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횡문근융해증과 급성 신부전 및 범발성 혈관내 응고장애를 동반한 열사병 1예
최대은,박수진,권오경,이한규,이영모,이상주,나기량,이강욱,신영태 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2
Heat stroke is a life-threatening illness characterized by an elevated core body temperature that rises above 40% and central nervous system dysfunctions that results in delirium, convulsions, or coma. Heat stroke is subdivided into two forms, classic and exertional. Since strenuous exercise is one of the major exacerbating and precipitating factors, the incidence of exertional heat stroke is high among young adult, especially military personnel undergoing military training. Exertional heat stroke commonly causes rhabdomyolysis, lactic acidosis, acute renal failure, shock and pulmonary edema. We report a case of heat stroke with rhabdomyolysis, acute renal failure, disseminated intravascular coagulopathy(DIC) after strenuous exercise. A 18 year old man was admitted to the hospital because of loss of consciousness. He was a wrestler and he had tried to lose 6kg in weight by jogging and strenuous exercise on that summer day with hot temperature. The development of this illness was favoured by much clothes inappropriate for that environmental condition with a purpose to enhance sweating, and by restricted intake of water and food. On admission, the blood pressure was 80/50mmHg, and body temperature was 39.4℃ with stuporous mentality. Laboratory finding were as follows : in complete blood cell count, hemoglobin was 16.7g/dL and platelet count was 158,000/ mm³. In blood chemistry, AST 1061U/L, ALT 201U/L, BUN 30mg/dL, Cr 2.2mg/dL, LDH 941IU/L, CK 696IU/L were resulted. In arterial blood gas analysis, pH 7.39, pCO₂ 30mmHg pO₂ 86mmHg, HCO₃ 18.4mEq/L, O₂ saturation 96.7% were resulted. In urinalysis, specific gravity 1.025, protein 3+, erythrocyte 2+ were resulted. In brain imaging study, brain CT finding was normal. After appropriate treatments with rapid cooling, hydration and supportive care, he improved with alert mental status. On 2nd hospital day, in laboratory result, thrombocytopenia and coagulopathy were appeared and renal insufficiency was aggravated. So he was treated with platelet concentrate and fresh frosen plasma for DIC, and enough hydration for appropriate urine volume preservation. After all, On 22nd hospital day, he fully recovered and discharged. Nowadays, with followed for some duration, he is wellbeing with no complications.
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병원간 응급의료 전달체계에 대한 연구 : 영동세브란스 병원 응급진료센타를 중심으로
최성욱,김인병,이한식 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1
Transporting an emergent patient to a hospital has a crucial role in proper patient care. Objective of this study is to review the current methods and various patient transport system used between the hospital. We have conducted a retrospective analysis of consecutive 753 patients who was transport-in and out from emergency department of YoungDong Severance Hospital from Sep. 1, 1994 to Feb. 28, 1995. All transferred patients were divided into two large category of trauma versus non-trauma, 363 to 390 patients, respectively. Average ISS(injury serverity score) for trauma patients were 7.31 point and average GCS score of 14.29 point for non-trauma patients. Most of the patients were trasfered-in during day and evening hours(84%), but there was no peak hours for transfer-out patients. Little more than half of all transferred patients used ambulance as a mode of transportation. Among all transfer-in patients, 65% were admitted for general care, emergency operation and ICU care. Others, 17%, 18% were discharged or transfer-out to other hospital, respectively. For transfer-out patients, 72% of transfer-out patients were for admission following recommandation by an emergency physician. Each level of hospital was divided into 4 subgroup ; private clinic, small hospital, general hospital and university hospital. ISS was also divided into score less than 10 points for mild and more than 11 points for moderate to severe injury. As a results, all of patients transferred from private clinic bad less than 4 point of ISS. Where as increasing percentage of patients with higher ISS was transferred-in from higher level of hospitals. Transfer-out hospitals were carefully selected by emergency physicians according to patient health status, speciality of referring hospital and closeness to patient residence For non-traumatic patient, GCS score was divided into GCS score 14or less and 15 point. Similar to trauma patient, there was increasing percentage of patient with lower GCS score transfer-in as hospital level increase. Patients with ISS less than 10 point and GCS score 15 point can be transferredto anappropriate level of hos-pital if EMSS operates properly. We suggest with a well organized EMSS, mandatory inter-hospital communication and good transfer record, proper patient transfer and treatment can be achieved.
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남성 알코올 의존 환자의 삶의 질과 정신-사회-영적 특성과의 관계
최삼욱,나란희,김한오,최성빈,최영숙 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.5
Objectives : This study was designed to evaluate the relationship between quality of life (QOL) and psycho-socio-spiritual characteristics in male patients with alcohol dependence. Methods : The sample consisted of 109 men with alcohol dependence defined by DSM-IV criteria. We assessed QOL by the WHO QOL assessment instrument-BREF (WHOQOL) and SmithKline Beecham QOL (SBQOL). Sociodemographic and alcohol related data were collected, and 7 questionnaires were administered : MAST, BDI, STAI, Drinker Inventory of Consequences (DrInC), Scale of Social Support (SSS), Religious Beliefs and Behaviors (RBB) and Spiritual Well-being Scale (SWBS). The correlations between each QOL score and other variables were examined, and stepwise multiple regression analysis was performed. Results : The WHOQOL score positively correlated with education level, SSS (support) and RBB and negatively correlated with MAST, DrInC, BDI, STAI (trait) and SSS (conflict) scores. In stepwise regression analysis, the scores on the STAl and BDI contributed to the score on the WHOOOL. The SBQOL score correlated with the income level, and negatively correlated with BDI and STAI score. STAI score was a weak predictor of SBQOL score. Conclusion : The significant predictors of QOL in patients with alcohol dependence were psychological factors such as anxiety and depression.
