고삼투압성 비케톤성 상태의 예후인자

안성훈,김양원,김미란,진헌철,안지영,이상래,류석용,김홍용,김성준,이병권,김경환 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: A hyperosmolar nonketotic state has been known to have a high mortality, and even now, despite this high mortality, only a few studies of this disease have been performed. We studied the prognostic factors for the hyperosmolar nonketotic state. Methods: We retrospectively studied the cases of 40 patients who were in a hypersomolar nonketotic state when admitted to Sanggye Paik Hospital during the 6-year Period from 1995 through 2000. We divided the hyperosmolar nonketotic patients into two groups, the complete recovery group and the incomplete recovery group, and compared the clinical features, the laboratory findings, and the precipitating factors between two groups. Results: 1) A total of 40 patients were studied: 24 in the complete recovery group and 16 patients in the incomplete recovery group. The mortality rate was 32.5%. 2) No significant statistical difference existed among the clinical features of the two groups, except for the sex(p<0.01). 3) Among the laboratory findings of both groups, analysis revealed that the effective osmolarity was significantly higher among those in the incomplete recovery group(p<0.01). Serum sodium concentration was also significantly higher among those in the incomplete recovery group(p<0.01). Serum creatinine was also significantly higher among those in the incomplete recovery group(p<0.05). Serum bicarbonate concentration, on the other hand, was significantly lower among those in that group(p<0.05).4) Infection was identified as the most common precipitating factor(62.5%). Among the precipitating factors of the two groups, there were significant statistical difference in pneumonia, UTI, and inappropriate glucose control. 5) A significant statistical difference existed among the initial level of consciousness of both groups(p<0.05). 6) The only significant independent factor responsible for prognosis of nonketotic hyperosmolar state patients was the sex. Conclusion: The sex was only significant independent prognostic factor of nonketotic hyperosmolar state patients.

견갑부 유리피판술 : ITS ANATOMY & CLINICAL APPLICATIONS 해부학적 구조 및 임상적 고찰

김홍래,백세민,이혜영 大韓成形外科學會 1983 Archives of Plastic Surgery Vol.10 No.2

Since the first successful microvascular free flap was performed by Daniel & Taylor in 1973, it has been popularized in the plastic and reconstructive surgery. The free skin flap has proved its great versatility as compared with conventional pedicle flap methods. It can be applied to extensive skin defects and one-stage pedicle flap procedure, and hospital stay is shorter. Early ambulation and rehabilitaion are possible. In 1980, Frenklin reported on the use of deltoid free flap, which was based on posterior circumflex humeral vessel. The flap has relatively thin subcutaneous tissue, but has thicker dermal layer, so provides stability to the sole and heel of foot. Anatomically the plane of dissection is easily identified. The donor scar is minimal, and functionally and cosmetically acceptable. Authors have good result using deltoid free flap for reconstruction of shallow tissue defects.

생리식염수 및 포도당수액 정액 투여가 에탄올 농도에 미치는 효과에 관한 연구

김원율,이상래,안지영,안성훈,류석용,김경환,김홍용 대한응급의학회 2000 대한응급의학회지 Vol.11 No.3

Background: In emergency department, there are many drunken patients with various emergency medical situations. In these patients, evaluation and management of the medical problems are delayed from time to time because of the uncooperative nature of the patients and because of consciousness and sensory changes. A precise evaluation can only be obtained when the patients become sober. For this purpose, most clinicians start IV fluid loading. This study was carried out to evaluate the effect of IV fluid(normal saline and glucose solution) on the rate of ethanol clearance in such patients Methods: Ten volunteers(healthy males in their twenties and with a Michigan alcohol screening test below 4) were enrolled in this study. Alcohol intake was restricted to at least 48 hours before the test and food intake to at least 4 hours. For the test, A predetermined dose of ethanol(1 gm/kg) was given to the volunteers. Each volunteer was tested on three consecutive times with 3 or more days interval for alcohol wash out period . On the lst day, the volunteers received ethanol only per os. On the second day, they received ethanol and a liter of IV 10% dextrose solution. Each day, blood was drawn from the antecubital vein to measure the ethanol level at the time of ethanol ingestion and at 0.5, 1, 1.5, 2, 3, 4, 5 and 6 hours after ingestion. The repeated measure ANOVA test was used for the statistical analysis. Results: The difference in the blood ethanol level between the 3 test was F=1.7, p=0.184 and the difference corrected by the time factor was F=0.32, and p=0.985. Conclusion: There was no significant difference in the blood ethanol level between the tests. In conclusion, the IV normal saline or glucose solution does not accelerate ethanol clearance in suffering

