산업재해로 인한 척추환자의 실태조사

서용길,김양옥 大韓産業醫學會 1991 대한직업환경의학회지 Vol.3 No.1

This analytical study was performed on 403 patients with spinal injuries by industrial accidents treated in a Labor Provinces area from Jan. 1987 to Dec. 1988. 1. Of the parients, 125 ones the largest number, were belong to transportation industry. 2. One hundred and sixteen patients(29.6%) were occurrd within one month after employment. 3. The largest number of the 403 patients was 242 ones(60.0%) with spinal sprain and strain in 1 region, and those of 463 injuries of the patients were 274 sprain and strains in nature(59.2%) and 368 injuries on lumber area in spine level(79.5%) respectively. 4. There were 16 patients with delayed diagnosis after 113 days on average following to failed diagnosis in the first medical institutes. 5. "The Additional Loss by Delayed Diagnosis" phenomenon was found in comparing 6,406 persondays for treatments of the patients with delayed diagnosis(15% of 43,921 persondays for overall patients) to number of 16 patients(4% of overall 403 patients), and 403.4 days per the patient with delayed diagnosis to 109.0 days per one of overall patients. 6. The medical institutes which the patients had treated most frequently at the first were the orthopaedician's clinics(126 patients) and the highest rate of failed diagnosis was 7% of general practitioner's clinics, and the highest diagnosis sensitivity of HNP at the first was 1.0 of general hospitals and neurosurgeon's clinics.

119구급대를 통한 서울지역 외상환자 진료체계에 대한 통계분석

서길준,이승한,조익준,권운용,송형곤,이중의,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Backgroud: Despite continous efforts to improve the prehospital trauma care system in Korea, the preventable death rate has been reported to be high. The purpose of this study was to evaluate the prehospital trauma care system in Seoul by analyzing 119 rescue databases. Methods: The 119 rescue data bases of 22,275 trauma patients, who were transported to the secondary and tertiary hospital in Seoul by Seoul 119 rescue services from January 1, 2000 to December 31, 2000, were analyzed. Results: The response time(mean 3.7 min.) showed no time, weekly, and regional variations. However, the transport time from field to hospital showed was high in the morning rush hour(7:00 to 10:00 am), and was gradually decreased and the lowest between 10:00 pm and 7:00 am. There was also a regional variation in the transport time, which was short in the central area and long in the peripheral area of Seoul. Prehospital cares were given to the 10,999 trauma patients(49.4%). Of the 464 unresponsive patients(2%), only 236 patients were identified in transported hospitals. The outcomes of these unresponsive patients were DOA(54%), survival(19%), death in ER(14%), transfer to other hospitals(8%), and death after admission(5%) in order. Conclusion: We suggest that this study may be helpful to the establishment and improvement of the prehospital trauma care system as well as the determination of the adequate numbers and locations of trauma center in Seoul.

비중격 만곡증 및 만성 비후성 비염 환자에서 비중격 성형술과 하비갑개 수술의 치료효과

김용대,서보수,조길성,송시연,윤석근,송계원 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.2

Septoplasty with turbinate surgery is common surgical treatment In patients with septal deviation and chronic hypertrophic rhinitis. The aim of this study was to evaluation objective outcomes of septoplasty with turbinate surgery by analysis of subjective symptom score with objective acoustic rhinometric test before and after surgery, prospectively. Materials and Methods: We reviewed 45 adult patients which were done septoplasty with bilateral turbinectomy or turbinoplasty and followed up at least 3 months by one rhinologist from November 1999 to April 2000, prospectively. We analyzed subjective symptom score. minimal cross-sectional area (MCA) , C-notch cross-sectional area, and total volume of both nasal cavity before and after surgery. Correlation test was studied between symptom improvement and acoustic rhinometric results. Results: Twenty nine cases were male and sixteen cases female. The average age was 26.9 year-old (range: 17 to 57 years). There was significantly improvement of symptom score in postoperative 3 months (p<0.05). There was significantly increased C-notch cross-sectional area and total volume in postoperative 3 months. Symptoms improvement were associated with acoustic rhinometric profiles, but, there was not significantly correlation. Conclusion: Septoplasty with turbinate surgery is considered to be effective for nasal obstruction in patients with septal deviation and turbinate hypertrophy. Acoustic rhinometric test is favorable objective test for evaluation of symptom improvement after septal surgery.

