was no statistically significance beween the control and experimental groups. 2) No patient developed high fever of more than 3g"C. until. 9 days after anesthesia in any group. 3) No si☞nificant change of mean arterial blood pressure was observed before and during anesthesia in each group. In this study no definite conclusion that enflurane and halothane might have affected the liver function.
김완식,박동호,심재철,서정국,정창우,황영희,김유재,강귀빈,유희구 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.2
Recent studies in western countries have reported that the mechanism of pain are concorded with gate control opiate receptor binding sites and the release of intrinsic morphine like substances, sodium glutamate and also with bradykinin, serotonin, histamine and prostaglandin E. Otherwise the mechanism of the stimulation producing analgesia has been reported to involve a neurophysiologic and neurohumoral inhibitory effect at the level of spinal cord, brain stem, thalamus and cortex. This has been clarified but further study should improve the chance of understanding the mechanism of pain. From the standpoint of pain management, medications used to manage pain have some unfortunate side effects. Nerve blocks cause anesthesia toxicity, major neurosurgical procedures have many complications. Subarachnoidal and epidural analgesics have unknown irritation pneumonia and drug toxicity, and celiac plexus or pituitary gland block with phenol or alcohol has unevenful complication. From January 1980 to december 1982, electrical acupuncture stimulation has been used on 210 cases at HANYANG university hospital in the pain clinic I found it useful in relieving pain which has not responded to various conventional methods which included medications, nerve blocks, neurosurgical intervention and neuropolytics. The results are as follows; 1) There are two kinds of treated patients; One is consultation case-12 from internal medicine, 16 from orthopedic surgery, 10 from neurosurgical and 2 from psychiatry. Another 170 cases were patients who directly to the clinic. And the age distribution shows the higest number of patients in the 3rd decade (21%) and in the 4th decade (24.8%). 2) The region of pain was 21% lumbar, 13.8% shoulder, 10% lower leg and head or face with 9.5%. 3) The duration of the pain showed 10 days 25.7%, 1~2 month 18.6%, one year 11.4% and the longest up to 20 years. 4) Patients who were able to walk into the clinic were 19.5%, moderate cases who to be accompanied were 58.6% and bedridden cases were 21.9%. 5) Treatment was conducted mainly on low frequency stimulation with various waves that included the general dynamic activity point plus reactive electro permeable point (REPP) 81.9% and REER plus head in situ needle 18.1%. 6) In 16.7% only one treatment was administered, in 46.1% 2~5 treatments were given, in 28.6% 6~10 treatments were given and in 3 cases more than 100 treatments were administered. 7) Of the 210 cases, 43.3% showed marked improvement, 41.4% were improved, 13.8% showed transient improvement and there were 3 cause of no improvement. The total confidence was 84.7%. 8) There are no serious complications except hypertensive shock case, submucosal hemorrhagic petechia 7 cases and generalized fatigue 18 cases. In conclusion, electrical acupuncture stimulation of the peripheral nervous system can be used to relieve pain replacing such conventional means as medications, nerve blocks, major neurosurgical procedures, neuroytics and physiopsychic therapy which are generally less effective.
강신조(Shin-jo Kang),조시완(Si-wan Cho),이희관(Hi-kwan Lee),공영식(Young-sik Kong),양균의(Gyun-Eui Yang) 한국자동차공학회 1996 한국자동차공학회 춘 추계 학술대회 논문집 Vol.1996 No.6_2
In conventional NC milling semi-finishing cutting has been neglected. The NC milling performs only rough cutting and finish cutting. When the uncut can leave big, finish cutting has troubles such as overload and tool breakage, etc. In consequence efficiency of manufacturing is decreased. The troubles can be overcome with semi-finish cutting.<br/> The semi-finish cutting using contour curve has many advantages to satisfy many cutting conditions, supporting with constant cutting force, good machinability and fast cutting speed. But tool interference in contour tool path is limited to 2 dimensional pocket, trimming, etc. The paper presents a method which can avoid the tool interference in 3 dimensional milling. The method uses characteristic points such as apex, sink and saddle point Ridge-valley curve makes contour tool path interference-free tool path. The method has better performance than conventional tool path.<br/> Also, the tool path results in good accuracy of surface by using scan-line tool path in finish cutting. With the many cutting conditions satisfied, the tool path can provide the reduction in lead time of production. For semi-finish cutting tool path interference-free contour tool path are generated.<br/>