이동체 데이터의 근접성을 이용한 디클러스터링 방법

홍은석(Eun-Seok Hong),서영덕(Young-Duk Seo),홍봉희(Bong-Hee Hong) 한국정보과학회 2003 한국정보과학회 학술발표논문집 Vol.30 No.1A

컴퓨터와 무선 통신 기술의 발달로 인하여 LBS(Location based Service)와 같은 새로운 이동체 관련 서비스가 생겨나고 있다. 이와 같은 서비스들은 이동체들이 일정 주기를 가지고 자신의 정보를 서버로 전송하는데 이는 많은 디스크 입출력을 요구하게 된다. 그러므로 이동체 데이터에 대하여 다중 디스크를 이용한 병렬 입출력이 요구되고 있다. 그러나 기존의 디클러스터링 방법은 시간 도메인을 고려하지 않거나 공간 관련성만을 고려하여 디클러스터링을 하므로, 하나의 디스크에 특정 이동체의 궤적이 집중 되는 문제점이 있다. 이 문제점은 디스크의 병목현상으로 인한 느린 응답시간과 낮은 처리율의 결과를 발생시킨다. 그러므로 이동 객체의 빠른 질의 처리를 위한 새로운 디클러스터링 기법이 필요하다. 이 논문에서는 다중 디스크 기반의 시스템에서 이동 객체에 대한 영역질의시 빠른 응답시간과 높은 처리율을 얻기 위하여 새로운 디클러스터링 기법을 제시한다. 이동체 데이터의 궤적 MBB중 공간 좌표로부터 Predefined Disk를 생성하고 PDT-Proximity를 이용하여 시간 도메인을 고려하는 방법이다. 위와 같이 이동객체의 특성을 고려한 새로운 디클러스터링 방법으로 시스템의 성능을 향상시킬 수 있다.

골반골 골절로 인한 동맥 파열로 동맥 색전술을 시행받은 환자에서의 생존 비교

김우연 ( Woo Youn Kim ),홍은석 ( Eun Seok Hong ),홍정석 ( Jung Seok Hong ),안력 ( Ryeok Ahn ),황재철 ( Jae Cheol Hwang ),김선휴 ( Sun Hyu Kim ) 대한외상학회 2008 大韓外傷學會誌 Vol.21 No.1

Purpose: This study was to evaluate the effect of arterial embolization on survival in patients with pelvic bone fractures and arterial bleeding. Methods: From January 2001 to December 2007, in all, 18 patients with pelvic bone fractures that had been treated with interventional arterial embolization were included in this retrospective study. The Injury Severity Score (ISS), the Revised Trauma Score (RTS), the initial hemodynamic status, the blood gas analysis, blood transfusion data, and mortality were the main outcome measurements. Results: Pelvic bone fractures were classified into lateral compression (LC), antero-posterior compression (APC), vertical shear (VS), and combined (CM) type according to the Young-Burgess classification. The Survivor group included 11 patients (61.1%), and the non-survivor group included 7 patients (38.9%). The mean ages for the survivor and the non-survivor groups were 40.0 and 45.6 years (p=0.517). The types of pelvic bone fractures were LC 11 (61.1%), APC 6 (33.3%), and VS 1 (5.6%): LC 7 (63.6%), and APC 4 (36.4%) in the survivor group and LC 4 (57.1%), APC 2 (28.6%), and VS 1 (14.3%) in the non-survivor group. The internal iliac artery was the predominant injured vessel among both the survivors (n = 5, 45.5%) and the non-survivors (n = 4, 57.1%). No differences in initial blood pressures, ISS, and RTS existed between the two groups, but the arterial pH was lower in the non-survivor group (pH 7.09 (±0.20) vs 7.30 (±0.08), p=0.018). The number of transfused 24-hour units of packed RBC was greater in the non-survivor group (24.1±12.5 vs 14.4±6.8, p=0.046). Conclusion: No differences in initial blood pressure and trauma scores existed between survivors and non-survivors with pelvic bone fractures, who had been treated with arterial embolization, but arterial pH was lower the in non-survivors.

