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병원 전 심정지로 내원한 영아의 심폐소생술에 대한 고찰
윤영윤,김홍재,한승철,염경인,문정미,전병조,허탁,민용일 대한응급의학회 2004 대한응급의학회지 Vol.15 No.6
P u r p o s e: Since 1960 pediatric advanced life support (PALS) has been studied and applied to clinical situations, ILCOR guidelines 2000 for CPR and ECC was achieved. Pediatric cardiopulmonary arrest differs from adult arrest in etiologies, mechanisms, and managements. This study was performed to identify the clinical manifestations and real picutre of CPR to recognize the need of standard CPR method that increases the survival in infants with out-ofhospital arrest. M e t h o d s: This study was planned by retrospectively reviewed the records of all children who arrived without spontaneous respiration and palpable pulse at the emergency room of the three Hospitals from January 1996 to July 2003. R e s u l t s: During that period, 45 infants presented with outof- hospital cardiopulmonary arrest. Overall, there was a return of vital signs in 15 of the 45 patients; 6 survived to discharge from hospital. 1. Out-of-hospital arrest in infants demonstrated that 60% were male, mean age was 133.4 days. Of these, 71.1% of the arrests occurred in the home with family members presents, those family members didn’t perform basic CPR in only 1 case. 2. In any ROSC group, the interval between the arrest and arrival at the hospital was 14.4 minutes. In ROSC never achieved group, the interval was 32.0 minutes. 3. Two of the 15 patients with SIDS(13.3%) and four of the 13 patients with respiratory arrest(30.8%) survived to hospital discharge. C o n c l u s i o n: Factors that predicted survival to discharged alive included a death caused by respiratory disease, a short interval between the arrest and arrival at the hospital, and a short duration of resuscitation efforts in the ER. We found that need of standard guideline and commonly applied CPR techniques.
빅 데이터를 활용한 비만 및 복부비만이 맥압에 미치는 영향에 대한 연구
윤영윤(Yeung Yoon Yoon),김성길(Sung Gil Kim),신지훈(Ji Hoon Shin) 한국전자통신학회 2018 한국전자통신학회 논문지 Vol.13 No.1
본 연구는 국가자료인 2012년도 국민건강영양조사 자료를 이용하여 20세 이상 성인(n=5,889)에서 비만 및 복부비만과 맥압(Pulse pressure, PP)의 관련성을 평가하고자 실시하였다. 연구결과에서 맥압에 대한 관련변수(연령 포함)를 보정하였을 때, 여성에서는, High PP (PP >61mmHg)의 위험비가 정상 체중군에 비하여 비만군에서 1.37 (95 % CI, 1.03-1.82)로 유의하게 높았고, 복부비만이 아닌 군에 비하여 복부비만군에서 1.38배 (95% CI, 1.07-1.78)로 유의하게 높았다. 그러나 남성에서는 비만 및 복부비만은 High PP와 유의한 관련성 없었다. 결론적으로 여성에서는 비만과 복부비만이 맥압을 증가시키지만, 남성에서는 유의한 관련성이 없었다. The aim of this study was to assess the association of obesity and abdominal obesity and pulse pressure (PP) in Korean adults. The study subjects were Korean adults 20 years or older (n=5,889) who participated in the Korea National Health and Nutrition Examination Survey 2012. After adjusting for relevant variables (include age), in women, the odds ratio (OR) of High PP (PP >61 mmHg) of the obesity [1.37 (95 % CI, 1.03-1.82)] and abdominal obesity [1.38 (95% CI, 1.07-1.78)] group compared to the normal group was not significant. However, in men, the OR of High PP of the obesity and abdominal obesity group compared to the normal group was not significant. In conclusion, the obesity and abdominal obesity were associated with pulse pressure in Korean women, but not in men.
