• Journal of Chest Surgery
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• 제26권11호
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• pp.856-860
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• 1993

We performed serial pulmonary function test and arterial blood gas analysis at preoperative period and postoperative 1st week in 337 patients who underwent pulmonary resection from May 1988 to April 1992 at Dept. of Thoracic and Cardiovascular Surgery, Seoul adventist hospital. Follow-up study for PFT and ABGA were possible in 30 % of the patients at postoperative 3rd or 4th month. In patient who underwent pneumonectomy, VC was decreased from 57.7% to 46.1%, FVC was decreased from 53.5 % to 41.2 % and MBC also decreased from 68.1% to 49.6 % at postoperative 1st week. But ABGA revealed that POa-, was increased from 87.2 mmHg to 92.7 mmHg, and PCO2 was decreased from 43.2 mmHg to 35.9 mmHg at postoperative 1st week. In patients who underwent lobectomy, VC was decreased from 78.1% to 68.30 %, FVC was decreased from 72.5% to 55.3% and MBC was decreased from 73.5% to 68% at postoperative 1st week.But, ABGA revealed that PO2 was increased from 95.2 mmHg to 97.9 mmHg and PCO2 was decreased from 42.3 mmHg to 39.0 mmHg at postoperative 1st week. The pulmonary function recovered at postoperative 3rd or 4th month and its ratio to preoperative value was 90% in lobectomy cases, but in pneumonectomy cases VC and MBC were recovered 20% and 15 % above the preoperative values. We concluded that resection of atelectasis, destructed lung, open negative and open positive cavity in the pulmonary tuberculosis were beni~t to improve ventilation-perfusion ratio,and pulmonary function was recovered nearly to preoperative level at postoperative 3rd or 4th month.

• 대한한의학회지
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• 제24권2호
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• pp.213-218
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• 2003

폐동맥고혈압으로 진단받은 객혈환자 1예에 대하여 청상보하탕 가미방을 투여하여 객혈량, 전신소력감 및 ABGA의 변화를 고찰해 본 결과 위와 같이 객혈량의 약 90％ 감소, 전신소력감의 약 40％ 감소 및 ABGA의 호전을 보였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제26권1호
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• pp.54-58
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• 1993

Simultaneous bilateral bleb resection was done through bilateral transaxillary thoracotomy in 10 patients with spontaneous pneumothorax during the period from May 1991 to Novemver 1992 in whom bilateral bulla or bleb was detected with using simple chest X-ray and chest CT scanning. To compare the effectiveness of bilateral transaxillary thoracotomy, we investigated 10 unilateral transaxillary thoracotomy patients with spontaneous pneumothorax and two clinical reports from other institutes which dealt the results of bilateral bleb or bulla resection through median sternotomy also. In bilateral transaxillary thoracotomy group,mean operation time was 115 minute,mean intraoperative bleeding was 329 cc, mean postoperative hospital stay was 7.5 days. Postoperative ABGA[Arterial Blood Gas Analysis] was in normal range and postoperative recovery rates of FVC[Forced Vital Capacity], FEV1[Forced Expiratory Volume at 1 second], TV[Tidal Volume] were 84.3%, 93.4%, 88.7%,respectively. In median sternotomy group,mean operation time was 129 minute,mean intraoperative bleeding was 490 cc, mean postoperative hospital stay was 12.4 days. Postoperative ABGA was in normal range and postoperative recovery rates of FVC, FEV1 were 97.3%, 97.4%, respectively. In unilateral transaxillary thoracotomy group, postoperative ABGA was in normal range also and postoperative recovery rates of FVC, FEV1, TV were 91.6%, 99.0%, 96.0%,respectively. In conclusion, simultaneous bilateral bleb resection through bilateral transaxillary thoracotomy should be considered in pneumothorax patients with bilateral bleb or bulla because of cost-effectiveness[reducing hospital days] and better cosmetic result without any impairment in recovery of respiratory function.

