BACKGROUND: The differentiation between hemorrhagic(HS) and norhemorrhagic(NHS) stroke is the most important first step in the management of acute stroke because clinical management of the two disorders differs substantially. Neuroimaging studies are useful in diagnosing and distinctioning between HS and NHS. The use of clinical variables, such as Siriraj stroke scores(SSS), has led to good sensitivity, specificity and predictive values. The aim of our study was to evaluate the use of the SSS in the Korean population and assess whether it could aid to expedite treatment decisions. METHODS: We reviewed 111 cases of stroke patients admitted to our hospital via the emergency department over a 6 months period from July to December 1998. Levels of consciousness, vomiting, headache, and atheroma markers used in the SSS were applied to these patients who met the criteria for a stroke. RESULTS: Of the 111 patients, the SSS classified 83 with sensitivities of 81.1%(NHS) and 73.3%(HS) and positive predictive values of 84.3% and 68.8%, respectively. The overall accuracy rate was 78.3%. CONCLUSION: Our results suggest that the SSS is not reliable in distinguishing stroke types in the Korean population. Definite neuroimaging studies are needed prior to thrombolytic therapy.
Consciousness ; Emergency Service, Hospital ; Headache ; Humans ; Neuroimaging ; Plaque, Atherosclerotic ; Sensitivity and Specificity ; Stroke* ; Thrombolytic Therapy ; Vomiting

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.
Acute Kidney Injury ; Amputation ; Burns* ; Compartment Syndromes ; Compliance ; Education ; Electricity ; Emergencies ; Emergency Service, Hospital ; Extremities ; Humans ; Length of Stay ; Male ; Mortality ; Myoglobinuria

Carthamus tinctorius L. is commonly known as safflower. This plant is cultivated mainly for its seed, which is used as essential oil and hot water extract. C. tinctorius has recently been shown to have antioxidant, analgesic, and anti-inflammatory activities. C. tinctorius seed is known as a relatively nontoxic material that is not associated with fatal adverse effects. We experienced a successful outcome in a 62-year-old male patient who was a victim of poisoning due to ingestion of C. tinctorius seed and undergone fatal adverse effects. He ate C. tinctorius seed mixed with alcohol and became lethargic state. In the emergency department, cardiac arrest with pulseless ventricular tachycardia occurred. He was treated by cardiopulmonary resuscitation with cardiac defibrillation. After return of spontaneous circulation, he was managed conservatively and was discharged without deficits approximately ten days after onset.
Cardiopulmonary Resuscitation ; Carthamus tinctorius* ; Eating ; Emergency Service, Hospital ; Heart Arrest* ; Humans ; Male ; Middle Aged ; Plants ; Poisoning ; Tachycardia, Ventricular* ; Water

Among members of the public, acupuncture has a reputation for being safe. Since 1965, many case reports of serious or even life-threatening incidents caused by acupuncture have been reported in the literature. A 55 year old male was admitted with complaints of abdominal pain after acupuncture therapy at an oriental medicine hospital. Abdominal Computerized Tomography (CT) scan showed a mass measuring 9.8 cm with active bleeding. Emergency operation was performed. He was diagnosed as ileocecal vein rupture following acupuncture. We report here on a case of an iliocecal vein rupture following acupuncture therapy and we review the relevant literature.
Abdominal Pain ; Acupuncture ; Acupuncture Therapy ; Emergencies ; Hemorrhage ; Humans ; Male ; Medicine, East Asian Traditional ; Rupture ; Vascular System Injuries ; Veins

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe thunderclap headache with multifocal segmental vasoconstriction of the cerebral arteries. RCVS can be diagnosed if the cerebral angiogram shows segmental stenosis and spontaneously resolves within weeks to months. RCVS is reversible, but might cause brain lesions such as subarachnoid hemorrhage or cerebral infarction. We report a 45-year-old woman with severe sudden onset frontal headache who was identified with reversible cerebral vasoconstriction syndrome.
Angiography ; Brain ; Cerebral Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Female ; Headache ; Headache Disorders, Primary ; Humans ; Middle Aged ; Subarachnoid Hemorrhage ; Swimming ; Vasoconstriction

Fahr's disease is a rare disease characterized by idiopathic abnormal deposits of calcium in intracranial areas. Fahr's syndrome occurs secondarily to other diseases. Endocrine disorders, particularly parathyroid hormone disorders, are most commonly associated with Fahr's syndrome. Common clinical features of Fahr's disease or syndrome include movement disorder, phychiatric disorder, epileptic seizure, dementia, headache, dystonia, myoclonus, tremor, and parkinsonism. We report on a case of a 35-year-old woman with Fahr's syndrome who presented with epileptic seizure and pseudohypoparathyroidism.
Adult ; Basal Ganglia ; Calcinosis ; Calcium ; Dementia ; Dystonia ; Epilepsy* ; Female ; Headache ; Humans ; Movement Disorders ; Myoclonus ; Parathyroid Hormone ; Parkinsonian Disorders ; Pseudohypoparathyroidism* ; Rare Diseases ; Seizures ; Tremor

