심폐소생술의 순환회복 예측인자로서 호기말 이산화탄소 분압의 유용성 및 의의 : 각 심정지 원인에 따른 분석

어은경,안기옥,김정연,전영진,정구영 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: In recent years, there has been increasing interest in the use of capnometry, the noninvasive, continuous measurement of end-tidal carbon dioxide(ETCO2) in expired air during CPR. The purpose of this study is to determine the significance of ETCO2 monitoring according to immediate cause of arrest during CPR as a prognostic indicator of successful resuscitation and survival. Methods: A prospective, clinical study was performed from May 1997 to December 2000 at the Department of Emergency Medicine, Ewha Womans University Mokdong Hospital. The study included 220 patients(231cases). All patients were immediately connected to a mainstream capnometer sensor between the tube and the bag after endotracheal intubation using an infrared capnometer. Results: The 107 patients(46.3%) with return of spontaneous circulation(ROSC) had higher maximal ETCO2 during CPR than the 113 patients without ROSC(31.0±19.4 vs 11.7±9.4 mmHg, P=0.000). The ETCO2 was not significantly different in relation to age, initial rhythm, and survival time after ROSC, but there was a significant difference in the immediate cause of arrest in the ROSC group(respiratory arrest: 40.2±23.5 mmHg, P=0.000). In case of cardiac arrest due to trauma, maximal ETCO2 was not significant in the ROSC group compared with the non-ROSC group(18.2±16.6 vs 10.8±7.5 mmHg, P=0.208). When maximal ETCO2 was less than 10 mmHg, we observed a sensitivity of 94.4% and a specificity of 39.5% in predicting ROSC. There were 6 patients with ROSC even though the maximal ETCO2 was less than 10 mmHg. Conclusion: Continuous ETCO2 monitoring during CPR may be noninvasive and valuable predictor of successful resuscitation and survival from cardiac arrest. However, ETCO2 should not be used as a single indicator for either cardiac arrest due to trauma or withdrawal of CPR.

심폐소생술동안 순환회복 예측인자로서 호기말 이산화탄소 분압의 의의

어은경,정구영 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: It is difficult to evaluate the effectiveness of ongoing cardiopulmonary resuscitation(CPR). Recent studies suggest that continuous end-tidal carbon dioxide(ETCO₂) monitoring may be useful non-invasive indicator of CPR. The purpose of this study is to determine whether ETCO₂monitoring during CPR could be used as a prognostic indicator of resuscitation and survival. Method: A prospective, clinical study was performed from May 1997 to April 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. All patients were immediately connected to mainstream capnometer sensor between the tube and the bag after endotracheal intubation using infrared capnometer. Result: The study included 70 patients (39 were men) with a mean age of 55 ±16 years. 37 patients with return of spontaneous circulation(ROSC) had higher maximal ETCO₂during CPR than 33 patients without ROSC (26.9 ±19.4 vs 10.2 ±9.0mmHg, P=0.0001). The ETCO₂was not significantly different in relation to age, gender, initial rhythm, and survival time after ROSC. But there was significant difference in immediate cause of arrest in ROSC group(P=0.0016). When maximal ETCO₂was less than 10mmHg, we observed sensitivity of 83.8%, specificity of 54.5% in predicting ROSC. There were 6 patients with ROSC in spite of maximal ETCO₂was less than 10mmHg. Conclusion: Continuous ETCO₂monitoring during CPR may be useful, noninvasive, and valuable predictor of successful resuscitation and survival from cardiac arrest. But ETCO₂should not be used as a single indicator for the withdrawal of CPR.

급성 뇌졸중 환자에 있어서 병원 도착까지 지연시간 및 지연요인 분석

류지영,어은경,김용재,정구영 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time-dependent. The purpose of this study is to investigate the factors that influence the time from symptom onset to hospital arrival and the total arrival delay time for patients with acute stroke. Methods: A prospective registry of patients presenting to the ED with signs or symptoms of acute stroke was established at Ewha Womans university Mokdong and Dongdaemun hospitals from March to December 1999, We analyzed the the prehospital delay time(reaction interval and total arrival delay) and factors associated with delayed arrival at the hospital. Results: The study included 256 patients(49% were women) with a mean age of 62±13 years. 50.9% of the patients arrived within 3 hours, and 94.9% patients arrived within 24 hours after onset of symptoms of acute stroke. The total arrival delay mine was 180 minutes(median time), and the reaction interval was 60 minutes(median time). Transportation by 119 or 129 ambulance was linked to shorter delay(47 minutes). Age, mental status, and degree of disability were statistically significant factors associated with delayed arrival at the hospital. Conclusion: Age, mental status, and degree of disability were significant factors associated with delayed arrival at the hospital. For effective treatment of acute stroke patients, increased public awareness to use an ambulance with direct transport to the acute-care hospital is required.

