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극단 저체중 신생아에서의 동맥관 개존증 결찰술을 위한 진정맥 마취 경험 2례
최영균,고명진,이상은,조광래,김영환,임세훈,이정한,이근무,정순호,김영재,신치만 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-
Running title: Cases of anesthesia for extremely low birth weight infant. Extremely low birth weight infants (birth weight < 1000 g) are prone to various morbidities such as respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia, patent ductus arteriosus, necrotizing enterocolitis and retinopathy. To accomplish successful anesthetic management, many precautions must be continuously taken during the operation. First, inspired oxygen concentration should be adjusted to avoid oxygen toxicity. Second, body temperature must be maintained adequately. Third, hemodynamic parameters should be kept stable. We report 2 cases of successful anesthetic management for extremely low birth weight infant who underwent ligation of patent ductus arteriosus at the neonatal intensive care unit.
동일한 혈관 내에 발생한 이식형 약제 주입기 카테터의 위치이상
오대석,김영재,김명훈,조광래,임세훈,이정한,이근무,정순호,신치만 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-
저자들은 56세 여성 환자의 왼쪽 쇄골 하 정맥에 시행한 이식형 약제주입기 카테터의 삽입 후 발생한 비정상 위치에 대한 증례를 보고하고자 한다. 카테터의 끝은 환자의 늘 어진 가슴, 체위, 신체의 움직임, 카테터의 유동성 등의 영향으로 천자된 정맥 내에서 견인되고 뒤쪽으로 이동하였다. 환자는 어떠한 증상도 호소하지 않았지만 비정상 위치의 카테터는 심각한 합병증을 유발할 수 있기 때문에 제거되었다. 따라서 시술자는 약제주입기 삽입 전에 환자의 신체 상태와 단순 흉부 촬영상을 확인하고 카테터의 비정상 위치가 발생할 수 있는 위험 징후를 알아차려야 하겠다.
복강경하 대장절제술을 시행 받는 환자에서 라모세트론과 온단세트론외 술 후 오심 및 구토 예방 효과 비교
김효중;어전영;어근무;어정한;엄세훈;조광래;김명훈 인제대학교 2011 仁濟醫學 Vol.32 No.-
Objectives : We evaluated the efficacy of ramosetron and ondansetron for preventing postoperative nausea and vomiting (PONV) in laparoscopic colectomy. Methods and Materials : Eighty patients who received laparoscopic colectomy were randomly divided into two groups: R group (ramosetron 0.1mg PO) and O group (ondansetron 4mg twice IV). Injection or oral medication was administered before the induction of anesthesia in each group. Injection was administered at the end of surgery in O group. General anesthesia was induced using propofol and rocuronium, and maintained with sevoflurane, remifentanil and air (FiO2 0.5), We investigated the incidences of PONV in each group by the Rhodes index of nausea, vomiting and retching (RINVR) at postoperative 6 and 24 hours. Results : The incidence of PONV was not different between group at each time points after surgery (at postoperative 6 hours: 20% in group R, 17.5% in group 0, at postoperative 24 hours; 12.5% in group R, 7.5% in group 0). There was no difference in the severity of PONV, satisfaction, rescue drug usage. Conclusion : Prophylactic therapy with ramosetron is as effective as conventional prophylactic therapy with ondansetron for preventing PONV in general anesthesia for laparoscopic colectomy.
Kim, Se-Hun;Kim, Hyun-Tae;Cheong, Soon-Ho;Lee, Kun-Moo;Lee, Jeong-Han;Lim, Se-Hun;Cho, Kwang-Rae;Kim, Myoung-Hun;Kim, Se-Hun;Kim, Hyun-Tae;Cheong, Soon-Ho;Lee, Kun-Moo;Lee, Jeong-Han;Lim, Se-Hun;Cho, 인제대학교 2011 仁濟醫學 Vol.32 No.-
목적: 이중분광계수(Bispectral Index Score)는 중환자실에서 진정의 정도를 가하는 도구로 사용되고있다. 저자들은 뇌손상환자에서 진정척도를 사용하여 의식의 정도를 측정할 때 말이나 통중의 자극으로 인해 이중분광지수가 변할수 있다고 가정하였다. 방법: 42명의 뇌손상환자에서 진정척도를 사용하여 자극을 주기 5분전과 5분후에 이중편광계수를 측정하여 연관성을 확인하였다. 결과: 이중편광계수는 측정시간에 따라 차이가 없었다. 평균 이중편광계수는 Glasgow Coma Score (GCS), Richmond Agitation-Sedation Scale (RASS), Reaction Level Scale(RLS)와 연관성이 있었다. 결론: 진정척도와 이중편광지수와의 연관성은 자국의 유무에 의해 영향을 받지 않는 것으로 보인다.
