독사 교상후 발생한 전신적 합병증 - 혈액학적 합병증과 신경학적 합병증을 중심으로 -

박은정,윤상규,안정환,최상천,김기운,민영기,이국종,정호성,정윤석,Park, Eun-Jung,Yoon, Sang-Kyu,Ahn, Jung-Hwan,Choi, Sang-Cheon,Kim, Gi-Woon,Min, Young-Gi,Lee, Kuk-Jong,Jung, Ho-Sung,Jung, Yoon-Seok 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.2

Purpose: This study explored and evaluated the systemic complications resulting from the bite of Korean venomous snake, focussing on hematologic and neurologic features. Methods: Medical records (demographic data, clinical measurements including laboratory results, severity score, and amount of antidote administration, and hospitalization course) of consecutive patients who presented with snakebites to two university teaching hospital during a 10-year period were retrospectively reviewed. Subgroup analysis was conducted for evaluations of anti-acetylcholine esterase administration in complicated victims. Results: The 170 patients displayed occurrence rates of hematologic and neurologic complications of 12.9% and 20.6%, respectively. Among 22 patients with hematologic complications, isolated thrombocytopenia was evident in eight patients (36.4%), prothrombin time (PT) / activated partial thromboplastin time (aPTT) prolongation in 11 patients (50.0%), and both in three patients (13.6%). The mean time to recovery was $4.5{\pm}1.8$ days for isolated thrombocytopenia, and $5.1{\pm}1.8$ days for PT and aPTT prolongation. Hematologic complications could occur suddenly 1?4 days after hospitalization. Among 35 patients with neurologic complications, dizziness was evident in 16 patients (45.7%), and diplopia / blurred vision in 19 patients (54.3%). The mean time to recovery was $3.4{\pm}0.6$ days in patients receiving anti-acetylcholine esterase and $6.9{\pm}1.8$ days in those not receiving anti-acetylcholine esterase (p=0.00). Conclusion: Occurrence rates of hematologic and neurologic complications following venomous snake bite differed as compared to other studies conducted in Korea. Onset of hematologic complications can occur rapidly days after admittance. Anti-acetylcholine esterase administration may be effective in treating neurologic complications.

중증 리튬 증독 후 발생한 심정지 1예 - 어려운 진단

안정환,최상천,윤상규,정윤석,Ahn Jung Hwan,Choi Sang Cheon,Yoon Sang Kyu,Jung Yoon Seok 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2

Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circultion (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.

하이브리드 로켓에서의 초기 포트직경을 고려한 산화제 유속과 고체연료 유속과의 관계에 관한 연구

이정표(Jungpyo Lee),조성봉(Sung Bong Cho),윤상규(Sang-Kyu Yoon),박수향(Su-Hayng Park),송나영(Na-Young Song),김기훈(Gihun Kim),조정태(Jungtae Cho),성홍계(Hong-Gye Sung),문희장(Heejang Moon),김진곤(Jin-Kon Kim) 한국추진공학회 2007 한국추진공학회 학술대회논문집 Vol.2007 No.11

중증 리튬 중독 후 발생한 심정지 - 어려운 진단

안정환 ( Jung Hwan Ahn ),최상천 ( Sang Cheon Choi ),윤상규 ( Sang Kyu Yoon ),정윤석 ( Yoon Seok Jung ) 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2

Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circulation (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.