파라콰트 중독에서의 항산화치료

권운용,조유환,송형곤,김명천,이중의,서길준,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Background: Paraquat causes severe tissue toxicity when ingested, but has no effective treatment modality. We have shown that high dose vitamin C has effective antioxidant activities against the paraquat intoxication in a previous animal experiment. This study was designed to evaluate the effect of antioxidant therapy with high dose vitamin C and vitamin E in human cases of paraquat intoxication. Methods: From August 1999 to August 2001, 19 paraquat intoxication patients who visited the emergency department of the Seoul National University Hospital and the Kyounghee University Hospital were enrolled to this study. They were devided into two groups, a control group(9 patients) and a study group(10 patients). The control group received only conservative managements including gastro-intestinal decontaminati-on. The study group received conservative managements plus the antioxidant therapy which was composed of vitamin C 24 gm/day intravenously and 20 gm/day orally, and vitamin E 1.6 gm/day orally. Results: In the study group, 5 of 10 patients(50%) survived, but all patients of the control group died(p=0.003). There were no significant differences in age, sex, and usage of gastric lavage and activated charcoal between the two groups. Difference in ingested amount of paraquat between the two groups could not be analyzed due to the inexact and subjective measuring methods based on patients' histories. Conclusion: Antioxidant therapy with high dose vitamin C and vitamin E is effective in vival rate in paraquat intoxicated patients.

발열이 있는 호중구 감소증 환자에서의 위험도 예측인자

정중식,권운용,김규석,임용수,이중의,서길준,윤여규 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Most febrile neutropenic patients are treated in an aggressive manner. However, identification of low-risk patients may enable clinicians to administer risk-based treatment. The object of this study is to certify the factors associated with increased risk at the time of visiting the emergency department. Methods: This is a retrospective study. We reviewed the medical records of 101 febrile neutropenic patients who had visited the emergency department of Seoul National University Hospital from January 1998 to August 1999. We assumed 22 risk prediction factors that could be assessed at admission to the emergency department and 5 factors that could be assessed during treatment course. To find independent risk-prediction factors, we analyzed these factors respectively by using multiple regression analysis. Results: Tachycardia(aOR=136.5), altered mentality(aOR=28.8), decreased renal function(aOR=20.1), and significant comorbidity(aOR=17,2) are the independent factors associated with higher mortality. Altered mentality(aOR=31.6) and decreased renal function(CCr < 75㎖/min, aOR=5.4) are those associated with a higher incidence of septic shock. Independent factors associated with persistent(more than 3 days) fever are the early(within 10 days) onset of fever after last chemotherapy(aOR=8.8) and the existence of new pulmonary infiltrates on a simple chest X-ray(aOR=4.3). Conclusion: The stability of vital signs, the change of mentality, the renal function, the existence of significant comorbidity, the existence of new pulmonary infiltrates, and the rate of neutropenia are clinically useful risk-prediction factors in febrile neutropenia at the time of visiting the emergency department.

사망 진단서(시체 검안서) 작성의 문제점

김규석,임용수,이중의,서길준,윤여규,어은경,염석란,정연권,이윤성 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: This study was conducted to analyze the current problems in completing death certificates and to identify the correct method for completing death certificates Methods: We reviewed 262 death certificates in three hospitals from March 1 to April 30, 2000, and 119 death certificates in one hospital from March 1 to 31, 2000. We identified major and minor errors and analyzed and compared them retrospectively. Results: A total of 381 death certificates were reviewed: 59 in Seoul National University Hospital,101 in Ewha Woman's University Hospital, and 102 in Gachon Medical College Hospital, which has no education program for completing death certificates in postgraduate training, and 119 in Samsung Medical Center which has an education program for completing death certificates. 358 certificates(94.0%) had at least one error. There were only 23 death certificates(6.0%) without an error. In 182 cases(47.8%), there was one major error. In 321 death certificates(84.3%), there were more than two errors. A comparison of Samsung Medical Center with the other hospitals showed that the number of total errors was statistically different(p=0.001). Conclusion: There were few death certificates without an error in this study. In a hospital which has postgraduate training in completing death certificates, there are fewer errors than in other hospitals which have no training course. Emergency physicians actually certify many deaths, so they must know the correct method of completing death certificates for statistics on morbidity and mortality.