2급 응급구조사의 성인외상환자에 대한 처치의 적절성 평가

장문수,어은경,김상현,김창섭,송근정,박한규,유지영,최동섭 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

In Korea, EMT have two classified subgroup of first and second degree : EMT-P, and EMT. For the beginning, authorization of the first EMT was made in this year through the EMT educational program. There are 8 items which EMT can perform the treatment without the supervision by a physician. But there was no previous report of pertinent assesment of treatment performed by the EMT. There upon authors have conducted review of assessment done by the EMT in EC setting, and proposed the following treatment application can be used by EMT at the field of accident. The study materials include adult trauma patient older than 15 years, and sustained trauma within 48 hours before visiting Ewha University DongDaeMoon Hospital Emergency Deparment. The duration of study was from Apr. 1 1995 to Aug. 31 1995. the study was conducted by 5 certified EMT. The EMT's performance was evaluated by the attending Emergency Medicine physician. The result were as followings ; 1. Among the total 5532 ED visiting patients during the study period, 1267 were adult trauma patients who recieved treatment within 48 hours of injury. 2. Among 1222 out of 1267 patients have completed performed survey. 3. Male to female ratio was 2.6 : 1, age distribution was from 15 to 87 years old and mean age was 34.6 years old. 4. The MOI showed : MVA (33.1%), blunt trauma (29.9%), slip down (16.8%), penetrating injury(15.4%), and miscellaneous (5.7 %), burn (3.1%), falling down injury(2.9 %), bite injury(1.1%) in order. 5. There were 437 cases of survey completed by the EMT. For assessment of mental status of 3 different method : AVPU, 5 scale mental status and GCS, were correlated with EM physician with 99.1%, 98.6%, 97.7 %, respectively. 6. For 320 out of 437 cases of survey completed, 319 patients recieved treatment by the EMT within 30 minute and 1 patient between 30 to 60 minute of an ED arrival. 7. For those 437 cases of survey completed, 266 patient (60.9%) had adequate treatment and 54 patients (12.4%) had inadequate treatment. 67 patient (15.3%) did not received treatment but it was adequate inway, and 50 patients (11.9%) did not received treatment even though patient required treatment. In cases of adult trauma patients, EMT's mental status assessment was correlated with EM physician's assessment. But treatment done by EMT without the supervision of EM physician was adequate only in 76.2 %. Therefore, continuous education and assessment of treatment performed by EMT in needed to improve field treatment by EMT future.

실험적 급성 심근경색증 후 좌심실 재성형에 관여하는 간질 조직의 변화에 대한 전환효소억제제의 기전에 대한 연구 : 백서의 非痛璧性 심근경색 후 좌심실 재성형 및 Transforming Grawth Factor β-1의 발현 변화와 이에 대한 레닌 안지오텐신계 차단제의 효과 분석 Effects on Transforming Growth Factor - β-1 Expression

연태진,김석연,김효수,김어진,김소영,정은주,서정욱,오병희 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.9

Goldman's Algorithm을 이용한 비외상성 흉통 환자의 분석

조석진,유진현,김찬웅,어은경,정구영 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Back ground : It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. Methods : A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. Results : The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. Conclusion : The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patients with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.

Optimization of a “Brand-new” Lung Organoid-on-a-chip Model for SARS-CoV-2 Infection

( Eun-young Eo ),( Bokyong Kim ),( Sohyun Park ),( Yeonjae Kang ),( Insoo Lee ),( Hyung-jun Kim ),( Young-jae Cho ) 대한결핵 및 호흡기학회 2023 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.136 No.0

F-70 Generation of lung cancer cell lines harboring EGFR T790M mutation using CRISPR/Cas9-mediated genome editing

( Mi-young Park ),( Min Hee Jung ),( Eun Young Eo ),( Seokjoong Kim ),( Sang Hoon Lee ),( Yeon Joo Lee ),( Jong Sun Park ),( Young Jae Cho ),( Jin Haeng Chung ),( Cheol Hyeon Kim ),( Ho Il Yoon ),( Ja 대한결핵 및 호흡기학회 2016 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.121 No.0

