Initial Electrocardiographic Findings Associated with Failed Resolution of ST-segment Elevation after Thrombolytic Therapy in Acute ST-segment Elevation Myocardial Infarction (STEMI)

나지웅,최필조,이정훈 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.3

Purpose: Electrocardiography is a non-invasive tool for use in prediction of reperfusion and outcome of acute myocardial infarction. We attempted to determine initial electrocardiographic findings associated with failed resolution of STsegment elevation (STE) among patients with ST-segment Elevation Myocardial Infarction (STEMI) treated with a thrombolytic agent Methods: This retrospective study included patients with STEMI who were treated with a thrombolytic agent at the emergency department between October 2008 and March 2011. During the study period, among 331 patients with STEMI, 43 patients were enrolled. Resolution of STE was evaluated by comparison of initial electrocardiography (ECG) with follow-up ECG, taken 90 minutes after thrombolytic therapy. Determination of success or failure of resolution of STE was based on the electrocardiographic criteria of the American College of Cardiology and the American Heart Association (ACC/AHA). Patients were divided into two groups according to these criteria, and initial electrocardiographic findings were compared for the two groups. Results: Of a total of 43 patients, 22(55.16%) demonstrated failed resolution of STE after thrombolytic therapy. The risk of failed resolution of STE was approximately nine times higher in the anterior location of STE, compared to the inferior location of STE (OR 9.09, 95% CI, 1.46-94.69,p<0.01). In addition, the absence of reciprocal ST depression was associated with a six times higher risk of failed resolution of STE, compared with the presence of reciprocal ST depression (OR 6, 95% CI, 1.17-39.23, p=0.01). However, other electrocardiographic findings, including abnormal Q-wave, wide QRS complex, and QTc prolongation did not differ statistically between the two groups. Conclusion: Failed STE resolution after thrombolytic therapy was more frequent in STEMI patients with ST elevation in an anterior location or without reciprocal ST depression.

종양치료제가 생쥐 막창자점막의 DNA 합성에 미치는 영향

나지웅,안의태,박경호,박대균,고정식 대한체질인류학회 2006 대한체질인류학회지 Vol.19 No.4

응급실로 내원한 외상성 화농성 근염 환자의 분석

나지웅 ( Ji Ung Na ),송형곤 ( Hyoung Gon Song ) 대한외상학회 2006 大韓外傷學會誌 Vol.19 No.1

Purpose: Pyomyositis is a rare disease in temperature climate region. The diagnosis of pyomyositis is often delayed, and pyomyositis is often misdiagnosed in the emergency department. Methods: The medical records of 11 patients who were diagnosed as having traumatic pyomyositis in the emergency department at Samsung Medical Center in Seoul, Korea, between 2000 and 2006 were reviewed. Their clinical features, such as history, symptoms, clinical findings, duration from onset of symptoms to diagnosis, medical history, laboratory data, results of imaging studies and clinical course were collected. Results: The psoas muscles were most commonly involved. Computer tomography and magnetic resonance imaging aided in accurate diagnosis of the infection and of the extent of involvement. Incision, drainage, and antibiotics therapy eradicated the infectioin in all patients Conclusion: Pyomyositis should be a part of the differential diagnosis for patients with traumatic muscle pain. Radiologic evaluation, such as computer tomography and magnetic resonance imaging, must be considered in the diagnosis of traumatic pyomyositis. (K Korean Soc Traumatol 2006;19:81-88)

초박형 라이트필드 카메라를 위한 HDR 이미징 알고리즘 개발

나지웅(Jiwoong Na),유재관(Jaekwan Ryu),조용진(Yongjin Jo),김민혁(Min H. Kim) 한국컴퓨터그래픽스학회 2023 컴퓨터그래픽스학회논문지 Vol.29 No.3

