혼수상태의 외상환자에서 초음파를 이용한 흉부 및 복부손상의 진단

임경수,이강현,이진웅,이부수,황성오,유수영,강성준 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

The need for rapid diagnosis and treatment of life-threatening thoracic and intra-abdominal injury result in controversy over the appropriate triage of unconscious blunt trauma patients. To aid in early decisions for these patients, a prospective analysis of 98 patients with glasgow coma scale(GCS) scores≤8 was undertaken. Although intra-thoracic and intra-abdominal injuries were frequently identified based on systolic blood ressure, the use of clinical signs alone resulted in more missed injuries than did using the emergency ultrasonography. In normotensive patients(n=34), intra-thoracic injuries was identified in one patient(2.9%), and intra-abdominal injuries were in 7 patients(20.6%). In shock(systolic blood pressure<90mmHg) Pa-tients(n=64), thoracic injuries and intra-abdominal injuries were diagnosed in 8(12.5%) and 27 patients(42.3%), thoracic and abdominal combined injuries were identified in 11 patients(17.2%). The sensitivity, specificity, and accuracy of emergency ultrasonography were 96.3%, 91.7%, 94.9%. This study suggests that all unconscious trauma patients undergo immediate emergency ultrasonography to prevent missing life-threatening injuries.

김치의 혈전용해작용

강정옥,정영기,김정옥,양웅석,공인수 동의대학교 기초과학연구소 1996 基礎科學硏究論文集 Vol.6 No.1

Fibrinolytic activity of fermented kimchi and ingredients used for the preparation were assayed by measuring the lysis area on plasminogen-rich fibrin plate. Fermented kimchi and pickled fish sauces from changlan, prwan, and anchovy showed the activity, and the activity of pickled fish sauces were high in the order of pickled changlan, pickled anchovy(pickled mulchi), and pickled prawn. However, the activity of kimchi may not be attributed to pickled fish sauce because kimchi containing fish sauce did not possess activities before fermentation. To investigate fibrinolytic agents in the kimchi if protein, the activities were determined from the samples heated for 30min at 100℃. There was no changes in the activities before and after heat treatment indicating the agents may be components other than protein. Since major changes occur during kimchi fermentation were increased sour taste due to production of organic acids such as lactic, citric, oxalic, and succinic acids, the authentic organic acids present were examined for fibrinolytic activities. The results indicates that the major component posses the activity is lactic acid.

외상후 혈뇨환자에서 응급 초음파검사의 의의

임경수,이강현,황성오,이진웅 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

The Ultrasonography is rapid, mobile, and noninvasive diagnostic tool in emergency center. As a result, we estimate it`s value as an advocated primary diagnostic modality in the immediate evaluation of patients with multiple trauma. We investigated 60 patients with traumatic hematuria(microscopic hematuria or gross hematuria) who visited our emergency department from 1995, July to 1996, March. To evaluate the injury of urinary systems, emergency physician examined patients with hematuria by ultrasonography, and comapared the results with those of excretory urography and computed tomography. We demonstrated 21 positive findings for abnormal fluid collection and renal parenchymal injury and bladder rupture on ultrasonography. All bladder injuries were diagnosised by ultrasonography, and all major renal injury(grade Ⅲ,Ⅳ,Ⅴ) were also diagnosised by that. The accuracy of emergency ultrasound examination in traumatic hematuria was 97.0%, and sensitivity was 95.0% with specificity of 97.4%. The ultrasonography was an accurate diagnostic adjunct in detecting renal injury and bladder injury in traumatic hematuria patients. Ultrasonography provides an excellent noninvasive diagnostic tool for the initial screening study of patients with traumatic hematuria.

