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림프관평활근종증을 동반한 산모의 제왕절개술을 위한 마취관리-증례 보고-
이미금,김홍순,손운락,박희연 대한마취통증의학회 2013 Anesthesia and pain medicine Vol.8 No.4
Lymphangioleiomyomatosis (LAM) is a rare, progressive cystic lung disease, characterized by a proliferation of immature smooth muscle cell (LAM cell) in the airway, parenchyma, lymph nodes and pulmonary vessels. It mainly affects women in their reproductive years. It is clinically manifested by recurrent pneumothorax,progressive dyspnea on exertion and chylothorax; it can also ultimately lead to respiratory failure. However, no curative treatment for LAM is currently available. We report an anesthetic management for cesarean delivery in a parturient newly diagnosed with LAM.
김홍순,이동철,이미금,손운락,김용범 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.1
Background: This study investigated the effect of pneumoperitoneum on the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic abdominal surgery. Methods: Thirty adult patients undergoing laparoscopic abdominal surgery were studied. Anesthesia was induced with 1.5 mg/kg of propofol, 12 ug/kg of alfentanil and 0.6 mg/kg of rocuronium and maintained with 2 vol% of sevoflurane and 0.05-0.2 μg/kg/min remifentanil. The neuromuscular relaxation was monitored by Train-of-Four (TOF) and post-tetanic count (PTC). Additional rocuronium of 0.2 mg/kg was administered for deep neuromuscular blockade at 30 min after pneumoperitoneum. Before (PPpre) and 30 min after pneumoperitoneum (PPpost), PTC was measured at 6 min intervals. The relationship between PTC and the time interval to reappearance of T1 response was observed. Results: The mean ± SD of the intervals between the detection of 4 counts of the PTC and the first response to TOF stimulation was 13.0 ± 1.1 min and 16.4 ± 6.3 min PPpre and PPpost, respectively (P = 0.20). There were significant negative relationships between PTC observed and the time interval to reappearance of T1 response (adjusted R2 = 0.869, P < 0.001 for PPpre data, and adjusted R2 = 0.561, P < 0.001 for PPpost data). Comparing the difference of regression equation between PPpre and PPpost data using a parallelism test, there was no statistically significant difference (P = 0.193). Conclusions: This study showed that PP with intra-abdominal pressure at the level of 13-14 mmHg did not affect the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic abdominal surgery.
KTX 산천과 TI21 무절연 AF 궤도회로간 귀선전류고조파 이동경로 분석연구
최재식(JaeSik Choi),김희식(HieSik Kim),공명상(MyongSang Kong),이수주(SooJoo Lee),손운락(UnRak Son) 한국철도학회 2014 한국철도학회 학술발표대회논문집 Vol.2014 No.5
최근 KTX산천에서 사용하는 전력변환시스템은 전력전자기술, 고속 대용량 반도체소자 및 마이크로프로세서의 기술발달에 힙입어 높은 성능과 승차감, 효율, 안전성, 에너지 소비측면에서 뛰어난 제어능력을 갖추게 되었다. 하지만 고속스위칭소자인 IGBT를 사용함에 따라 발생하는 고조파로 인해 전기차량은 물론 변전소, 신호시스템, 데이터전송 및 감시시스템에 영향을 주게된다. 특히 전력변환장치의 정수배 근방 주파수에서 발생하는 귀선전류고조파의 영향으로 TI21무절연AF궤도회로가 부정동작하는 사례가 발생되었다. 본 논문에서는 고속전기차량과 궤도회로간 귀선전류고조파 이동경로 분석에 대해 논한다. KTX-Sancheon, developed with Korean Technology, has been operated on Gyeongbu, Honam, Gyeongjeon normal lines and Geongbu high speed line. When the high speed trains were made a trial run on Gyeongbu and Honam downbound normal lines in 2010, The signals stop occurred since specific track circuits such as C type AF track circuits didn’t work properly on the upbound line opposite. To deal with this problem, we improved C type AF track circuit receivers from analog into digital type which have a noise analysis function so that the problem didn’t occur any longer. In this paper, we aimed at defining principles, a test and a way of verification about electromagnetic noise analysis function of the improved track circuit receivers.