소아복부둔상시 저혈량성 쇽과 연관된 복부전산화 단층촬영술의 유용성

박광철,조수형,조남수,박진,변주남 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: We reviewed retrospectively the clinical features and contrast material-enhanced computed tomography(CT) after blunt abdominal trauma demonstrated a characteristic hypoperfusion complex. Our purpose were to evaluate the hypothesis that children with this "hypoperfusion complex" CT finding were associated with a tenuous hemodynamic state, severe injury and a poor outcome. Methods: Between January 1996 and December 1999, 39 consecutive children who sustained blunt trauma and were suspected clinically of having intraabdominal injury underwent CT. Demographic data, blood pressure, indication for CT, pediatric trauma score(PTS) and Glasgow coma score(GCS) were recorded at the time of the initial examination. Results: Three of the 39 children(8%) demonstrated a characteristic finding at CT which was described as the hypoperfusion complex. The "hypoperfusion complex" was present in the 3 of the 39 traumatized children(8%), but was the main radiographic finding in the 3 of the 14 children with a severe pediatric trauma score(PTS<8) and in the 3 of the 6 children with a Glasgow coma score(GCS<8) who were examined with CT. Conclusion: The CT findings in all children with the hypoperfusion complex by definition included marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidney and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava(IVC); and moderate to large peritoneal fluid collection. This "hypoperfusion complex" is a relatively rarely observed in injured children but appears to be associated with severe injury and a poor outcome. The pediatric trauma score provides a useful profile of injury severity in children. Prompt diagnosis of hypovolemic shock is important so that supportive therapy can be instituted to prevent further metabolic abnormalities and their potential cardiotoxic effects. In summary, the intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability and is associated with a poor outcom.

응급의료센터로 내원한 헬기 후송 환자의 현황 및 분석

박진,조남수,조수형 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Our hospital is only emergency medical center that possess the landing zone of helicopter in chon-nam, Korea. An analysis of the present condition of helicopter-transport patient, was performed in order to pursuit and extend the availability of air transport in the future. The result were as follows; 1) The investigated in the present condition by yearly: 2 cases in 1991, 5 cases in 1992, 4 cases in 1993, 9 cases in 1994, 5 cases in 1995. 2) In the proportion of male to female, showed a ratio of three to one [male;72%(18), female;28%(7)] and showed third decade(7 cases), fifth decade(6 cases), sixth decade(4 cases) in comparison of age. 3) The geographical distribution of occurrence showed island areas(64%), inland areas(36%), and 6 cases of inland areas occurred of mountainous region. 4) One cause of events was traumatic causes(52%), which included traffic accident(5 cases) & fall down(4 cases). The other cause was disease(48%). 5) The expended time of helicopter from start to arrive at accident spot within Chon-nam area is from ten minutes to forty-five minutes, as mean expended time is thirty minutes. 6) The expended time from occurrence of patient to admitted hospital was from minimum twenty-five minutes to maximum eight hours and forty minutes, as expended time is one hundred and eighty-six minutes. 7) After arrived at landing zone, via emergency department to admitted patient; 12 cases, performed emergency operation; 4 cases, D.O.A. state; 2 cases, hopeless discharge; 2 cases, transfer to other hospital; 4 cases. Up to now, the present condition of helicopter-transport system was looked upon as petty affairs, and determination of transport was swayed by geographic element rather than severity of injury. And so, it is considered that epochal turning point is necessary for development of helicopter-transport system.

