외상에 의한 병원전 및 응급실 사망 환자의 10년 전후의 비교

오성범 ( Sung Bum Oh ),이강현 ( Kang Hyun Lee ),차경철 ( Kyung Chul Cha ),지호진 ( Ho Jin Ji ),김호중 ( Ho Jung Kim ),김현 ( Hyun Kim ),황성오 ( Sung Oh Hwang ),배금석 ( Keum Suk Bae ),김헌주 ( Hun Joo Kim ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2

Background: Trauma-induced deaths can be prevented by implementation of trauma system during prehospital phases and in-hospital phases. To reduce the preventable death rate (PDR), it is essential to improve the treatment strategy during the prehospital phases and the in-hospital phases. This study was designed to compares the prehospital death and emergency department (ED) death in a city before and after implementation of trauma system. Method: We evaluated the prehospital and ED data of 106 trauma patients who had died in 1991 and 2001. Trauma deaths were reviewed and the preventability of those deaths was judged by three professional panels according to appropriateness of diagnosis and treatment in prehospital phases and in-hospital phases. Deaths were classified as preventable and nonpreventable. We compared the preventable death of 1991 with those of 2001. Result: Trauma patients were 993 in 1991 and 3,094 in 2001. Trauma-induced deaths were 60 in 1991 and 46 in 2001. The death rate decreased from 6% in 1991 to 1.5% in 2001 (p<0.001). Death rate by traffic accident decreased from 90% (54/60) in 1991 to 67% (31/46) in 2001 (p<0.001). The PDR decreased from 40% (24/60) in 1991 to 13% (6/46) in 2001 (p<0.001). The time elapsed from the scene of accident to ED arrival decreased from 111 minutes in 1991 to 53 minutes in 2001 (p<0.001). There was no significant difference in Injury Severity Score between 1991 and 2001 (p=0.283). Conclusion: The rate of preventable death decreased from 1991 to 2001. Implementation and improvement of the trauma system has positive effects on trauma-induced death rate, PDR and the time elapsed from the scene of accident to ED arrival.

4차산업혁명에서 전문서비스업의 변화와 감정평가의 역할

오성범 ( Oh Sung Bum ) 한국감정평가학회 2018 감정평가학논집 Vol.17 No.3

감정평가는 불완전시장에 대한 공적 개입의 일환으로서, 균형가격 등 정상적인 시장정보를 생산하고 시장의 기능을 보완하는 역할을 수행해왔다. 그러나, 부동산 정보가 다양한 빅데이터와 융ㆍ복합되면서 자동평가모형이 개발되는 등 시장참가자에 의한 가격 접근성이 향상되고 있으며, 이는 감정평가에 대한 회의로까지 이어지고 있는 실정이다. 빅데이터에 기반한 자동평가모형의 도입은 감정평가정보의 사적 활용과 경합할 것으로 예상되나, 과세, 보상, 담보 등 국민의 재산권 및 시장안정성을 보호하는 역할을 수행하는 공적 감정평가활동의 대체는 제한적일 것으로 판단된다. 그러나, 전문지식의 누적성과 비경합성에 의한 시장 환경의 변화는 향후 감정평가업의 능률화, 체계화를 견인하는 외부적 압력으로 작용할 것이다. 감정평가사는 가치평가 전문지식을 개발하고 관리하면서, 시장참여자들이 이를 활용할 수 있게 돕는 것이다. 방대한 양의 공공데이터와 가격정보의 개방은 필연적이므로, 빅데이터를 포용하고 해석하지 못한 감정평가정보는 시장의 신뢰와 무관하게 시장의 인지도를 상실할 것이다. 감정평가사는 누구보다 먼저 빅데이터를 받아들이고 관리하면서, 국민에게 혜택을 주는 다양한 부동산정보를 생산하고 무작위적 시장정보에 대한 관리자로서의 위상을 세워야 할 것이다. Property appraisal has been responsible for producing market information and supplementing the function of market as a part of public intervention on the imperfect market. Recently, emerging various big data services for real-estate markets become a threat for property appraisal industry. The introduction of the automatic evaluation model based on the big-data is expected to compete with existing property appraisal services in the private sector. Its substitution on public appraisal activities, such as property taxation, might be limited in order to ensure property rights, but big-data in the real-estate market could be an external pressure to streamline and systematize the appraisal business. Since the opening and sharing of public data and price information is inevitable, appraisal information that does not embrace and utilize big data will lose market competitiveness. Therefore, property appraisers should accept and manage big data actively, produce various real estate information for the people, and strengthen their position as a real estate market information specialist.

