• 한국화재소방학회논문지
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• 제33권6호
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• pp.95-104
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• 2019

화재 시 발생하는 연기는 가스상 물질과 이들을 흡착한 미연탄소 등의 입자상 물질로 이루어져 있다. 연기 중 가스상 물질의 흡입에 의한 인체피해는 대부분 단기적으로 이루어지는 데 비하여 입자상 물질의 흡입에 의한 피해는 가스상의 흡착상태에 따라서 상대적으로 장기적으로 이루어진다. 입자상 물질이 호흡기벽에 침착하여 호흡기 및 순환기 계통에 영향을 미치는 것과 관련하여, 침착되는 연기입자의 양과 호흡기 내 침착위치는 인체피해 산정의 중요한 요소인데, 이들은 연소조건에 영향을 받는 크기 및 농도 등 입자상태와 함께 호흡조건에 영향을 받는다. 이 연구에서는 화재 시 발생하는 연기의 흡입에 의한 인체피해 연구와 관련된 호흡기 내 연기입자 침착특성 파악을 위하여 연료종류, 연소조건 및 호흡조건에 따라 호흡기 내 영역별로 침착되는 연기입자의 입경에 따른 개수 및 질량 농도를 구하였다. 또한 각 조건별로 흡입연기의 일정기간 동안 호흡기 내 질량 침착량을 대기환경 미세먼지 기준치와 비교 분석하였다.

• Tuberculosis and Respiratory Diseases
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• 제76권5호
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• pp.237-239
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• 2014

The early pulmonary consequences of inhalation injury are well documented; however, little is known about delayed pulmonary complications following thermal inhalation injury. Although thermal injury below the vocal cords is rare because of effective heat dissipation in the upper airway, inflammatory endobronchial polyps have previously been reported as a delayed complication associated with inhalation injury. We report an extraordinary case of tracheobronchial polyps in patients with smoke inhalation injury. This report shows the delayed development and natural course of tracheobronchial polyps following thermal injury.

• Tuberculosis and Respiratory Diseases
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• 제60권5호
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• pp.564-570
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• 2006

화상환자에서의 흡입화상은 이환률 및 사망률에 영향을 미치는 중요한 인자이다. 호흡기계의 손상은 침범 부위 및 정도에 따라 매우 다양하게 나타나는데, 기도 손상의 경우 성문하 협착 등의 기도폐색을 일으킬 수 있으며, 폐실질의 손상은 저산소증, 폐렴, 호흡부전 및 급성호흡곤란증후군의 병태생리를 제공하게 된다. 흡입화상의 초기 방사선소견으로는 정상, 경화, 기관지주위 비후, 심인성 및 비심인성 폐부종, 무기폐, 간질성 혹은 폐포성 폐 침윤의 형태로 나타날 수 있다. 후기 변화로는 기관지확장증, 폐쇄 기관지염 및 폐 섬유화 등이 증례 보고된 바 있다. 하지만 성인 흡입화상 환자에서의 공동성 병변에 대해서는 보고 된 바 없다. 저자들은 44세 남자로 얼굴 및 양손에 9%의 경미한 피부 화염화상을 입었으나 흡입화상으로 인한 호흡기 합병증에 대한 치료가 더 중요시 되었던 환자로 치료 과정에서 좌상엽의 공동성 병변을 관찰하게 되었다. 추적 과정에서 이 공동은 계속 변화하는 양상이었으며 한차례 대량 객혈이 있었으나 그 후로는 다른 호흡기계 합병증 없이 저절로 소실해 가는 과정을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제74권3호
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• pp.120-123
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• 2013

Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest radiographic findings were consistent with acute pneumonitis. He recovered spontaneously and was discharged after 5 days without other specific treatment. His pulmonary function test, 4 days after methane gas exposure, revealed a restrictive ventilatory defect. In conclusion, acute pulmonary injury can occur with a restrictive ventilator defect after a short exposure to methane gas. The lung injury was spontaneously resolved without any significant sequela.

• Tuberculosis and Respiratory Diseases
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• 제55권2호
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• pp.188-197
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• 2003

연구배경 : 고열과 유독가스에 의한 흡입 폐 손상은 화상 환자에서 화재와 관련한 주된 사망원인이다. 따라서 조기진단과 적절한 치료가 중요한데, 본 연구는 초기 COHb 농도가 증가한 화상 환자의 임상 특성 및 경과를 관찰하고 흡입 폐 손상에 대한 예후인자를 알아보고자 하였다. 방 법 : 2001년 8월부터 2002년 7월까지 응급실 통해 내원한 1,416명 환자 중 동맥혈 가스검사에서 COHb 농도가 5% 이상인 39명을 사망군(12명)과 생존군(27명)으로 나누어, 임상특성, 임상적 흡입 손상 정도, 흉부 X-선 소견, 화상 체표 면적, APACHE II 점수, SAPS II 점수 등을 후향적으로 비교하였다. 결 과 : 생존군과 사망군 사이에 COHb 농도는 각각 $10.3{\pm}8.8%$, $9.7{\pm}5.7%$, 화상 체표면적은 $16.6{\pm}17.8%$, $60.7{\pm}28.8%$였다. 임상적 흡입 폐 손상 정도 및 초기 흉부 X-선 소견은 생존군과 사망군 사이에 유의한 차이점을 관찰할 수 없었다. 두 군사이의 사망관련 인자로는 화상 체표면적, APACHE II 점수, SAPS II 점수, 기계 호흡 및 총 입원기간이 관여하고 있었으나 다변량 분석에서 화상 체표 면적이 가장 중요한 사망관련 인자였다. 결 론 : 초기 동맥혈 COHb 농도가 증가되어 있는 화상환자의 예후는 불량할 것으로 기대되기 때문에 치료에 많은 관심을 기울여야 할 것으로 사료된다. 하지만, COHb이 흡입 폐 손상을 동반한 화상 환자의 예후에 미치는 효과에 대해서는 향후 전향적 연구를 통해서 검토되어져야 할 것으로 생각된다.

