OBJECTIVE: This study was done to evaluate the risk factors and prevalence of symptom-giving pelvic girdle relaxation in pregnant women. METHODS: Three hundreds thirty-two postpartum women were asked to fill out a questionnaire within one week after their parturition. The diagnostic criteria of this lesion were adopted from the Norwegian Medical Association's and Larsen's criteria. The questionnaire were included age, parity, BMI(kg/cm2), weight gain during the pregnancy, history of symptom giving pelvic girdle relaxation in previous pregnancy, level of exercise and vocational status during and before the pregnancy and baby's birth weight. The answers were evaluated to determine the risk factors. The correlation was tested by student t-test and logistic regression. RESULTS: The prevalence of symptom-giving pelvic girdle relaxation during pregnancy was 18.9%. The history of symptom-giving pelvic girdle relaxation in previous pregnancy, multiparity and the absence of regular exercise before and during pregnancy showed correlation with symptom-giving pelvic girdle relaxation in pregnancy (p<0.05). CONCLUSION: It is suggested that women who experienced symptom-giving pelvic girdle relaxation in previous pregnancy should be checked for this lesion before pregnancy. Regular exercise is required to lower the incidence and lessen the severity of this lesion in pregnancy.
Birth Weight ; Female ; Humans ; Incidence ; Logistic Models ; Parity ; Parturition ; Postpartum Period ; Pregnancy ; Pregnant Women* ; Prevalence* ; Surveys and Questionnaire ; Relaxation* ; Risk Factors* ; Weight Gain

There have been many reports regarding complications associated with cardiopulmonary resuscitation(CPR) and it may be true that there are many unrevealed complications. Although it is used to say that 'any CPR is better than no CPR', inadvertent or inadequate CPR may insult in serious organ injury. This report describes a 64-year-old woman who suffered Mallory-Weiss tear resulting from inadvertent cardiopulmonary resuscitation by a bystander who had never been trained. Possible mechanisms of gastric injuries caused by CPR are suggested, and importance of adequate CPR training are emphasized in this report.
Cardiopulmonary Resuscitation* ; Female ; Humans ; Mallory-Weiss Syndrome* ; Middle Aged

No abstract available.
Child* ; Edema* ; Gallbladder* ; Humans

BACKGROUND: The mechanically ventilated patient's stay in the emergency department (ED) is brief but ventilatory management and intervention must be optimal. Agitation, anxiety, distress, and discomfort are common complications far the ventilated patient. So, sedation is necessary to reduce these complications. METHODS: Patients were monitored and mechanically ventilated. Midazolam was intravenously administered as loading dose(3-5mg), followed by continuous infusion at a rate of 0.06mg/kg/hr, titrated to achieve a predetermined sedation level (Ramsay's sedation score: 2-5 points, Glasgow coma score scathe : 8-11 points). RESULTS: After onset of predetermined sedation, systolic and diastolic blood pressure and heart rate remained stable during continuous infusion when compared with those of the initial state. Arterial blood gas and peak inspiratory pressure remained unchanged but respiratory rate was decreased to allowable ranges. CONCLUSION: A short-term continuous infusion of midazolam was a safe and erective method for sedation of ventilated patients in ED.
Anxiety ; Blood Pressure ; Coma ; Dihydroergotamine ; Emergency Service, Hospital ; Heart Rate ; Humans ; Midazolam* ; Respiratory Rate

The role of GABA or glycine as an inhibitory neurotransmitter is well established, and GABAergic or glycinergic neurons appear to play an important role in the mammalian retinas. It has been reported that certain amacrine, bipolar, displaced amacrine and ganglion cells are consistently labeled with anti-GABA or anti-glycine antisera in the mammalian retinae so far, and it has been suggested that colocalization of GABA and glycine within the retinal neurons could be common in the mammalian retina by recent immunecytochemical and electrophysiological studies. This study was conducted to localize GABAergic and glycinergic neurons and to define whether GABA and glycine are colocalized within same retinal neurons of the rat retina by immunocytochemical method using anti-GABA and anti-glycine antisera. The results were as follows : 1. GABAergic neurons of the rat retina were amacrine, interplexiform, bipolar, displaced amacrine and ganglion cells, and processes of GABAergic neurons formed dense networks with distinct two bands in the inner plexiform layer. 2. Glycinergic neurons were amacrine, bipolar, displaced amacrine and ganglion cells,and their processes were evenly distributed as dense networks through whole inner plexiform layer. 3. 28.5% of GABA immunoreactive amacrine cells and 9.8% of GABA immunoreactive bipolar cells located in the inner nuclear layer,and 11.9% of labeled neurons located in the ganglion cell layer showed glycine immunoreactivity in the rat retina. These results demonstrate that GABA and glycine, major inhibitory neurotransmitters, are colocalized within certain amacrine and displaced amacrine cells, and a few bipolar cells, and that neurons synthesizing and utilizing both GABA and glycine as their neurotransmitters may play an unique role in the visual processing in the rat retina.
Amacrine Cells ; Animals ; GABAergic Neurons ; gamma-Aminobutyric Acid* ; Ganglion Cysts ; Glycine* ; Immune Sera ; Neurons* ; Neurotransmitter Agents ; Rats* ; Retina* ; Retinal Neurons

