응급실에서 시행된 기관내 삽관의 현황

김병철,강보승,송형곤,이정훈,송근정,정연권 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. Methods : We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center form April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. Results : Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). Conclusion : At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.

응급실의 약물중독 환자

송근정,조광현,이한식 大韓應急醫學會 1992 대한응급의학회지 Vol.3 No.1

Any short of medical drug, insecticide or foods sometimes makes harmful situation whether it is beneficial or not. Nowadays, the treatment for drug intoxication started mostly in emergency department. The initial treatment must start as soon as possible. The prognosis is depend upon a kind of drug, exposure time and time of initial treatment. Authors conducted a review of acute poisoned patients seen from April 1983 to July 1992, who visited emergency department of Yong Dong Severance Hospital. The results were as follows, 1. The patients of Drug intoxication account for 0.68% of total emergency department patients. 2. Male to female ratio was 1:1.9 and the age distribution revealed a high incidence in second decade(35.7%) 3. From all the cases of drug intoxication and 67.2% was done on purpose. 4. The drug used were sedatives, CO intoxication, pharmaceuticals, pesticide, in order. 5. Admission rate was 23.8% and mean hospital day 6.0 days. 6. ICU admission rate was 30.0% and mean staying time was 4.7 days.

아급성기 대량 재해 지역에서의 의료 지원 : '99 대만 지진 의료 지원을 중심으로

송형곤,강보승,송근정,정연권 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: There was a powerful earthquaken(Richter Scale 7.6) In Tiawan, on Sep.21, 1999. We supported the organized medic긴 services in that area during 5 days. Methods: We made the protocol and analyzed the results prospectively. Results: We took care of a total of 708 patients from sep. 23 to sep. 27. Traumatized patients related to the earthquake were 245(34.6%), and most of them had minor injuries. Two hundred thirty-nine(239, 33.8%) patients visited us for medical disease related to living in a group. There were 29(4.1%) patients who complained of neuropsychiatric problems due to the post-earthquaken stress. Because the condition of the patients was so bad, 18(2.5%) were transferred to receive more medical services. Conclusion: In disaster area, organized medical services have two different roles, especially in the subacute stage. One is responsibility for real emergency medical care, and the other is medical care of non-emergency patients.

The Effect of Long-term Administration of Green Juice of Angelica Keiskei Koidz on the Contents of Several Selected Elements of the Mouse Organs

Song,Sook Ja,Lee,Jin Hee,Shin,Kyung Ok,Jeong,Soon Young,Chung,Keun Hee 韓國營養學會 1997 Journal of Nutrition and Health Vol.30 No.9

법적인 문제를 일으키는 응급환자

송근정,장문준,이한식 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Recently, number of legal problems beside of malpractice is increasing in hospital, especially in ED, with a social economic development. A retrospective study of consecutive 72 patients who visited YDSH ED profiled legal problems due to stab wound, D.O.A. patient caused by violent crime, patient had been arrested by lawfal agent, rape, gun-shot wound, hopeless person and organ donor were included in this study. The purpose of this article is due to prevent and prepare for the such legal problem by understanding legal aspect of problems listed above. The results were as follows : 1. There was 59 patients of stab wound with male/female ratio of 2.7 to 1, admission/discharge was 23 to 36 patients. 2. Five D.O.A. patients were caused by violent crime, 3 patients by blunt trauma and 2 patients by stab injury. 3. Three patients were related with arrest. 4. Two patients were related with rape. 5. There was I patient in hopeless, gun-shot wound and donor respectively.

손상정도계수와 외상치를 이용한 외상환자의 분석

송근정,장문준,김성중,조광현,김인병,최성욱,이한식 대한응급의학회 1993 대한응급의학회지 Vol.4 No.2

Trauma is one of the most common causes of death. Recently, injury severity score(ISS) is widely used to evaluate and classify the patients with multiple injury. Trauma score(TS) was developed as a means of providing rapid accurate assessment of the injured patient. Authors conducted a review of trauma patients who visited the emergency department of YongDong Severance Hospital from September 1992 to August 1993. ISS and TS were collected from comprehensive initial evaluation. The results were as follows : 1) The subjects were 10.2%(2,666 patients) of total 26,202 emergency patients. 2) Male to female ratio was 2.1 : 1. The age distribution was highest under 10 year(24.9%). The mean ISS was 3.5, and the mean ISS increased with ago. 3. Analysis of injury mechanism showed high incidence of traffic accident(35.3%), blunt trauma 25.7%, fall 24.2%, stabbing 10.7%, and others 4.3% in order. 4. The 8.0% of patients were admitted after initial management and their mean Iss was 12.6 mean TS was 15.5. 5. Among admitted traffic accident patients, the mean ISS of passenger T.A., pedestrian T.A. and driver T.A. were 19.0 ±9.9, 14.4 ±10.6, and 11.3 ±7.7 respectively. 6. Among 42 mortality cases, 25 patients were D.O.A. and 17 were expired. The mean ISS of D.O.A. Patients was 30.0; the mean Iss and mean Iss and mean TS of expired patients were 28.3 and 11.8 respectively. 7. The most common cause of death was head trauma(66.7%). 8. By comparing the ISS and TS of admitted and expired patients, mortality occurred above 16 point of ISS. The mortality increased with increasing ISS, but it was influenced by the trauma site and the severity of the particular injury site. Mortality also occurred below 15 point of TS, the mortality increased inversely with TS, and the mortality with TS, and the mortality was high below 13 point (above 40%).

