외상성 뇌손상 환자에 있어서 S100β의 혈중 농도와 뇌손상의 정도 및 예후의 관계

김오현,이강현,윤갑준,박경혜,장용수,김현,황성오,Kim, Oh Hyun,Lee, Kang Hyun,Yoon, Kap Jun,Park, Kyung Hye,Jang, Yong Su,Kim, Hyun,Hwang, Sung Oh 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2

Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

직무전문성 향상과 인적 자원의 효율적 활용을 위한 국방자격제도 발전에 관한 연구

김오현,노명화,이강성,Kim, Oh-Hyun,Roh, Myoung-Hwa,Lee, Gang-Sung 한국국방경영분석학회 2008 한국국방경영분석학회지 Vol.34 No.2

본 연구는 지식 정보기만 사회에서 국방분야의 직무전문성을 향상하고 군 인적자원을 효율적으로 활용하기 위한 수단으로서 국방자격제도 개선을 제안하고 있다. 국방자격제도는 기존 군 내부 제한된 영역에서 운영되는 틀에서 벗어나 민간과 상호 교류를 위해 선진국처럼 댐 국가적 차원으로 확대 승격시키기 위해 국방자격법을 제정하고 관련조직을 운영할 필요가 있다. 이렇게 함으로써 국방자격제도는 군 전문분야 및 기술수준을 체계적으로 관리할 수 있으며, 기존의 장병자격취득 지원제도를 혁신적으로 발전시킬 수 있을 것으로 기대된다. 또한 군이 필요로 하는 전문기술인력을 안정적으로 확보하고 군 경력의 사회적 인정을 통한 전역 후 취업지원을 보장할 수 있을 것이다. In this study, we proposed that Military Qualification System(MQS) should be reshaped for enhancement of the professional and efficient management of human resource in the military sector. It should be also prepared that Military Qualification Law and Organization to operate the MQS. By doing that, we can expect several benefits. Firstly, military professionalism is systemically managed and enhanced, secondly military qualification for military personnel will be innovatively developed, thirdly supplement of skilled personnel are secured with stabilities in the military sectors, and finally outplacement of retired personnel are also qualified with military career and training.

외상성 뇌손상 환자에 있어서 S100β의 혈중 농도와 뇌손상의 정도 및 예후의 관계

김오현 ( Oh Hyun Kim ),이강현 ( Kang Hyun Lee ),윤갑준 ( Kap Jun Yoon ),박경혜 ( Kyung Hye Park ),장용수 ( Yong Su Jang ),김현 ( Hyun Kim ),황성오 ( Sung Oh Hwang ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2

Purpose: S100β, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. S100β, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S100β, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum S100β, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for S100β, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum S100β, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups (0.74±1.50 μg/L vs 7.62±6.53 μg/L P=0.002). A negative correlation existed between serum S100β, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum S100β, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlations between serum S100β, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of S100β, was 7.62 ß∂/L (SD=±6.53) in the expired patients, 1.15 μg/L in the mildly disable patient, and 0.727 μg/L (SD=±0.73) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of S100β, has a poor prognosis for neurologic outcome. (J Korean Soc Traumatol 2007;20:138-143)

의식이 명료한 일산화탄소 중독환자를 대상으로 응급실에서 시행한 간이정신상태검사의 임상적 의의

육현 ( Hyun Youk ),차용성 ( Yong Sung Cha ),김현 ( Hyun Kim ),김성훈 ( Sung Hoon Kim ),김지현 ( Ji Hyun Kim ),김오현 ( Oh Hyun Kim ),김형일 ( Hyung Il Kim ),차경철 ( Kyoung Chul Cha ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hw 대한임상독성학회 2016 대한임상독성학회지 Vol.14 No.2

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

Semantic Interference Effect in Picture-Word Naming Tasks between Youth and Elderly

김오현(Oh Hyun Kim),최소영(So Young Choi),황민아(Min A Hwang) 한국언어청각임상학회 2016 Communication Sciences and Disorders Vol.21 No.3