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최영식,이상용,김유훈,조갑래,이봉우,양경무,정낙은,서중석,이한영,이원태,강현욱 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2
Disposal of a homicide victim by dismemberment is rare, but individual cases are on record in most major medicolegal departments. Recognition of postmortem mutilation may be of importance in the interpretation of certain murders committed by sexual perverts and other mentally deranged individuals and sometimes performed for the sole reason of easier disposal of the body. Postmortem dismemberment is usually readily recognizable as such; The edges of the injuries are dry and lack evidence of bleeding. The joints may be disarticulated without fracture, or the use of an axe or saw may be evident from examination of bones. Parallel horizontal or oblique furrows in the bone surface are caused by skipping of the saw prior to establishing depth. Such patterns on the bone may assist in identifying the particular saw involved. So we report 25 dismembered corpses that autopsied in National Institute of Scientific Investigation. This paper can help in attempting to establish not only the first criminal investigation steps but also the medicolegal approach methods in unidentified and dismembered deaths.
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최한철,고영무,정재헌,신종연,김일선,최성욱,정효수 대한치과기재학회 1999 대한치과재료학회지 Vol.26 No.4
Dental magnetic materials have been applied to removable prosthetic appliances, maxillofacial prostheses, obturator and dental implant but they still have some problems such as low corrosion resistance in oral environments. To increase the corrosion resistance of dental magnetic materials, surfaces of Sm-Co and Nd-Fe-B based magnetic materials were plated with TiN and then electrochemical corrosion test were performed in 4 kinds of electrolyte solutions(0.9% NaCl. 1% lactic acid, 0.05% HCl and modified Fusayama's artificial saliva). From this study, corrosion behavior, amount of elements released, mean average surface roughness values and the changing of mean surface microhardness values were measured comparing with control group of non-sputtered plating magnetic materials. The results were as follows: 1. TiN layer coated on magnet grows into preferred direction with lamellar structure and its thickness is 3.0㎛. 2. Sm-Co base magnetic materials coated with TiN have good corrosion resistance in 1% lactic acid and their pitting corrosion can not be seen. 3. Nd-Fe-B base magnetic materials coated with TiN showed good tendency of corrosion resistance in 0.05% HCl solution. 4. The amount of elements released from both Sm-Co and Nd-Fe-B base magnetic materials coated with TiN were more significantly decreased than that of uncoated magnetic materials. 5. The mean surface roughness values of both Sm-Co and Nd-Fe-B base magnetic materials coated with TiN were smooth than that of uncoated magnetic materials after corrosion test. 6. The decreasing rate of microhardness of both Sm-Co and Nd-Fe-B base magnetic materials coated with TiN were lower than that of uncoated magnetic materials after corrosion test. 7. Dental magnetic materials coated with TiN produced various corrosion products such as TiO, TiO₂, Ti₂O₃on the surface and resulted in better corrosion resistance than uncoated magnetic materials. In conclusion, it is considered that the corrosion problem of dental magnetic materials could be solved to some extent by EB-PVD with TiN on the surface of dental magnetic materials.
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김동욱,최한석 木浦大學校 情報産業硏究所 1999 情報産業硏究誌 Vol.7 No.-
The Purpose of this thesis is to design and implementation of a XML document editor supporting XSL for user friendly. This Editor support edit of hierarchical architecture and various XML documents type. Also, an XSL stylesheet editor specifies the presentation of a class of XML documents by describing how an instance of the class is transformed into an XML document that uses the formatting vocabulary. This thesis implements an exclusive user friendly XML document editor supporting various function different from previous XML editor.
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고영무,최한철,정재헌,정효수,최성욱 대한치과기재학회 1999 대한치과재료학회지 Vol.26 No.4
In order to investigate the various properties of dental magnetic materials studies on corrosion behavior, decreasing rate of magnetic flux density, amount of elements released, mean average surface roughness values and the changing of mean surface microhardness values for dental application were done. To increasing the corrosion resistance of dental magnetic materials, surfaces of Sm-Co and Nd-Fe-B based magnetic materials were plated with gold(Au), platinum(Pt), titanium(Ti), chromium(Cr) and cobalt(Co), and then electrochemical corrosion test were performed in 4 kinds of electrolyte solution(0.9% NaCl, 1% lactic acid, 0.05% HCl and modified Fusayama's artificial saliva). The results were as follows: 1. In Sm-Co and Nd-Fe-B based magnetic materials, the pitting corrosion of experimental group was higher than that of the control group, the experimental group was less corrosive than control hroup. 2. The amount of elements released from experimental group was more significantly decreased than that of control group. 3. Decreasing rate of magnetic flux density of experimental groups was significantly lower than that of control group after corrosion test. 4. The mean average surface roughness value of one(Sm-Co based magnetic materials not plated) of the control group was much increased in modified Fusayama's artificial saliva after first corrosion but that of the other(Nd-Fe-B based magnetic materials not plated) was much increased in 0.05% HCl solution. 5. The decreasing rate of surface microhardness values of experimental groups were lower than that of control group after corrosion, 6. Intergranular corrosion started first from the grain boundary of the control group and they advanced gradually to general corrosion, and the pitting corrosion occurred locally at area of existing pits in experimental group.
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장문준,황태식,최성욱,김인병,손대곤,조광현,이한식 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1
An unconscious 20 year old male carried into the emergency department after an electric shock injury 20 minutes earlier. Cardiopulmonary resuscitation was undertaken when asystole appeared on the electrocardiograph monitor. A 12-lead electrocardiograph was taken when in that myocardial infarction was found after performing cardiopulmonary resuscitation on an electrical injury patient. We present out case's electrocardiographs with echocardio-graphic findings and radionuclide imaging studies.
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