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RISS 인기검색어
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- 저자 : 배병관 ( Byung Kwan Bae ) (검색결과 2 건)
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골반골절 환자의 골절위치와 출혈량간의 상관관계 분석을 통한 대량수혈 필요에 대한 간단한 예측도구 개발: 골반골 출혈 지수
이상식 ( Sang Sik Lee ),배병관 ( Byung Kwan Bae ),한상균 ( Sang Kyoon Han ),박성욱 ( Sung Wook Park ),류지호 ( Ji Ho Ryu ),정진우 ( Jin Woo Jeong ),염석란 ( Seok Ran Yeom ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4
Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean age=46.7±16.6 years) were enrolled for analysis. The average ISS of the patients was 16.2±7.9, and the average amount of packed RBC transfusion for 24 hr was 3.9±4.6 units. The regression equation resulting from the multiple linear regression analysis was ``packed RBC units=1.40×(sacrum fracture)+1.72×(pubis fracture)+1.67×(ilium fracture)+0.36`` and was found to be suitable (p=0.005). We simplified the regression equation to ``Pelvic Bleeding Score=sacrum+pubis +ilium``. Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management. (J Trauma Inj 2012;25:139-144)
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황산구리 중독에서 대안 해독제로의 succimer 사용 1례
한상균 ( Sang Kyoon Han ),박성욱 ( Sung Wook Park ),조영모 ( Young Mo Cho ),왕일재 ( Il Jae Wang ),배병관 ( Byung Kwan Bae ),염석란 ( Seok Ran Yeom ),박순창 ( Soon Chang Park ) 대한임상독성학회 2021 대한임상독성학회지 Vol.19 No.1
Copper sulfate is widely used as a fungicide and pesticide. Acute copper sulfate poisoning is rare but potentially lethal in severe cases. Copper sulfate can lead to cellular damage of red blood cells, hepatocytes, and myocytes. Toxic effects include intravascular hemolysis, acute tubular necrosis and, rhabdomyolysis. A 76-year-old man presented with vomiting and epigastric pain. He had ingested a copper-containing fungicide (about 13.5 g of copper sulfate) while attempting suicide 2 hours prior to presentation. From day 3 at the hospital, laboratory findings suggesting intravascular hemolysis were noted with increased serum creatinine level. He was treated with a chelating agent, dimercaptosuccinic acid (succimer). His anemia and acute kidney injury gradually resolved with a 19-day regimen of succimer. Our case suggests that succimer can be used for copper sulfate poisoning when other chelating agents are not available.
ScienceON
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