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- 저자 : 홍훈표 ( Hoon Pyo Hong ) (검색결과 9 건)
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천일영 ( Yil Young Chen ),홍훈표 ( Hoon Pyo Hong ),김명천 ( Myung Chun Kim ),고영관 ( Young Gwan Ko ),김동필 ( Dong Pil Kim ) 대한외상학회 2003 大韓外傷學會誌 Vol.16 No.2
Portal venous gas is a severe and life-threatening sign since it is associated with an overall mortality rate ranging from 75% to more than 90% in instances due to noniatrogenic causes, but its mechanism is still not fully understood. However, after blunt abdominal trauma, portal venous gas is found even if only rarely. Because of developments and improvements in diagnostic procedures, especially computed tomography and ultrasonography, portal venous gas and intestinal pnuematosis can detected, and treated early, and a recent study reported mortality rates as low as 29%. Therefore, in the emergency department, the emergency physician must pay attention to portal venous gas in patients with blunt abdominal trauma. Delay in diagnosis and treatment may lead to intra-abdominal catastrophe, sepsis, and increased mortality. We report a case of portal venous gas and intestinal pnematosis after blunt abdominal trauma.
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향정신성 약물 중독에 의한 QTc 연장과 그 위험성에 대한 고찰
박관호 ( Kwan Ho Park ),홍훈표 ( Hoon Pyo Hong ),이종석 ( Jong Seok Lee ),정기영 ( Ki Young Jeong ),고석훈 ( Seok Hun Ko ),김성규 ( Sung Kyu Kim ),최한성 ( Han Sung Choi ) 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.2
Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual’s risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients. The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion: Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.
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황현철 ( Hyun Chul Hwang ),홍훈표 ( Hoon Pyo Hong ),김동필 ( Dong Pil Kim ),김명천 ( Myung Chun Kim ),고영관 ( Young Gwan Ko ) 대한외상학회 2003 大韓外傷學會誌 Vol.16 No.2
Purpose: This study was performed to review our experience with geriatric pelvic fracture patients in our emergency center. Methods: Pelvic bone fracture patients who visited the emergency center of Kyung Hee University Hospital and Dongsuwon General Hospital from March 2001 to July 2003 were analyzed using a retrospective medical records review. Variables included in the data analysis were demographics, injury pattern, transfusion needs, and outcome of pelvic fractures in older versus younger patients. Results: We cared for 93 patients with pelvic fractures during the study period. The mean age was 38 years, 56% were men, and the mean Injury Severity Score (ISS) was 19. Overall mortality was 13%. Seventy-five percent were younger than 55 years, and 25% were older than 55 years. Severe pelvic fractures were more common in older patients. The initial systolic blood pressure was lower and the heart rate higher in older patients, although the ISS was not different between the two age groups. Older patients were 2.2 times as likely to undergo transfusion and those undergoing transfusion, required more blood. Lateral compression (LC) fractures occurred 2.7 times more frequently in older patients than anteroposterior (AP) compression fractures. Conclusion: In older patients, pelvic fractures are more likely to produce severe complications and sequelae. Fracture patterns differ in older patients, with LC fractures occurring more frequently and commonly causing significant blood loss. The outcome for older patients with pelvic fractures is significantly worse than it is for younger patients, particularly for higher injury severity. Recognition of these differences should help clinicians to identify patients at high risk for bleeding and death early and to refine diagnostic and resuscitation strategies.
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독시라민 중독으로 발생한 횡문근융해증 환자에게서 혈중 크레아틴인산활성화효소 수치가 정상화되는 시기를 예측할 수 있는 인자
신민철,권오영,이종석,최한성,홍훈표,고영관,Shin, Min-Chul,Kwon, Oh-Young,Lee, Jong-Suk,Choi, Han-Sung,Hong, Hoon-Pyo,Ko, Young-Gwan 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.2
Purpose: Doxylamine succinate (DS) is frequently used to treat insomnia and it may induce rhabdomyolysis in the overdose cases. The purpose of this study is to evaluate the factors that can predict the serum creatine kinase (CK) level normalization time for patients with rhabdomyolysis due to DS ingestion. Methods: This study was conducted on 71 patients who were admitted with rhabdomyolysis after DS ingestion during the period from January 2000 to July 2009. Rhabdomyolysis was defined as a serum CK level over 1,000 U/L. The collected data included the general characteristics, the anticholinergic symptoms, the ingested dose, the peak serum CK level, the time interval (TI) from the event to the peak CK level and the TI from the event to a CK level below 1,000 U/L. We evaluated the correlation between the patients' variables and the TI from the event to the peak CK level time and the time for a CK level below 1,000 U/L. Results: The mean ingested dose per body weight (BW) was $30.86{\pm}18.63\;mg/kg$ and the mean TI from the event to treatment was $4.04{\pm}3.67$ hours. The TI from the event to the peak CK level was longer for the patients with a larger ingestion dose per BW (r=0.587, p<0.05). The CK normalization time was longer for the patients with a larger ingested dose per BW (r=0.446, p<0.05) and a higher peak CK level (r=0.634, p<0.05). Conclusion: The ingested dose per BW was correlated with the TI from the event to the peak CK level, and the ingested dose per BW and the peak CK level have significant correlations with the CK normalization time. These factors may be used to determine the discharge period of patients who had rhabdomyolysis following a OS overdose.
