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소병학,김영민,박규남,김세경 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2
Eclampsia is characterized by generalized tonic-clonic convulsions that develop in women with hypertension induced or aggravated by pregnancy. Because identification of patients at risk and preventive therapies are imperfect, eclamptic seizures continue to occur occasionally during puerperium. Nearly all cases of postpartum eclampsia develop within 24 hours of delivery, but typical cases are seen up to 26 days postpartum. Convulsion with initial presentation more than 48 hours but less than 4 weeks after delivery are commonly referred to as late postpartum eclampsia. We describe two cases of late postpartum eclampsia and give a review of literature.
소병학,이원재,심병용,김훈교,김치홍,So Byung Hak,Lee Won Jae,Shim Byoung Yong,Kim Hoon-Kyo,Kim Chi Hong 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.1
MCPP (2-(2-methyl-4-chlorophenoxy)propionic acid; mecoprop), a hormonal weedkiller has been widely used. Although chronic exposure is generally considered to be mildly toxic to man, acute intoxication can be severe and should thus be taken seriously. We report the case of a patient who died after ingestion of MCPP. A 64-year-old man ingested about 400 ml of $50\%$ MCPP solution. He was stuporous and had an inadequate respiration. He had an hypotension which did not respond to vasopressors and died about twelve hours after ingestion.
소병학,박승현,김기명,김세경 대한응급의학회 2002 대한응급의학회지 Vol.13 No.2
This paper presents one case of subdural tension pneumocephalus which deteriorated in the early phase of head trauma. Pneumocephalus occurs in 0.5 to 1.0% of head trauma cases. Most patients have nonspecific signs and symptoms, such as headache. Therefore, a high index of suspicion in a patient with recent head trauma is necessary. Therapy is often noninvasive, allowing the craniodural defect to heal spontaneously. However, if enough air collects within the cranium or the brain itself, a mass effect with marked midline shift may develop. This is referred to as tension pneumocephlus and may result in herniation symdrome. Prompt decompression is essential.
심정지 후 성공적 심폐소생술 시행 환자에서 혈중 Cytochrome c, TNF-R1, Fas Ligand의 발현양상
소병학,윤준성,정시경,김형민,박규남,최승필 대한응급의학회 2010 대한응급의학회지 Vol.21 No.2
Purpose: Numerous reports have suggested that apoptosis may play an important role in postresuscitation syndrome. The aim of this study is to assess the levels of molecules that are associated with apoptosis in the serum of patients who underwent successful resuscitation after cardiac arrest. Methods: The serum levels of cytochrome c, tumor necrosis factor type 1 receptor (TNF-R1) and Fas ligand in 11 patients were measured at 0, 4, 12, 24, 48 and 72 hours after successful resuscitation. The primary endpoint consisted of survival to hospital discharge. Ten healthy volunteers were also evaluated as a control group. Results: Patients with successful resuscitation had increased levels of cytochrome c and TNF-R1 at 0, 4, 12, 24 and 48hours after return of spontaneous circulation (ROSC), as compared with those levels of the healthy volunteers (p<0.05). Higher levels of TNF-R1 at 12, 24 and 48 hours after ROSC were found in the non-survivors as compared to those levels of the survivors (p=0.01, 0.03, 0.02). The Fas ligand level at ROSC was also higher in the patients with successful resuscitation (p=0.00). However, the Fas ligand levels at 24, 48 and 72 hours after ROSC were lower in the patients with successful resuscitation than those levels in the healthy volunteers. Conclusion: These results suggest that apoptosis belonging to the TNF-R1 and cytochrome c pathways may be involved in the pathogenesis of postresuscitation syndrome. The serum levels of the death-receptor TNF-R1 could serve to quantitate the severity of injury and to prognosticate the survival outcomes.
소병학 ( Byung Hak So ),이미진 ( Mi Jin Lee ),김현 ( Hyun Kim ),문정미 ( Jeong Mi Moon ),박경혜 ( Kyung Hye Park ),성애진 ( Ae Jin Sung ),염석란 ( Seok Ran Yeom ),오성범 ( Seong Beom Oh ),유지영 ( Ji Young You ),이경우 ( Kyung Wo 대한임상독성학회 2010 대한임상독성학회지 Vol.8 No.2
Purpose: The aim of this study was to investigate toxic exposures in emergency centers with using a toxic exposure surveillance system-based report form as a preliminary study. Methods: We retrospectively reviewed the medical records of toxic exposure patients who visited emergency centers from January to December 2008. Results: 3,157 patients from 11 emergency centers were enrolled. Males were involved in 47.9% of the total cases of exposure and in 60.1% of the cases of fatal exposure. Suicidal intent was the most common (61.0%) reason and most (87.4%) fatal exposures were suicidal. Pesticides were involved in 30.7% of the cases and sedative/hypnotics/ antipsychotics were involved in 20.5%. The substances most frequently involved in fatalities were pesticides, and a 48.4% fatality rate was recorded for paraquat exposure. Conclusion: The toxic exposure data showed the preliminary poisoning events in emergency centers. It is recommended that toxicology professionals should develop a toxic surveillance system and serial reporting should be performed.
이산화탄소 소화설비 오작동에 의한 이산화탄소 집단 중독
정원중,소병학,김형민 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.2
Carbon dioxide is a colorless, odorless, nonirritating gas with many practical uses. In particular, because it can displace oxygen from the environment, it is used as a fire extinguisher. We describe an incident that occurred as a result of malfunction of a carbon dioxide-based fire extinguishing system in our hospital. Twelve casualties reached our emergency department. Symptoms of exposure included nausea, dizziness, loss of consciousness, vomiting,chest discomfort, and seizure. Results of initial arterial blood gas analysis showed acidosis in five patients. A new pneumonic infiltration at the left. upper lung field was observed in one patient, while sinus tachycardia in electrocardiography (ECG) was observed in another patient. Oxygen was initially supplied to all casualties, until symptoms of intoxication had disappeared. Three patients were admitted to the hospital,but were discharged without complication. Despite occurrence of massive casualties, with significant symptoms due to unintentional exposure to high concentrations of carbon dioxide, patients’ symptoms were relieved by supportive care.
卞容地,蘇秉學,姜錫憲,尹錫,元鎮,澤 대한신경정신의학회 1967 신경정신의학 Vol.6 No.1
An intensive study was performed by the psychiatrist and clinical psychologist to evalu ate the characteristics of the relations of family triangle and intrafamilial environment which assumed to be the pathologic influence on the form ative processes of schizophrenic patients. 18 cases of chronic schizophrenic patients and their families were studied by the psychiatric interview and clinical psychological tests i. e. Rorschach test, sentence completion test and T. A . T. The results were interpreted in terms of parents-children relations and interrelation of parents. It is assumed that there exists deep interdependency in the mother-child relations. The predominant featues of mothers attiude toward children seemed to be highly overprotective. The interrelations of parents are characterized as to be cold and hostile with out affective ties. The characteristics of father ’s attitude are emasculated. These features are seemingly equal to that of the mothers of schizophrenics and the mutu al relation of parents of schizophreics assumed by Lidz. Wynne and other investigators in the western society. Furthur studies on this problems would be stimulated along the lines of transcultural comparisons.