만성교약성심낭염의 외과적 치료

김종환(Chong Whan Kim),이영근(Young Kun Lee),노준량(Joon Rhying Rho),손광현(Kwang Hyun Sohn),서경필(Kyung Phill Suh),이영균(Yung-Kyoon Lee),김광우(Kwang Woo Kim),곽일용(Il Yong Kwak),홍창의(Chang Yee Hong),장재헌(Jae Hun Chang) 대한외과학회 1971 Annals of Surgical Treatment and Research Vol.13 No.1

麻醉前處置劑 Flunt (Ro 5-4200)과 Meperidine HCI의 比較的 硏究

金庸樂,咸秉文,崔重立,郭一龍 한국의 현대의학사 1974 한국의 현대의학 Vol.7 No.1

Cyclopropane 및 Fluothane 麻醉가 出血性쇽크犬의 血力學에 미치는 影響-比較的 硏究

郭一龍,金光宇,金庸樂 한국의 현대의학사 1972 한국의 현대의학 Vol.5 No.2

개에서 Phenylephrine 에 의한 유도고혈압이 뇌혈역학에 미치는 영향

곽일용,오용석,함태수,전영태 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.30 No.1

Background: Induced hypertension has long been considered a potential adjunct to the management of focal cerebral ischemia. Whether induced hypertension causes an increase in cerebral blood flow(CBF), dependent on cerebral perfusion and/or an intracerebral redistribution of CBF by a vasoconstrictive effect of vasoconstrictor is controversial. In this study, effect of phenylephrine induced hypertension on the cerebral hemodynamics and mechanism of reduced ischemic area were studied. Methods: Six mongrel dogs weighing between 13 and 18 kg were anesthetized with halothane 0.5 vo1%-N₂O 1 L/min-O₂ 1 L/min. Ventilation was controlled to maintain PaCO₂ within 35∼40 mmHg. Cerebral blood flow was measured and calculated by the posterior sagittal sinus outflow method. Cerebral metabolic rate for oxygen(CMRO₂) was calculated. Intracranial pressure(ICP) was also measured. Phenylephrine was infused to increase mean arterial blood pressure(MAP) to a level 30% above baseline value and MAP was held constant for 20 minutes before CBF, ICP, CMRO₂ determination. These parameters were measured at 10, 20 minutes after induced hypertension. Results: Induced hypertension resulted in increased MAP and decreased heart rate. There were no differences between baseline, hypertension 10 min, and hypertension 20 min in terms of PaCO₂, PaO₂, hematocrit and temperature. CBF was not changed after induced hypertension(39.1±9.7 vs 40±10 vs 40.2±10.1 ml 100g(-1) min(-1) (mean±SD) at baseline, hypertension 10 min, hypertension 20 min, respectively). Cerebral metabolic rate was not changed also after induced hypertension. ICP increased after induced hypertension significantly(20.5±12.5 vs 26±15.3 vs 29.8±17 mmHg at baseline, hypertension 10 min, 20 min, respectively). Conclusions: Phenylephrine is a cerebral vasoconstrictor and that causes redistribution of cerebral blood flow to ischemic brain area.

Shock의 最近治療에 대한 考察

郭一龍 대한의학협회 1965 대한의학협회지 Vol.8 No.10

좌측 이중관 기관지튜브의 적절한 삽관깊이는 신장과 흉쇄유돌근의 길이와 상관관계가 있다

곽일용,오용석,박금숙,박재현 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.4

Background : When a double-lumen endotracheal tube (DLT) is used for one-lung ventilation, its position should be accurate. But only a few studies has been performed about how to predict the depth of insertion for DLT preoperatively. The purpose of this study is to investigate which physical measurements are correlated with the depth of insertion for left-sided DLT and how the depth of insertion for DLT can be explained with these physical measurements. Methods : After placing a 5 cm-high pillow under the patient's head, we intubated left-sided disposable DLT (BronchocathTM, Mallinckrodt medical Ltd, USA) in 65 adults. We tape-measured sternocleidomastoid muscle (SCM) length and sternal length. We positioned the proximal margin of the bronchial cuff of DLT just below carinal bifurcation through fiberoptic bronchoscope, and recorded the depth of insertion for DLT at the upper incisor level. Results : The depth of insertion for DLT was correlated with both height (y=3.96 0.15x, r2=0.51, p=0.0001) and SCM length (y=16.73 0.82x, r2=0.49, p=0.0001). Sternal length (r2=0.11, p=0.0081) was weakly correlated with the depth of insertion for DLT. The best regression model was depth of insertion for DLT (cm)=6.88 0.09 height (cm) 0.46 SCM length (cm). Conclusions : The depth of insertion for DLT is correlated with SCM length as well as height. So we may use them in predicting the depth of insertion for DLT. (Korean J Anesthesiol 1998; 35: 722∼726)

개에서 Sevoflurane 마취중에 Diltiazem 투여가 심혈관계 및 산소화에 미치는 영향

곽일용,조대순 대한마취과학회 1993 Korean Journal of Anesthesiology Vol.26 No.5

Diltiazem was administered by two different dosages with 200 μg/kg 1V+10 μg/kg/min infusion, 400 μg/kg 1V+20 μg/kg/min infusion, in order to assess the interaction between sevoflurane and diltiazem on the cardiovascular function and oxygenation in dogs during inhalation of 1.0 MAC of sevoflurane. Significant decrease in heart rates, mean arterial pressure, pulmonary vascular resistance, systemic vascular resistance, coronary perfusion pressure were observed. Subsequently rate pressure product, as a parameter of myocardial oxygen consumption, decreased with no significant changes of oxygen extraction ration in 1.0 MAC of sevoflurane anesthesia with the above dosages of diltiazem in dogs. The author concludes that concomittent use of diltiazem in clinical doses induced tolerable hemodynamic depression and no untoward effects on oxygenation during maintenance of anesthesia with 1 MAC of sevoflurane. These combination would be safe for anesthetic cares in patient with ischemic heart diseases and coronary arte diseases in which adequate oxygen supply in the heart is essentially necessary.

