소아 및 청소년 중독 환자에서 중독 양상의 차이

서주현,어은경,Suh Joo-Hyun,Eo Eun-Kyung 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Objectives: To analyze the general characteristics and clinical differences of poisoning in children and adolescents and to take precautions of occasions. Methods: We retrospectively evaluated poisoning children and adolescents (less than 19 years) visiting to the emergency medical center of tertiary hospital in urban area. We collected demographic data, substance exposure data (materials, causes of poisoning and amount), and clinical outcome of poisoning for the past 2 years and 9 months. Results: 189 cases were reported of concerning poisoning in children and adolescents. The age groups were divided into four categories. (1) Infants group:<2 year, (2) Preschool age group: $2{\sim}5year$, (3) Children group: $6{\sim}12year$ and (4) Adolescents group: $13{\sim}18year$. The most vulnerable age group was the infants group. There were two-peaks of age distribution in poisoned patients on the whole. Various types of materials belonged to classes of druqs (56.6%). household products (34.4%) and industrial solvents (9.0%). On adolescents group, the frequency of drug poisoning was significantly high, in comparison with infants, preschool age, and children group (p=0.001). Most of the patient groups had been poisoned accidentally(73.5%), while most cases of adolescents poisoning had been intentional. 63% of the adolescents group had a suicidal purpose. Conclusion: The incidence of poisoning was most highly due to drugs. The cause of poisoning is most commonly accidental. while in adolescent group, intentional poisoning is mostly common. Special cares, like keeping children away from drugs, will be needed to prevent children poisoning, and psychiatric consultation and supportive cares can reduce the adolescents poisoning cases.

시안화칼륨 중독으로 인해 발생한 파킨슨씨병 1례

서주현,어은경,Suh, Joo-Hyun,Eo, Eun-Kyung 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.2

Acute cyanide poisoning is usually the result of attempted suicide which is often lethal within minutes or leads to a very poor prognosis after delayed and inadequate treatment. It affects the cerebral structures with the highest oxygen requirement, such as the basal ganglia, the cerebral cortex. We experienced a-45-year-old man who ingested Potassium Cyanide. He was stuporous. In 25 minutes, respiratory arrest developed and cardiopulmonary resuscitation was done. After return of spontaneous circulation, he admitted to intensive care unit, and conservative treatment was started. The clinical status was improved by degrees, but he couldn't perform daily activity like before. Minimal limitation of movement and memory deficit were left. In magnetic resonance imaging, which taken at the 11th day after admission, there were both basal ganglia and folia of cerebellum abnormality.

유아의 다중지능과 관련된 생물생태학적 변인 연구 - 유아의 기질 및 어머니의 양육태도, 조화적합성을 중심으로 -

서주현,이순형,Suh, Joo-Hyun,Yi, Soon-Hyung 한국가정관리학회 2009 가정과삶의질연구 Vol.27 No.6

This study investigates how bioecological variables affect the child's multiple intelligence through independent and interactional ways. The subjects of this study were 147 pairs of 5-year-old children and their mothers, and the Project Spectrum was employed to measure multiple intelligences. Each mothers was asked to answer a questionnaire on her child's temperament, her maternal parenting style, 'goodness of fit' and 'the fit of child's intelligence'. Data were analyzed using a factor analysis and a hierarchical multiple regression with SPSS WIN 15.0. The main findings were as followings; First, 'the goodness of fit' to the child's temperament moderated the effect of a maternal parenting style that would foster child's dependency on the mathematical intelligence through interaction. 'The fit of child's intelligence' also moderated the effect of maternal positive parenting style to the child's mathematical intelligence. Second, in language intelligence, girls were more verbally intelligent than boys. In that regard, because the sex variable entails a combination of both inherent attribute and social-cultural effects, that result can be interpreted as an interaction between the individual and the environment. Lastly, a maternal parenting style that would foster child's dependency moderated the effect of the child's regular temperament on interpersonal intelligence. This means that the child's regular temperament can be a protective factor for the negative effect of a maternal parenting style that would foster child's dependency This study suggests that interactional factors such as 'goodness of fit' should be considered in studies involving children.

많은 양을 음독한 급성 amitraz 살충제 중독 1례

서주현,노형근,Suh, Joo-Hyun,Roh, Hyung-Keun 대한임상독성학회 2008 대한임상독성학회지 Vol.6 No.1

Amitraz is used as farm-animal insecticide. Its side effects in humans are related to its pharmacological activity on alpha 2-adrenergic receptors. The case describes a previously healthy 46-year-old woman who intentionally ingested approximately 250mL of liquid amitraz. She presented with vomiting, altered mental status, miosis, dry mouth, hypopnea, metabolic and respiratory acidosis, hypotension, hypothermia, polyuria, metabolic acidosis, elevated serum aminotransferase and abdominal distension. Supportive treatments including mechanical ventilation, hydration, dopamine infusion, bicarbonate infusion and gastric decompression resulted in improvement. By hospital day 3, she recovered with resolution of abdominal distension. It is paramount to recognize amitraz poisoning when a pesticide-intoxicated patient presets with signs and symptoms consistent with organophosphate intoxicated patients but with greater alpha 2-adrenergic related symptoms such as decreased bowel motility and xerostomia.

