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Acrylonitrile is most commonly used aliphatic nitrile compounds characterized by the structural formula R-C=N and used mostly to make acrylic fibers, plastics, synthetic rubber, and wall coverings In recent, because of its extensive usage and the rapid expansion of the chemical industry, many poisonings have been reported and many studies on its health effects have been performed Acute toxicity resembles cyanide poisoning and results mainly in effects on the nervous system High exposure also can cause temporary damage to red blood cells and the liver and can cause lead to death Because long-term occupational exposure to the acrylonitrile has been with cancer in humans, the U.S EPA dassifies acrylonitrile as probable carcinogen For this reason, The federal govemment has developed regulations and advisories to protect individuals from the potential health effects of aaylonitrile in the enviroment, but there are few studies, case reports and regulations of the govemment in our country We experienced acute poisoning caused by acrylonitrile inhalation that occurred in an industrial accident. So, we report this case with literature reveiw
추진기에서 캐비테이션이 발생되면 효율이 저하되고 진동과 소음이 발생한다. 소음은 캐비테이션이 처음으로 발생되는 시점부터 크게 증가되므로 캐비테이션 초생속도(CIS)를 가능한 높이는 것이 중요하다. 본 논문에서는 가변추진기의 캐비테이션 초기발생 현상을 확인하기 위하여 처음으로 캐비테이션 실선관측을 수행하였다. 관측 결과 가변추진에서 캐비테이션 초기발생은 볼트 캐비테이션으로 확인되어 볼트부위를 개선한 새로운 형상의 가변추진기를 제안하였다. 개선된 가변추진기에서는 볼트 캐비테이션이 전혀 발생되지 않았으며, CIS는 개선 전 가변추진기 보다 약 4.5 노트 향상된 것을 확인하였다. 본 연구 결과는 향후 저소음 가변추진기 개발과 CIS 성능 향상에 매우 유용한 자료로 활용될 것이다. If cavitation occurs in propeller, it generates vibration and noise accordingly which results in low efficiency of propeller. It"s important to increase cavitation inception speed(CIS) since the noise of cavitation increases significantly from the beginning of cavitation. This paper describes the result of actual observation and measurement onboard ship with controllable pitch propeller(CPP), so as to verify the first occurrence phenomenon of cavitation. The research suggests new type of controllable pitch propeller with improved CIS at the bolt as it started with bolt cavitation as result of observation. It"s not found bolt cavitation on the CPP proposed in this paper, furthermore its CIS is increased approximately by 4.5 knots than the existing CPP. The result of the research can be used for development of low-noise CPP and improving performance of CIS.
Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was 37.70±19.78 years with 36.6% of the patients being under 30 years forage. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs. (J Korean Soc Traumatol 2008;21:100-107)
김용인 ( Yong In Kim ), 노기철 ( Ki Cheul Noh ), 강영준 ( Young Joon Kang ), 임용수 ( Yong Su Lim ), 양혁준 ( Hyuk Jun Yang ), 이근 ( Gun Lee ), 진욱 ( Wook Jin ), 황성연 ( Seong Youn Hwang ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2
Background: Simple cervical X-rays often miss cervical spine injuries. Magnetic resonance imaging is valuable in these cases. The aims of this study is to determine high-risk factors of the cervical injuries, and to contribute to make indications of cervical MRI in evaluation of blunt trauma patients. Methods: We retrospectively reviewed the patients who visited our ED due to nuchal pain and examed by simple cervical X-ray and cervical MRI after blunt trauma. We analyzed the incidence of abnormal MRI findings in various patients groups. We also compared the incidence of missed cervical spine injury by level of injured spine. We thought cervical MRI to be goldstandard of this analysis. Results: The incidence of abnormality on cervical MRI is higher in male patients than female patients (p<0.01). Old (age≥40) patients frequently shows abnormal cervical MRI findings than young patients (p<0.001). In patients who had neurologic abnormality, the incidence of abnormality on cervical MRI is higher than neurologically normal patients (p<0.001). But, mechanisms of injuries and associated injuries are not related to the incidence of abnormality on cervical MRI. Injuries of lower cervical spine (C7) are frequently missed than those of other cervical spines (p<0.01). Conclusion: When evaluate cervical injuries in male, old, and neurologically abnormal patients, we must consider cervical MRI although the simple cervical X-ray is normal. We must pay more attention to lower cervical spine injuries than other cervical spine injuries.
