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.

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.

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

치질을 투과한 조사광에 의한 복합레진 중합시 치질의 두께, 광세기 및 조사 시간이 복합레진의 표면 경도에 미치는 영향

조수경,김동준,황윤찬,오원만,황인남 大韓齒科保存學會 2005 Restorative Dentistry & Endodontics Vol.30 No.2

본 연구에서는 치질을 투과한 광에너지량을 측정하고 치질을 투과한 광에너지에 의한 광중합 복합레진의 중합 정도를 표면 경도를 측정하여 분석하였다. 광조사기로는 할로겐 광원을 사용하는 Optilux 501 (Demetron, USA)을 사용하였으며, 중합용 light guide는 840 mW/cm²의 광세기를 갖는 직경 12 mm의 light guide와 1100 nW/cm²의 광세기를 갖는 직경 7 mm의 Turbo light guide를 사용하였다. 광원을 투과시킬 치질은 건전한 상악 중절치의 순면에서부터 법랑질과 상아질을 포함하도록 0.7x0.7cm 의 크기로 두께 1.0 mm와 2.0 mm의 치아 절편을 준비하였다. 직경 5 mm, 두께 2 mm의 주형에 Al 색상의 광중합 복합레진(Charisma, Kulzer, Germany)을 충전하고 각 군에 주어진 조건에 따라 광중합하였다. 시편은 크게 치질의 두께에 따라 (대조군, 1 mm, 2 mm) 3개의 군으로 나누었으며, 각 군은 다시 light guide의 종류와 광조사 시간에 따라 4개의 군으로 나누었다. 제작된 시편은 미세경도측정기를 이용해 광조사면의 비커스 경도를 측정한 결과, 2 mm 치질군과 대조군의 Turbo-light guide으로 40초 동안 중합한 시편이 가장 높은 표면 경도값을 보였으며, 2 mm 치질군에서 light guide의 종류에 상관없이 20초 동안 중합한 시편들이 가장 낮은 표면 경도값을 보였다 (p < 0.05). 이상의 결과는 1 mm 이하와 같은 얇은 치질을 투과하여 복합레진을 중합하는 경우 광세기와 광조사 시간을 증가시키면 중합 정도도 증가하나, 특정 두께 이상의 치질을 투과 시 광세기나 광조사 시간을 증가시키더라도 중합 정도의 증가는 기대하기 어렵다는 것을 시사한다. In this study we measured the amount of light energy that was projected through the tooth material and analyzed the degree of polymerization by measuring the surface hardness of composites. For polymerization, Optilux 501 (Demetron, USA) with two types of light guide was used: a 12 mm diameter light guide with 840 nW/cm² light intensity and a 7 mm diameter turbo light guide with 1100 nW/cm². Specimens were divided into three groups according to thickness of penetrating tooth (1 mm, 2 mm, 0 mm). Each group was further divided into four subgroups according to type of light guide and curing time (20 seconds, 40 seconds). Vickers' hardness was measured by using a microhardness tester. In 0 mm and 1 mm penetrating tooth group, which were polymerized by a turbo light guide for 40 seconds, showed the highest hardness values. The specimens from 2 mm penetrating tooth group, which were polymerized for 20 seconds, demonstrated the lowest hardness regardless of the types of light guides (p < 0.05). The results of this study suggest that, when projecting tooth material over a specified thickness, the increase of polymerization will be limited even if light intensity or curing time is increased.

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.

응급실 내원 환자 14,836례의 통계적 고찰

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

Cases of 14,836 patients who visited the emergency room at the Chosun University Hospital from January 1 to December 31, 1994 were analyzed statistically according to sex, age, department, admission, discharge and used transportations. The results were as follows: 1) Considering sexual distribution, male patients were 52.3% and female patients were 47.7%. 2) According to age categories, 4th decade of life was most frequent. 3) According to the department distribution, internal medicine accounted for 22.7%, orthopedic surgery 15.4%, neurosurgery 12.4% and pediatrics 11.7%. 4) The rate of patients admitted via emergency room was 38.0% of total number of patients visited emergency room. The department distribution was as follows: internal medicine 24.1%, neurosurgery 13.7%, orthopedic surgery 12.1%, general surgery 10.5%. 5) 62.0% of patients visited emergency room were discharged. The department distribution was as follows: internal medicine 21.9%, orthopedic surgery 17.5%, pediatrics 13.3%. 6) The number of DOA patients was 212(14.3%) and it showed highest rate in December. 7) A car and taxi were the most frequently used transportation(70%) but the used rate of hospital, 119 and 129 ambulance tended to increase. 8) Emergency room was visited most frequently from 20 to 24 hours. 9) Consumed time from arrival to emergency care of the relevant department was within one hour(67%).