Tyrosine kinase inhibitors (TKIs) such as gefitinib and erlotinib are effective against lung adenocarcinomas harboring epidermal growth factor receptor (EGFR) mutations. However, cancer cells can develop resistance to these agents with prolonged ex-posure; in over 50% of cases, this is attributable to the EGFR T790M mutation. Moreover, additional resistance mutations can arise with the use of new drugs. Cancer cell lines with specific mutations can enable the study of resistance mechanisms. In this study, we introduced the EGFR T790M mutation into the PC9 human lung cancer cell line which has a deletion in exon 19 of the EGFR gene by the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated (Cas)9-mediated genome editing. EGFR pyrosequencing revealed that PC9-EGFR T790M cell clones had a higher T790M muta-tion rate than PC9-G cells generated by long-term exposure to gefitinib; moreover, resistance in these clones was comparable to or higher than that in PC9-G cells. The clones were also highly sensitive to the 3rd-generation EGFR TKI (AZD9291), which is cytotoxic to lung cancer cells with EGFR T790M. The CRISPR/Cas9 programmable nuclease system can be used to generate various cancer cell lines with specific mutations that can facilitate studies on resistance mechanisms and drug efficacy.

외상으로 인한 상처의 치료에 있어서 선택적 항균제의 효과 및 적응증에 관한 연구

김재은 ( Jae Eun Kim ),서주현 ( Joo Hyun Suh ),최윤희 ( Yoon Hee Choi ),배현아 ( Hyun A Bae ),정진희 ( Jin Hee Jung ),어은경 ( Eun Kyung Eo ),전영진 ( Young Jin Cheon ),정구영 ( Koo Young Jung ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.1

Purpose: The primary goal of wound management is to avoid infection. Wounds in all patients presenting to the Emergency Department are contaminated with bacteria. Despite this, there is a low incidence of infection. Unfortunately, physicians continue to use antimicrobial agents indiscriminately. The authors intended to determine the effect of selective antimicrobial agents and the indications for appropriate antimicrobial agent use in traumatic simple wounds. Methods: This prospective study was performed from Jul. 2005 to Aug. 2005. A pilot study had been performed from Nov. 2003 to Jul. 2004 at the Ewha Woman`s University Mokdong Hospital. Structured data sheets were completed at the times of the patient`s visits to the Emergency Department and to the Outpatient Department for follow-up. Infection was determined at the time of follow-up. The indications of antimicrobial agent use are immunocompromised patients, wounds contaminated for 3 hours or longer, devitalized tissue, and extremity wounds except hand wounds caused by sharp objects. Results: The study enrolled 216 injured patients. The general characteristics of patients and wounds between the two groups were not significantly different. The antimicrobial agent use and infection rate of the pilot study were 227 cases (90.4%) and 10 cases (4.0%), and those of this study were 100 cases (46.3%) and 9 cases (4.1%). In this study, antibiotic use was reduced to almost half compared with the previous study, but the infection rate was similar (p<0.001). Conclusion: Rational use of antimicrobial agents in simple wounds reduced the use of antimicrobial agents in the Emergency Department without increasing the infection rate. (J Korean Soc Traumatol 2007;20:40-46)

응급실을 경유하여 진단된 소뇌경색 환자의 임상적 고찰

김성은,장혜영,어은경,김용재,전영진,정구영 대한응급의학회 2002 대한응급의학회지 Vol.13 No.3

Purpose: Diagnosis of a cerebellar infarct without signs such as weakness, ataxia, or focal neurologic findings is difficult. This study used a clinical review of cerebellar infarctions for the purpose of accurately diagnosing and properly managing such patients. Methods: We retrospectively studied 94 cerebellar infarct patients who had been admitted to the university hospital via the emergency department from May 1995 to March 2001. We reviewed clinical records and radiologic findings and analyzed risk factors of cerebrovascular disease, chief complaints and associated symptoms, neurologic examinations, electrocardiograms, and brain CT and/or brain MRI findings. Results: Fifty -four(57.4%), of the patients were men and forty (42.6 %) were women, and their mean age was 64.1±13.0 years. The most frequent risk factor was hypertension (55.3 %), and others were diabetes mellitus (26.6 %), cerebrovascular disease (17.0 %), ischemic heart disease (10.6 %), and atrial fibrillation (6.4 %). As to the involved territory, 54(57.4%) posterior inferior cerebellar artery infacrcts, 15 (16.0 %) superior cerebellar artery infarcts, 3 (3.2 %) anterior inferior cerebellar artery infarcts, and 19 (20.2 %) combined-territory infarcts were found. As for symptoms and signs, vertigo (69.1 %) and nausea and/or vomiting (64.9 %) were the most frequent: others were dysarthria (38.3 %), headache (37.2 %), ataxia (43.6 %), motor weakness (38.3 %), nystagmus (30.9 %), and so on. Especially, seven (7.4 %) patients showed isolated vertigo without paralysis, weakness, or ataxia. Conclusion: Vertigo, nausea, and vomiting were frequent clinical findings in 94 cerebellar infarct patients. Nine of these patients showed isolated vertigo. The posterior inferior cerebellar artery was the most frequently involved territory.