• 약학회지
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• 제38권5호
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• pp.525-529
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• 1994

Antiinflammatory activity of an 1% flurbiprofen transdermal gel was evaluated using the carrageenan-Induced rat paw edema method. The application of 50 mg of the gel on the rat hind paw, at various time intervals from 0 to 24 hrs before the carrageenan injection, significantly inhibited edema formation in all groups of dosed rats, indicating that the antiinflammatory activitv was maintained up to 24 hrs after the transdermal application of the 1% flurbiprofen gel. The topical $ED_{50}$ of flurbiprofen in the gel was 1.0 mg/kg, whereas the oral $ED_{50}$ of the drug in a suspension was 1.7 mg/kg.

• 대한방사선기술학회지:방사선기술과학
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• 제38권1호
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• pp.1-6
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• 2015

Whole spine scanography(WSS)는 전신에 X선을 조사하는 검사로 치료기간 동안 빈번한 X선 조사가 이루어지는 검사이다. 일반촬영 분야에서는 많은 X선이 전신에 조사되는 검사이다. 따라서 논문에서는 Auto image pasta기법의 디지털 WSS 검사에서 환자의 검사방향에 따른 유효선량과 장기선량을 전산모사를 통하여 평가하였고, 영상에서 척추의 확대도와 각도의 변화를 평가하였다. 전후면 자세에서의 평균 유효선량은 0.069 mSv였고, 후전면 자세에서 평균 유효선량은 0.0361 mSv로 약 2배의 차이를 보였다. 전후면 자세에서 남성의 평균 유효선량은 0.089 mSv, 여성에 대한 평균 유효선량은 0.431 mSv로 나타났고, 후전면 자세에서 남성의 평균 유효선량은 0.050 mSv, 여성에서는 0.026 mSv로 나타났다. 확대율에서는 후전면 자세에서 전후면 자세에 비해 5%정도 확대 되었으나 각도에는 큰 변화를 보이지 않았다. 따라서 임상 환경에서 동일한 검사조건에서 환자의 자세를 변화시키는 것만으로도 환자의 피폭선량을 감소시킬 수 있음을 확인하였다. 특히 WSS와 같이 치료기간 동안 반복되는 검사에서 환자의 피폭선량 최적화를 위하여 검사 프로토콜의 재정립이 필요함을 확인하였다.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.13-19
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• 2024

Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.

• 대한응급의학회지
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• 제29권6호
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• pp.616-623
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• 2018

Objective: The shock index (SI), as a trauma triage tool, is a capable clinical indicator of hemodynamic instability and hypovolemic shock, but the conception of SI is contradictory to shock. The reverse shock index (RSI) was introduced recently, but its utility has not been sufficiently proven. Methods: This study examined the RSI utility by evaluating the procedures performed at an emergency department (ED) and the associated outcomes when the RSI is used alone or in combination with the Korean Triage and Acuity Scale (KTAS). This was a retrospective study conducted by including data of 4,789 adult trauma patients for a year. The clinical variables, procedures performed on patients, and outcomes were investigated. The median RSI was 0.9 in the RSI<1 group. Results: Patients in the RSI<1 group had a higher odds of requiring procedures at the ED and for experiencing worse outcomes: intubation (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.3-13.1; P<0.001), chest tube insertion (OR, 6.5; 95% CI, 0.4-111.84; P<0.001), use of emergency drugs (OR, 3.6; 95% CI, 1.5-8.5; P<0.001), circulatory support (OR, 5.4; 95% CI, 2.3-12.9; P<0.001), intensive care unit admission (OR, 3.5; 95% CI, 1.8-6.8; P<0.001), and mortality during the ED stay (OR, 20.4; 95% CI, 5.5-75.7; P<0.001). In the group with KTAS 1-3, trends similar to those in the RSI<1 group were observed. Patients with RSI<1 had more severe injuries and poorer outcomes than those with $RSI{\geq}1$, regardless of whether the RSI was used alone or in combination with KTAS. Conclusion: RSI can provide an appropriate triage with concurrent KTAS use.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.119-127
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• 2010

Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7237-7243
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• 2015

