http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Decrease of Proapolipoprotein AI was Associated with Poor Prognosis in Patients with Septic Shock
권운용,서길준,조유환,김규석 대한응급의학회 2011 大韓應急醫學會誌 Vol.22 No.3
Purpose: Proteomics is a peptide screening approach to identify proteins related to physiological and pathological changes. Our objective was to analyze changes in serum proteome profiles in patients suffering from septic shock,during the first 24-h period of therapy and to determine whether these changes were associated with prognosis. Methods: This was a retrospective observational study based on prospectively collected data that was conducted in an emergency intensive care unit (ICU) of a tertiary referral hospital. Consecutive patients admitted to the ICU with septic shock were enrolled. We obtained serum samples from the patients at admission (0 h) and 24 h after admission (24h). Then, we analyzed the serum proteome profiles, performed Western blots, and measured serum lipid profiles. Results: Twenty-seven patients were enrolled. Thirteen patients were grouped into the survivors (SURV) group and fourteen into the non-survivors group on day 30 (NONSURV). Proteomic analyses and Western blot showed that the expression intensities of proapolipoprotein AI remained unchanged in SURV but decreased in NON-SURV during the first 24-h period of septic shock (p=0.015). Serum high density lipoprotein (HDL) cholesterol level also remained unchanged in SURV but decreased in NON-SURV (p=0.036). Conclusion: The decrease in serum proapolipoprotein AI expression during the first 24-h period of therapy was associated with a consistently low serum HDL cholesterol level and a poor prognosis in patients with septic shock.
권운용,박준석,어은경,오범진,이미진,이성우,서주현,노형근,서길준,Kwon, Woon-Yong,Park, Joon-Seok,Eo, Eun-Kyung,Oh, Bum-Jin,Lee, Mi-Jin,Lee, Sung-Woo,Suh, Joo-Hyun,Roh, Hyung-Keun,Suh, Gil-Joon 대한임상독성학회 2007 대한임상독성학회지 Vol.5 No.1
Purpose: The aim of this study was to evaluate the characteristics and the prognostic factors of carbamate poisoned patients who visited emergency departments. Methods: From August 2005 to July 2006, we investigated the demographic feature, dose of exposure, time of exposure, alcohol intake, route of exposure, reason of exposure, site of exposure, pre-existing medical condition, time from exposure to emergency department (ED), transfer from other hospitals, vital sign at ED arrival, symptom or sign at ED arrival, and result of care of the patients who visited the ED of thirty-eight hospitals in Korea. According to the result of care, we divided the patients into two groups, the survival and the dead. To evaluated the prognostic factors, we calculated the odds ratio of each factor for the survival. Results: Among the sixty-eight patients, fifty-five patients (80.9%) were survival and thirteen patients (19.1%) were dead. The patients in the dead were older than the patients in the survival. The Glasgow coma scale (GCS) of the patients in the dead was lower than the GCS in the survival. The odds ratio of the GCS at ED arrival for the survival was 1.58 (95% CI; 1.23-2.05). Other factors showed no statistical significances. Conclusion: The GCS at emergency department arrival was the prognosis factor of the carbamate poisoned patients who visited emergency departments. If the carbamate poisoned patients showed altered mentalities, they should be provided intensive care, immediately.