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.
Purpose: Traumatic brain injury (TBI) is the most common cause of pediatric trauma patients came to the emergency department. Without guidelines, many of these children underwent repeat brain computed tomography (CT). The purpose of this study was to evaluate the value of repeat brain CT in children with TBI. Methods: We conducted a retrospective study of TBI in children younger than 19 years of age who visited the emergency department (ED) from January 2011 to December 2012. According to the Glasgow Coma Scale (GCS) and Pediatric Glasgow Coma Scale score of the patients, study population divided in three groups. Clinical data collected included age, mechanism of injury, type of TBI, and outcome. Results: A Total 83 children with TBI received repeat brain CT. There were no need for neurosurgical intervention in mild TBI (GCS score 13-15) group who underwent routine repeat CT. 4 patients of mild TBI group, received repeat brain CT due to neurological deterioration, and one patient underwent neurosurgical intervention. Routine repeat CT identified 12 patients with radiographic progression. One patient underwent neurosurgical intervention based on the second brain CT finding, who belonged to the moderate TBI (GCS score 9-12) group. Conclusion: Our study showed that children with mild TBI can be observed without repeat brain CT when there is no evidence of neurologic deterioration. Further study is needed for establish indication for repetition of CT scan in order to avoid unnecessary radiation exposure of children. [ J Trauma Inj 2015; 28: 149-157 ]
안현철 ( Hyun Chul An ), 임용수 ( Yong Su Lim ), 조진성 ( Jin Seong Cho ), 김진주 ( Jin Joo Kim ), 양혁준 ( Hyuk Jun Yang ), 박원빈 ( Won Bin Park ), 우재혁 ( Jae Hyug Woo ), 현성열 ( Sung Youl Hyun ) 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.5
Purpose: Studies have demonstrated that B-type natriuretic peptide (BNP) has a predictive value for sudden cardiac arrest in heart failure patients. The aim of this study was to investigate the usefulness of serum BNP levels for theprediction of death in post-cardiac arrest patients treated withtherapeutic hypothermia (TH). Methods: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between April 2007 and August 2010 were evaluated and divided into two groups based on death within 3 months. Initial serum BNP levels were checked and BNP levels compared between both groups. Results: A total of 162 patients were enrolled in the study. Among 162 patients, 109 patients were male (mean age of 50 years). The BNP levels of the non-survival group (n=77) were higher than those of the survival group (n=85); however, there was no statistical difference (19.45 pg/ml vs. 30.75 pg/ml, p=0.174). The BNP cutoff value of 106 pg/ml for death within 3 months had a sensitivity of 35.1% and a specificity of 78.8%. In the logistic regression analysis, BNP levels higher than 106 pg/ml were significantly associated with death within 3 months (odds ratio [OR], 2.625; 95% confidence interval [CI], 1.066-6.463) and other independent factors were BLS to ROSC (OR, 1.105; CI, 0.082- 1.038), non-VF/VT (OR, 3.698; CI, 1.632-8.380), and APACHE II score (OR, 1.117; CI, 1.035-1.204). Conclusion: Initial Serum BNP levels are related with death within 3 months for patients that received TH after OHCA. However, additional randomized and controlled studies are needed.
Digoxin is commonly used in treatment of various heart conditions, such as atrial fibrillation, atrial flutter, and sometimes heart failure. The therapeutic range of digoxin is narrow. Therefore, Digoxin toxicity is common. However, severe digoxin intoxication is uncommon. Many cases involving application of Digoxin immune Fab for digoxin intoxication in other countries have been reported. However, no cases have been reported in Korea. We reported on one case, a 34-year-old male with acute and severe digoxin intoxication who was treated with digibind.. His chief complaint was gastrointestinal symptoms, including nausea and vomiting. Electrocardiography (ECG) showed third degree atrioventricular (AV) block. After an infusion of digibind., third degree AV block rhythm waschanged to first degree AV block. Nowadays, we can obtain a digoxin antidote from the national poisoning information center. Therefore, we should actively consider application of Digoxin immune Fab in patients with severe digoxin intoxication.