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RISS 인기검색어
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- 저자 : 민순식(Sun Sik Min) (검색결과 4 건)
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이근,박철완,표창해,안석근,임용수,민순식 대한응급의학회 1998 대한응급의학회지 Vol.9 No.1
Many patients whose chief complaint is headache caused by accident such as traffic accident, falling, or assaults visit to emergency center. Majority of these patients has mild or moderate symptoms, and there is no need to treat surgically. However, the fact that head injury can cause SIADH(syndrome of inappropriate secretion of antidiuretic hormone)is likely to be overseen. Acute hyponatremia might have been associated with death or permanent brain damage. Hyponatremia is best handled by early recognition and correction of a downward trend in the serum sodium. Unfortunately, this is often difficult in the head-injured patient, where hyponatremia may occur fairly rapidly and is confused by symptoms of head injury. When moderate to severe hyponatremia occurs, it is important to determine its etiology and expeditiously initiate corrective action. There has not been any reported case of the occurrence of symptomatic SIADH after mild head injury in Korea yet. The authors report the experience of three cases of symptomatic SIADH after mild head injury with review of the literatures.
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대형 화재로 인한 사상자의 손상 유형과 합병증 : 동인천 라이브호프 화재를 중심으로
신중호,김재광,염석란,신종환,민순식,임용수,양혁준,이근,황성연 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3
Background: High risks of fire alway exist for buildings in urban areas, especially those in downtown. Crowds, as well as more complex and larger structures, may cause more victims in the event of fire; therefore, emergency medical service plans must be established for such disastrous events. Methods: On the evening of October 30,1999, a fire broke out in downtown, Dong-Incheon Live-Hof restaurant; 56 people were killed and 76 were injured. Most of them were teenagers. We retrospectively reviewed the medical records of the victims, Results: 1) Among the 56 dead, 54 died from smoke inhalation, one from extensive burns, and one from sepsis during treatment. 2) Among the 76 injured, 70 patients suffered from smoke inhalation, 53 from burns, and 9 from several types of trauma (sprains, contusions, lacerations, abrasions, fractures, etc.). 3) Later complications were laryngeal edema, pulmonary edema, scar contracture, and hypoxic brain damage, and so forth. 4) Post traumatic stress syndrome was unexpectedly more prevalent in mildly to moderately injured survivors and witnesses than in seriously injured survivors. Conclusion: Many complications exist after a fire. Some may be resolved in time, but others may result in permanent sequelae. Early rescue, early triage, and early management during transport by emergency medical service (EMS) personnel can result in fewer complications and a lower mortality rate. Therefore, we propose the establishment of plans to be followed during various major disasters.
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심근 좌상 환자에서 ^(99m)Tc-MIBI-Heart SPECT의 유용성
신중호,양혁준,이근,민순식,염석란,김재광,임용수,진욱,현성열 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1
Purpose: This study analyzed the value of ^(99m)Tc-MIBI SPECT(Single Photon Emission Com-puted Tomography) in the deagnosis of myocardial contusion after blunt chest trauma. Methods: We evaluated 24 patients with cardiac contusions after blunt chest trauma who were diagnosed by clinical symptoms, chest x-ray, electrocardiogram(ECG), and Creatine phospho-kinase(CPK). ^(99m)Tc-MIBI SPECT was performed within 48 hours along with the above tests prospectively. Results: 1. Among the 24 patients, 14 patients were finally diagnosed as having a myocardial contusion by means of ECG, echocardiography, (^99m)Tc-MIBI SPECT, and cardiac enzyme. 2. The sensitivity, specificity and accuracy of ^(99m)Tc-MIBI SPECT were 46.7%, 66.7%, and 54.2%, respectively. The same results for initial ECG were 46.6%, 88.9%, and 62.5%. 3. For those who had positive findings in ^(99m)Tc-MIBI SPECT, average hospital stay was 14.5 days and abnormal electrocardiogram was found in 90.0%. However, for those who had negative findings, average hospital stay was 11.2 days and abnormal electrocardiogram was found in 35.7%. Conclusion: ^(99m)Tc-MIBI SPECT is not a definite modality in diagnosing myocardial contusion, but can be useful in diagnosing and determining the need for hospitalization after cardiac contusion.
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김정철,김창현,김재광,양혁준,이훈규,민순식,이근,현성열,박희권 대한외상학회 2000 大韓外傷學會誌 Vol.13 No.2
Background: Survival from traumatic cardiac rupture is rare. Though the diagnostic methods and operative skills have been markedly improved recently, The mortality rate still remains high. However, victims with traumatic cardiac rupture who reach the hospital alive can be saved by early diagnosis and immediate surgical management. Method: Between February 1997 and July 1999, seven consecutive patients with penetrating or blunt injury to the heart visited our emergency center and were operated on at the Department of Thoracic and Cardiovascular Surgery in Gil Hospital of Gachon Medical School. The authors reviewed their medical and operation records retrospectively. Results: 1. The male-to-female ratio was 2.5:1. The causes of penetrating injury was stab injury by knife in 3 cases and by grinder in one case. The causes of blunt injury were encompassed passenger traffic accident in 1 case and pedestrian traffic accident in 2 cases. 2. The major common sites of cardiac injury were the rt ventricle in 3 patients with penetrating trauma and the 1t ventricle 2 patients with blunt trauma. 3. The frequently associated injuries in blunt cardiac rupture were rib fracture (4 cases) and hemothorax (5 cases). 4. Echocardiography was performed in 6 cases, and pericardial effusion was detected in all case. 5. The average time interval from arrival to operation was 100 minutes for penetrating injuries and 90 minutes for blunt injuries. 6. The mortality rate for patients with a penetrating cardiac rupture was 25% (1/4) and that for patients with a blunt cardiac rupture was 77% (2/3). Conclusion: In the emergency room, the place where emergency patients are treated called the ER, emergency room, bedside 2-D echocadiography was useful in detecting anatomical abnormalities in suspected cardiac rupture patients with unstable conditions. Echocardiography must be immediately available in the resuscitation area and must be performed and interpreted by the emergency physician or surgeons in the emergency room.
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