6미터 이하 저고도 추락 환자의 안전성 여부

서영우 ( Young Woo Seo ),홍정석 ( Jung Seok Hong ),김우연 ( Woo Yun Kim ),안력 ( Ryeok Ahn ),홍은석 ( Eun Seok Hong ) 대한외상학회 2006 大韓外傷學會誌 Vol.19 No.1

Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (≥3 m, <6 m), and group C (≥6 m). Collected data included the patient`s age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients` ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn`t have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall. (K Korean Soc Traumatol 2006;19:54-58)

저속 추돌 사고 시 에어백 팽창에 의한 손상

김규열 ( Gyu Yeol Kim ),배정한 ( Jeong Han Bae ),서영우 ( Young Woo Seo ),조홍래 ( Hong Rae Cho ),홍은석 ( Eun Seok Hong ) 대한외상학회 2003 大韓外傷學會誌 Vol.16 No.2

In addition to lap and shoulder belt, automotive airbag has reduced the frequency of fatalities and serious injuries from motor vehicle crash. Today, an increasing number of automobiles are being equipped with additional passive safety devices: driver and passenger airbags. With this increasingly frequent application of these safety features in automobiles, there are increasing number of reports about airbag-associated injuries including minor trauma on mainly head, face, eye, chest, and extremities. And also a little number of lethal injuries by airbag deployment were reported. That is even occurred at low velocity traffic collision. If the driver or passenger have his or her hand or arm across the steering wheel hub or torso move forward and contact with airbag module cover before airbag deployed especially if the lap-shoulder restrain is not worn, airbag deployment is then much more likely to cause serious injury even in the very low speed crash. In a review of literatures, the effectiveness of the passenger-side airbag and few data on passenger-side airbag related injury in the frontal crash doesn`t known in Korea, because most cars are equipped with only the driver`s side airbag and the low occupancy rate of the frontal passenger side airbag. This report describes three patients with severe injuries that were caused by airbag inflation during low velocity motor vehicle accidents. We should be aware of the explosive nature of airbag deployment and realize that the injury may be far greater than expected from a low energy motor vehicle accident.

내재된 둔상으로 인한 좌측 총 장골동맥 파열에 따른 출혈성 심정지 (질 내 경로를 통한 자위 행위로 인한 손상 의심): 증례보고

경규혁 ( Kyu Hyouck Kyoung ),김미진 ( Mi Jin Kim ),최병호 ( Byung Ho Choi ),홍정석 ( Jung Seok Hong ),홍은석 ( Eun Seog Hong ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4

A 34-year-old woman experienced a sudden cardiac arrest after complaining of abdominal pain. The cause of that serious event was a hidden hemorrhagic shock. On computed tomography of her pelvic area, we found that her left common iliac artery had been ruptured. No bone fractures were observed. Her angiography showed neither atherosclerosis nor an aneurysm of the artery. Because spontaneous ruptures of the common iliac artery are rare, we suspected, based on her husband’s statement, that a hidden blunt trauma to the artery had occurred via an endo-vaginal route due to dildo masturbation. Unfortunately, she died without recovery, in spite of our having controlled the bleeding by using an angiographic endovascular stent-graft. [ J Trauma Inj 2014; 27: 211-4 ]

외상후 복부 다발성 고형장기 손상

박형도 ( Hyung Do Park ),김선휴 ( Sun Hyu Kim ),이종화 ( Jong Hwa Lee ),홍정석 ( Jung Seok Hong ),홍은석 ( Eun Seog Hong ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.2