응급실은 병원으로 입원하는 주요 경로로서, 감염환자의 1차적 내원의 가능성이 높은 곳이다. 국내에서 질병관리본부가 2009년에 제정한 "응급실에서의 감염관리 표준지침"이 응급실 감염환자 관리 방안과 표준시설기준을 규정하고 있으나 각 병원 응급실의 감염환자 시설은 병원마다 차이가 있고 지침에 따른 일관된 감염환자 관리시설을 갖추었다고 보기 어렵다. 본 연구는 응급실에서의 감염관리 표준지침의 실효성을 알아보기 위해 법적 강제성을 갖는 "응급의료에 관한 법률"과 비교하여, 첫째 지침이 법률 시설기준에 반영된 여부를 분석하였고, 둘째 2009년 전후에 신축 또는 개축한 응급실들을 분석대상으로 하여 각 시설기준 항목들의 반영여부를 파악하였다. 그 결과 지침과 법률 시설기준의 상호연관성은 없었다. 분석대상 응급실들의 시설은 법적기준을 모두 충족한 반면 지침의 감염관리시설은 선별적으로 적용되어 있었고, 설치 항목들이 건축년도에 관계없이 분석대상 응급실에 대부분 적용되어 "응급실에서의 감염관리 표준지침"의 제정과는 무관한 것으로 나타났다. 본 연구 결과는 향후 응급실의 감염관리시설의 법적기준 체계 보완에 참고자료로 활용 될 수 있을 것이다.

• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.592-607
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• 2021

Objective : Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods : Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results : The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion : Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

• Journal of Contemporary Eastern Asia
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• 제21권1호
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• pp.72-76
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• 2022

• Archives of Pharmacal Research
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• 제20권1호
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• pp.53-57
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• 1997

For the purpose of defining the effects of the N-substituted alkyl groups on the anticonvulsant activities of N-Cbz-.alpha.-aminosuccinimides, various (R)- and (S)-N-alkyl substituted N-Cbz-.alpha.-aminosuccinimides (1 and 2) were prepared from the corresponding (R)- and (S)-N-Cbz-aspartic acid by using known reaction and were evaluated the anticonvulsant activies in the MES and PTZ tests, including their neurotoxicities. The most active compound in the MES test was (R)N-Cbz-.alpha.-amino-N-methylsuccinimide (1b) $(ED_{50}=52.5 mg/kg, Pl=3.2)$. And in case of the PTZ test, (R)-N-Cbz-.alpha.-amino-N-ethylsuccinimide (1c) was the most active compound $(ED_{50}/=32.5mg/kg, Pl=3.1)$. The order of anticonvulsant activities of these compounds against the MES test, as judged from the ED_50values for the R series (1), was N-methyl > N-isobutyl > non-substituted > N-ethyl, N-allyl > N-benzyl compound; for the S series (2) N-methyl > N-altyl > non-substituted > N-isobutyl > N-ethyl > N-benzyl compound. The anticonvulsant activities in the PTZ tests of these compounds exhibited somewhat different pattern ; for the R series (1) Nethyl > N-methyl > N-isobutyl> non-substituted > N-allyl > N-benzyl compound in order of decreasing activity; for S series (2) N-ethyl > N-allyl, non-substituted > N-isobutyl > N-methyl > N-benzyl compound in order of decreasing activity.

• Biomolecules & Therapeutics
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• 제1권2호
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• pp.125-130
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• 1993

The araC prodrugs (1~5) carrying a special acyl group at 5'-Ο-or $N^4$-position were evaluated for in vitro antiviral activity against various human viruses. When tested against HSV-1 and HSV-2 cultured in the verso cells, the prodrugs exhibited slightly higher $ED_{50}$ values compared with one of the parent araC but showed more increased $CC_{50}$ values in all cases. Consequently the overall selectivity indexes of prodrugs were higher than that of arab. The prodrugs, except compound 5, exhibited very potent activity similar to that of araC ($ED_{50}$ about $0.12{\mu}g/mι$) when evaluated against another human DNA virus, cytomegarovirus. However, theses araC prodrugs were completely inactive against RNA viruses i.e. poliovirus and coxackie B3 virus at the concentration of 4250{\mu}g/mι.$