Should We Convert Prehospital Supraglottic Airway to Endotracheal Tube Immediately in Out-of-Hospital Cardiac Arrest? A Preliminary, Retrospective, Observational Study

임현범,천성빈 대한응급의학회 2017 大韓應急醫學會誌 Vol.28 No.6

Purpose: This study examined whether the immediate conversion of the prehospital supraglottic airway (SGA) to endotracheal intubation (ETI) is associated with the return of spontaneous circulation (ROSC) and survival to discharge among out-of-hospital cardiac arrest (OHCA) victims. Methods: This retrospective observational study included OHCA victims aged ≥18 years who were treated from 2014 to 2016. The patient-, prehospital arrest-, and emergency department (ED)-related variables were collected based on the Utstein template. The immediate conversion of SGA to ETI was defined when it had been initiated within ≤2 minutes after arrival at the ED. To investigate the factors related to ROSC and survival to discharge, multiple logistic regression analysis of the immediate conversion of SGA to ETI and variables showing a difference (p<0.15) on the Mann-Whitney U and chi-square test was performed. Results: A total of 129 patients were enrolled, with a median age of 59 years (interquartile range, 51 to 72 years). Of these, 30 (23.3%) were female, 41 (31.8%) achieved ROSC, and 7 (5.4%) survived to discharge. Sixty-nine (53.5%) received immediate conversion showing no differences in the demographic and clinical characteristics compared to the delayed conversion group. Multiple logistic regression analysis showed that ROSC was related to the existence of lung disease, presence of witnesses, and a cardiopulmonary resuscitation duration ≤15 minutes at the ED, whereas the survival to discharge was associated with the prehospital shockable initial rhythm. Neither ROSC nor survival to discharge were related to the immediate conversion of SGA to ETI. Conclusion: The immediate conversion of prehospital SGA to ETI at ED in an OHCA victim might be unrelated to ROSC and survival to discharge.

악안면 골결손부의 이종골이식을 이용한 수복에 관한 연구

김경원,조용석,이경호,임현범 충북대학교 의과대학 충북대학교 의학연구소 1998 忠北醫大學術誌 Vol.8 No.2

연구목적 : 구강 및 악안면영역의 소수술시 발생할 수 있는 골결손부에 대하여 이종골을 이용한 골이식을 시행하고 치료결과 및 예후를 평가하고자 하였다. 재료 및 방법 : 1996년 1월부터 1996년 12월까지 내원한 환자중 골결손부에 대힌 골이식이 필요하였던 환자중 이식 후 추적 관찰이 가능하였던 36명에 대하여 의무 기록과 방사선 사진을 이용하여 분석하였다 결과 : 대상 환자중 10대와 20대(72.7%)가 가장 많았으며, 골이식이 필요하였던 질병으로는 낭종, 양성 종양, 매복치, 치근단 질환 등이었으며, 이식후 평균 7개월의 추적 관찰을 시행한 결과 36례중 6례(약17%)에서 술후 경미한 정도의 감염 소견이 있었으며 그 외는 특별한 합병증이 발견되지 않았다. 결론 : 구강 및 악안면영역의 비교적 작은 골결손부에 대하여 이종골이식을 선택적으로 시행할 수 있을 것으로 생각된다. Purpose : We evaluated the result and prognosis of the heterogenic bone graft for restoration of the bone defect in oral and maxillofacial region. Materials and Methods : We collected and analysed the patents who received the heteogenic bone graft from January 1996 to December 1996 in Chungbuk National University Hospital. Results : Prevalent age groups of heterogenic bone graft were 2nd and 3rd decades(72.2%), and cysts and benign tumors, impacted teeth, apical lesions were causative diseases of bone defects. The average period of follow-up was 7 months after operation. Major complications were postoperative infections(17%), but they were not severe. Conclusion : We recommend a heterogenic bone graft for restoration of the relatively small bone defect in oral and maxillofacial region selectively.