간경변 환자의 정맥류 출혈에서 Octreotide의 지혈효과
권운용,정중식,김규석,김성혜,신상도,이중의,서길준,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.1
Purpose: This study was conducted to confirm the effects of octreotide in patients with variceal bleeding. Methods: We performed a retrospective analysis of 26 patients with variceal bleeding, who visited the Emergency Center of Seoul National University Hospital from January 1st to June 31st,1996, the control group, and a prospective analysis of 28 patients with variceal bleeding, who visited the Emergency Center of Seoul National University Hospital from March 1st to August 31st, 1999, for the octreotide-infused group. The octreotide-infused group recieved a continuous infusion of octreotide, 25㎍/hr, for 5 days after an initial bolus of 50 ㎍. When active bleeding continued over 1 hour, over 5 pints of packed-RBC were needed for transfusion within 24 hours, or when the systolic blood pressure was under 90mmHg, a ballon tamponade with Sengstaken-Blackemore tube was used. T-test and X2 test were used for statistic at analysis (p<0.05). Results: Forty-one patients were male(octreotide-infused group 22, control group 19) and 13 were female(octreotide-infused group 6, control group 7). The mean age was 55 years(octreotide-infused group 56 years, control group 52 years). There were no significant differences in vital signs, hemoglobin/hematocrit levels, and Child-Pugh's classifications between the octreotide-infused group and the control group initially. There was a significant difference in the rates of early bleeding control within 24 hours(p<0.05), but there were no significant differences in the rates of rebleeding, mortality within 1 week, and use of a balloon tamponade. Conclusion: Variceal bleeding is a serious complication of liver cirrhosis and has a high mortality rate. Octreotide is an effective vasoactive agent for control of early bleeding, Thus, octreotide should be used first before endoscopic definitive therapies, to stabilize the vital signs of patients and to secure a field for endoscopic procedures.
권운용,조유환,송형곤,김명천,이중의,서길준,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4
Background: Paraquat causes severe tissue toxicity when ingested, but has no effective treatment modality. We have shown that high dose vitamin C has effective antioxidant activities against the paraquat intoxication in a previous animal experiment. This study was designed to evaluate the effect of antioxidant therapy with high dose vitamin C and vitamin E in human cases of paraquat intoxication. Methods: From August 1999 to August 2001, 19 paraquat intoxication patients who visited the emergency department of the Seoul National University Hospital and the Kyounghee University Hospital were enrolled to this study. They were devided into two groups, a control group(9 patients) and a study group(10 patients). The control group received only conservative managements including gastro-intestinal decontaminati-on. The study group received conservative managements plus the antioxidant therapy which was composed of vitamin C 24 gm/day intravenously and 20 gm/day orally, and vitamin E 1.6 gm/day orally. Results: In the study group, 5 of 10 patients(50%) survived, but all patients of the control group died(p=0.003). There were no significant differences in age, sex, and usage of gastric lavage and activated charcoal between the two groups. Difference in ingested amount of paraquat between the two groups could not be analyzed due to the inexact and subjective measuring methods based on patients' histories. Conclusion: Antioxidant therapy with high dose vitamin C and vitamin E is effective in vival rate in paraquat intoxicated patients.
Clinical Features of Acute Epiglottitis in Adults in the Emergency Department
유경민,권운용,서길준,김경수,김재성,박민지 대한응급의학회 2016 대한응급의학회지 Vol.27 No.1
Purpose: Acute epiglottitis is a potentially fatal condition that can result in airway obstruction. The aim of this study is to examine the clinical features of adult patients who visited the emergency department (ED) with acute epiglottitis. Methods: This retrospective observational study was conducted at a single tertiary hospital ED from November 2005 to October 2015. We searched our electronic medical records (EMR) system for a diagnosis of “acute epiglottitis” and selected those patients who visited the ED. Results: A total of 28 patients were included. There was no pediatric case with acute epiglottitis during the study period. The mean age of the patients was 58.0±14.8 years. The peak incidences were in the sixth (n=7, 25.0%) and eighth (n=8, 28.6%) decades. The male-to-female ratio was 2.1:1. The most common symptom was sore throat (n=23, 82.1%), followed by dyspnea (n=15, 53.6%), hoarseness (n=7, 25.0%), fever (n=6, 21%), and dysphagia (n=5, 17.9%). The diagnosis of acute epiglottitis was confirmed when edema and hyperemia of the epiglottis were visualized by laryngoscopy. Twenty-six patients were treated conservatively with antibiotics and steroids without definite airway management. Two patients were intubated, but no patients required tracheostomy. Conclusion: In adult patients with acute epiglottitis, sore throat and dyspnea were the most common symptoms but fever was infrequent. Most patients improved with conservative management only. Definite airway management was required in only two patients in whom endotracheal intubations were performed successfully in the ED by emergency physicians, and surgical airway management was not required.