고칼륨혈증에서 심전도의 진단적 의의

윤수영,박원녕,정성필,김승호,이한식 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Hyperkalemia is a common and potentially life-threatening metabolic disorder. The electrocardiogram(ECG) is known to be a relatively sensitive diagnostic tool for hyperkalemia. However many exceptions, in which patients showed normal ECG findings even though hyperkalemic, have been reported. The purpose of this study was to determine the extent of correlation between the ECG findings and hyperkalemia and to determine when the ECG has value for diagnosing hyperkalemia. Methods: Patients who had been diagnosed as having hyperkalemia at two university hospitals during three years were enrolled in this study. We reviewed the medical records of the patients and evaluated the following 6 ECG abnormalities: tall T waves, narrow T waves, QRS widening, atrioventricular block, loss of P waves, and sine waves. We defined tall T waves and narrow T waves as 20 percentiles of heights and widths of the T waves from the 100 patients with normokalemia. Results: During the study period, there were 100 hyperkalemic patients, and we analyzed 69 available electrocardiograms. Abnormal ECG findings were revealed in 67%of 69 patients. The higher the serum potassium level, the more abnormal ECG findings. The common ECG abnormalities were tall T waves and loss of P waves. The patients with normal ECGs even though hyperkalemic had relatively low potassium levels. And whether chronic renal disease was not correlated to the ECG abnormality. Conclusion: The electrocardiogram is a good diagnostic tool for hyperkalemia if it is used with accurate diagnostic criteria. Thus, hyperkalemia should be considered when the ECG shows tall T waves or loss of P waves.

Status of an Underground Research Tunnel for the validation of HLW disposal concept in Korea

Pil-Soo Hahn 한국암반공학회 2006 한국암반공학회 학술대회 및 세미나 자료집 Vol.- No.-

In Korea, an underground tunnel(KURT) for R&D related to a high-level radioactive waste disposal in a geological formation is under construction in a granite body. The facility will be used for a validation of the safety, feasibility, stability, and appropriateness of the Korean disposal system. During the last few years, a site characterization, concept development, design, construction, and some in situ tests before and during its construction have been successfully carried out. Based on the geological, geotechnical, hydraulic, and socio-economical conditions of the site, an optimum design of the KURT has been suggested. The o riginal KURT design was adjusted for a consideration of the geological and hydraulic conditions confronted during the construction. The length of the access tunnel in the final design was 180m. There are two research modules, one was 45m long and the other was 30m long, at the end of the access tunnel. To achieve a greater depth more effectively, a 10% downward slope was adapted. In this paper, the current status of KURT and its future plans will be introduced.

EFFECTS OF LONDON - VAN DER WAALS FORCES ON THE THINNING AND RUPTURE OF A DIMPLED LIQUID FILM AS A SMALL DROP OR BUBBLE APPROACHES A FLUID - FLUID INTERFACE

한필수 ( Pil Soo Hahn ) 한국화학공학회 1986 춘계학술발표회 Vol.1986 No.-

연구발표논문초록 - 특별강연 ( 전달현상 (Ⅱ) )

한필수 ( Pil Soo Hahn ) 한국화학공학회 1986 춘계학술발표회 Vol.- No.-

Sorption behavior of U(VI) on a reference montmorillonite (SWy-2)

Sung Pil HYUN,Young Hwan CHO,Pil Soo HAHN,Soo Jin KIM 한국암석학회 2000 한국암석학회 학술발표회 논문집 Vol.- No.-

The Association of CHADS-P2A2RC Risk Score With Clinical Outcomes in Patients Taking P2Y12 Inhibitor Monotherapy After 3 Months of Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention

Pil Sang Song,Seok-Woo Seong,Ji-Yeon Kim,Soo Yeon An,Mi Joo Kim,Kye Taek Ahn,Seon-Ah Jin,Jin-Ok Jeong,Jeong Hoon Yang,Joo-Yong Hahn,Hyeon-Cheol Gwon,Woo Jin Jang,Hyuck Jun Yoon,Jang-Whan Bae,Woong Gil 대한심장학회 2024 Korean Circulation Journal Vol.54 No.4

Background and Objectives: Concerns remain that early aspirin cessation may be associated with potential harm in subsets at high risk of ischemic events. This study aimed to assess the effects of P2Y12 inhibitor monotherapy after 3-month dual antiplatelet therapy (DAPT) vs. prolonged DAPT (12-month or longer) based on the ischemic risk stratification, the CHADS-P2A2RC, after percutaneous coronary intervention (PCI). Methods: This was a sub-study of the SMART-CHOICE trial. The effect of the randomized antiplatelet strategies was assessed across 3 CHADS-P2A2RC risk score categories. The primary outcome was a major adverse cardiac and cerebral event (MACCE), a composite of all-cause death, myocardial infarction, or stroke. Results: Up to 3 years, the high CHADS-P2A2RC risk score group had the highest incidence of MACCE (105 [12.1%], adjusted hazard ratio [HR], 2.927; 95% confidence interval [CI], 1.358–6.309; p=0.006) followed by moderate-risk (40 [1.4%], adjusted HR, 1.786; 95% CI, 0.868–3.674; p=0.115) and low-risk (9 [0.5%], reference). In secondary analyses, P2Y12 inhibitor monotherapy reduced the Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding without increasing the risk of MACCE as compared with prolonged DAPT across the 3 CHADS-P2A2RC risk strata without significant interaction term (interaction p for MACCE=0.705 and interaction p for BARC types 2, 3, or 5 bleeding=0.055). Conclusions: The CHADS-P2A2RC risk score is valuable in discriminating high-ischemic-risk patients. Even in such patients with a high risk of ischemic events, P2Y12 inhibitor monotherapy was associated with a lower incidence of bleeding without increased risk of ischemic events compared with prolonged DAPT.

