국내 응급실에서의 골수강내 주입법 사용 현황

최상천 ( Sang Cheon Choi ),박현수 ( Hyun Soo Park ),김재우 ( Jae Woo Kim ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.1

Purpose: Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments. Methods: We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique. Results: Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique. Conclusion: The intraosseous infusion technique is currently underrepresented at emergency departments in Korea. (J Korean Soc Traumatol 2007;20:6-11)

지역중소기업의 디자인권리 창출을 위한 특허기술을 기초로 한 세라믹스피커 디자인개발에 관한 연구

최상천 ( Sang Cheon Choi ),허진용 ( Jin Yong Hur ),윤명한 ( Myung Han Yoon ) 한국정보디자인학회 2011 정보디자인학연구 Vol.16 No.-

본 연구는 중소기업의 디자인권리를 창출하고 지식재산권의 강화를 위하여 디자인 개발 시 특허청에 등록된 제품을 중심으로 선행디자인 검색을 통하여 지역 중소기업의 제품개발에 유리하도록 진행되고 기업의 지식재산 강화를 위하여 하나의 표준 프로세스로 진행하고자한다. 진동스피커 시장동향 분석 및 경쟁상품 분석과 최근 디자인 트랜드를 고려한 상품 사용자 층의 설정 및 분석, 사용자 타겟이 선호하는 디자인분석 및 그에 따른 스피커디자인 개발로 제품외형 디자인 개발(3D 시뮬레이션 및 CAD도면) 이후 소형진동 세라믹스피커 외장디자인 개발, 기업의 마케팅 방향에 부합하는 세라믹스피커 디자인 개발, 타 경쟁사와 차별화되는 독창적인 세라믹스피커 디자인 개발 이후 디자인 권리화를 위한 디자인 출원으로 경쟁력을 확보한다. 젊은이들이 선호할 수 있는 감성도가 높은 제품디자인 개발과 최근 이슈화되고 있는 스마트 폰과 연동될 수 있는 디자인 개발에 그 목적을 두고 있다. This research wishes to creates medium and small enterprises` design patents and when develops design for strengthening of intellectual property right, is gone so that is profitable in product development of area medium and small enterprises through search which is design product registered in the Korean Industrial Property Office and progresses in a standard process for knowledge property strengthening of enterprise. With development, ceramics speaker design development coinciding on marketing direction of enterprise, other rival company which is small size shock ceramics speaker design since product external form design development (if is 3D simulation and CAD degree) by connection shock speaker market eastern exposure analysis and competition goods analysis and set and analysis, design analysis that user target prefers and development that is design accordingly of goods user class which consider the latest design trend differentiation since done unique ceramics speaker design development by design application for design right anger competitive power secure.

실시간 네트워크 모니터링을 위한 동적 스케줄링 방법

천진영(Jin-Young Cheon),최상방(Sang-Bang Choi) 한국정보과학회 2001 한국정보과학회 학술발표논문집 Vol.28 No.1A

SNMP(Simple Network Management Protocol) 네트워크 모니터링에서 에이전트 정보가 시간에 따라 변하는 정보인 경우 매니저는 이를 시간 지연 없이 관찰할 필요가 있으며, 이 때 주로 폴링(Polling)을 사용한다. 폴링에서는 한번의 에이전트 정보 전송을 위해서는 두 번의 메시지(요구와 응답) 전송이 필요하다. 본 논문에서는 기존의 폴링 방법보다 적은 네트워크 부하로 여러 에이전트가 정보의 시간적 변화량에 따라 최적의 에이전트 모니터링 주기를 결정하고 매니저는 이 주기들을 취합하여 모니터링에 의한 부하가 전체 네트워크 부하의 일정 부분이하가 되도록 매니저 모니터링 주기를 결정하게 된다. 에이전트는 최종적으로 매니저 모니터링 주기에 따라 스스로 정보를 전송함으로써 기존의 폴링 방법보다 상대적으로 작은 네트워크 부하로 실시간 모니터링이 가능하다. 본 문에서는 기존의 SNMP 폴링과 제안된 방법에 대해 설명을 하고 SNMP를 이용한 제안된 방법의 구현 시 필요한 구조를 제시하고 시뮬레이션을 이용하여 기존의 방법과 제안된 방법을 평가한다.

중증 리튬 증독 후 발생한 심정지 1예 - 어려운 진단

안정환,최상천,윤상규,정윤석,Ahn Jung Hwan,Choi Sang Cheon,Yoon Sang Kyu,Jung Yoon Seok 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2

Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circultion (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.