Zolpidem 중독의 임상적 특징에 대한 연구

서주현,노형근,어은경,전영진,정구영,Suh, Joo-Hyun,Roh, Hyung-Keun,Eo, Eun-Kyung,Cheon, Young-Jin,Jung, Koo-Young 대한임상독성학회 2008 대한임상독성학회지 Vol.6 No.2

Purpose: The hypnotic effect of zolpidem is comparable to benzodiazepines, but has less abuse and addiction potential than benzodiazepines, so is one of the most commonly prescribed hypnotics. The frequency of acute zolpidem overdose has increased, but clinical analysis and severity predictors are not known in Korea. Methods: A retrospective evaluation of histories, clinical courses, and laboratory findings of each patient treated from June, 2000, to May, 2006, in a university hospital for acute zolpidem intoxication. Results: We evaluated 30 patients, including 16 co-intoxication cases. Twenty-five patients presented mental alterations but became alert within 2 days. All patients recovered completely. The median zolpidem concentration was 0.9 mg/L (range: $0.2{\sim}7.4\;mg/L$). There was a weak correlation between the amount ingested and zolpidem concentration (r=0.25). None of them presented severe laboratory abnormalities, and these abnormalities did not relate to zolpidem concentration. Conclusion: The clinical progress of acute zolpidem intoxication is mild. We could not predict zolpidem concentration or clinical severity from the amount ingested and could not predict the clinical course from laboratory findings in the emergency department.

심한 간독성을 보인 amatoxin 중독 증례

서주현,김성진,정영국,최웅길,권영세,노형근,Suh Joo-Hyun,Kim Sung-Jin,Chung Young-Kuk,Choi Woong-Gil,Kwon Young-Se,Roh Hyung-Keun 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Poisoning with mushroom containing amatoxin may be a real medical emergency and is characterized by long incubation time lag, gastrointestinal symptoms, hepatotoxic phase and sometimes death. We report a family of parents and two children who ingested wild mushroom and recovered from varying degrees of hepatotoxicity. After eating cooked wild mushroom and its soup, they all developed abdominal pain, vomiting and diarrhea 11 hours later, Their liver enzymes reached peak level between 48 and 72 hours after the ingestion. Among the family members, 5-year-old girl showed the most severe hepatic toxicity of AST/ALT 14,099/13,176 IU/L. They were all treated with supportive measures including repeated activated charcoal and penicillin G and recovered from the hepatotoxicity between 7 and 28 days after the ingestion. Being based on the shape and a typical course of the amatoxin poisoning, we presume that this wild mushroom belongs to Amanita virosa.

어머니의 정서적 자녀가치가 어머니와 아동의 행복감에 미치는 영향: 양육스트레스와 모자상호작용의 매개효과

서주현(Suh, Joo Hyun),배희분(Bae, Hee Boon) 학습자중심교과교육학회 2019 학습자중심교과교육연구 Vol.19 No.4

본 연구는 어머니의 정서적 자녀가치가 양육스트레스와 모자상호작용을 매개로 어머니의 행복감과 궁극적으로 아동의 행복감에 미치는 영향을 구조적으로 파악하는 데 목적을 두었다. 이를 위해 육아정책연구소 한국아동패널 6차(2013년), 8차년도 (2015년) 조사에 모두 응답한 1,269쌍의 어머니와 아동 데이터를 활용하였으며 구조 방정식 모형과 붓스트랩 방식으로 검증하였다. 연구결과 자녀가 만 5세 때 어머니가 인식하는 정서적 자녀가치는 2년 후 자녀 초등학교 입학 시기에 겪게 되는 양육스트 레스와 모자상호작용을 매개로 어머니 본인의 행복감은 물론 자녀의 행복감에도 영향을 미치는 것으로 나타났다. 이를 통해 그동안 연구가 부족했던 정서적 자녀가치의 중요성을 확인하였고, 양육스트레스와 모자상호작용의 개선과 증진이 어머니와 초등학교 전이기 아동의 행복감을 높이기 위해 필요함을 알 수 있었다. 이러한 결과는 어머니와 자녀가 모두 행복해지려면 정서적 자녀가치를 높이는 것은 물론, 어머 니의 양육스트레스를 낮추고 모자간 상호작용의 시간과 기회를 증진하는 다양한 방안들이 모색되어야 할 것이라는 정책적, 교육적 제언을 가능하게 하는 것이다. This study is for investigating structural relationships about the effect of the mother’s emotional value for their children on happiness of mother and children mediated by parenting stress and mother-child interactions. The data were derived from research of Panel Study of Korean Children. The data of 1,269 Pairs of mother and their child who participated in both 6th and 8th Panel Study were analyzed by Structural Equation Model using SPSS and AMOS. To verify mediating effects, Bootstrapping methods were used. Results is as follows. Mother’s emotional value for their children affects happiness of mother and children mediated by parenting stress and mother-child interactions. This results is significant as it verifies the importance of mother’s emotional value for their children and it implies the intervention or execution of program to help mothers to perceive the value of their children can improve mother-child interactions and reduce parenting stress and this may lead to improve mother’s happiness and to the end to children’s happiness.

