야생동물들의 119 구조대, 한국 동물 구조단

장문준 사회발전연구소 1995 한국인 Vol.14 No.12

에너지기반 웨이블릿을 사용한 열차 바퀴의 상태 모니터링

장문준,배석주 대한산업공학회 2013 대한산업공학회 춘계학술대회논문집 Vol.2013 No.5

에너지기반 웨이블릿을 사용한 열차 바퀴의 상태 모니터링

장문준,배석주 한국경영과학회 2013 한국경영과학회 학술대회논문집 Vol.2013 No.5

응급실 체류 시간 단축

장문준 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

선상의료에 대한 고찰 : 금강산 유람선 현대 봉래호를 중심으로

이한식,송근정,장문준 대한응급의학회 2000 대한응급의학회지 Vol.11 No.1

Background. Maritime medicine refers to the medical care and education of medical disease which may develop during a cruise. Recently, cruise passengers are increasing around the world and maritime medicine has been initiated in Korea with the beginning of the trip to Mt. Kumgang in 1998. Nowadays, there are about 4,000 passengers per week. Therefore, the data were analyzed to promote the understanding of maritime medicine, which was first applied on the Mt. Kumgang cruise, and to help the medical members who will be participating in the maritime medicine in the future. Methods. From November 1998 to February 1999, all patients who visited to medical cabin of the cruise ship(Hyundai Pongnae) were analyzed retrospectively. Result. 2,162 patients excluding 182 patients who re-admitted were analyzed. In each cruise, there were 65.5(9.0%) passengers and 42(13.0%) crews. The male to female ratio was 1.6 : 1, with 709 males and 451 females. The common problems were respiratory and musculoskeletal diseases followed by dermatologic and gastrointestinal problems in order of frequency. There were 18 patients who had trauma above 4 points in ISS. Ten patients were confined to the medical cabin. The ship returned to Donghae-port one time, 8 patients were evaluated immediately and 41 patients were referred without urgency. Conclusion. Maritime medicine has a particular characteristic of dealing with various cases and treatments including emergencies with limited space, man-power, facilities and equipment. It obviously proposes the participation emergency medical doctors in the maritime medicine because medical personnel must take part in not only medical management but also in education and prevention including CPR. The medical staff in charge of maritime medicine should establish a proper plan depending on the purpose of the cruise and must endeavor to solve the problem.

응급실 환자 과밀화 요인의 분석

장문준,장석준,이한식 대한응급의학회 1992 대한응급의학회지 Vol.3 No.2

The overcrowding and congestion of a university hospital's emergency department is not only from shortage of admission room but from multiple factors. This kind of phenomenon restrict quality and property of treatment of emergency department patients. Once patient visit emergency department, patient goes through a physical and laboratory examinations, then decided whether patient could be either admit or discharge from emergency department or transfer to other hospitals. In a course of process many factors can delay a medical examination and treatment of emergency department patient. Therefore overcrowding and congestion of emergency department is growing from bad to worse. In this article, by analyze the time required for emergency department patient to go through a process from initial arrival to leave emergency department. Authors made an analysis and present with followed suggestions for improvement in an emergency department. We investigated factors for delay of examination and treatment in emergency department, therefore, causing overcrowding phenomenon, for 4, 194 patients visited Young Dong Severance Hospital emergency department from September 1st, 1991 to October 31th, 1991. The results were as follows : 1) Distribution of department was Internal medicine, Emergency department and Pediatrics in order. 2) In 24 hour period, 1,546(36.9%) patients visited during evening hours. For 3,246 patients, 90% of them spent less than 10 minutes for receipt. 3) In time interval between receipt and notification to each department, 42.2% in 10 minutes, more than 90% was within 1 hour. 4) For routine laboratory results, 1,423 patients(63%) spent between 1 to hours and 8.5% of them spent more than 2 hours. 5) For routine radiologic examination, 2,098 patients (63%) spent between 10 to 30 minutes and 4.1% spent more than 2 hours. 6) For 200 patients(36.6%), waiting time for special radiologic examination was between 1 to 2 hours and 7% waited more than 4 hours. 7) In time interval between notification and initial assessment of each department, 1,789 patient(42.7%) took less than 10 minutes and more than 1 hour for 5.;2% of patients. 8) Admission rate was 20.7%(869 patients) and for 203 patients it took less than 1 hour but for 12% of patient more than 12 hours for admission order. 9) 31% of patient was to transfer to admission room within 1 hour, 20.1% of patient was after 24 hour. 10) In time interval between receipt and discharge, 878 patient(26.6%) took 1 to 2 hours and 5.1% more than 24 hours.

