• 대한화상학회지
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• 제22권2호
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• pp.25-29
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• 2019

Purpose: This study was performed to investigate the effect of plasma lactate clearance as predictive factor of major burn patients. Methods: A retrospective review was performed on 119 patients from January 2014 to December 2018, who were admitted as severe burn patients to ICU unit. Plasma lactate was measured upon admission to the hospital and 24hrs after admission. And, hospital day, ICU day, TBSA (Total Body Surface Area) and numbers of surgical intervention were collected after admission. Results: Higher lactate clearance showed negative statistical correlation with survival, hospital day, ICU day & number of surgical interventions. Conclusion: In this study, 24hr lactate clearance might be used as predictor of clinical prognosis following major burn injury.

• 한국콘텐츠학회논문지
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• 제9권8호
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• pp.158-165
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• 2009

원격의료에 있어서 의사와의 상담은 매우 중요하다. 그러나 의사가 환자의 상태를 보다 정확히 판단하기 위해서는 최소한의 청진이 필요하다. 최근에 인터넷을 기반으로 화상 상담시스템이 개발되었으나 심장질환의 경우에는 원격으로 심음을 청진할 수 없어 원격의료 상담에 활용할 수 없었다. 이와 같은 문제를 해결하려면 의사와 환자가 상담도중에 심음을 측정하고 이를 실시간으로 전송할 수 있어야 한다. 본 논문에서는 의사가 인터넷을 통해 전송된 심음을 듣고 청진할 수 있는 실시간 심음 전송용 원격의료 화상청진 시스템을 제시하였다. 또한 u-헬스케어 환경에 적합하도록 모니터링 요원을 통해 주치의를 연결시켜줄 수 있도록 기능을 설계하고 구현하였다. 제안된 시스템은 환자와 의사의 이동성을 지원하기 위해 서버에이전트를 두어 사용자 인증과정에서 네트워크 주소정보를 제공하도록 기능구현을 하였다. 본 논문에서 구현한 시스템은 향후 심장질환자의 원격진료에 활용할 수 있을 것이다.

• 사물인터넷융복합논문지
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• 제6권4호
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• pp.27-32
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• 2020

인구 고령화에 따라 치매환자가 크게 늘어나고 있으며, 이에 따른 사회 경제적 부담이 커지고 있다. 현재 치매환자를 효과적으로 관리하는 방법은 조기에 치매 초기 환자를 파악하는 것이다. 그러나 의료진이 부족한 농촌과 섬 지역에서는 병원을 방문해서 조기 검사를 받기 어려운 문제가 있다. 이 문제를 해결하는 방법으로 본 논문에서는 원격 치매 조기 검사 시스템을 제안한다. 원격 치매 조기 검사 시스템은 환자가 실시간 화상 통신을 기반으로 한 원격 의료 기술을 활용하여 원격의 치매 전문가에게 검사 및 진료를 받을 수 있는 시스템이다. 치매 원격 조기 검진 시스템은 섬 지역의 보건지소 의료진이 사용하는 로컬 클라이언트 시스템, 영상을 전송 및 저장/관리하는 화상 서버, 원격 치매 전문가가 활용하는 전문가 클라이언트로 구성된다. 로컬 클라이언트는 환자가 보건지소의 의료진과 같이 사용할 수 있도록 함으로써 현 의료법의 원격협진 기준을 만족시킨다. 또한 전문가 클라이언트는 치매 전문가가 사용하며, 환자의 정보를 저장/관리하고, 환자의 이력 정보를 분석하고 향후 치매 진행 정도를 예측할 수 있다.

• 대한화상학회지
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• 제22권1호
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• pp.10-14
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• 2019

Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

• 대한화상학회지
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• 제22권1호
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• pp.1-9
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• 2019

Purpose: The aim of this study was to investigate the characteristics of Acute Kidney Injury Network (AKIN)-defined nephrotoxicity in patients undergoing intravenous colistimethate sodium (CMS) therapy for major burns. Methods: This retrospective study included burn patients who received more than 48 h of intravenous CMS between September 2009 and December 2015. Data collection was performed using the institution's electronic medical record system. Patients assigned to the developed nephrotoxic group experienced aggravation of current AKIN stage during CMS treatment; those assigned to the non-nephrotoxic group experienced no change in current or exhibited improved AKIN stage during CMS therapy. Results: A total of 306 patients were included in this study. All patients were grouped according to AKIN stage: AKIN 0 (n=152); AKIN 1 (n=6); AKIN 2 (n=9); AKIN 3 (n=139). The baseline creatinine (Cr) level was 0.73 mg/dL. The incidence of nephrotoxicity was 50.3% according to AKIN stage; overall mortality was 45.8%. The non-nephrotoxic group consisted of 127 (74.7%) patients and 43 (25.3%) were in the developed nephrotoxic group. In patients requiring continuous renal replacement therapy (CRRT), baseline Cr level was 0.83 mg/dL, pre-CMS Cr level was 1.17 mg/dL, and post-CMS Cr level was 1.34 mg/dL. Conclusion: CMS can be administered without signs of nephrotoxicity for a certain period (approximately 1 week), it can be used relatively safely for 2 weeks. Application of CMS is a reasonable option for treating infections caused by multi-drug resistant gram-negative bacteria in patients with major burns. The caution should be exercised nevertheless.

