• 한국방사선학회논문지
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• 제6권2호
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• pp.107-114
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• 2012

사고로 인해 응급실을 내원한 중증외상환자로 등록된 환자 중 혈관조영술을 시행 받고, 동맥 출혈이 진단되어 동맥색전술을 시행 받은 환자를 대상으로 생존군과 사망군을 비교하여 생존의 영향을 미치는 인자와 치료방법으로 혈관조영술 및 색전술의 유용성과 적절한 시행 시점을 연구하였다. 2006년 7월부터 2010년 12월에 경기도에 위치한 H병원 응급실에 중증외상환자로 분류된 환자 중 혈관조영술과 동맥색전술을 시행한 환자 45명을 대상으로 하여 후향적 분석을 실시하였다. 주요 지표로 ISS(Injury Severity Score)와 RTS(Revised Trauma Score), 적혈구 용적률 (Hematocrit)를 삼았다. 다발성 손상의 의한 중증외상환자의 경피적 동맥색전술은 모두 성공적으로 시술되었고, 환자의 사망률과 합병증을 줄이는데 도움을 줄 수 있으며, RTS, ISS, Hematocrit, 쇼크 등이 사망률 조기 인자로써 예측이 가능하였으며 생체활력증후가 안 좋은 환자는 색전술 시행 시점을 가능한 빠르게 진행시켜야 한다.

• 한방안이비인후피부과학회지
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• 제29권3호
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• pp.14-26
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• 2016

Objectives : This study was performed to investigate the protective effects and mechanisms of Salvia miltiorrhizae Radix extract (SME) on endotoxin shock.Methods : We used two models; LPS-induced sepsis model for in vivo model, and murine peritoneal macrophages responses for in vitro. SME was administrated orally to mice. After 1 hr, LPS was injected intraperitoneally. Survival rate was checked each time per 12 hr for 5 days. Mice were sacrificed 3 hr after LPS injection, then blood samples and organs were harvested. Cytokines secretion was measured by ELISA. Organs tissues were observed with microscope. Murine peritoneal macrophages were cultured for 1 hr either in a medium alone or in a medium that contained SME, as indicated. Then, the cells were treated with LPS for 24 hr. mRNA levels of cytokines were measured by real-time RT-PCR. Cytokine levels in the supernatants were measured by ELISA. The amount of nitrite was measured by using the Griess method to evaluate NO production. The cell lysates were analysed by Western blotting using antibodies for iNOS and β-actin was used as an internal control to monitor equal protein loading.Results : SME improverd the survival rate of mice model. SME inhibited the secretion of inflammatory cytokines and organs damages on Endotoxin Shock model. SME suppressed cytokine expression, cytokine secretion,NO production, iNOS expression in LPS-induced murine peritoneal macrophages.Conclusions : The results suggest that SME has protective effects on endotoxin shock through suppression of inflammatory cytokines, organ damages, NO production and so on.

• 대한임상독성학회지
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• 제8권1호
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• pp.30-36
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• 2010

Purpose: The purpose of this study is to analyze the clinical characteristics of anaphylaxis and anaphylactic shock caused by bee venom. Methods: We retrospectively collected the data of the patients who experienced anaphylaxis caused by natural bee sting or acupuncture using bee venom from January 1999 to December 2008. Seventy subjects were divided into the shock and non-shock groups. The clinical characteristics, sources of bee venom, treatments and outcomes were compared between the two groups. Results: The mean age of the subjects was $45.5{\pm}16.3$ years old and the number of males was 44 (62.9%). There were 25 patients in the shock group and 45 in the non-shock group. The age was older (p=0.001) and females (p=0.003) were more frequent in the shock group. Transportation to the hospital via ambulance was more frequent in the shock group (p<0.001). No difference was found in species of bee between the two groups. The cephalic area, including the face, was the most common area of bee venom in both groups. Anaphylaxis caused by bee sting commonly occurred between July and October. Cutaneous and respiratory symptoms were the most frequent symptoms related to anaphylaxis. Cardiovascular and neurologic symptoms were more frequent in the shock group. The amount of intravenously administered fluid and subcutaneous injection of epinephrine were much more in the shock group than that in the non-shock group. Conclusion: Older age was the factors related to anaphylactic shock caused by bee venom. Further validation is needed to evaluate the gender factor associated with shock.

