급성요관산통을 주소로 응급실로 내원한 환자에서 hydromorphone과 pethidine 의 치료효과 비교를 위한 무작위배당 연구

최욱진,김원영,손창환,유정민,서동우,이재호,이윤선,오범진,김원,임경수 대한응급의학회 2011 대한응급의학회지 Vol.22 No.2

Purpose: To compare the efficacies and side effects of intravenous hydromorphone and pethidine in the emergency department (ED) treatment of ureteral colic. Methods: A prospective, controlled, randomized clinical trial was conducted in a university-affiliated tertiary referral center. All adult patients who presented to the ED with severe ureteral colic were included. The patients received either 1 mg of hydromorphone (n=26) or 50 mg of pethidine (n=26) intravenously. Pain intensity was determined using a 10 cm visual analogue scale 0, 15, 30, and 120 minutes after injection. Results: Dermographic characteristics and baseline pain scores of both groups were comparable (p>0.05). The pain intensity level for the hydromorphone group was lower than for the pethidine group at 15, 30, and 120 minutes. Pain relief was better with hydromorphone at 15 minutes (p<0.05). Side effects of the two groups were not statistically significant. Conclusion: The ureteral colic patients receiving hydromorphone achieved more pain relief. The side effects were similar for either treatment. Hydromorphone should be the preferred agent in suspected ureteral colic, when an opioid analgesic is to be used.

Development of Mobile Electronic Health Records Application in a Secondary General Hospital in Korea

최욱진,박민아,홍은석,김선휴,안력,홍정석,송승열,김탁,김정근,여승운 대한의료정보학회 2013 Healthcare Informatics Research Vol.19 No.4

Objectives: The recent evolution of mobile devices has opened new possibilities of providing strongly integrated mobile services in healthcare. The objective of this paper is to describe the decision driver, development, and implementation of an integrated mobile Electronic Health Record (EHR) application at Ulsan University Hospital. This application helps healthcare providers view patients’ medical records and information without a stationary computer workstation. Methods: We developed an integrated mobile application prototype that aimed to improve the mobility and usability of healthcare providers during their daily medical activities. The Android and iOS platform was used to create the mobile EHR application. The first working version was completed in 5 months and required 1,080 development hours. Results: The mobile EHR application provides patient vital signs, patient data, text communication, and integrated EHR. The application allows our healthcare providers to know the status of patients within and outside the hospital environment. The application provides a consistent user environment on several compatible Android and iOS devices. A group of 10 beta testers has consistently used and maintained our copy of the application, suggesting user acceptance. Conclusions: We are developing the integrated mobile EHR application with the goals of implementing an environment that is user-friendly, implementing a patient-centered system, and increasing the hospital’s competitiveness.

Microstructure and Mechanical Properties of Continuous Welded 50N Rail

최욱진,송민지,임남형,이수열 대한금속·재료학회 2019 대한금속·재료학회지 Vol.57 No.12

Rails are subjected to repeated stresses due to wheel-rail contact during train service. Rails under stress conditions undergo microstructural changes, and these cause degradations of the structural integrity and lifetime of rails. In this study, three different rails (newly-manufactured rail, newly-manufactured headhardened rail, and worn (used) rail) were compared to examine the effects of heat treatment and repeated wheel-rail contact stress on the microstructure and mechanical behavior of continuous welded rail. The crystal structure, constituent phase distribution, tensile property, and hardness were investigated at various locations along a cross section of the rails. All three rails consisted of a mixture of BCC and FCC crystal structures as a majority phase with a very small amount of cementite (Fe3C) as a minor phase. Rietveld analysis revealed that the weighted fractions of the BCC crystal structure were approximately 74%, 64%, and 85% for the new rail, head-hardened rail, and worn rail, respectively. While the web and foot areas of the three rails showed no significant differences in mechanical properties, the railheads of the three rails revealed much higher yield strength, tensile strength, and hardness. The highest tensile strength and hardness were measured at the railhead in the head-hardened rail, and were attributed to the evolution of the bainite phase, generated by additional heat treatment. The higher mechanical strength of the railhead of the worn rail is thought to have resulted from a combination of work hardening and smaller lamellar spacing of the pearlite phase, induced by repeated wear processes during train operation.

