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대량 폐동맥 혈전색전증으로 인한 심정지 환자의 심폐소생술 - 혈전용해제사용 경험 2 예 -
조준휘(Jun Hwi Cho),황성오(Sung Oh Hwang),이강현(Kang Hyun Lee),이진웅(Jin Woong Lee),이서영(Seo Young Lee),박해상(Hae Sang Park),김성환(Seong Whan Kim) 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1
The massive pulmonary thromboembolism is serious illness that can lead to death within an hour after its occurrence. The incidence of cardiac arrest caused by massive pulmonary thromboembolism has been known as about 7%. Invasive therapeutic modalities to treat massive pulmonary thromboembolism during cardiac arrest including thoracotomy or cardiopulmonary bypass have been shown little effect. Administration of a thrombolytic agent is an alternative choice of treating massive pulmonary thromboembolism during cardiac arrest. This report describes our experience of cases with massive pulmonary thromboembolism that were treated with administration of a thrombolytic agent during CPR.
김성은,조준휘,천승환,이승용,최기훈,배지훈,서정열,안희철,안무업,옥택근,박찬우,Kim, Sung-Eun,Cho, Jun-Hwi,Cheon, Seung-Whan,Lee, Seung-Young,Choi, Ki-Hoon,Bae, Ji-Hoon,Seo, Jeong-Yeul,Ahn, Hee-Cheol,Ahn, Moo-Eob,Ok, Taek-Gun,Park, Chan 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2
Paraquat, is a widely used for its great effect as a herbicide. But the mortality rate by paraquat intoxication is known to be very high. It is thought to act by changing form to superoxide and peroxide free radical. Almost paraquat intoxication is through ingestion. A few intoxication of paraquat is through skin absorption. But there was no known death case through skin absorption. We experienced a case of a expired patient by paraquat intoxication through skin abrasion and scratching wound. A 75-year-old man was visited emergency room after motorcycle accident during transporting paraquat. He has multiple abrasion and scratching wound on extremities, and pelvic bone fracture. There was no evidence of ingestion of paraquat. But serum/urine gramoxone level was all positive. In spite of wound irrigation and hemoperfusion, his condition was been gone form bed to worse. 2 days after, multiple organ failure and the respiratory arrest were developed and he was expired. Paraquat intoxication through skin wound is extremely dangerous and death by that could possibly happen
옥택근,조준휘,박찬우,김성은,최기훈,배지훈,서정열,정재봉,안희철,안무업,유기철,Ok, Taek-Gun,Cho, Jun-Hwi,Park, Chan-Woo,Kim, Sung-Eun,Choi, Ki-Hoon,Bae, Ji-Hoon,Seo, Jeong-Yeul,Chung, Jae-Bong,Ahn, Hee-Cheol,Ahn, Moo-Eob,You, Ki-Cheol 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.2
Acute poisoning is one of the diseases which need the most fastest emergency measures at the very beginning. However, at present, The Korea doesn't manage the toxication all over the country, and in particular, there is no guide to medical cure paying due regard to the traits of each area. This paper focused on the issue that the necessary data in preparing the facilities for the treatment of the poisoned patients and materials for medical treatment including antidote would have to be collected, after finding the special features of the symptoms by searching the present conditions of the poisoning in small towns next to farm villages in the North area of Youngseo, Kangwon province. This study was based on the questionnaires from 111 patients who were carried into the emergency room by the poisoning in two university hospitals of the North area of Youngseo, Kangwon, for one year, 2002. Upon investigation, the patients(111) visiting emergency room by the acute poisoning during the research period was found to be 0.37 percent of all patients(30,085) visiting emergency room. Among them, the most high percentage was given in their twenties and thirties at the rate of $39.6\%$, and the ratio($40.5\%$) of the poisoned patients after their fifties was much higher than a research($10\%$) of other areas. Many poisoned patients came to their rescue in an emergency room generally in spring and in winter, from 7 a.m. to 3 p.m. Agricultural chemical of the toxic materials had a majority at a ratio of $57.7\%$, and paraquat of the agricultural chemicals was found to have a lot of toxicity by $31.7\%$. As the trace of the toxication, the oral poisoning was common by $89.2\%$, and $55.9\%$ in the case of operating gastric lavage and nasogastric irrigation, but only $14.4\%$ for prescribing antidote. The mortality of the acute poisoned patients was $17.2\%$, and the toxication by paraquat held a majority. As a result, the acute poisoning of the North area in Youngseo, Kangwon had both of the characteristics of the rural and the city, and the patients over their fifties by the population aging had more attack of the disease than other regions. Also, with the high ratio of the toxication by the agricultural chemicals, especially, the lethal agricultural chemical was used frequently. Therefore, these dangerous situations need to find the ways to cope with.
