PURPOSE: The purpose of this study was to identify the triage and length of stay of cancer patients who visited an emergency department in a cancer center. METHODS: Aretrospective descriptive study design was used. Data were collected from medical records of patients who visited an emergency room from March 7 to June 30, 2016. Data were analyzed using descriptive statistics and Kruskal-Walis tests. RESULTS: In total, 2,699 cancer patients visited the emergency room excluding cases with insufficient records. The mean age was 58.7±18.7 years, and males were 47.0% and 56.0%, respectively. In triage, 184 (6.8%) were ‘emergency’ patients, 823 (30.5%) were ‘urgent’, and 1,692 (62.7%) were the most ‘non-emergency’ patients. The average stay of length in the emergency room was 5.79±7.69 hours. CONCLUSION: These findings show that development of triage tool and communication system with staff are needed to reduce overcrowding and length of stay of the emergency department.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay* ; Male ; Medical Records ; Triage*

The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (l)Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3parts, that is, occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was slightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of occupational Medicine(18.2%), several kinds of Medical College Journal(17.0%), The Korean Journal occupational Health(15.l%), The Korean Journal of preventive Medicine(15.l%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(l8.2%), occupational organization 3(9.1%) and occupational health delivery system l(3.0%). of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was l85(71.l%), followed by women worker, white color workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (l) study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.
Classification* ; Surveys and Questionnaires ; Disease Management ; Education ; Epidemiology ; Female ; Humans ; Korea* ; Male ; Occupational Health Services ; Occupational Health*

No abstract available.

Rafts, cholesterol- and sphingolipid-rich membrane microdomains, have been shown to play an important role in immune cell activation. More recently rafts were implicated in the signal transduction by members of the TNF receptor (TNFR) family. In this study, we provide evidences that the raft microdomain has a crucial role in RANK (receptor activator of NF-kappaB) signaling. We found that the majority of the ectopically expressed RANK and substantial portion of endogenous TRAF2 and TRAF6 were detected in the low-density raft fractions. In addition, TRAF6 association with rafts was increased by RANKL stimulation. The disruption of rafts blocked the TRAF6 translocation by RANK ligand and impeded the interaction between RANK and TRAF6. Our observations demonstrate that proper RANK signaling requires the function of raft membrane microdomains.
Carrier Proteins/metabolism ; Glycoproteins/*metabolism ; Human ; Membrane Glycoproteins/metabolism ; Membrane Microdomains/*metabolism ; Protein Transport/physiology ; Proteins/*metabolism ; Receptors, Cytoplasmic and Nuclear/*metabolism

BACKGROUND: The aim of this study was to monitor trends in antimicrobial susceptibilities of Neisseria gonorrhoeae isolates, in particular, to examine the possibility of increasing prevalence of fluoroquinolone resistance in Korea and the relationship between patterns of mutations involving gyrA and parC genes and the ciprofloxacin resistance level. METHODS: The antimicrobial susceptibilities of 489 gonoccocal isolates which were nationwide collected from patients visiting Health Centers were determined by NCCLS disk diffusion and agar plate dilution methods. PCR and direct DNA sequencing of the amplicons were performed to identify mutations within the quinolone resistance-determining regions of gyrA and parC genes. RESULTS: The proportion of resistance to penicillin, tetracycline, or both remained as high as 94%. The isolates with ciprofloxacin resistance remarkably increased from 1% in 1999 to 5% in 2000 and also resistance to cefoxitine and ceftriaxone were shown to be increased. The strains resistant to spectinomycin was little reported. Four isolates with 16 microgram/mL of MIC for ciprofloxacin all showed the same alternations of Ser-91 to Phe, Asp-95 to Gly in GyrA and Ser-87 to Arg in ParC, but ciprofloxacin-susceptible strains have little amino acid substitution. CONCLUSION: Considering the increasing prevalence of isolates with resistance to ciprofloxacin and ofloxacin, it is likely that the antibiotics such as spectinomycin, or ceftriaxone are recommended as the first-line treatment for gonoccocal infections in Korea. The results from this study suggest that mutation analysis for quinolone resistance-determining regions of gyrA and parC genes are important in epidemiological studies for the spread of ciprofloxacin resistant strains.
Agar ; Amino Acid Substitution ; Anti-Bacterial Agents ; Cefoxitin ; Ceftriaxone ; Ciprofloxacin ; Diffusion ; Humans ; Korea* ; Neisseria gonorrhoeae* ; Neisseria* ; Ofloxacin ; Penicillins ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis, DNA ; Spectinomycin ; Tetracycline

