Yun Kwon Kim

Yonsei University, Sŏul, Seoul, South Korea

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Publications (10)8.77 Total impact

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    ABSTRACT: BACKGROUND: An adjunct to assist cardiopulmonary resuscitation (CPR) might improve the quality of CPR performance. STUDY OBJECTIVES: This study was conducted to evaluate whether a simple audio-visual prompt device improves CPR performance by emergency medical technicians (EMTs). METHODS: From June 2008 to October 2008, 55 EMTs (39 men, mean age 34.9±4.8 years) participated in this study. A simple audio-visual prompt device was developed. The device generates continuous metronomic sounds for chest compression at a rate of 100 beats/min with a distinct 30(th) sound followed by two respiration sounds, each for 1second. All EMTs were asked to perform a 2-min CPR series on a manikin without the device, and one 2-min CPR series with the device. RESULTS: The average rate of chest compressions was more accurate when the device was used than when the device was not used (101.4±12.7 vs. 109.0±17.4/min, respectively, p=0.012; 95% confidence interval [CI] 97.2-103.8 vs. 104.5-113.5/min, respectively), and hands-off time during CPR was shorter when the device was used than when the device was not used (5.4±0.9 vs. 9.2±3.9 s, respectively, p<0.001; 95% CI 5.2-5.7 vs. 8.3-10.3 s, respectively). The mean tidal volume during CPR with the device was lower than without the device, resulting in the prevention of hyperventilation (477.6±60.0 vs. 636.6±153.4mL, respectively, p<0.001; 95% CI 463.5-496.2 vs. 607.3-688.9mL, respectively). CONCLUSION: A simple audio-visual prompt device can improve CPR performance by emergency medical technicians.
    No preview · Article · May 2012 · Journal of Emergency Medicine
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    Ki Young Kim · Yun Kwon Kim · Kang Hyun Lee · Suk Joong Yong
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    ABSTRACT: We investigated the factors that affected the use of a realtime telemetry system (RTS) in emergency ambulances. During the study, a total of 7144 patients were transported to a hospital in the city of Wonju via ambulance. In 466 of these cases (7%), the Emergency Medical Technician (EMT) used the RTS. Based on the Elaboration Likelihood Model, we extracted variables from the run records, such as the qualifications of the EMT, level of the patient's consciousness and the transport time. The results indicated that EMTs with higher levels of expertise were more likely to use the RTS when the level of patient consciousness was low, regardless of transport time. Conversely, EMTs with low levels of expertise were more likely to use the RTS when the transport time from scene to hospital was long and were less likely to use the RTS when the transport time was short. There appear to be several ways of improving RTS usage in the pre-hospital situation.
    Full-text · Article · Dec 2011 · Journal of Telemedicine and Telecare
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    ABSTRACT: With the development of information technology, real-time telemetry has been invented for checking patients' physiologic parameters during their transport, via an Emergency Medical Service (EMS) system. We developed a Real-Time Telemetry System (RTS), which sends physiologic parameters including electrocardiogram (ECG), vital signs, and pulse asymmetry in real-time from the ambulance to a hospital through the Emergency Medical Information Center, a kind of central control unit. Therefore, we asked whether the RTS monitoring affects the use of medical direction in EMS system. Of six ambulance stations covering EMS transport with RTS monitor, 941 patients who were classified as emergency patients by an Emergency Medical Technician were retrospectively enrolled in this study. We divided them into two groups: group 1 (the patients using RTS monitoring) and group 2 (control group). The mean age was 53.5 ± 22.8 years, and 494 patients were men. RTS monitoring was used in 118 (20%) patients. Medical direction for treatments in group 1 was much more than that of group 2 (8.0% vs. 0.3%; p <0.001). Ambulance diversion to proper hospitals in group 1 was much more than that of group 2 (14.4% vs. 0.1%; p <0.001). The mean treatment time at the scene in group 1 also decreased more significantly than that of group 2 (4.4 ± 3.5 min vs. 6.3 ± 5.9 min; p <0.001). The results showed that intermediate medical direction in the cases using the RTS was conducted more than in the conventional method-ambulance to the hospital. These results suggest that the RTS monitoring enhances the quality in developing EMS system.
    Full-text · Article · May 2011 · Telemedicine and e-Health
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    ABSTRACT: Reexpansion pulmonary edema (REPE) is a rare yet sometimes fatal complication associated with the treatment of lung diseases such as pleural effusion, pneumothorax, and hemothorax. The current study summarizes our experience with REPE for a 3-year period. We prospectively collected demographic and clinical data on consecutive patients presenting to an academic university-based emergency department with spontaneous pneumothorax that was treated with closed thoracostomy for a 3-year period. Eighty-four study patients were enrolled between December 2002 and September 2005. Reexpansion pulmonary edema developed in 25 of 84 (29.8% [95% confidence interval, 21.0-40.2]) patients. Many cases of REPE were small and asymptomatic and only diagnosed on computed tomography of the chest. There was only one death (1.2% [95% confidence interval, A to B]). Reexpansion pulmonary edema was associated with patients with larger pneumothoraces without fibrotic changes and with patients with hypoxia and fibrotic changes. Classic REPE as seen on chest radiograph was 16 (19.0%) in 84 patients. Diffuse REPE as seen only on computed tomography and involved more than 1 lobe was 1 (1.2%) in 84 patients. Isolated REPE as seen only on computed tomography and limited to lesser than 1 lobe was 8 (9.5%) in 84 patients. The rate of REPE after tube thoracostomy of spontaneous pneumothorax is greater than previously reported and often asymptomatic. The risk of developing REPE is greater with larger pneumothorax, especially in patients without fibrotic lung changes, and with hypoxia in patients with fibrotic changes.