강산 및 강알칼리 음독에서 냉각 용액을 사용한 희석 요법과 중화 요법의 가능성

이중의,송형곤,김동훈,권운용,곽영호,서길준,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: There is no effective treatment modality for caustic agent ingestion. Dilution and neutralization are prohibited because of the risk of secondary thermal injury. This experiment is designed to evaluate the amount of dilution and neutralization heat and to gauge the applicability of dilution and neutralization therapy using cold solutions to suppress the peak temperature. Methods: This is an in-vitro chemical experiment. HCl, CH3COOH, NaOH, and NH4OH are selected as representatives of strong and weak acids and strong and weak alkali, respectively. 20℃, 11.6M, 5.8M, and 2.9M solutions of each acid and alkali are made and mixed using a magnetic stirrer at a room air temperature of 28℃. The peak temperature, the duration above 40℃, and the heat amount are measured or calculated. Results: When a 11.6M HCl or NaOH solution is diluted with same amount of water, 32 or 18cal. per mL of HCl or NaOH is produced, respectively. HCl produces a significant peak temperature, but NaOH does not. The lower the concentration, the lower the amount of heat production. 11.6M CH3COOH and NH4OH solutions don't produce dilution heat.11.6M and 5.8M solutions of all acids and alkali produce destructive neutralization heat. However, 2.9M solutions produce neutralization heat which might be controllable. When a 11.6M HCl or NaOH solution is neutralized with a -10℃ 2.9 M NaOH or HCl solution, respectively, the peak temperature produced is below 40℃ and seems to add little thermal damage to viable tissue. Conclusion: Dilution and neutralization with a cold solution in cases of strong acid or alkali ingestion is a promising method to avoid thermal injury.

IN-PILE PERFORMANCE OF HANA CLADDING TESTED IN HALDEN REACTOR

Kim, Hyun-Gil,Park, Jeong-Yong,Jeong, Yong-Hwan,Koo, Yang-Hyun,Yoo, Jong-Sung,Mok, Yong-Kyoon,Kim, Yoon-Ho,Suh, Jung-Min Korean Nuclear Society 2014 Nuclear Engineering and Technology Vol.46 No.3

An in-pile performance test of HANA claddings was conducted at up to 67 GWD/MTU in the Halden research reactor in Norway over a 6.5 year period. Four types of HANA claddings (HANA-3, HANA-4, HANA-5, and HANA-6) and a reference Zircaloy-4 cladding were used for the in-pile test. The evaluation parameters of the HANA claddings were the corrosion behavior, dimensional changes, hydrogen uptake, and tensile strength after the claddings were tested under the simulated operation conditions of a Korean commercial reactor. The oxide thickness ranged from 15 to 37 mm at a high flux region in the test rods, and all HANA claddings showed corrosion resistance superior to the Zircaloy-4 cladding. The creep-down rate of all HANA claddings was lower than that of the Zircaloy-4 cladding. In addition, the hydrogen content of the HANA claddings ranged from 54 to 96 wppm at the high heat flux region of the test rods, whereas the hydrogen content of the Zircaloy-4 cladding was 119 wppm. The tensile strength of the HANA and Zircaloy-4 claddings was similarly increased when compared to the un-irradiated claddings owing to the radiation-induced hardening.

上顎에 發生한 複合性 齒牙腫에 治驗例

徐鎭寬(Gene Kwan Suh),李容五(Yong Oh Lee),林吉雄(Gil Oung Lim),金宣勇(Sun Yong Kim),卞相吉(Sang Gil Byun),朴靜東(Jung Dong Park) 대한치과의사협회 1975 대한치과의사협회지 Vol.13 No.8

顎下唾液腺에 發生한 巨大한 混合腫의 治驗例

徐鎭寬(Gene Kwan Suh),李容五(Yong Oh Lee),林吉雄(Gil Oung Lim),金宣勇(Sun Yong Kim),卞相吉(Sang Gil Byun),朴靜東(Jung Dong Park) 대한치과의사협회 1976 대한치과의사협회지 Vol.14 No.3