한중(韓中) 근대 미션계 대학의 건축양식 비교 연구

장문준(Zhang, Wen-Jun),류성룡(Ryoo, Seong-Lyong) 대한건축학회 2021 대한건축학회 학술발표대회 논문집 Vol.41 No.1

This comparative study of architectural forms between Korea and China is to focus on the modern missionary universities’ architectures. Architecture is also called solid art of history and culture, and it is effected by the society and politics. Since late 19<SUP>th</SUP> century, after the Opium War and Ganghwa Island Treaty, western missionary universities are established Korea and China. However, in the late 1910s, the architecture form of Collegiate Gothic in missionary universities is totally different from the Traditional Revival Style in China. From this study, we can understand the differences between Korean and Chinese missionary universities’ architectural forms and get the reasons from different aspects in history, politics and techniques.

DNR이 결정된 환자에 대한 고찰

장문준,윤수영,오진호,윤천재,정성필,이한식 대한응급학회 1998 대한응급의학회지 Vol.9 No.2

Background: Do-Not-Resuscitate (DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. Methods: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups: DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. Results: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. Conclusion: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.

Dapsone투여로 유발된 methemoglobin 혈증에서 N-acetylcysteine 의 효과

장문준,김승호,이한식 대한응급의학회 1997 대한응급의학회지 Vol.8 No.2

Background To determine whether N-acetylcysteine(NAC) reduces methemoglobin. Method: We carried out an in vivo experiment in rats, weighed about 300g. Each rat was ingested 200mg of dapsone(4,4` diaminodiphenyl sulphone) to induce methemoglobinemia. After 1 hour, 30 rats were received NAC 160mg(2ml) and another 30 rats, served as control, were received 2ml of normal saline orally, 4 times hourly. Serum methemoglobin concentrations were checked 1,6, and 24 hours after dapsone ingestion. Result: The methemoglobin concentrations on each time were 27.1±5.8%, 235±8.8%, 17.1±6.4%(mean±SD) in control group and 25.5±6.3%, 25.5±8.8%, 65.5±31.2%(mean±SD) in NAC group. There were no difference on methemoglobin concentrations at 1 and 6 hours between two groups(P>.05). At 24 hours, the methemoglobin concentrations of NAC group was significantly higher than those of control group(P<.01). Conclusion: NAC had no therapeutic effects on dapsone induced methemoglobinemia in this experimental setting.

응급환자에서의 쇼크계수의 의의

장문준,황태식,손대곤,이한식 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

For the emergency patients in need of immediate resuscitation, cardiac catherization along with intensive cardiac monitoring is necessary to evaluate the cardiovascular stability. But this method requires machinery, technique and time which limits its use in emergency situations. In 1961, Allgower and Buri first discribed shock index, heart rate divide by systolic blood pressure, as easy to calculate and easy to use in acute settings given the simple measurements of the heart rate and the blood pressure. It has been said in circulatory failure patients shock index is inversely related to left ventricular stroke work. Because shock index is an indicator for resuscitation and also a prognostic indicator it could be applied in triaging an emerency patients. Therefore we studied the significance and the possible triage application of shock index in emergency patients. In the period of 6 months from May 1 to October 31, 1994. Among total 15,782 patients, who visited Yonsei University-affliated Yong Dong Emergency Department, 2425 patients were included in the study. There were 201 admissions to the intensive care unit and 2105 patients to general beds and 199 selected patient from discharged. Retrospective chart review for pulse rate, systolic blood pressure, diastolic pressure and shock index was done. Statistical analysis was performed using t'-test, p value of less than 0.05 was designated significant. Average shock index for ICU patients were 0.96 ±0.50, general ward admittees were 0.67 ±0.18, and discharged were 0.65 ±0.16. There were significant statistical difference in shock indices between ICU and general ward patients, and ICU and discharged patients. Shock index is helpful in identifing patients with potential for admission to the ICU in emergency situations. Therefore we conclude that the shock index should be recognized as a triage tool.