    No preview · Article · Oct 2009 · The American journal of emergency medicine
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    ABSTRACT: Medullary thyroid carcinoma accounts for 3% of all thyroid gland malignancies. It commonly metastasizes to liver, lung, and bone. It rarely metastasizes to skin, and only a few such cases have been documented. Cutaneous metastasis suggests a poor prognosis, with a mean survival of 7.5-19 months. The most effective treatment for skin metastasis is complete surgical removal of all local and regional lesions. The response to systemic chemotherapy is typically poor. We report a case of medullary thyroid carcinoma with cutaneous metastases, which responded to chemotherapy.
    Preview · Article · Jan 2009 · Cancer Research and Treatment
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    ABSTRACT: A patient with a pleural effusion that is difficult to safely drain by a "blind" thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient's inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses.
    Preview · Article · Jun 2008 · Tuberculosis and Respiratory Diseases
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    ABSTRACT: Background: The study of pneumonia among young men living in a group is rare, prospective study was conducted to determine the etiology, and compare the effects of macrolide and second-generation cephalosporin on the treatment of pneumonia among combat policemen. Patients and Methods: From January 2003 to April 2004, Fifty-two patients with pneumonia were treated with either azithromycin(n=25) or cefuroxime(n=27). In order to determine the cause of the pneumonia, culture studies and serologic tests for antibodies to Mycoplasma pneumoniae and Chlamydia pneumoniae were carried out. During the two weeks of medication, the Chest X-rays, blood tests and culture studies(if necessary) were followed weekly. A serologic study was followed at the end of the second week. Results: The main pathogens for pneumonia among combat policemen were Mycoplasma pneumoniae(50.0%), Chlamydia pneumoniae(10.8%), and Streptococcus pneumoniae(3.8%). The treatment was successful in most cases(51/52 cases, 98.1%). The effects of azithromycin and cefuroxime were similar (96.0% vs 100%, p>0.05). In one patient who had taken azithromycin, the clinical and radiological findings did not improved until intravenous second generation cephalosporin had been infused. Conclusion: Atypical pathogens were the main causes of the pneumonia in the combat policemen, and the effects of macrolide and second generation cephalosporin for pneumonia were similar. However, further studies will be needed to determine if single therapy with macrolide is possible.
    Preview · Article · Mar 2005 · Tuberculosis and Respiratory Diseases
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    ABSTRACT: A large number of pollutants such as sulfur dioxide, nitric oxide, carbon monoxide, particulate matter, and ozone influence on the body. These pollutants put a burden on the lung and the sequelae resulting from the oxidative stress are thought to contribute to the development of fibrotic lung disease, emphysema, chronic bronchitis and lung cancer. Also, carbon monoxide generated from the incomplete combustion of carbon-containing compounds is an important component of air pollution caused by traffic exhaust fumes and has the toxic effect of tissue hypoxia and produce various systemic and neurologic complications. The objective of this study is to compare the difference of pulmonary function and serum carboxyhemoglobin(CO-Hb) level between the traffic policemen and clerk policemen.
    Preview · Article · Dec 2003 · Tuberculosis and Respiratory Diseases
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    ABSTRACT: Background: We have studied the 67Ga SPECT to determine the activity of pulmonary tuberculosis, especially in patients with minimal extent of the disease on chest radiographs. Because active minimal pulmonary tuberculosis is sometimes difficult to diagnose by means of initial chest X-ray, sputum examination and 67Ga planar imaging, we compared 67Ga planar imagings with SPECT to evaluate minimal pulmonary tuberculosis activity. Methods: 67Ga planar imagings and SPECTs of 69 patients suspected of minimal pulmonary tuberculosis by the initial chest X-ray were performed and compared to each other. Active pulmonary tuberculosis was defined by a positive AFB smear and/or culture in the sputum and changes shown on the serial chest X-ray findings. Results: 1) 67Ga planar imaging imagings showed positive uptakes in 24 patients and no uptakes in 13 patients, which confirms active pulmonary tuberculosis. But SPECT imagings showed positive uptakes in 25 patients and no uptakes in 12 patients. 2) Patients confirmed with inactive pulmonary tuberculosis showed no uptake on 67Ga planar imaging. Only one of the 32 patients confirmed as having inactive pulmonary tuberculosis showed positive uptake on 67Ga SPECT imaging. Conclusions: According to the results of our study, 67Ga planar imaging and SPECT are both sensitive in detecting the activity of minimal pulmonary tuberculosis. The difference between the two methods is not statistically significant, and the negative predictive value of teh 67Ga SPECT is not higher than that of 67Ga planar imaging.
    No preview · Article · Jan 2000 · Tuberculosis and Respiratory Diseases
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    ABSTRACT: to the sum of heart and liver radioactivity during the first 30 seconds. Results: The shunt index in 4 patients with cirrhosis (59.8±27.2%) was significantly higher than that of normal control (5.0±1.2% p
    Preview · Article · Jan 1999

Publication Stats

22 Citations
8.77 Total Impact Points

Institutions

  • 2009-2012
    • Yonsei University
      • Department of Emergency Medicine
      Sŏul, Seoul, South Korea
    • Korea National Police University
      Sŏul, Seoul, South Korea
  • 2011
    • Konkuk University
      Sŏul, Seoul, South Korea
    • Halla University
      Genshū, Gangwon-do, South Korea
  • 2008
    • National Police Hospital
      Sŏul, Seoul, South Korea