목 적 : 뇌경색 질환은 기온차가 급격한 겨울철에 많이 발생하는데 경기북부 지역에 위치한 본원 응급실에 내원한 환자 중 Brain MRI를 검사한 환자를 대상으로 하절기와 동절기를 비교하여 기온차에 따른 Brain Infarction 환자 분포를 알아보고자 한다. 대상 및 방법 : 하절기(2012년~2014년 6월-8월)와 동절기(2012년~2014년 11월- 1월)에 본원 응급실을 내원한 환자 중 MRI Brain acute stroke, MRI Brain diffusion, MRA Brain + diffusion 검사를 시행한 환자를 대상으로 하였다. 하절기 1001명(남:574명,여:427명), 동절기 1141명(남:586명, 여:555명)을 대상으로 판독 결과가 infarction으로 나온 환자의 성별, 연령별로 분류 하였다. 결 과 : Infarction은 하절기 393명(남:249,여:144), 동절기 455명(남:259,여:196)으로 확인되었다. 하절기 393명 중 20대 4명 (남:3,여:1) 30대 3명(남:1,여:2), 40대 16명(남:10,여:6), 50대 74명(남:60,여:14), 60대 72명(남:55,여:17), 70대 123명(남:73,여:50), 80대 84명(남:37,여:47), 90대 16명(남:10,여:6), 100대 1명(여:1)이었고, 동절기 455명 중, 30대 3명(남:2,여:1), 40대 16명(남:12,여:4), 50대 60명(남:47,여:13), 60대 99명(남:65,여:34), 70대 162명(남:95,여:67) 80대 101명(남:35,여:66), 90대 14명(남3,여11)으로 확인되었다. 결 론 : 응급실에 내원한 Brain MRI 검사환자 중 하절기 보다는 동절기에 뇌경색 질환이 증가하는 것을 알 수 있고, 연령대는 70대에서 뇌경색 질환이 가장 많이 발생하였다.

The maxillofacial region is susceptible to damage because facial bone is prominent. The aim of this study is to evaluate the incidence, etiology, seasonal distribution, and patterns of maxillofacial injuries and investigate the percentage of bone fractures on CT scans by patient’s gender and age. Electronic medical records of 1,483 patients who had maxillofacial injuries and visited the Emergency Medical Center of Chonnam National Hospital were evaluated. Age, gender, etiology, seasonal occurrence, frequency of fracture, and the pattern of bone fracture were analyzed by using IBM SPSS Statistics 21 (SPSS Inc., Chicago, IL, USA). Male to female ratio was 2.82:1. The most common causes of injury were falls or collisions (male 40.09%, female 48.2%), followed by traffic accidents and violence. The number of injuries related to sporting accidents, assult, and industrial accidents was higher in male patients than that of female patients. With regard to the seasonal occurrence, 434 cases (29.26%) occurred in the summer, while 306 cases (20.63%) occurred in the winter. In this study, 946 patients (63.79%) were identified to have facture and 537 patients (36.21%) were found to be without fracture on CT scans. The orbital bone (41.38%) was the most commonly fractured in the mid facial structures. The most common fracture site in the mandible was the body of the mandible (23.13%). The patterns of maxillofacial injuries were various based on gender, age, cause of injury, and season.

The rise of medical knowledge and awareness of the importance of dental and stomatognathic system increase the patients who visit dental emergency room. The chief complaints of patients who visited the emergency room varies from a pain, trauma, hemorrhag. The purpose of this study was to classify dental emergency patients by chief complaint and to analyze in indiviual group and to provide more effective emergency dental care. This study was carried out with 1129 patients visiting emergency room of the dankook university dental hospital from 7/2011 to 6/2012. Dental emergency patients was classified trauma, pain, hemorrhage group by chief complaint and studied mothly, the day of the week, time, age distribution and cause of the individual group. The chief complaint of visiting emergency room were trauma 660 people (58.5%), pain 347 people (30.7%), hemorrhage 96 (8.5%), other 26 patients (2.3%). The monthly distribution was observed in May (12.8%), March (10.5%), September (10.2%). The trauma patients were frequent in the spring and early summer but painful patients visited in September (12.7%) and May (11.8%) in March (11.2%). The peak age group was 20 to 29 years(20.9%), followed by 0 to 9 years(19.4%), 40 to 49years (15.2%,). In trauma group the peak age was under the age of 10 (31.7%), followed by 10 to 19 years (18.8%), 20 to 29 years (17.1%) . However, in pain group, peak age was 20 to 29 years (26.8%) followed by 40 to 49 years(21.3%), 30 to 39 years (19.6 %). The most common cause of trauma were subluxation(16.5%), laceration13.7%), uncomplicated crown fracture(12.05%) and in pain group was pulpal origin(46.1%), followed by periodontal origin( 20.7%), post op pain(8.9%). Undefined pain or neuralgia were 7.9%. The most common cause of hemorrhage was post extraction( 66.7%), post operation(16.7%), spontaneous bleeding due to periodontitis(12.5%). In conclusion, the trauma, pain were different in monthly distribution and the peak age of patients. Dental emergeny doctor should understand pattern of indiviual emergency group and perform proper diagnosis and treatment for more effective emergency care.