Characterization of aquatic groundwater colloids by a laser-induced breakdown detection and ICP-MS combined with an asymmetric flow field-flow fractionation

백민훈,Pil-Soo Hahn,윤종일,Muriel Bouby,Jae-Il Kim 한국화학공학회 2007 Korean Journal of Chemical Engineering Vol.24 No.5

Determination of Forward Dissolution Rate of Glass by a Single-Pass Flow-Through Test

Seung Soo Kim,Kwan Sik Chun,Jong-won Choi,Sung Ki Kim,Pil-Soo Hahn 한국방사성폐기물학회 2005 방사성폐기물학회지 Vol.3 No.4

Single-pass flow-through (SPFW) 방법에 의한 유리고화체의 용해율 측정에서 정밀도를 구하기 위하여 연구소간 실험프로그램의 하나로서 붕규산유리고화체의 정용해율을 구하였는데, 이 SPFT 방법은 American Society for Testing and Materials (ASTM)에서 표준화를 위하여 작성되었다. 이를 위해 100/200 mesh 크기의 모의 저방사능 유리고화체 분말시료를 , 알곤 분위기에서 SPFT 방법으로 리튬 완충용액 (pH=10)을 이용하여 용해실험을 시도하였다. 얻어진 용출액 중 규소와 붕소의 농도에 따라 용해율의 변화를 구한 결과, 유리의 정용해율이 부근으로 나타났다. The forward dissolution rate of a borosilicate waste glass was determined as an interlaboratory study(ILS) testing program for the evaluation of precision in the measurement of the dissolution rate or a waste glass using a single-pass flow-through(SPFT) test, whose conducting practice has been written for standardization through American Society for Testing and Materials (ASTM). A simulated low-activity waste glass powder with a size of 100/200 mesh was dissolved by lithium buffer solution (pH=10) at 70? under Ar atmosphere. By plotting the dissolution rates as a function of silicon and boron concentration in eluate, the forward dissolution rate of the glass was obtained as about in our laboratory.

응급실로 내원한 환자에서 응급 심전도 판독의 정확도

장양수,황태식,정성필,이한식,고재욱,정현수,박정수 대한응급의학회 2000 대한응급의학회지 Vol.11 No.1

Background. The emergency physician(EP)'s interpretation of the electrocardiogram(ECG) is important in determining the disposition of patients evaluated in an emergency department(ED) for chest pain or other cardiac complaints. This is particularly important in life-threatening ECG findings. When the cardiologist's final interpretation was defined as the correct one, the concordance compared with the EP was reported to be 50-60%, while the missed diagnosis of acute myocardial infarction(AMI) was reported as 0.6-8.0%, which could be deleterious to the patient. Method and Material. One hundred and twenty eight ECGs were interpreted by two residents from each year residency. ED records of the study patients were reviewed, and the EP's and cardiologist's ECG interpretations were compared. The ECGs were classified by severity according to the following system: class Ⅰ, normal or minor abnormalities only; class Ⅱ, abnormalities with potential to alter case management; and class Ⅲ, potentially life-threatening abnormalities. Result. The overall concordance between EP's and cardiologist's ECG interpretations was 59.3% and the concordance comparing each year residency showed no statistical significant differences (p value less than 0.05). The underdiagnosed rate was 48.4%, 32.0%, 23.4%, 22.7% for first, second, third and fourth year residency respectively, and 2.3%, 5.5%, 10.9%, 5.5% respectively for the overdiagnosed rate. Conclusion. Although the overall concordance showed a relatively high result in our study, the concordance of class Ⅲ ECG resulted in a much lower rate. Therefore, additional studies are needed to identify variables that contribute to ED ECG misinterpretation and to develop methods to resolve these difficulties. Assessment of department ECG misinterpretation would be useful in focusing on resident and staff education.

추락 환자의 손상정도에 영향을 미치는 요인

정성필,정상원,정현수,황태식,장문준,이한식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.1

Background : We designed this study to determine whether trauma history and initial assessment anticipate the injury severity of the free-fall patient. Methods : Two hundred patients who admitted emergency department of Severance hospital because of the fall from a height were enrolled in this study. The height of fall, the body orientation, and the characteristics of impacted material, and the Injury Severity Sacre(ISS) were evaluated by retrospective chart reviews. And regression equations were determined for predicting ISS on the basis of clinical parameters using multiple regression analysis. Results : According to the characteristics of impacted material, the ISS was higher in the hard surface (13.7±9.5) than the soft surface(10.5±8,8)(p<0.05). There were correlations between height of fall and ISS(p<0.01, r=5). To the body orientation, the ISS was higher in the head-to feet orientation(18.2±11.7) than the feet-to-head(10.9±7.0) or other position(8.5±5.8)(p<0.01). The regression equations were as follows, ISS=2+0.082×age(year)-1.54×(Glasgow Coma Scale)-3×(feet-to-head orientation)+0.65×height of fall(m)+2.7×(hard surface)(p<0.01, R²=0,53). Conclusion : This study suggest that the injury severity of patient with free falls are significantly related to the height of fall, the characteristics of impacted material and the body orientation.