태반조직의 유전자형 분석

조남수,황정호,이영애 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-

응급실에서 기관내 삽관후 발생한 후두육아종 1례

조남수,김용배,조수형,송민엽,송성용 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Endotracheal intubation has been used widely for the maintenance of airway in the emergency patient and CPR in the acute airway obstruction patient and to treat respiratory insufficiency. Endotracheal intubation has many advantages but it may cause several complications which rate about 4% of endotracheal intubation patient. Among these complications, laryngeal granuloma is a relatively rare complication arising about 1 case per 10,000∼20,000 cases. Authors report a case of laryngeal granuloma which developed after endotracheal intubation required during emergency treatment. Case: A 55-year old female patient visited Chosun University Hospital Emergency Room complaining of dyspnea, cyanosis and sweating on Feb. 8th 1995. According to past history, she had a little obesity, dyspnea on exercise and mild hypertension. At arrival, blood pressure was 240/110mmHg, pulse rate 150 rates/min, respiratory rate 12/min, body temperature 36.5℃ and cyanosis with sweating on whole body was observed. And the mental state was semicoma. At 5 minutes after arrival, sudden respiratory arrest developed and immediate endotracheal intubation which emergency treatment was performed it was difficult to intubate endotracheally due to short neck and obesity. At 1 hour after arrival, general condition of the patient recovered well and extubation was done. The patient was transferred to internal medicine department and discharged after 12 days of medical treatment. At 2 months after discharge, the patient felt a progressive hoarseness and foreign body sensation of larynx. She was diagnosed as laryngeal granuloma at ENT department of Chosun University. She underwent the surgical operation and discharged in good health after 7 days of admission.

LED 전광판 제어 ASIC의 설계

남상길,조경연,이수범,김종진 釜慶大學校 1997 釜慶大學校 論文集 Vol.2 No.2

The wide spread of multimedia system demands a wide viewing angle display device which can imform a message to many peoples in open area. This paper is about the design and simulating of a large viewing LED pannel control ASIC(Application Specific Integrated Circuit). This LED pannel control ASIC runs on 16bit micropricessor MC68EC000 and has following functions : 16 line interlaced LED pannel contriller, memory controller, 16 channel priority interrupt cotroller, 2 channel direct memory access controller, 2 channel 12 bit clcok and timer, 2channel infrared remocon receiver, 2 channel RS-23C with 16 byte FIFO, IBMPC/AT compatible keyboard interface, battery battery backuped real time clock and timer,2controller, battery backuped 256 byte SRAM and watch dog timer. The 0.6 micronCMOS Sea of Gate is used to desing the ASIC in amiunt of about 39,000 gates,and it is simulated at 48MHz

서남해안 지방에서 발생한 Vibrio vulnificus 감염의 임상적 고찰

조남수,김춘호,김성중,김용배,조수형,안태훈 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: V. vulnificus infection in found between May and October when the man who has hepatic disorder or immunity disorder eats raw shellfish and it causes the systemic symptoms such as sudden fever, chilling, shock and stupor and local skin lesions like bleb and necrosis. This disease has 46∼61% of fatality rate in spite of intensive treatment. This study conducts the examination of history, epidemic study, ingesting raw fish and bacteriologic investigation in the patients with similar clinical symptoms to the above and examines the diagnostic dorrelations. Method: It is conducted with 31 cases who admitted at emergency medical center of Chosun University Hospital from May of 1995 to September of 1998 and are suspected to have V.vulnificus infection. It analyze bacteriologic examination, the survey of residence, eating raw shellfish, hepatic disorder, alcohol drinking habits and skin lesion. Results: 1) The rate of male and female is 15.5:1 and in the age, 18 cases are in fifties, seven are in forties and six are over sixties. 2) Clinically, V.vulnificus is detected in 20 of 31 cases which is suspected to have V.vulnificus infection and it is not detected in 5 cases. Other bacteria are detected in 6 cases and they include staphylococcus aureus, pseudomonas species, β-hemolytic streptococcus and E-coil. 3) In local distribution, Kohung has 10 cases, Shinan and Mokpo have six, Haenam and Kangjin have five, Yongkwang and Muan have five, Naju and Yongam have five and Kwangju has one. 4) Eating fishes and raw shellfishes is found in 31 cases. In the kind of shellfishes, eating raw clam is 10 cases, raw thin-shelled surf calm is 8 cases, raw oyster is 5 cases and sliced raw fish is 4 cases and pickled sea foods are 4 cases. 5) The cases with hepatic disorder are 23 and 15 cases with heavy alcohol drinking Carrier are included. The cases with Diabetic Mellitus are four and those with pulmonary tuberculosis are two. Two cases have not basal diseases. 6) On the opinion of skin lesion, 20 cases show vesicular necrosis, 7 cases have dendriform erythema, 3 cases have papule and one case doesn't show clear skin lesion. Conclusion: When V.vulnificus infection is detected, it is fatal and those who have hepatic disorder or heavy alcohol drinking habit must avoid eating fishes and shellfishes raw in summer. It is important to have emergency treatment for the patient whose V.vulnificus infection is suspected. It is considered that the administration of initial antibiotics is effective by generalizing the clinical symptom, epidemic opinion and patient history even before the results of bacteriologic confirmed.

