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흉부 외상 환자에서 일반흉부촬영과 비교한 흉부단층촬영의 진단적 유용성
최규일 ( Kyu Ill Choi ),서강석 ( Kang Suk Seo ),류현욱 ( Hyun Wook Ryoo ),박정배 ( Jung Bae Park ),정제명 ( Jae Myung Chung ),안재윤 ( Jae Yoon Ahn ),강성원 ( Seong Won Kang ),이재혁 ( Jae Hyuck Yi ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.2
Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients` characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn`t be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn`t be found on CXR to be verified, which helped us to could accurately evaluate patients. (J Korean Soc Traumatol 2009;22:142-7)
글리포세이트 중독 환자에서 급성 신손상 발생의 임상 양상과 위험 인자
박형훈 ( Hyung Hun Park ),최규일 ( Kyu Ill Choi ),이제원 ( Je Won Lee ),박정민 ( Jung Min Park ),박진욱 ( Jinwook Park ),노상문 ( Sang Moon Noh ),조재경 ( Jaekyung Cho ),이대로 ( Daero Lee ),조재철 ( Jae Chul Cho ),박동찬 ( Dong C 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.2
Purpose: Acute kidney injury (AKI) in patients with glyphosate poisoning has a poor prognosis. This study aimed to predict the risk factors for AKI in patients with glyphosate poisoning at the emergency department (ED). Methods: Clinical data on glyphosate poisoning patients at ED who were older than 18 years were collected retrospectively between January 2013 and December 2019. The clinical characteristics and clinical outcomes of the AKI group in patients with glyphosate poisoning were compared with the non-AKI (NAKI) group. Results: Of 63 glyphosate poisoning patients, AKI was observed in 15 (23.8%). The AKI patients group showed the following: old age (p=0.038), low systolic blood pressure (p=0.021), large amount of ingestion (p=0.026), delayed hospital visits (p=0.009), high white blood cells (WBC) (p<0.001), high neutrophil counts (p<0.001), high neutrophil-lymphocyte (LN) ratios (p<0.001), high serum potassium (p=0.005), low arterial blood pH (p=0.015), and low pO2 (p=0.021), low bicarbonate (p=0.009), and high Poisoning Severity Score (PSS) (p<0.001). AKI patients required hemodialysis, ventilator care (p<0.001, p=0.002), and inotropics (p<0.001). They also showed more intensive care unit admission (p<0.001), longer hospitalization (p<0.001), and high mortality (p<0.001). Logistic multivariate regression analysis showed that high WBCs (OR, 1.223) and increased LN ratios (OR, 1.414) were independently associated with the occurrence of AKI. Conclusion: In patients with glyphosate poisoning at ED, high WBCs and increased LN ratios can help predict the occurrence of AKI.