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차용성,이강현,이석정,권호철,이종욱,김형일,김오현,차경철,김현,황성오 대한응급의학회 2018 Clinical and Experimental Emergency Medicine Vol.5 No.2
Objective Clinically, consumptive coagulopathy, such as disseminated intravascular coagulopathy (DIC), is the most important among the common venomous snakebite complications owing to the serious hemorrhage risk associated with this condition. We evaluated the predictive value of the delta neutrophil index (DNI)—a new indicator for immature granulocytes—for DIC diagnosis. Methods This retrospective observational study consecutively assessed adult patients with venomous snakebites for over 51 months. Patients were categorized into the no DIC and DIC groups. DNI values were measured within 24 hours after snakebite. Results Thirty patients (26.3%) developed DIC. The DIC group had significantly higher median initial DNI than the no DIC group (0% vs. 0.2%, P<0.001). When the DIC group was divided into early and late groups (within and over 24 hours after snakebite, respectively), the DNI of the former was significantly higher than that of the latter and no DIC group. The late DIC group had significantly higher DNI than the no DIC group. Furthermore, DNI positively correlated with the DIC score (r=0.548, P<0.001). The initial DNI (odds ratio, 4.449; 95% confidence interval, 1.738 to 11.388; P=0.002) was an early DIC predictor. The area under the curve based on the initial DNI’s receiver operating characteristic curve was 0.724. Conclusion DNI values were significantly higher in the DIC group. Additionally, DNI was an early predictor of DIC development in patients with venomous snakebites in the emergency department.
Adverse Cardiovascular Events after a Venomous Snakebite in Korea
차용성,김오현,이준우,김형일,차경철,김현,이강현,황성오 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.2
Purpose: Although cardiac involvement is an infrequently recognized manifestation of venomous snakebites, little is known of the adverse cardiovascular events (ACVEs) arising as a result of snakebite in Korea. Accordingly, we studied the prevalence of ACVEs associated with venomous snakebites in Korea and compared the clinical features of patients with and without ACVEs. Materials and Methods: A retrospective review was conducted on 65 consecutive venomous snakebite cases diagnosed and treated at the emergency department of Wonju Severance Christian Hospital between May 2011 and October 2014. ACVEs were defined as the occurrence of at least one of the following: 1) myocardial injury, 2) shock, 3) ventricular dysrhythmia, or 4) cardiac arrest. Results: Nine (13.8%) of the 65 patients had ACVEs; myocardial injury (9 patients, 13.8%) included high sensitivity troponin I (hs-TnI) elevation (7 patients, 10.8%) or electrocardiogram (ECG) determined ischemic change (2 patients, 3.1%), and shock (2 patient, 3.1%). Neither ventricular dysrhythmia nor cardiac arrest was observed. The median of elevated hs-TnI levels observed in the presentstudy were 0.063 ng/mL (maximum: 3.000 ng/mL) and there was no mortality in the ACVEs group. Underlying cardiac diseases were more common in the ACVEs group than in the non-ACVEs group (p=0.017). Regarding complications during hospitalization, 3 patients (5.4%) in the non-ACVEs group and 3 patients (33.3%) in the ACVEs group developed bleeding (p=0.031). Conclusion: Significant proportion of the patients with venomous snakebite is associated with occurrence of ACVEs. Patients with ACVEs had more underlying cardiac disease and bleeding complication.
차용성 ( Yong Sung Cha ),이강현 ( Kang Hyun Lee ),김선휴 ( Sun Hyu Kim ),장용수 ( Yong Su Jang ),김현 ( Hyun Kim ),신태용 ( Tae Yong Shin ),황성오 ( Sung Oh Hwang ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.1
Purpose: Few studies have been done for spinal injuries after skiing and snowboarding accidents. Assuming that the riding patterns of skiing and snowboarding were different, we analyzed the differences between the mechanisms, diagnoses and levels of spinal injuries caused by them. The purpose of this study was to gain a better understanding of spinal hazards associated with skiing and snowboarding in order to educate skiers and snowboarders. Methods: We conducted a prospective study of 96 patients who had sustained spinal injuries as a result of skiing and snowboarding accidents from January 2003 to March 2006. We used a questionnaire, radiological studies, history taking, and physical examinations. We analyzed the mechanism of injury, the level of spinal injury, the severity of spinal injury, and the Abbreviated Injury Scale scores (AIS score). We used the t-test and the chi-square test. Results: The skiing and the snowboarding injury group included in 96 patients. The skiing injury group included 30 patients (31.2%), and the snowboarding injury group included the remaining 66 patients (69.8%). The primary mechanism of injury in skiing was collisions and in snowboarding was slip downs (p=0.508). The primary level of spinal injury in skiing and snowboarding was at the L-spine level (p=0.547). The most common athlete ability of the injured person was at the intermediate level (p=0.954). The injured were most commonly at the beginner or the intermediate level (p=0.302). The primary diagnosis of spinal injury in skiing and snowboarding was back spain (p=0.686). The AIS scores did not differed between the two groups (p=0.986). Conclusion: The most common spinal injury after skiing and snowboarding accidents was back sprain. There was no difference in the severity of spinal injury between skiing and snowboarding accidents. (J Korean Soc Traumatol 2007;20:33-39)
DGS 회로를 이용한 IMT-2000용 전력증폭기의 설계 및 구현
차용성(Yong-Sung Cha),강병권(Byeong-Gwon Kang),김선형,박준석(Jun-Seok Park) 한국정보기술학회 2002 Proceedings of KIIT Conference Vol.2002 No.-
본 논문에서는 IMT-2000용 전력 증폭기를 설계 및 제작하였다. 전력증폭기의 주파수 대역은 IMT-2000용 순방향 주파수인 2110㎒~2170㎒에서 AB급으로 동작하도록 하였고, 고효율성과 우수한 선형성 소자인 LDMOSFET를 사용하였다. 설계 특성에 맞는 최적부하를 찾아 마이크로 스트립 회로로 입력 및 출력 정합 회로를 구현하였다. 임피던스 정합 방법으로는 소자를 실제 측정상태에서 입력단과 출력단에 튜너를 삽입하고 기본 주파수에서 최대 출력상태를 만족하는 임피던스를 튜너로 구현한 후, 튜너를 제거하고 튜너의 입력 임피던스를 Network Analyzer로 측정하여 최적 부하 임피던스를 추출하는 로드풀 방법을 사용하였다. 대전력 증폭기의 측정결과로는 2-톤 인가시 40.57㏈m의 출력결과를 얻을 수 있었고-30.61㏈c의 상호 혼변조 특성을 확인하였으며, 원신호의 하모닉(Harmonic) 주파수 성분과는 -19.56㏈c의 차이를 보였고, DGS 회로를 적용한 증폭기의 시뮬레이션 결과 -30㏈c 이상의 감쇠를 보임으로서 하모닉 성분을 억제시키는 결과를 확인하였다.