Tox-Info 시스템의 중독정보 데이터베이스와 응급실에 내원하는 중독 환자 분포의 비교

김현종 ( Hyun Jong Kim ),김양원 ( Yang Weon Kim ),김현 ( Hyun Kim ),박창배 ( Chang Bae Park ),소병학 ( Byung Hak So ),이경룡 ( Kyeong Ryong Lee ),이경우 ( Kyung Woo Lee ),이경원 ( Kyung Won Lee ),이성우 ( Sung Woo Lee ),이장영 ( 대한임상독성학회 2012 대한임상독성학회지 Vol.10 No.1

Purpose: The Tox-Info system is a poisonous substance information database developed by the Korean National Institute of Food and Drug Safety Evaluation. The aim of this study was to estimate the coverage effectiveness of the Tox-Info system by comparing the toxic substances included in the database with the distribution of the toxic substances implicated in the cases of intoxicated patients presenting to emergency departments. The secondary aim of the study was to propose any additional substances that should be added to the database. Methods: We retrospectively reviewed the medical records of patients suffering with toxic exposure who had visited any of 12 selected emergency departments in Korea from January 2010 to December 2011. The identified toxic substances were classified into groups including prescription drugs, agricultural chemicals, household products, animals or plants, herbal drugs, and others. We calculated the coverage rate of the Tox-Info database relative to the number of intoxication cases and the type of toxic substances involved. Results: A total of 5,840 intoxicated patient records were collected. Their mean age was 46.6±20.5 years and 56.2% were female. Of the total intoxication cases, 87.8% of the identified toxic substances were included in the Tox-Info database, while only 41.6% of all of the types of identified toxic substances were included. Broken down by category, 122 prescription drugs, 15 agricultural chemicals, 12 household products, 14 animals or plants and 2 herbal drugs involved in poisoning cases were not included in the Tox-info database. Conclusion: This study demonstrated the clinical usefulness of the Tox-Info system. While 87.8% of the substances involved in the cases were included in the Tox-Info database, the database should be continuously updated in order to include even the most uncommon toxic substances.

유기인계-피레스로이드계 혼합제제 농약에 의한 중독

홍대영,백광제,이경룡,권운용,박준석,어은경,오범진,이미진,이성우,서주현,노형근,김준식,Hong, Dae-Young,Baek, Kwang-Je,Lee, Kyeong-Ryong,Kwon, Woon-Yong,Park, Joon-Seok,Eo, Eun-Kyung,Oh, Bum-Jin,Lee, Mi-Jin,Lee, Sung-Woo,Suh, Joo-Hyun,Roh, 대한임상독성학회 2007 대한임상독성학회지 Vol.5 No.1

Purpose: Owing to organophosphate-pyrethroid mixtures are widely used, suicidal or unintentional poisoning is common. But there have been relatively few reports of poisoning. The purpose of this study is to evaluate the difference of the severity and toxicity between organophosphate-pyrethroid mixtures poisoning and single organophosphate poisoning. Methods: From August 2005 to July 2006, 65 patients presented with organophosphate-pyrethroid mixtures poisoning to emergency medical center. Date were gathered by report form it was drawn up. Results: 65 patients were enrolled in 28 hospitals and their mean age was $56.5{\pm}16.2$ years old. The most common cause of poisoning was suicide, in 52 cases(80%). Chlorpyrifos-cypermethrin, malathion-esfenvalerate were the most frequent chemicals involved, and the mean ingestion amount was 135.4ml. The most common symptom of the patients was nausea/vomiting, in 16 patients. The average GCS score was 13. The mean ICU stay was $4.4{\pm}5.2$ days, and mortality was 3.1%. Conclusion: The severity and toxicity of organophosphate-pyrethroid mixture poisoning were lower than that of single organophosphate poisoning.

일상 환경에서 정서 상태 정보 수집을 위한 IoT 벽걸이형 기기의 멀티모달 알림 방식 탐구

장상수(Sangsu Jang),이경룡(Kyung-Ryong Lee),김도희(Doohee Kim),고건일(Geonil Goh),윤가희(Gahui Yun),한민주(Minju Han),김수빈(Subin Kim),김형숙(Hyungsook Kim),박영우(Young-Woo Park) 한국디자인학회 2021 한국디자인학회 학술발표대회 논문집 Vol.2021 No.5

GP2X를 기반으로 한 슈팅 게임의 기획 및 구현

황은섭(Eun-Seob Hwang),이경룡(Kyung-Ryong Lee),이지연(Ji-Yeon Lee),김새롬(Sea-Rom Kim),주문원(Moon-Won Choo),노웅기(Woong-Gee Noh) 한국멀티미디어학회 2010 한국멀티미디어학회 학술발표논문집 Vol.2010 No.2