위준선,윤영윤,전병조,윤한덕,허탁,민용일 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1
Purpose: As Gwangju Wide Regional Emergency Medical Center was newly opened during February 2001, a comparative analysis was performed of patients who had visited the emergency department before and after the opening in order to measure the difference and to provide basic data for its management. Methods: The 9,995 patients, who had visited between February 1. 1999, and July 31, 1999, before the opening and the 12,457 patients who visited between February 1, 2001, and July 31, 2001, after its opening were compared according to sex, age, non-trauma or trauma, means and form of visit, attending department, length of stay in the emergency department, form of discharge, and time of death verification (dead-on-arrival(D.O.A) versus dead-after-arrival (D.A.A) ) Results: The total number of patients increased by 24%. The admission rate was 31.8% before the opening and 40.6% after the opening; the mean length of stay in the emergency department was 15.7 hours before the opening and 12.2 hours after the opening. The mean length of stay of admitted patients decreased from 26.6 hours before the opening to 18.3 hours after the opening. Conclusion: The decrease in the mean length of stay in the emergency department from 15.7 hours before the opening to 12.2 hours after the opening is viewed as a positive result, but is still not satisfactory. Accordingly, it is considered urgent that every clinical department take an active part in improving circulation of patients both in the Emergency Intensive Care Unit(EICU) on the second floor and in the emergency ward on the fifth floor, as well as in providing rapid medical care and decisions on treatment strategies in the emergency department on the first floor.
위준선,정승태,윤영윤,정경운,문정미,전병조,허탁,민용일 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1
Risk factors for infective endocarditis include injection drug abusers and patients with structural heart defects undergoing dental procedures. Infective endocarditis is clinically important because it is hard to diagnose it in its early stage owing to its various clinical manifestations, and because its morbidity and mortality increase when neurologic complications occur. This is a case of infective endocarditis in the course of treatment of which complicating cerebral hemorrhage and infarction progressed rapidly and prompted death.
염경인,한승철,윤영윤,문정미,전병조,허탁,민용일 대한응급의학회 2004 大韓應急醫學會誌 Vol.15 No.4
P u r p o s e: This study intended to identify prognostic factors influencing recovery, progressing chronic renal failure (CRF) and mortality in acute renal failure (ARF) patients at the emergency department. M e t h o d s: We retrospectively analyzed 104 patients with ARF and with serum creatinine (Cr) level above 2 mg/dL and glomerular filtration rate (GFR) < 62.5 mL/min/ 1.73m2 (< 50%), who were treated at the emergency department fome Jan. 1998 to Aug. 2003. R e s u l t: Among the 104 patients, 71 patients were male and 33 patients were female. The overall mortality was 16.3%. Based on a univariate analysis, sex, age > 60 years, underlying disease, cause of ARF, urine volume, existence of oliguria, duration of oliguria, proteinuria, GFR, serum BUN, serum Cr, BUN/Cr ratio, arterial pH, PaO2, S a O2, serum Na+, serum K+, serum albumin, serum total bilirubin, serum osmolarity, serum AST, serum ALT, serum creatine kinase, and serum myoglobin were all significant factors discriminating between recovery patients and nonrecovery patients (progressing CRF, mortality). Based on a multivariate analysis, sex, existence of oliguria, duration of oliguria, GFR, BUN/Cr ratio, PaO2, serum K+, SaO2, serum bilirubin, and serum osmolarity were useful factors which might affected non-recovery. C o n c l u s i o n: In ARF, the prognostic factors were serum K+, S a O2, duration of oliguria, and BUN/Cr ratio. The higher serum K+, the lower SaO2, the longer the duration of oliguria, and the lower the BUN/Cr ratio are for ARF patients at the emergency department, the more the intensive care emergency physician must perform.
위준선,한승철,정승태,윤영윤,정경운,문정미,전병조,허탁,민용일 대한응급의학회 2003 대한응급의학회지 Vol.14 No.2
Massive hemoptysis represents a major medical emergency that is associated with high mortality. The causes of hemoptysis are various and include pulmonary and cardiovascular disorders and trauma. The causes of pulmonary disorder are tuberculosis, bronchiectasis, abscess, malignancy, bronchitis, and fungal infection. The causes of cardiovascular disorder are mitral stenosis, pulmonary embolism, and congestive heart failure. A fistula between an aortic aneurysm and the pulmonary parenchyma is one of the causes of hemoptysis, but it is a rare. However, if undiagnosed, it is a uniformly fatal cause of massive hemoptysis. This is a case of bleeding from a fistula between an aortic arch aneurysm and a lung parenchyma in a patient with an aortic arch aneurysm who presented with massive hemoptysis. He had suffered intermittent hemoptysis since he was diagnosed with an aortic arch aneurysm three years before. A high clinical suspicion must be maintained when a history of intermittent hemoptysis is obtained in patients with an aortic aneurysm or prior aortic graft surgery.