BACKGROUND: Emergency Medical Technicians can do emergency care only under the control of the physicians. Emergency medical services system(EMSS) in Korea is now extended from the level of basic life support(BLS) to advanced life support(ALS). Unfortunately we don't have any official medical control system yet. We and regional EMSS, 119 rescue team(BLS), have had monthly joint meeting to validate and improve the prehospital care since August, 1998. METHODS: From August, 1998 to February, 1999, 1,708 patients were transported to Ewha Mokdong Hospital by regional 119 rescue team. Eight hundred and six(47.2%) run record were collected and analyzed. The appropriateness of the prehospital care were evaluated based on the comparison of assessment data and treatment data in each run record. The run record were divided into 5 groups; 1) necessary-adequate, 2) necessary-inadequate, 3) necessary-undo, 4) unnecessary-done, and 5) unnecessary-undo. 1) and 5) were judged as acceptable, and 2), 3), and 4) as unacceptable. RESULTS: Among 806 transported patients, 60.8% required one or more emergency care. 21.0% of required care were not provided, and 20.7% of provided care were not adequate. 78.8% of unprovided and 75.9% of inadequate care were 'airway and oxygen supply'. Overall unacceptable rate was decreased from 31.7% to 17.0% during first 5 months, but it rose up again to 24.7% after 2 months. Cardiopulmonary resuscitation(CPR) was performed in 29 prehospital cardiac arrest victims and admitted to ICU in 5 cases. CPR was not provided in 8 necessary situations, and unnecessary CPR was done in 3 cases. CONCLUSION: EMSS in Korea also need a kind of medical control system, even for BLS level. Major portion of the quality assurance program could be 'airway and oxygen supply', but attention should be focused in cardiac arrest victims and CPR. Record keeping and reliance of run record data are now pending problems. Fire department should develop a formal medical control system and the referring hospital should have an organization for maintaining the quality of prehospital care.
Cardiopulmonary Resuscitation ; Emergency Medical Services* ; Emergency Medical Technicians ; Fires ; Heart Arrest ; Humans ; Joints ; Korea ; Oxygen ; Retrospective Studies*

No abstract available.
Erythema Infectiosum*

Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.
Adolescent ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

This is a case of recurrent malignant fibrous histicytoma, histologic features of which are reminiscent of a clear cell carcinoma of soft tissue or myxoid liposarcoma. The tumor recurred 2 years and 10 months after the initial removal of the primary tumors in the lateral aspect of the left tigh. In view of histogenesis of malignant fibrous histiocytoma, possibility of recurrent tumor with a wide range of histologic features including clear cell type is discussed. Pertinent clinical history with review of the initial tumor is mandatory for a definite assessment of histologic feature of recurrent malignant fibrous histiocytoma.

No abstract available.
Humans* ; Keratinocytes* ; Protein-Serine-Threonine Kinases* ; Serine* ; Threonine*

Acrokeratosis verruciformis is a familial disease characterized by indolent papules resembIing flat warts on the backs of the hands and feet with lesser involvement of volar surfaces, wrists, and ankles. A cas of 42 years old female with acrokeratosis verruciformis is reported. The skin lesions of this patient showed numerous rice to pea sized, flat-topped, round or polygonal, warty papules on the dorsal aspects of the hands and feet and also, pitted keratolysis on both volar surface of the hands. The hitologic findings were those of features of acrokeratosis verruciformis, i.e. the epidermis shows marked hyperkeratosis with slight acanthosis and papillomatosis and circumscribed elevations of the epidermis resembling church spires characteristically.
Adult ; Ankle ; Darier Disease* ; Epidermis ; Female ; Foot ; Hand ; Humans ; Papilloma ; Peas ; Skin ; Warts ; Wrist

No abstract available.
Hepatitis, Chronic*

No abstract available.
alpha-Fetoproteins* ; Humans ; Infant* ; Infant, Newborn*

Fibrosarcoma in newborns and infants, designated as congenital, infantile, or juvenile fibrosarcoma is an uncommon soft tissue neoplasm occurring most frequently during the first year of life. Infantile fibrosarcoma is associated with favorable clinical behavior that is markedly different from that of adult fibrosarcoma., We report a case of infantile fibrosarcoma occured in a 3-year-old boy presenting as a palpable mass in the left lower extremity since 3 months of life. Histologic findings of the tumor are similar to those of f ibrosarcomas in adult.
Infant ; Adult ; Male ; Female ; Infant, Newborn ; Humans

Gastric glomus tumor is an uncommon benign, submucosal neoplasm and does not require radical surgical procedure. Because there are no specific clinical or radiologic features associated with the glomus tumor, it can be recognized only by its histologic characteristics. We report a 30-year-old woman who had 10 years history of epigastric hunger pain. Radiologically, a gastric submucosal tumor was discovered, which was suggestive of leiomyoma. Gastric antrectomy was performed. The tumor cells showed immunohistochemical and ultrastructural evidence of smooth muscle differentiation.
Female ; Humans