옥택근,조준휘,박찬우,천승환,이승용,김성은,최기훈,배지훈,서정열,안희철,안무업,조병렬,김용훈,Ok Taek Geun,Cho Jun Hwi,Park Chan Woo,Cheon Seung Whan,Lee Seung Yong,Kim Sung Eun,Choi Ki-Hoon,Hae Ji Hoon,Seo Jeong Yeul,Ahn Hee Cheol,Ahn Moo Eo 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.1
The majority of acute toxic poisoning occur via oral route. The most important emergency treatment of acute poisoning are gastric lavage. Gastric lavage should be considered a patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 mins of ingestion. But, gastric lavage does not consist properly in the cases of emergency situation or an inexperienced doctors treat. The purpose of this study was to determine whether gastric lavage is performed properly. Eighty patients were enrolled in the study in 12-month period from January to December 2002. A retrospective chart review was performed on patients identified as drug overdose who admitted to ER. To assess whether there was a subgroup of patients who may have been candidates for the initiation of gastric lavage in the ER, the patients divided in two groups by time interval from toxin ingestion to ER arrival. The group 1 that admit within 60 minutes after drug ingestion was 38 cases ($47.5\%$), and the group 2 patient who admitted after 60 minutes was 42 cases ($52.5\%$). The average age was $44\pm19$ years in group 1, and $48\pm24$ years in group 2. There were no differences in sexual distribution of two groups. The mean time interval was $49\pm20$ minutes in the group $1,258\pm190$ minutes in the group 2. Only thirty ($37.5\%$) of the patients had an overdose for which the treatment of gastric lavage was potentially feasible according to guideline. The correctly performed gastric lavage was 18 ($47.4\%$) in group 1, 12 ($28.6\%$) in group 2. We must enforce education about the gastric lavage, and do so that may treat according to guideline.
옥택근,박찬우,조준휘,천승환,이승용,김성은,최기훈,배지훈,서정열,안희철,안무업,조병렬,김용훈,Ok, Taek-Gun,Park,, Chan-Woo,Cho, Jun-Hwi,Cheon, Seung-Whan,Lee, Seung-Young,Kim,, Sung-Eun,Choi, Ki-Hoon,Bae, Ji-Hoon,Seo, Jeong-Yeul,Ahn, Hee-Cheo 대한임상독성학회 2005 대한임상독성학회지 Vol.3 No.2
Purpose: With the recent boom in 'eating healthy', many adults are interested in dieting to prevent future diseases. However only well trained experts can distinguish between what are edible vegetables and herbs from their poisonous look-alikes. In cases where a patient unknowingly ingests a poisonous herb, is caught off guard by the poisonous side effects that occur because of their lack of knowledge of what they have ingested. This paper will focus on the need to educate the public about the risks involved with ingesting wild vegetables and herbs and study the emergency diagnosis and treatment of poisoned patients that enter the emergency room. Method: This study was done in the spring of 2004 (from March to May) in the Kangwon Young-Seo districts of Korea. 15 subjects used in this study, entered the emergency room showing signs of toxic symptoms. Data was collected by examining subject's records. Additional data was collected by collaborating with physicians in the hospital that diagnosed and treated the subjects. Identifying the poisonous vegetable or herb is the first step to proper diagnosis and treatment. Subjects admitted to the emergency room, underwent a battery of tests: laboratory examination, ECG, radiological exam and etc. Results: The demographics of the study encompassed subjects with the average age of $50{\pm}19$ years old. There were 10 men and 5 women. Common symptoms of this study included; gastrointestinal symptoms such as nausea, vomiting, epigastric pain and so on. In the case of Caltha palustris ingestion, additional symptoms were present; bradycardia and hypotension which lasted for a long time. While cases that ingested Scopolia parviflora had little effect on vital signs but manic episodes lasted for about three days. Veratrum patulum ingestion showed signs of bradycardia and hypotension but contrary to Caltha palustris recovery was shorten by treating with dopamine. However, dizziness, headache and paresthesia of the extremities continued for a long time. Finally Sium ninsi ingestion showed visual disturbance, paresthesia of the extremities, dizziness as their initial symptoms. Conclusion: The risks involved with ingesting wild plants without the proper knowledge can lead to serious side effects and steps need to be taken to educate the public. In addition, all emergency physicians need to have a working knowledge of the symptoms and signs associated with ingesting toxic wild plants and need to treat accordingly.
박찬우,옥택근,조준휘,최동욱,허애영,이희영,김용훈,조병렬,김성은,최기훈,배지훈,서정열,정재봉,Park,, Chan-Woo,Ok, Taek-Gun,Cho, Jun-Hwi,Choi, Dong-Wook,Her, Ae-Young,Lee, Hee-Young,Kim,, Yong-Hoon,Cho, Byung-Ryul,Kim,, Sung-Eun,Choi, Ki-Hoon 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1
With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.
