The Organ Injury Scaling Committee of the American Association for the Surgery of Trauma recently published a consensus classification of hepatic and splenic injuries. The hepatic and splenic injury scales, based on parenchymal laceration and intrahepatic hematoma include grade 1 to 6 and grade 1 to 5 respectively, representing the least to most severe injury. Forty-eight patients with hepatic and splenic injury were evaluated by abdominal CT from January 1995 to May 1996 and we compared abdominal CT grading with operative grading. Four CT grades did not correlate with operative finding. CT grading showed a sensitivity of 80%, specificity 80% in regard to operative grading. We conclude that 1) CT is an accurate technique to determine the extent of hepatic and splenic injury. 2) CT grading of hepatic and splenic trauma has a high correlation with operative grading.
Classification ; Consensus ; Hematoma ; Humans ; Lacerations ; Liver ; Sensitivity and Specificity ; Spleen ; Tomography, X-Ray Computed ; Weights and Measures

STUDY OBJECTIVES: To compare the quality of CPR provided by medical students and pre-EMTs performing three-rescuer CPR with that achieved by same students trained to provide standard two-rescuer CPR and to find the most effective method of resuscitation and to educate this methods to students. MATERIAL AND METHODS: From July 1 to September 30, 1996, we had trained 60 groups consisted of the medical students, students of EMS technology and pre-EMT. Each group practiced two-rescuer CPR and three- rescuer CPR for 120 minutes with Resusci(R) Anne and performed CPR for at least 3 minutes without feedback. To eliminate any visual cues of performance the mannequin's recorder was hidden. Each actions were recorded by Resusci(R) skillmeter and Laerdal printer. To compare the Quality of two-rescuer CPR and three-rescuer CPR, we analyzed the data by SPSS with paired t-test. RESULTS: Three-rescuer teams delivered a mean minute ventilation and a mean minute cardiac compression substantially greater than that produced by two-rescuer teams(11.30 +/-.85 vs 9.09+/-.22, p<0.001, 99.22+/-2.42 vs 95.12+/-5.75, p<0.001). Three-rescuer teams produce the more correct actions in chest compression and ventilation(93.84+/-.56% vs 83.49+/-6.94%, 90.90+/-.33% vs 77.00+/-7.06%). CONCLUSION: Three-rescuers can produce better CPR than two rescuers when a bag-valve-mask devices is used and the technique is easily leaned and readily retrained, so we think that repeated education and training of this CPR methods to students is needed.
Cardiopulmonary Resuscitation* ; Cues ; Education ; Humans ; Resuscitation ; Students, Medical ; Thorax ; Ventilation

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction*

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction*

OBJECTIVE: We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). METHODS: A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. RESULTS: The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). CONCLUSION: In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health.
Comorbidity ; Health Surveys ; Humans ; Low Back Pain* ; Male ; Mental Health ; Physical Examination ; Prevalence* ; Public Health ; Quality of Life*

No abstract available.
HIV ; Humans* ; Mothers* ; Pregnancy*

No abstract available.
Factor VII Deficiency* ; Factor VII*

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder that frequently causes forefoot deformities. Arthrodesis of the first metatarsophalangeal joint is a common surgery for severe hallux valgus. However, joint-preserving surgery can maintain the mobility of the joint. This study aimed to investigate the clinical and radiographic outcomes of distal chevron metatarsal osteotomy (DCMO) for correcting hallux valgus deformity associated with RA. Methods: Between August 2000 and December 2018, 18 consecutive patients with rheumatoid forefoot deformities (24 feet) underwent DCMO for hallux valgus with/without lesser toe surgery. Radiological evaluations were conducted, assessing the hallux valgus angle, the intermetatarsal angle between the first and second metatarsals, and the Sharp/van der Heijde score for erosion and joint space narrowing. Clinical outcomes were quantified using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society forefoot scores to measure function and alignment. Results: The mean hallux valgus angle decreased from 38.0° (range, 25°–65°) preoperatively to 3.5° (range, 0°–17°) at the final follow-up (p < 0.05). The mean intermetatarsal angle decreased from 14.9° (range, 5°–22°) preoperatively to 4.3° (range, 2°–11°) at the final follow-up. (p < 0.05). Regarding the Sharp/van der Heijde score, the mean erosion score (0–10) showed no significant change, decreasing from 3.83 (range, 0–6) preoperatively to 3.54 (range, 0–4) at the final follow-up (p = 0.12). Recurrent hallux valgus was observed in 1 patient and postoperative hallux varus deformity was observed in 2 feet. Spontaneous fusion of the metatarsophalangeal joint developed in 1 case. Conclusions DCMO resulted in satisfactory clinical and radiographic outcomes for correcting RA-associated hallux valgus deformity.

BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included. Each lesion was divided into 3 segments based on lumen area (LA) index, calculated by dividing the lesion LA by the reference LA. RESULTS: Among the 3 segments, the mid-segment showed the highest proportion of necrotic core (NC; proximal, mid-, and distal segments: 20.9±11.8%, 22.7±11.3%, and 17.5±11.2%, respectively, p=0.044). VH-IVUS-derived thin-cap fibroatheroma (VH-TCFA) was also more frequently found in the mid-segment than in proximal and distal segments (36.7%, 58.3%, and 16.7%, p < 0.001). The mid-segment also showed the highest prevalence of plaque rupture (45.0%, 78.3% and 11.7%, p < 0.001) and thrombus (61.7%, 95.0%, and 41.7%, p < 0.001) compared to proximal or distal segments. When the lesions were divided into 2 groups according to the median value (4.0 mm2) of minimum lumen area (MLA), plaque rupture at the distal segment was observed only in high MLA lesions (23.3% vs. 0.0%, p=0.011). CONCLUSION: Analysis of longitudinal lesion geometry using the LA index can be useful in evaluating plaque vulnerability and the incidence of plaque rupture and thrombus in STEMI patients.
Coronary Artery Disease ; Coronary Vessels ; Diagnostic Imaging ; Humans ; Incidence ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Prevalence ; Rupture ; Thrombosis ; Ultrasonography

OBJECTIVE: Pattern with essential hypertension generally shows the same circadian pattern as the normothensive person with a night-time reduction or "DIP" in blood pressure in sleep. The definition of "Dipper" and "Non-dipper" are assigned according to arbitrary criteria e.g. a night time average blood pressure which is at least 10% less than the average daytime blood pressure. Prospective evidence that the absence of an overnight dip is a strong adverse prognostic indicator for target organ damage .Thus we investigate circardian rhythm of blood pressure, related target organ damage, its frequency & drug in hypertensive subjects. Method : 24hr ambulatory blood pressure monitoring, history taking, physical examination, fundoscopy, ECG, chest X ray, dipstick urinanlysis, serum creatinine level are performed in essential hypertensive subjects. Exclusion criteria are duration of hypertension over 5 years, DM, renovascular hypertension & heart failure. RESULTS: Total 42 patients performed study.17 subjects classify dipper group,25 subjects classify non-dipper group. Between dipper & non-dipper group shows no significantly difference at stroke history, C/T ratio over 0.5 in chest X-ray, left ventrcular hypertrophy in ECG,ST-T change in ECG, proteinuria & serum creatinine level. Non-dipper group shows significantly difference to dipper group in frequency of hypertensive retinopathy and number of combined drug used subjects. CONCLUSION: Number of hypertensive retinopathy is significantly frequency in non-dipper group. Hypertensive retinopathy is atherosclerotic complication, thus we predict other target organ damage, therefore non-dipper type circardian rhythm of blood pressure is adverse prognostic factor for target organ damage of hypertensive subjects.
Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Creatinine ; Electrocardiography ; Heart Failure ; Humans ; Hypertension ; Hypertension, Renovascular ; Hypertensive Retinopathy ; Hypertrophy ; Physical Examination ; Prospective Studies ; Proteinuria ; Stroke ; Thorax