실신을 주소로 응급실에 내원한 환자의 진단적 검사 유형과 의료 비용에 대한 연구

윤희,나지웅,신태건,심민섭,조익준,송형곤,김준수 대한응급의학회 2011 대한응급의학회지 Vol.22 No.6

Purpose: Syncope is a common clinical problem. However,diagnosis of the cause of syncope is not simple due to a wide variety of forms of syncope. The aim of this study was to assess current diagnostic methods and the associated medical costs which accompany the evaluation of patients suffering syncope who admitted to an emergency department (ED). Methods: This study is a prospective, observational, single center study. Patients included in the study visited the ED of a single, tertiary hospital between January and December 2009, and were diagnosed with syncope. We investigated the diagnostic yields (DY) for the tests that were employed and evaluated factors related to medical costs. Results: A total of 124 patients were enrolled in this study. Blood tests, chest radiography, postural blood pressure (BP) measurement and computerized tomography of the brain were performed in over 60% of cases, but DY for each of these tests was less than 3%, except for postural BP measurement (7.4%). The test which demonstrated a relatively high DY was the head-up tilt test (68.1%). The ratio of the cost of each test among the total medical costs required by all patients (constituent ratio) was highest for brain imaging tests (12.2%). The total cost of syncope evaluation per patient was 1,454,000±2,865,000 won. Factors including hospital admission and diagnosis of cardiac syncope resulted in significantly higher total medical costs for those patients. Conclusion: Among the tests performed in the ED for syncope evaluation, blood tests, chest x-ray and brain imaging tests were commonly used but resulted in relatively low diagnostic yield. Independent factors which increased medical costs were hospital admission and diagnosis of cardiac syncope.

종양치료제가 생쥐 막창자점막의 DNA 합성에 미치는 영향

고정식,나지웅,안의태,박경호,박대균,정은주 대한체질인류학회 2006 대한체질인류학회 학술대회 연제 초록 Vol.49 No.-

심폐소생술 지침에서 권장하는 가슴압박 깊이를 남녀에 동일하게 적용하는 것이 적절한가?

김상훈,나지웅,이장희,신동혁,한상국,최필조 대한응급의학회 2019 대한응급의학회지 Vol.30 No.5

Objective: This study examined whether the depth of chest compression (CC) recommended by current cardiopulmonary resuscitation guidelines is equally appropriate to both men and women. Methods: Retrospective analysis of the chest computed tomography (CT) findings was performed. The anteroposterior diameter (APD), internal compressible depth (ICD), and anterior chest wall thickness were measured at the midpoint of the lower half of the sternum. The residual diameter (RD) for simulated CC was also obtained. If the RD was less than 20 mm, it was assumed that a potential injury would occur. Results: A total of 319 adults (173 men, 141 women), who underwent chest CT at the emergency room, were enrolled. A statistically significant difference was observed between the mean APD and ICD between men and women. The mean APD and IPD were 8 mm shorter and 9.5 mm shorter, respectively, in women than in men. When adjusted for age, height, weight, and body mass index (BMI), the differences in the value of these parameters increased even more. In simulated CC with a 60 mm depth, the predictors of RD of less than 20 mm were weighed (odds ratio [OR], 0.888; 95% confidence interval [CI], 0.826-0.954; P=0.001) and BMI (OR, 0.706; 95% CI, 0.579-0.862; P=0.001), and all cases with RD of less than 20 mm were women. Conclusion: Chest compression of more than 60 mm may increase the potential risk of injury, particularly in women. The maximum allowable chest compression depth of less than 60 mm should be emphasized for women.

Prognosis evaluation of a great dane dog with dilated cardiomyopathy

김윤혜,나지웅,소경민,박철 한국동물위생학회 2017 韓國家畜衛生學會誌 Vol.40 No.4

A five-year-old, male, Great Dane weighing 107 kg was presented with anorexia, abdominal distension, and dyspnea for 5 days. Physical examination, blood works, radiography, electrocardiography (ECG), and echocardiography were performed. Based on severely low fractional shortening (FS) and marked four chamber enlargement in echocardiography, continuous atrial fibrillation and occasional ventricular premature complex (VPC) on ECG, the dog was diagnosed as dilated cardiomyopathy (DCM) concurrent with congestive heart failure. Pleural effusion and ascites were modified transudate. In accordance with DCM scoring system recommended by European Society of Veterinary Cardiology (ESVC), DCM score was 13/15 in this case. Concentrations of cTnI and NT-pro-BNP were 1.0 ng/mL and 693 pmol/L, respectively. Since the former and the latter were remarkably high values, it was certain that the patient had grave prognosis. Intensive care was performed for the dog and the clinical signs as well as the radiographic abnormalities were resolved. However, when he presented serious dyspnea again at 25 days post therapy, the dog was dead. In case of canine DCM, the scoring system for the diagnosis and cardiac biomarkers including NT-pro-BNP and cTnI could be useful to advise owners on the status and prognosis of their dog with DCM.

