간 손상에 대한 의사결정과 응급처치

신상도(Sang Do Shin) 한국간담췌외과학회 2007 한국간담췌외과학회지 Vol.11 No.2

보문 : 체험마케팅이 브랜드 자산에 미치는 영향에 관한 연구 -브랜드 홍보대사를 중심으로-

신상무 ( Sang Moo Shin ),김도훈 ( Do H. Kim ) 한국의류학회 2010 한국의류학회지 Vol.34 No.2

타워크레인 텔레스코핑 작업의 풍속 및 하중에 대한 구조 안전성 연구

정성룡,이도근,백신원,신상연,Jung, Sung-Lyoung,Lee, Do-Geun,Paik, Shinwon,Shin, Sang-Yeon 한국안전학회 2021 한국안전학회지 Vol.36 No.1

This study analyses the load imbalance of the tower crane used in telescoping work for structural safety, owing to the difference in wind speed and balance weight position. This is because wind speed and position of the balance weight have a significant impact on the structural stresses of a tower crane during telescoping work. Therefore, structural analysis was performed on the 290HC model, which is often used at construction sites and has only one cylinder installed. Moreover, two models were classified to determine the load acting on the connecting part of the telescopic cage to slewing platform and the cylinder. Five types of balance weight positions were applied at regular intervals from jibs; moreover, four types of wind load criteria were differently applied. Hence, the telescopic cage columns were destroyed at all balance weight positions at a wind speed of 30 m/s and only at certain locations at a wind speed of 20 m/s. Furthermore, failures occurred for cylinders, torsional, and bending at wind speeds of 30 m/s and 20 m/s, load imbalances above the allowable thresholds considering the safety factor. In addition, the load imbalance in the telescoping work also varied depending on the position of the balance weights. The results of these studies have validated that the current standards of adjusting the appropriate position of the balance weights on the jib are completely valid, with the telescoping work to be executed only at wind speeds of less than equal to 10 m/s.

의사 탑승 헬기를 이용한 산악 응급 환자 이송: 시범 연구

박정호 ( Jeong Ho Park ),신상도 ( Sang Do Shin ),이의중 ( Eui Jung Lee ),박창배 ( Chang Bae Park ),이유진 ( Yu Jin Lee ),김경수 ( Kyoung Soo Kim ),박명희 ( Myoung Hee Park ),김한범 ( Han Bum Kim ),김도균 ( Do Kyun Kim ),권운용 ( W 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

Purpose: We aimed to compare the transport time, the proportion of direct hospital visit and the emergency procedures between the current mountain rescue helicopter emergency medical service (HEMS) and physicianstaffed mountain-rescue HEMS. Methods: During weekends from October 2, to November 21, 2010, 9 emergency physicians participated as HEMS staff in the mountain-rescue HEMS program of the Seoul fire department. Patient demographic data, transport time, proportion of direct hospital visits, and emergency procedures were recorded. We also collected data on HEMS mountain-rescued patients from June 1, to September 1, 2010, and we compared them to those for the study patients. After an eight-week trial of the HEMS, we performed a delphi survey to determine the attitude of the physician staff, as well as the feasibility of using a physician staff. Results: Twenty-four(24) patients were rescued from mountains by physician-staffed HEMS during the study period, and 35 patients were rescued during the pre-study period. Patient demographic findings were not statistically different between the two groups, but the transport time and the emergency procedures were. During the study period, the time from call to take-off was 6.1±4.1min (vs. 12.1±8.9min during the pre-study period, pvalue=0.001), and the time from call to arrival at the scene was 15.0±4.8min (vs. 22. 3±8.1min during the pre-study period, p-value=0.0001). The proportions of direct hospital visit were not different between the two groups, but more aggressive emergency procedures were implemented in the study group. The delphi survey showed positive agreement on indications for HEMS, rapidity of transport and overall satisfaction. Conclusion: A pilot trial of physician-staffed HEMS for mountain rescue showed rapid response and more aggressive performance of emergency procedures with high satisfaction among the attending physicians. (J Trauma Inj 2012;25:230-240)

지역응급의료센터에서 손상구역 운용이 응급실 과밀화 지표에 미치는 영향

강진욱 ( Jin Wook Kang ),신상도 ( Sang Do Shin ),서길준 ( Gil Joon Suh ),유은영 ( Eun Young You ),송경준 ( Kyoung Jun Song ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2

Purposes: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, burns, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. Methods: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients` data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. Results: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). Conclusion: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it`s impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable. (J Korean Soc Traumatol 2007;20:77-82)