배경 및 목적: 본 연구는 청년과 노인을 대상으로 그림-단어 간섭과제에서 범주 일치 여부에 따라 의미처리에 차이를 보이는지 알아보았다. 방법: 실험 과제는 표적자극(그림)과 방해자극(글자)이 같은 범주에 속하는 조건(범주 일치 조건)과 서로 다른 범주에 속하는 조건(범주 불일치 조건)으로 구성하였으며, 참가자에게 방해자극을 무시하고 표적자극의 이름을 명명하는 그림-단어 간섭과제를 수행하도록 하였다. 결과: 실험 결과, 범주 일치 여부에 따른 그림-단어 간섭과제의 정반응 점수에서 노인 집단이 청년 집단에 비해 다소 낮은 수행을 보였으며, 노인 집단의 경우 범주 일치 조건에서 낮은 정확도가 관찰되었다. 이 같은 차이는 반응시간 측정치에서 더 두드러져 노인 집단이 청년 집단에 비해, 범주 일치 조건이 범주 불일치 조건에 비해 처리 속도가 지연된 것으로 나타났다. 특히 집단(청년/노인)과 범주 일치 여부(일치/불일치)의 상호작용 효과가 통계적으로 유의미하여 범주 일치 조건에서 유발되는 간섭효과가 노인 집단에서 상대적으로 크게 나타남을 확인할 수 있었다. 논의 및 결론: 이 같은 결과는 노인 집단이 청년 집단에 비해 그림-단어 간섭과제에서 목표자극에 주의를 유지하기 어렵고, 이로 인해 더 낮은 의미처리 수행을 보이게 됨을 시사하였다. Objectives: The purpose of this study is to investigate whether elderly groups are able to do semantic processing during a picture-word interference task and whether their semantic processing is more affected by words in the same category or different categories. Methods: The participants in this study were 15 younger adults and 15 normal elderly. The tasks were composed of conditions where the target stimulation and distractive stimulation were in the same category or in different categories. The tasks were composed of a total of 30 questions. On the picture-word interference task, participants were supposed to name the picture. Results: The results of the study are summarized as follows. First, on the picture-word interference task, the accuracy of response of the elderly group was significantly lower than the younger group. Second, the reaction time of the elderly group was significantly slower, but both groups had a longer reaction time in the same category condition. Conclusion: The results indicated that the elderly group had more interference effects than the younger group. Although both groups resolved interference, the reaction time of the elderly group was slower. But in the same category condition, both groups had a longer reaction time than in different category conditions.

과학 교과서 진화론 개정 청원

김오현(Oh-hyun Kim) 한국창조과학회 2023 Origin Research Journal Vol.3 No.1

만성 리튬 중독환자의 지연성 정정맥 혈액 투석여과 사례

김태수 ( Tae Su Kim ),차용성 ( Yong Sung Cha ),김김현 ( Hyun Kim ),김오현 ( Oh Hyun Kim ),차경철 ( Kyoung Chul Cha ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hwang ) 대한임상독성학회 2013 대한임상독성학회지 Vol.11 No.1

A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and 85μg/dL (reference range: 19~54μg/dL), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient’s neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

앉은 부채 섭취 후 발생한 심장독성 3예

김태훈 ( Tae Hoon Kim ),김현 ( Hyun Kim ),김오현 ( Oh Hyun Kim ),차용성 ( Yong Sung Cha ),차경철 ( Kyoung Chul Cha ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hwang ) 대한임상독성학회 2012 대한임상독성학회지 Vol.10 No.1

Recently, some patients have visited the emergency department for treatment of different symptoms of acute poisoning after intake of unidentified herbs, which can be mistaken for wild edible greens, because wild edible greens are good for health and contain vitamins, enzymes, minerals, fibers, and anticancer materials. Winter or early spring, is extremely high, with rapid onset of severe symptoms of poisoning. There have been no reports of poisoning by SymplocarpusRenifolius in Korea, however, we report on three severe cases involving patients who experienced cardiogenic shock with nausea, vomiting, abdominal pain, chest discomfort, dizziness, numbness, and general weakness.