Syringomyelia is a relatively uncommon, chronic, slowly progressive, degenerative process characterized by cavitation and gliosis within the substance of the spinal cord and/or the medulla. There have been only a few case reports in Korea. The authors reviewed 17 patients with syringomyelia diagnosed by delayed metrizamide spinal CT and/or MR imaging at Seoul National University Hospital from January, 1983 to June, 1987. Eleven were male and the age of onset was less than 40 in 16 (mean 23.4). The mean duration of symptoms was 87.1 months (range 3-276). Clinical features were similar to classical cases except sphincter involovement and abnormal sweating were more common in this report. The syrinx cavity which showed dye collection within spinal cord in delayed metrizamide spinal CT and low signal intensity in T1 weighted MR imaging was located mainly at cervicothoracic junction. The causes were the hindbran abnormality in 5, intramedullary cord tumor in 5, trauma in 3, adhesive arachnoiditis in 1 and unknown in 3. The cases with sensory dissociation had shorter duration of symptoms than those without sensory dissociation and showed normal results in SEPs study. Eleven patients were treated surgically and nine of them improved. MRI and SEPs are thought to be good aids for the understanding of the mechanism and course of syringomyelia.
Adhesives ; Age of Onset ; Arachnoid ; Arachnoiditis ; Gliosis ; Humans ; Korea ; Magnetic Resonance Imaging ; Male ; Metrizamide ; Seoul ; Spinal Cord ; Sweat ; Sweating ; Syringomyelia*

BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) has been well known pathogen as a cause of travelers' diarrhea. Nowadays, however, ETEC is also increasingly recognized as the cause of foodborne or waterborne outbreaks. We investigated an outbreak of a high school in Gwangju metropolitan city to trace the source of infection and the mode of transmission of ETEC. MATERIALS AND METHODS: All symptomatic persons were interviewed and filled out the questionnaires. We surveyed their clinical symptoms and the foods that they ate. We checked the facilities of the school, dinning room and water supply system. Microbiologic examination were carried out on above symptomatic persons and many environmental specimens. All gathered samples were examined in Gwangju city Health & Environment Research Institute. ETEC isolates were submitted to Korea Center for Disease Control and Prevention (KCDC) for Pulsed-field gel electrophoresis (PFGE). We also requested water quality analysis of water samples to Waterworks Research Institute. RESULTS: The 39 students and one sibling who visited and ate school meal showed symptoms. All staffs and cooks showed no symptom. Among 51 stool specimens, ETEC was isolated from 19 (18: students, 1:cook). ETEC was also isolated from specimens from a purifier and a water tap of the dinning room and water tank (underground water). In PFGE test, isolates from 18 persons showed identical pattern, but the PFGE patterns from water were different. Isolates of water samples showed different PFGE patterns even within the same sample. Investigation of the water distribution system revealed that contaminated underground water had been supplied to the dinning room and students of the school were exposed to it. CONCLUSION: This is the outbreak of ETEC infection occurred in a high school. Besides students, ETEC was also isolated from water samples. Considering some epidemiologic features, we suspect the mode of transmission may be waterborne despite the inconsistent PFGE results.
Academies and Institutes ; Centers for Disease Control and Prevention (U.S.) ; Diarrhea ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxigenic Escherichia coli* ; Groundwater ; Gwangju ; Humans ; Korea ; Meals ; Siblings ; Water ; Water Quality ; Water Supply ; Surveys and Questionnaires

BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) has been well known pathogen as a cause of travelers' diarrhea. Nowadays, however, ETEC is also increasingly recognized as the cause of foodborne or waterborne outbreaks. We investigated an outbreak of a high school in Gwangju metropolitan city to trace the source of infection and the mode of transmission of ETEC. MATERIALS AND METHODS: All symptomatic persons were interviewed and filled out the questionnaires. We surveyed their clinical symptoms and the foods that they ate. We checked the facilities of the school, dinning room and water supply system. Microbiologic examination were carried out on above symptomatic persons and many environmental specimens. All gathered samples were examined in Gwangju city Health & Environment Research Institute. ETEC isolates were submitted to Korea Center for Disease Control and Prevention (KCDC) for Pulsed-field gel electrophoresis (PFGE). We also requested water quality analysis of water samples to Waterworks Research Institute. RESULTS: The 39 students and one sibling who visited and ate school meal showed symptoms. All staffs and cooks showed no symptom. Among 51 stool specimens, ETEC was isolated from 19 (18: students, 1:cook). ETEC was also isolated from specimens from a purifier and a water tap of the dinning room and water tank (underground water). In PFGE test, isolates from 18 persons showed identical pattern, but the PFGE patterns from water were different. Isolates of water samples showed different PFGE patterns even within the same sample. Investigation of the water distribution system revealed that contaminated underground water had been supplied to the dinning room and students of the school were exposed to it. CONCLUSION: This is the outbreak of ETEC infection occurred in a high school. Besides students, ETEC was also isolated from water samples. Considering some epidemiologic features, we suspect the mode of transmission may be waterborne despite the inconsistent PFGE results.
Academies and Institutes ; Centers for Disease Control and Prevention (U.S.) ; Diarrhea ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxigenic Escherichia coli* ; Groundwater ; Gwangju ; Humans ; Korea ; Meals ; Siblings ; Water ; Water Quality ; Water Supply ; Surveys and Questionnaires

OBJECTIVE: To evaluate obstetric variables in the placental abruption that affect on perinatal mortality. METHODS: We reviewed clinical data of all singleton deliveries complicated with placental abruption between January 2000 and December 2007, in Department of Ob. & Gyn., Sanggye Paik Hospital. RESULTS: Placental abruption complicated 54 cases (0.55%) of all deliveries (n=9,903) from January 2000 to December 2007. The peak age was 26-30 years (42.1%). The most common symptom was vaginal bleeding (57.4%) and intrauterine fetal death had already occurred in 9.3%. Perinatal mortality rate was 13.0% and there was no maternal death. 38.9% of placental abruption occurred between 33 to 36weeks of gestational age. 38.9% of placental abruption was diagnosed before delivery with ultrasonography and 9.3% was chronic placental abruption. 33.3% of placental abruption was associated with preeclampsia, and then associated with PPROM (24.1%), uterine myoma (3.7%), chronic hypertension (1.9%) and smoking (1.9%). When the hypertensive disorders were associated, fetal distress rate was higher than normotensive pregnancy (63.2% vs 20.0%, P-value: 0.005). Mean gestational age (days) (194+/-32.8 vs 248.12+/-28.0, P-value<0.001) and the severity of placental abruption (P-value: 0.005) affect perinatal mortality in placental abruption. The most common complication of placental abruption was DIC (16 cases, 29.6%), followed by Couvelaire uterus (4 cases, 7.4%) and uterine rupture (1 case, 1.9%). CONCLUSION: Obstetric variables that affect perinatal mortality were gestational age at the diagnosis and the severity of placental abruption.
Abruptio Placentae ; Dacarbazine ; Female ; Fetal Death ; Fetal Distress ; Gestational Age ; Hypertension ; Maternal Death ; Myoma ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Smoke ; Smoking ; Uterine Hemorrhage ; Uterine Rupture ; Uterus

Carcinosarcoma of the esophagus is regarded as a rare malignant neoplasm composed of both carcinomatous and sarcomatous elements. Esophageal carcinosarcoma classified into 3 subgroups, pseudosarcoma, so called carcinosarcoma, and true carcinosarcoma. we report a case of large polypoid tumor consist of squamous cell carcinoma, undifferentiatred small cell and spindle cell proliferation. The patient was 47 year-old man who had suffered from dysphasia and substernal chest pain for 2 months. A protruded tumor in size of 8x4x3.5 cm with stalk was found in midesophagus at the level of 28 cm from the incisor. The tumor was round with smooth surface stained with Lugol solution. There were multiple erosions at the stalk of the tumor, Partial esophagectomy and esophagogastrostomy was done, Undifferentiated small cell was confirmed by immunoreactivity to neuron specific enolase and electron microscopic findings.
Aphasia ; Carcinoma, Squamous Cell ; Carcinosarcoma* ; Cell Proliferation ; Cellular Structures* ; Chest Pain ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Incisor ; Middle Aged ; Phosphopyruvate Hydratase