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Lung Transplantation for Chronic Humidifier Disinfectant-Associated Lung Injury
김원영,So-Woon Kim,Kyung-Wook Jo,Sae Hoon Choi,,Hyung Ryul Kim,Yong Hee Kim,김동관,Seung-Il Park,홍상범 대한중환자의학회 2016 Acute and Critical Care Vol.31 No.2
In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the longterm course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient’s clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
김원영,이영석,이재완,서창호,Kim, Won-Young,Lee, Young-Seok,Lee, Jae-Wan,Seo, Chang-Ho 한국정보통신학회 2008 한국정보통신학회논문지 Vol.12 No.3
유비쿼터스 환경에서의 컴퓨팅 기기들은 초경량 컴퓨팅 환경으로서 사용자들이 컴퓨터의 존재를 인지할 수 없도록 사용자 신체나 주변 환경에 내장되며, 크기가 작고, 적은 기능을 가진 많은 컴퓨터를 여러 곳에 분포하여 네트워크로 통신한다. 초경량 컴퓨팅 환경에서는 사용자들에게 서비스를 제공하기 위해 사용자의 정보를 교환하는 일이 많으며, 사용자의 정보를 보호하기 위해서는 보안 기술이 반드시 포함되어야 한다. 본 논문에서는 초경량 컴퓨팅 환경에서 표준화 된 보안 서비스를 제공하는 초경량 환경을 위한 보안 서비스 지원을 위한 API를 연구하고 설계한다. 초경량 환경의 보안 서비스 지원을 위한 API는 일반적인 컴퓨팅 환경에서와 같이 데이터 암호화, 데이터 인증, 키 관리 등의 보안 서비스를 제공하며, 초경 량 컴퓨팅 환경에 맞는 RC5와 SHA1 알고리즘 사용, 효율적인 메모리 관리를 위해 각 서비스를 라이브러리화하여 필요시마다 라이브러리를 할당/해제하는 등의 초경량 컴퓨팅 환경의 문제점을 해결할 수 있도록 설계, 구현한다. Computers used fer light-weight computing environments are considerably limited in resources and performance running in ubiquitous environment. Because of the limited resources, it is difficult to apply existing security technologies to the light-weight computers. In this paper, light-weight security software is implemented using RC-5 encryption and SHA-1 authentication algorithm which is appropriate for light-weight computing environments. The design of components based on security software of a light-weight computer application and the test-bed for security software are presented. The simulation verifies the correctness of the security software. The architecture of the light-weight and reconfigurable security software for light-weight computer applications is proposed. The proposed security software is small size and provides reconfigurable security library based on the light-weight component and the software manager that configures software platform is loaded with the library at the time it is needed.
김원영,최욱진,이종호,박하영,오범진 대한응급의학회 2008 大韓應急醫學會誌 Vol.19 No.6
Purpose: The frequency of gunshot injuries in Korea has recently increased, and treatment and evaluation of gunshot wounds are not confined to military medicine. Here, we evaluated patterns of gunshot injuries to determine factors affecting mortality. Methods: This was a retrospective, multi-center study of gunshot injury in three tertiary military medical centers. The medical records of patients with gunshot injuries between January, 200X, and December, 200X, were reviewed. Injury severity was evaluated according to the Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma Score and Injury Severity Score (TRISS) indices. Results: We recruited 37 patients, with most injuries in the head and neck (35.1%), with the brain showing the highest ISS score. The mean injury-to-hospital arrival time was 96.6 ±58.2 minutes, and the hospital arrival-to-emergency operation time was 122.6±84.5 minutes. A total of 7 patients (18.9%) suffered severe injury, defined as ISS 16, and a Maximal Abbreviated Injury Scale (ABI) 4 was seen in 6 patients (16.2%). Mortality due to gunshot injury was 18.9%. In the survival group (n=30), the mean ISS was 5.9 ±6.0, RTS was 7.5±1.1, and TRISS was 0.98±0.06. In the death group (n=7), mean ISS was 18.4±9.5 RTS was 1.1±1.4, and TRISS was 0.21±0.34. Brain injury, multiorgan injury, ISS 16, and maximal ABI 4 were significantly associated with death after gunshot injury. Conclusion: The head and neck were the most frequently injured sites, with attempted suicide contributing to more than 30% of gunshot injures in South Korea. Multi-organ injury was the most significant factor affecting mortality.
P-25 Predicting mortality in patients with tuberculous destroyed lung on mechanical ventilation
김원영,조은정,엄중섭,목정하,김미현,김기욱,박혜경,이민기,이광하 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-
Background: Given the poor prognosis of tuberculous destroyed lung (TDL) necessitating mechanical ventilation, it is important to identify patients who might benefit from such treatment. The aim of this study was to develop a mortality prediction model for patients with TDL requiring mechanical ventilation. Methods: Consecutive TDL patients who received mechanical ventilation and were admitted to the medical ICU of the Pusan National University Hospital were reviewed. Binary logistic regression was used to identify factors predicting ICU mortality. The TDL-Vent score was calculated as the sum of simplified regression weights (SRW), and its predictive ability was compared to Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores. Results: A total of 125 patients were included; 36 (29%) of these died during a stay in the ICU. Multivariate analysis identified age ≥ 65 years (SRW 1), vasopressor use (SRW 1), and PaO2/FiO2 ratio < 180 (SRW 1) for inclusion in the TDL-Vent score. The area under the receiver operating characteristic curve of the TDL-Vent score was 0.72 (95% confidence interval, 0.63-0.80) and was larger than those of APACHE II (0.63; 95% confidence interval, 0.54-0.72) and SOFA (0.62; 95% confidence interval, 0.53-0.71) scores. The cutoff value for predicting ICU mortality based on maximum Youden’s index was ≥ 2. Conclusions: The TDL-Vent score is a simple model that may be useful for predicting ICU mortality among patients with TDL requiring mechanical ventilation.
Cervical Myelopathy Caused by Intracranial Dural Arteriovenous Fistula
김원영,김진범,남택균,김영백,박승원 대한척추신경외과학회 2016 Neurospine Vol.13 No.2
myelopathy, which may make early diagnosis and management to be difficult. We recently experienced a case of cervical myelopathy caused by intracranial dAVF. A 60-year-old man presented with a 3-year history of gait disturbance due to a progressive weakness of both legs. Neurological examination revealed spastic paraparesis (grade IV) and Babinski sign on both sides. Magnetic resonance imaging showed serpentine vascular signal voids at C2-T1 on T2-weighted image with increased signal intensity and swelling of spinal cord at C1-C4. We performed a brain computed tomography angiography and found intracranial dAVF with multiple arteriovenous shunts. Venous drainages were noted at tentorial veins and cervical perimedullary veins. After Onyx embolization, the patient showed gradual improvement in motor power and gait disturbance. The venous drainage pattern is a well-known prognostic factor of dAVF. In our case, the intracranial dAVF drained to spinal perimedullary vein, which seemed to result in the ischemic myelopathy. Although it is rare condition, it sometimes can cause serious complications. Therefore, we should keep in mind the possibility of intracranial dAVF when a patient presents myelopathy.