• 대한의용생체공학회:의공학회지
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• 제33권3호
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• pp.148-154
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• 2012

Hemorrhagic shock is a primary cause of deaths resulting from injury in the world. Although many studies have tried to diagnose accurately hemorrhagic shock in the early stage, such attempts were not successful due to compensatory mechanisms of humans. The objective of this study was to construct a survival prediction model of rats in acute hemorrhagic shock using a random forest (RF) model. Heart rate (HR), mean arterial pressure (MAP), respiration rate (RR), lactate concentration (LC), and peripheral perfusion (PP) measured in rats were used as input variables for the RF model and its performance was compared with that of a logistic regression (LR) model. Before constructing the models, we performed 5-fold cross validation for RF variable selection, and forward stepwise variable selection for the LR model to examine which variables were important for the models. For the LR model, sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (ROC-AUC) were 0.83, 0.95, 0.88, and 0.96, respectively. For the RF models, sensitivity, specificity, accuracy, and AUC were 0.97, 0.95, 0.96, and 0.99, respectively. In conclusion, the RF model was superior to the LR model for survival prediction in the rat model.

• 대한임상독성학회지
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• 제10권2호
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• pp.91-96
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• 2012

Purpose: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. Methods: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. Results: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was $55{\pm}23.5$, and the mean volume of the acid was $84.5{\pm}71.3$ ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. Conclusion: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.

• Journal of Chest Surgery
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• 제29권10호
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• pp.1076-1080
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• 1996

허혈후 재관류시 일산화질소의 전구체인 L-arginin에 심근기능에 미치는 영향은 각 연구의 조건에 따라 일정하지 않다. 저자들은 L-arginine의 농도에 의한 심근보호효과의 차이를 알아보고자 본 연구를 시행하였다. 란겐돌프 관류장치하의 흰쥐 적출심장에 37.5$^{\circ}C$에서 30분의 허혈과 30분의 재관류를 실시하면서 재관류시 관류액에 L-arginine을 첨가하여 농도를 1, 2, 3, 4 mm/L로 하였고 대 조군에는 L-arginine을 첨가하지 않았다. 허혈기 직전과 재관류 30분에 좌심실 수축기능(좌심실 발생압, 좌심실압 최대 순간 증가율), 이완기능(좌심실압 최대 순간 감소율)과 관상관류량을 측정하였다. L-arginine 농도가 1mm/L, 2 mm/L인 실험군은 좌심실 발생압, 좌심실압 최대 순간증가율, 좌심실압 최대 순간감소율 및 관상관류량의 회복률이 대조군에 비해 통계적 유의성은 없었으나 우수한 경향을 보였다. 그러나 L-arginine의 농도가 증가함에 따라 회복률은 감소하여 4 mM/L농도의 실험군은 대조군보다 유의하게 낮은 회복률을 보였다(p(0.05). 이러한 연구결과를 통해 심근허혈후 재관류시 심근기능 및 관상관류량 회복을 향상시키기 위해서는 L-arginine을 2mM/ 이하의 농도로 투여 해야 하며 향후 그 이상의 높은 농도에서 나타난 회복 저하에 관한 연구가 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.222-224
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• 2008

자발성 종격동기종은 기저질환이나 외상의 병력이 없이 발생할 수 있고 드물게는 운동중에 발생할 수 있다. 저자들은 23세 남자 환자에서 태권도중에 발생한 자발성 종격동기종 1예를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.

• 디자인학연구
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• 제19권6호
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• pp.5-8
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• 2006

본 논문은 '거꾸리'라고도 불리는 스트레칭 운동에 이용되는 인버젼 기구의 사용성을 워블메카니즘을 이용하여 효과적으로 개선시킨 가정용 인버젼 기구의 디자인 개발에 관한 것이다. 근래 현대인의 삶에서 건강이 생활의 중심으로 대두되면서 운동을 즐기는 사람들이 늘어났고, 전신 스트레칭이 과다한 업무나 운동의 부작용으로 인한 디스크의 압박 해소에 효과적임이 일반인에게 널리 알려지면서 인버젼 기구의 사용자가 증가하게 되었다. 그러나 기존의 수동 인버젼 기구는 사용자가 테이블의 회전을 위해 무게 중심을 일일이 조정해야 하는 번거로움과 미숙련자들에게는 사용 미숙으로 인해 테이블이 갑자기 회전하는 안전사고 위험 등의 단점이 있었다. 이에 본 연구는 작고 단순한 구조로 큰 감속비를 내며 역전이 방지되는 워블메카니즘을 테이블의 회전 장치와 발목을 고정하는 장치에 도입함으로써 수동 조작 방식에서 자동 방식으로의 개선을 가능하게 하였다. 그 결과, 다양한 신체 조건의 사용자들에게 편리성과 안전성을 높여 주었고, 동력전달 장치 구조의 단순화를 통한 디자인 외부 요소의 단순성을 구현하였다. 이에 가정에서 사용자의 사용이 편리하고 설치 및 보관이 용이한 접이식 가정용 인버젼 기구를 개발하였다.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.80-83
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• 2009