급성 약물 중독에 대한 임상적 고찰

조수형,조남수,김용배 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

A clinical observation was made on 194 cases of drug intoxication to Chosun University hospital via emergency room during one year from January 1994 to December 1994. The observed results were summarized as follows; 1. The ratio of drug intoxicated patients to total patients of emergency room was 1.3%(194 patients of the total 14,836 patients) 2. Female was slightly more than male (54% : 46%) and the age group of the third decade was of the largest proportion. 3. In monthly distribution, September had the largest propotion(14.4%). The largest proportion of the time interval on arrival to emergency room and of presumed time of poisoning was night(8 p.m. ∼12 p.m.). 4. Suicidal attempt was the most common motive of drug intoxication(82.5%). 5. The most common drug of intoxication was S.H.T.(sedatives, hypnotics, tranquilizer)(24.7%). 6. The abnormal signs on arrival to emergency room were tachycardia, tachypnea, hypertension in order of frequency. 7. The observed abnormal laboratory findings on arrival to emergency room were leukocytosis(97 cases), glucosuria(21 cases), proteinuria(10 cases) in order of frequency. 8. The outcome of the patients were recovery(42.8%), against discharge(35%), hopeless discharge(16%), death(6,2%).

고비중 Bupivacaine과 Tetracaine에 의한 척추마취의 비교

조남수,유병식,박은주 최신의학사 1989 最新醫學 Vol.32 No.11

광주·전남 지역 병원간 응급 의료 전달 체계에 대한 연구 : 조선대학교 병원 응급의료센터를 중심으로

조남수,조수영 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background: To provide basic data to help construct regional EMSS. Methods: Using a questionnaire, the authors investigated prospectively the data of 766 patients transferred directly to Emergency Medical Center of Chosun University Hospital from other hospitals from April 1 to May 31, 2000. Results: 1) Transfer records; Transfer records of 407(53.1%) patients were faithful, 159(20.7%) patients were unfaithful. 47(6.2%) patients made a phone call to the emergency room or the Department of Emergency Medicine, 9(1.2%) patients to other departments, and 144(18.8%) patients were others. 2) The distribution of the region; A regional distribution of 766 patients transferred to Chosun University Hospital. The transfer took less than 1 hour in 134 patients, it took 1~2 hours in 150 patients, 2~3 hours in 222 patients and 3 hours or more in 260 patients. 3) The mode of transfer; Of the 766 patients, 8(1.1%) patients were transferred by foot, 78(10.2%) patients by a 119 rescue ambulance, 428(55.9%) patients by a hospital ambulance, 31(4.0%) patients by an emergency rescue party, 149(19.5%) patients used private cars, 67(8.8%) patients used public transportation and 5(0.6%) patients were transferred by others means. 4) The reason of transfer; 138(18%) transferred patients from primary hospital or secondary hospital wanted the transfer. 306(39.9%) patients were transferred due to inducement, 162(21.1%) patients due to the absence of specialized departmental doctors, 64(8.4%) patients due to emergency surgery, 46(6%) patients due to bed deficit and 50(6.5%) patients due to other reasons. 5) Diagnosis and treatment in ER; Among all transferred patients, 6 patients were in pericardiocentesis, 103 patients in CT(brain), 61 patients in MRI(brain), 65 patients CT(other part), 10 patients in MRI(other part), 15 patients in closed thoracostomy, 148 patients in central vein catheterization, 5 patients in 4-vessel angiogram and 152 patients in endotracheal intubation. 6) The result of treatment; 458(59.8%) patients were admitted, 148(19.3%) patients to ICU, 15(2%) patients were admitted to a delivery room, 14(1.8%) patients were transferred to an other hospital, 30(3.9%) patients were in a mortuary, 101(13.2%) patients were discharged and 221 patients were admitted for an emergency operation. Conclusion: For effective and well organized EMSS the following are required. Communication prior to the patients transfer. Reinforcement of ambulance equipment and training of emergency staff for long distance transfer of a serious case. A detailed record of early state and treatment of transferred patients. The standardizational the transfer records which contains first aid treatment including fluid treatments, address and early vital signs of patients. Investigation and study for newlydeveloped transfer records.