암환자 응급진료의 현황 및 문제점

허대석,윤영호,정주영,김홍수,김성혜,신상도,김중의,오은경,유철규,방영주,김노경,Heo, Dae-Seog,Yun, Young-Ho,Jeong, Joo-Young,Kim, Hong-Soo,Kim, Sung-Hye,Shin, Sang-Do,Rhee, Joong-Eui,Oh, Eun-Kyung,Yoo, Chul-Gyu,Bang, Yung-Jue,Kim, Noe-K 한국호스피스완화의료학회 1998 한국호스피스.완화의료학회지 Vol.1 No.1

Purpose : Cancer is a common cause for admission to emergency room(ER). Cancer patient present to ER with undiagnosed cancer, acute vague problem of cancer, or treatment related complication. But there is little information on the magnitute of the problems in the Korea. The purposes of our study were to evaluate the appropriateness of care for oncologic emergencies in Korea. Materials and Methods : This study was undertaken of all cancer patients above 15 years old presenting to the Seoul National University Hospital ER, who visited during the period from Oct. 16 to Nov. 15, 1997. ER record was reviewed and ER doctors evaluated patients' reason for visiting ER, appropriateness in patients' utilization of ER, oncology emergency Results : 266 cancer patients(17.4% of total patients) visited ER during this period and 166 cancer patients(62.4%) utilized inappropriately ER. Their average stay is 32.0 hours and 65.8% of them stayed for 6 hours. There were complaints of patients such as pain(44.8%), abdomen distension(9.4%), and dyspnea(7.5%). The most common oncologic emergency in ER during this study were gastrointestinal(34.0%), neurologic(21%), hematologic(8.0%), infectious(7.0%), respiratory(6.0%), and genitourinary(5.0%). Conclusion : For the care of symptoms like pain, most of cancer patients utilize ER inappropriately due to lack of attention from primary health delivery system. For the better care, the palliative medicine should be established in Korea. 목적: 우리나라에서 암환자들이 긴급한 의료문제가 발생한 경우, 어떤 경과를 거쳐 진료를 받고 있는지 자세히 연구된 자료가 없다. 대부분의 1, 2차 의료기관이 암환자진료에 소극적이어서, 사소한 증세조절을 위해서도 3차의료기관의 응급실을 방문해야 하는 등 많은 문제점이 있다. 이에 연구자들은 3차의료기관 응급실을 방문한 암환자들의 적절성여부를 평가하여 암환자의 응급진료상의 문제점을 파악하고자 한다. 방법: 서울대학교 응급실을 방문한 성인암환자들의 응급실방문의 목적, 주증상, 적절성 등을 응급실근무 전공의와 간호사를 통해 조사, 평가하였다. 결과: 1997년 10월 16일부터 11월 15일사이 한달간 서울대학교병원응급실을 방문한 환자중 암환자는 17.4%(266명)를 차지하였다. 이중 응급실이용이 부적절하다고 판단된 환자는 166명(62.4%)이었으며, 이들의 응급실재원 평균시간은 28.7시간이었고, 주증상은 통증이었다. 결론: 통증과 같은 증상조절을 위하여 응급실을 방문하는 암환자의 대부분이 1, 2차의료기관에서도 진료가 가능한 상태로 암환자의 증상조절이 보다 효율적으로 이루어질수 있도록 완화의학 및 의료전달체계의 조속한 확립이 요망된다.

권역 응급의료센터에 내원한 비외상성 객혈 환자에서 기관지 동맥 색전술의 장기 생존 효과

천성빈 ( Song Bin Chon ),정성구 ( Sung Koo Jung ),곽영호 ( Young Ho Kwak ),서길준 ( Gil Joon Suh ),유은영 ( Eun Young You ),신상도 ( Sang Do Shin ) 대한결핵 및 호흡기학회 2004 Tuberculosis and Respiratory Diseases Vol.57 No.2

구급대원용 개인보호복 개발을 위한 기초연구

노유민,남윤자,이혜린,김태한,김주현,신상도,No, Yoo-Min,Nam, Yun-Ja,Lee, Hye-Rin,Kim, Tae-Han,Kim, Chu-Hyun,Shin, Sang-Do 한국응급구조학회 2018 한국응급구조학회지 Vol.22 No.1

Purpose: The purpose of this study was to provide basic data for the development of personal protective equipment (PPE) for emergency medical technicians (EMTs) during chemical, biological, radiological, nuclear, and explosive situations. Methods: Body measurements were obtained for adults aged from 20 to 59 years from the data in the 6 th Size Korea national sizing survey. These data were compared to the sizes of protective clothing currently available in the market. In-depth interviews with active paramedics with experiences of wearing PPE were conducted. Results: Most of the imported protective clothing turned out to be unfit for Korean adults. This showed the urgent need for developing appropriately sized protective clothing for Korean emergency technicians. In total, 55.0% of the respondents indicated that the current protective clothing is unsafe, and 71.0% requested the clothing to have level C protective performance. Regarding the design, many people wanted hooded all-in-one type of clothing. Conclusion: Considering these requirements, most of the wearers wanted their protective clothing to be fundamentally protective of their body, be available in various sizes with adjustable parts, and easy to wear and take off. They also wanted the clothing to be secure in clear sight, while not revealing any parts of their body and not interfringe with their ability to communicate with others.

