스쿠버 다이빙 후 발생한 잠수 폐부종

강희동 ( Hui Dong Kang ),오세현 ( Se Hyun Oh ),정상구 ( Sang Ku Jung ) 대한스포츠의학회 2017 대한스포츠의학회지 Vol.35 No.3

Immersion pulmonary edema (IPE) is a form of pulmonary edema that can occur in divers or swimmers. IPE is a rare condition, but can be life-threatening and recurrent condition. The pathophysiology of IPE is still incompletely understood. We present a case of scuba diving induced pulmonary edema in a 46-year-old woman diving in cold seawater. After 20 minutes of diving at 18 m, she felt difficulty of breathing. Symptoms on surfacing were dyspnea, cough, and frothy sputum. Chest X-ray showed pulmonary edema and she was treated with an intravenous diuretic and supplemental oxygen. The patient showed rapid resolution of symptoms and was discharged on the same day. Sport physician should be aware of this potentially life-threatening recurrent condition.

반복적인 비경구노출에 의한 유기인계 중독: 중간형증후군과 급성췌장염 1례

오세현,강희동,이부수,Oh, Se-Hyun,Kang, Hui-Dong,Lee, Boo-Soo 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.2

Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

중독감시체계를 이용한 중독정보 수집 및 분석: 후향적 기초조사

오범진,김원,조규종,강희동,손유동,이재호,임경수,Oh Bum-Jin,Kim Won,Cho Gyu-Chong,Kang Hui-Dong,Shon Yoo-Dong,Lee Jae-Ho,Lim Kyoung-Soo 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Purpose: Toxic Exposure Surveillance System (TESS) is widely used for poisoning data collection and making a counterplan. But, there were few reports about poisoning data collection using TESS in Korea. The aim was to collect poisoning data using TESS report form and investigate the recognition of emergency physician about the necessity of TESS as preliminary survey. Methods: Retrospectively, we gathered data from hospital records about the patient who admitted hospital emergency room due to poisoning. Date were gathered by paper and/or web client system report form in patients recruited by ICD-10 codes Results: From Jun 2004 to May 2005,3,203 patients were enrolled in 30 hospitals and their mean age was $44.9{\pm}20.3years$ old(male: female = 1,565: 1,638). The most frequent site of exposure was their own residence (73.2%, 2,345/3,203) and most of reported patients were older than 20 years(89.7%, 2,871/3,203). Frequent substances involved in poisoning were medication(41.9%) and pesticide(33.3%). Intentional poisoning was 60.7%(1,954). In fatality, overall frequency was 5.1%(162/3,203) and the most frequent route of exposure was ingestion(96.3%, 156/162) and the most frequent substance was pesticide(85.2%, 138/ 162). Antidotes were administered in 202 patients(2-PAM, atropine, antivenin, N-acetylcystein, vitamin K, flumazenil, ethanol, methylene blue, naloxone, calcium compound). 19 of 20 emergency physicians agreed with necessity of TESS. Conclusion: Data collection using TESS report form showed preliminary poisoning events in Korea. Frequent poisoning substance were medication and pesticide. The fatality was mainly related with pesticide ingestion. Many doctors in emergency room recognized the necessity of TESS.

국내 농약 제품표지 내용 및 유독성 표시의 적절성

오범진,노형근,김원,조규종,손유동,강희동,임경수,Oh Bum Jin,Roh Hyung-Keun,Kim Won,Cho Gyu Chong,Shon Yoo Dong,Kang Hui Dong,Lim Kyoung Soo 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2

Purpose: The morbidity of pesticides are largely related with accidental ingestion in human. The four principal ideals of clarity, completeness, conformity and consistency of label are important to make a correct usage and prevent unnecessary health risk. The aim of this study is to evaluate the appropriateness of pesticides labelling practice in Korea. Methods: The photographic label images of pesticide products were gathered through visiting thirteen manufacturers that produce pesticide products in Korea. We scored labelling practice by guidelines of Food and Agriculture Organization of the United Nations in 1995. Results: From August 2005 to November 2005, we gathered 1,296 label images of pesticide and $58.3{\%}$ (755/1,296) of images were scored by check lists for reviewing label content. The average score of four check list categories was $71.9{\pm}2.2$. Each categorical score were $91.7{\pm}0.9$ for the information appearing on the label, $31.3{\pm}0.0$ for safety precaution, $77.7{\pm}2.0$ for instructions for use, $87.0{\pm}8.7$ for general configurations. In safety precaution, the sentence of keeping locked up the product and two mandatory safety pictograms were missed in all label images. In general configurations category, there was score difference in product package types between bottle and bag container ($85.1{\pm}9.0$ vs. $90.3{\pm}7.2$, p < 0.01). Conclusion: Although there was no comparable previous data, the score of safety precaution was lowest than other categories because the two mandatory safety pictograms and locked up warning sentence were missed. In general configurations, the colour contrast was more inappropriate in the labels on bottle than bag container.

