제왕절개수술에서 저혈압 예방을 위한 수액의 비교 관찰 : 제 1 보:척수마취

심재철,김완식,박동호,황영희,김흥대,김지영,차영덕,서병태 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.3

Rheomacrodex-D 10% W/V in dextrose (500 ml) was prophylactically infused before anesthesia over 15 to 20 minutes to prevent hypotension during spinal anesthesia in 20 patients undergoing elective Casarean section. Apgar scores and the incidence and severity of hypotension were compared to results obtained in 20 patients who were given 500 ml of Hartmann's solution. The results were as follows; 1) Mean arterial pressure decreased up to 20 torr from control values in patients hydrated with Hartman's solution and also changed significantly in patients given Rheomacrodex-D (p<0.05). 2) The incidence and severity of hypotension at 10 minutes, and 15 minutes, and 15 minutes after spinal anesthesia (p<0.05) was significantly less in patients given Rheomacrodex-D than in patients hydrated with Hartmann's solution 3) The Apgar scores, both at 1 minute and 5 minutes, were significantly higher (p<0.05, p<0.005) in infants born of mothers given Rheomacrodex-D than in infants whose mothers were given Hartmann's solution. 4) The cases of hypotension defined as a descrease in systolic arterial pressure lower than 100 torr or a decrease in mean arterial pressure to 25% from control values were 12 cases in 20 patients hydrated with Hartmann's solution and 6 cases in 20 patients given Rheomacrodex-D.

소아마취의 임상통계학적 고찰

김완식,박동호,황영희,김흥대,안기량,석민호,김지영,장경덕,서병태 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.1

Midazolam maleate, a water soluble banzodiazepine unlike diazepam, was synthetized by Walser and Fryer in 1975. In order to ealuate the effectiveness as an induction agent for general anesthesia, 22 elective surgical patients belonging to ASA classification 1 and 2 were selected. And ten patients (male 7, female 3, average 33.5 years old) were induced with midazolam maleate 0.2mg/kg and twelve patients (mdale 7, female 5, average 32.5 years old) with diazepam 0.3mg/kg. The results were summarized as follows. 1) Anesthesia was induced in all of midazolam group by one intravenous injection, but only 6 patients of diazepam group could induced by one injection and the other 6 patients needed 2 or more injections. 2) The changes of blood pressure and pulse rate after induction and intubation were almost similar in the two groups, but greater individual variation was seen in diazepam group. 3) A buring sensation following intravenous injection was noted in 11 cases of diazepam group, but none in midazolam group and no phlebitis in either group. From the above results, diazepam and midazolam are almost similar in nature but midazolam is definitely effective as an induction agent and has less side effects. Therefore midazolam maleate is regarded as a more effective agent than diazepam as an induction for general anesthesia.

“Loosco” 사용 증례 보고

김완식,박동호,황호성,이진근,유희구 대한마취과학회 1977 Korean Journal of Anesthesiology Vol.10 No.2

In the 1st two years (Frcm April 1975 to March 1977), we have had experience with 15 surgical infant patients undergoing general inhalation anesthesia with the $quot;Loasco$quot; Infant Ventilator. The Locsco$quot; Infant Ventilator is designed for the ventilation of neonates and infants on the lines of an open sysern with a gas mixture of air-oxygqn or oxygen-anesthetics. However we used it with a gas mixture of halothane-N2O-oxygen, This study was undertaken to evaluate the value of ventilatory support with the Loosco$quot; lnfant Ventilator auring general inpa!ation anesthesia for 15 surgical patients ivhose age was less than 2 years of age. The blood gas analysis showed slight underventilation cnmbined with metabolic acidosis during the first 15 minutes, in which respiratory frequency was set at 30 times per minute, but the ventilation was gradually improved by inciease in respirataey frequency to 35 times per minute during tlie lost 20 ninute. In this study, ive corsiderec. the irnportant tactors ivhich inftuenced the value of the blood gas analysis. Not only caveful anesthetic niaoagement to keep the airway and to corvect cardiovascuiar clerangeineht, but also frequent and repeated blood gas analysis and its aeeurate interpretation were stressed for using the $quot;Loosco Infant Uentilator during pediatric general anesthesia.

유로그라핀(Urografin)에 의한 과민반응 증례보고

김완식,박동호,황호성,유희구,김전석 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.2

Since 1929, the iodine compounds were used intravenous pyelogram by the Swick, it was accepted for the use of intravenous pyelogram in the worldwide. Nevertheless, it has several minor and major side reactions, also it has been used to IVP or cholecystography at X-ray room without prepared for side reaction or resuscitation. We have experienced a case of sever hypersensitivity reaction with the urografin during IVP at X-ray room. Here, we review with the several articles including its etiology, symptoms and treatments. Especially, we classified the mild and severe reactionsby David and Frederick from Table 1 Table 6. Furthermore we considered that t is necessary to prepared the resuscitating instruments during IVP with urografin under local or general anesthesia.

Atropine과 Neostigmine이 심박수 및 심전도에 미치는 영향

김영석,김완식,김인규,박동호,황영희,안기량 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.2

Four modes of administrating atropine and neostigmine to reverse pancuronium block were studied in thirty-eight anesthetized patients, with special referance to their effects on heart rate and electrocardiogram. At the end of operation in group 1 a mixture of atropine (0. 5 mg) and neostigmine(1. 0 mg) was rapidly injected together. In group 2 the same mixture was slowly injected in 3 minutes. In group 3 atropine was rapidly injected and 2 minutes later neostigmine was rapidly injected. In group 4 neostigmine was slowly injected in 1 minute and then immediately atropine was rapidly injected. The results were as follows. 1) In all groups a transient increase in heart rate was followed by a decrease which continued over 30 minutes. 2) The changes in heart rate were most pronounced when atropine was given before neostigmin(group 3) On the ther hand when atropine was given immediately after neostigmine the changes in heart rate seemed to be smallest. 3) A small number of cases showed transient ECG changes in each group. It is considered that one must be careful about arterial gas and ECG changes although the number of cases is small and certain correlation was not indicated but the ECG of the five of 38 patients are abnormal, four of these are among the abnormal cases in the gas study, two of the four abnormals are under PaO₂, 60 mmHg.