학교 손상과 관련된 병원 전단계 응급 의료 실태 및 위해 환경 요인

송경준 ( Kyoung Jun Song ),정성구 ( Sung Goo Jeong ),곽영호 ( Young Ho Kwak ),서길준 ( Gil Joon Suh ),권운용 ( Woon Yong Kwon ),신상도 ( Sang Do Shin ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.1

Purpose: This study was designed to evaluate the risk factors of injury and pre-hospital emergency service system in school. Methods: A designed questionnaire was made up by nurse-teachers. We described the frequency and the distribution by types of school, gaining method of information about emergency care, education programs and concerns about injury prevention, transportation methods, and number of injured victim. After all school were divided with two groups such as high and low injury group based on median points of injury count, the adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) of each risk factor were measured using the multivariate logistic regression analysis. Results: 246 female nurse-teachers were responded. Of them, 143 worked at primary school, 50 at middle school, 29 at high school, and 18 at special school, respectively. Injury was the second common cause visiting to nursing room. 43.67% of victims were directly transported by nurse-teacher. Degree of attention about injury prevention was relatively high (63.0%) but education program was not sufficient (83.0%). There were no oxygen devices, ventilatory devices, airway maintenance devices, electrocardiography equipments, and critical drugs except immobilization devices, stretchers, oral antibiotics, and fluids in most schools. Mean number of victim visiting to nursing room due to injury was 2.6 per a day per 1,000 students. Adjusting for related factors, ``disordered shopping and parking area to near school`` (adjusted OR 1.840; 95% CI 1.077~3.143), ``risky window without safety equipment`` (adjusted OR 1.786; 95% CI 1.019~3.131), and ``when number of involved indoor condition was increased by one`` (adjusted OR 1.255 95% CI 1.004~1.568) were significant risk factors on high injury incidence. Conclusion: Injury was one of the most common health problems in school but there was no equipped for emergency care. ``Disordered street near to school`` and ``risky indoor conditions`` were significant risk factors on school injury.

LCD 백라이트용 외부전극 형광램프의 인버터 회로 해석

정종문,신명주,이미란,김가을,김정현,김상진,이민규,강미조,신상초,안상현,길도현,유동근,구제환,Jeong, Jong-Mun,Shin, Myeong-Ju,Lee, Mi-Ran,Kim, Ga-Eul,Kim, Jung-Hyun,Kim, Sang-Jin,Lee, Min-Kyu,Kang, Mi-Jo,Shin, Sang-Cho,Ahn, Sang-Hyun,Gill, Do 한국진공학회 2006 Applied Science and Convergence Technology Vol.15 No.6

외부전극 형광램프를 광원으로 하는 백라이트의 저항$(R_L)$과 전기용량(C), 그리고 인버터의 트랜스포머 인덕턴스(L)로 구성된 회로를 분석하였다. 램프의 저항과 전기용량은 램프에 흐르는 전류와 전압의 위상차 및 Q-V 그래프에서 결정된다. 32인치용 EEFL 램프 하나의 저항 값은 $66\;k\Omega$이고 전기용량은 21.61 pF이다. 20 개의 EEFL을 병렬 연결한 백라이트의 저항은 $3.3\;k\Omega$이고 전기용량은 402.1 pF이다. 램프 및 트랜스포머 회로에서 임피던스 매칭 주파수는 2 차 코일의 인덕턴스 $L_2$와 결합계수 k로 나타내며, $\omega_M=1/\sqrt{L_2C(1-k^2)}$ 이다. 램프 시스템의 전류와 전압은 임피던스 매칭 주파수에서 최대값을 갖는다. 이러한 해석 해의 결과는 실험 결과와 잘 일치한다. The circuit of the EEFL system and the inverter has been analyzed into the resistance RL, the capacitance C of the EEFL-backlight system, and the inductance of transformer in the inverter. The lamp resistance and capacitance are deter-mined from the phase difference is between the lamp current and voltage and from the Q-V diagram, respectively. The single Lamp of EEFL for 32' LCD-BLU has the resistance of $66\;k\Omega$ and the capacitance of 21.61 pF. The resistance, which is connected by parallel in the 20-EEFLS BLU, is $3.3\;k\Omega$ and the capacitance is 402.1 pF. The matching frequency in the operation of lamp system is noted as $\omega_M=1/\sqrt{L_2C(1-k^2)}$, where $L_2$ is the inductance of secondary coil and k is the coupling coefficient between primary and secondary coil. The lamp current and voltage has maximum value at the matching frequency in the LCD BLU system. The results of analytic solutions are in good agreement with the experimental results.