• 대한임상독성학회지
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• 제16권2호
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• pp.61-67
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• 2018

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

• 대한임상독성학회지
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• 제15권2호
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• pp.69-78
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• 2017

Purpose: This study reports the clinical features of infant, child, school aged and adolescent patients treated for acute poisoning in nationwide emergency departments (EDs). Methods: We retrospectively analyzed clinical data pertaining to patients under 19 years of age who were treated for acute poisoning in nationwide EDs from 2013 to 2015. The data were collected by the National Emergency Department Information System (NEDIS). All patients were divided into three groups: 'Infant and child group' (0 to 5 years), 'school age group' (6 to 12 years) and 'adolescent group' (13 to 18 years). General characteristics, Korea Standard Classification of Disease $7^{th}$ (KCD-7) codes and results of care were collected. Results: There were 14,500 pediatric poisoning cases during the study period. The distribution of patient age was bimodal with two peaks among infant, child and adolescent group. The proportion of alert mentality at the ED visit of the infant and child group was 99.3%, while that of the adolescent group was 86.4%. The proportion of intentional intoxication was higher in the adolescent group (40.7%) than other age groups. Among children less than 13 years of age, various poisonous substances and therapeutic drugs were common. Conclusion: There were some clinical differences in acute poisoning patients between age groups. It is necessary to establish a preventive plan considering characteristics by age. Since the KCD-7 code has limitations in analyzing the characteristics of poisoning patients, it is necessary to consider the registration system of poisoning patients.

• 지역사회간호학회지
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• 제11권2호
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• pp.411-422
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• 2000

The purpose of this study is to identify the difference of emergency care conditions where the nurse is posted in the 119 relief squard or not. The data composed a total of 777 cases of emergency activity of one police stand in Seoul during March, June. September and December in 1998. The results of this study were as follows: 1. The age of the subjects was 20-60 age 54.3%, over 60 age 35.4% with an average age of 50.2. Among them men were 55.0%, the unemployed were 60.8%. The place of the occurrence of an accident was the house, 49.7% and the cause as illness was 59.6%. 2. The main symtom was pain the 36.2% the main consciousness state was alert 76.9%: The state of the patients as chronic was 59.6%. 3. The consulting hospital of the 119 relief squad as a third medical center was 79.9%. The distance to the medical center as less than 5 km was 77.2%, and an average transfer distance was 5.38 km. The cases of doctor guided emergency care was 0.9%, the cases that had posted nurses in 119 relief squads was 48.6%. 4. The case of the best emergency care operation was difficulty in breathing, 62.1% and the second was unconsciousness, 46.1 %. The more serious the consciousness state, the higher the rate of emergency care operation. There wasn't any difference in emergency care operation concerning transfer distance. 5. The cases that had the posted nurses was 19.1%, the cases of no nurse was 11.7% among the cases of emergency care operation during transfering; the cases that had posted nurses had the higher emergency care operation. (p<0.05). Airway maintenance was 14.8% in cases that had the posted nurses, while in the cases of no nurse, 10.9%; and oxygen inspiration was 16.0% in cases that had the posted nurses while in the cases of no nurse 7.6% (p<0.01); spinal fixation was 6.6% in cases that had the posted nurses while in the cases of no nurse 4.6%(p<0.05). With these results, we can conclude that the cases that had the posted nurse showed higher emergency care operation.

• 대한임상독성학회지
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• 제20권2호
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• pp.58-65
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• 2022

