No abstract available.
Perfusion* ; Stroke Volume* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Perfusion* ; Stroke Volume* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Triage and transportations are important and life-saving medical task performed at the site of mutiple-casualty incidents(MCIs). We pursued three road traffic accidents victims to find out any problem in triaging and transporting them, and to provide an information for equipping an local disaster planning. METHODS: The medical records of 70 consecutive patients who were transported to five emergency facilities in Kangnung, on three MCIs from 1998 to 2000, were analysed, retrospectively. The intervals and types of transport vehicles were analysed. We compared the prehospital time between severity-based groups, which were graded into 3 groups according to the Triage score(0, 1~8, 9). RESULTS: Among the 70 patients, 33 patients(47.1%), 21 patients(30%), and 16 patients(22.9%) were transported to Level I, Level II, and Level III trauma centers, respectively. The time elapsed from scenes to the Level I trauma center was significantly shorter(p=0.003) than to others, but no differences in the mean Triage score between trauma centers were seen(p>0.05). The 119 rescue services transported 58.6%(41 patients) of victims to emergency facilities, and 58.5%(24 patients) of them was concentrated to Level I. There were no significant differences in the prehospital time between three Triage score groups(p>0.05). CONCLUSION: There was no medical control such as triage and transportation in the cases of three MCIs. In the construction of emergency medical service system(EMSS) preparing MCIs or disasters, we suggest the integration and unification of 119 rescue services and emergency medical information centers for effective medical control. We propose to making a new and simple triage guideline. The prehospital personnel should be educated and disaster drills should be performed under the guideline.
Accidents, Traffic ; Disaster Planning ; Disasters ; Emergencies ; Emergency Medical Services ; Humans ; Information Centers ; Medical Records ; Retrospective Studies ; Transportation* ; Trauma Centers ; Triage*

Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. 99mTc-MIBI and other 99mTc-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of Pgp-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with 11C have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and N-[11C]acetyl-leukotriene E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo.
Animals ; Colchicine ; Cyclosporine ; Daunorubicin ; Drug Resistance, Multiple* ; Drug Therapy ; Humans ; Leukotrienes ; Molecular Imaging ; P-Glycoprotein ; Positron-Emission Tomography ; Quinidine ; Tamoxifen ; Tomography, Emission-Computed, Single-Photon ; Verapamil

BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

To evaluate the effectiveness of computed tomography for the differential diagnosis of cervical lymphadenopathy, we reviewed CT scans of 26 patients with cervical lymphadenopathy retrospectively. These included 10 patients with tuberculous lymphadenitis, 11 patients with metastasis and 5 patients with lymphoma, We evaluated the CT scans with a special attention to internal nodal density, feature of contrast enhancement and location of lymphadenopathy. Tuberculous lymphadenitis involved multiple nodes unilaterally and showed central low density with even or uneven rim enhancement, usually occurring in young patients (mean: 31.6 years). Two cases with tuberculous lymphadenitis showed calcifications within the lymph nodes. Lymphoma involved unilateral or bilateral nodes and appeared as conglomerated isodense mass with even rim enhancement. Metastasis involved multiple nodes unilaterally and showed focal, diffuse of mixed pattern of central low density with variable rim enhancement, usually occurring in old patients (mean: 59.4 years). Locations of most frequent lymph node involvements were internal jugular group (76%), spinal accessory group (54%) and retropharyngeal group(12%).
Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphatic Diseases* ; Lymphoma ; Neoplasm Metastasis ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

The authors tried to evaluate the effect of the growth factors on cell proliferation in the human retina astrocyte culture. Each growth factor, EGF, bFGF, GGF, IGF-1 or PDGF, together with BrdU was added to astrocytes-enriched cultures in the serum-free media. The proliferating effect of each growth factor was evaluated by a double immunofluo- rescenece labelling for GFAP and BrdU. By and addition of each growth factor, the number of retinal astrocytes at the synthetic stage significantly increased than those of control group (p<0.01). In comparision, PDGF was more potent than IGF-1 (p<0.01). Above data extended the concept of astrocytic proliferation caused by several growth factors in human retinal injury.
Astrocytes ; Bromodeoxyuridine ; Cell Proliferation ; Culture Media, Serum-Free ; Epidermal Growth Factor ; Humans ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Neuroglia* ; Retina ; Retinaldehyde*

The diagnosis of internal jugular vein thrombosis (IJVT), a vascular disorder, can be easily overlooked. Disruption of blood flow through the internal jugular vein can take place in a variety of clinical settings. CT and ultrasonography are useful diagnostic tools. Recently, we experienced a case of IJVT after deep neck infection. This case showed sore throat, odynophagia and swelling of right submandibular area. CT scan revealed diffuse neck swelling and incomplete occlusion of the right internal jugular vein at the thyroid level. Treatment began with antibiotics and hydration. We present a case of IJVT after deep neck infection with literature review.
Anti-Bacterial Agents ; Diagnosis ; Jugular Veins* ; Neck* ; Pharyngitis ; Thrombosis* ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography

Objectives : 201Tl - chloride, 99mTc - MIBI, 99mTc(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we performed three consecutive SPECT using 201Tl, 99mTc - MIBI, 99mTc(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods : SPECT was carried out at 10min and 3hr for 201Tl after injection of 2 mCi, and 2hr for 99mTc - MIBI and 99mTc(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - bakground(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for 201Tl. Results : The diagnostic sensitivity of 201Tl, 99mTc - MIBI and 99mTc(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer Conclusion : 201Tl and 99mTc - MIBI showed higher sensitivity than 99mTc(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.
Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Succimer* ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary

Objectives : 201Tl - chloride, 99mTc - MIBI, 99mTc(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we performed three consecutive SPECT using 201Tl, 99mTc - MIBI, 99mTc(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods : SPECT was carried out at 10min and 3hr for 201Tl after injection of 2 mCi, and 2hr for 99mTc - MIBI and 99mTc(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - bakground(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for 201Tl. Results : The diagnostic sensitivity of 201Tl, 99mTc - MIBI and 99mTc(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer Conclusion : 201Tl and 99mTc - MIBI showed higher sensitivity than 99mTc(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.
Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Succimer* ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis, Pulmonary