국소 증상을 이용한 독사교상의 초기 평가

전덕호,이동필,최우익 대한응급의학회 2004 大韓應急醫學會誌 Vol.15 No.6

P u r p o s e: Life-threatening effects from poisonous snakebites seem to be relatively rare in Korea. Therefore, the purpose of our study is to verify a new triage system by using mainly the local effect scoring system to determine whether it may be used as a general guide for snakebite toxicity in the early injury stage. M e t h o d s: A retrospective study of 108 snakebite patients who visited the Emergency Department of Keimyung University Dongsan Medical Center from April 2000 to December 2003 was conducted. A local effect scoring system was used to grade the toxicity, and the results was compared with those obtained using the traditional grading s y s t e m . R e s u l t s: According to the grading system for severity, grades 0, I and II was most common ones whereas and grades III and IV were relatively rare (9.3%, 1.9%). Local effect scores of 9 to 16, which were considered to correspond to grades III & IV, were documented in 15 cases (13.9%). For the patients with scores from 9 to 16, the average length of stay and the average dosage of the antivenin were 4.54 days and 2.0 vials compared with 1.43 days and 0.73 vials for those with a score of 8 or less, and these differences were statistically significant (p<0.05). There were 9 complicated cases, but they were not considered to be l i f e - t h r e a t e n i n g . C o n c l u s i o n: The local effect scoring system correlated well with the traditional grading system for snakebite severity and may provide an instrument for evaluating the severity of snakebites in the early injury stage. Also, our study supports the conclusion that snakebites in Korea should be reevaluated for the severity.

밀리미터파 광전송용 선형 광변조 기술

한상국,전덕호 한국광학회 2001 광학과 기술 Vol.5 No.1

급성 중크롬산 암모늄 중독 1례

최대해,주명돈,전덕호,최우익,이동필 대한응급의학회 2004 大韓應急醫學會誌 Vol.15 No.3

Soluble compounds of chromium are widely used in industrial processes, including printing, photography, pyrotechnics, dyeing, electroplating, aircraft, shipbuilding, and leather tanning. Exposure in industry is generally via the inhalation of dusts and fumes. Ingestion of chromium (chromate or dichromate salt) has occurred accidentally in suicide attempts and during drug experimentation and may causes ulceration of the bowel, diarrhea, hemorrhagic diathesis, acute renal failure, and hepatic damage. Ingestion of hexavalent chromium compounds is considered to be one hundred times more toxic than the trivalent compounds. Chromium poisoning in children is an uncommon, potentially lethal form of poisoning which could possibly increase in incidence because of the resumed greater domestic distribution of dichromate in Korea. We report a case of ammonium dichromate ingestion by a child that resulted in a healthy discharge.

수영 중에 벼락두통을 호소한 가역성 뇌혈관 수축 증후군 1례

오세광,유병대,전덕호,이동하,김기환 대한응급의학회 2018 대한응급의학회지 Vol.29 No.1

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe thunderclap headache with multifocal segmental vasoconstriction of the cerebral arteries. RCVS can be diagnosed if the cerebral angiogram shows segmental stenosis and spontaneously resolves within weeks to months. RCVS is reversible, but might cause brain lesions such as subarachnoid hemorrhage or cerebral infarction. We report a 45-year-old woman with severe sudden onset frontal headache who was identified with reversible cerebral vasoconstriction syndrome.

Manual Removal of a Finger Stuck Tightly in a Door Handle: The Lubricant and Compressor Technique

김재우,김호중,전덕호 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.2

Until now, tight-fitting material, such as a ring on a digit, has been treated primarily using ring cutter techniques. If this was not available, most physicians would attempt to pull materials out using simple instruments available in the emergency room. The material selected most often was lubricant. However, for cases in which the tight-fitting material was unusual in that the finger was fully covered so that the joint or distal part could not be located in order to check on complications, there have been no methods for consideration with references. Therefore, we treated a patient whose finger was stuck in an unusual circumstance, and removed it manually using the lubricant and compressor technique.

Retrograde Intubation in Patients with Severe Cervical Ankylosing Spondylitis - A Laryngeal Mask Airway (LMA) Combined Technique

김재우,김호중,전덕호 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.3

Occurrence of cervical spineankylosis is rare, and intubation of patients with this condition can be difficult, particularly when fiberoptic laryngoscopy is not available. We performed successful endotracheal intubation in a 64-year-old male patient using a 7-mm cuffed polyvinyl chloride (PVC)tube with the help of a laryngeal mask airway (LMA). The LMA was initially used for rapid ventilation of the patient,and the guide wire was passed into the airway from the site of puncture of the cricothyroid membrane. This wire was easily observed in the LMA tube, and the use of long forceps was not required.

