http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
다양한 신경학적 이상을 나타낸 glufosinate ammonium(바스타$^{(R)}$) 급성 경구 중독 1례
백진휘,김준식,이현규,박현주,하충건,노형근,Paik Jin Hui,Kim Jun Sig,Yi Hyeon Gyu,Park Hyun Joo,Ha Choong-Kun,Roh Hyung-Keun 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2
BASTA is an herbicide which contains glufosinate ammonium as a main component with an anionic surfactant, polyoxyethylene alkylether sulfate, and nonselectively inhibits glutamine synthetase. It became a wildly used herbicide in Korea and its intoxication is now increasing. A 42-year old woman ingested about 300ml of BASTA in a suicide attempt. She showed unconsciousness and respiratory distress in the beginning, and later developed multiple generalized convulsions, low blood pressure, fever and diabetes insipidus. Although she became alert 12 days after the ingestion, she showed retrograde amnesia for a period of about recent 10 years. A neuropsychological test on day 22 revealed frontal lobe dysfunction, visual memory disturbance and slight decrease in visuospatial function. All these neurological abnormalities that might occur due to glufosinate ammonium were almost improved in the follow-up test performed a month later.
다양한 신경학적 이상을 나타낸 glufosinate ammonium(바스타®) 급성 경구 중독 1례
백진휘 ( Jin Hui Paik ),김준식 ( Jun Sig Kim ),이현규 ( Hyeon Gyu Yi ),박현주 ( Hyun Joo Park ),하충건 ( Choong Kun Ha ),노형근 ( Hyung Keun Roh ) 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2
BASTA is an herbicide which contains glufosinate ammonium as a main component with an anionic surfactant, polyoxyethylene alkylether sulfate, and nonselectively inhibits glutamine synthetase. It became a wildly used herbicide in Korea and its intoxication is now increasing. A 42-year old woman ingested about 300ml of BASTA in a suicide attempt. She showed unconsciousness and respiratory distress in the beginning, and later developed multiple generalized convulsions, low blood pressure, fever and diabetes insipidus. Although she became alert 12 days after the ingestion, she showed retrograde amnesia for a period of about recent 10 years. A neuropsychological test on day 22 revealed frontal lobe dysfunction, visual memory disturbance and slight decrease in visuospatial function. All these neurological abnormalities that might occur due to glufosinate ammonium were almost improved in the followup test performed a month later.
김아진,백진휘 한국의료윤리학회 2015 한국의료윤리학회지 Vol.18 No.1
취약함이란 그들 자신의 이익을 스스로 보호할 수 없는 상태를 의미한다. 응급의료에서의 취약함도 이와 다르지 않으며 특히 선택가능하지 않으나 환자의 경과나 결과에 나쁜 영향을 미치는 요인들이라고 가정한다. 응급의료에서 취약함의 요인들은 많으나 여기에서는 3가지를 논할 것인데, 관계적 자율성을 지지할 수 있는 가족의 부재, 응급대불제도의 불완전성, 의사결정능력의 결여에 관한 것이다. 각각의 요인들을 설명할 수 있는 이론과 제도, 개념을 간단히 기술하면서 해당 사례에 적용을 할 것이다. 또한 각각의 요인들이 서로 독립적이지 않을 것이다. 해당 요인에 영향을 받는 환자들이 스스로 결정할 수 있고, 의학적 이익을 보호받기 위하여 보완되어야 할 것이라고 생각되는 것들에 대하여 논할 것이다. Vulnerability population cannot protect their interest themselves. Vulnerability in emergency medicine is not different. We assume the factors that influence the patient’s course or patient’s outcome badly. We will discuss three factors of the vulnerability in emergency medicine. Those are the family without relational autonomy, the incompleteness of emergency subrogation payment system, and a lack of decision making capacity. We will describe theory, concepts, systems related factors and then apply them to our case. The factors are not independent. We discuss things to be made up for the autonomy and medical interest of the vulnerable patients that influenced by factors.