顔面骨 骨折의 臨床的 考察

이문희,김홍래,이두형 慶熙大學校 1982 論文集 Vol.11 No.-

The auther studied 194 cases of facial bone fracture in 108 patients who were admitted and treated at Department of Plastic and Reconstructive Surgery of Kyung Hee University Hospital from January, 1974 to June, 1981. The results are as follows: 1. It was affected more often in males than females, 5.7 to 1, in the group of the third and forth decades and in the seasons of summer and autumn. 2. The major causes of fracture were as follows in order of frequency; in male, 48 patients (44.4%) by automobile accidents, 27(25.0%) by fights and 14(1.9%) by industrial accidents; in female. 8(7.4%) by automobile accidents, 6(5.6%) by falls and 2(1.9%) by fight. 3. The major site of the fracture were as follows in order of frequency; 46 cases (23.7%) of nasal bone, 39(20.1%) of zygoma and zygomatic arch and 37(19.1%) of maxilla. 4. Multiple fractures of facial bone occured more frequently than single bone reduction and the most common site of fracture in single bone was nasal bone. 5. Most patients treated with 1-2 weeks after fracture and most required open fracture(61.1%) than closed reduction (24.1%) with exception for nasal bone. 6. Complication rate of its sites was high in the blow-out(79.2%) and alveolus fracture (100%).

소방구급대원의 응급처치 적절성 평가와 재교육 필요성

류석용,김원율,김경환,이상래,이경호,김홍용,이승한 대한응급의학회 2000 대한응급의학회지 Vol.11 No.2

Background: The prehospital emergency medical system(EMS) for 119 rescue has progressed considerably, but leaves much to be desired. To improve prehospital EMS, we need to evaluate prehospital patient care, and reeducation. Methods: The records of 1,882 patients, who visited Sanggye Paik Hospital Emergency Department via 119 rescue from April 1 to July 30, 1999, were analyzed according to the quality of patient care as documented by the 119 rescue protocol and database. Patients are grouped into 5 classes based on the quality of the care received. Class 1A received adequate care, class 1B received inadequate care, class 1C did not receive the necessary care, and class 2A received unnecessary care, class 2B did not receive unnecessary care. The results of such analyses are presented to the fireman at monthly meetings, thus reeducating them. Results: The overall results were 1027 cases in Class 1A(55%), 83 in 1B(4%), 149 in 1C(8%), 21 in 2A(1%), and 602 in 2B(32%). Well performed care(1A+2B) occured in 1629 cases(87%) and badly performed care(1B+1C+2A) occured in 253cases(13%). Well perfomed care gradually increased from April to July (April 83%, May 85%, June 87%, and July 89%). Conclusion: Meticulous appraisal of the quality of prehospital patient care and reeducation through the regular meetings of EMS physicians and firemen in each community is needed for developing a model protocol for indirect retrospective medical control of the prehospital EMS.

자발성 심막기종 1례

안지영,이상래,안성훈,류석용,김홍용 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Pneumopericardium, as a form of barotrauma, refers to the presence of air within the pericardial sac. The causes of pneumopericardium are various, Clinically, pneumopericardium is typically present with dyspnea and precordial chest pain. On physical examination, heart sounds are usually distant, and precordial tympany may be elicited. The diagnosis can be made by clinical and radiographic findings. Management of pneumopericardium depends on many factors, such as the age of the patient, the suspected causes, and the extent of clinically observed respiratory compromise. The case shown here, a patient who developed pneumopericardium, involved an associated underlying pulmonary parenchymal process as the cause of pneumopericardium.

둔부 통증을 주소로 내원한 괴사성 근막염 1례

안승찬,류석용,이상래,조석진,오성찬,김홍용 인제대학교 2008 仁濟醫學 Vol.29 No.-

Necrotizing fasciitis (NF) is a rare, life-threatening infection resulting in necrosis of the skin, subcutaneous tissue, and fascia. A very severe and usually fatal fasciitis is caused by a virulent species of streptococcus that is often referred to as the "flesh-eating bacteria". Mortality rates have been noted high. Certain conditions can predispose patients to NF, such as diabetes mellitus, immunosuppressive medications, and AIDS. Patients usually complain of excessive pain as well as constitutional symptoms. Because of this rapid progression, it is important to diagnose and treat NF quickly to decrease mortality. Treatment includes broad-spectrum antibiotic coverage, nutritional supplements, hemodynamic support, wound care, and prompt surgical debridement. We report a case of a 51-year-old man who had presented with right hip pain. Previously, he had been diagnosed with diabetes mellitus and alcoholic liver cirrhosis.

