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      • KCI등재

        Nicotine 패치에 의한 Nicotine 중독 증례

        손유동,이재성,강구현,최정태,안무업,서정열,안희철,Sohn, You-Dong,Lee, Jae-Sung,Kang, Gu-Hyun,Choi, Jung-Tae,Ahn, Moo-Eob,Seo, Jeong-Youl,Ahn, Hee-Cheol 대한임상독성학회 2007 대한임상독성학회지 Vol.5 No.1

        Nicotine poisoning arising from the use of nicotine patches is rare. However, because nicotine patches are classified as an OTC drug, the risk of misuse or abuse is increasing. Nicotine poisoning using nicotine patches shows an unusual clinical presentation compared to that from oral ingestion of multiple doses of nicotine. We present a case of misused nicotine patches that cause a nicotine poisoning. A thirty-nine year-old healthy man visited the ER with complaints of an intermittent cramping abdominal pain with nausea and vomiting. Upon physical examination, there were no specific findings except increased bowel sounds, and the patient's initial laboratory findings were also unremarkable except for an increased bilirubin level. CT revealed a mild degree of fatty liver. The patient's symptoms did not improve any further with conservative management. During his ED stay, we meticulously took his history again, and we discovered that he had used nicotine patches for three days, six days before admission, and had misused the nicotine patches as NSAID patches. The patient's diagnosis of nicotine poisoning was confirmed by a urine cotinine level ten times the normal value. After a 12-hour stay in the ED, his symptoms disappeared without any specific management.

      • KCI등재

        외상환자의 전산화 단층촬영소견에서 나타난 달무리 소견의 임상적 유용성

        이승용 ( Seung Yong Lee ),손유동 ( You Dong Sohn ),안희철 ( Hee Cheol Ahn ),강구현 ( Gu Hyun Kang ),최정태 ( Jung Tae Choi ),안무업 ( Moo Eob Ahn ),서정열 ( Jeong Youl Seo ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2

        Purpose: The management of hemorrhagic shock is critical for trauma patients. To assess hemorrhagic shock, the clinician commonly uses a change in positional blood pressure, the shock index, an estimate of the diameter of inferior vena cava based on sonography, and an evaluation of hypoperfusion complex shown on a CT scan. To add the finding for the hypoperfusion complex, the ``halo sign`` was introduced recently. To our knowledge, this ``halo sign`` has not been evaluated for its clinical usefulness, so we designed this study to evaluate its usefulness and to find the useful CT signs for hypoperfusion complex. Methods: The study was done from January 2007 to May 2007. All medical records and CT images of 124 patients with trauma were reviewed, of which 103 patients were included. Exclusion criteria was as follows: 1) age < 15 year old and 2) head trauma score of AIS ≥ 5. Results: The value of kappa, to assess the inter-observer agreement, was 0.51 (p < 0.001). The variables of the halo-sign-positive group were statistically different from those of the halo-sign-negative group. The rate of transfusion for the halo-sign-positive group was about 10 times higher than that of the halo-sign-negative group and the rate of mortality was about 6 times higher. Conclusion: In the setting of trauma, early abdominal CT can show diffuse abnormalities due to hypoperfusion complex. Recognition of these signs is important in order to prevent an unwanted outcome in hemorrhagic shock. We conclude that the halo sign is a useful one for hypoperfusion complex and that it is useful for assessing the degree of hemorrhagic shock. (J Korean Soc Traumatol 2007;20:144-148)

      • 노인 외상 환자의 임상적 고찰

        안희철,서정열,정재봉,최영미,최정태,유기철,안무업,최광민,김홍기,김성환,조준휘 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1

        Purpose: This study was conducted to examine various clinical factors for their ablity to predict mortality in geriatric patients following trauma. Methods: In this retrospective study, medical records from Chun Cheon Sacred Heart hospital were reviewed for patients 65 years and older who sustained trauma. The following variables were extracted and examined, independently and in combination, for their ablity to predict death: age, gender, mechanism of injury, blood pressure, and respiration, pulse rate, as well as Glasgow Coma Score, Revised Trauma Score, and Injury Severity Score. These patients had entered the hospital following trauma during a 2-year period (1999-2000). Results: The Injury Severity Score (more than 28), the Glasgow Coma Score (less than 9), and the Revised Trauma Score (less than 9), were variables that correlated with mortality. Mortality rates were higher for men than for women. Admission variables associated with the highest risks of death included hypotension (mean blood pressure <78 mmHg); pedestrian and motorcycle traffic accident; skull fracture, subdural hemorrhage, and diffuse axonal injury; and hemothorax and lung contusion. Conclusion: Admission variables in geriatric trauma patients can be used to predict the outcome and may also be useful in making decisions about triage, and treatment of the patient.

      • KCI등재후보

        C-단백 결핍에 의한 응고항진으로 발생한 폐동맥 혈전색전증

        조준휘,박찬우,조병렬,최대희,조성준,이성호,황성오,안희철,안무업,서정열,유기철 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1

        A pulmonary thromboembolism usually results from a serious complication of deep venous thrombosis (DVT). However, several prothrombotic genetic risk factors are known to predispose a patient to thrombotic events, with manifestation at a young age. Protein C and S deficiencies are known to increase the risk of venous thrombosis and pulmonary thromboembolism. We report a case of a young patient with protein C and S deficiencies suffering from a massive pulmonary thromboembolism.

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