서영호,백진휘,신승열,김아진,강수 대한응급의학회 2020 Clinical and Experimental Emergency Medicine Vol.7 No.3
Objective Emergency physicians experience difficulty in determining the disposition of patients with elevated troponin I levels using emergency room tests. In this study, we aimed to investigate factors that could discriminate between the occurrence of type 1 myocardial infarction (T1MI) and type 2 myocardial infarction (T2MI) in patients with elevated troponin I levels. Methods Patients admitted to the emergency department between January 1, 2017 and June 30, 2017 with elevated troponin I levels who underwent subsequent cardiac biomarker testing were included. Samples for baseline blood tests, such as cardiac biomarker levels, were collected within approximately 10 minutes of admission. Electrocardiogram, transthoracic echocardiography, and percutaneous coronary intervention results were retrospectively examined via patient report and chart reviews. Results During the study period, 169 of 234 (72%) patients were diagnosed with T2MI and 65 (28%) were diagnosed with T1MI. Among various factors, typical chest pain (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.46 to 13.24; P=0.008), high troponin I levels (OR, 1.50; 95% CI, 1.19 to 1.90; P<0.001), high cholesterol (OR, 1.01; 95% CI, 1.00 to 1.02; P=0.008), and low D-dimer levels (OR, 0.87; 95% CI, 0.77 to 0.98; P=0.027) were significantly associated with T1MI incidence. Conclusion Our findings in this study indicate that typical chest pain, high levels of troponin I and cholesterol, and low levels of D-dimer were associated with the diagnosis of T1MI. Further studies are suggested to determine the cut-off values for accurate diagnosis of T1MI in the ED.
복부 Computed Tomography 촬영을 통해 기종성 신우신염으로 발견된 의식 변화 환자
한승백,백진휘,정현민,김지혜,문연숙 대한요로생식기감염학회 2014 Urogenital Tract Infection Vol.9 No.1
Emphysematous pyelonephritis is an acute gas forming necrotizing infection of the renal parenchyma with high mortality, which shows non-specific clinical findings. Elderly patients with altered mentality and shock require careful monitoring and abdominal computed tomography scanning is thought to be beneficial in prompt detection of infection focus and management. We report on a patient with altered mentality who showed emphysematous pyelonephritis on abdominal computed tomography and provide a review of the literature.
윤성현,백진휘,정현민,김지혜,김준식,한승백 대한응급의학회 2014 大韓應急醫學會誌 Vol.25 No.1
Saponated cresol solutions are common household disinfectantsworldwide. Their main component, concentrated cresol,is extremely toxic and fatal; however, precise information onthe clinical manifestations of cresol intoxication is not available. We report on a case of suicidal poisoning by ingestionof saponated cresol. A 63-year-old male presented withunconsciousness and brownish discoloration on the neckand anterior chest wall after ingesting 100 ml of 50%saponated cresol solution with suicidal attempt. The patientshowed a wide range of clinical features of cresol intoxication,including decreased consciousness, respiratory distress,strong carbolic acid odor, dark brown urine, and chemicaldermal burns on multiple areas. General treatment of cresolintoxication is intensive supportive care. In addition, reducingsystemic absorption is most important in patients with cresolintoxication who present with cresol burns. Because the rateof cresol absorption through the skin is proportional to thesize of the area involved and the duration of contact of thechemical with the skin rather than to the concentration of thecresol solution, gross decontamination, including removal ofcontaminated clothing and vigorous flushing with water, isvery important. Quantitative assays for cresol and its metabolitesin blood or urine are needed in order to confirm the diagnosis. However, because these analytical methods are timeconsuming and are not routinely available in most emergencydepartments, the clinical manifestations of this casemay be useful in early diagnosis and treatment.
응급실을 방문하는 성인 환자에서 예후 평가를 위한 조기경고점수의 비교
이형후,강수,백진휘,박상협 대한응급의학회 2020 대한응급의학회지 Vol.31 No.1
Objective: This study compared the effectiveness of the Modified Early Warning Score, the National Early Warning Score, the VitalPAC Early Warning Score (ViEWS), the Rapid Acute Physiology Score, the Rapid Emergency Medicine Score (REMS), and the Worthing Physiological Scoring system for predicting hospitalization, intensive care unit (ICU) admission and in-hospital mortality. Methods: Our study was performed on all the patients admitted to the emergency department, except those who were pregnant, dead on arrival or self-discharge patients between 1 January 2019 and 31 March 2019. The outcomes of the study were hospitalization, ICU admission, and in-hospital mortality. Receiver operating characteristics (ROC) curve analysis was performed to evaluate and compare the six scores. Results: REMS was found to have the greatest efficacy for the prediction of hospitalization. The area under the ROC curve (AUROC) was 0.705. ViEWS was found to have the greatest efficacy for prediction of ICU admission and in-hospital mortality (include the 2-day and 7-day mortality). AUROC was 0.727 in ICU admission, 0.918 in 2-day mortality, 0.813 in 7-day mortality, and 0.775 in in-hospital mortality. Conclusion: The efficiency of ViEWS was better than other scores for predicting the patients’ severity. For predicting hospitalization, REMS could be the best predictor because of the age variable.