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양혁준,박철완,이근 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2
This study reviewed 103 deaths resulting from trauma in a 30 months in a 30 months period at the Emergency Department of Chung Ang Gil Hospital to evaluate problems in prehospital and hospital resuscitative care. The results were summarized as follows : 1. Among 103 patients who died of trauma, 71 patients were male(68.9%) and 32 patients were female(31.1%). The mortality rate was 0.095% of all 107,741 patients who admitted to the Emergency Department.(Death On Arrival was 0.53%(573 cases) and Death After Arrival was 0.24%(256 cases)during the same period.) 2. The patients who arrived at the Emergency Department from 30 to 60 minutes after onset of urgent situation was 43.7%, but within 1 minutes only 10.7%. The cases transferred by ambulances was only 19.4%, most of rest were moved by public or private vehicles. 3. The cause of trauma was Traffic Accident in 75%, among them 42.7% were pedestrian injury. 4. The time interval between arrival at Emergency Department and onset of cardiac arrest was commonly within 10 minutes in 40.8% of patients. In 43.7% of patients, death was pronounced within 30 minutes after onset of cardiac arrest. 5. The trauma resuscitation were performed as primary surveys and then secondary procedures. The primary surveys were completed in about 3 minutes after the patients arrival : access of airway (89.3%), oxygen administration(86.4%), IV access(92.2%), and EKG monitoring(81.6%). The secondary procedures were initiated within 10 minutes : endotracheal intubation(81.6%), CVP monitoring(46.6%), paracentesis & DPL(44.7%) and thoracentesis & chest tube insertion(21.4%). 6. The main causes of death were brain injury(36.4%) and irreversible shock(32.0%). On physical examination, the most frequent injuried site was head and neck as 35.4%. 7. The mean ISS of all deaths was 45.24 ±13.59, the mean GCS was 6.44 ±3.36 and the mean RTS was 3.20 ±2.38. By the TRISS method, the mean Ps of deaths was 0.2441. Unexpected death, who were died inspite of Ps?0.5, were 23 cases.
앉은 자세와 기립 자세의 비율이 정상 성인의 체간 굴곡 유연성에 미치는 영향
권혁철,정동훈 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.2
For spinal flexibility measurements to be meaningful to clinicians or researchers, they must have a normative information and an understanding of how different variables affect spinal range of motion (ROM). Normal spinal ROM measurements are influenced to differing degrees by many factors. These factors include age, gender, time of day, leisure activities, previous history of low back pain, warming up, and the techniques with which normative data are collected. The additional variables of standing height, ratio of standing height to sitting height, and obesity had not been previously studied extensively and were shown to have a significant effect on flexibility in the sagittal plane. These relationship cannot be explained easily. Thus, the purpose of this study was to determine the relationship between spinal flexibility and individual factors (weight, standing height, and ratio of standing height to sitting height) that influence it. Fifteen healthy subjects between the ages of 20 and 27 years were studied. Two physical therapists measured independently the spinal forward bending ROM in the sagittal plane by Remodified Schober test and Finger-to-floor test. In order to determine the statistical significance of the result the Pearson's correlation was applied at the .05 level of significance. The results of this study were as follows: 1) Significant relationship was not identified between spinal flexibility and weight. 2) Significant relationship was not identified between spinal flexibility and standing height. 3) Significant relationship was not identified between spinal flexibility and ratio of standing height to sitting height.
문철,권혁도,이동근,박경옥,성길현,이재은 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1
Necrotizing fascitis is a severe soft tissue infection characterized by extensive necrosis of superficial fascia, suppurative fascitis, vascular thrombosis, widespread undermining of surrounding tissues. Accociated systemic problems are widespread undermining of surrounding tissues, Accociated systemic problems are common, with chronic alcoholism and diabetes being most prominent. Most commonly this disease presents in the extremities, trunk, and perineum. Necrotizing fascitis of dental origing is rare and its fulminating clinical course is not well documented in the dental literature. The present report is a case of necrotizing fascitis following vital extirpation of the pulp in a patient with uncontrolled diabetes mellitus and liver cirrhosis. Originally throught to be caused by hemolytic streptococcus organism or stphylococcus aureus, advances in anaerobic culturing have shown it to be a synergistic bacterial infection involving aerobic and ovligate anaerobes. it is relatively rare in relatively rare in haea and neck regions. If it was not diagnosed and treated in early stages, necrotizing fascitis can be potentially fetal, with a mortality rate approaching 40%. It's treatment requires early recognition, prompt and aggressive surgical debriment and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. Recently, we experienced two cases of necrotizing fascitis in cervicofacial region, One patient was 60 years old male with uncontrolled Diabetes Mellitus and other patient was 48 years old with steroid therapy during 30 years. Local surgical wound healing was successful but, patients were died after admission, because of lung abscess, gastrointestinal bleeding, septic shock and respiration hold.
앉기 자세와 수근관 증후군의 상관관계에 관한 고찰 : A Literature Review
권혁철,공진용 한국전문물리치료학회 2002 한국전문물리치료학회지 Vol.9 No.3
The objectives of this study was to investiage the effects of sitting posture on carpal tunnel syndrome. Carpal tunnel syndrome (CTS) continoes to be one of the most widely publicized maladies of the cumulative trauma disorder. Many studies have reported a positive association between CTS and highly repetitive work, high force, and poor posture. High force and repetitive work have especially been associated with CTS, but the evidence for work being a primary cause of CTS is strongest when these factors are combined. In addition to carpal tunnel syndrome, hand, wrist, and other disorders are attributed to these work-related movements. Such disorders are referred to as repetitive stress injuries, cumulative trauma disorder, overuse syndromes, and chronic upper limb pain syndrome. Incorrect posture also may play a role in the development of CTS in people who work at a computer and other types of keyboards. The tendency to roll the shoulders forward, round the lower back, and thrust the chin forward can shorten the neck and shoulder muscles, compressing nerves in the neck. This, in turn, can affect the wrist, fingers, and hand. The treatment and prevention of carpal tunnel syndrome continue to be approached with a segmental view of the human body. For example, the most common ergonomic solution for carpal tunnel syndrome associated with keyboard use is to keep the wrists in a neutral position by using a wrist rest in front of the keyboard and good sitting posture.