구강내 접근을 통하여 2개의 titanium miniplate를 이용한 하악골 우각부 골절의 치료에 관한 연구

임현범,조용석,김경원 충북대학교 의과대학 충북대학교 의학연구소 1996 忠北醫大學術誌 Vol.6 No.2

하악골은 기능운동시에 하악골의 상연부에서는 인장력이 발생하고, 하악골의 하연부에서는 압축력이 발생한다고 알려져 있다. 이러한 이론을 기초로 하여 Champy 등은 하악골의 골절시에 이에 대한 치료를 위한 이상적인 골접합선을 제시하고, 우각부 골절의 경우 하악골의 상행지 외사선 부위에 하나의 miniplate만을 이용한 고정으로 충분하다고 주장하였으나, 이를 실제 임상에 적용하는데 있어서 많은 문제점들이 야기되어 이에 대한 반론이 제기된 바 있다. 이에 저자는 하악골의 우각부 골절 치료시에 구강내 접근을 통하여 2개의 비압박성 타이타니움 소형금속판(noncompressive titanium miniplates)를 이용하여 내고정술을 시행한 결과 만족할 만한 안정성과 결과를 얻었기에 보고하는 바이다 With physiologically coordinated muscle function, tension forces at the upper border of the mandible and compressive forces at the lower border are produced. According to this theory, Champy insisted the ideal osteosynthesis line for the mandibular body. In case of mandibular angle fracture, the plate is most favorably placed on the broad surface of the external oblique line as high as possible Champy et al. reported that the stability of the miniplate system was sufficient and satisfied. But, it was doubted by many clinicians and oral surgeons, especially when immediate postoperative function is desired. So the authors treated the mandibular angle fracture patients with two noncompressive titanium miniplates via intraoral approach using transbuccal trochar appliance. All Patients have showed good postoperative functions without complications. Thus, the use of two titanium miniplates seems to be an effective treatment of mandibular angle fracture.

외상에 의한 영구치의 손상과 치아 고정술의 예후에 관한 연구

임현범,조용석,김경원 충북대학교 의과대학 충북대학교 의학연구소 1997 忠北醫大學術誌 Vol.7 No.1

경제 성장과 더불어 교통수단의 발달과 취미 활동에 대한 높은 관심과 함께 교통사고, 스포츠 등의 레저 활동, 폭력 등에 의하여 악안면부의 외상은 빈번하게 발생할 수 있다. 1996년 1월부터 1996년 12월까지 1년간 본과에 내원한 악안면부 외상 환자 중 상악골, 하악골, 관골 등의 악안면골 골절을 동반하지 않고 주로 치아 손상을 주소로 이에 대한 치아 고정술을 시행한 환자 43명에 대하여 의무 기록과 방사선 사진 등의 자료를 참고로 하여 영구치의 손상과 치아 고정술의 예후에 대하여 평가하여 다음과 같은 결론을 얻었기에 추후 영구치 손상 환자에 대한 치료술식과 예후 판정에 참고로 하고자 문헌 고찰과 함께 보고하는 바이다. 1. 치아 외상은 여자보다 남자에게서 더 많이 발생하였다. 2. 치아 외상을 받은 호발 연령은 10대와 20대였다 3. 치관 외상의 주된 원인은 낙상, 교통사고와 운동 순이었다. 4. 치아 외상시 가장 호발부위는 상악 전치부였다 5. 치아고정시 아치 바와 강선을 이용한 방법과 강선과 치과용 레진을 이용한 방법의 예후에는 큰 차이가 없었다. 6. 치아고정시 가장 큰 병발증은 치아 실활에 따른 신경치료, 치근 흡수, 발치였다. The injuries of the offal and maxillofacial region occrurred frequently because of the accidents, sports and violences. The authors experienced the injuries of the teeth that did not involve the bony fracture of the maxillofacial bones. We reviewed the 96 teeth of 43 patients that were fixed after replacement and/or replantation of luxated teeth during 1year(1996). We analysed and evaluated the treatment methods and the prognosis of the fixated teeth using the hospital records and radiographies. The results were as follows. 1. The occurrences of teeth injuries were more frequent in male than in female 2. The prevalent age groups were the second and third decades. 3. The major etiologies of teeth injuries were fall-down, traffic accidents and sports. 4. The prevalent teeth injured area were the upper anterior teeth area. 5. The prognosis of the teeth fixation methods between arch bar with wiring and wire with dental resin were not different significantly. 6. The major complications were the endodontic treatment due to discoloration and/or non-vitalization of teeth, root resorption and extraction of injured teeth.