No abstract available.
Carcinoma, Basal Cell* ; Photochemotherapy*

The most common problem in pterygium operation is the recurrence. Therefore radiation therapy or instillation of mitomycin-C after pterygium operation have used to prevent the recurrence of pterygium. We evaluated recurrence rate and complication rate with mitomycin-C and without mitomycin-C after the operation of pterygium in 113 eyes. The 112 patients(113 eyes) underwent simple surgical excision, whose mean age was 50.7 tears, and whose follow-up period was 6 to 12 months. 0.04% solution of mitomycin-C was instilled to 61 eyes and not to 52 eyes. Recurrence was noticed in 12 out of 61 eyes(19.6%) among the group not using mitomycin-D and in 2 out of 52 eyes(3.8%) among the group using mitomycin-C after pterygium operation. One eye in patients using mitomycin-C showed severe corneal edema due to endothelial decompensation by the toxicity of mitomycin-C. It is concluded that mitomycin-C ws effective to prevent recurrence after pterygium operation, but we should be aware of the severe complications by the toxicity of mitomycin-C.
Corneal Edema ; Follow-Up Studies ; Humans ; Mitomycin* ; Pterygium* ; Recurrence*

BACKGROUND AND PURPOSE: The systemic inflammatory response syndrome(SIRS), as defied recently by critical-care specialists, may result from various etiologies including infection, bum, or trauma. The purpose of this study was to determine whether TNF- alpha is associated with the development of systemic inflammatory response syndrome caused by multiple trauma. METHODS: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study Multiple blood samples were serially drawn to measure seam TNF-alpha level on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-alpha was measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value far serum TNF-alpha. RESULTS: Serum TNF-alpha. levels of SIRS group were persistency elevated above reference value until 3 days after on admission. Peak seam TNF-alpha level at 12 hours after admission was higher in SIRS group than non-SIRS group(p< 0.05). There was no significant correlation between injury severity score and TNF-alpha levels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. CONCLUSION: the result of this study suggests that persistent elevation of TNF-alpha and degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Multiple Trauma* ; Reference Values ; Specialization ; Systemic Inflammatory Response Syndrome* ; Tumor Necrosis Factor-alpha* ; Volunteers

BACKGROUND AND PURPOSE: The purpose of this study is to compare two clinical predictive rules, the pre-arrestmorbidity(PAM) index and the prognosis-after-resuscitation(PAR) score, which predict failure to survive following in-hospital cardiopulmonary resuscitation(CPR). METHOD: The study population consisted of 162 consecutive adult patients who underwent CPR at Wonju Christian Hospital over a year period. The PAM index and PAR score were calculated from the most recent data available for each variable prior to cardiac arrest. Each predictive tool was compared between the group of discharge alive and the group of in-hospital mortality. Performance of the predictive scores was also compared by receiver-operating characteristic(ROC) curves where appropriate. RESULTS: PAM index of study population was 4.39+/-2.69 and PAR score was 2.99+/-3.36. PAM index in the group of discharge alive was 1.87+/-2.79, and PAM index in the group of ih-hospital mortality was 4.51+/-2.62. PAR score in the group of discharge alive was 0.75+/-1.75, and PAR score in the group of in-hospital mortality was 3.1+/-3.4. The PAM index identified 15 patients with a score>8, while the PAR score identified 39 patients with a score>4, none of whom survived. The sensitivity of the PAR score for the prediction of failure to survive was 25%, while that of the PAM index was 10%; neither index incorrectly identified a patient as a non-survivor who eventually survived. Both of predictive methods were not significantly different in the ROC curve. CONCLUSION: Although further confirmation is necessary, PAM index and PAR score may provide useful prognostic information to physicians and patients involved with decisions about do-no- resuscitate orders.
Adult ; Cardiopulmonary Resuscitation* ; Gangwon-do ; Heart Arrest ; Hospital Mortality ; Humans ; Mortality ; ROC Curve

Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.
Decontamination ; Eating ; Gastric Emptying ; Gastric Lavage ; Humans ; Korea ; Pesticides ; Toxicology