위암으로 인한 위전절제술을 시행한 환자에서의 영양상태 및 공장점막의 변화

조석주(Suck Ju Cho),제갈영종(Young Jong Jegal) 대한외과학회 1990 Annals of Surgical Treatment and Research(ASRT) Vol.39 No.6

췌십이지장 절제술전 담관배액의 의의

진상수(Jin Sang Soo),조석주(Cho Suck Ju),김현종(Kim Hyun Jong),조영국(Cho Young Kook) 대한외과학회 1991 Annals of Surgical Treatment and Research Vol.40 No.1

부산광역시 e-응급서비스시스템 인프라 구축

김형회(Hyung Hoi Kim),조훈(Hune Cho),김화선(Hwa Sun Kim),조석주(Suck Ju Cho) 한국멀티미디어학회 2008 멀티미디어학회논문지 Vol.11 No.9

외상 환자에 대한 바늘감압술에서 흉벽 두께와 바늘 길이의 관계

김지완 ( Jee Wan Kim ),정진우 ( Jin Woo Jeong ),조석주 ( Suck Ju Cho ),염석란 ( Seok Ran Yeom ),한상균 ( Sang Kyoon Han ),박성욱 ( Sung Wook Park ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2

Purpose: A tension pneumothorax is a fatal condition that requires immediate intervention. Although a definitive treatment for a tension pneumothorax is a tube thoracostomy, needle decompression can provide temporary relief, that is lifesaving. The traditional procedure for needle decompression involves inserting a needle or catheter at the second intercostal space, the midclavicular line. Recent evidence suggests that the commonly used catheters do not have sufficiently penetrate the chest wall. There are also claims that a lateral approach to needle decompression is easier and safer than the traditional anterior approach. The purpose of this study is to evaluate the optimal approach for needle decompression for the Korean population by measuring chest wall thicknesses at the points used for both the anterior and the lateral approaches. Methods: The chest wall thickness (CWT) of trauma victims who visited the Emergency Center of Pusan National University Hospital was measured by computed tomography (CT) images. The CWT was measured at the points used for the anterior and the lateral methods and was compared with the length of commonly used catheters, which is 45 mm. Results: The mean CWT at the second intercostal space, the midclavicular line, was shorter than the CWT at the 5th intercostal space, the anterior axillary line. However, the percentage of patients whose CWT was greater than 45 mm was larger when measured anteriorly (8.2%) that when measure laterally (5.7%). Female patients and those older than 60 were more likely to have an anterior CWT greater than 45 mm (28.2% for females and 15.5% for those older than 60). Conclusion: The percentage of trauma victims in Korea whose CWT is greater than 45 mm is lower than the values previously reported by other countries. However, females and older patients tend to have thicker chest walls, so the lateral approach would be suggested when performing needle decompression for such patients with suspected tension pneumothoraces. (J Korean Soc Traumatol 2010;23:63-67)

부산,경남 지역에서 전원 의뢰된 중증외상 분석을 통한 119 구급대의 환자 분류와 이송병원 선정에 대한 고찰

임종언 ( Jong Eon Lim ),염석란 ( Seok Ran Yeom ),조석주 ( Suck Ju Cho ),한상균 ( Sang Kyun Han ),박성욱 ( Sung Wook Park ),이성화 ( Sung Hwa Lee ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service`s (EMS`s) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea. (J Trauma Inj 2012;25:145-151)

일개 응급센터에 내원한 외상성 혈관손상 환자의 임상적 특성

박용면 ( Yong Myeon Park ),염석란 ( Seok Ran Yeom ),정진우 ( Jin Woo Jeong ),한상균 ( Sang Kyun Han ),조석주 ( Suck Ju Cho ),류지호 ( Ji Ho Ryu ),김용인 ( Yong In Kim ),정성운 ( Sung Woon Chung ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.1

Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2:1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treate-ment, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a `critical pathway` to improve the outcomes of patients with blunt abdominal vascular injury. (J Korean Soc Traumatol 2009;22:5-11)

응급실 사망 환자의 분석

고필성,조석주 대한응급의학회 2000 대한응급의학회지 Vol.11 No.2

Background: The prehospital care system in the Pusan area is primitive in organization, and the emergency medical system of every hospital needs to be developed. A analysis of patients who were treated in emergency rooms and who died is necessary in order to establish an emergency medical service system which is appropriate for the community. Method: The authors reviewed the records of 117 patients who died in the emergency room of Pusan National University Hospital from January 1998 to December 1998. Results: 1) Among the 117 patients, 68 patients were male (58.1%) and 49 patients were female (41.9%). The incidence of patients over the age of 70 was very high (33 cases, 28.2%). 2) Among the 117 patients, 99 patients died due to disease(84.6%), 16 die to trauma, and 2 due to intoxication. The most prevalent disease was cardiovascular disease. 3) Among the 117 patients, 63 patients arrived voluntarily (53.8); the remainder were transferred from other hospitals. Forty-eight patients were transported by 119 ambulance (41.0%), and 41 patients were transported by hospital ambulance. 4) As for consciousness level, 52 patients(44.4%) were alert upon arrival at the emergency room, but 42 patients (35.9%) were unresponsive. 5) In 53 patients, the intervals between arrival at the emergency room and the onset of cardiac arrest were from 2 to 24 hours (45.3%). 6) Cardiac arrest was most frequent between 10:00 pm and 8:00 am. 7) Cardiopulmonary resuscitation was done in 74 patients (63.2%), and the mean duration was from 30 minutes to 1 hour. 8) Sixty-sex patients were patients of internal medicine, and their mean stay time was 17 hours 27 minutes. Conclusion: These results suggest that systematic education in advanced cardiopulmonary resusciatation, expansion of emergency physicians, an increase in the number of intensive care units are required.

