유방암의 재발양상과 이에 따른 생존율 및 혈청 표지자들의 변화 분석

임태호(Tai Ho Im),정파종(Pa Jong Jung) 대한외과학회 1998 Annals of Surgical Treatment and Research Vol.54 No.3

과탄산 나트륨 음독 후 발생한 심한 위장관 손상 1례

원태영,김승우,강보승,임태호,Won Tae Young,Kim Seung Woo,Kang Bo Seung,Im Tai Ho 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.2

Laundery detergent ingestions are generally considered to have minor consequences. But some detergent ingestions have severe consequences. Unlike household bleaches contain sodium hypochlorite, bleaching agents that contain sodium carbonate have the potential to cause significant mucosal damage to the gastrointestinal tract if ingested. Especially, when ingested in solid form of Sodium carbonate, corrosive injury is much heavier. Therefore, patient who ingest sodium carbonate peroxyhydrate need more intensive management than patient who ingest other bleaches. We experienced a case of serious caustic injury after ingestion of Sodium Carbonate Peroxyhydrate. We report this case with review of literature.

국내 하지손상의 발생현황에 대한 분석

김창선 ( Chang Sun Kim ),최혁중 ( Hyuk Joong Choi ),김재용 ( Jai Yong Kim ),신상도 ( Sang Do Shin ),고상백 ( Sang Baek Koh ),이국종 ( Kug Jong Lee ),임태호 ( Tai Ho Im ) 대한외상학회 2008 大韓外傷學會誌 Vol.21 No.1

Purpose: We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea Methods: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical. Results: From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer`s medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February. Conclusion: The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.

전국 응급의학과 수련병원의 응급실 병력지에 대한 분석

임태호,임훈,이종호,강형구,장문준,조광현,장석준,김승호,정상원 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: This study was designed to analyze the current emergency department(ED) medical records of teaching hospitals in Korea. Methods: The five-item questionnaires were mailed to the EDs of 40 hospitals. Among them, 27 questionnaires and 35 ED medical records were returned for reply rates of 67.5% and 87.5%, respectively. Results: 1) The actual number of data elements in the ED medical records used by each hospital varies widely. It ranges from 1 to 15 data elements with an average of 7.5 data elements. 2) Thirteen data elements, signature of nurse, checklist style in review of systems, checklist style in physical examination, neurologic examination, figure of face, Glasgow coma scale, trauma scale, treatment plan, mode of transfer, condition on transfer, documents sent with patient, condition on discharge or discharge instruction, use of pediatric chart and vaccination history are used by less than 50% of the medical records examined. 3) There was no difference in the total number of data elements or in redesign and computerization of ED medical record based on the location of the hospital, the type of hospital administration, or the number of years since the start of EM residency program. 4) There was a statistically increased number of data elements in redesigned medical records. 5) In the survey, 89% of the residents replied that medical records needed to be redesigned. With respect to uniformity, 58% of the residents disagreed. A well-designed checklist chart rather than a descriptive chart was preferred by 89% of the residents. Conclusion: The currently used ED medical records have much room for improvement. The age of the ED had little impact on the quality of ED medical records. More attention and effort in this field are needed. In addition, The Korean Society of Emergency Medicine should provide guidelines for ED medical records.

응급실에서 시행된 기도삽관의 현황과 난이도의 예측

정성필,임태호,장문준,김승호,이한식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

Background : This study was designed to describe the current trends of emergency tracheal intubation and predict difficult airway intubations in emergency department (ED) at a teaching hospital in Korea. Methods : All patients who was taken endotracheal intubation in ED during a 1-year period (Mar 1997 through Feb 1998) were included in the study population. Medical records of the patients were retrospectively reviewed. Among them, 56 patients were prospectively evaluated parameters to predict difficult airway intubations. Results : During the study period, a total of 413 patients(1.5%) required endotracheal intubation. Except for 2 cases, all patients intubated orotracheally, and 298(72%) patients were intubated by emergency medicine resident. Pharmacologic adjuncts were used in 200(48%) patients, the neuromuscular blocking agent(NMBA) was used in 16(3.8%). Commonly used drugs were thiopental and vecuronium. The difficult intubation was not associated with presence of denture, length and circumference of neck, and mental status. The visibility of vocal cord on laryngoscopy significantly correlated to the difficult airway. Conclusion : At this institution, the majority of ED intubation were performed by emergency physicians and NMBA was not routinely used. The visibility of vocal cord during the direct laryngoscopy could be a predictor of difficult intubation in ED.

