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부지환,강정호,김우정 사단법인 인문사회과학기술융합학회 2015 예술인문사회융합멀티미디어논문지 Vol.5 No.5
Proper transportation of patients within the golden time is essential in emergency medical service system. Awareness of transportation in 178 paramedics was surveyed with questionnaire. The subjects included 155 men (87.1%), and the mean age was 37.1±6.1 years. In comparison according to gender, women paramedics showed significantly higher scores in decision of destination depending on patients' severity (p=0.018), whereas men paramedics in going to the nearest hospital under emergent situation (p=0.014). In comparison according to qualification licenses, first responders revealed significantly lower scores in decision of destination on patients' claim (p=0.033) and going to the nearest hospital under emergent situation (p=0.023), whereas significantly higher in decision of destination depending on patients' severity (p<0.001), explanation of proper destination to the patients with different opinion (p=0.003), and consideration of retransfer on decision of destination (p=0.002). 응급의료체계에서 적절한 이송은 환자의 치료 결과에 중요한 영향을 줄 수 있다. 제주 지역 119 구급대원 178명을 대상으로 설문을 통해 이송에 대한 인식을 조사하였다. 조사 대상 중 남자는 87.1%였고, 평균 나이는 37.1±6.1세였다. 성별에 따른 이송 인식으로는 환자 상태에 따른 이송 병원 결정(p=0.018)과 이송 병원 의견이 다를 때 환자 설득 정도(p=0.006)가 유의하게 여자 구급대원이 높았고, 환자가 중증일 때 가까운 병원으로 이송 정도(p=0.014)는 남자가 높았다. 자격 종류에 따른 이송 인식으로는 이송 병원 선정 시 환자 의견에 따른 결정(p=0.033)과 중증일 때 가까운 병원으로 이송 정도(p=0.023) 항목에서 구급교육의 점수가 높았고, 환자 상태에 따른 구급대원의 이송 병원 결정(p<0.001), 이송 병원 의견이 다를 때 환자 설득(p=0.003), 이송 병원 결정 시 재이송 고려(p=0.002) 항목에서는 유의하게 낮아, 자격 종류에 따른 유의한 차이를 보였다.
부지환,Hammig Mark D.,정만희 한국원자력학회 2023 Nuclear Engineering and Technology Vol.55 No.2
A dual-particle imager (DPI) is configured in a hand-held form factor, then one can efficiently and conveniently deploy the DPI to detect the presence of special nuclear materials (SNM) and identify any isotopic variations that differ from their natural abundances. Here we show that by maximizing the areal coupling between a pixelated scintillator array and the partitioned photosensor readout such as a silicon photomultiplier (SiPM), the information utilization of the gamma-ray and neutron information in the radiation field can be enhanced, thus enabling one to rapidly acquire spatial maps of the distributions on gamma-ray and neutron emitters.