Purpose: Alcohol is one of the most commonly co-ingested agents in deliberate self-poisoning (DSP) cases presenting at the emergency department (ED). The increased impulsivity, aggressiveness, and disinhibition caused by alcohol ingestion may have different clinical features and outcomes in cases of DSP. This study investigates whether alcohol co-ingestion affects the clinical features and outcomes of DSP patients in the ED. Methods: This was a single-center retrospective study. We investigated DSP cases who visited our ED from January 2010 to December 2016. Patients were classified into two groups: with (ALC+) or without (ALC-) alcohol co-ingestion. The clinical features of DSP were compared by considering the co-ingestion of alcohol, and the factors related to discharge against medical advice (AMA) of DSP were analyzed. Results: A total of 689 patients were included in the study, with 272 (39.5%) in the ALC+ group. Majority of the ALC+ group patients were middle-aged males (45-54 years old) and arrived at the ED at night. The rate of discharge AMA from ED was significantly higher in the ALC+ group (130; 47.8%) compared to the ALC- group (p=0.001). No significant differences were obtained in the poisoning severity scores between the two groups (p=0.223). Multivariate analysis revealed that alcohol co-ingestion (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.01-1.98), alert mental status (OR=1.65; 95% CI, 1.17-2.32), past psychiatric history (OR=0.04; 95% CI, 0.01-0.28), age >65 years (OR=0.42; 95% CI, 0.23-0.78), and time from event to ED arrival >6 hrs (OR=0.57; 95% CI, 0.37-0.88) were independent predictive factors of discharge AMA (p=0.043, p=0.004, p=0.001, p=0.006, and p=0.010, respectively). Conclusion: Our results determined a high association between alcohol co-ingestion and the outcome of discharge AMA in DSP patients. Emergency physicians should, therefore, be aware that DSP patients who have co-ingested alcohol may be uncooperative and at high risk of discharge AMA.

• 대한임상독성학회지
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• 제10권1호
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• pp.33-36
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• 2012

Opioids are the one of the most commonly used drugs to control cancer pain all over the world. But, we should not overlook the potential risk of opioid intoxication because they have well-known detrimental side effects. The opioid intoxication can be diagnosed thorough various clinical manifestations. The altered mental status, respiratory depression, and miosis is very representative clinical features although these symptoms don't always appear together. Unfortunately the opioid-toxidrome can be varied. A 42 years old man came to our emergency room after taking about 900 mg morphine sulfate per oral. He was nearly alert and his respiration was normal. Even though his symptoms didn't deteriorated clinically, serial arterial blood gas analysis showed increase in PaCO2. So we decided to use intravenous naloxone. Soon, he was fully awaked and his pupils size was increased. After a continuous infusion of intravenous naloxone for 2 hours, PaCO2 decreased to normal range and his pupil size also returned to normal after 12 hours. Though the levels of serum amylase and lipase increased slightly, his pancreas was normal according to the abdominal computed tomography. He had nausea, vomit, and whole body itching after naloxone continuous infusion, but conservatively treated. We stopped the continuos infusion after 1 day because his laboratory results and physical examinations showed normal. As this case shows, it is very important to prescribe naloxone initially. If you suspect opioid intoxication, we recommend the initial use of naloxone even though a patient has atypical clinical features. In addition, we suggest intranasal administration of naloxone as safe and effective alternative and it's necessary to consider nalmefene that has a longer duration for opioid intoxication.

• 대한임상독성학회지
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• 제6권2호
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• pp.91-98
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• 2008

Purpose: The hypnotic effect of zolpidem is comparable to benzodiazepines, but has less abuse and addiction potential than benzodiazepines, so is one of the most commonly prescribed hypnotics. The frequency of acute zolpidem overdose has increased, but clinical analysis and severity predictors are not known in Korea. Methods: A retrospective evaluation of histories, clinical courses, and laboratory findings of each patient treated from June, 2000, to May, 2006, in a university hospital for acute zolpidem intoxication. Results: We evaluated 30 patients, including 16 co-intoxication cases. Twenty-five patients presented mental alterations but became alert within 2 days. All patients recovered completely. The median zolpidem concentration was 0.9 mg/L (range: $0.2{\sim}7.4\;mg/L$). There was a weak correlation between the amount ingested and zolpidem concentration (r=0.25). None of them presented severe laboratory abnormalities, and these abnormalities did not relate to zolpidem concentration. Conclusion: The clinical progress of acute zolpidem intoxication is mild. We could not predict zolpidem concentration or clinical severity from the amount ingested and could not predict the clinical course from laboratory findings in the emergency department.