흉부압박의 횟수증가가 구조자에게 미치는 생리학적 변화와 심폐소생술 정확도에 미치는 영향

최욱진,Choi, Uk-Jin 사단법인 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.3

Purpose : This study was designed to examine physiological changes in the body of rescuers conduct CPR according to the 2005 new guideline from American Heart Association. The ratio of artificial respiration has changed from 15 : 2 into 30 : 2 in 2005. The researcher tried to know the correlation between the physiological changes and the accuracy of CPR. Method : The examinees of this study were 26 students (Dept. of Emergency Medical Service). After the training, participants conducted 10 minute CPR and soon after the CPR, their vital signs were checked, and lactic acid and concentration of ammonia were analysed from their blood samples. Questionnaires to ask their subjective fatigue level were filled out after blood samples and 10 minute - CPR was performed. Results : 1) After the CPR, concentrations of ammonia were $149.71{\mu}{\ell}/d{\ell}$ and $162.17{\mu}{\ell}/d{\ell}$ in 15 : 2 and 30 : 2, respectively. The number was higher in 30 : 2 but it wan not statistically meaningful (p = .493). Log value of lactic acid was a little higher in 30 : 2 with 42 log($mmol/{\ell}$) and 54 log($mmol/{\ell}$) in 15 : 2 and 30 : 2, respectively but it was not statistically meaningful (p = .113). 2) Blood pressure in 15 : 2 and 30 : 2 were 118.50 mmHg and 125.08 mmHg while pulse in two different cases were 96.14 and 97.25, showing no statistically significant differences (blood pressure : p = .155, pulse : p = .841). 3) Subjective fatigue was a bit high in 30 : 2 with 5.93 and 6.92 points in 15 : 2 and 30 : 2 respectively but it was not statistically meaningful (p = .142). 4) In the 10 minute CPR, respiration accuracy was 96.21% in 15 : 2 and 94.79% in 30 : 2. There was no statistical significances between the two(p = .225). In the meanwhile, chest compression accuracy was 92.57% in 15 : 2 and 91.83% in 30 : 2. From the beginning to the end of chest compression, there showed no difference(p = .425). the type of CPR did not influence upon the accuracy of chest compression(p = .756). Conclusion : In the CPR conducted by skilled rescuers for 10 minutes, there were no statistically meaningful differences between 15 : 2 and 30 : 2 in the concentration of fatigue element in a blood, subjective fatigue, vital signs and accuracy of CPR. Therefore, 30 : 2 CPR recommended by American Heart Association need to be recommended and performed in scene size up.

보건교사의 응급의료체계 인식과 활용 실태

최욱진,Choi, Uk-Jin 사단법인 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.2

Purpose : This study aims to provide basic data to establish an effective emergency medical service system by analyzing health educator' understanding and use of emergency medical service system at schools. Method : 93 questionnaires from 200 elementary, middle and high school nurses in the city D were collected from May 26 to July 7, 2008 and ${\chi}^2$ analysis and frequency analysis were carried out with SPSS win PC 14.0. Results : 1. As for emergency contact points, 3(3.30%) answers 'they do not have any knowledge', 40(43.96%) said 'they have some idea' and 48(52.75%) said 'they do know about it'. Among 24 respondents who have less than five years of working experience, 2(8.33%), 16(66.67%) and 6(25.00%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. As for 9 who have 6-10 years of career, 1(12.50%), 4(50.00%) and 3(37.50%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. Among 32 respondents who have 11~20 years, there were no respondents with no knowledge on the given question, and 9(29.03%) said they have some understanding and 22(70.97%) answered they have clear understanding on the topic. From this result, it can be said that there is statistically meaningful differences among different working year groups with ${\chi}^2=16.583$ and p= .010. 2. As for 119 emergency contact in the given district, 24(29.63%), 30(37.04%) and 27 (33.33%) answered 'do not know', 'know' and 'know very well' respectively. As for the question to ask whether they know Emergency Medical Information Center 1339, 66(70.97%) answered 'Yes' and 27(29.03%) answered 'No'. When it comes to emergency contact numbers and list of hospitals, 59(63.44%) said 'they have some list', 20(21.51%) answered 'they have well established contact network' and 14(15.05%) said 'they have none'. 3. As for the use of 119 service at the time of emergency at schools, 59(63.44%), said 'Yes' and 12(12.90%) answered 'No'. Among those who said 'yes', 29(31.18%), 24(25.81%) and 5(5.38%) answered they have used the service 1-2, 3-5 and 6-10 times respectively. Conclusion : In order to ensure health educator to effectively deal with emergency situations at schools, there should be special activities to enhance health educator' understanding on 119 and Emergency Medical Information Center 1339 and at the same time, a system should be established to connect schools, 119 in a given district, hospitals and Emergency Medical Information Center 1339.