국내 토종 휴대용 게임기 제조사인 GPH사에서 출시하고 있는 GP2X WIZ 를 기반으로 한 슈팅게임 개발사례를 소개한다. 게임의 난이도 레벨 선정함에 있어 유연성을 향상시키고 웜홀시스템이란 새로운 게임적 요소를 제안하고 있다. 이 시스템은 플레이 중간에 다른 공간 으로 이동할 수 있는 포탈이 랜덤으로 생성되고 다른 공간으로 이동하며 공간의 속성이 동적으로 변화함으로써 매니아적 특성을 진행시킬 수 있는 요소이며, 캐릭터 자체가 변하는 기존의 슈팅게임에 비해 주인공 캐릭터에게 직업을 부여해 선택한 직업에 따라 캐릭터 스프라이트와 공격기술을 다르게 적용하는 또 다른 새로운 요소도 구현하고 있다.

의도성 여부를 중심으로 한 일산화탄소 중독환자의 임상적 특성

조민기 ( Min Ki Cho ),김양원 ( Yang Weon Kim ),이경룡 ( Kyeong Ryong Lee ),이경우 ( Kyung Woo Lee ),이장영 ( Jang Young Lee ),조규종 ( Gyu Chong Cho ),조준호 ( Junho Cho ),김현종 ( Hyun Jong Kim ),김승환 ( Seong Hwan Kim ),정성필 대한임상독성학회 2012 대한임상독성학회지 Vol.10 No.2

Purpose: The purpose of this study was to identify the changes in the characteristics of patients with carbon monoxide (CO) poisoning, as well as the distinctive differences in intentionally exposed patients. Methods: The medical records of CO poisoning patients, who visited nine emergency departments between January 2010 and December 2011, were reviewed retrospectively. The clinical information including age, gender, hospitalization, type of discharge, cause and location of exposure, site of onset, concentration of initial blood carboxyhemoglobin (COHb), methods of treatment and presence of neurological complications was examined. The subjects were divided into an intentional and non-intentional group and the differences between them was compared. Results: A total 209 subjects were recruited. The median age was 38 years (29~49.5 years). They frequently complained of nausea and vomiting, and the most common exposures occurred in winter, normally in the home. The cause of exposure was usually fire, followed by incomplete combustion of fuels. The median initial blood COHb was 13.15%. The proportion of intentionally exposed patients was 21%. They were significantly younger, more frequently discharged against medical advice, and showed a higher initial blood COHb level (22.85%) than the non-intentional group. Conclusion: This study suggests that those with intentional CO poisoning are normally discharged against medical advice even when they have a higher initial COHb level. An adequate explanation of the delayed neurologic sequelae and short term follow-up observation is recommended for those patients with intentional exposure.

위에 발생한 거대 위장관 간질종양 1예

이경영,유영범,김태원,이경룡 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Gastrointestinal tumors(GIST) are rare group of neoplasias of the gastrointestinal track, which originate from or differentiate into interstitial cells of Cajal (ICC). GIST traditionally have been designated as smooth muscle tumor. However, with increasingly accurate analytic tools, immunohistochemistry and ultrastructure, most investigators were able to demonstrate that ICC, a complex cellular network postulated to act as pacemaker cells of the gastrointestinal track, which exhibit both myoid and neural features, could be a candidate for tumor histogenesis. Most ICC are only c-kit-positive, however a subset are positive for both c-kit and CD34. Most GISTs are asymptomatic and are thus usually discovered incidentally during routine check, at operation of other organs. When symptoms occur, GISTs usually present with gastrointestinal bleeding due to ulceration of the overlying gastric mucosa. Bleeding may be massive, leading to hematemesis and melena. Recently, we experienced a large sized(5×5×5 cm) GIST on the upper body of the stomach, which caused massive upper gastrointestinal bleeding in a 61-year-old man and was treated by local resection with adequate safety margin about 2 cm.

