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일개 병원에서의 일산화탄소 중독증으로 내원한 환자에 대한 분석
김경환,김아진,신동운,노준영,Kim Kyung Hwan,Kim Ah Jin,Shin Dong Wun,Rho Jun Young 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.1
Purpose: The frequency of carbon monoxide poisoning has been decreased in the interior of the Korea. But occasionally it is occurred and the risk of exposure is high in working place so far. Because of the characteristics of gas, the detection of exposure and poisoning could be delayed and fatality is high. We should apprehend of carbon monoxide poisoning. So we would report analysis of patients with carbon monoxide poisoning. Methods: A retrospective review of CO poisoned patients visited emergency department from January 2000 to December 2004 was conducted. Results: 24 patients were enrolled. Their average of age was $37.6\pm20.9$ years old and COHb was $19.4\pm13.32\%$. The blood level of initial COHb and mental status on arrival were not correlated each other. The blood level of initial COHb and loss of consciousness were not correlated, too. Initial electrocardiography (EKG) was not correlated with cardiac enzymes such as CK-MB and troponin I. But base excess was correlated with mental status on arrival and complication such as rhabdomyolysis. Hyperbaric oxygen therapy was correlated with base excess and mental status on arrival. Conclusion: The clinical features of carbon monoxide poisoning are nonspecific. For proper diagnosis, it is important that we should consider patient's environment and take patient's history carefully. The blood level of initial COHb does not reflect severity of poisoning accurately. So We should determine the treatment of choice depending on patient's status.
김경환,박준석,신동운,노준영,김혜진,구홍두,조진경,김아진,Kim Kyung-Hwan,Park Jun-Soek,Shin Dong-Wun,Rho Jun-Young,Kim Hey-Jin,Gu Hong-Du,Cho Jin-Kyung,Kim Ah-Jin 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1
Purpose: In the year of 2005, it enforced the basic study for establishing program of Poison Control Center by National Institute of Toxicologic Research. The object of our survey is to analyze the characteristics of intoxication from the City of Goyang by same protocol. Methods: We retrospectively reviewed the data of medical records of the intoxication patient in the two hospitals of the Goyang from 2004 June 1st to 2005 May 31th. The investigation protocol applied the TESS report form which was used from the Basic study for establishing program of Poison Control Center. Results: The intoxication patients were total 269 persons, the patients of A hospital were 184 persons, B hospital were 185 persons. The most common intoxication materials were medicines, in afterwords it was an agricultural chemical. The most common place of intoxication was the home. The intentional suicidal attempts in the reason of intoxication were 51.2%. The rate of the patients who discharges from the emergency department was 50.4% and death rate was 4.3%. Conclusion: We concluded that the continuous and systemic report and analysis should be accomplished from the Goyang area.
2세 미만 소아의 경도 두부 외상 후 두개골 골절 및 두개내 병변의 위험 인자
정종일 ( Jong Il Jeong ),김아진 ( Ah Jin Kim ),신동운 ( Dong Wun Shin ),노준영 ( Jun Young Rho ),김경환 ( Kyung Hwan Kim ),김홍용 ( Hong Yong Kim ),박준석 ( Jun Seok Park ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2
Purpose: This research was performed to determine which clinical signs and symptoms of brain injury are sensitive indicators of skull fracture (SF) and intracranial injury (ICI) in head injured children. Methods: We conducted a prospective study of minor head trauma in children younger than 2 years of age for a 1-year period. Skull radiographs, brain computed tomography (CT), and data forms, including mechanism of injury, symptoms, physical findings, and hospital course, were completed for each child. Results: Of 137 study subjects, 17 (12.4%) had SF/ICI. Falls were the most common mechanism of injury, and heights of fall above 1 meter were associated with incidence of SF/ICI (p<0.05). Scalp abnormalities were not associated with incidence of SF/ICI. As for clinical symptoms, lethargy and a grouping of features (irritability & vomiting) were associated with incidence of SF/ICI (p<0.05). The incidence of seizure, loss of consciousness, vomiting, irritability, and scalp abnormality did not differ significantly between those with normal radiologic findings and those with SF/ICI. Among asymptomatic patients, 11 (14.5%) patients had SF/ICI, and among patients with normal scalp findings, 9 (12.7%) patients had SF/ICI. Conclusion: Clinical signs and symptoms, except for lethargy and a grouping of features (irritability & vomiting), were not sensitive predictors of SF/ICI. Nevertheless, SF/ICI occurred among normal children. In such a case, a liberal policy of CT scanning is warranted. (J Korean Soc Traumatol 2007;20:83-89)
급성 심근경색증 진단을 위한 Triage® Cardiac System의 진단적 유용성 : Comparison with Established Devices
이상래,김미란,노준영,류석용,김홍용,김성준 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4
Purpose: The purpose of this study is to evaluate the diagnostic value of the Triage® Cardiac System (Biosite, USA) for quantitative detection of acute myocardial infarction. Methods: During a three-month period, we prospectively studied the cases of patients who visited the emergency department (ED) with suspicious acute ischemic chest pain. With the exclusion of patients with stable angina (according to ACC/AHA guideline) and non-cardiogenic chest pain, a total of 20 patients were studied. We evaluated the sensitivity and the specificity of the Triage® Cardiac System, and we compared the results with those from an established device (Elecsys® 1010, Boehringer Mannheim, Germany) by using a Pearson correlation and the student t-test. Results: The mean operating time of the Triage® Cardiac System was faster than that of the established device (16±1.2 min vs 30±0.6 min). The sensitivity and the specificity were same for the two devices. The sensitivity and the specificity of CK-MB were 63.6% and 88.9% respectively, and those of cardiac troponin were 54.5% and 100%. In the evaluation of patients who arrived at the ED after 4 hours of symptom onset, the sensitivity and the specificity were high. The Pearson correlation of CK-MB between the two devices was significant (r=0.970, p<0.01). The CK-MB values of acute myocardial infarction were significantly different with unstable angina (Triage® Cardiac System: t=2.857 p=0.017; Elecsys® 1010: t=2.804 p=0.018). Conclusion: The Triage® Cardiac System is a good diagnostic device for acute myocardial infarction, and its fast reporting of the result and its ease to use in the ED are superior to those of the established device.