철도 및 지하철의 궤도 선형 설계 프로그램 개발

김종남(Jong-Nam Kim),송규석(Gyu-Suk Song),안창근(Chang-Keun Ahn) 한국철도학회 2010 한국철도학회 학술발표대회논문집 Vol.2010 No.10

生理的食鹽水 負荷가 腎臟內 電解質 및 尿素分布에 미치는 影響

安昌根,洪淳國 고려대학교 의과대학 1972 고려대 의대 잡지 Vol.9 No.2

Rapid intravenous infusion of saline is known to suppress reabsorption of sodium and water in the proximal tubule. It is now well established that the increase in urinary excretion of sodium which occurs during acute saline loading is due to a decrease in sodium reabsorption by the tubules rather than to a increase in the amount of sodium filtered by the glomeruli. The mechanism responsible for this decrease in tubular reabsorption is not entirely clear. It is well known that expansion of the extracellular fliud volume with isotonic saline solution inhibits both fractional and over all salt and water reabsorption in the proximal tubule. Depression of the fraction of filtrate reabsorbed by the proximal tubule during saline loading greatly exceeds the simultaneous fractional increase in sodium excretion, making it unnecessary to propose that decreases in distal tubular reabsortion are involved in the natriuretic response to saline infusion. However, other evidence indicates that large depression of reabsorption by the proximal tubule alone may not effect large changes in sodium excretion, and may be necessary to postulate that the effect of saline infusion to increase sodium excretion results from limited reabsorption both the proximal tubule and some more distal segment of the nephron. At the moment the role of changes in distal tubular reabsorption in the natriuretic response to volume expansion is not clear. This study was made to clear the still unsolved problem of which osmotic gradient is made in the inner medulla or not during saline loading. On experiments 31 rabbits weighing between 1.5-2.5㎏, 11 in unloaded control group, 11 in saline loaded group, and 9 in saline loaded with aortic constriction, were studied. Inuline clearance for GFR, PAH clearance for RPF, sodium, potassium, urea, and osmolarity in serum and urine were measured. The kidney slices were made for analysis of sodium, potassium and urea. The results were as follows: 1) Natriuresis was observed without any relation to glomerular filtration rate and renal plasma flow by saline loading, and filtrered sodium was not paralleled to excreted sodium. 2) Free water reabsorption was increased in saline loaded rabbits. 3) Sodium did not make any significant gradient in inner medulla by saline loading. 4) The distributed rate of urea did not make any significant gradient in inner medulla by saline loading. 5) The distributed rate of potassium in the kidney was similar to normal control rabbit.

Acute Rental Failure로 Anuria가 온 환자를 대상으로 Mannitol, K-ion Exchange Resin Testosterone등의 약물과 Peritoneal Dialysis를 하고난후의 경과와 치료

安昌根,崔根春 中央醫學社 1971 中央醫學 Vol.20 No.2

These Three cases of Reports are Courses and Results of Acute Renal failure Treatment with Mannitol, K-ion Exchange Resin, Testosterone and Peritoneal Dialysis. The Result was very well, especially Peritoneal Dialysis except too Late of Care.

A.C.D. 저장 혈액의 가온 수혈시 전해질 변화에 관한 연구

김광우,주경란,안창근 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.1

In the operation room of S.N.U.H., 10 patients were transfused with A,C.D. stored blood after warming to 36C by using a blood warmer. Observed changes of Na+, Cl-, K+ and. Ca++ were as follows. 1) Before warming, the electrolytes of A.C.D. stored blood were Na+ 148. 2 mEq/1, Cl-; 117. 0 mEq/1 and K+; 8. 4 mEq/l. After warming to 36C, these were significantly reduced(P $lt;0. 05) and became 144. 6mEq/1, 112. 4mEg/1 and 68. 13mEq/1 respectively. 2) There was a tendency to increasing of K+ cOncentration in proportion to storage duration. 3) In the case of calcium, pre-warmed concentration of calcium was 4. 09 mEq/1 and there was no significant change after warming(P$gt;0.05).

Ketamine 麻醉의 臨床經驗

尹承旼,安昌根 中央醫學社 1972 中央醫學 Vol.23 No.5

From the analysis of data of 54 cases of minor operation on children with Ketalar with a doses of 5 mg or 10 mg per kg. of body weight for each injection, IM and 1 mg per kg, of body weight I.V., which was given simultaneously with Hydroxyzine, we concluded following results. 1. A dosage of 10- I. M. per kg. of body weight poduced good results in more than 90% of cases. But the effect on debilitated infants is not certain. 2. It acts stimulously on the cardiovascuslar system. 3. The depressive effect on the respiratory system are not remarkable, except in debilitated infants. 4. Using. with a tranquilizer(Hydroxyzine), the side reactions seem to be markedly decreased in incidence and severity.