심하게 위축된 상·하악 구치부에 대한 치과용 임플란트의 진보된 매식술

김경원, 조용석, 임현범, 이경호, 박현진 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

-본문참고-

구순열 및 구개열 신생아의 수술 전 악정형장치(발육유도장치)에 관하여

김경원,임현범,이경호 충북대학교 의과대학 충북대학교 의학연구소 1998 忠北醫大學術誌 Vol.8 No.1

연구목적 : 구순열 및 구개열 환자에게 수술 전에 시행하고 있는 포유상을 겸한 악정형장치에 대한 소개와 발육유도장치로서의 지속적인 연구의 기초자료로 삼고자 한다. 대상 및 방법 : 본과에서 제작하는 악정형장치의 제작 방법을 소개하고 문헌의 전형적인 Hotz plate와 비교 검토하며, 실제 사용한 8례의 환자에 대한 평가를 시행한다. 결과 : 악정형장치의 장착으로 구순열 및 구개열 환자의 현저한 포유 능력의 개선과 상악 악궁의 배열이 개선된 것이 관찰된다. 결론 : 현재 사용되고 있는 악정형장치의 개선과 발육유도장치로서의 기능에 대한 보다 장기적이고 체계적인 연구가 필요하다. Purpose : This study was an introduction of the presurgical orthopedic appliance as a prosthetic plate for bottle feeding and growth guiding for the cleft lip and palte patients, and a basis of the continuing study about the orthopedic appliance. Materials and Methods : We described the method of making an orthopedic appliance which was used at out department and compared with the typical Hotz plate. And we evaluated 8 cases in our department. Results : After an application of presurgical orthopedic appliance, remarkable improvement of sucking ability of a cleft lip and palate patients and good arrangement of maxillary arch form were observed. Conclusion : The improvement of the presurgical orthopedic appliance and continuing study were needed.

경부에 발생한 갑상설관낭의 증례보고

이현수,임현범,하주효,양수남 대한악안면성형재건외과학회 2004 Maxillofacial Plastic Reconstructive Surgery Vol.26 No.2

청소년 자원봉사 활동기관 관리실태 및 의식조사

송순,임현범 한국청소년복지학회 2000 청소년복지연구 Vol.2 No.1

The aim of this study is to consider the actual condition of management in the organizations of a juvenile voluntary service and the consciousness of staff. Fifty three organizations in J city were selected for this study. First, this study investigated how a juvenile voluntary service was managed, especially focusing on the collection plans, training, exclusive charge post, consideration of aptitude and interests, evaluation, connection with other organizations, programs, and service contents. Second, the consciousness of staffs about a juvenile voluntary service activity was surveyed. The results of the study are summarized as follows: (1) Juvenile volunteer programs in respective organizations are carried out without any basic plans and any manager in charge(33 in total, 62.3%), and have no links to other groups(34, 64.2%). (2) The volunteers are not assigned to the tasks according to their ability and aptitude(14, 26.4%), and there is no specific voluntary program(40, 75.5%). (3) Most services are about making up for the labor shortage(40, 75.5%), and the education of volunteers is given when needed(38, 71.7%). (4) The expost management is not performed properly(38, 71.7%) and most of the evaluation is made without consulting the guidebook(45, 84.9%). (5) There was no durability of a juvenile service because of the simplicity of the service contents(17, 56.7%) and lack of consideration for personal aptitude(43, 81.1%). (6) The staffs thought that a juvenile service was necessary for helping the development of their sociability(30, 56.6%) and indicated the limitation to the service content as the problem(26, 49.1%). (7) The state of the management of a juvenile voluntary service was insufficient, and rarely systematized. The service content had no variety and the staff thought that a juvenile service contributed to individual growth and social development.