슈퍼와파린(superwarfarin) 살서제 중독으로 인한 장기간 혈액응고장애 1례
박찬우 ( Chan Woo Park ),조준휘 ( Jun Hwi Cho ),배준호 ( Joon Ho Bae ),문중범 ( Joong Bum Moon ),천성빈 ( Sung Bin Chon ),안기옥 ( Ki Ohk Ahn ),이희영 ( Hui Young Lee ) 대한임상독성학회 2011 대한임상독성학회지 Vol.9 No.2
Superwarfarin, such as brodifacoum, is a highly lethal vitamin K antagonist used as a rodenticide. Brodifacoum has a particularly long half-life in the body, which ranges to several months, and therefore requires prolonged treatment with antidotal vitamin K. We experienced a case whereby an 18-year-old male was presented to the hospital with a severe bleeding disorder. It was discovered that he had ingested brodifacoum rodenticide with intent to commit suicide. Despite continual treatment with vitamin K, the bleeding disorder persisted for several months before he recovered. We report this case with literature review.
광주광역시 요양시설 코로나19 집단 발생 사례에서 코로나19 백신 접종에 의한 사망 예방 효과
류소연(So Yeon Ryu),조준휘(Jun Hwi Cho),이란(Ran Lee),박소영(So Yeong Park),정다운(Daun Jung),배소현(So Hyun Bae),고화평(HwaPyeong Ko) 한국농촌의학 지역보건학회 2022 농촌의학·지역보건 Vol.47 No.2
Objectives: The purpose of this study was to identify the effectiveness of COVID-19 vaccinations on deaths of the COVID-19 cases in some elderly long-term care facilities (LTCF) in Gwangju Metropolitan City. Methods: The study subjects were 659 COVID-19 cases in residents of 7 elderly LTCF, Gwangju, from 21 Dec. 2021 to 28 Jan. 2022. The used variables were confirmed dates for COVID-19, demographic characteristics, co-morbidities, presentation of symptoms, death and vaccination related characteristics including type of vaccine, doses and dates. Vaccination status were classified as not vaccinated, partially and fully vaccinated. The associations of vaccination status and deaths of COVID-19 cases were tested by chi-square test and multiple logistic regression analysis. Results: The rates of not vaccinated, partially vaccinated and fully vaccinated were 19.4%, 10.2% and 70.4%, respectively. The mortality rate of the cases was 6.4%. The death rate by vaccination status was 16.4% in not vaccinated, 15.4% in partially vaccinated and 2.6% in fully vaccinated, showing a statistically significant difference. The adjusted odds ratios (ORs) (95% confidence intervals, CIs) of death compared to fully vaccinated were 7.64 (3.87-16.34) in non-vaccinated, and 6.97 (3.44-14.14) in partially vaccinated. Conclusions: COVID-19 vaccination seems to work effectively in preventing deaths of COVID-19 cases of elderly LTCF residents. This finding support that fully vaccinations in high risk group such as elderly LTCF residents is very important for one of strategies of COVID-19 management.
최기훈,안희철,안무업,정재봉,김성은,배지훈,서정열,조준휘,박찬우,옥택근,Choi Gi Hoon,Ahn Hee Cheol,Ahn Moo Eob,Chung Jae Bong,Kim Sung Eun,Bae Ji Hoon,Seo Jeong Yeol,Cho Jun Hwi,Park Chan Woo,Ok Taek Gun 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1
In emergency department, the clinicians occasionally meet some patients with toxicity caused by ingestion of unknown wild edible greens or herbal agents. Due to there was few quantitative or qualitative studies about the mechanism or clinical features of these materials, it' s hard to approach to the patients and start the initial management in emergency department. Authors experienced the case of poisoning by Scopolia Japonica ingestion. We report this case with review of Scopolia Japonica.
장예근 ( Yegeun Jang ),김채현 ( Chae Hyeon Kim ),조준휘 ( Jun Hwi Cho ),정회준 ( Hoe Jun Jung ),지봉준 ( Bongjun Ji ),연재흠 ( Jaeheum Yeon ),임경재 ( Kyoung Jae Lim ) 한국농공학회 2022 한국농공학회 학술대회초록집 Vol.2022 No.-
The concepts and technologies of the digital twin are getting introduced to the agricultural engineering field to produce a virtual representation of agricultural infrastructure for real-time communication between the infrastructure on-site and its 3D model that is mimically reproduced in the virtual environment. At the 2021 Korea Society of Agricultural Engineers annual conference, This research team introduced how building information model can be displayed on the GIS-based digital twin platform. Based on the result this research team achieved, this study introduces how a digital map can be visualized on top of the BIM-GIS-based digital twin system. To achieve the research objective of this study, the source code of the digital twin platform had to be revised to load a geo JSON data source. In detail, a terrain JSON link associated with a digital map that we want to visualize on top of the GIS-BIM digital twin platform should be inserted into the file path. After that, the function of ‘clamp to ground’ should be revised as “true” to visualize the digital map on top of the existing digital twin system. After revising the existing source code, the digital map was successfully located where the user wants to put it. Therefore, since this study successfully demonstrated how to visualize not only building information model but also a digital map on the 3D GIS-based digital twin platform, the primary purpose of the digital twin could be taken one step closer to its practicality. This study is expected to be connected with the next research associated with the GIS-based digital twin platform in the agricultural engineering field.