• 대한화상학회지
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• 제23권2호
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• pp.37-41
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• 2020

Purpose: The purpose of this study was to investigate the usefulness of Procalcitonin (PCT) as a predictor of mortality in patients with burn sepsis, which is closely related to mortality. Methods: A retrospective study was conducted on 912 PCT patients diagnosed with burn sepsis in patients who survived fluid resuscitation for at least 3 days, aged 18 years or older who were admitted to Burn Intensive Care Unit (BICU) of Hallym University Hangang Sacred Heart Hospital from January 2008 to December 2018. Results: Compared with the surviving group, TBSA (31%:65%), Inhalation (59.66%:74.23%) and ABSI (8 points:12 points) were statistically significantly higher in the death group. Looking at the changes in PCT levels in each survival and death group from Week 1 to Week 4, there was a statistically significant difference in PCT levels in the survival and death groups each week (P<0.001). Although there were statistical differences between the survival and death groups in each state (P<0.001), there was no difference in PCT values for each state in both groups (P=0.090). Conclusion: In burn patients suspected of sepsis, the use of PCT is useful for predicting survival and death. It is necessary to conduct research based on prospective study through systematization of measurement standards and data from multiple institutions to increase the utilization of PCT through research that complements the limitations.

• 대한화상학회지
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• 제22권2호
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• pp.21-24
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• 2019

Incidence of low-temperature contact burn by use of an electric pad is increased recently, especially in depressed sensory. Acquired immune deficiency syndrome patient using antiretroviral agent suffered with sensory depression as side effect. There are many limitations in wounds treatment of these patients. These patients are vulnerable to infection due to their weak immunity, so it is necessary to keep them in a state of isolation when a wound occurs. We report a case of a third degree burn by electric pad with a surface area of approximately 5% of the body surface of a patient who underwent a sensory depression, which is a side effect of antiretroviral drugs used for treatment in patients with AIDS. In this regard, we report the case with literature review, which is safely recovered using negative-pressure wound therapy and split-thickness skin graft.

• 대한물리치료과학회지
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• 제3권4호
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• pp.197-206
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• 1996

• 대한간호
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• 제18권5호통권103호
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• pp.63-72
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• 1979

A total of 116 pediatric burn patients under the age of 7 who were admitted in General Surgery department of The National Medical Center during the past 5 years, from January 1974 to December 1978 were clinically reviewed. The abstracted results of this s

• Journal of Oral Medicine and Pain
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• 제38권2호
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• pp.109-114
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• 2013

구강점막의 화학화상은 다양한 화학제품과의 접촉에 의해 일어날 수 있으며 국소 점막염, 각화성 백색병소, 출혈, 통증성조직 표면 등과 같은 임상적 특징을 나타낸다. Policresulen(알보칠$^{(R)}$)은 산부인과, 피부과, 이비인후과 영역에서 점막이나 피부의 소독 및 지혈 목적으로 사용되는 일반의약품이다. pH 0.6의 강산성을 띠고 있어서 강력한 부식제로 작용할 수 있으며 구강점막에 접촉될 경우 괴사나 화학화상과 같은 부작용을 나타낼 수 있기 때문에 사용상 세심한 주의를 요한다. 56세 여자 환자가 입술의 궤양과 부종 및 염증성 삼출물을 주소로 구강내과에 내원하였다. 이 환자는 약 10년 전부터 혓바늘이 가끔 발생하였으며 그런 경우에 알보칠$^{(R)}$을 종종 사용했었다고 하였다. 최근에는 혀와 입술의 통증 때문에 알보칠$^{(R)}$을 혀와 입술에 광범위하게 여러 차례 도포한 적이 있다고 하였다. 임상검사상 혀의 전방 1/2 부위에서 홍반성 미란 및 염증성 삼출물이 관찰되었고 상, 하순에 출혈성 가피 및 궤양이 형성되어 있었다. 알보칠 사용을 중단하게 한 후 구순부에 스테로이드 연고 도포 및 스테로이드 구강 가글액 사용 후 1주일 만에 병소는 현저히 줄어들었으며 2주 후 완치되었다. 본 증례를 통해서 일반의약품으로 쉽게 접할 수 있는 Policresulen(알보칠$^{(R)}$)의 오용으로 인한 구강점막의 출혈성 궤양의 발생 양상 및 치료과정을 소개하였으며, 구강점막에서 발생하는 화학화상에 대해 고찰하였다.