• 대한디지털의료영상학회논문지
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• 제10권2호
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• pp.33-37
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• 2008

To keep the online medical records available to anyone without constraint of time and space, introducing EMR (Electronic medical record), which is a clinical support management system. The purpose of this study is to develop interface standard of clinical test device. Integration and sharing of medical information is faced with enormous obstacles because medical organizations and associated companies are separately developing the interface. I hope that multi-function management system with workstation concept is operated to efficiently transmit clinical device result data based on this study. Transfer of precise medical result data available for decision making will improve quality of health care service.

• 대한흉부심장혈관외과학회:학술대회논문집
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• 대한흉부외과학회 1995년도 제27차년차학술대회 및 총회
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• pp.117-117
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• 1995

• 성인간호학회지
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• 제23권1호
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• pp.87-99
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• 2011

Purpose: The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room. Methods: The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program. Results: The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (${\beta}$=.226) and then shivering (${\beta}$=.222). Conclusion: The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.574-582
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• 1998

연구배경: 기관지 내시경은 기도를 통하여 내시경을 삽입한 후 약 10-30분 가량의 시술을 포함하기 때문에 호흡기계에 병태 생리학적 변화를 동반할 가능성이 있다. 이에 저자들은 기관지내시경 검사에 따른 경피적 산소 포화도의 변화와 검사 전후 동맥혈 가스 및 폐기능의 변화를 보고자 하였다. 방 법: 144명의 환자를 대상으로 기관지 내시경을 입으로 삽입하여 실시하였으며 내시경 전과정을 통하여 pulse oximetry를 사용하여 왼쪽 검지 손가락 끝에서 l 분 간격으로 산소 포화도를 측정하였다. 16명의 환자를 대상으로 내시경 시행전과 직후에 폐기능과 동맥혈 가스검사를 시행하였다. 결 과: 기관지내시경의 평균 시술시간은 14.5분이었고, $SaO_2$는 평균 8.4분후에 최저로 떨어져 $89.0{\pm}5.54%$로 기저치보다 8% 저하되었으나 종결시 회복되었다. 산소 공급군과 비공급군에서 시술시간은 산소공급군에서 유의하게 길었으나, $SaO_2$의 감소는 산소비공급군에서 8.4%로, 산소 공급군의 6.4%보다 컸으나 통계적 유의성은 없었다. 산소 비공급군에서 Biopsy군와 BAL군이 Washing군에 비하여 $SaO_2$ 저하가 더 큰 경향을 보였으나 종결시에는 유사하게 회복되었다. 기관지내시경 시행전 $PaO_2$ 및 $FEV_1$의 정도는 기관지내시경중의 $SaO_2$ 감소정도에 큰 영향을 미치지 않았다. 기관지내시경을 전후하여 시행한 ABG상 경미한 $PaO_2$의 감소와 $PaCO_2$의 증가를 보였으며, vP기능 검사상 $FEV_1$의 감소(P<0.05)와 RV의 증가를 보였으나 기도 저항과 폐확산능의 변화는 없었다. 기관지내시경을 전후하여 비교하였을 때 Washing군은 폐기능의 큰 변화가 없었으나, Biopsy군과 BAL군은 기관지내시경후 $FEV_1$이 감소하고 RV가 증가하였으며, 통계적으로 유의하진 않았으나 BAL군에서 더욱 두드러졌다.

• 대한디지털의료영상학회논문지
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• 제8권1호
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• pp.21-26
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• 2006

Hospitals these days are trying to introduce the a practice has recently been generalized in the test or diagnosis process, where test results and images from different test labs are interlinked together. This process is identical to that of physical aspect in EMR process, which computerizes the paper results within the hospital. One of the prerequisites for the process of computerizing test results is the interface between clinical test devices in the test labs. However, due to the variety of prescription inputs, disparity of test result papers, complexity of job in test labs and diversify of interfaces among the different devices, interconnection with the hospital information system is a complicated job. A universal control of clinical test devices which have independent communication protocols has become possible by connecting them with an interface workstation. As for the patients, waiting time for test has been reduced, and, thanks to the synchronized result retrieval system, it has become possible to check the test results on the very day of the test. As a result, the length of hospitalization has been reduced, too. In terms of workflow, as the transfer of charts and transfer of result papers are separated, the embarrassing job of collecting result papers has disappeared. As patients' test appointment and the results processing can be made on-line, extra work for doctors have disappeared. And, thanks to the computerization of test results information management, the job of statistical processing has become convenient.