한약복용 후 발생한 칸타리딘 중독 1례

지호진,김현,김선휴,오성범,문중범,이강현,황성오,Ji Ho Jin,Kim Hyun,Kim Sun Hyu,Oh Sung Bum,Moon Joong Bum,Lee Kang Hyun,Hwang Sung Oh 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.1

Blister beetles produce cantharidin, which is toxic to people and animals. Cantharidin has been believed to be an aphrodisiac and an abortifacient based on its tendency to cause marked irritation to the genitourinary system leading to priapism in men and pelvic congestion in women for many years. Cantharidin was used by oriental traditional medicine for more than 2000 years. Typical signs related to cantharidin ingestion are gastrointestinal tract and urinary tract irritation, endotoxemia, shock and myocardial dysfunction. Cantharidin is a severe irritant to epithelial linings (gastrointestinal tract, urinary tract, and skin) and develop systemic inflammatory response syndrome. We report a case of corrosive esophagogastritis and acute renal failure by ingestion of cantharidin.

흉부 외상 환자에서 경식도 심초음파에 의한 대동맥 손상 진단의 유용성

안희철 ( Hee Cheol Ahn ),오성범 ( Sung Bum Oh ),김호중 ( Ho Jung Kim ),김현 ( Hyun Kim ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hwang ),김헌주 ( Hun Joo Kim ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2

Background: Early recognition of thoracic aortic disease is critical to reduce morbidity and mortality. The accuracy and safety of TEE in trauma patients has recently challenged to traditional diagnostic modality for assessing thoracic aortic disease such as computed tomogram (CT) scan, aortography, and magnetic resonance imaging (MRI). The purpose of this study was to evaluate the utility of TEE as an emergency diagnostic procedure for detection of thoracic aortic injury in trauma patients. Methods: From March 1998 to October 2002, 21 traumatic patients who had a suspicious of thoracic aortic injury and underwent TEE as the first diagnostic tool in the emergency department were enrolled. Indications of TEE in the suspicious thoracic aortic disease were typical chest pain, mediastinal widening or massive left side hemothorax. Results: There was no complication during TEE or post procedure of TEE in all patients. The findings of TEE were as followings: aortic dissection was 9 cases (43%), periaortic hematoma was 5 cases (24%), and aortic rupture, aneurysm, intramural hematoma, RA rupture, cardiac tamponade, and both hemothorax was 1 case in each other. The open thoracotomy on 11 patients were performed and emergency department thoracotomy on 2 patients were performed. Ten patients were performed conservative management. Conclusion: We suggest that TEE is a useful and safe diagnostic modality to detect thoracic aortic injury in hemodynamically unstable patient after trauma.

약물중독에 의한 내원 전 심정지 환자의 특성과 심폐소생술 결과

김윤권,김현,원호경,이권일,오성범,문중범,이강현,황성오,Kim Yun Kwon,Kim Hyun,Won Ho Kyong,Lee Kwon Il,Oh Sung Bum,Moon Joong Bum,Lee Kang Hyun,Hwang Sung Oh 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2

Purpose: This study was to investigate the resuscitation outcomes and the clinical characteristics of non-traumatic drug-induced out-of-hospital cardiac arrest by analyzing data from a single institution's registry. Method: We conducted a retrospective study of 795 patients who came to the emergency department with non-traumatic drug-induced out-of-hospital cardiac arrest during the period $1991{\~}2004$. Only patients over 18 years of age were included. Clinical characteristics. variables associated with cardiac arrest, and data during resuscitation were obtained from our cardiac arrest database. Patients were divided into two groups: drug-induced cardiac arrest (drug group, n=33), and non drug-induced cardiac arrest (non-drug group, n=762). Results: Spontaneous circulation was restored in 23 ($72{\%}$) patients in the drug group and in 314 ($45{\%}$) patients in the non-drug group ($x^2=0.020$). The patients who discharged alive number were 46 ($6{\%}$) in the non-drug group and 0 ($0{\%}$) in the drug group ($x^2=0.005$). The witnessed arrest, the epinephrine doses, and total defibrillation energy were not different between two groups. Conclusion: The return of spontaneous circulation rate was higher in the drug group than the non-drug group. However the drug group was lower survival discharge rate than in the non-drug group.

불화수소 음독 후 발생한 심금염 1례

김선휴,김 현,지호진,장용수,오성범,이강현,황성오,Kim Sun Hyu,Kim Hyun,Ji Ho Jin,Jang Yong Soo,Oh Sung Bum,Lee Kang Hyun,Hwang Sung Oh 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1

Hydrofluoric acid (HF), one of the strongest inorganic acids, is used mainly for industrial purpose. Hydrofluoric acid injuries has a potential for both systemic as well as severe local tissue destruction. One of the most serious consequences of severe exposure to HF by any route is marked lowering of serum calcium (hypocalcemia) and other metabolic changes, such as hypomagnesemia and which may result in a fatal outcome if not recognized and treated. promptly cardiotoxicity is not well known except arrhythmias, which are a primary cause of death. We report a case of myopericarditis by ingestion of hydrofluoric acid.