대학병원 응급의료센터로 전원되는 중증 외상환자의 현황 및 문제점

한상수 ( Sang Soo Han ),정경원 ( Kyoung Won Jung ),권준식 ( Jun Sik Kwon ),김지영 ( Hu Young Kim ),최상천 ( Sang Cheon Choi ),이국종 ( Kug Jong Lee ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2

Purpose: The incidence of multiple trauma is increasing nowadays and is the leading cause of death among young adults, Initial treatment is well known to be crucial in multiple trauma victims. However, many indiscriminate transfers occur due to the lack of a well-organized trauma system in Korea. The objective of this study is to demonstrate the current serious state in which major trauma patients are transferred to the Emergency Medical Center of a university hospital from another medical center. Methods: From November 2009 to October 2010, we performed a retrospective study to analyze the characteristics of patients who visited the Ajou University Medical Center located in Gyeonggi-do. We evaluated the ISS (injury severity score), and a score over 15 point was identified as major trauma. The major trauma patients were separated into two groups according to the visit route, and the characteristics of each group were analyzed. Results: Among the 88,862 patients who visited to the Emergency Medical Center, trauma patients accounted for 19,950, and 343 of them were evaluated as major trauma patients. Among the 343 patients, 170 patients had been transferred from other medical centers. The proportion of males to females was 3.3:1, and the mean ISS was 22.7. The leading cause of trauma was motor vehicle accidents. Of the total 170 patients, 77.6% were admitted to the Intensive care unit and 36.3% underwent surgery. The 170 patients that had been transferred to our medical center, 78.8% were transferred from Gyeonggi-do, 15.3% were transferred from other regions, and 5.9% were miscellaneous, Conclusion: Almost half of the major trauma victims treat at our medical center had been transferred from other medical centers, Establishing a traumatic system, supported by well-organized trauma centers and emergency medical services, that can reduce inappropriate transfers among medical facilities is essential.

Zipeprol(레스피렌$^{(R)}$)을 탐닉하던 노인의 급성 중독 사망례

이두환,최상천,안정환,조영신,김기운,민영기,정윤석,Lee, Doo-Hwan,Choi, Sang-Cheon,Ahn, Jung-Hwan,Cho, Young-Shin,Kim, Gi-Woon,Min, Young-Gi,Jung, Yoon-Seok 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.2

Zipeprol dihydrochloride is a non-opioid mucolytic, antitussive agent and it is frequently prescribed for respiratory symptoms such as cough and sputum. The main pharmacologic mechanisms of zipeprol are inhibition of superior laryngeal nerve stimulation and direct antagonism for stimulation of the bronchial receptors, which might have an effect for the drug's mucolytic action. Many cases of drug abuse with zipeprol have occurred world-wide due to the hallucinogenic effect of the drug. In Korea, zipeprol was reported to be the most commonly abused drug among young people for the 1990s. Zipeprol associated death was first reported since 1991 and 69 cases of death related to zipeprol abuse were further reported during 8 years (between 1991 and 1998). In addition to the hallucinogenic effect, dyspnea, extrapyramidal symptoms, seizure, cerebral edema have been reported as the signs and symptoms of toxic zipeprol overdose. However, zipeprol abuse is not common for old age people and non drug abusers. We report here on a fatal case of acute zipeprol poisoning in an eighty five year old drug addicted woman.

체외제거가 필요한 중독환자에서 응급의학과 의사에 의해 시행된 지속적신대체요법에 대한 임상적 고찰

안정환,최상천,정윤석,민영기,Ahn, Jung-Hwan,Choi, Sang-Cheon,Jung, Yoon-Seok,Min, Young-Gi 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.2

Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

베르테르 효과의 영향; 의도적 일산화탄소 중독의 증가

허인영,최상천,이정아,안정환,민영기,정윤석,조준필,김진숙,Heo, In-Young,Choi, Sang-Cheon,Lee, Chung-Ah,Ahn, Jung-Hwan,Min, Young-Gi,Jung, Yoon-Seok,Cho, Joon-Pil,Kim, Jin-Sook 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.2

Purpose: Suicide attempts are known to be influenced by mass media reports. The purpose of this study was to evaluate the effects of mass media reporting celebrity suicides on an increase of intentional carbon monoxide (CO) poisoning and suicide attempts. Methods: We retrospectively reviewed the medical records of the consecutive patients who presented with suicide attempts to the Emergency Department of Ajou University Hospital during a 24 month period. We obtained the demographic data, any past history of suicide attempt and the methods of suicide attempts from the medical records of the suicide attempters. Time series analysis was conducted for evaluating the influence of mass media reporting of celebrity suicide on the suicide rates. Results: We finally enrolled 770 patients during the study period. The total number of suicide attempts by CO poisoning was 18 and the average number of suicide attempts by CO was $0.33{\pm}0.73$ per week. All of the suicide attempts by CO poisoning occurred after a celebrity committed suicide using CO from burning charcoal. Conclusion: This study showed that celebrity suicide by CO poisoning resulted in the Werther effect, which made the rate of intended CO poisoning increase, and the study provided further evidence for the need to actively restrain mass media reporting of suicide to decrease the Werther effect.

베타차단제를 포함한 정신과적 약물 중독: 심혈관계 영향을 중심으로

주성우 ( Sung Woo Joo ),민영기 ( Young-gi Min ),최상천 ( Sang-cheon Choi ),박은정 ( Eun Jung Park ) 대한임상독성학회 2016 대한임상독성학회지 Vol.14 No.2

Purpose: Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system. Methods: A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled. Results: Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis. Conclusion: Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

응급실 증후군 감시체계의 운영 현황과 활성화 방안

조준필,민영기,최상천,Cho, Joon-Pil,Min, Young-Gi,Choi, Sang-Cheon 대한예방의학회 2008 예방의학회지 Vol.41 No.4

Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only fur the early detection of bioterrorism but also for more effective public health responses to disease.