Ether, Fluothane 및 Methoxyflurane이 皮質下 中樞神經系統의 呼起反應에 미치는 影響

郭一龍,金光宇,金庸樂 최신의학사 1971 最新醫學 Vol.14 No.3

In twenty seven cats the effect of ether, fluothane and methoxyflurane on evoked potentials from the thalamus and reticular activating system of the midbrain have been recorded photographically. These anesthetics all depressed the amplitude of the evoked responses affecting the midbrain reticular potentials to a greater degree than the thalamic potentials. In the concentrations utilized, methoxyflurane(1 per cent) proved the most potent in this regard, followed in order by fluothane(2 per cent) and ether (10 per cent). Conduction latency was unaffected in all cases. The results suggest that the potency of these anesthetics is closely related to the suppression of the multisynaptic midbrain reticular system and support the concept that the general anesthetic state is associated with a reversible suppression of the midbrain ascending reticular activating system. Of the three anesthetics studied, methoxyflurane affected most and fluothane least the direct thalamic system. Herein may be the explanation of why fluothane is not a potent analgesic.

國産 脊椎麻醉劑 T-Cain이 中樞神經系統에 미치는 影響一實驗的 硏究

郭一龍,金光宇 최신의학사 1971 最新醫學 Vol.14 No.1

To determine the possible histotoxic effect of T-Cain(p-butylaminobenzoyl-diethylamino-ethanol hydro?chloride, a home-made spinal anesthetic) on the central nervous system, a cytological, biochemical and histological study was performed. Anesthesia of 25 unpremedicated mongrel dogs (weighing 7.5-11.5 kg) was induced with the injection of Pentothal sodium (Abbott, 15-20 mg/kg) into the foreleg cephalic vein and maintained with endotra?cheal nitrous oxide-oxygen in.semiclosed circle absorption system. Respiration was assisted or controlled as necessary throughout the procedure. Following the anesthetic induction, femoral artery was cannulated with a polyethylene catheter and arterial pressure was continuously recorded. through the Statham transducer on the Twin-Viso (Sanborn) at the paper speed of 2.5 or 25 mm/sec. Lead ti ECG was also recorded simultaneously. The animals were then turned to prone position for lumbar laminectomy. The spinal dura was incised and spinal cord exposed under direct vision. Cerebrospinal fluid was aspirated for cytological (red blood cells, lymphocytes, and polymorphonuclear leukocytes) and biochemical (sugar and protein) studies. Of 25 dogs five were used as control. Physiological saline solution (0.08 ml/kg) was injected into the subarachnoid space in 10 dogs (saline group). In another 10 dogs (T-Cain group), 0.08 ml/kg of 0.5°% T?Cain solution in 10% D/W was injected intrathecally. In all groups the cytological and biochemical studies were repeated one hour and seven days after the initial experiment. Arterial hypotension and the lack of motor response to painful stimuli to the hindlegs upon recovery from general anesthesia were considered as the indication of having established sufficient spinal anesthesia. On the seventh post-laminectomy day all animals were anesthetized with Nembutal (Vitarine), surgical wound was reopened, and the aforementioned studies in addition to biopsies of the lumbar spinal cord, leptomeninges, and dura were performed. All animals received daily intramuscular injnctions of crystalline procaine penicillin G, 400, 000 units, and dihydrostreptomycin sulfate, 0.5 gm prophylactically throughout the experiment. The results are as follows: Except for arterial hypotension nad rise in protein content of the cerebrospinal fluid in the T-Cain

Remeflin 의 호흡촉진작용의 기전에 관한 실험적 연구

곽일용,이건일 대한마취과학회 1976 Korean Journal of Anesthesiology Vol.9 No.1

To ten male volunteers, 25 to 35 years old and without any known disease, physiological saline solution (placebo) 1 ml, morphine 10mg, and Remeflin 16 mg were administered intramuscularly. Effects of tbese agents upon ventilation at rest and reapiratory response to carbon dioxide rebreathing were studied. The results are as follows: 1) Morphine significantly decreased respiratory rate, minute volume, and Pao2 and increased Paco2 without significantly affecting either tidal volume or arterial pH. 2) In morphine-induced respiratory depression, Remeflin improved ventilation by significantly increasing tidal volume and minute volume with resultant increase in Pao2 and decrease in Paco2, Remeflin did not significantly alter respiratory rate and arterial pH 3) Morphine displaced respiratory response curve to carbon dioxide obtained vrith placebo 7 torr to the right and Remeflin 6 torr to the left. No changes in slope of the curves were observed. 4) It is concluded that Remeflin stimlulatea respiration by directly acting upon the respiretory center.