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경부 관통상 환자에서 표재성 손상과 심부 손상을 구별할 수 있는 임상 예측 인자
정우한,최경호,오영민,최세민,오주석,박정택,이두효,김기욱,홍성엽,정현호 대한응급의학회 2022 대한응급의학회지 Vol.32 No.6
Objective: The frequency of penetrating neck injuries has gradually increased with the development of industry and the rising crime rates. There have been few studies with penetrating neck injuries reported in Korea. Thus, we analyzed clinical factors that could differentiate between superficial and deep injuries in patients with penetrating neck injuries. Methods: We investigated the medical records of 90 patients with penetrating neck injuries who visited the emergency department between January 2010 and March 2020. To identify the degree of injuries, we compared age, sex, onset and arrival time, onset-to-arrival time, initial vital signs, Glasgow Coma Scale, Revised Trauma Score, cause, mechanism, location and number of injuries, anatomical zone, alcohol intake and psychiatric history were classified as early clinical factors. Results: Among 90 patients, 51 had superficial injuries, and 39 had deep injuries. The early clinical factors showing statistically significant differences were the Glasgow Coma Scale, Revised Trauma Score, cause of injury and anatomical zones. As the Glasgow Coma Scale increased by 1 point, deep injuries decreased by 0.807 times compared to superficial injuries. Homicidal injuries were 3.233 times deeper than suicidal injuries. Conclusion: If the Glasgow Coma Scale is low or the cause of injury is homicide, the possibility of a deep penetrating injury is high. Therefore, it is important to treat the patient carefully, considering these factors.
이종석,이학중,문성수,석광호,박우한,한창순 대한핵의학회 1980 핵의학 분자영상 Vol.14 No.2
저자들은 혈중 TSH의 방사면역측정을 정상인과 각종 갑상선질환 환자들에게 실시하여 의미있는 결과를 얻었기에 이에 보고하는 바이다. 환자들은 1978년 1월부터 1980년 8월까지 국립경찰병원 내과에 내원한 각종 갑상선환자 41예와 정상인 22예를 대상으로 하였다. 1) 정상인 22예의 혈충 TSH치는 평균 4.2∼1.7μU/ml이고, 그 범위는 1.9∼7.4μU/ml이었다. 2) 원발성 갑상선기능저하증 9예에 있는 혈중 TSH의 평균치가 97.1±116.4μU/ml이고 그 범위는 14.0±300μU/ml였다. 3) Graves씨병 17예는 혈중 TSH치의 평균이 1.5±0.6μU/ml였다. 4) 갑상선염 8예는 갑상선기능상태에 따라 혈중 TSH치의 변화가 많았으며 그 범위는 1.6∼220μU/ml이었다. 5) 갑상선결절 7예는 혈중 TSH치의 평균이 2.4±2.0μU/ml이었다. 6) Graves씨병에 Taoazole치료후 TSH치가 상승하는 것을 볼 수 있었고, 이것이 병경과를 판정하는데 아주 유용하였다. 이상의 결과로써 혈중 TSH의 측정은 갑상선질환의 진단뿐 아니라 치료경과를 판정하는데도 좋은 수단이 될 수 있다고 하겠다. The radioimmunoassay of TSH (human thyrotropin) was performed by utilizing anti-h-TSH antibody and purified human thyrotropin supplied from Daiichi from Jan. 1978 through Aug. 1980 the serum concentration of TSH was measured on 41 cases with various thyroid diseases, and 22 normal persons. Among 41 cases, 9(22%) were primary hypothyroitlism, 17(41%) Graves' disease, 8(20%) subacute or chronic lymphocytic thyroiditis, and 7(17%) nodular goiter. The results were as follows:1) The normal values of serum TSH in 22 cases of control group were 4.2±1.7μU/ml, (1.9∼7.4μU/ml), which were within normal range in kit used in this study. 2) The serum TSH concentration in 9 cases with primary hypoehroidism were 97.1±116.4μU/ml(14. 0∼300μU/ml), which were significantly elevated as compared, with normal control values. 3) The serum TSH concentration in 17 cases with Graves' disease were 1.5±0.6μU/ml(1.0∼2.5μU/ml), which were below than normal control. 4) The serum TSH concentration in 8 cases with subacute or chrotic thyroiditis revealed wide ranges(1.6∼220μU/ml), according to the state of thyroid function. 5) The serum TSH values in 7 cases with nodular goiters were 2.3±2.0μU/ml, which were strictly within normal levels. 6) The serum TSH levels were elevated during prolonged treatment with Tapazole(Methimazole) without serial check of the serum TSH concentration in Graves' disease, so the serial measurement of serum TSH concentration was considered of available index of thyroid states.