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.167-171
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• 2009

Purpose: It is important to begin a transfusion safely and appropriately as soon as possible in a hemorrhagic shock patient. A group $O^+$ unmatched pack red blood cell (universal $O^+$) transfusion may satisfy that requirement. We report our experiences with universal $O^+$ to compare its usefulness for hemorrhagic shock patients with that of a matched pack red blood cell transfusion in the emergency department (ED). Methods: This is a retrospective study. Patients who had systolic blood pressure of less than 90 mmHg or a pulse rate of more than 120 beats per minute in the ED were included, and their medical records were reviewed. The collected data were demographic data, vital signs, blood test results, time to transfusion, the amount of transfusion, complications, and diagnoses. We calculated the emergency transfusion score (ETS) based on the patients' medical records. Results: Two hundred thirty-five patients were included. Forty-eight patients (36 trauma and 12 non-trauma patients) were transfused with a universal $O^+$. These patients had less time to transfusion compared with the cross-matched transfusion groups (35${\pm}$42 versus $170{\pm}187$ minutes, p<0.001). There were no differences in complications between groups (p=0.076). Of the patients who were transfused with universal $O^+$, 94.4% got more than 3 ETS. Conclusion: The universal $O^+$ transfusion, compared with matched pack red blood cell transfusion, should be a useful treatment for ED hemorrhagic shock patient due to its having a shorter time to transfusion without an increase in complications.

• 한국산업보건학회지
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• 제22권4호
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• pp.301-308
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• 2012

Objectives: To evaluate the pulmonary toxicity of 2 Korea asbestos(chrysotile, anthophyllite), Sprague-Dawely rats were exposed to 2 mg domestic asbestos by intratracheal instillation(IT). Methods: Lung function of rats was analyzed by pressure transducer(MAX1320, Buxco Electronics, USA). The effects of 2 mg asbestos(chrysotile ; $8,814,244{\times}10^{6}$ fibers/mg, average diameter 0.08 ${\mu}m$, average length 4.39 ${\mu}m$, anthophyllite ; $5,182{\times}10^{6}$ fibers/mg, average diameter 0.95 ${\mu}m$, average length 7.29 ${\mu}m$) on pulmonary function and pathological changes were evaluated at after a single IT. Lung function and histopathological evaluation were assessed in 5 animals from each group at each time point. Results: Due to differences in fiber numbers, chrysotile induce marked lung pathology and lung function change than anthophyllite at the same mass dose. Chrysotile showed notable thickening of interstitial areas surrounding the alveolar ducts and terminal bronchioles. Conclusions: On a mass dose basis, chrysotile that have 1,700 times numbers of fibers per unit weight than anthophyllite produced a greater persistent lung injury than anthophllite for at least 4 weeks after exposure.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

• 한국화재소방학회논문지
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• 제26권3호
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• pp.91-99
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• 2012

분말소화기를 조작하거나 해체하는 과정 중에 아주 드물게 사상자가 발생하는 경우가 있다. 부식된 분말소화기는 조작 중 또는 해체(폐기)과정 중에 폭발하면 로켓과 같이 위쪽으로 솟아오르면서 소화기 조작자나 해체과정 중인 사람의 머리나 가슴, 목 부위 등을 쳐서 사상사고를 발생하게 한다. 이 논문에서는 분말소화기파열사고사례를 알아본 후, 파열사고의 원인과 파열로 인한 반동력, 예방대책에 대해 알아보았다. 소화기 파열사고의 예방대책으로 훈련이나 교육에 부식된 소화기의 사용 자제, 부식된 소화기에 대한 위험성 교육 및 홍보, 기설치 가압식분말소화기에 파열위험성 표시, 내용연수 표시 의무화, 일정기간 경과 소화기에 대한 수압검사 제도의 도입 검토, 폐소화기 회수시스템 구축, 폐소화기의 재활용시스템 구축, 노후소화기관련 상담창구 운영 등을 제안하였다.