To investigate acute drug intoxication trends in the elderly visited Emergency Medical Centers, Data was collected from the records of poisoning patients visited Five different Hospitals from January 1. 2007 to December 31. 2007. The analysis was conducted by using 135 cases of 624 cases. When considering only the elderly and making comparisons between the urban areas and the rural areas the following data was produced. In regard to patients with acute drug intoxication, the main substance of choice was pesticides. Cases of acute drug intoxication are definitely higher for those categorized as the rural elderly (75.0%) when compared with those categorized as the urban elderly (44.1%). The male to female ratio, those living together as a family, past suicide attempts, mental state and sobriety condition when they came, monthly distribution etc. between the two groups did not demonstrate a difference between them. In regard to reasons given for acute drug intoxication, suicide was the highest at 60.7% of the cases. When comparing accidental reasons for poisoning, the urban elderly, at 34.2% of their cases, were higher than in the rural elderly, at 23.7%. After first aid was administered, the admission rate was higher for the rural elderly (47.4%) than for the urban elderly (33.9%). This shows that the rural elderly have a more severe acute drug intoxication poisoning problem than the urban elderly do.

To investigate acute drug intoxication trends in the elderly visited Emergency Medical Centers, Data was collected from the records of poisoning patients visited Five different Hospitals from January 1. 2007 to December 31. 2007. The analysis was conducted by using 135 cases of 624 cases. When considering only the elderly and making comparisons between the urban areas and the rural areas the following data was produced. In regard to patients with acute drug intoxication, the main substance of choice was pesticides. Cases of acute drug intoxication are definitely higher for those categorized as the rural elderly (75.0%) when compared with those categorized as the urban elderly (44.1%). The male to female ratio, those living together as a family, past suicide attempts, mental state and sobriety condition when they came, monthly distribution etc. between the two groups did not demonstrate a difference between them. In regard to reasons given for acute drug intoxication, suicide was the highest at 60.7% of the cases. When comparing accidental reasons for poisoning, the urban elderly, at 34.2% of their cases, were higher than in the rural elderly, at 23.7%. After first aid was administered, the admission rate was higher for the rural elderly (47.4%) than for the urban elderly (33.9%). This shows that the rural elderly have a more severe acute drug intoxication poisoning problem than the urban elderly do.

The purpose of this research is to compare between past and present resuscitation outcome of cardiac arrest patients in one emergency department. A clinical analysis of 429 cases of CPR performed in one emergency department from April 2013 to March 2015 was conducted. Then we compared this with previous paper that were written in same emergency department in 2004. During the period, 429 patients received resuscitations. Between the two studies, all patients under CPR were increased 2.27 times (94.33 pts/years to 214.5 pts/years). As the cause of cardiac arrest, traumatic cardiac arrest increased to 30.1% form 24.1%. Cardiogenic cardiac arrest showed highest survival rate in two studies, and the ratio was increased from 6.8% to 15.2%. VF/VT showed highest survival rate in two studies, and the ratio was increased from 8.8% to 20.7%. In this study, At least who once became ROSC patients was 260 people (60.6%), permanent surviving patient was 34 people (7.93 %), patients with CPC score 1-2 was 26 people (6.06%). The survival rate of patients with cardiac arrest has increased compared to the past. But in-hospital cardiac arrest survival rate is still low so it is necessary to increase the recovery rate of cardiogenic arrest survival rate to increase the permanent survival rate and good prognosis patients.

This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

한 대학병원 응급실에 방문한 응급환자들이 방사선에 얼마나 피폭되는지를 알아보고자, 2006년 3월 16일 부터 31일까지 15일 동안 방문환자 200명을 임의 추출하여 방사선 피폭선량을 측정한 결과는 다 음과 같다 1. 연구대상자의 분포는 타병원전원환자 50명(25.0%), 교통사고환자 24명(8.3%),기타사고환자 50명 (25.0%), 일반환자 76명(38.0%)이었다. 2. 환자의 방사선 촬영횟수를 보면 환자 1인당 타병원, 전원환자 6.4회, 교통사고환자 14.5회, 사고환 자 2.6회, 일반환자 2.4회로 교통사고환자들이 타환자군에 비해 방사선촬영 건수가 3～4배 많았다 3. 환자의 방사선촬영종류별 피폭선량을 보면 일반촬영 28.9mGy, CT촬영 84.2 mGy, 특수촬영 1.02mGy로 CT촬영피폭이 일반촬영 비해 10배 정도 많았다. 4. 환자의 평균 방사선 피폭선량을 보면 타병원 전원환자는 24.6mGy, 교통사고환자는 55.2 mGy, 사 고환자는 17.1mGy 일반환자는 17.0mGy로 타병원 전원환자와 교통사고환자가 상대적으로 피폭이 많았다. 5. 방사선촬영 부위별로 보면 일반촬영에서는 두부피폭 1.7mGy로 사고환자에서 피폭이 많았고, 흉 부 2.0mGy, 복부 1.6mGy는 일반환자 에게 많았으며, 척추 3.4mGy, 골반부 1.8mGy, 상지부 0.5mGy, 하지부 0.6mGy는 교통사고 환자에게 피폭이 많았으며, 통계적으로 유의한 차이를 보였다 (P<0.001). 6. CT촬영에서는 타병원 및 전원환자가 두부 10.9mGy으로 많았고, 흉부와 복부는 각각 2.9mGy, 3.6mGy로 일반환자에게 많았고, 척추, 골반부 1,9mGy 2.7mGy는 교통사고환자에게 많았다. 특히 복부피폭은 통계적으로 유의한 차이를 보였다.(P<0.05) 결론적으로 한 대학병원 방문한 응급환자 특히 교통사고환자의 방사선 검사시 일반 외래 환자들의 촬영보다는 과다한 검사와 피폭이 노출선량한도가 2배 이상 증가하는 실정이다. 따라서 병원 관리자 및 방사선취급자는 환자 방사선 촬영시 노출을 최소한으로 제한하고, 방사선피폭감소를 위해 병원의 종 사자인 방사선사의 기술적인 연구와 및 보조연구자 및 의료인 등 모두가 예방할 수 있는 대책이 필요할 것으로 생각한다.