• 대한의생명과학회지
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• 제12권3호
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• pp.281-287
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• 2006

Cigarette smoke causes atypical structure of pulmonary and oxidative damage. Therefore, we carried out to determine if exposure to cigarette smoke alters pulmonary structure and anti-oxidant related enzyme in a animal model, when natural product extracts using by Nebulizer. The rat were divided into four groups: $H_2O-treated$ (Control), natural product (Camellia sinensis) extracts-treated (CS), natural product extracts-treated with cigarette smoke-exposed (CS+SM) and cigarette smoke-expose (SM). All groups are similar to Control group in weight, but SM group is lower than the other groups. Microscopic image of the pulmonary structure in SM group showed deleterious alterations in the morphology, but the other groups are maintained in normal structure. In anti-oxidant related enzymes, SOD (superoxide dismutase) and catalase, SM group represents the lowest enzyme activity among all groups. But G6PD (glucose-6-phosphate dehydrogenase) and LPO (lipid peroxidation) is SM group represents the highest enzyme activity among all groups. These result indicate that the natural product extracts is an efficient tissue protective substance against smoke-induced lung injury.

• 대한임상독성학회지
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• 제13권1호
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• pp.46-49
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• 2015

Carbon monoxide (CO) intoxication is a leading cause of severe neuropsychological impairments. Peripheral nerve injury has rarely been reported. Following are brief statements describing the motor peripheral neuropathy involved bilateral lower extremities of a patient who recovered following acute carbon monoxide poisoning. After inhalation of smoke from a fire, a 60-year-old woman experienced bilateral leg weakness without edema or injury. Neurological examination showed diplegia and deep tendon areflexia in lower limbs. There was no sensory deficit in lower extremities, and no cognitive disturbances were detected. Creatine kinase was normal. Electroneuromyogram patterns were compatible with the diagnosis of bilateral axonal injury. Clinical course after normobaric oxygen and rehabilitation therapy was marked by complete recovery of neurological disorders. Peripheral neuropathy is an unusual complication of CO intoxication. Motor peripheral neuropathy involvement of bilateral lower extremities is exceptional. Various mechanisms have been implicated, including nerve compression secondary to rhabdomyolysis, nerve ischemia due to hypoxia, and direct nerve toxicity of carbon monoxide. Prognosis is commonly excellent without sequelae. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.

• 한국응급구조학회지
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• 제8권1호
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• pp.179-187
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• 2004

The purpose of the study was to injury types in Daegu subway fire accident, Sampung department store collapse, Mokpo airport civil aircraft accident, and Buan sunken ship disaster. The conclusion obtained from these analyses are as following. 1. The total of victims were Sampung department store collapse(l440 people). Buan sunken ship disaster(355 people), Daegu subway fire accident(340 people), and Mokpo airport civil aircraft accident(110 people). 2. The total of dead people were Sampung department store collapse(502 people), Buan sunken ship disaster(287 people), Daegu subway fire accident(192 people), and Mokpa airport civil aircraft accident(66 people). 3. The total of injured people were Sampung department store collapse(938 people), Daegu subway fire accident(148 people), Mokpo airport civil aircraft accident(84 people), and Buan sunken ship disaster(67 people). 4. The major types of victims presented smoke inhalation such as coughing, dyspnea, and sore throat in Daegu subway fire accident. 5. The major types of victims presented crushing(multiple fractures), vertebral, and soft tissues injuries in Sampung department store collapse. 6. The major types of victims presented multiple fractures. In addition to, a lot of people showed vertebral injuries and shock symptoms in Mokpo airport civil aircraft accident. 7. The major types of victims presented drowning as well lots of hypothermia patients in Buan sunken ship disaster. There were a wide variety of types in human disaster. Therefore, the most important disaster training program need to each disaster aspect in the local emergency medical services system. Moreover, the emergency medical services personnel should be understand and training for injury types of each human disaster.

• KSBB Journal
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• 제27권6호
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• pp.367-374
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• 2012

Cigarette smoking (SM) is considered to be well known environmental toxin which contributes to the onset of various diseases. SM cause direct lungs damage, activate lungs inflammatory responses, and in some cases leads to the development of lung cancer. Cytokines in injured starfish (Asterina pectinifera) is the potential changes in its expression during the regeneration process. Especially, expression of TGF-${\beta}1$ has increased in arm cut starfish extract after eight days. Also, starfish including saponin like the ginseng. Saponin is widely used in the world because of some effective pharmacological activities. Therefore, the current study was designed to elucidate the pharmacological activities of starfish extract against cigarette smoking induced damage in cell line and pulmonary tissue. We investigate that the effect of eight days starfish extract after arm cut (8d) and intact starfish extract on cell line and mouse lung injury by SM. In cell proliferation analysis, although cigarette smoking extract (CSE) was co-treated, the higher proliferation ability is shown in 8d treatment than intact starfish extract. 8d and intact starfish extract was directly transported to pulmonary cells through respiratory organ by nebulizer inhalation. In this case of cigarette smoking, the pulmonary structure was damaged and functions become abnormal. However, 8d treated groups showed similar with the control group compared with SM group. Among them, 8d was proved to be more effective than intact starfish extract. These results demonstrate that 8d could more protect pulmonary structure and function than intact starfish extract against cigarette smoking by ginseng like saponin and regulation of inflammatory cytokines.