병렬처리 시스템에서의 효율적인 동기최적화 기법에 관한 연구

황종선,김병두,박두순 한국생산성학회 1992 生産性論集 Vol.6 No.1

This paper discusses an effective synchronization algorithm. It is different from the existing synchronization methods by inserting appropriate synchronization instructions between statements according to different kinds of data dependences. The overhead caused by too many synchronization instructions in a loop can be a critical problem. Synchronization optimization is a method which discriminates and eliminates the redundant synchronization instructions in a loop. In this paper, a new synchronization optimization algorithm - ICPG (Improved Controlled Path Graph) - is developed, and the algorithm is extended to the case of nested loops. In case of nested loops, the existing methods were not safe because of the incomplete management in hyper-rectangle areas, etc. But, the errorneous methods are completely corrected in this paper. Finally, performance analysis using simulation on the UNIX operating system is carried out. It is shown that the ICPG algorithm is much more effective than the existing methods.

인공호흡시 1회 호흡량이 심혈관계에 미치는 영향

김완식,박동호,황호성,김영석 대한마취과학회 1975 Korean Journal of Anesthesiology Vol.8 No.1

Eleven supine adult patients undergoing general inhalation anesthesia with halothane-nitrous oxide-oxygen and dtubocurarine were studied. In order to determine the effectiveniss of the method to estimate the minute volume by ones height and, to find the merrits of changed tidal volume uader the coastant minute volume, we observed the changes in PaCO2, arterial pH, base excess, systolic and diastolic blood pressure and pulse rate during geaeral anesthesia with mechanical veatilation. In this study, there were no signifieant changes in PaCO2, arterial pH, base excess, systolic and diastolic blood pressure and pulse rate during mechanical ventilation with the changed tidal volume. Furthermore, we considered that the large tidal volume prevented miliary atelectasis and increasiag A-aDO2.

전신 마취중 발생한 부적합수혈 증예 보고

김완식,박동호,황호성,유희구 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.1

We have experienced a case of incompatible blood transfusion during general anesthesia in which 300ml of improperly typed blood were tranfused. Upon discovery of the error, the tranfusion was discontinued and the patient was immediately, carefuliy and aggressively treated with proper fresh blood, plasma expander(Rheomacrdex-D), fluids(Hartmanns solutipn and 10% dextrose in water) and drugs (Solu-Cortef 300 mg, furosemide 400 mg, 20% manitol 500 ml, digoxine 0. 5 mg, morphine 15 mg). The free hemoglobin in the plasma and urine and blood gas of the femoral or radial artery were rnonitorecl throughout the resuscitative procedure. It is felt that accidental incompatible blood transfusion of more than 300 ml should be preventable and that the patients life may be saved without serious complications with imme-diate and proper management.

Dieulafoy 양 병변에 의한 십이지장게실 출혈 1 예

김상현,김경환,이동현,송철수,정노원,박상제,김은규,하홍성,나일환,황윤이,성은영,최익수,신영기 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.1

Duodenal diverticula are first reported by Chomel in 1710. Duodenal diverticula are relatively common in adults with a prevalence of 23% in SRCP. The most duodenal diverticulum is asymptomatic. Complications such as obstruction, cholangitis, blliary stones, ulceration, perforation and hemorrhage can occur in approximately 10%. However, relatively few cases of bleeding from a duodenal diverticulum have been reported. The cause of bleeding from a duodenal diverticulum is uncertain and various suspected etiologies were suggested, such as ectopic gastric mucosa, stasis-induced ulceration, erosion into major vessels, aortoenteric fistuias, intradiverticujar polyp, aspirin-induced erosion. We report a case of a bleeding duodenal diverticulum by a Dieulafoy-like lesion and suggest this 1esion as one of posslble causes of blee4ng in duodenal diverticulum.

고로슬래그시멘트를 사용한 다공성 황토콘크리트의 성능 평가

김황희,강수만,박종식,박상우,전지홍,이진형,차상선,박찬기,Kim, Hwang-Hee,Kang, Su-Man,Park, Jong-Sik,Park, Sang-Woo,Jeon, Ji-Hong,Lee, Jin-Hyung,Cha, Sang-Sun,Park, Chan-Gi 한국농공학회 2010 한국농공학회논문집 Vol.52 No.3

This study aims to evaluate a porous concrete using hwang-toh, blast furnace slag and blast furnace slag (BFS) cement instead of type I cement. The tests that were carried out to analysis the properties of porous hwang-toh BFS cement concrete included compressive strength, continuous void ratio, absorption rate, and pH value, repeated freezing and thawing test were conducted. Test results indicated that the performance in porous hwang-toh concrete are effective on the kaoline based binder materials. The pH value were shown in about 9.5 ~ 8.5. The compressive strength was increased and void ratio was decreased with increasing the kaoline based binder materials, respectively. The void ratio and compressive strength were in the range of about 21 ~ 30 %, 8 ~ 13 MPa, respectively. The increased in void ratio of more than 25 % is showed to reduce the resistance of repeated freezing and thawing. Also, the resistance of repeated freezing of thawing and the compressive strength of porous hwang-toh BFS cement concrete are independent with hwang-toh content and BFS cement amount. But, the void ratio was decreased with increasing the high volume hwang-toh contents (more than 15 %).