해부학 실습에 의한 의과대학생들의 formaldehyde 폭로 정도와 formaldehyde 과민반응에 대한 조사연구

조수현,김헌,남윤정,김용대 충북대학교 의과대학 충북대학교 의학연구소 1993 忠北醫大學術誌 Vol.3 No.1

Formaldehyde induces not only irritation symptoms of eyes and respiratory tract but hypersensitivity reactions, such as contact dermatitis, allergic rhinitis, and asthma. To estimate the levels of exposure to formaldehyde during cadaver dissection in anatomy laboratory and to investigate the prevalence rates of irritation symptoms, allergic rhinitis and bronchial asthma, air concentrations of formaldehyde within cadaver dissection room were measured, and self-administrative questionnaire and enzyme linked immunosorbent assay(ELISA) were performed upon medical(n=182) and premedical students(n=69). For measurement of air formaldehyde level, chromotropic acid method(NIOSH method 3500) was used. Formaldehyde was conjugated to human serum albumin, and used as antigen in ELISA after identification of conjugation with immunoelectrophoresis. Prevailing symptoms during cadaver dissection were soreness of eyes or throat(92.9%), lacrimation(74.3%), rhinorrhea(49.7%), and sneezing(32.2%). Mean titers of IgE and IgG antibodies specific to formaldehyde-human serum albumin conjugate(F-HSA) of medical students were higher than those of premedical students. However, there was no case whose titers of anti-F-HSA antibody were higher than the twice of those of anti-HSA antibody or higher than the twice of the mean titers of premedical students. These results suggest that medical students were exposed to relatively high concentration of formaldehyde, but few asthma or allergic rhinitis were induced by formaldehyde exposure during cadaver dissection practice.

응급 수술에 대한 기술통계학적 고찰 : 한 종합병원의 1개년을 중심으로 This statistical data derived from our hospital for one year

조남수,김용배,소금영 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

경련 발작에 대한 초·중·고교 응급처치교육 모듈 평가

조준필,박남수,안정환 韓國學校保健學會 2009 韓國學校保健學會誌 Vol.22 No.1

Purpose : The purpose of this study was to evaluate the effectiveness of first aid education module on convulsion and seizure for students in elementary, middle and high school. Methods : This study has implemented to 2 types of test groups and control group in each 3rd and 5th grade of elemenary school, 2nd grade of middle school and high school within target school. The data were collected through a self-reported questionnaire to before, after and one month after education from July, 11 to September 4, 2007. Results : The test group who received first aid education possessed greater knowledge about convulsion and seizure relative to the control group not received education. The overall students has satisfied and been understood well with this module. The educators agreed to the practical aspects of this module in school setting. Conclusion : The above results implicated the importance of a continuous and systematic first aid education program among students. For effective first aid education, there needs a development of targeted educational materials for each grade student and training programs for educators.

인도네시아 지진해일에 대한 의료지원보고

조수형,김선표,최웅지,김성중,조남수,이준영,문성표 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

An unprecedented magnitude of disaster, Tsunami, washed away Southeast Asia, on December 26, 2004. and more than 200,000 peoples were killed by the disaster. Staffs of our hospital visited Indonesia for voluntary medical supports from January 12, to January 21, 2005. We summarize here our 10 days' experiences in Indonesia.