척추마취시 Ephedrine 주입과 Crystalloid 용액 투여가 저혈압 예방에 미치는 효과

김혜경,안창근,신재식,길홍모 대한마취과학회 1994 Korean Journal of Anesthesiology Vol.27 No.8

This study was desinged for compare the efficacy of ephedrine infusion that of crystalloid administration in reducing the incidence of hypotension during spinal anesthesia. Sixty ASA 1 and 2 patients scheduled for transurethral prostatic resection and lower extremity surgery under spinal anesthesia were ramdomly allocated to receive either 15 ml/kg crystalloid (crystalloid group) or an ephedrine infusion (infusion group). Spinal anesthesia was performed using 12-14 mg of 0.4% tetracaine. Analgesic sensory level was T10 in both groups. Thirty patients in the crystalloid group received crystalloid solution (Ringer'lactate solution, 15 ml/kg) within 20 min prior to induction of spinal anesthesia. Thirty patients in the infusion group immediately after induction spinal anesthesia received ephedrine infusion at a rate 5 mg/ min for the first 2 min and then 1 mg/min for the next 18 min. Cardiovascular responses (systolic blood pressure and heart rate) and complications (hypotension, nausea and vomiting) after induction of spinal anesthesia were compared and results were as follows; 1) The incidence of hypotension was ll/30 (36%) in the crystalloid group and 3/30 (10%) in the infusion group (p$lt;0.001). 2) Systolic blood pressure after induction of spinal anesthesia in the crystalloid group significantly decreased from 5 min to 20 min as compared to the infusion group (p$lt;0.05). But, systolic blood pressure did not decrease siginificantly until 9 min after spinal anesthesia in the infusion group. 3) The mean heart rate after induction of spinal anesthesia in the crystalloid group significantly increased at 1 min as compared to infusion group; thereafter, there was no significant difference between the two groups. 4) The incidence of nausea and vomiting was 1/30 in the crystalloid group and 0/30 in the infusion group; The difference between the two groups was not significant. 5) Reactive hypertension or tachycardia did not occur in either group. Considering above results, we conclude that a prophylactic ephedrine infusion is effective for minimizing and managing hypotension associated with spinal anesthesia.

産婦人科領域에서의 硬膜外痲醉

金炳斗,安昌根 中央醫學社 1977 中央醫學 Vol.33 No.5

Lumbar epidural block in obstetrics & gynecology has many advantages than spinal anesthesia. We generally studied gynecologic patients(38 cases) and a few parturients also. Standard continuous epidural anesthesia was performed in three patients, using a 6-8 ml does of 0. 5% lidocaine with adrenaline. Our aim was to relieve pain during the long passive phase, so that mothers would be res-ted. The onset of analgesia was rapid(5-10min) and the duration was on aver-age 1-1½ hour in initial dosage. Two third of parturients delivered spontaneously, and one third of parturient delivered supporting vaccum.

중환자실 환자관리 실태보고 : 1981. 7. 1 ~ 1982. 6. 30

이명애,안창근,신종남 대한마취과학회 1984 Korean Journal of Anesthesiology Vol.17 No.4

기관지흉막루 환자의 마취

김상범,곽호성,안창근,오화진 대한마취과학회 1996 Korean Journal of Anesthesiology Vol.31 No.5

Bronchopleural fistula is an uncommon but serious complication of lung resection, with a high mortality and morbidity. Problems associated with bronchopleural fistula and empyema are related to positive-pressure ventilation, which may result in infectious contamination of healthy lung tissue, loss of air, decreased alveolar ventilation leading to carbon dioxide retention, and the development of a tension pneumothorax. We experienced difficult intubation in patient who has large bronchopleural fistula and anatomic deviations of intact bronchus of the left lung, so we used a long single lumen tube made by attaching an another cuffed endotracheal tube under direct vision. The arterial oxygenation was effective, but carbon dioxide elimination was inadequate. After the operation, the ordinary cuffed endotracheal tube was intubated orally and the patient was transferred to the ward without problems 6 days after the operation.

지속적 상박신경총 액와부차단에 대한 임상적 고찰

김혜경,정선희,안창근,최광균,정기봉 대한마취과학회 1986 Korean Journal of Anesthesiology Vol.19 No.2

Several methods for the management of intractable pain for various conditions including malignant disorders, herpes zoster, and low back pain and/or sciatica in 80 patients were described and analyzed. Neurolytic blodks of celiac plexus were given to the patienta suffering from intra-abdominal pain from malignant origin or chronic pancreatitis. Herpes zoster was treated mainly by chemical sympathectomy via paravertebral route and occassionaly corticosteroid was administered epidurally with the local anesthetic, bupivacaine. All the patients with low back pain and/or sciatica were given epidural corticosteroid one to three times. Other peripheral verve blocks and regional corticosteroid therapy were given to the rest of the patients. Fair to excellent result was obtained in 71% of the patients but the response was poor in the remaining 28% of the patients. It seems that the earlier the patients were referred to the pain clinic, the better the results were.