• Journal of Trauma and Injury
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• 제32권3호
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• pp.136-142
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• 2019

Purpose: Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV). Methods: This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows. Results: NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05). Conclusions: NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.

• Tuberculosis and Respiratory Diseases
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• 제69권4호
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• pp.298-302
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• 2010

Scedosporium apiospermum, the anamorph of Pseudallescheria boydii, is a ubiquitous saprophytic fungus. S. apiospermum can cause life-threatening infections usually in immunocompromised patients or after near-drowning incidents. Here, we report the first case of disseminated infection caused by S. apiospermum after near-drowning in Korea. A 44-year-old healthy man developed aspiration pneumonia, followed by multiple brain abscesses, and endopthalmitis, after a near-drowning incident in a septic tank. S. apiospermum infection was diagnosed on the 33rd day after the incident had occurred. The patient died from the progressive renal failure 255 days after incident, although he had been treated with voriconazole.

• 한국응급구조학회지
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• 제5권1호
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• pp.165-175
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• 2001

The purpose of this study is to investigate the actual status of occurrence of near-drowning accident by regions, sex, causes, places, months and days through Bureau of Statistics for 3 years from 1998 to 2000. 1. As the results of the drowned persons for 3 years from 1998 to 2000, the total number of them were 5,058 persons and 1,686 persons the yearly mean experienced near-drowning accidents. In the actual status of drowned persons by regions, 255 persons(15.1%) of Kyung-Ki regions are highest, 27 persons(1.62%) of Che-Ju regions are lowest. 2. In the actual status of drowned persons by sex, the yearly mean 1324 male persons(78.58%) and 362 female persons(21.42%) of 1,686 persons the yearly mean are drowned and the number of male drowned persons is 3.7 times higher than that of female. 3. In the actual status of drowned persons by age, among 1,686 drowned persons the yearly mean, 467 persons between fifteen and nineteen are drowned(9.23%). 4. In the actual status of drowned persons by causes, the major causes due to the poor swimming skills are 43.4%. 5. In the actual status of drowned persons by places, the major places are rivers and riversides(50.0%). 6. In the actual status of drowned persons by months, among 1,686 drowned persons the yearly mean, 319.33 persons(18.94%) on the July and 403.66 persons(23.94%) on the August had the highest the drowning accident. It is one of major cause of seasonal accidental death especially in summer. 7. In the actual status of drowned persons by day of the week, among 1,686 drowned persons the yearly mean, most of near-drowning accidents are happened on weekend(56.62%).

• Journal of Chest Surgery
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• 제43권2호
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• pp.164-167
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• 2010

여러 가지 원인에 의해 발생된 급성 호흡부전에서 체외순환막형산화요법은 폐기능을 회복시키는데 도움이 될 수 있다. 물놀이 사고로 인해 발생된 급성 호흡부전 환자에서 기존의 적절한 치료에 반응하지 않는 경우 체외순환막형산화요법으로 성공적으로 치료한 보고들이 있다. 저자들은 물놀이 사고로 급성호흡부전이 발생한 2명의 환자를 정정맥 체외순환막형산화요법으로 치료를 하였다. 정맥 도관의 삽입은 모두 경피적으로 양측 대퇴정맥을 이용하였다. 2명의 환자 모두 성공적으로 체외순환막형산화요법을 제거할 수 있었으나, 1명의 환자에서 저 산소성 뇌손상과 거미막 및 출혈이 발생하였다.

• Tuberculosis and Respiratory Diseases
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• 제55권3호
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• pp.287-296
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• 2003