PURPOSE: The purpose of this study is to understand what kinds of chemical substances have been used annually and to investigate incidents that occurred due to chemical hazard release and to analyze statistically clinically chemical injury patients who visited one regional emergency medical center in Gumi city with documented references review. METHODS: Annual chemical waste emission quantity (Kg/Year) (Cwep) was reproduced using national web site data governed by the Ministry of Environment and 5 years (from 1 .Jan. 2010 to 31. Dec. 2014) of medical records of chemical injury patients who visited our emergency department were reviewed retrospectively. By applying exclusion criteria, 446 patients of 460 patients were selected. RESULTS: Dichloromethane, Toluene, Trichloroethylene, and Xylene were always included within Top 5 of Cweq. Six cases of chemical incidents were reported and in 3 of 6 cases involving Hydrogen fluoride were included during the study period. Male gender and twenties were the most prevalent group. Injury evoking chemicals were Hydrogen fluoride, unknown, complex chemicals (over 2 substances) in sequence. The most frequent site of wounds and injuries was the respiratory tract. Gas among status, intoxication among diagnosis, and discharge among disposition was most numerous in each group. CONCLUSION: There have been no uniform clinical protocols for chemical wounds and injuries due to various kinds of chemicophysical properties and ignorance of antidotes. Therefore conduct of a multicenter cohort study and experiments for ruling out chemicals according to chemicophysical priority as well as development of antidotes and clinical protocols for chemical injury patients is needed.
Antidotes ; Chemical Hazard Release* ; Clinical Protocols ; Cohort Studies ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Gyeongsangbuk-do ; Humans ; Hydrofluoric Acid ; Male ; Medical Records ; Methylene Chloride ; Respiratory System ; Retrospective Studies* ; Toluene ; Trichloroethylene ; Wounds and Injuries ; Xylenes

PURPOSE: There has been an increase in the number of nontraumatic prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population. We performed this study to identify the proper resuscitation technique to be used to increase the survival rate in nontraumatic, prehospital cardiac arrest. METHODS: We reviewed the charts of patients with nontraumatic, prehospital cardiac arrest who visited our Emergency Department of Keimyung University Hospital during the period of May 2001 through April 2002. RESULTS: Out of 60 cases of nontraumatic, prehospital cardiac arrest, 27 (45%) experienced no ROSC, 15 (25%) experienced transient ROSC, 6 (10%) died after 24 hours, and 12 (20%) alived and were discharged. Among those discharged, 10 had visited our emergency department for cardiac causes and 2 for non-cardiac causes. EKG findings were VF in 8, PEA in 2, and bradycardia in 2. In the discharged survival cases, the cardiac arrest had been witnessed. CONCLUSION: We failed to find significant statistical survival differences based on the causes of cardiac arrest, the initial EKG monitoring, or the method of visit. Witnessed cases of cardiac arrest had a higher survival rate than nonwitnessed cases (p<0.05).
Bradycardia ; Cardiovascular Diseases ; Electrocardiography ; Emergency Service, Hospital ; Heart Arrest* ; Humans ; Peas ; Resuscitation ; Survival Rate

PURPOSE: This study was conducted to identify the characteristics associated with sulfuric acid injury in the emergency department. METHODS: Data were collected retrospectively from January 2007 to December 2015 on all sulfuric acid injuries presenting to the emergency department in Gu-mi Soonchunhyung University Hospital. Patients injured by sulfuric acid were recorded over a nine year study period and collected data included demographics, injury mechanism, injured body part, hospital care and final diagnosis. RESULTS: A total of 26 cases were identified. Most patients were male (88.5%) and the face was the most commonly injured body part. The most common mechanism of injury was splashing injury. A total of 16 (61.5%) patients were identified as having lesions worse than second degree burns. CONCLUSION: Sulfuric acid can cause severe and fatal skin burn. When working with sulfuric acid, acid proof protect clothing, goggles and glove should be worn. Furthermore, safety education and workplace environment improvement are necessary to reduce sulfuric acid injury.
Burns ; Burns, Chemical ; Clothing ; Demography ; Diagnosis ; Education ; Emergency Service, Hospital ; Eye Protective Devices ; Humans ; Male ; Occupational Injuries ; Retrospective Studies ; Skin ; Sulfur*

As the corticospinal tract crosses at the medulla, supratentorial stroke generally influences the opposite extremity. However, new incidences of hemiparesis might occur in the ipsilateral brain if there was a previous infarction in the opposite brain or a congenital structural abnormality. The occurrence of ipsilateral hemiparesis after cerebral infarction is very rare; however, we report here the case of a patient who developed right hemiparesis that was identified as acute right middle cerebral artery infarction.
Brain ; Cerebral Infarction ; Extremities ; Humans ; Incidence ; Infarction ; Infarction, Middle Cerebral Artery ; Middle Cerebral Artery ; Paresis ; Pyramidal Tracts ; Stroke