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이정한(Lee Cheong-han),윤상호(Yoon Sang-ho) 대한전기학회 2006 대한전기학회 학술대회 논문집 Vol.2006 No.7
가공 송전선로의 경과지는 대부분 낮은 산악지로서 때때로 국지적인 기상현상에 노출되어 있다. 이러한 현상으로 매년 11월부터 익년3월 사이에 국지성 톨풍에 의한 갤로핑(Galloping)현상이 발생한다. 이 현상이 우리 전력소의 154㎸ 금포T/L(금오 S/S 포천S/S)에서 발생하였다. 갤로핑 현상은 바람으로 인하여 전력선이 횡진과 출렁임이 발생하는 것을 말하며, 전력선이 심한 진동을 일으켜 전력선 상간 또는 전력선과 가공지선간의 혼촉으로 고장전류가 생기고, 고장전류에 의한 보호계전기 동작으로 선로가 Trip되며, 이로 인하여 전력공급이 중단된다. 또한 전력선의 기계적인 진동에 의하여 전력선의 단선으로 영구고장을 일으킬 수 있다. 본 논문에서는 경기북부지역의 산악지에 설치된 154㎸ 송전선로에서 산비탈면을 타고 오르는 상승 바람에 의한 갤로핑 사례를 국내 최초로 현장에서 촬영한 동영상 자료를 토대로 소개하고, 갤로핑 발생시 송전선로에 미친 영향 등 검토 결과를 알아본다. 그리고 전력선 상호간 혼촉이 발생한 지점의 아크 흔적을 설명하고, 갤로핑으로 인한 상간 상간 혼촉방지를 목적으로 개발된 폴리머 상간 스페이서의 시공사례를 소개하며, 현재까지 상간 스페이서(interphase spacer)가 설치된 송전선로의 점검 결과를 소개하고자 한다.
말초혈관질환 환자를 위한 척추-경막외 병용마취 중 상지 혈압 차이로 알게 된 좌측쇄골하동맥의 협착 (증례보고)
김용한 ( Yong Han Kim ),임세훈 ( Se Hun Lim ),이재인 ( Jae In Lee ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),이정한 ( Jeong Han Lee ),이근무 ( Kun Moo Lee ),정순호 ( Soon Ho Cheong ),최영균 ( Young Kyun Choe ),김영재 ( Yo 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.2
Remifentanil이 QT dispersion에 미치는 영향
이원진 ( Won Jin Lee ),김영환 ( Young Hwan Kim ),조광래 ( Kwang Rae Cho ),이상은 ( Sang Eun Lee ),이정한 ( Jeong Han Lee ),임세훈 ( Se Hun Lim ),이근무 ( Kun Moo Lee ),정순호 ( Soon Ho Cheong ),최영균 ( Young Kyun Choe ),김영재 ( 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.6
Background: QT dispersion (QTd) is an indirect measure of the heterogeneity of ventricular repolarization and can be used as a risk factor for complex ventricular arrhythmias. We measured the effect of remifentanil on QTd and heart-rate corrected QT dispersion (QTcd). Methods: Sixty ASA class I and II patients, who were between 20 and 60 years old, and who were scheduled for general anesthesia, were studied. After the patient entered the operating room, a 12 lead EKG recording was taken and intravenous infusion of remifentanil was started. The infusion rate was 0.1 μg/kg/min in group 1 and 0.2 μg/kg/min in group 2. Another EKG recording was taken 10 minutes after infusion had started. Results: In both groups, QTd following remifentanil infusion was not significantly different than control values (76.6±23.3 ms vs 81.8±34.9 ms, P=0.459 in group 1; 70.7 ms±29.7 ms vs 73.7 ms±37.1 ms, P=0.734 in group 2). Neither was QTcd: (83.2 ms±25.2 ms vs 89.6 ms±36.2 ms, P=0.371 in group 1; 81.0 ms±35.2 ms vs 83.4 ms±40.9 ms, P=0.829 in group 2). Conclusions: Remifentanil infusion at a rate less than 0.2 μg/kg/min does not change QTd or QTcd. (Korean J Anesthesiol 2009; 57: 737∼41)
임상연구 : Remifentanil과 Porpofol을 사용한 마취유도 시 교류저항 심장도 검사를 이용한 혈역학적 변화의 측정
정순호 ( Soon Ho Cheong ),박대식 ( Tae Sik Park ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),이정한 ( Jeong Han Lee ),이근무 ( Kun Moo Lee ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.1
Background: Remifentanil-propofol combination is used to minimize the cardiovascular responses during anesthetic induction; however, it may generate side effects such as hypotension or bradycardia. The authors investigated the changes of stroke volume and cardiac output using impedance cardiography (ICG) when hypotension or bradycardia is generated during propofol-remifentanil anesthetic induction. Methods: Ninety ASA physical status class I patients who were scheduled to undergo elective ambulatory surgery were randomly assigned to one of three groups (n = 30 each). Normal saline (Group S), remifentanil 0.25μg/kg/min (Group R0.25), or remifentanil 0.5μg/kg/min (Group R0.5) was infused intravenously. Propofol was slowly administered two minutes after the administration of remifentanil or normal saline. Heart rate, mean arterial pressure, cardiac output and stroke volume were measured at preinduction (baseline), preintubation and postintubation. Results: Mean arterial pressure in Group R0.5 at preintubation decreased compared to that of the baseline, however, the stroke volume index was sustained. The stroke volume index at postintubation decreased proportionally as heart rate increased in heart rate in all groups, and then cardiac index was preserved. Conclusions: Hypotension was generated during induction of anesthesia when remifentanil 0.5μg/kg/min and propofol 1.0 mg/kg were used, however, the stroke volume index was sustained. (Korean J Anesthesiol 2007; 53: 42~7)
임상연구 : Desflurane 흡입마취 시 Remifentanil 지속정주가 기도반응성에 미치는 효과
안성태 ( Sung Tae Ahn ),이정한 ( Jeong Han Lee ),정순호 ( Soon Ho Cheong ),이근무 ( Kun Moo Lee ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.4