부산지역의 병원간 응급 의료 전달 체계에 대한 연구 : 부산대학교병원 응급의료센터를 중심으로

고필성,조석주 대한응급의학회 1998 대한응급의학회지 Vol.9 No.1

Five hundred and thirty five cases of patients who were transferred to the Department of Emergency Medicine in Pusan University Hospital from Aug 1, 1997 to Aug 31, 1997 and from Oct 1, 1997 to Oct 31, 1997 were studied prospectively. The results were as follows: 1. Total 535 patients were transferred to the emergency department of PNUH(Pusan National University Hospital) for 2 months(average 8.2 a day). Male to female ratio was 1.58:1 and peak age group was 6th decade(17.0% of total). 2. In distribution about arrival time of transferred patients, 40.7% was from 08:00 to 16:00, 39.3% was from 16:00 to 24:00, and 20.0% was from 0:00 to 8:00. 3. Cases that were communicated with the emergency department of PNUH were 7.7%, cases that were communicated with other departments of PNUH were 10.1%, and 82.2% of total cases were transferred without any communication. 4. A 40.7% of patients was transferred by a hospital ambulance, 33.1% of patients used non-emergency vehicles such as taxis or buses, 25.3% of patients was transferred by an 119 or 129 rescue ambulance, and 0.9% was transferred by on foot or others. 5. Transferring hospital was divided into 3 groups; primary hospital, secondary hospital, and university hospital. The majority was secondary hospital(83.6%). 6. The cases that patients wanted to be treated in PNUH were the greatest in number as 55.5%, the cases transferred due to emergency surgery were 9.3%, the cases transferred without specialized department concerned were 28.6%, the cases transferred because of bed deficit were 1.7%, and the cases transferred due to other cause were 4.9%. 7. Traumatic patients were 32.5%, and among them 9.9% was due to motor vehicle accident, among these 78.5% was mild patients. Non-traumatic patients were 67.5% and among them 74.2% was mild patients. 8. Among all transferred patients, 75.7% was admitted for general care, emergency operation, and ICU care. The percentage of discharge was 19.1%, the percentage of death was 2.4%, and the percentage of transfer to other hospital was 2.8%. Generally, because of bed deficit and of availability of operation room, patients were transferred to other hospital. 9. Among specialized departments, the proportion of the department of internal medicine, neurosurgery and pediatrics was 29.3%, 17.2%, and 11.4% respectively. In conclusion, it is considered that proper patient transfer and effective medical service can be achieved through the well-organized EMSS, good triage, and cooperative interhospital communication.

중국 민항기 추락사고시의 재해의료체계 분석 : 현장응급의료소 운영상황을 토대로 Review of Disaster Response to the Air China Aircraft Crash near Kimhae Airport

조석주,염석란,정진우 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1

Purpose: The purpose of this study was to use a review of the regional disaster that occurred on April 15, 2002, to improve the National Disaster Medical System and to operate the Disaster Medical Assistance Team and the Mobile Emergency Support Unit better. Methods: We retrospectively analyzed 39 survivors among the 167 victims of the Air China aircraft crash, Kimhae, Korea, on April 15, 2002, by using reports of the on-site disaster medical assistance team members, recordings of notifications to the Busan and the Kyoungnam 1339 Emergency Information Centers from the scene of accident, and medical records of the victims transported to hospitals. Results: On the date of accident, April 15, 2002, 27 of the 39 survivors were transported to 5 hospitals in Kimhae and 12 were transported to 8 hospitals in Busan. On the next day, April 16, two patients who had been transported to hospitals in Kimhae were transferred to medical centers in Busan. One of them expired, and the other was subsequently transferred to a medical center in Seoul and expired on May 2, 2002. Conclusion: Still now, our National Disaster Medical System contains many problems, especially lack of cooperation between related parts, and insufficient communications. This study shows that we should recheck our National Disaster Medical Dystem and construct a cooperative Police. Fire defense organization, 1339 emergency Medical Information Center, and regional medical service system.

응급센터에 내원한 HIV 감염자

조석주 大韓應急醫學會 1997 대한응급의학회지 Vol.8 No.1

The author has reviewed 16 HIV infected individuals who visited emergency center. The results were as follows; 1. In view of sex, age distribution, and clinical state, most of the patients managed in emergency room were known HIV infected patients, and they were in progressed state to AIDS. 2. The symptom, and sign were nonspecific in most of the patients. 3. In view of sex, age distribution, course of infection, clinical state, and other foreign report, patients who visit emergency room have proportionaly high incidence of HIV infection to general population. Therefore, systemized effort is needed to detect, and manage them.