다발성 장기 기능이상과 전격성 폐렴을 동반한 운동유발성 열사병 증례 1례

최욱진,이재욱,이세원 대한응급의학회 2009 대한응급의학회지 Vol.20 No.4

Heat stroke is defined as a core body temperature that rises above 40C accompanied by central nervous system abnormalities such delirium, convulsions or coma. Despite treatment with optimal cooling, heat stroke causes deaths by complications including rhabdomyolysis, renal failure, hepatic dysfunction, disseminated intravascular coagulation syndrome, acute respiratory distress syndrome, bowel ischemia, myocardial injury, and multiple organ failure. In some cases of survival, heat stroke it can cause irreversible CNS damage. Therefore, if exertional heat stroke is properly diagnosed in the emergency room, we must initiate early and aggressive treatment in order to prevent the multiorgan failure and high mortality associated with this condition. To our knowledge, case reports in the literature are rare describing that patients with multiple organ dysfunction and fulminant pneumonia following exertional heat stroke. This study reports on a relevant case, as well as findings from the literature. The case history is presented of a 20- year-old man who presented with exertional heat stroke with sustained hyperpyrexia ongoing after the first day of admission despite optimal treatment including intensive fluid resuscitation. On the 3rd day of admission, chest infiltrated lesions were discovered. From the high-resolution computed tomography results, multifocal consolidations were discovered in both lungs. Blood cultures revealed Staphylococcus hominis. Treatment with proper antibiotics was begun after identifying the blood culture. The patient fully recovered and was discharged on the 10th day after admission.

BWTS 원격 모니터링을 위한 트렌드 분석 및 진단

최욱진,김진훈,최휘민,이광섭,최우진,김주만 대한임베디드공학회 2014 대한임베디드공학회논문지 Vol.9 No.3

On lot of ships, Ballast Water Treatment Systems(BWTS) are in use, or the newly built ship should be mandatory installation by 2017. It is IMO(International Maritime Organization) regulations. Because the vessel is in long distance, It is managed this system only in the vessel and it may occur considerable cost of maintenance when a problem arises from BWTS. We describe in this paper how to monitor treated ballast water to make sure the ballast water and BWTS on a ship is in proper condition, but before the port entrance. In addition, analysing and forecasting trend signal to prevent failure. Also we can expect reduce the cost of BWTS maintenance. We can monitor the sensor data value's change which collected through satellite from BWTS. And we can observate the ballasting and de-ballasting state of the vessel easily.

보건교사의 응급처치 교육 필요도 및 교육 요구도에 관한 연구

최욱진,조근자 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.1

경추 고정 마네킹에게 직접 후두경 (Macintosh laryngoscope), 부지 (Gum elastic bougie), 비디오 후두경 (Pentax AirWay Scope)을 사용한 기관내삽관 비교

최욱진,조근자 한국응급구조학회 2011 한국응급구조학회지 Vol.15 No.3

Surge capacity 의 기본 개념과 병원에서의 대비

최욱진 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.2