Improvement of Recloser-Fuse Operations and Coordination in a Power Distribution System With SFCL
Myoung-Hoo Kim,Sung-Hun Lim,Jae-Chul Kim IEEE 2011 IEEE transactions on applied superconductivity Vol.21 No.3
<P>In this paper, we describes how to coordinate between recloser and fuse in power distribution system with superconducting fault current limiters (SFCL). The recloser and fuses are the main overcurrent protective devices in power distribution system. Universally, to protect against permanent faults, fuses are installed on overhead feeder laterals and the reclosers as a backup protection against temporary faults remove many unnecessary outages. Here, the recloser is set to trip using TCC curve for a temporary fault before any of the fuses can melt. If the fault is a permanent fault, the fuse has to melt just before the last delay trip of the recloser. However, the application of a resistive SFCL in power distribution system affects the recloser-fuse operation and coordination as decreased fault currents. In case that when a permanent fault occurs, the recloser could be locked-out after the last delay trip before the fuses operate. Therefore, to solve these cases, we performed experiments which are the recloser-fuse operation and coordination in the modeled power distribution system with the SFCL. Based on the experimental verification, we improved to coordinate the recloser-fuse in power distribution system with SFCL.</P>
( Myoung Jin Ko ),( Jeong Han Lee ),( Soon Ho Cheong ),( Chee Mahn Shin ),( Young Jae Kim ),( Young Kyun Choe ),( Kun Moo Lee ),( Se Hun Lim ),( Young Hwan Kim ),( Kwang Rae Cho ),( Sang Eun Lee ) 대한마취과학회 2010 Korean Journal of Anesthesiology Vol.58 No.4
Background: This study was done to evaluate the effect on pain relief when acetaminophen was added to lidocaine for intravenous regional anesthesia (IVRA). Methods: Sixty patients undergoing hand or forearm surgery received IVRA were assigned to three groups: Group C received 0.5% lidocaine diluted with 0.9% normal saline to a total volume of 40 ml (n=20), Group P received 0.5% lidocaine diluted with intravenous acetaminophen 300 mg to a total volume of 40 ml (n=20) and Group K received 0.5% lidocaine diluted with 0.9% normal saline plus ketorolac 10 mg made up to a total volume of 40 ml (n=20). Sensory block onset time, tourniquet pain onset time, which was defined as the time from tourniquet application to fentanyl administration for relieving tourniquet pain and amount of analgesic consumption during surgery were recorded. Following deflation of tourniquet sensory recovery time, postoperative pain and quantity of analgesic uses in post-anesthesia care unit were assessed. Results: Sensory block onset time was shorter in Group P compared to Group C (P<0.05). Tourniquet pain onset time was delayed in Group P when compared with group C (P<0.05). Postoperative pain and analgesic consumption were reduced in Group P and Group K compared to Group C (P<0.001). Conclusions: The addition of acetaminophen to lidocaine for IVRA shortens the onset time of sensory block and delays tourniquet pain onset time, but not with ketorolac. Both acetaminophen and ketorolac reduce postoperative pain and analgesic consumption. (Korean J Anesthesiol 2010; 58: 357-361)
노인환자에서 질식 자궁절제술중 발생한 심한 저혈압의 증례 보고
조헌,장성호,임혜자,공명훈,윤희동,김난숙 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.12
An anesthesiologist should keep in mind the various risk factors during anesthetic man- agement of geriatric patients. Unlike young patients, elderly patients may manifest more than one pathophysiologic process associsted with progressive degenerative changes in various organs. The successful anesthetic management requires detailed information about the cause and severity of the underlying disease, thorough understanding of geriatric specific hemodynamic particularities, and more careful monitoring by experienced personnel. We experienced a case of profound hypotension during general anesthesia for vaginal hysterectomy in a 67 year-old female patient. Anesthesia was induced with thiopental-vecuronium and was maintained with nitrous oxide, oxygen and enflurane. One hundred and five minutes after the induction, profound hypotension and bradycardia with S-T segment depression developed without specific events and were corrected by vigorous therapeutic managements. She discharged from the hospital on 7th postoperative day without complications.
배전계통에 분산형 전원 증가에 따른 초전도 전류제한기 적용시 보호기기 협조동작 특성 분석
김명후(Myoung-Hoo Kim),김진석(Jin-Seok Kim),유일경(Il-Kyoung You),문종필(Jong-Fil Moon),임성훈(Sung-Hun Lim),김재철(Jae-Chul Kim) 대한전기학회 2009 대한전기학회 학술대회 논문집 Vol.2009 No.11
This paper analyzed that characteristic of coordinating operation of protective device in a power distribution system with Superconducting Fault Current Limiter (SFCL) and Distributed Generation (DG). In a power distribution system with DG, the fault current is increased because the DG is adding current source when a permanent fault occurs, and the protective devices in each other could not be coordinated. However, when SFCLs are applied into a power distribution system with DG, the coordination of protective devices could be accomplished. Therefore, to solve these problems, we analysed the operation of protective devices coordination in a power distribution system linked DG with SFCL.