Resuscitation

차경철 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.2

The Frequency of Reexpansion Pulmonary Edema after Trocar and Hemostat Assisted Thoracostomy in Patients with Spontaneous Pneumothorax

차경철,김현,지호진,권우철,신형진,차용성,이강현,황성오,Christopher C. Lee,Adam J. Singer 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.1

Purpose: Several risk factors for development of reexpansion pulmonary edema (REPE) after drainage of pneumothoraces have been reported, but the association between the method of thoracostomy and the development of REPE is unknown. The aim of this study was to compare the frequency of REPE after treatment of spontaneous pneumothorax with trocar or hemostat assisted closed thoracostomy. Materials and Methods: We performed a prospective, observational study including 173 patients with spontaneous pneumothorax who visited the emergency department from January 2007 to December 2008. In 2007, patients were treated with hemostat-assisted drainage, whereas patients in 2008 were treated with trocar-assisted drainage. The main outcome was the development of REPE, determined by computed tomography of the chest 8 hours after closed thoracostomy. Outcomes in both groups were compared using univariate and multivariate analyses. Results: Ninety-two patients were included, 48 (42 males) of which underwent hemostat-assisted drainage and 44 (41 males) underwent trocar-assisted drainage. The groups were similar in mean age (24±10 vs. 26±14 respectively). The frequencies of REPE after hemostat- and trocar-assisted drainage were 63% (30 patients) and 86% (38 patients) respectively (p=0.009). In multivariate analysis, trocar-assisted drainage was the major contributing factor for developing REPE (odds ratio=5.7, 95% confidence interval, 1.5-21). Age, gender, size of pneumothorax, symptom duration and laboratory results were similar between the groups. Conclusion: Closed thoracostomy using a trocar is associated with an increased risk of REPE compared with hemostat-assisted drainage in patients with spontaneous pneumothorax.

심폐소생술 중 에피네프린 반복 투여에 따른 혈역학적 효과

차경철,안교진,노영일,정우진,황성오 대한응급의학회 2023 대한응급의학회 학술대회초록집 Vol.2023 No.2

요율 낮고 손해율 높은 영문계약 시정되야

차경철,Cha, Gyeong-Cheol 한국화재보험협회 1989 防災와 保險 Vol.42 No.-

요율제도와 연관된 방재서비스 기법을 도입해야

차경철,Cha, Gyeong-Cheol 한국화재보험협회 1990 防災와 保險 Vol.45 No.-

패혈성 쇼크에서 혈압상승제 투여 방법에 따른 혈역학적 효과 비교

차경철,황성오,오성범,김선휴,지호진,김현,이강현,김경진,김호중 대한응급의학회 2004 대한응급의학회지 Vol.15 No.4

테서렉트 조형원리를 적용한 장신구 표현 연구

신영희,차경철 사단법인 한국조형디자인협회 2023 조형디자인연구 Vol.26 No.3

본 연구는 테서렉트(Tesseract)의 기하학적인 시공간 이론 개념을 활용한 형태적인 구조 연구를 바탕으로 하며, 입사 기법을 이용한 다차원의 형태를 조형 장신구로 표현하는데 목적을 둔다. 연구전개를 위하여 수학자 찰스 하워드 힌튼(Charles Howard Hinton)의 테서렉트 개념과 특성을 고찰한다. 또한 조형 장신구로 완성함에 있어 앙리 푸앵카레(Henri Poincaré)의 테서렉트에 대한 하이퍼큐브 형태와 크리스 맥뮬런(Chris McMullen)의 글로메스(Glomes) 원형 이론을 차용하여 정리하고 응용한다. 새로운 조형원리의 향상을 위해, 테서렉트의 원리를 적용한다. 이론적인 바탕은 테서렉트의 수학적인 개념, 조형성, 그리고 조형원리인 수직, 수평, 반복, 중첩, 확장, 변화에 대한 분석을 통해 단계적으로 구현한다. 그리고 테서렉트 개념이 적용되어진 장신구 디자인에 활용된 사례들을 찾아 분석한다. 본 연구 작품은 자연의 이미지를 토대로 입사 문양을 만들고, 이를 3D 기법과 결합하여 입체적인 형태로 형상화하며 또한 이런 과정을 통해 시공간 차원을 은유적으로 작품에 표현함으로써 완성한다. 본 연구에서는 디자인과 실용성을 접목시키는데 중점을 두었으며, 일반적인 평면 입사 반지에 4차원 테서렉트의 조형 언어 개념을 적용하는 것에 큰 의미를 둔다. This study is based on a structural research that employs the geometric spacetime theory of the Tesseract, with the aim of representing multi-dimensional forms as sculptural jewelry using the perspective technique. In the development of the research, the concepts and characteristics of the Tesseract by mathematician Charles Howard Hinton are examined. The completion of the sculptural jewelry involves borrowing and applying the theories of Henri Poincaré's hypercube form of the Tesseract and Chris McMullen's Glomes sphere. The principles of the Tesseract are utilized to enhance new sculptural principles. The theoretical basis involves the mathematical concept of the Tesseract, its plasticity, and the application of sculptural principles such as verticality, horizontality, repetition, overlapping, expansion, and change, which are gradually implemented. Also, instances where the Tesseract concept has been applied to jewelry design are sought and analyzed. The artwork of this study is completed by creating perspective patterns based on the image of nature, forming them into three-dimensional shapes using 3D techniques, and metaphorically expressing spacetime dimensions in the work through such processes. In this study, the focus was on integrating design and practicality. Significant emphasis was placed on applying the conceptual language of a 4D tesseract to conventional inlay rings.