• 한국운동역학회지
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• 제25권3호
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• pp.283-291
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• 2015

Objective : The purpose of this study was to determine the differences in the head and tibial acceleration signal magnitudes, and their powers and shock attenuations between flat-footed and normal-footed running. Methods : Ten flat-footed and ten normal-footed subjects ran barefoot on a treadmill with a force plate at 3.22m/s averaged from their preferred running speed using heel-toe running pattern while the head and tibial acceleration in the vertical axis data was collected. The accelerometers were sampled at 2000 Hz and voltage was set at 100 mv, respectively. The peak magnitudes of the head and tibial acceleration signals in time domain were calculated. The power spectral density(PSD) of each signal in the frequency domain was also calculated. In addition to that, shock attenuation was calculated by a transfer function of the head PSD relative to the tibia PSD. A one-way analysis of variance was used to determine the difference in time and frequency domain acceleration variables between the flat-footed and normal-footed groups running. Results : Peaks of the head and tibial acceleration signals were significantly greater during flat-footed group running than normal-footed group running(p<.05). PSDs of the tibial acceleration signal in the lower and higher frequency range were significantly greater during flat-footed running(p<.05), but PSDs of the head acceleration signal were not statistically different between the two groups. Flat-footed group running resulted in significantly greater shock attenuation for the higher frequency ranges compared with normal-footed group running(p<.05). Conclusion : The difference in impact shock magnitude and frequency content between flat-footed and normal-footed group during running suggested that the body had different ability to control impact shock from acceleration. It might be conjectured that flat-footed running was more vulnerable to potential injury than normal-footed running from an impact shock point of view.

• 한국운동역학회지
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• 제30권3호
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• pp.197-204
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• 2020

Objective: The purpose of this study was to investigate the effect of increased running speed on the magnitude of impact shock attenuation in high frequency (9~20 Hz) at support phase on the treadmill running. Method: Twenty-four healthy male heel-toe runners participated in this study. Average age, height, mass, and preference running speed were 23.43±3.78 years, 176.44±3.38 cm, 71.05±9.04 kg, and 3.0±0.5 m/s, respectively. Three triaxial accelerometer (Noraxon, USA) were mounted to the tuberosity of tibia, PSIS (postero-superior iliac spine), and forehead to collect acceleration signals, respectively. Accelerations were collected for 20 strides at 1,000 Hz during treadmill (Bertec, USA) running at speed of 2.5, 3.0, 3.5, and 4.0 m/s. Power Spectrum Density (PSD) of three acceleration signals was calculated to use in transfer function describing the gain and attenuation of impact shock between the tibia and PSIS, and forehead. One-way ANOVA were performed to compare magnitude of shock attenuation between and within running speeds. The alpha level for all statistical tests was .05. Results: No significant differences resulted for magnitude of the vertical and resultant impact shock attenuation between the tibia and PSIS, and forehead between running speeds. However, significant differences within running speed were found in magnitude of the vertical shock attenuation between tibia and PSIS, tibia and forehead at speed of 2.5, 3.0 m/s, respectively. Conclusion: In conclusion, it might be conjectured that muscles covering the knee and ankle joints and shoe's heel pad need to strengthen to keep the lower extremities from injuries by impact shock at relatively fast running speed that faster than preferred running speed.

• Journal of Chest Surgery
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• 제34권1호
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• pp.35-40
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• 2001

배경: 혈역학적으로 문제가 되며 인도메타신 치료가 불가능한 미숙아 동맥관 개존증에서 동맥관 결찰술은 비교적 안전하고 효과적인 치료법으로 알려져 있다. 대상 및 방법: 1995년 1월부터 2000년 5월까지 동맥관 개존증을 가진 50명의 미숙아를 대상으로 인도메타신 치료와 동맥관 결찰술의 치료성적을 검토하였다. 결과: 50례의 미숙아 동맥관 개존증 중 28례에서 혈역학적으로 문제가 되어 치료가 요구되었고 그 중 5례에서는 인도메타신 치료를, 나머지 23례는 인도메타신 치료의 금기가 되어 동맥관 결찰술을 시행하였다. 제태기간과 출생시 체중은 치료를 시행하지 않았던 군(32.1$\pm$2.1주, 1731$\pm$450.9g)과 인도메타신 치료군(32.0$\pm$2.1주, 1830$\pm$165.5g)보다 동맥관 결찰술군(29.6$\pm$2.1주, 1435$\pm$431.0g)이 가장 짧았다(p<0.05). 치료를 시행한 28례에서 치료시 나이(8.6$\pm$5.5일, 7,3$\pm$4.4일)는 인도메타신 치료군과 동맥관 결찰술군 간에 차이가 없었으나, 체중(1670$\pm$43.6g, 1211$\pm$22.4g)은 동맥관 결찰술군에서 의의있게 적었다(p<0.05). 치료후 생존율은 100%와 73.9%로 인도메타신 치료군에서 높았고 술후 사망은 23.7$\pm$22.4일(6-68일)째 발생하였으며 사망원인은 패혈증 5례, 뇌실질내 출혈과 기관지폐이형성증이 각각 2례, 패혈증 쇼크와 기흉이 각각 1례로 수술과는 직접적인 관련이 없었다. 결론: 미숙아 동맥관 개존증에서 조기에 동맥관 결찰술을 시행하는 것은 비교적 안전하고 효과적이며, 특히 인도메타신 치료를 시행할 수 없는 경우와 초저체중의 미숙아에서도 안전하게 적용 될 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제43권2호
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• pp.172-175
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• 2010