• 한국인터넷방송통신학회논문지
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• 제24권3호
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• pp.49-53
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• 2024

해양 안전은 바다에서의 사고로부터 인명을 보호하고, 보다 안전한 해양 환경을 조성하는 데 중요한 요소다. 본 연구에서는 해양 안전을 향상시키기 위한 TPMS 디바이스를 개발하고, 이를 통해 바다에서의 사고 상황을 감지하고 신속한 대응을 가능케 하는 기술적 솔루션을 제시한다. 이를 위해 개발한 튜브 압력 측정 시스템(TPMS)을 활용하여 튜브의 팽창을 감지하고, 실시간으로 데이터를 수집하여 주변 기기와 통신함으로써 빠른 대응이 가능하도록 설계되었다. 실험 결과를 통해 TPMS(Tube Pressure Monitoring System)가 효과적으로 압력을 감지하고, Main IoT 디바이스와 통신하며 안정적인 데이터 송수신이 가능함을 확인하였다. 또한 비상 상황에 빠르게 대응할 수 있도록 비상 상황 알림 메시지를 수신하고 정보를 조회할 수 있는 모바일 앱을 개발하였다. 개발한 디바이스와 모바일 앱은 해양 안전 분야뿐만 아니라 다양한 응용 분야에서도 활용 가능한 기술을 포함하고 있으며, 향후에는 실제 현장에서의 적용 가능성을 확대할 것이다. 이러한 결과는 해양 환경의 안전성을 높이는 데 기여할 것으로 기대된다.

• 한국인터넷방송통신학회논문지
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• 제21권5호
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• pp.1-9
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• 2021

우리나라에서는 코로나19 대응을 위해 국민들에게 CBS (Cell Broadcast Service) 기술을 활용한 긴급재난문자 서비스를 통해 코로나19 관련 다양한 정보를 제공해왔다. 특히 지방단치단체(지자체)에서는 긴급재난문자 서비스를 코로나19 대응을 위한 주요 수단으로 취급하여 적극적으로 활용해왔다. 하지만 체계가 잡히지 않은 과도한 사용으로 긍정적인 효과 대비 국민의 피로감이 증가한다는 문제 제기로 인해 현재는 긴급재난문자 송출이 제한되고 있다. 본 논문에서는 긴급재난문자를 효율적으로 운용하는 방안을 수립하는데 있어서 기초 자료를 제공하는 것을 목적으로, 코로나19가 발생한 2020년 1월부터 2021년 6월 현재까지 발령된 긴급재난문자 건수와 코로나19 확진자 발생률을 비교 분석하였다. 또한 긴급재난문자 서비스를 많이 활용한 광역지자체에 대해 월별 긴급재난문자 사용량과 확진자 발생률을 상세 비교하여 상관 관계를 분석하였다. 본 논문의 결과가 장기화되고 있는 코로나19 대응을 위한 긴급재난문자 사용 전략을 수립하는데 있어 기초자료로 활용되기를 기대한다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 추계학술대회
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• pp.286-287
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• 2018

우리나라의 1인 가구 비중은 증가하고 있으며 여성이나 노인들의 위험 상황에 지원하기 위한 시회적인 요구가 증가하고 있다. 이런 문제를 해결하기 위해서는 누구나 모션 센서가 내장된 핸드폰을 가지고 있으며 범죄나 건강상의 응급 상황에 핸드폰의 간단한 동작을 통해 병원의 응급센터나 경찰에 신고하는 체계적인 방법이 중요한 문제로 대두되고 있다. 본 논문은 모바일 앱의 백그라운드 상태에서 사용자의 모션 인식을 통해 응급 신고 처리를 위한 설계 방법을 제안한다. 제안된 방법은 추가된 하드웨어 없이 비용이 저렴하고 간단한 손동작으로 실내와 실외 환경에서 응급 처치 서비스를 제공한다.

• 대한임상독성학회지
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• 제3권2호
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• pp.103-106
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• 2005

BASTA is an herbicide which contains glufosinate ammonium as a main component with an anionic surfactant, polyoxyethylene alkylether sulfate, and nonselectively inhibits glutamine synthetase. It became a wildly used herbicide in Korea and its intoxication is now increasing. A 42-year old woman ingested about 300ml of BASTA in a suicide attempt. She showed unconsciousness and respiratory distress in the beginning, and later developed multiple generalized convulsions, low blood pressure, fever and diabetes insipidus. Although she became alert 12 days after the ingestion, she showed retrograde amnesia for a period of about recent 10 years. A neuropsychological test on day 22 revealed frontal lobe dysfunction, visual memory disturbance and slight decrease in visuospatial function. All these neurological abnormalities that might occur due to glufosinate ammonium were almost improved in the follow-up test performed a month later.