실시간 되먹임 지도가 일반인들이 가슴 압박만 하는 심폐소생술의 질에 미치는 영향

서주현(Joo Hyun Suh),김경욱(Kyung Wuk Kim),강지훈(Ji Hoon Kang),고재욱(Jai Woog Ko) 한국의료시뮬레이션학회 2013 한국의료시뮬레이션학회지 Vol.2 No.1

추락 후 사망 예측인자로서의 추락 높이

서주현 ( Joo Hyun Suh ),어은경 ( Eun Kyung Eo ),정구영 ( Koo Young Jung ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.2

Purpose: The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve analysis. Results: The mean age of patients was 36.5±19.4 years old. 110 were male and 35 were female. Mean height of fall was 11.1±8.5m. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is 8.9±5.8m for 94 survivors and 15.2±11.0m for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between ``below 13.5m group`` and ``above 13.5m group``, but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient`s death.

아버지의 자녀가치가 아버지와 아동의 행복감에 미치는 영향 : 양육행동의 매개효과

서주현(Suh, Joo Hyun) 학습자중심교과교육학회 2020 학습자중심교과교육연구 Vol.20 No.4

본 연구는 아버지의 정서적, 도구적 자녀가치가 아버지의 온정적 양육행동과 통제적 양육행동을 매개로 하여 아버지의 행복감에 영향을 미치고 이를 통해 궁극적으로 아동의 행복감에 미치는 영향력의 경로를 구조적으로 파악하고자 하였다. 이를 위해 육아정책연구소 한국아동패널 6차(2013), 8차년도(2015) 조사에 모두 응답한 1,269쌍의 아버지와 아동을 대상으로 구조모형을 검증하였다. 연구 결과, 자녀가 만 5세경에 아버지가 인식하는 자녀에 대한 정서적 자녀가치는 아버지의 온정적 양육행동을 매개로 하여 2년 후 자녀가 초등학교에 입학하는 시기의 아버지의 행복감에 영향을 미치고 이는 자녀의 행복감에도 영향을 미치는 것으로 나타났다. 반면, 아버지의 도구적 자녀가치는 자녀의 행복감에 유의한 직접적, 간접적 영향을 미치지 않는 것으로 나타났다. 이러한 결과는 아버지가 자녀 양육에 있어 정서적인 가치를 높게 인식할수록 자녀에게 온정적 양육행동을 많이 하게 되고 이는 아버지의 행복감 및 아동의 행복감을 높이는 요인이 되므로 아버지가 자녀 양육에 대한 정서적 가치를 높게 인식하는 것이 중요함을 의미한다. 따라서, 아버지가 자녀 양육의 정서적 가치를 인식할 수 있는 교육 프로그램의 개발과 실행이 아버지와 자녀의 행복감을 높일 수 있는 유용한 조기 개입 방안으로 추천된다. This study is for investigating structural relationships about the effect of the father’s emotional/instrumental value for their children on happiness of father and their children mediated by warm/dominant parenting behaviors. The data were derived from research of Panel Study of Korean Children. The data of 1,269 Pairs of father and their child who participated in both 6th and 8th Panel Study were analyzed by Structural Equation Model using SPSS and AMOS. To verify mediating effects, Bootstrapping methods were used. Results is as follows. Father’s emotional value for their children affects happiness of father mediated by warm parenting behaviors and it affects the happiness of their child. Father’s instrumental value for their children didn’t affects happiness of father and their child. This results is significant as it verifies the importance of father’s emotional value for their children. It also implies the intervention or execution of program to promote fathers’ perception of the emotional value of their children can improve fathers’ warm parenting behaviors and this may lead to heighten father’s happiness and to the end children’s happiness, too.