Purpose: This study evaluated the characteristics and the prognosis of multiple intraabdominal solid organ injuries, including those to the liver, spleen, and kidney, after blunt trauma. Methods: From January 2001 to March 2009, 39 patients with multiple intraabdominal solid organ injuries, which had been confirmed by contrast-enhanced computed tomography after blunt trauma, were included in this retrospective study. The injury severity score (ISS), abbreviated injury scale (AIS), revised trauma score (RTS), American Association for the Surgery of Trauma (AAST) injury grade of solid organs, initial hemodynamic status, blood gas analysis, blood transfusion, and the mortality were the main outcome measurements. Results: Injured groups were classified into liver/kidney (n=17), liver/spleen (n=4), spleen/kidney (n=13), and liver/kidney/spleen (n=5) groups. Patients were older in the liver/kidney group than in the liver/kidney/spleen group (43 vs 18 years, p=0.023). The initial systolic blood pressures tended to be lower in the liver/kidney group than in the other groups (84 vs 105, 112, and 114 mmHg, p=0.087). The amounts of 24-hour packed RBC transfusion were 32 units in the liver/kidney group and 4 units in the liver/kidney/spleen group, but the difference was not statistically significant. Differences were found in neither the RTS, ISS, and AIS for head, chest, abdominal, and pelvic injuries nor the AAST injury grade for solid organ, but injuries to the chest were more severe in the liver/spleen group than in the spleen/kidney group (AIS 4.0 vs 2.8, p=0.028). Conservative treatment was the most frequent applied treatment in all groups. There were 6 mortalities: 3 due to hypovolemia, 2 to sepsis, and 1 to brain injury. Mortalities occurred only in the liver/kidney group. Conclusion: Patients who had intraabdominal solid organ injuries of the liver and the kidney simultaneously, tended to be transfused more at an early time after trauma, to have lower initial systolic blood pressures, and to have a higher mortality. (J Korean Soc Traumatol 2009;22:193-8)

한국인의 항파상풍 항체의 정성적 조사

손유동 ( You Dong Sohn ),임경수 ( Kyoung Soo Lim ),최욱진 ( Wook Jin Choi ),안지윤 ( Ji Yun Ahn ),김원 ( Won Kim ),최윤백 ( Youn Back Choi ),홍은석 ( Eun Seok Hong ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.1

Background: In Korea, vaccination against tetanus began in the mid-1950s. At present, there is a routine immunization schedule with diphtheria, pertussis, and tetanus (DPT) vaccines at 2,4,6 month after birth and booster at 15-18 month and 4-6 years. However, further prophylactic programs according to guidelines of Center for Disease Control do not exist due to the absence of tetanus toxoid. And we have usually used only passive immunization, tetanus immunoglobulin, as a prophylactic regimen for injured patients. In this study, we aimed to determine the tetanus antibody titers levels of Koreans and point out problems of prophylactic programs after a routine immunization schedule. Methods: This study was conducted with 112 healthy adults from August 29, 2003 to September 19, 2003. No volunteers had unstable vital signs, or had taken any medication for chronic illnesses. A questionnaire was used for the volunteers to assess their knowledge about tetanus vaccination schedule, and the whole blood was withdrawn from each volunteer to determine qualitative anti-tetanus antibody titers using TQS (Tetanus Quick Stick). TQS had been introduced as a rapid, easy method to determine the immune status. Results: Of the 112 studied subjects, only 13 (11.6%) were found to have protective levels of anti-tetanus antibody titers. There was no association between quantitative antibody titers and age, sex, educational status, economy, place of birth or residence, military service, and vaccination. Conclusion: Although tetanus is a preventive disease by the antibodies developed as a result of vaccination and its occurrence is not very common, it is associated with a rather high mortality rate. Recently, there has beena tetanus immunization shortage in Korea caused by an absence of tetanus toxoid. The effect of a tetanus shortage makes the tetanus antibody values go under the protective level for most adults. We recommend that tetanus prophylaxis in Korea should be performed following the guidelines of Center for Disease Control and Prevention.

응급센터로 내원한 외상성 심낭삼출 환자의 치료

조준휘,이강현,오범진,김성환,강구현,황성오,박승일,김은기,홍은석 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

Background : Current guidelines of advanced trauma life support recommend open thoracotomy when pericardiocentesis reveals bloody pericardial effusion in patients with blunt chest trauma. However, open thoracotomy may not be always required for treating patients alive until arriving emergency department, because rapid accumulation of the blood into pericardial space results in immediate death at scene. We report our experiences of treating traumatic pericardial effusion, and discuss the therapeutic modality in patients with traumatic pericardial effusion. Methods : The study consisted of 37 patients(20 males and 17 females with the mean age 42) sustaining traumatic pericardial effusion. The patients were divided according to treatment modality into 3 groups(group Ⅰ: patients receiving conservative management, group Ⅱ: patients treated with pericardiocentesis, group Ⅲ: patients required emergency thoracotomy). We compared clinical presentations, hemodynamic profiles and echocardiographic findings among three groups. Results : Cardiac tamponade was present in 14 of 37 patients. Pericardiocentesis was performed in 13 patients, and open thoracotomy in 4 patients. Pericardiocentesis was curative in 9 patients. Thoracotomy was performed in only 3(24%) of 13 patients required pericardiocentesis. 3 (75%) of 4 patients having moderate or severe pericardial effusion from penetrating injury were required open thoracotomy. Conclusion : In selected patients who have traumatic pericardial effusion by blunt chest injury, pericardiocentesis may be curative, and thoracotomy may not be required as long as bleeding via indwelling pericardial catheter is not sustained after pericardiocentesis.