소아에서 외상 후 발생한 장중첩증

이현정,장혜영,김재우,전덕호,유병대 대한응급의학회 2015 대한응급의학회지 Vol.26 No.1

Intussusception is the most common abdominal emergency in children younger than 2 years old. It is often considered idiopathic. However, an underlying disease can cause a pathological lead point for the intussusception. Its incidence after trauma is uncommon, and traumatic intussusception in children is even rarer. In Korea, traumatic intussusception in a child has never been reported. We experienced a case of traumatic intussusception in a 3-year-old girl. The patient was injured by a plastic bar while playing, and she soon complained of abdominal pain. We identified an ileo-ileal intussusception on computed tomogram. The intussusception was reduced successfully by air reduction in the emergency department. She was sent to home without complication after three hospital days.

난소 낭종 파열에 의한 혈복증 환자들의 병력 및 임상 특성

김형규,조영순,이명갑,유병대,전덕호,김호중 대한응급의학회 2010 대한응급의학회지 Vol.21 No.6

Purpose: To evaluate and analyze the clinical characteristics and history of patients with hemoperitoneum due to ovarian rupture. Methods: Subjects were fertile females who visited the emergency department between January 2006 and December 2008. We did retrospective chart reviews only for patients diagnosed with hemoperitoneum. We investigated the characteristics and history of enrolled patients. Results: A total of 76 females (mean age = 28 years) were enrolled. Of the 76, 32 (41.8%) were initially checked for coitus history by emergency physicians (EP). Of the 76, 52(68.4%) were operated on and the remaining 24 (31.6%)were only observed. Only 4 patients had knowledge of a history of ovarian cysts. Conclusion: Coitus history and ovarian cyst history should be done by EPs during the initial examination of fertile females who complain of lower abdominal pain.

일개 병원의 자전거와 이륜차 손상환자의 특성 및 배포된 국가손상감시정보의 분류 방식에 대한 연구

김성계,조영순,이명갑,유병대,전덕호,김호중 대한응급의학회 2010 大韓應急醫學會誌 Vol.21 No.6

Purpose: To study characteristics of bicycle and motorcycle injured patients in a university hospital and in an edited national injury surveillance report. Methods: Between July 2007 and January 2010, we collected data on bicycle and motorcycle injured patients in a university hospital. First, we compared the characteristics of each group. Second, we analyzed injury severity using their injury severity score (ISS) and their revised trauma score (RTS). We compared the categories of an edited national injury surveillance report with our university-acquired data. Results: The total number of patients in traffic accidents was 4,111 (including 204 bicycle riders and 165 motorcycle riders). For those in bicycle accidents, a large fraction was < 10 years old or > 51 years old. For those in motorcycle accidents. Those in motorcycle accidents had an increased proportion of liver cirrhosis and of previous experience with a similar accident. Bicycle accidents had a higher proportion of cases where just the driver or just the passenger was injured. Just falling was the most cause of injury. Others were injured by collision with a car or by both. Motorcycle riders who wore helmets were better protected. Most accidents occurred after 19:00: motorcycle accidents most frequently between 0:00 and 7:00 and between 13:00 and 18:00 hours. Injury severity score were not different. Admission to the hospital and fatalities were highest for motorcycle accidents. The place of injury and alcohol intoxication status were reported for traffic accidents. Conclusion: Bicycle and motorcycle injuries were already considered as important factors in traffic accidents included in the injury surveillance report. More factors, including age,time, past history, etc. should be added.

경련으로 나타난 봉합재료에 의해 발생한 심장눌림증 1례

김혜미,이명갑,유병대,전덕호,김호중,임훈,조영순 대한응급의학회 2010 대한응급의학회지 Vol.21 No.2

Cardiac tamponade is a potentially acute, life threatening emergency that can cause death if it is not promptly diagnosed and treated. Cardiac tamponade is a comparatively uncommon presentation to the emergency department and it is usually associated with penetrating trauma. We report here on a case of cardiac tamponade due to suture material that was used for colectomy ten years previously. A 17-year-old male was admitted to an emergency department with a complaint of loss of consciousness and convulsion. He also complained of chest pain, dyspnea and hypotension. After a while, he displayed cyanosis and his jugular veins were distended. The emergency echocardiogram showed a large amount of pericardial effusion with features of tamponade. Pericardiocentesis was immediately performed. Although 800 cc of fresh blood was drained from the pericardial cavity,his bleeding wouldn’t stop. So, the patient was moved immediately to the operation room, and pericardiectomy and median sternotomy were performed. The surgeon found that the foreign suture material had penetrated the pericardium and he successfully removed it. The removed foreign body was a bundle of thread. The patient was discharged without any complications after 9 days.