응급실의 전신염증반응 증후군 환자에서 프로칼시토닌의 유용성

박경혜,차경철,김현,황성오,이강현 대한중환자의학회 2012 Acute and Critical Care Vol.27 No.1

Background: The aim of this study was to investigate whether obtaining serum procalcitonin (PCT) levels in patients with systemic inflammatory response syndrome (SIRS) helps the differential diagnosis between sepsis and non-sepsis and predicts disease severity in the emergency department (ED). Methods: This prospective study enrolled 132 consecutive adult patients with SIRS who visited the ED. Serum C-reactive protein (CRP) levels and serum PCT levels were compared between sepsis and non-sepsis groups upon ED admission. Sequential Organ Failure Assessment (SOFA), Multiple Organ Dysfunction Score (MODS), and Acute Physiology and Chronic Health Evaluation (APACHE) III scores were calculated, and their correlations with CRP and PCT levels were evaluated. The PCT and CRP levels were assessed to predict sepsis in terms of comparing receiver operating characteristic (ROC) curves. Results: Eighty patients were included in the sepsis group. The levels of PCT and CRP in the sepsis group were significantly higher. In the sepsis group, the initial serum PCT correlated with the SOFA and MODS scores, and this also correlated in the non-sepsis group, but CRP did not. No differences were found when the PCT and CRP ROCs were compared. Conclusions: Correlation between PCT and severity in the non-sepsis group is considered to be clinically meaningless because of low levels. Additionally, PCT levels had similar diagnostic value for sepsis as CRP levels. PCT is recommended for prediction of severity in sepsis patients in ED, but not for differential diagnosis between sepsis and non-sepsis.

A Randomized Controlled Trial of Compression Rates during Cardiopulmonary Resuscitation

황성오,차경철,김규석,조유환,정성필,유제성,신종환,이휘재,박유석,김승환,최상천,박은정,김원영,서동우,문성우,한갑수,최한성,강형구,박승민,권운용,최은희 대한의학회 2016 Journal of Korean medical science Vol.31 No.9

The objective of this study was to compare the efficacy of cardiopulmonary resuscitation (CPR) with 120 compressions per minute (CPM) to CPR with 100 CPM in patients with nontraumatic out-of-hospital cardiac arrest. We randomly assigned patients with nontraumatic out-of-hospital cardiac arrest into two groups upon arrival to the emergency department (ED). The patients received manual CPR either with 100 CPM (CPR-100 group) or 120 CPM (CPR-120 group). The primary outcome measure was sustained restoration of spontaneous circulation (ROSC). The secondary outcome measures were survival discharge from the hospital, one-month survival, and one-month survival with good functional status. Of 470 patients with cardiac arrest, 136 patients in the CPR-100 group and 156 patients in the CPR-120 group were included in the final analysis. A total of 69 patients (50.7%) in the CPR-100 group and 67 patients (42.9%) in the CPR-120 group had ROSC (absolute difference, 7.8% points; 95% confidence interval [CI], -3.7 to 19.2%; P = 0.183). The rates of survival discharge from the hospital, one-month survival, and one-month survival with good functional status were not different between the two groups (16.9% vs. 12.8%, P = 0.325; 12.5% vs. 6.4%, P = 0.073; 5.9% vs. 2.6%, P = 0.154, respectively). We did not find differences in the resuscitation outcomes between those who received CPR with 100 CPM and those with 120 CPM. However, a large trial is warranted, with adequate power to confirm a statistically non-significant trend toward superiority of CPR with 100 CPM. (Clinical Trial Registration Information: www.cris.nih.go.kr, cris.nih.go.kr number, KCT0000231)

Shock Duration after Resuscitation Is Associated with Occurrence of Post-Cardiac Arrest Acute Kidney Injury

김용원,차경철,차용성,김오현,정우진,Tae Hoon Kim,한병근,김현,이강현,Eunhee Choi,황성오 대한의학회 2015 Journal of Korean medical science Vol.30 No.6

This retrospective observational study investigated the clinical course and predisposing factors of acute kidney injury (AKI) developed after cardiac arrest and resuscitation. Eightytwo patients aged over 18 yr who survived more than 24 hr after cardiac arrest were divided into AKI and non-AKI groups according to the diagnostic criteria of the Kidney Disease/Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for AKI. Among 82 patients resuscitated from cardiac arrest, AKI was developed in 66 (80.5%) patients (AKI group) leaving 16 (19.5%) patients in the non-AKI group. Nineteen (28.8%) patients of the AKI group had stage 3 AKI and 7 (10.6%) patients received renal replacement therapy during admission. The duration of shock developed within 24 hr after resuscitation was shorter in the non-AKI group than in the AKI group (OR 1.02, 95% CI 1.01-1.04, P < 0.05). On Multiple logistic regression analysis, the only predisposing factor of postcardiac arrest AKI was the duration of shock. In conclusion, occurrence and severity of post-cardiac arrest AKI is associated with the duration of shock after resuscitation. Renal replacement therapy is required for patients with severe degree (stage 3) post-cardiac arrest AKI.