• 대한임상독성학회지
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• 제13권1호
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• pp.36-39
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• 2015

Copper sulfate is a copper compound used widely in the chemical and agriculture industries. Most intoxication occurs in developing countries of Southeast Asia particularly India, but rarely occurs in Western countries. The early symptoms of intoxication are nausea, vomiting, diarrhea, and abdominal cramps, and the most distinguishable clue is bluish vomiting. The clinical signs of copper sulfate intoxication can vary according to the amount ingested. A 75-year old man came to our emergency room because he had taken approximately 250 ml copper sulfate per oral. His Glasgow Coma Scale (GCS) score was 14 and vital signs were blood pressure 173/111 mmHg, pulse rate 24 bpm, respiration rate 24 bpm, and body temperature $36.1^{\circ}$ .... Arterial blood gas analysis (ABGa) showed mild hypoxemia and just improved after 2 L/min oxygen supply via nasal cannula. Other laboratory tests and chest CT scan showed no clinical significance. Three hours later, the patient's mental status showed sudden deterioration (GCS 11), and ABGa showed hypercarbia. He was arrested and his spontaneous circulation returned after 8 minutes CPR. However, 22 minutes later, he was arrested again and returned after 3 minutes CPR. The family did not want additional resuscitation, so that he died 5 hours after ED visit. In my knowledge, early deaths are the consequence of shock, while late mortality is related to renal and hepatic failure. However, as this case shows, consideration of early definite airway preservation is reasonable in a case of supposed copper sulfate intoxication, because the patients can show rapid deterioration even when serious clinical manifestation are not presented initially.

• Journal of Chest Surgery
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• 제32권8호
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• pp.702-708
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• 1999

배경: 미숙아 동맥관 개존증의 약물적 치료로 Indomethacin을 사용하는데 이때 발생하는 합병증, 부적응증, 또는 동맥관이 다시 열릴 경우 외과적으로 교정함으로써 수술에 따른 위험성 및 합병증이 적고 지속적인 동 맥관 폐쇄가 가능하다. 대상 및 방법: 1996년 4월부터 1998년 8월까지 동맥관 개존증을 동반한 미숙아중 수 술 당시의 체중이 1.5 kg 이하인 11명의 환아(남아: 5, 여아: 6)를 대상으로 하였다. 술전 동반질환으로 선천 성 심질환(7), 유리질막증(6), 폐렴(4), 뇌실내 출혈(4), 기흉(3), 고빌리루빈혈증(2), 괴사성 장염(2), 신부전증 (1), 간질(1), 수두증(1) 등이 있었다. 사용된 외과적 술식은 헤모클립을 사용한 경우(8)와 동맥관을 결찰한 경 우(3)가 있었다. 동맥관의 크기는 3~6 mm(5.0$\pm$1.2)였다. 결과: 동맥관을 폐쇄한후 수축기 및 확장기 혈압이 상승하였고 심박동수는 감소하였다. 동맥혈 개스 결과도 호전되었다. 수술과 관련된 합병증은 없었다. 술후 6명의 환아에서 호흡기 증상의 호전과 함께 인공호흡기이탈이 가능했고 모두 외래 추적 관찰중이다(3개월~ 12개월). 술후 5명의 환아가 사망하였는데 사망 원인은 유리질막증(2례), 기관지폐 이형성증과 폐렴(1례), 패 혈증(1례), 심부전증과 특발성 호흡곤란증(1례)이었다. 결론: Indomethacin에 부적응증 혹은 합병증이 있거나, Indomethacin용법에 효과가 없거나 또는 혈역학적으로 의미있는 단락을 동반하는 미숙아 동맥관의 우선 치료 법은 조기 외과적 교정술이다.