Characteristics of blood tests in patients with acute cerebral infarction who developed symptomatic intracranial hemorrhage after intravenous administration of recombinant tissue plasminogen activator

이청조,나지웅,이장희,한상국,Pil Cho Choi,이영환,박상오,신동혁 대한응급의학회 2019 Clinical and Experimental Emergency Medicine Vol.6 No.2

Objective Patients suspected as having acute ischemic stroke usually undergo blood tests, in­cluding coagulation-related indexes, because thrombocytopenia and coagulopathy are contrain­dications for recombinant tissue plasminogen activator (rtPA) administration. We aimed to iden­tify blood test indexes associated with symptomatic intracranial hemorrhage (sICH) in patients with acute ischemic stroke who received intravenous rtPA.Methods This retrospective observational study included patients diagnosed with acute ischemic stroke who were treated with intravenous rtPA at the emergency department of a tertiary hos­pital in Seoul between February 2008 and January 2018. Blood test indexes were compared be­tween the sICH and non-sICH groups. Logistic regression and receiver-operating characteristic curve analyses were performed.Results In this study, 375 patients were finally included. Of 375 patients, 42 (11.2%) showed new intracranial hemorrhage on follow-up brain computed tomography, of whom 14 (3.73%) had sICH. Platelet count, aspartate aminotransferase and lactate dehydrogenase levels were sig­nificantly different between the sICH and non-sICH groups, and platelet count showed statisti­cal significance in the regression analysis. Significantly lower platelet counts were observed in the sICH group than in the non-sICH group (174,500 vs. 228,000/mm3, P=0.020). The best cutoff platelet count was 195,000/mm3, and patients with platelet counts of <195,000/mm3 had a 5.4- times higher risk of developing sICH than those with platelet counts of ≥195,000/mm3.Conclusion Platelet count was the only independent parameter associated with sICH among the blood test indexes. Mild thrombocytopenia may increase the risk of sICH after intravenous ad­ministration of rtPA.

Cutaneous Myiasis Associated with Tick Infestations in a Dog

최정구,김한종,나지웅,김성현,박철,Choi, Jungku,Kim, Hanjong,Na, Jiwoong,Kim, Seong-hyun,Park, Chul The Korean Society of Veterinary Clinics 2015 한국임상수의학회지 Vol.7 No.2

시골에 사는 12년령의 중성화 안한 수컷 말라뮤트가 회음부위의 염증과 통증을 주호소로 내원하였다. 회음부 신체검사에서 구더기와 구멍이 있는 피부 병변이 존재하였다. 혈액검사에서는 미약한 빈혈과 혈소판 증가증 이외에 특이소견은 보이지 않았으며 진단은 임상증상 및 구더기의 존재에 의해 쉽게 되었다. 즉시 삭모 및 소독을 실시하였으며 삭모 중 진드기가 발견되어 SNAP 4DX (IDEXX Laboratories, Westbrook, ME, USA)를 이용해 진드기 및 관련 병원체의 감염유무를 평가하였고 검사결과는 모두 음성이었다. 치료는 이버멕틴(300 mcg/kg)을 피하 주사로 한번 주사하였으며 2차 감염을 예방하기 위해 항생제를 처방하였다. 이 후 구더기증과 상처부위는 2주 이내에 치료되었다. A 12-year-old intact male, Alaskan Malamute dog, which lives in the countryside, was presented with inflammation and pain around perineal areas. Thorough examination revealed maggots and punched-out round holes lesion around the perineal region. Complete blood counts (CBC) and serum biochemical examinations showed no remarkable findings except mild anemia and mild thrombocytosis. The diagnosis was easily done, based on clinical signs and maggots identification. Cleaning with chlorhexidine, povidone-iodine lavage and hair clipping away from the lesions were performed soon after presentation. SNAP 4Dx Test (IDEXX Laboratories, Westbrook, ME, USA) was performed to rule out other vector-borne diseases since the ticks were found on the clipped area and vector-borne pathogens. The test result was negative. The dog in this case was treated with ivermectin (300 mcg/kg SC) one time. Also, treatments with amoxicillin clavulanate (20 mg/kg PO, BID) was established to prevent secondary bacterial infections. Then, myiasis resolved with 2 weeks and the affected area was healed.