61세 남자 환자가 급성 흉통을 주소로 전원 되었으며, 심전도상 ST분절 상승 소견 및 흉통으로 급성 심근 경색 진단 하에 심혈관 조영술을 시행하였다. 좌회선동맥 둔각변연분지의 완전 폐색 소견 보여 대동맥 내 풍선장치 삽입 하에 혈관 중재술을 시행하였으나, 성공적인 혈관 중재술 후에도, 쇼크 지속되어 체외막 산소화 장치를 삽입하였다. 그러나, 이후에도 상태는 호전되지 않았고, 청진 및 심초음파상 심한 급성 승모판 폐쇄 부전 발견되어 승모판막 치환술을 시행하였다. 술 후 이틀째 체외막 산소화 장치 및 대동맥 내 풍선장치를 제거할 수 있었고, 수술 후 48일째 자가 보행 가능한 상태로 퇴원하였다.

• Journal of Chest Surgery
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• 제41권4호
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• pp.536-539
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• 2008

52세 여자는 승용차 조수석에 앉아가다가 타차와 충돌후 다발성 늑골골절과 혈기흉과 함께 다량의 출혈을 야기한 우측 전완의 절단에 가까운 손상을 입었다. 응급실에 도착시 명료하지 못한 의식과 저혈압의 소견을 보였다. 혈액량 감소 쇼크로 판단되어 다량의 혈액과 수액을 급속수액주입기(레벨 1)를 이용하여 좌측 쇄골하정맥관을 통해 주입하였다. 폐좌상의 소견이 호전되었을 때 일반 흉부 X선 사진의 좌폐야에 이물질이 확인되었다. 폐동맥조영술에서 15 cm 정도의 이물질이 좌측 폐기저동맥에 있었다. 경피적 중재시술을 통해 혈관 겸자로 잡아 제거할 수 있었다.

• 한국임상약학회지
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• 제30권3호
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• pp.161-168
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• 2020

Background: Recently, a study comprising adult patients with sepsis admitted in the intensive care unit (ICU) was conducted. The patients were treated with high doses of intravenous ascorbic acid, thiamine, and hydrocortisone; the clinical outcomes demonstrated significant therapeutic benefits. The mortality rate in children with sepsis is approximately 25%. However, the effects of additional treatment with ascorbic acid and thiamine ("vitamin protocol") in children are rarely investigated. Methods: A retrospective analysis was performed using medical records of patients diagnosed with sepsis and admitted to the pediatric ICU (PICU) between September 2016 and June 2019. The control group received treatment only as per sepsis protocol, whereas the treated group received both sepsis protocol and the vitamin protocol. The primary endpoint was change in Vasoactive-Inotropic Score (VIS) for 5 days. The secondary endpoints included the length of stay in the PICU, duration of using mechanical ventilators and vasopressors, and mortality rate. Results: The number of patients in the treated and control groups was 33 and 24, respectively. The treated group showed greater decrease in their VIS for 5 days than the control group (44.4 vs 18.6); however, the difference was not statistically significant. The length of stay in the PICU was significantly longer for the treated group than for the control group [10.0 days (Interquartile range (IQR), 6-18) vs 4.5 days (IQR, 4-10.3); p=0.004]. Conclusions: No significant treatment benefits were observed following vitamin protocol administration to the pediatric patients with sepsis. Further studies are necessary for improving the efficacy and safety of the vitamin protocol.

• 대한치과마취과학회지
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• 제14권4호
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• pp.243-250
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• 2014

Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction and may cause death within a few minutes. Differential diagnosis of anaphylaxis is made by clinical signs, such as, mental change, respiratory distress, hypotension, hypoglycemia, urticaria and angioedema. Especially, insulin reaction, myocardial infarction and vasovagal syncope are considered as differential diagnosis. In cases of fatal anaphylaxis, respiratory and cardiovascular disturbances predominate and are evident early in the reaction. This is a case report of the intensive care of anaphylactic shock after intravenous injection of the penicillin in a old medically compromised patient with the maxillary osteonecrosis. The anaphylactic shock symptoms, such as, unconsciousness, respiratory disorder, no pulsation on carotid artery and cardiopulmonary arrest are occurred in intravenous injection of augmentin 1.2 g after the skin test. In spite of immediate emergency cares, such as intravenous injection of epinephrine, endotracheal intubation, cardiopulmonary resuscitation, and continuous intensive care, the patient is expired in 58 hours after anaphylactic shock attack.