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경추보조기를 착용 후 후굴곡 하였을 때 나타나는 미끄러짐 현상
최한성 ( Han Sung Choi ),고영관 ( Young Gwan Ko ),김명천 ( Myung Chun Kim ),홍훈표 ( Hoon Pyo Hong ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2
Background: In many study reports, the cervical collar is effective in restricting 60 to 70 percent of cervical motion in 4 directions; flexion, extension, lateral bending, and rotation. But we discovered the phenomenon of sliding in the extensive motion of cervical vertebrae during the investigation about the effectiveness of cervical collars. Thus, the purpose of this study was to find out whether the cervical collars are effective in restricting the extensive motion of the cervical spine Methods: Fifteen volunteers, young men (23~32 years), with clinically and radiographically normal cervical spines were studied. The active cervical motion angles in flexion and extension were measured in each subject and were compared with the motion angles permitted in each of the two cervical orthoses (Philadelphia collar, Stifneck collar). We compared the restricting ability of cervical orthoses in the non-sliding state with the sliding state, especially during extension. One sample t-test, and paired t-test were used in the calculation of the statistics and the significant difference was indicated when p< 0.05. Results: With the pressure forced inferoposteriorly from the apex of the skull while extended, we created the sliding and compared the previously established method of measurement and the non-sliding state. The results showed significant difference among the three. The results, which the use of the previous method without considering the sliding was compared with the new method in consideration of the sliding, differed significantly. This phenomenon diminished the effect of restricting the cervical motion of the cervical orthoses by 50%. Conclusion: With the pressure forced inferoposteriorly given to a person wearing cervical orthoses, we could observe the occurrence of the phenomenon that occiput was slid along the rear slope face of cervical orthoses and that reduced the restricting effect of cervical extensive motion around 10%. Therefore, it must be considered that cervical orthoses need to be improved to reduce the motion for the direction.
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굴곡과 신전 수동운동 상태에서 개별경추의 진자운동 및 병진운동의 운동학적인 특징
박성혁 ( Sung Hyuk Park ),최한성 ( Han Sung Choi ),홍훈표 ( Hoon Pyo Hong ),고영관 ( Young Gwan Ko ) 대한외상학회 2006 大韓外傷學會誌 Vol.19 No.2
Purpose: The aim of this study was to determine the kinematical characteristics of the pendular and the translational movements of each cervical vertebra at flexion and extension for understanding the mechanism of injury to the cervical spine. Methods: Twenty volunteers, young men (24~37 years), with clinically and radiographically normal cervical spines were studied. We induced two directional passive movements and then took X-ray pictures. The range of pendular movement could be measured by measuring the variation of the distance between the center point of two contiguous cervical vertebrae, and the range of translational movement could be measured by measuring the variation of the shortest distance between the center point of a vertebra and an imaginary line connecting the center points of two lower contiguous cervical vertebrae. The measurements were done by using a picture archiving and communicating system (PACS). Results: The total length of all cervical vertebrae in the neutral position was, on average, 133.66 mm, but in both flexion and extension, the lengths were widened to 134.83 mm and 134.79 mm, respectively. The directions of both the pendular and the translational movements changed at the 2nd cervical vertebra, and the ranges of both movements were significantly larger from the 5th cervical vertebra to the 7th cervical vertebra for flexion and combined flexion and extension motion (p<0.05). Conclusion: The kinematical characteristics for flexion and extension motions were variable at each level of cervical vertebrae. The 1st and the 2nd cervical vertebrae and from the 5th to the 7th cervical vertebrae were the main areas of cervical spinal injury. This shows, according to Hook`s law, that the tissues supporting this area could be weak, and that this area is sensitive to injury. (J Korean Soc Traumatol 2006;19:126-134)
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