Particle size spectrometer using inertial classification and electrical measurement techniques for real-time monitoring of particle size distribution

Kwon, Hong-Beom,Kim, Hong-Lae,Hong, Ui-Seon,Yoo, Seong-Jae,Kim, Kyongtae,Han, Jangseop,Kim, Min-Ki,Hwang, Jungho,Kim, Yong-Jun The Royal Society of Chemistry 2018 Lab on a chip Vol.18 No.17

<P>To achieve real-time monitoring of aerodynamic submicron particle size distributions at a point-of-interest, we developed a high-performance particle size spectrometer that is compact, low-cost, and portable. The present system consists of four key components: a unipolar mini-discharger for electrically charging particles, an inertial size-separator for classifying charged particles into five size fractions in terms of their aerodynamic sizes, a portable multi-channel electrometer for detecting femto-ampere currents carried by charged particles at each stage, and a retrieval algorithm for converting the current data into a smooth particle size distribution. The unipolar mini-discharger and inertial size separator were quantitatively characterised by using standard polystyrene latex (PSL) particles. The experimentally determined cut-off diameters at each stage in the inertial size separator were 1.17, 0.94, 0.71, 0.54, and 0.23 μm, respectively. Then, the system was compared with a commercial reference aerodynamic particle sizer (APS) in the environment where the number concentration and the average size of TiO2particles were changing. The present system resolved peak size and geometric standard deviation of particles to within 11.2%, and 6.3%, respectively, indicating that the system can be used to accurately monitor submicron particle size distributions in real time.</P>

Vacuum Ultraviolet Photolysis of Ethyl Bromide at 104.8-106.7 nm

Kim, Hong-Lae,Yoo, Hee-Soo,Jung, Kyung-Hoon Korean Chemical Society 1981 Bulletin of the Korean Chemical Society Vol.2 No.2

Vacuum ultraviolet photolysis of ethyl bromide was studied at 104.8-106.7 nm (11.4-11.6 eV) in the pressure range of 0.2-18.6 torr at $25^{\circ}$ using an argon resonance lamp with and without additives, i.e., NO and He. Since the ionization potential of $CH_3CH_2Br$ is lower than the photon energy, the competitive processes between the photoionization and the photodecomposition were also investigated. The observations indicated that 50% of absorbed light leads to the former process and the rest to the latter one. In the absence of NO the principal reaction products for the latter process were found to be $CH_4, C_2H_2, C_2H_4, C_2H_6, and C_3H_8$. The product quantum yields of these reaction products showed two strikingly different phenomena with an increase in reactant pressure. The major products, $C_2H_4$ and $C_2H_6$, showed positive effects with pressure whereas the effects on minor products were negative in both cases, i.e., He and reactant pressures. Addition of NO completely suppresses the formation of all products except $C_2H_4$ and reduces the $C_2H_4$ quantum yield. These observations are interpreted in view of existence of two different electronically excited states. The initial formation of short-lived Rydberg transition state undergoes HBr molecular elimination and this state can across over by collisional induction to a second excited state which decomposes exclusively by carbon-bromine bond fission. The estimated lifetime of the initial excited state was ${\sim}4{\times}10^{-10}$ sec. The extinction coefficient for $CH_3CH_2Br$ at 104.8-106.7 nm and $25{\circ}$ was determined to be ${varepsilon} = (1/PL)ln(I_0/I_t) = 2061{\pm}160atm^{-1}cm6{-1}$ with 95% confidence level.

Verification of light & radiation field coincidence quality assurance for radiation therapy by using a-Se based DR system

Kim, Jin-Young,Park, Eun-Tae,Choi, Yun-Seon,Cho, Heung-Lae,Ahn, Ki-Jung,Park, Sung-Kwang,Kim, Ji-Na,Suh, Tae-Suk,Kim, Jin-Seon,Hong, Ju-Yeon,Park, Jeong-Eun,Kim, Kyo-Tae,Oh, Kyung-Min,Kim, Hyunjung,Jo Korean Physical Society 2015 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.66 No.8