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      • KCI등재

        응급센터에서 시행하는 약물선별현장검사의 유용성

        엄인경 ( In Kyung Um ),박종수 ( Jong Su Park ),한갑수 ( Kap Su Han ),조한진 ( Hanjin Cho ),최성혁 ( Sung Hyuck Choi ),이성우 ( Sung Woo Lee ),홍윤식 ( Yun Sik Hong ) 대한임상독성학회 2011 대한임상독성학회지 Vol.9 No.1

        Purpose: The role of a point of care test (POCT) is currently becoming important when treating patients and making decisions in the emergency department. It also plays a role for managing patients presenting with drug intoxication. But the availability of the test has not yet been studied in Korea. Therefore, we investigated the utility and the availability of POCT for drug screening used in the emergency department. Methods: This was a retrospective study for those patients with drug intoxication between January 2007 and December 2010 in an urban emergency department. Results: Between the study period, 543 patients were examined with a Triage□-TOX Drug Screen. Among those, 248 (45.7%) patients showed negative results and 295 (54.3%) patients showed positive results. The sensitivity of the test for benzodiazepine, acetaminophen and tricyclic antidepressants were 85.9%, 100%, 79.2%, respectively. Conclusion: POCT of drug screening in emergency department showed good accuracy especially in patient with benzodiazepine, acetaminophen and tricyclic antidepressant intoxication. Therefore, it can be useful diagnostic tool for the management of intoxicated patients.

      • KCI등재

        노인외상환자의 예후 인자

        문철규,전정민,최성혁,문준동,이성우,홍윤식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

        Background: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals: It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, the study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. Methods: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Center of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analyzed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved group depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. Results: Of 139 patients, the mean age was 74±7.1 years, mean ISS 9.3±7.26, mean hospital stay 27±27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS(p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40±25.1 days in patients with ISS over 6 while 6±8.6 days in those with ISS 5(p<0.05). Hospital stay in the improved was 26±26.9 days while 31±24.8 days in the improved old-old group (p=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26±10.1 days while 4±7.3 days in those without previous illness and hospital morbidity (p<0.05). Conclusion: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care for the geriatric trauma patients with previous medical illnesses is needed.

      • KCI등재

        외상성 기흉에 동반된 후복막기종 : 증례보고 Case Report

        홍윤식,이성우,최성혁,전정민,문철규,문준동 대한외상학회 1998 大韓外傷學會誌 Vol.11 No.1

        We describe a 23-year-old patient from blunt injury after motor vehicle accident. The cardiorespiratory and mental status were sufficient. He had pneumoretroperitoneum, left pneumothorax, complex zygoma fracture and left clavicle frature. Close drainage of left hemithorax and the diagnostic workups were done for evaluation of retroperitoneal free air. As free retroperitoneal gas has its source in a ruptured retroperitoneal viscus in common case, close attention was paid to possible abdominal symptoms. Abdominal computed tomography failed to demonstrate any pathology except free air in retroperitoneum. Surgical exploration of intraperitoneun and retroperitoneum wasn't revealed any injury. The patient was discharged after fixation of zygomatic fracture. The underlying pathophysiology of free retroperitoneal air in the absence of viscus and diaphragm lesions are discussed and the literatures are reviewed.

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