심정지환자에서 epinephrine투여시 혈중 catecholamine의 변화

임경수,황성오,이부수,이강현,이진웅,임종천,김영식,김선만,김 현 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

Background : Cardiac arrest is a potent stimulus for the release of endogenous catecholamine and high plasma catecholamine concentration has been reported during cardiopulmonary resuscitation(CPR). Few data were present about the clinical effect of high plasma catecholamine and endogenous catecholamine response to exogenous epinephrine administration during CPR. Purpose : This study was designed to evaluate endogenous catecholamine response to cardiac arrest and exogenously administered epinephrine during CPR. Method : In 21 cardiac arrest victims, blood sample for epinephrine and norepinephrine was drawn before and 1 minute after each epinephrine administration during CPR. 1mg of epinephrine was administered immediately after intravenous access and 3 minute interval during CPR. Plasma catecholamines were quantitated by high-performance liquid chromatography. Result : Baseline plasma epinephrine concentraqtion was higher in patients with cardiac arrest than normal controls (985±1627 vs 194±173 pg/ml, p<0.05). Baseline plasma norepinephrine concentration was also elevated in patients with cardiac arrest than normal controls, although statistically insignificnat(1965±4915 vs 360±250 pg/ml). Plasma epinephrine concentration in cardiac arrest patients was significantly elevated after exogenous administration of epinephrine, but its response was blunted after the third does of epinephrine. Plasma norepinephrine concentration in cardiac arrest patients was also elevated, but its response was observed only after the first epinephrine administration. Plasma epinephrine concentration was persistently higher in patients with return of spontaneous circulation (ROSC) than patients without ROSC. there was no significant difference of plasma norepinephrine concentration whether spontaneous circulation was restored or not. Endogenous epinephrine response to exogenous epinephrine was not observed in patients having prolonged arrest time over 20 minutes. Conclusion : Results of this study suggests that significant amount of catecholamine is released by exogenous epinephrine administration in spite of high plasma catecholamine concentration, and degree of endogenous catecholamine response influences resuscitation outcome.

항공기 세로운동에 대한 가변구조모델추종제어시스템의 설계에 관한 연구

李康態,黃壽贊 한국항공대학교 1992 論文集 Vol.30 No.-

항공기의 세로운동에 대한 가변구조모델추종제어기를설계 하였다. 슬라이딩모드에서 발생하는 채터링의 크기를 최소로 하는 다변수제어 알고리즘을 제시하고 그 타당성을 컴퓨터시뮬레이션을 통하여 보았다. A variable structure model-following controller is designed for the longitudinal motion of an aircraft. The proposed multivariable control law reduces the magnitude of the chattering in sliding mode. Simulation results show the performance of the control system.

다발성 외상환자에서 필수적 단순 방사선검사의 의의

임경수,황성오,임종천,이부수,이강현,이진웅 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

In the guidelines of Advanced Trauma Life Support(ATLS), essential plane roentgenograms (chest AP vIew, cervical spine lateral view and pelvis AP view) are recommanded when primary survey and resuscitation phase are finished in care of multiple injured patients. A prospective study was carried on 376 multiple trauma patients who admitted to Wonju Christian Hospital from July, 1995 to October. We analyzed clinical significance of essential X-ray in multiple trauma patients, and classified the patients by their status of mentality. The one is alert group when their Glasgow Coma Scale(GCS) is over 13 point, the other is disoriented mentality group when their GCS are below 12 point. The alert group was redivided by presence of clnical symptoms and/or signs, and clinical significances of essential X-ray were analyzed. Among the 376 patients, 330 patients are alert group that their GCS score is over 13 point and 46 patients are disoriented group who's GCS were below 12 point. The detection rate of abnormality in essential X-ray is higher in disoriented group than alert group(cervical-spine lateral view : 13.5% vs 3.0% cheat AP view : 0.4%, pelvis AP view : 0%). This study suggests that their are no needs of taking essential X-ray in patients who is alert in mental state and have no clinical symptoms and/or signs.