응급환자의 중증도 분류를 위한 지표의 개발 : Triage Score와 Modified Triage Score NEW METHODS TO TRIAGE ALL EMERGENCY PATIENTS

임경수,홍은석,김선만,황성오 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Up to now, triage system for all emergent patients, which can be used fast and conviently according to their severity has not been developed yet. For the triage of trauma patient, emergency medical technicians and emergency medical doctors are commonly using R.T.S. (Revised Trauma Score). The R.T.S. consists of GCS(Glasgow coma scale), systolic blood, pressure and respiration rate per minute. But it is difficult for emergency medical technicians to calculate GCS in the prehospital because of its complexity and need for more time. Therefore we develop the Triage Score by remodelling the R.T.S. by replacing GCS with AVPU scale and systolic blood pressure that is under 49 mmHg after adding 1-49 mmHg with 0 mmHg and respiration rate per minute that is under 5/min after adding 1-5/min with 0/min. We stuied the significance and the possible triage application of Triage Score in traumatic emergency patients. For nontraumatic emergency patients, we develop the Modified Triage Score to triage the cardiovascular emergencies by adding the item of chest pain to Triage Score. A prospective study was carried out on 530 patients from March 1 to 31 1996. There were 210 trauma patients and 320 nontraumatic emergency patients and the result shows as follows. For trauma patients, there was linear correlation between R.T.S. and Triage Score(R²=0.965). Comparison analysis between high risk group (admission+death patients) and low risk group(discharge patients) of nontraumatic emergency patients by using Modified Triage Score is statistically significant(P<0,001) The cardiovascular emergencies could not categorized as urgency by Triage Score, but that was possible by application of Modified Triage Score. In conclusion, we can triage the injured patients effectively by Triage Score and the nontraumatic emergency patients including emergency cardiovascular disease can be categorized as urgency by applying the Modified Triage Score.

하부 늑골골절과 masked 복부손상과의 상관관계

이강현,임경수,홍은석,황성오 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Some emergency physicians neglect abdominal injuries if a patient does not complaint of abdominal pain or abdominal tenderness was absent on physical examination. But intra-abdominal injuries are correlated closely with lower rib fractures and pelvic bone fractures. In cases of lower rib fractures, intra-abdominal organs are injured as a diaphragm is elevated as high as 5th intercostal space in expiration period. When intra-abdominal solid organ is ruptured, a patient complaints of abdominal pain, but there`s no abdominal pain if small hematoma occurs in solid organs. Although the most of solid organ hematoma are resolved spontaneously without complications, sometimes delayed rupture of hematoma occurs especialy in patients with the coagulopathy. So emergency physician must evaluate the abdomen closely when the possibility of intra-abdominal injury is high. To evaluate the intra-abdominal injuries, we investigated 57 patients with lower rib fractures by ultrasonography. The patients were divided in 2 groups according to presence of abdominal symptomes; patients with abdominal symptoms(n=10). Among 57 patients, intra-abdominal injuries were found in 35 patients. In group with lower rib fractures and presence of abdominal symptoms, intra-abdominal injuries were diagnosised in 32 patients(68.9%) with 48 cases(hepatic injury; 20, spleen injury; 19, renal injury 7, hemoperitoneum without solid organ injury; 2). In group with lower rib fractures and abscence of abdominal symptoms, intra-abdominal injuries were diagnosised in 3 patients(30.0%) with 3 cases(spleen injury; 1. hemoperitoneum without solid organ injury;2). In conclusion, emergency physician must do ultrasonography to evaluate intra-abdominal injuries in patients with lower rib fractures although a patient does not complaint of abdominal pain.