청소년 자원봉사 활동기관 관리실태 및 의사조사

송순,임현범 한국청소년복지학회 2000 청소년복지연구 Vol.2 No.1

The aim of this study is to consider the actual condition of management in the organizations of a juvenile voluntary service and the consciousness of staff. Fifty three organizations in J city were selected for this study. First, this study investigated how a juvenile voluntary service was managed, especially focusing on the collection plans, training, exclusive charge post, consideration of aptitude and interests, evaluation, connection with other organizations, programs, and service contents. Second, the consciousness of staffs about a juvenile voluntary service activity was surveyed. The results of the study are summarized as follows: (1) Juvenile volunteer programs in respective organizations are carried out without any basic plans and any manager in charge(33 in total, 62.3%), and have no links to other groups(34, 64.2%). (2) The volunteers are not assigned to the tasks according to their ability and aptitude(14, 26.4%), and there is no specific voluntary program(40, 75.5%). (3) Most services are about making up for the labor shortage(40, 75.5%), and the education of volunteers is given when needed(38, 71.7%). (4) The expost management is not performed properly(38, 71.7%) and most of the evaluation is made without consulting the guidebook(45, 84.9%). (5) There was no durability of a juvenile service because of the simplicity of the service contents(17, 56.7%) and lack of consideration for personal aptitude(43, 81.1%). (6) The staffs thought that a juvenile service was necessary for helping the development of their sociability(30, 56.6%) and indicated the limitation to the service content as the problem(26, 49.1%). (7) The state of the management of a juvenile voluntary service was insufficient, and rarely systematized. The service content had no variety and the staff thought that a juvenile service contributed to individual growth and social development.

삼하게 위축된 상·하악 구치부에 대한 치과용 임프란트의 진보된 매식술

김경원,조용석,임현범,이경호,박현진 충북대학교 의과대학 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

목적: 최근에는 기능적, 심미적인 요인 등으로 인하여 일반적인 보철치료 대신 임플란트 매식을 이용한 보철치료가 요구되는 경우가 많다. 그러나 통상적인 임플란트 매식술이 불가능할 정도로 심하게 위축된 상하악 구치부에 대하여 보다 진보된 임플란트 매식술을 시행하고 그 결과를 소개하고자 한다. 대상 및 방법: 잔존 치조골이 심하게 위축된 상악과 하악 구치 결손부에 대하여 상악동저 거상술 및 자가골 이식과 하치조신경 재위치술을 이용하여 임플란트 보철치료를 각각 시행하였다. 결과: 통상적인 임플란트 매식술이 곤란하였던 증례에서 진보된 임플란트 매식술을 이용하여 시술한 후 12개월 추적 관찰 결과 특별한 합병증 없이 성공적인 임플란트 보철치료가 이루어졌다. 결론: 잔존 치조골이 심하게 위축되어 통상적인 임플란트 매식술이 불가능한 상하악 구치부에 있어서 상악동저 거상술 및 자가골 이식과 하치조신경 재위치술은 선택적인 경우에 매우 효과적인 치료법이 될 수 있다. Purpose: Instead of ordinary prosthodontic treatment, implant prosthodontic treatment is frequently required because of functional and esthetic reasons. We introduce the advanced surgical techniques of implant installation in case of severely atrophied posterior edentulous alveolar ridges of maxilla and mandible. Materials and Methods: The sinus lift and autogenous bone graft and the inferior alveolar nerve repositioning were performed in case of severely atrophied alveolar ridge of maxilla and mandible respectively. Result: After postoperative follow up for 12 months, successful clinical results of implant prosthodontics were gained without specific complications. Conclusion: Advanced surgical techniques including sinus lift and autogenous bone graft and inferior alveolar nerve repositioning can be applied selectively in case of severely atrophied alveolar ridges of maxilla and mandible.