외상환자의 초기 사망 예측 지표로서의 내원 초기의 염기 결핍, 젖산 및 강이온 차이의 유용성 비교

박경혜 ( Kyung Hye Park ),이강현 ( Kang Hyun Lee ),김선휴 ( Seon Hyu Kim ),오성범 ( Sung Bum Oh ),문중범 ( Joong Bum Moon ),김현 ( Hyun Kim ),황성오 ( Sung Oh Hwang ),김헌주 ( Heon Ju Kim ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.2

Purpose: Currently, there is a variety of systems available for predicting prognosis of trauma patients such as trauma score, Injury severity score (ISS) and acid-base variables. But it is not clear that the initial acid-base variables are predictors of prognosis in trauma patients at the emergency department. The objective of this study is to compare the base deficit, lactate and strong ion gap as an early predictor of mortality in trauma patients. Methods: Retrospective record review of 136 trauma patients needed to admit to intensive care unit via emergency department (June 2004 to February 2005). Data included age, injury mechanism, ISS, Revised trauma score (RTS), Multiple organ dysfunction score (MODS), Acute physiology and chronic health evaluation III (APACHE III), Glasgow coma scale (GCS), laboratory profiles, calculated anion gap and strong ion gap. Patients were divided into survivors and non-survivors, shock group and non-shock group with comparison by t-test; significance was assumed for p<0.05. Correlation between acid-base variables and mean arterial blood pressure (MABP) was evaluated. Results: There was a significant difference between the RTS (p=0.00), APACHE III (p=0.00), MODS (p=0.00), GCS (p=0.00) of survivors and non-survivors. There was no significant difference between the ISS (p=0.082), lactate (p=0.541), base excess (p=0.468) and SIG (p=0.894) of survivors and non-survivors. There was a significant difference between the RTS (p=0.023), APACHE III (p=0.002), lactate (p=0.000), base excess (p=0.000) and SIG (p=0.000) of shock and non-shock group. There was no significant difference between the ISS (p=0.270), MODS (p=0.442) and GCS (p=0.432) of shock and non-shock group. The base excess was most correlated to MABP (r2=0.150). Conclusion: Initial base deficit, serum lactate and SIG are not predictors of mortality in moderate to severe trauma patients. Initial base deficit, serum lactate and SIG are correlated with the mean arterial blood pressure in trauma patients in emergency department.

불화수소 음독 후 발생한 심근염 1례

김선휴 ( Sun Hyu Kim ),김현 ( Hyun Kim ),지호진 ( Ho Jin Ji ),장용수 ( Yong Soo Jang ),오성범 ( Sung Bum Oh ),이강현 ( Kang Hyun Lee ),황성오 ( Sung Oh Hwang ) 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1

Hydrofluoric acid (HF), one of the strongest inorganic acids, is used mainly for industrial purpose. Hydrofluoric acid injuries has a potential for both systemic as well as severe local tissue destruction. One of the most serious consequences of severe exposure to HF by any route is marked lowering of serum calcium (hypocalcemia) and other metabolic changes, such as hypomagnesemia and which may result in a fatal outcome if not recognized and treated. promptly cardiotoxicity is not well known except arrhythmias, which are a primary cause of death. We report a case of myopericarditis by ingestion of hydrofluoric acid.

練習方法에 따른 學習效果의 比較 硏究 : 籠球 Free-throw와 Dribble을 中心으로 With Empasis on the Basketball Shooting and Dribble

李參在,吳成範 全北大學校附設 스포츠科學硏究所 1988 논문집 Vol.- No.5

The purpose of this study is to find out effective learning method on basketball skill learning on the focus of mental practice by an experimental study. For this objective 200 female students in middle school were randomly selected as subjects. Divided into four experimental groups-control group(50), mental group(50), mental+physical group(50), and physical group(50), -they have been trained in field goal speed test for four weeks, in dribble test for four weeks on the basis of prescribed training program. After the training was finished, the results through the statistical analysis of the effect are as follows. 1. It appeared that there was the learning effect in sequence of mental and physical practice, physical practice, and mental practice. 2. In doing only mental practice of the practice method, it appeared that there was the learning effect. 3. In physical practice and mental and physical practice, it appeared that there was the learning effect two weeks, and in mental practice, four weeks.

스키 또는 스노우보드 손상 환자에서 응급의료 정보센터를 이용한 전원의 효과

김선휴,이강현,지호진,오성범,김현,황성오,김성훈,이영희 대한스포츠의학회 2004 대한스포츠의학회지 Vol.22 No.1

The purpose of this study is to analyze the effects of transportation via Emergency Medical Service Information Center in a ski or snowboard injured patients. We evaluated 233 patients with ski or snowboard injuries who transported to emergency department from Nov. 2002 to Feb. 2003 via Emergency Medical Service Information Center or not. Among the patients, 66 patients were transported via Emergency Medical Service Information Center(group 1) and 167 patients were transported without using the information center(group 2). Transportation time and time for treatment of group 1 were shorter than that of group 2. Transportation time after injury were 119±92 minutes in group 1, 128±82 minutes in group 2. Treatment time after arrival of emergency department were 116±54 minutes in group 1, 126±75 minutes in group 2. Our results show that transportation after winter sports injury via Emergency Medical Service Information Center is effective for transportation and treatment.