응급의료 헬리콥터를 이용한 환자이송에 대한 고찰

송형곤,김병철,송근정,정연권,신백효 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: The first EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used for transporting emergent patients. Authors, here upon, report the transporting experiences. Methods: From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. Result: A total of 65 patients were transported. Male to female ratio was 1.95:1. The mean transport time was 64.1 min(10 - 160 min). Majority of the evacuated patients was surgical patients (General Surgery : 16, Orthopedic surgery : 10, Neurosurgery : 6, Internal medicine : 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation attended the patients. No medical problems or deaths developed during the air evacuation period. Conclusion: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.

十全大補湯이 抗癌劑를 投與한 생쥐의 胸腺細胞에 미치는 影響

金大根,殷載淳,全薰,宋正模 대한본초학회 1998 大韓本草學會誌 Vol.13 No.2

The purpose of this research was to investigate effects of Sipjeon-Daebo-Tang(SDT) on thymocytes of anti-tumor drugs administered mice. DNA fragmentation, mitochondrial transmembrane potential and subpopulation were tested using a flow cytometry. and the cell viability was tested using a MTT assay. Etoposide, vincristine and doxorubicin enhanced DNA fragmentation and reduced mitochondrial transmembrane potential of thymocytes, but SDT recoverd the action of vincristine and doxorubicin. Etoposide or vincristine decreased the population of CD4 single positive cell in thymocytes, but SDT enhanced the population of CD4+ single positive cell. Etoposide, vincristine and doxorubicin decreased the cell viability of thymocytes, but SDT enhanced the cell viability. These results suggest that SDT has a regulative function of thymocytes in anti-tumor drugs administered mice.

불완전 전뇌 허혈후 소생의 백서 모델을 이용한 재관류 뇌혈류량과 허혈성 뇌조직 손상도와의 관계

서정필,송근정,황태식,정연권,신백효,김승호 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: Experimental data indicate that low-flow reperfusion following prolonged cardiocirculatory arrest may aggravate early cerebral microcirculatory reperfusion disorders. We investigated the influence of cerebral reperfusion flow change to the ischemic histopathologic damage of brain tissue after incomplete forebrain ischemia in rats. Materials and method: Anesthetized Sprague-Dawley rats were undergone ligation of both internal carotid artery by microvascular clamp for 10 minutes. After release of the clamp, reperfusion was started with several different flow levels (0, 10, 20, 30, 50, and 100%) of internal carotid artery comparing to pre-clamping phase using flowmeter. After 15minutes of reperfusion, rat brains were prepared by perfusion-fixation with 3% formaldehyde. Under light microscopic examination of Hematoxylin-Eosin stained tissue slide, histopathologic damage was examined at cortex, putamen, and hippocampus regions. Categorical hisotopathologic damage scores were derived in each regions by manual counts of ischemic neurons. Result: The histopathologic damage scores were 0, 10.2±0.5, 7.6±1.5, 5.9±1.4, 5.0±2.8, 3.5±0.7, and 1.0±0.0 in control, 0, 10,20, 30, 50, and 100% reperfusion groups, respectively(p<0.05). Conclusion: Our results showed significant increment of brain histopathologic damage scores along with decreasing amount of cerebral reperfusion flow after incomplete forebrain ischemia. We believe restoration of reperfusion flow to pre-ischemic level would be a critical component in attenuation of brain ischemic damage.

급성 충수돌기염 의증 환자의 진단에서 컴퓨터 단층촬영과 초음파검사의 비교 분석

이정훈,최필조,심민섭,송근정,정연권 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: This study was conducted to compare the accuracy of computered tomography(CT) and sonography(US) in diagnosing acute appendicitis and to analyze the radiologic factors which influence the result. Methods: We retrospectively studied the cases of 53 patients who were suspected of having appendicitis and who were examined by CT and US covered a three-year period. The final diagnosis was determined from the surgico-pathologic diagnosis and clinical follow-up for two months, as well as from the discharge diagnosis. Results: Thirty-eight(38) patients had acute appendicitis; 15 patients did not. In the analysis, CT and US, respectively, revealed sensitivities of 89.5% and 73.7%, specificities of 93.3% and 60.0%, positive predictive values of 97.1% and 82.4%, negative predictive values of 77.8% and 47.4%. Among patients diagnosed with acute appendicitis, 10 patients were discordant in the US and the CT examinations; CT findings were correct in 8 and US findings in 2. Among non-appendicitis patients, 5 patients were discordant in the US and the CT examinations; CT was correct in 5 and US in 0. Nighteen(19) patients had complications such as an abscess or a perforation. Among these patients, the degree and the extent of the complication were accurately evaluated by CT in 15 patients and by US in 5 patients. Conclusion: CT is more accurate than US in diagnosing and excluding acute appendicitis. The use of CT will substantially decrease unnecessary laparotomies and post-operation complications.