Adrenaline-Cocaine gel의 국소마취 효과

김옥준,최옥경,이경룡,장석준,구홍두,정성필,하영록,박인철,김승환,심호식 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2

Lidocaine is commonly used in children as well as adults as a local anesthetics for dermal laceration repair. Local infiltration of wounds with lidocaine(local anesthetics) inflicts pain on pain, particularly distressing in children. To avoid this pain, the use of topical tetracaine-adrenaline-cocaine(TAC) solution and adrenalin-cocaine(AC) gel is proposed. We have evaluated the anesthetic effect of AC gel for minor dermal laceration repair. For three months(Jul to Oct, 1994), the residents of emergency medicine have sutured minor dermal laceration patients who were treated at to the Department of Emergency Medicine, Severance Hospital Yonsei University College of Medicine. The patients population ranged from 9 months to 46 years with an average of 10.2 years. Thirty of the patients were younger than 10 years of age. Lacerations were located on the face in 33 patients and on the scalp in 4 patients. Larger lacerations were encountered in 4 patients. The average dose of AC gel applied per laceration was 0.45 mL(containing 81.9mg cocaine). Two hundred thirty four sutures of total 240 (97.5%) were placed without eliciting any pain. The average anesthetic induction time was 123 seconds. There were no observed adverse reactions with AC gel application or reported complications of wound healing in any patient. Our results support the use of AC gel is an excellent anesthetic effect for dermal laceration.

한국 소아에서 적절한 기관내 삽관의 깊이

윤유상,강형구,이경룡,박인철,윤천재,이한식,김승호 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3

Purpose: In pediatric intubation, it is difficult to select the correct tracheal tube size and proper depth. Children have as many different tube size as they have ages. This study was performed to evaluate the Pediatric Advanced Life Support(PALS) guideline for intubation in Korean children. Methods: We studied pediatric patients who were admitted with intubation from 1996 to 2001 at out hospital. We selected 33 Korean patients under 15 years of age for evaluation in this study. Their medical records and chest radiographs were compared. The distance of the tracheal tube tip from the carina on the postintubation chest X-ray was determined. Results: Thirty-three patients were enrolled in the study. The depth of tracheal intubation was proper in 12 patients (36.3%), too deep in 16 patients (48.4%), and too shallow in 5 patients (15.1%). The reasons for intubation were respiratory failure (24.2%), mental change (57.6%), and status epilepticus (18.1%). Conclusion: We conclude that the PALS guideline for tracheal intubation is not suitable for Korean children. Determination of the proper depth of tracheal intubation for Korean children is needed though further study. Department of Emergency Medicine, Kon-Kuk University College of Medicine, Cjungju, Korea¹

젊은 여자에서 우연히 발견된 원발성 후복막 기형종 1예

유영범,이경영,성무경,조승제,전혜정,이경룡 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-

Primary retroperitoneal teratomas are rarely seen in adults. They occur mostly in children. They are usually asymptomatic in adults, but they may cause symptoms due to tumor compression. As the tumors grow larger, palpable abdominal mass, progressive abdominal distension, abdominal pain, and even nausea and vomiting are occasionally noted. The diagnosis of retroperitoneal teratoma can be made accurately by CT scan. And ultrasonography and magnetic resonance(MR) imaging are also a helpful tools in delineating the precise position. Retroperitoneal teratomas should be surgically removed if possible, regardless of where they are benign or malignant because histologically benign ones may eventually prove fatal due to continued growth. We report a huge (12 x 7 x 9.5 em) primary retroperitoneal teratoma which were found incidentally and complete resected in a 27-year-old female patient.

중증도 분류도구로서 변형 Emergency Severity Index의 평가자간 신뢰도

박유석,조진경,윤천재,박인철,이경룡,김승호 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3

Purpose: Triage in the emergency departmen (ED) is the preliminary clinical sorting process before full disclosure of patients' problems so that patients with the highest acuity are treated first in the setting of resource constraints. To overcome the inter-rater variability of existing triage tools, the Emergency Severity Index(ESI) was developed and was shown to be both valid and reliable in practice. Because of the disparity in practice patterns and some inappropriate criteria in the original ESI, the authors have modified the ESI and determined its inter-rater reliability. Methods: We applied the modified ESI to a convenient sample of adults who visited an urban academic ED between July 24, 2001, and August 5, 2001. After completion of a short, 4-hour training course on the modified ESI, an intern and emergency medicine resident pair triaged the patients independently. The inter-rater reliability was measured using a weighted kappa analysis and was categorized as excellent( 0.8),good (0.60-0.79),or fair( 0.59). Results: Five hundred forty-two patients were enrolled. The overall weighted kappa between the intern and the resident was 0.82 (95% Cl : 0.78-0.86). Among the 542 patients, 469/542 (87%), pairs agreed exactly, 67(12%) pairs disagreed by 1 level, and 6 (1%) pairs by 2 levels. Conclusion: In this study, the modified ESI demonstrated excellent inter-rater reliability when used by residents and interns for our ED patients.