부지환,정만희 한국원자력학회 2023 Nuclear Engineering and Technology Vol.55 No.5
As the demand for the detection of special nuclear materials (SNMs) increases, the use of imaging instruments that can sensitively image both gamma-ray and neutron signatures has become necessary. This study compared the pulse shape discrimination (PSD) performance of gamma/neutron events when employing either a pixelated stilbene or a plastic (EJ-276) scintillator array coupled to a silicon photomultiplier (SiPM) array in a dual-particle imager. The stilbene array allowed a lower energy threshold above which neutron and gamma-ray events can be clearly distinguished. A greater number of events can, therefore, be used when forming both gamma-ray and neutron images, which shortens the time required to acquire the images by nearly seven times
부지환,김태한,신종환,이휘재,홍기정,정진희 대한응급의학회 2014 大韓應急醫學會誌 Vol.25 No.1
Purpose: Differentiating gynecological emergency surgeryindications among reproductive-age female patients presentingwith acute abdominal pain is challenging for emergencydepartment (ED) physicians. We evaluated the clinicaldemographics of female patients diagnosed with gynecologicalsurgery indications in the ED and found clinicalpredictors associated with surgical indications overall andwith each surgical indication. Methods: We conducted a prospective review study of thehospital registries of reproductive-aged women who presentedwith abdominal pain but without underlying diseasefrom April 2008 to October 2010. These registries includedinformation concerning the patient’s basic characteristics,medical history, gynecologic history, symptoms, physician’s examination, and laboratory results. Using a multivariatelogistic regression analysis, we found a number of statisticallysignificant factors indicating a gynecological emergencynecessitating surgery. Results: A total of 1047 cases involving female patients ofreproductive age were initially included. We found 89patients(8.50%) who were diagnosed as having gynecologicalsurgery indications: 50(4.78%) were diagnosed withhemorrhagic ovarian cyst rupture, 16(1.53%) with ectopicpregnancy, and 23(2.20%) with ovarian torsion. Pain ofmore than 14 days from the last menstrual period (OR,2.332; 95% CI, 1.406-3.968; p=0.001), bilateral lowerabdominal tenderness (OR, 0.467; 95% CI, 0.288-0.758;p=0.002), rebound tenderness (OR, 0.54; 95% CI, 0.329-0.887; p=0.015), normal C-reactive protein value (CRP)(OR, 3.286; 95% CI, 1.717-6.290; p<0.001), and positivehuman chorionic gonadotropin test (OR, 0.058; 95% CI,0.024-0.142; p<0.001) were related to gynecologic emergencysurgery indication in a patient with abdominal pain. Conclusion: Clinical findings of the last menstrual period,bilateral abdominal tenderness, rebound tenderness, CRPvalue, and urine hCG result can be helpful in exclusion ofgynecologic emergency surgical indications.
강정호,부지환,김우정 사단법인 인문사회과학기술융합학회 2015 예술인문사회융합멀티미디어논문지 Vol.5 No.5
Farmers' injuries are more frequent and severe than those in the other job groups. To identify the characteristics of agricultural injuries in Jeju, 119 first aid records and emergency department based injury surveillance system data for four years were analyzed retrospectively. Farmers' injuries in 119 first aid records were 1,947 cases, and mean age of injured patients was 63.9±11.8 years. The proportion of major trauma was 27.4%. The more frequent months of farmers' injuries were from August to October. In comparison between farmers' and non-farmers' injuries, farmers' injuries showed more male proportion (70%), mean age (54.0±17.0 years), and old age proportion (29%) than non-farmers' injuries did, with significance(p<0.001). However, farmers' injuries revealed less usage of 119 rescue transportation (26%) and self-injury proportion (2%) significantly (P<0.001). Further studies including expansion of injury surveillance for agricultural injuries would be needed for in-depth investigation. 농업인 손상은 다른 직업군 손상에 비해 발생 빈도나 중증도가 높다. 제주 지역 농업인 손상의 특성을 파악하기 위해 4개년 동안의 119 구급일지와 응급실 기반 손상감시체계의 손상 자료를 후향적으로 조사하였다. 조사 기간 동안의 119 구급일지 자료 중 농업인 손상은 1,947건이었고, 손상 환자의 평균 나이는 63.9±11.8세였다. 중증외상의 비율은 27.4%였고, 연중으로는 8~10월 농번기에, 일중으로는 일몰 시간에 손상이 많았다. 응급실 손상감시체계 자료에서 농업인 손상은 1,193건이었다. 농업인 손상과 비농업인 손상으로 나누어 비교한 결과, 농업인 손상에서 남자의 비율이 70%, 평군 연령은 54.0±17.0세, 65세 이상 노인 비율이 29%로 유의하게 높았고(p<0.001), 119 구급대 이용율은 26%, 자해 비율은 2%로 유의하게 낮았다(p<0.001). 농업인 손상의 심층 조사를 위해 관련 조사 항목을 확대한 연구가 필요하다.