급성 아세트아미노펜 중독에서 N-acetylcysteine 투여 결정 관련 인자

이정화 ( Jeong Hwa Lee ),최상천 ( Sangchun Choi ),윤상규 ( Sang Kyu Yoon ),신규철 ( Kyu Cheol Shin ) 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.2

Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

하이브리드 로켓의 산화제 종류에 따른 고체연료 연소특성 비교

이정표(Jung-Pyo Lee),조성봉(Sung Bong Cho),김수종(Soo-Jong Kim),윤상규(Sang-Kyu Yoon),박수향(Su-Hayng Park),김진곤(Jin-Kon Kim) 한국추진공학회 2006 한국추진공학회 학술대회논문집 Vol.2006 No.11

흉부 둔상 후 전종격동 출혈에 의한 종격동 압전 1예

윤상규,박종석,조준필 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Sternal fractures are most common in drivers of motor vehicles whose anterior chest hits the steering wheel during sudden deceleration. Sternal fractures may result in mediastinal hematoma secondary to bone marrow oozing. The hematoma usually resolves itself without complications, so an anterior mediastinal hematoma causing tamponade is rarely reported. We describe a case of blunt chest trauma resulting in a sternal fracture with a resultant anterior mediastinal hematoma and mediastinal tamponade.

응급의학과 의사에 의한 각막 이물 제거

윤상규,최상천,김기운,민영기,조준필 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1

Purpose: This study was performed to evaluate the success rate and the safety in the treatment of corneal foreign body injury by an emergency physician trained in their removal. Methods: Any patients presenting at the emergency department of a large university-based residency teaching hospital with corneal foreign body injuries during ninety months were included in this prospective study. Twenty patients were eligible. Junior residents participated in this study. They were taught to remove corneal foreign bodies by the attending emergency physician. Healing evaluation was performed by an ophthalmologist. Patients not presenting for a visit were contacted by telephone, and information was collected on the assessment of discomfort and the presence of symptoms. Results: All corneal foreign bodies were successfully removed, and no adverse effects were noted. Conclusion: Corneal foreign body removal by emergency physician, if properly trained, appears to be successful and safe.

한국 성인에서의 후두개염의 방사선학적 진단기준

민영기,정윤석,윤상규,박인철,조준필 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Backgrounds: A retrospective study was performed to define objective radiologic parameters in diagnosing epiglottitis on soft-tissue lateral neck radiographic study. Methods: Parameters of soft-tissue structures(epiglottis width, third vertebral body width, ratio of epiglottic width to third vertebral body width) in 30 adult patients compared with those of age and sexmatched controls with foreign body in throat whose radiographic reading was normal. Results: Epiglottis width of more than 11mm, ratio of epiglottis width(EW) to the third vertebral body width(C3W) of more than 0.5 were, respectively, found to be 100% sensitive and specific in differentiating between patients with and without epiglottitis. Conclusion: These preliminary results suggest that EW/C3W ratio of more than 0.5, EW of more than 11mm, respectively, may be useful in the diagnosis of epiglottitis in adult patients.

상심실성 빈맥의 치료로서 아데노신의 편리한 투여 방법

최상천,윤상규,김기운,허재민,백경원,정윤석 대한응급의학회 2003 대한응급의학회지 Vol.14 No.3

Purpose: The purpose of this study was to observe the success rate, the average of total administration doses and the complications associated with a convenient method of adenosine admininstration for paroxysmal supraventricular tachycardia (PSVT). Methods: A non-blind, randomized, prospective study was conducted during the 30 months from January 1999 to June 2001. We enrolled 65 cases during this period. The number of cases in the standard method group was 35, and that in the mixed method group was 30. In the standard method group, 6 mg of adenosine was administered intra venously; therefore, 15~20 ml of normal saline was immediately flushed. This method is usually used and recommended. In the mixed method group, 6 mg of adenosine had been previously mixed with 15 ml of normal saline was administered intravenously without any additional manipulation. We evaluated the success rate, the average successful doses, and the complications of each group. Results: The success rate was 80% in the standard method group and 85.7% in the mixed method group, but this difference was not statistically significant (Chi square test, p=0.39). The average of total admininstration doses were 10.3±6.3 mg in the standard method group and 11.0±6.5 mg in the mixed method group, but this difference is not statistically significant (student t-test, p=0.07). There was no remarkable complication in the mixed method group. Conclusion: The mixed method was effective and more convenient than the standard method. A further, larger study is required.