BACKGROUND: Plasmodium vivax malaria was recently re-presenting infectious disease in Korea since was being controlled for about 10 years age, but has been increasing years by year in the soldiers or farmers working at the near Demilitarized Zone(DMZ). So we analyzed the Characteristics of the patients diagnosed as malaria since 1997 in Yeungnam university hospital. METHODS: From January 1997 to August 1999, the 23 patients complainted of the febrile and chilly sense were diagnosed as Plasmodium vivax malaria in Yeungnam university hospital. We analyzed the patient's records for clinical findings(i.e. clinical symptoms and signs), occupation and regions of working or visiting, laboratory findings, treatment and its results, etc. RESULTS: Male patients were 21 and female patients were 2 among the total 23 patients, the 19 of 21 male patients were soldiers discharged from military services. All patients had been visited or worked near the DMZ, as the northern part of Kyungki-do(21 cases) or Kangwon-do(2 cases). And all patients complainted of delayed onset(means 6 months) of fever and chills after working or visiting at this zones. On physical examination, liver or spleen were palpated initially at least 1 finger breadth in 9 cases(39.1%), and peripheral blood smears showed the infected RBCs(i.e. gametocyte, ring form, schizont, trophozoite) in all cases, and 21 cases(91.3%) showed thrombocytopenia. All patients were treated by the combined regimen of 2-days hydroxychloroquine and 14-days primaquine. All cases showed clinical and laboratory improvement initially, but 5 cases were recurred after 2 months and showed re-improvement. And none of 23 cases showed the significant complications and deaths after medical treatment. CONCLUSION: Plasmodium vivax malarial infection is currently re-presenting disease near the DMZ. So we should consider the active prevention and management of malaria.
Chills ; Communicable Diseases ; Female ; Fever ; Fingers ; Humans ; Hydroxychloroquine ; Korea ; Liver ; Malaria ; Malaria, Vivax* ; Male ; Military Personnel ; Occupations ; Physical Examination ; Plasmodium vivax* ; Plasmodium* ; Primaquine ; Schizonts ; Spleen ; Thrombocytopenia

BACKGROUND: The medicolegal problems can be occurred in all medical field, Especially ED can be more exposed to the legal claims due to the very nature of ED business and characteristics of ED patient (or their family member). All emergency physicians, as a ED manager, should be concerned about the law associated with emergency cairo for handling the medicolegal problem. So they can deal with and prevent the legally risky situations that may be occurred in ED practice. Ultimately we can reduce the risk of a malpractice lawsuit and provide good emergency care services. SUGGESTION: The authors would like to suggest several items that we have thought the ED physicians and managers always have to remember to manage the medicolegally risky situations. 1. Every member of ED health care team must be trained in understanding the patients' wants and desires. 2. The emergency physicians and nurses must realize that they are the best risk management tools in the hospital. 3. ED physician should have the knowledge of the law associated with emergency health care. 4. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care providers of every health care institutes. 5. We should never forget the time honored sentences, 'Good medicine is good law'.
Academies and Institutes ; Commerce ; Delivery of Health Care ; Emergencies ; Emergency Medical Services ; Empathy* ; Health Personnel ; Humans ; Jurisprudence ; Malpractice ; Patient Care Team ; Risk Management

Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.
Brain ; Child ; Community Health Services ; Decompression Sickness ; Disaster Planning ; Disasters ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Heart ; Hot Temperature ; Humans ; Jurisprudence ; Resuscitation ; Specialization ; Spouse Abuse ; Substance-Related Disorders ; Triage

No abstract available.
Female ; Fetal Heart* ; Fetal Movement* ; Heart Rate, Fetal* ; Music* ; Pregnancy

Chilaiditis syndrome is very rare clinical condition that interposed of the hepatic flexure of large bowels between the liver and diaphragm. Clinically it is characterized by abdominal pain that becomes increasingly worse during the day and is often accentuated by deep breathing. On radiologic studies, it shows gas within the hepatic flexure interposed between the liver and diaphragm, which is simulating a pneumoperitoneum. A case was admitted at emergency care center of Yeungnam university hospital and we report it.
Abdominal Pain ; Chilaiditi Syndrome* ; Diaphragm ; Emergency Medical Services ; Liver ; Pneumoperitoneum* ; Respiration

OBJECTIVE: The objective of this survey is to introduce the recent adolescent sexuality, such as the level of sexual knowledge of adolescent, their actual state for the attitudes and behaviors toward sex, and in Korea in comparison with the past and to seek the answers to the improvement of the teproductive health statos of the adolescents. METHOD: The total number of 11,433 girls was drawn fiom middle and high schools girls in Seoul, Pusan, Incheon, Kwangju, Taegu, Taejeon and Ansan. Among them, the number of 82 girls was drawn fiom factory workers in Ansan. For the data collection, the survey was conducted during the period fiom Feb 15, 1994 to May 23, 1995 by using prepared questionaire. RESULT: Of those who respond to this study, 37.6% had sexual problems, which was that of acquaintance of the opposite sex(44.7%), menstruation(33.1%), and sexual maturity(13.1%). Among them, only 5.5% had a feeling of satisfaction about sex education. In regard to the attitude toward the friendly relationsbip with the oppasite sex, the approval rate respondents was 80.4%. Many respondents felt chastity and a virtue, but only 60.1% answered that pemarital chastity should be kept. For the each age group, age at sexual intercourse is revealed that among the respondents about 31.5% are experienced sexual intercourse for under 14 yearss old group, 25.3% for 15 years old, 26.3% for 16 years old, 12.6% for 17 years old, 3.3% for 18 years old, 1.0% for 19 years old. The major information source of knowledge source was school(38.4%), mass-media such as TV/radio(22.6%), book and magazine(19.9%), friends(16.2%), and parents (1.5%). CONCLUSION: In order to cope with the problems of adolescent sexuality, a drastic and strong policy measures should be taken by the government. At the same time, the public should be aware of the urgency of adolescent sexual problems. The most effective countermeasures appear to be education. Sexual education is necessary for the youth that they should bave an adequate sexual knowledge, attitudes and behaviors in their adolescent period.
Adolescent* ; Busan ; Coitus ; Daegu ; Daejeon ; Surveys and Questionnaires ; Education ; Female ; Gwangju ; Gyeonggi-do ; Humans ; Incheon ; Korea ; Parents ; Seoul ; Sex Education ; Sexuality* ; Virtues ; Young Adult

Erythema multiforme(EM) is related disorders of skin and mucous members which is typically associated with antecedent medications or infections, etc. EM is an erythematous maculopapular cutaneous eruption of variable form. However, the pathophysiology of the EM remains obscure. Treatment at present is symptomatic and supportive. In conclusion, the authors report two cases of EM that complained of the erythematous maculopapular cutaneous eruption following antibiotics treatment with the review of literatures.
Anti-Bacterial Agents* ; Erythema Multiforme* ; Erythema* ; Skin

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

No abstract available.
Animals ; Enalapril* ; Nicardipine* ; Nitroprusside* ; Rats* ; Skin*

BACKGROUND: The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). MATERIALS AND METHODS: We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. RESULTS: Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. CONCLUSION: Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.
Angina Pectoris ; Chest Pain* ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies ; Humans ; Male ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Thorax* ; Transportation