PURPOSE: Arterial hypotension is a recognized complication of emergency intubation, whereas there have been contradicting opinions regarding postintubation hypotension. The aim of this study was to determine the incidence, related factors, and impact on patient outcomes associated with postintubation hypotension (PIH) in intubations performed in the emergency department. METHODS: A structured chart audit of all consecutive adult patients requiring emergency endotracheal intubations over a two-year period (2011.1.1.~2012.12.31.) was performed retrospectively. Patients older than 20 years who had no systolic blood pressure below 90 mmHg at any time before intubation were included. Patients were analyzed in two groups, those with PIH, defined as any recorded systolic pressure less than 90 mmHg within 60 minutes of intubation, and those with no PIH. The primary outcome was in-hospital mortality. RESULTS: Overall, 186 patients intubated in the emergency department were identified, and 18.4% (34 of 186) developed PIH. Advanced age was an independent factor of developing PIH (OR: 3.4, 95% CI: 1.3-9.0, p=0.02). Patients with PIH had significantly higher in-hospital mortality (53% vs 29%; p=0.01), and multiple logistic regression showed that PIH was an independent predictor of in-hospital mortality (OR: 2.5, 95% CI: 1.1-5.5 p=0.03). CONCLUSION: Postintubation hypotension occurs in 18.3% of hemodynamically stable patients before intubation. PIH is independently associated with in-hospital mortality. Advanced age is an independent predicting factor of PIH.
Adult ; Blood Pressure ; Emergencies ; Emergency Service, Hospital* ; Hospital Mortality* ; Humans ; Hypotension* ; Incidence ; Intubation ; Intubation, Intratracheal ; Logistic Models ; Mortality ; Retrospective Studies ; Risk Factors*

Pneumopericardium is defined as the presence of air inside the pericardial space. Usually, it is reported as a complication of blunt or penetrating chest trauma, but rare iatrogenic and spontaneous cases have been reported. Pneumopericardium is relatively stable if it does not generate a tension effect on the heart. However, it may progress to tension pneumopericardium, which requires immediate pericardial aspiration. We report a case of iatrogenic pneumopericardium occurred in a 70-year-old man who presented dyspnea at emergency department. The patient underwent pericardiocentesis for cardiac tamponade due to large pericardial effusion, and iatrogenic tension pneumopericardium occurred due to misuse of the drainage device. After evacuating the pericardial air through the previously implanted catheter, the patient became stable. We report this case to increase the awareness of this fatal condition and to help increase the use of precautions against the development of this condition during emergency procedures.
Aged ; Cardiac Tamponade/etiology ; Drainage ; Dyspnea/diagnosis ; Emergency Medical Services ; Heart Ventricles/physiopathology ; Humans ; Male ; Medical Errors ; Pericardial Effusion/diagnostic imaging/*therapy ; *Pericardiocentesis ; Pneumopericardium/*diagnosis/therapy ; Tomography, X-Ray Computed

PURPOSE: As a first step towards reform of the emergency medical service system, we aimed to assess the current status of our emergency department triage systems and illustrated the current status and problems of the Korean emergency department triage system. METHODS: We conducted e-mail and telephone surveys of the triage officers of all 136 emergency medical centers in Korea. RESULTS: All 136 emergency departments responded to the survey. In Korea, a triage scale derived from the 'emergency symptoms based on the requirements of the Emergency Medical Service Act' is the most-used triage scale. We identified factors showing significant association with use of verified triage vs. unverified scales, including level of triage scale, type of hospital, type of emergency department, perception of problems regarding the triage scale, educational performance, and number of annual visits. CONCLUSION: Results of our survey showed that in Korea various kinds of triage scale are in use and the reliability and validity of more than half of them are unverified. Reform of the Korean national triage system is in progress and our survey findings should be helpful in guiding reorganization of the national triage systems of many countries.
Electronic Mail ; Emergencies ; Emergency Medical Services* ; Emergency Service, Hospital* ; Korea ; Patient Safety ; Reproducibility of Results ; Telephone ; Triage* ; Weights and Measures*

The purpose of this study was to evaluate the effects of routine haecho bibimbab (boiled rice with assorted seaweed mixtures) consumption on the bowel habits in humans. Forty free-living adults (female 38, male 2) participated in this study (mean age 41.2 +/- 7.5). After a baseline survey on general characteristics, life style and dietary habits, the participants were asked to consume haecho bibimbab during two-week period for lunch. Habitual bowel movements were checked out every day by a questionnaire and nutrient intake was estimated by a 24-hour recalls before and after the study. After 2 weeks of clinical trial, the bowel habits had improved. Haecho bibimbab increased the number of bowel movements, changed hard stools into softer ones. It also lessen the sense of incomplete evacuation, and abdominal pain during defecation, increased water intake (p < 0.001) and improved gastrointestinal problem. The participants believed that haecho bibimbab was effective in improving their constipation symptoms and bowel habits (p < 0.01). Routine haecho bibimbab consumption tended to increase especially vitamin A, E and folate intake (p < 0.01). The present findings suggest that routine seaweed-based lunch meal (haecho bibimbab) consumption may improve bowel habits without side effects.
Abdominal Pain ; Adult ; Constipation ; Defecation ; Drinking ; Folic Acid ; Food Habits ; Humans ; Life Style ; Lunch ; Male ; Meals ; Surveys and Questionnaires ; Seaweed ; Vitamin A

