STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

A case of malignant synovioma of the right knee joint is presented. Microscopically it showed sarcomatous growth of spindle cells and irregular slit spaces which were lined by tumor cells. A–K amputation has carried out on 10th hospital day and discharged on 30th hospital day without any complications.
Amputation ; Knee Joint ; Sarcoma, Synovial

A case of eosinophilic granuloma in 38-year-old male was reported. The patient was admitted with chief complaints of pain on the left thigh, tenderness and limping associated with localized swelling on upper 1/3 of left thigh. The diagnosis was confirmed by radiological evidence and biopsy findings. This case was healed completely by curettage. The review of literature was made briefly.
Adult ; Biopsy ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Eosinophils ; Humans ; Male ; Thigh

PURPOSE: To describe the clinical experience and safety profile of a combination of 23-gauge and 20-gauge transconjunctival sutureless vitrectomy (TSV) METHODS: Thirty-seven eyes of thirty-seven consecutive patients who underwent 23-gauge combined with 20-gauge transconjunctival vitrectomy surgery by a single surgeon from August 2006 through December 2006 were reviewed retrospectively for surgical indications, wound problems, and postoperative complications. RESULTS: Thirty-seven eyes, including eyes with proliferative diabetic retinopathy (n=24), macular hole (n=3), epiretinal membrane (n=3), vitreous hemorrhage due to branch retinal vein occlusion and choroidal neovascular membrane (n=3), vitreous opacity secondary to uveitis (n=1), rhegmatogenous retinal detachment (n=1), and vitreoretinal traction syndrome (n=1), underwent operation. Seven eyes at 23-gauge sclerotomy sites and 15 eyes at 20-gauge sclerotomy sites had subconjunctival hemorrhage. Three eyes required sutures at 20-gauge sclerotomy sites intraoperatively due to wound leakage. One wound hemorrhage occurred at a 23-guage sclerotomy site. Vitreous hemorrhage (4 eyes), hyphema (2 eyes), and vitreous hemorrhage with hyphema (1 eye) occurred postoperatively. Postoperative hypotony, retinal detachment, and other complications did not occur. CONCLUSIONS: A combination of 23-gauge and 20-gauge transconjunctival sutureless vitrectomy which was created by modifying transconjunctival sutureless vitrectomy systems published previously guarded against sclerotomy wounds and a variety of vitreoretinal surgical indications.
Choroid ; Diabetic Retinopathy ; Epiretinal Membrane ; Eye ; Hemorrhage ; Humans ; Hyphema ; Membranes ; Retinal Detachment ; Retinal Perforations ; Retinal Vein Occlusion ; Retrospective Studies ; Sutures ; Traction ; Uveitis ; Vitrectomy ; Vitreous Hemorrhage

OBJECTIVE: To investigate the clinical significance of endometrial thickness and pattan as a predictor of successful implantation of embryos in ovum donation and cryopreserved-thawed embryo transfer program. METHODS: From January, 1996 to March, 1998, 31 cycles of ovum donation and 31 cycles of cryopreserved-thawed embryo transfer were enrolled in this prospective study. Endometrial thickness was measured three times: prior to progesterone administration (P), 1 day and 3 days after P. In cryopreserved-thawed embryo transfer cycles, the measurement at 1 day after P was omitted. Endometrial pattern was observed prior to progesterone, and was considered meaningful when a multi-layered triple-line was seen with prominent outer and central hyperchogenic lines and inner hypoechogenic regions. RESULTS: There were no differences in embryo quality, dose or duration of estrogen, and endometrial thickness or pattern between conception and non-conception cycles in both ovum donation and cryapreserved-thawed embryo transfer pmgram. In ovum donation cycles, no cortelation was observed between estrogen dose and endometrial thickness or pattern. In cryopreserved-thawed embryo transfer cycles, total estrogen dose and endometral thickness at 3 days after P has a inverse correlation, and estrogen dose over 4.3 mg per day can predict expression of a multi-layered triple-line pattern, CONCLUSION: Endometrial thickness or pattern. cannot predict a successful implantaion of embryos in both ovum donation and cryopreserved-thawed embryo transfer cycles.
Embryo Transfer* ; Embryonic Structures* ; Estrogens ; Fertilization ; Oocyte Donation* ; Ovum* ; Progesterone ; Prospective Studies

