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장지용 ( Jee Yong Jang ), 임용수 ( Yong Su Lim ), 양혁준 ( Hyuk Jun Yang ), 박원빈 ( Won Bin Park ), 현성열 ( Sung Youl Hyun ), 조진성 ( Jin Sung Cho ), 김진주 ( Jin Joo Kim ), 이미진 ( Mi Jin Lee ) 대한응급의학회 2011 大韓應急醫學會誌 Vol.22 No.2
Purpose: In patients resuscitated from out-of-hospital cardiac arrest (OHCA), the influences of serial serum glucose and variability on neurological outcome are not well understood. We investigated the influence of serum glucose and variability on neurological outcome in OHCA survivors. Methods: Records of 105 OHCA survivors who received therapeutic hypothermia (TH) between April, 2007 and January, 2010 were retrospectively reviewed. By neurological prognosis at 6 months after restoration of spontaneous circulation, patients were divided to two groups based on cerebral performance category (CPC) score; 1-2 (good) and 3-5 (poor). The serial measured glucose level and glucose variability during 72 hours were compared between the groups. Results: The poor CPC group had statistically higher mean, median and maximum glucose level, but not minimal glucose, compared to the good CPC group. The poor CPC group also comparatively displayed higher standard deviation and time-glucose variability index (TGVI) of glucose level during 72 hours. Multiple logistic regression demonstrated that increased TGVI was significantly associated with poor neurological outcome (odds ratio 1.304, 95% confidence interval 1.078-1.578) Conclusion: Serial glucose level and variability are strongly related with neurological outcome in post-resuscitated patients who received TH after OHCA. Further randomized controlled studies are needed.
김도민 ( Do Min Kim ), 박원빈 ( Won Bin Park ), 임용수 ( Yong Su Lim ), 김진주 ( Jin Joo Kim ), 장재호 ( Jae Ho Jang ), 장지용 ( Jee Yong Jang ), 양혁준 ( Hyuk Jun Yang ), 이근 ( Geun Lee ) 대한임상독성학회 2014 대한임상독성학회지 Vol.12 No.2
Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.
우재혁 ( Jae Hyug Woo ), 이근 ( Gun Lee ), 조진성 ( Jin Seong Cho ), 양혁준 ( Hyuk Jun Yang ), 임용수 ( Yong Su Lim ), 김진주 ( Jin Joo Kim ), 박원빈 ( Won Bin Park ), 장지용 ( Jee Yong Jang ), 장재호 ( Jae Ho Jang ), 현성열 ( Sung Youl H) 대한응급의학회 2015 大韓應急醫學會誌 Vol.26 No.5
Purpose: This study describes the disaster medical responses to the disaster scene of long-distance on a highway; 106-vehicle chain collision on Yeong-Jong Grand Bridge on February 11, 2015 and we discuss the disaster communication by social media. Methods: Records of disaster medical responses from records of relevant organizations and messages of social media were collected. Medical records and the results of triage were reviewed retrospectively. Casualties were categorized into four groups according to results of triage; Red- Yellow-Green-Black. Kappa statistics were used to measure agreement between results of triage and casualties' outcome. Results: Disaster Medical Assistant Team (DMAT) arrived on the scene one hour after accidents occurred. DMAT settled in a temporary base camp in the middle part of the scene and did not build an emergency air shelter. DMATs from four hospitals were separated into four mobile units of DMAT and they joined the rescue team. Disaster communication by social media was useful. Seventy six casualties were transported and two died; 28.9% of casualties were transported to the nearest regional emergency medical center; 20.0% of red casualties were transported to a higher level of care again. Kappa statistics were 0.122 (95% CI, -0.049~0.291; p=0.094). Conclusion: In the disaster scene of long-distance on a highway, adequate location of triage and treatment area may be the front or rear of the scene and separation of DMATs can be helpful. Disaster communication by social media was helpful. Education and policies will be required for more effective triage and dispersion of casualties.