A 3-month-old female Maltese puppy was hospitalized with persistent diarrhea in a local veterinary clinic. Blood chemistry and hematology profile were analyzed and fecal smear was examined. Diarrheal stools were examined in a diagnostic laboratory, using multiplex real-time polymerase chain reaction (PCR) against 23 diarrheal pathogens. Sequence analysis was performed using nested PCR amplicon of 18S ribosomal RNA. Coccidian oocysts were identified in the fecal smear. Although multiplex real-time PCR was positive for Cyclospora cayetanensis, the final diagnosis was Cystoisospora ohioensis infection, confirmed by phylogenetic analysis of 18S rRNA. To our knowledge, this the first case report of C. ohioensis in Korea, using microscopic examination and phylogenetic analysis.
Animals ; Chemistry ; Cyclospora ; Diagnosis ; Diarrhea ; Dogs ; Female ; Hematology ; Humans ; Infant ; Korea ; Oocysts ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; RNA, Ribosomal, 18S ; Sequence Analysis

alpha-Lipoic acid and L-carnosine are powerful antioxidants and are often used as a health supplement and as an ergogenic aid. The objective of this study was to investigate the effects of alpha-lipoic acid and/or L-carnosine supplementation on antioxidant activity in serum, skin, and liver of rats and blood lipid profiles for 6 weeks. Four treatment groups received diets containing regular rat chow diet (control, CON), 0.5% alpha-lipoic acid (ALA), 0.25% alpha-lipoic acid + 0.25% L-carnosine (ALA + LC), or 0.5% L-carnosine (LC). Superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and lipid peroxidation products, malondialdehyde (MDA) concentrations, were analyzed in serum, skin, and liver. Blood lipid profiles were measured, including triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C). Skin and liver SOD activities of the ALA and LC groups were higher than those of the CON group (P < 0.05), but serum SOD activity was higher only in the LC group compared to that in the CON group (P < 0.05). Additionally, only liver GSH-Px activity in the LC group was higher than that of the CON and the other groups. Serum and skin MDA levels in the ALA and LC groups were lower than those in the CON group (P < 0.05). Serum TG and TC in the ALA and ALA + LC groups were lower than those in the CON and LC groups (P < 0.05). The HDL-C level in the LC group was higher than that in any other group (P < 0.05). LDL-C level was lower in the ALA + LC and LC groups than that in the CON group (P < 0.05). Thus, alpha-lipoic acid and L-carnosine supplementation increased antioxidant activity, decreased lipid peroxidation in the serum, liver, and skin of rats and positively modified blood lipid profiles.
Animals ; Antioxidants ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diet ; Glutathione Peroxidase ; Lipid Peroxidation ; Lipoproteins ; Liver ; Malondialdehyde ; Rats ; Skin ; Superoxide Dismutase ; Thioctic Acid ; Triglycerides

Pumpkins have considerable variation in nutrient contents depending on the cultivation environment, species, or part. In this study, the general chemical compositions and some bioactive components, such as tocopherols, carotenoids, and beta-sitosterol, were analyzed in three major species of pumpkin (Cucurbitaceae pepo, C. moschata, and C. maxima) grown in Korea and also in three parts (peel, flesh, and seed) of each pumpkin species. C. maxima had significantly more carbohydrate, protein, fat, and fiber than C. pepo or C. moschata (P < 0.05). The moisture content as well as the amino acid and arginine contents in all parts of the pumpkin was highest in C. pepo. The major fatty acids in the seeds were palmitic, stearic, oleic, and linoleic acids. C. pepo and C. moschata seeds had significantly more gamma-tocopherol than C. maxima, whose seeds had the highest beta-carotene content. C. pepo seeds had significantly more beta-sitosterol than the others. Nutrient compositions differed considerably among the pumpkin species and parts. These results will be useful in updating the nutrient compositions of pumpkin in the Korean food composition database. Additional analyses of various pumpkins grown in different years and in different areas of Korea are needed.
Arginine ; beta Carotene ; Carotenoids ; Cucurbita ; Fatty Acids ; gamma-Tocopherol ; Korea ; Linoleic Acid ; Linoleic Acids ; Nutritive Value ; Seeds ; Sitosterols ; Tocopherols