연구배경 : 익수 사고로 인한 사망은 유아기 및 청소년기에 흔히 발생하며, 전 세계적으로 사고사의 원인 중 세번째로 흔한 사인이다. 익수 환자에 대한 국내보고는 극히 드물며, 몇몇 보고가 있었으나 그 대상이 주로 소아였었고 성인에 대한 그 원인과 예후들에 대한 임상적 자료가 드물기에 성인을 대상으로 익수 손상 환자에 대한 임상적 특성을 알아보고자 하였다. 방 법 : 1990년 7월부터 2003년 3월까지 경북대학교병원 응급실로 내원한 15세 이상의 성인 익수 손상 환자 31명을 대상으로 익수 사고 및 손상 환자의 특성, 흉부방사선소견, 임상 경과 및 결과, 그리고 예후에 대한 예측 인자에 대해 의무기록지를 통해 후향적으로 조사하였다. 결 과 : 성인의 익수 손상은 20세 전후와 65세 이상의 연령에서 각각 10예 (32.3%), 7예 (22.6%)로 가장 호발하였다. 사고의 원인으로는 수영 미숙 12예 (38.7%)에 이어 음주가 10예 (32.3%)로 두번째로 많았으며, 익수 장소로는 강이 9예 (29%), 공중목욕탕이 7예 (22.6%) 순이었다. 단순흉부사진상 익수 손상에 의한 폐부종은 약 90%에서 하부쪽에 우세하게 양측성의 중심성 분포를 보였으며 10%에서는 상부에만 분포하였다. 치료 경과중 폐렴과 급성호흡곤란증후군의 호흡기 합병증이 각각 10예 (32.3%), 5예 (16.1%)로 가장 많이 발생하였으며, 17예 (54.8%)에서는 특별한 합병증이 없었다. 현장에서 소생술이 시행된 환자의 87.5%에서 회복된 것을 포함하여 25예 (80.6%)에서 신경학적인 손상 없이 회복되었고, 2예 (6.5%)에서 심각한 신경학적 손상을 남겼으며, 4예 (12.9%)는 사망하였다. 예측인자에 대한 기초 변수의 비교에서 나이, 동맥혈 가스의 산소화 지수, 그리고 의식 상태가 예후에 대한 뚜렷한 차이를 보였다. 결 론 : 65세 이상의 연령, 음주 등의 이차적인 원인과 공중목욕탕에서의 발생이 성인 익수 손상에서 상대적으로 중요하였으며, 현장에서 즉각적인 소생술 시행과 함께 적절한 호흡보조 치료로 80%이상에서 후유증 없이 회복된 결과는 성인 익수 손상 환자에서도 적극적인 심폐소생술이 시도되어야 할 것을 시사한다.

• 대한원격탐사학회지
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• 제36권1호
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• pp.1-13
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• 2020

Seasonal changes in river water vary seasonally as well as locationally, and the assessment is essential. In this study, we used the recent technique of post-classification by using the Google earth engine (GEE) to map the seasonal changes in Mahanadi river of Odisha. However,some fixed problems results during the rainy season that affects the livelihood system of Cuttack such as flooding, drowning of children and waste material deposit. Therefore, this study conducted 1) to map and analyse the water density changes and 2) to analyse the seasonal variation of river water to resolve and prevent problem shortcomings. Our results showed that nine types of variation can be found in the Mahanadi River each year. The increase and decrease of intensity of surface water analysed, and it varies in between -130 to 70 ㎥/nf. The highest frequency change is 2900 Hz near Cuttack city. The pi diagram provides the percentage of seasonal variation that can be observed as permanent water (30%), new seasonal (28%), ephemeral (12%), permanent to seasonal (7%) and seasonal (10%). The analysis is helpful and effective to assess the seasonal variation that can provide a platform for the development of Cuttack city that lies in Mahanadi delta.

• Journal of Trauma and Injury
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• 제30권3호
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• pp.75-79
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• 2017

Purpose: Although trauma is the most common cause of death under age 18, Korean national pediatric trauma data has lack of clinical data. This study is to prepare manpower resources, equipment, and make a correct policy decision on pediatric trauma victims Methods: The study enrolled 528 patients under age 16 with traumatic injury visited Wonju Severance Christian Hostpital Trauma Center, from February 12, 2015 to December 31, 2016. We analyzed the distribution of gender, age, place and time of the accident, injury mechanism, injury severity, and injured organ by medical record. Results: The major injury mechanisms were blunt injury in 485 (91.90%), penetrating injury in 27 (5.10%), burn in 13 (2.50%), near drowning in 2 (0.40%), and foreign body ingestion in 1 (0.20%). Ninety-seven (18.4%) patients were injured at home and 67 (12.7%) patients were injured at school. The overall mortality rate was 1.13% (n=6). 5 mortalities were related to automobile accident and one was fall down. Mean Injury Severity Score (ISS) was 4 (2, 8). No statistical significance was observed in the mean ISS between each age group. The peak time of accident occurrence was between 16 and 17 o'clock. The mean ISS was higher in blunt injury group than penetrating injury with statistical significance ($6.50{\pm}7.60$ vs. $3.00{\pm}8.10$; p<0.05). The most common injury site was upper extremity. Mean ISS was highest in thorax injury. However, mean ISS of thorax injury was higher with statistical significance only compared with face, neck and upper extremity injury. Conclusions: We reported our pediatric trauma patients data of our hospital level I trauma center, which is the only one level I trauma center of Gangwon Province. These data is useful to prevent and prepare for pediatric trauma.