소화기 ; 집단으로 발생한 박새( Veratrum patulum) 중독 23예

이세형 ( Se Hyung Lee ),김영돈 ( Young Don Kim ),하동천 ( Dong Cheon Ha ),한군희 ( Koon Hee Han ),정우진 ( Woo Jin Jeong ),강희동 ( Hui Dong Kang ),천갑진 ( Gab Jin Cheon ) 대한내과학회 2010 대한내과학회지 Vol.79 No.4

고산 지대에서 임의로 산나물을 채취하여 먹은 후 구역, 구토 등을 호소하며 저혈압 및 서맥을 보이는 경우 임상적으로 박새 중독을 의심하여야 하며, 진단 후에는 입원 상태에서 면밀한 생체 징후 감시와 적절한 보존적 치료를 시행한다면 빠른 시일 내에 회복될 수 있다. 저자들은 박새 잎을 섭취 후 집단으로 구토와 서맥, 저혈압 등의 중독 증상을 보인 23명의 환자들을 아트로핀 정맥 주사와 대증요법을 통해 치료한 예를 경험하였기에 보고하는 바이다. Veratrum patulum is a perennial plant with toxicity, which grows wild in the high mountain areas of Korea. Various types of steroidal alkaloids contained in Veratrum patulum are known to cause symptoms such as nausea, vomiting, bradycardia and hypotension. Twenty-three patients were admitted to our center with chief complaints of nausea and vomiting after ingesting leaves of Veratrum patulum. The mean age of the group was 44 years old and was comprised of 19 males and 4 females. Some patients showed hypotension and bradycardia with symptoms such as dizziness. Ten patients with severe bradycardia coupled with other symptoms received atropine administration. Nausea and vomiting were improved after the administration of anti-emetics. Blood pressure and the pulse rate were all normalized on the day after admission, and all of the patients were discharged without any symptoms. (Korean J Med 79:417-421, 2010)

수도권지역 일개 전문 응급의료센터로 내원한 외상환자의 연령군별 특성

조규종 ( Gyu Chong Cho ),문이상 ( Lee Sang Mun ),강희동 ( Hui Dong Kang ),손유동 ( You Dong Sohn ),오범진 ( Bum Jin Oh ),김원 ( Won Kim ),임경수 ( Kyoung Soo Lim ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.2

Background: Although trauma has been the major cause of death in korea, there are few reports describing the epidemiologic characteristics of trauma victims according to age-group. Thus, this study aimed to describe the epidemiologic characteristics of trauma victims visiting an urban emergency medical center in Korea. Method: This study was conducted with all trauma victims who visited the emergency departments of Asan Medical Center from April 11, 2005 to May 10, 2005. After the subjects were divided into three groups such as child (≤ 14 years old), adult(15-64 years old) and elderly(≥ 65 years old), the prehospital courses, injury mechanisms, injury severities and clinical results were compared. Result: Among total 5,927 patients who visited the emergency medical center, 896(15.1%) patients were trauma victims. Although child under the age of 15 comprised 28.7% of the total trauma victims, less severe injuries(injury severity score < 9) accounted for 97.7% of the cases. The hospitalization rate for injury among child was 21.5%. however, although elderly aged 65 comprised only 5.9% of the total trauma victims, more severe injuries(injury severity score ≥ 9) accounted for 30.2% of the cases. The hospitalization rate for injury among elderly was 56.4%. Conclusion: Patterns of injury and clinical results by age-group were considerably different. less severe and non-hospitalized injuries were more common in child than other age-groups. while severe and hospitalized injuries were common in elderly.

Li2B4O7 단결정 성장과 열형광 특성

박강수 ( Park Gang Su ),안정근 ( An Jeong Geun ),김동진 ( Kim Dong Jin ),황윤회 ( Hwang Yun Hoe ),김형국 ( Kim Hyeong Gug ),박명환 ( Park Myeong Hwan ),강희동 ( Kang Hui Dong ),김도성 ( Kim Do Seong ) 한국센서학회 2003 센서학회지 Vol.12 No.1

Czochralski 법으로 조직등가 물질인 Li₂B₄O_(7) 단결정을 성장하고 열형과 특성을 조사하였다. 단결정 성장시 종자결정의 회전속도는 10 rpm, 인상속도는 0.18 mm-h^(-1) 이하에서 core가 없는 양질의 단결정을 얻을 수 있었으며, X-선 회절분석을 통해 성장한 Li₂B₄O_(7) 단결정의 구조는 정방정계임을 확인하였다. 열형광 glow 곡선은 쉽게 분해할 수 있는 세 개의 peak 들이 중첩되어 나타났으며, X-선에 대한 Li₂B₄O_(7) 단결정 TLD의 열형광감도는 50 mGy에서 1.5 Gy까지의 선량범위에서 선형적으로 나타났다. 기온율법에 의한 열형광 glow 곡선 분석과 PL 스펙트럼 분석 결과에 의한 glow peak의 활성화에너지는 각각 0.93, 1.78, 2.25 eV으로 평가되었다. Thermoluminescent properties of Li₂B₄O_(7) single crystal grown by Czochralski method have been investigated. The high quality Li₂B₄O_(7) single crystal without core was obtained at rotation speed of 10 rpm for seed crystal and pulling speed below 0.18 ㎜·h^(-1). The structure of Li₂B₄O_(7) single crystal was classified as tetragonal by XRD analysis. The TL glow curve was composed with three overlapped peaks which can be easily deconvoluted and the TL response of Li₂B₄O_(7) single crystal TLD to S-ray radiation is linear within the range of 50 mGy ~ 1.5 Gy. activation energies of three TL glow peaks analyzed by the various heating rates method and P spectrum were 093, 1.78 and 2.25 eV, respectively.