OBJECTIVE: We aimed to describe electrocardiographic (ECG) findings in spontaneous pneumothorax patients before and after closed thoracostomy. METHODS: This is a retrospective study which included patients with spontaneous pneumothorax who presented to an emergency department of a tertiary urban hospital from February 2005 to March 2015. The primary outcome was a difference in ECG findings between before and after closed thoracostomy. We specifically investigated the following ECG elements: PR, QRS, QTc, axis, ST segments, and R waves in each lead. The secondary outcomes were change in ST segment in any lead and change in axis after closed thoracostomy. RESULTS: There were two ECG elements which showed statistically significant difference after thoracostomy. With right pneumothorax volume of greater than 80%, QTc and the R waves in aVF and V5 significantly changed after thoracostomy. With left pneumothorax volume between 31% and 80%, the ST segment in V2 and the R wave in V1 significantly changed after thoracostomy. However, majority of ECG elements did not show statistically significant alteration after thoracostomy. CONCLUSION: We found only minor changes in ECG after closed thoracostomy in spontaneous pneumothorax patients.
Electrocardiography* ; Emergency Service, Hospital ; Hospitals, Urban ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracostomy*

In this study, we investigated that anti-inflammatory effect of quercetin on picryl chloride(PCL)-induced contact dermatitis in BALB/c Mice. Experimental animals were divided into three groups and comprising five animals. All groups of oral administration was begun on the first day of PCL treatment and ceased on day 5. For the induction of contact dermatitis, BALB/c mice were sensitized with 40 microliter of 1.5% picryl choloride (PCL) to the left and right ear, respectively. Ear swelling responses were much weaker in high-dose group (100 mg/kg) than control group (0 mg/kg). Total serum IgE levels and histamine levels were measured by sandwich ELISA method using mouse IgE, histamine measuring Kit. Both total serum IgE and histamine levels were significantly decreased in high-dose group (100 mg/kg) than other groups. Degranulation of mast cells were also confirmed by Toluidine Blue (TB) staining method. In high-dose group (100 mg/kg), the number of mast cells were significantly decreased and there are many mast cells were shown degranulation in control group (0 mg/kg). All of these results demonstrate that the pharmacological actions of quercetin indicate their potential activity for allergic inflammatory diseases through the down-regulation of mast cell activation.
Administration, Oral ; Animals ; Dermatitis, Contact ; Down-Regulation ; Ear ; Enzyme-Linked Immunosorbent Assay ; Histamine ; Immunoglobulin E ; Mast Cells ; Mice ; Picryl Chloride ; Quercetin ; Tolonium Chloride

OBJECTIVESTo investigate the hair growth-promoting effect of Miscanthus sinensis var. purpurascens (MSP) flower extracton on in vitro and in vivo models.

METHODSMSP flower extract was extracted in 99.9% methanol and applied to examine the proliferation of human dermal papilla cells (hDPCs) in vitro at the dose of 3.92-62.50 μg/mL and hair growth of C57BL/6 mice in vivo at the dose of 1000 μg/mL. The expression of transforming growth factor β1 (TGF-β1), hepatocyte growth factor (HGF), β-catenin, substance P was measured by relative quantitative realtime polymerase chain reaction. Histopathological and immunohistochemical analysis were performed.

RESULTSMSP (7.81 μg/mL) down-regulated TGF-β1 and up-regulated HGF and β-catenin in hDPCs (P<0.01). MSP (1000 μg/mL)-treated mice showed the earlier transition of hair follicles from the telogen to the anagen phase. The number of mast cells was lower in the MSP-treated mice than in other groups (P<0.05 vs. NCS group). Substance P and TGF-β1 were expressed in hair follicles and skin of the MSP group lower than that in negative control. Stem cell factor in hair follicles was up-regulated in the MSP-treated mice (P<0.01).

CONCLUSIONSThe MSP flower extract may have hair growth-promotion activities.

Animals ; Antioxidants ; pharmacology ; Cell Count ; Cell Proliferation ; drug effects ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Female ; Flowers ; chemistry ; Hair Follicle ; cytology ; drug effects ; growth & development ; Hepatocyte Growth Factor ; metabolism ; Humans ; Mast Cells ; cytology ; Mice, Inbred C57BL ; Phosphorylation ; drug effects ; Plant Extracts ; pharmacology ; Poaceae ; chemistry ; RNA, Messenger ; genetics ; metabolism ; Skin ; metabolism ; Stem Cell Factor ; metabolism ; Stress, Psychological ; pathology ; Substance P ; metabolism ; Transforming Growth Factor beta ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; beta Catenin ; metabolism