응급실 단기 재방문 환자

정성필,장석준,고재욱,임태호,최영환,이한식,황태식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.1

Background. When patients return to the emergency department shortly after being seen, it is generally assumed that their initial evaluation or treatment was inadequate. But in other aspects many short term revisits may be unnecessary in the aspect of emergency care because it is known that substantial numbers of patients use emergency department for nonemergency problems. So we analysed the tendency and the cause of short term revisit patients, determined the rates and the associated demographic, clinical, disease variables as a tool of quality assurance. Method. We carried out a chart review of patients seen in the emergency department, who revisited within 72 hours, of Young Dong Severance Hospital retrospectively between January 1, 1998 and September 30, 1999 (period 2), and compared with result between April 1, 1990 and March 31, 1991 (period 1) respectively. Results. In the period 1, the total revisit patients were 204/21,025 (0.97%), in that period scheduled revisits were 15.2%, the unscheduled were 84.8%, and the frequent revisits (more than 3 times) were 6.4%. In the period 2, the total revisit patients were 4,722/72,802 (6.49%), in that period scheduled revisits were 86.3%, the unscheduled were 13.7%, and the frequent revisits were 24.8%. The most common cause of revisit during the period 2 is a drug addictor (31.2%) that frequently used the emergency room for seeking drug. Conclusion. The scheduled revisit patients for dressing, medication, re-evaluation were increased enormously, so the medical care of these patients might be a part of job that performed in emergency department. And if the health care system could support the adequate nursing care facility, the portion of avoidable revisits of emergency department can be decreased. We also found that the emergency department is an important points for the early identification and referral for the treatment of patients who revisited emergency room for seeking drug, and the analysis of physician related factor in revisits patients may be used as a tool of quality assurance in the emergency department.

응급실 내원 손상 환자들의 음주 형태

장순봉,최혁중,김승우,임태호,이형중 대한응급의학회 2003 대한응급의학회지 Vol.14 No.3

Purpose: The purpose of this research was to analyze drinking on the day of injury, usual drinking pattern, factors associated with the injury and socioeconomic factors for patents who visited the emergency room (ER) for injuries. Methods: From among all the trauma patients who visited ER, this research included 474 patents who were over 18 years of age and who visited the ER within 48 hours of their injury. Questionnaire surveys, telephone surveys, and serologic tests were conducted for all the patients. Results: The drinking rate before injury was 51.9% among the 337 drinkers. The rate of drinkers was 72.2% (male 85%, female 42.6%), and the rate of habitual drinkers was 22.4% among the 466 subjects. The rates of habitual drinkers and nonhabitual drinkers were 31.5% and 68.5%, retrospectively, among the 337 drinkers. Such groups as assaulted patients, patents operated on under local anesthesia, patients injured indoor or outdoor except on roads, patients diagnosed as laceration, and patients injured between midnight and 8 a.m., and between 4p.m. and midnight had significantly higher incidents of drinking on the day of the injury (p=0.00~0.02). Such groups as males, older people, married people, people with low levels of education, people with high incomes and assaulted patients had significantly higher numbers of habitual drinkers (p=0.00~0.04). Conclusion: This study suggests that alcohol use is an important factor for patients who visit the ER for injuries and alcohol drinking. But it can, not be concluded that there is a causal relation between alcohol use and injury. Such groups who visit the ER for injuries as males, older people, married people, people with low levels of education, people with high incomes and assaulted patients need to be screened for alcohol misuse.

포토플레티스모그라피를 이용한 정맥기능의 평가: 검사방법의 수립

곽진영,이홍기,권오정,이광수,박훤겸,백홍규,남영수,임태호 대한혈관외과학회 1997 Vascular Specialist International Vol.13 No.2

Background: It is essential to evaluate hemodynamics of vascular disease in addition to anatomic details. It has been known that the plethysmography represents intravascular(arterial or venous) volume or pressure. Photoplethysmography(PPG) is convenient to use and has been widely used for measurement of venous refill time(VRT). However, it has not been used for evaluation of venous function. Objective: Our study aims at testing the feasibility of evaluation of venous function using PPG. Methods: The maneuver established for air PG was slightly modified and applied for the PPG. The test was performed with the object seated in a chair and the legs dependent. The PPG probe was attached to the limbs within 5 cm from medial malleolus. After standardized procedure of leg-raising, putting the leg in dependent position, 1 tip-toe exercise, and 10 tip-toe exercises, the measured parameters were initial emptying time(E1), amount of volume change(V1), refilling time by hydrostatic pressure(F1), refilling time after 1 tip-toe exercise(F2), and ejected volume(V2) and refilling time after 10tip-toe exercises(F3). Results: The mean(±S.D.) values of each parameters were; El(±S.D.)= 14.5±6.8 s(N=29), V2/Vl= 0.39±0.14(N=30), Fl=44.9±18.3s(N=30), F2=15.5±3.9s(N=30), and F3=23.2±5.9s(N=29). There was no correlation between El and V2/Vl(r = -0.09, P=0.63), but the parameters of venous refill(F3, F2, Fl) showed significant correlation(r = 0.424, P=0.02, F3 vs. F2, and r= 0.627, P = 0.0003, F3 vs. Fl). Conclusion: El and V2/Vl are independent parameters representing different functional status I.e. emptying time by hydrostatic pressure and relative emptying volume during exercise respectively, and Fl and F2 are parameters of venous refill related to F3. They could be useful for evaluation qf venous function in addition to conventional measurement of VRT.