아파트 안방의 공간구성요소에 관한 연구

이청웅,강형구,박수연 朝鮮大學校 建設技術硏究所 2002 建設技術硏究 Vol.22 No.1

In this study, as it is said that housing planning can be completed in correlation with major living space, they should recognize the characteristic of furniture use as well as various activities of life as well as various activities of life which are carried omit at home. In this study, the results of each research are summarized as follows. First, diverse activities of life focused on personal lives took places in An-bang. The type of furniture use was composed of standing-oriented type, both standing and sitting and continuous sitting type. When it comes to the preference of the use of furniture, most people preferred to use beds and sofas, they also wanted to diminish An-bang and expand a living room. Second, focused on the pattern of furniture use according to the characteristic of each dweller, the younger, and the more educated, the more they used An-bang as a main space for the husband and wife and they referred to use in a standing-oriented furniture. They also wanted to expand a living room instead of curtailing An-bang in the use of space. Third, when 1 studied main activities of life according to the type of furniture use, there weren't any family activities of life at An-bang in case of standing-oriented type families. There were a few activities of life in case of continuous sitting type and both the standing and sitting type families, but it scarcely happened. Regardless of the type of furniture, people preferred to expand the living room instead of diminishing An-bang. Fourth, the age of housewives turned out to influence the type of the use of furniture, so 1 could come to a conclusion that younger Housewives preferred to buy a standing-oriented furniture, there wasn't any difference in a living room.

노인외상환자의 외상중증도계수와 동통감지력의 변화에 대한 임상적 고찰

이진웅,임경수,김영식,황성오,이강현,김선만,김 현 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Because elderly individuals are participitating in social work as adult inspite of their physical handicapes such as hearing difficulty, visual difficulty and limit of motion, they are continually exposed to the risk of injury. Trauma is now fifth cause of death in elderly of over 65 years old, and the elderly suffer disproportionately high injury-related motality comparing with younger adults. In addition, sometimes elderly patients don`t complaint of pain on injured site because of high threshold to pain. We studied about occurence of neglected injury due to high threshold to pain in geriatric trauma patients. When we diagnosised injury that patients did not complaint of pain on injured site through physical examination and radiologic examination, we defined that as neglected injury. There were 8 (8%) geriatric patients who didn`t complaint of pain on injured site on admission to emergency center, but only 0.7% of adult patients had neglected injury. The severity was estimated by use of AIS(Abbreviated Injury Scale), and the severity of all neglected injuries were above AIS 2 point. The neglected injury were head injuries(4 in number), abdominal injury(1), pelvic injuries(2) and extremity injury(1). So if geriatric trauma patients were admitted to emergency center, we recommand full physical and radiological examinations although patients don`t complaint of pain.

僧帽辦膜狹窄症의 血力學的 평가와 右心機能에 관한 硏究

柳秀雄,姜明進 최신의학사 1981 最新醫學 Vol.24 No.1

원주지역에서 발생한 비외상성 심정지의 일주변화

박금수,김영식,이진응,임종천,이강현,임경수,황성오,최경훈 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

To estimate the quality of the emergency medical services system of Wonju City, we studied the diurnal variations of 179 non-traumatic cardiac arrest victims who received cardiopulmonary reuscitation at the emergency center of Wonju Christian Hospital. Diurnal variations of non-traumatic cardiac arrest patients were as follows ; The occurence of cardiac arrest at day-time was higher than night-time; 18 cases (11%) from midnight to AM 4, 25 cases (14%) from AM 4 to AM 8, 42 cases (24%) from AM 8 to AM 12, 46 cases (25%) from AM 12 to PM 4, 35 cases (19%) from PM 4 to PM 8, 13 cases (7%) from PM 8 to midnight. Witness cardiac arrest was increased more during the day than night ; 40% from midnight to AM 4, 48% from AM 4 to AM 8, 57% from AM 8 to AM 12.52% from AM 12 to PM 4, 60% from PM 4 to PM 8, 38% from PM 8 to midnight. The transportation time at night-time cardiac arrest was more longer than day-time cardiac arrest ; 30±12mins from midnight to AM 4, 26±9mins from AM 4 to AM 8, 27±12mins AM 8 to Am 12, 25±11mins from AM 12 to PM 4, 25±9mins from PM 4 to PM 8, 35±15mins from PM 8 to midnight. The rate of restoration of spontaneous circulation(ROSC) in day-time cardiac arrest was higher than the night-time cardiac arrest ; 30% from midnight to AM 4, 36% from AM 4 to AM 8, 32% AM 8 to AM 12, 44% from AM 12 to PM 4, 41% from PM 4 to PM 8, 15% from PM 8 to midnight. The survival rate of cardiac arrest has been correlated with collapse time, early bystander CPR, early advanced care. To improve outcome for prehospital cardiac arrest, we concluded that early bystander CPR, and early advanced life support should be performed at the scene and during the transportation especially at night.