OBJECTIVE: To evaluate the maternal and fetal outcomes after transvaginal selective fetal reduction(SFR) in multifetal pregnancy. MATERIALS AND METHODS: Transvaginal SFR using fetal intracardiac puncture with KCl injection and aspiration of amniotic fluid was performed in 58 multifetal pregnancies achieved after assisted reproductive technology(ART). After transvaginal SFR, 55 twin and 3 singleton pregnancies were evaluated and analyzed retrospectively with the medical records of mothers and babies. RESULTS: Of 58 cases, abortion within 4 weeks after SFR occurred in 1 case(1.7%). Miscarriage of all fetuses occurred in 8 cases(13.8%) from 4 weeks after SFR until 24 weeks of gestation. Perinatal death occurred in 8 newborns from 5 mothers due to extreme prematurity in 7 cases and anencephaly in 1 case. Take-home baby rate, that is, discharge with at least 1 healthy baby, was 77.6%(45/58). CONCLUSION: Transvaginal SFR is an acceptable and effective management option in the cases of excessive multifetal pregnancy after infertility treatment. The ultimate successful outcomes of reduced multifetal pregnancy may be enhanced by more extensive experience with SFR.
Abortion, Spontaneous ; Amniotic Fluid ; Anencephaly ; Female ; Fetus ; Humans ; Infant, Newborn ; Infertility ; Medical Records ; Mothers ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Punctures ; Retrospective Studies

PURPOSE: To report a case of macular edema after the use of the oral hypoglycemic agent rosiglitazone. METHODS: A 43-year-old man, who had diabetic mellitus and was on oral rosiglitazone therapy, complained of a visual disturbance in his left eye. After fundus examination and optical coherence tomography, macular edema was observed, therefore rosiglitazone therapy was discontinued. RESULTS: After 2 weeks, his visual acuity improved, and macular edema decreased in the left eye on optical coherence tomography. CONCLUSIONS: Rosiglitazone use should be considered as one of the potential causes of macular edema.
Adult ; Humans ; Macular Edema* ; Tomography, Optical Coherence ; Visual Acuity

OBJECTIVE: Endocervical infection of Chlamydia trachomatis is one of the most common sexually transmitted diseases(STD) in women, and it usually disseminates into the upper genital tract, especially at the uterine exploration. This study was performed to investigate the prevalence rate of endocervical Chlamydia trachomatis in infertile women with the application of polymerase chain reaction(PCR) for the detection of Chlamydia trachomatis DNA. METHODS: From March, 1996 to October, 1999, endocervical swabs were obtained in 101 infertile patients at SNUH. Chlamydia trachomatis DNA was extracted and amplified by a commercially available Amplicor Chlamydia trachomatis PCR kit(Roche Diagnostics, Branch burg, USA). The clinical characteristics of infertile patients were reviewed and analyzed. RESULTS: The mean age was 31.0 years old, and the mean duration of infertility was 43.4 months. The prevalence rate of endocervical Chlamydia trachomatis in infertile patients was 4.0%(4/101). There was no significant difference in the prevalence rate of Chlamydia trachomatis infection among the different infertility factor groups: 7.1%(2/28) in tubal-peritoneal factor group, 8.3%(1/12) in cervical factor group, and 8.3%(1/12) in unexplained infertility group. Two patients suffered from chronic cervicitis. CONCLUSION: The application of PCR for the detection of Chlamydia trachomatis DNA was a rather rapid and accurate diagnostic method. Therefore, it could be recommended as a diagnostic test applicable to the routine infertility work-up.
Chlamydia Infections* ; Chlamydia trachomatis* ; Chlamydia* ; Diagnostic Tests, Routine ; DNA* ; Female ; Humans ; Infertility ; Polymerase Chain Reaction* ; Prevalence* ; Uterine Cervicitis

No abstract available.
Animals ; Female ; In Situ Hybridization ; Mice* ; Ovary*

A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively.
Actinomycosis/*complications ; Adult ; Case Report ; Colonic Diseases/*etiology/microbiology ; Female ; Human ; Intestinal Obstruction/*etiology/microbiology ; Pelvic Inflammatory Disease/*complications