Background: Because desflurane can cause airway reactivity, the use of opioids are aimed at its reduction. This study was designed to evaluate the effect of continuous remifentanil infusion on the airway reactivity during desflurane inhalation. Methods: 108 adult ASA physical status class I patients were enrolled in this study. The patients were divided into four groups. The breathing circuit was primed with 8 vol% desflurane in 3 L/min each of N2O and O2. Anesthesia was induced with 0.2 mg/kg of intravenous etomidate. After 2 minutes, either 20 ml/hr saline, or 0.15, 0.25 or 0.35μg/kg/min remifentanil, groups S, R1, R2 and R3, respectively, was infused. Each patient inhaled the gas mixture through a tight fitting facemask. During this period, the coughing, secretions, breathing hold, laryngospasms, excitatory movements and hemodynamics were measured. Results: The coughing, spasms, secretions and excitatory movements were significantly lower in the remifentanil than the saline infusion group (P<0.05). However, the breathing hold was significantly higher in group R3 (P<0.001). The mean arterial pressure and heart rate were more stable in groups R1 and R2. Conclusions: These results demonstrate that groups R1 and R2 had significantly reduced airway reactivity, with stabilize hemodynamics, during desflurane inhalation. (Korean J Anesthesiol 2007; 53: 448~52)
임상연구 : 마취 방법이 대장 절제술 후 장운동에 미치는 영향
이근무 ( Kun Moo Lee ),배우종 ( Jong Woo Bae ),김영환 ( Young Hwan Kim ),임세훈 ( Hoon Se Lim ),이정한 ( Jeong Han Lee ),정순호 ( Soon Ho Cheong ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( Chee Mahn Shin ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.51 No.6
Background: Gastrointestinal bowel movements are reduced by opioid-based anesthesia. Remifentanil is commonly used as total intravenous anesthesia. This study compared to the effect of various anesthetic methods on gastrointestinal bowel movement after colon surgery. Methods: Ninety patients were allocated randomly into three groups. Thirty patients received intraoperative inhalation anesthesia (desflurane + N2O, Group I), 30 patients received intraoperative total intravenous anesthesia (propofol + remifentanil, Group II), and 30 patients received intraoperative epidural anesthesia (epidural lidocaine + propofol, Group III). All patients received postoperative epidural analgesia with a mixture of ropivacaine and morphine. The time to the first passage of flatus, hospital stay and visual analog pain scale were recorded. Results: There was no significant difference in first passage of flatus among groups (Group I: 92.7 ± 19.6, Group II: 86.9 ± 19.4, Group III: 81.9 ± 12.8 hours, P = 0.063). There were no significant difference in the hospital stay and visual analog scale among the three groups. Conclusions: Total intravenous anesthesia with remifentanil did not reduce the gastrointestinal bowel movements compared with those of inhalation or epidural anesthesia. (Korean J Anesthesiol 2006; 51: 659~62)
편도절제술을 받는 소아에서 Sevoflurane 마취 후 각성흥분에 대한 Ondansetron의 영향
이근무 ( Kun Moo Lee ),강동화 ( Doug Hwa Kang ),이상은 ( Sang Eun Lee ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),이정한 ( Jeong Han Lee ),정순호 ( Soon Ho Cheong ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.5
증례보고 : 상악암 환자의 갓세르 신경절 고주파 열응고술 후 발생한 급성 세균성 수막염
이근무 ( Kun Moo Lee ),안도건 ( Do Gun An ),김영환 ( Young Hwan Kim ),임세훈 ( Se Hun Lim ),이정한 ( Jeong Han Lee ),정순호 ( Soon Ho Cheong ),최영균 ( Young Kyun Choe ),김영재 ( Young Jae Kim ),신치만 ( Chee Mahn Shin ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.52 No.2
Since 1920, when Harvey Cushing first used radiofrequency in electrosurgery, the procedural technique has developed rapidly. Even though this procedure is minimally invasive and safer than other neurodestructive procedures, it is still not free of complications. A 72-year-old female patient had constant facial pain, despite several operations and radiotherapies for her maxillary cancer. The region innervated ophthalmic branch and maxillary branch of the trigeminal nerve was involved, with radiofrequency procedure of the gasserian ganglion for pain control also performed at the area. After the procedure, her blood pressure became elevated and she complained of a headache, and six hours later, she became irritable and distracted. Bacterial meningitis was diagnosed by a spinal tap, with third-generation cephalosporin administered as the treatment. The following day, her symptoms had improved and the pain was also reduced. She was discharged from hospital after 14 days, without any sequelae. (Korean J Anesthesiol 2007; 52: 249~51)