유기인계 중독에 의한 심근손상 환자에서의 경흉부 심장 초음파검사를 사용한 심장기능평가

이윤석 ( Yoonsuk Lee ),김오현 ( Oh Hyun Kim ),김형일 ( Hyung Il Kim ),차경철 ( Kyoung Chul Cha ),김현 ( Hyun Kim ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hwang ),차용성 ( Yong Sung Cha ) 대한임상독성학회 2015 대한임상독성학회지 Vol.13 No.2

Purpose: Cardiac complications may occur in cases of organophosphate (OP) poisoning. However, a few studies regarding patterns of cardiac toxicity as determined by transthoracic echocardiography (TTE) after exposure to OP have been reported. In the current study, the authors examined cardiac functions using TTE in patients with myocardial injury caused by exposure to OP. Methods: A retrospective review was conducted on 16 consecutive cases of OP poisoning with myocardial injury(defined as elevated troponin I within 48 hours of arrival at the regional emergency center in South Korea and diagnosed and treated at the center from January 2012 to November 2014. Results: TTE was performed in 11 (69%) of the 16 patients with an elevated troponin I (TnI) level within 48 hours. Of these 11 patients, 5 patients (45.5%) exhibited reduced ejection fraction (EF), and 3 exhibited regional wall motion abnormality (RWMA). Two patients (18.2%) had both reduced systolic function and RWMA. Two of the 5 patients with reduced EF returned to normal systolic function, however two patients did not regain normal systolic function after admission. One patient expired due to multiple organ failure, and 4 patients were transferred with a moribund status. Twelve of 15 patients who survived to discharge (at 4 to 35 months) were followed. Five of these patients died during follow-up and 7 survived without further complications. Conclusion: OP can cause reversible cardiac dysfunction including reduced systolic function and RWMA. Serum TnI may be useful for initial assessment of cardiac function during the workup of patients suffering from OP poisoning. After the initial assessment of cardiac enzyme, further evaluation with TTE in patients with abnormal cardiac enzyme will be necessary to understand the cardiac toxicity.

부식제 중독 환자에서 시간에 따른 내시경 합병증 비교

최진걸 ( Jin Geul Choi ),김오현 ( Oh Hyun Kim ),김현 ( Hyun Kim ),이동건 ( Dong Keon Lee ),고진 ( Jin Go ),김태훈 ( Tae Hoon Kim ),차경철 ( Kyoung Chul Cha ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hwang ),차용성 ( Yong Sung C 대한임상독성학회 2014 대한임상독성학회지 Vol.12 No.2

Purpose: Endoscopy has been recommended as a primary procedure for determining the extent of damage and prognosis in patients with caustic ingestions. Endoscopy within the first 24 hours has been suggested, however, such immediate endoscopy is not always possible. Therefore, we wanted to determine complications and possible delayed sequelae after the endoscopy performed dependent on time, including less than 24 hours and more than 24 hours, after ingestion of relatively high toxic caustic agents. Methods: From January 2005 to May 2013, 105 consecutive patients were diagnosed with caustic poisoning in the emergency department of the Wonju Severance Christian Hospital. Out of 95 patients who underwent endoscopy, while excluding 49 patients who ingested sodium hypochlorite and 15 patients due to insufficient data, 41 patients were ultimately included. We compared general characteristics, complications related to endoscopy, late sequelae, total admission length, and mortality between two groups. Results: Twenty eight patients (68.3%) were diagnosed with acid ingestion. Median endoscopy time was 17.8 (IQR 9.7-36.9) hours and performed in 16 patients (39%) after 24 hours. There were no complications, such as perforation and bleeding in either endoscopy within 24 hours group or endoscopy after 24 hours group. In addition, no difference in ingested materials, endoscopy grade, or late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group. Conclusion: No difference in complications and late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group when endoscopy was performed based on a clinician’s assessment.