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

OBJECTIVES: The most frequently cited health related slogan in North Korea is that socialistic medicine is preventive medicine. It implies that North Korea puts preventive medicine at the operational center of its national health care system. This study aimed at examining and comparing preventive medicine practices in North Korea with those of South Korea. METHODS: Efforts have been made to obtain a textbook for analysis its contents. Many people have iassisted in the study by joining the interview. Some of these people are as follows: a former professor of PyongYang Medical School, NK physicians living in South Korea, WHO staffs, diplomatic officials, etc. The major items of analysis consisted of industrial medicine and hygiene, nutrition, school health, epidemiology, health statistics and heath policy & management. RESULTS: Public health philosophy is finely rooted and well integrated in the operation of the North Korean national health care system, particularly in the area of industrial medicine and hygiene. Preventive medicine with a strong health surveillance system spanning a number of broad social organizations is a major tool to improve the health of the people in North Korea. The emphasis on preventive medicine has a close relationship with the 'Juche Philosophy' and the shortage of pharmaceuticals and medical equipment. To cope with the shortage problem, North Korean health workers are encouraged to grow medicinal herbs. We have found that they put little effort into teaching newly emerging diseases, such as AIDS, VDT syndrome, hazards of EMF, and agricultural chemical poisonings. Of the subjects of the preventive medicine text, 78.9% coincide with those of South Korean industrial health manuals and 34.2% with South Korean epidemiology texts. However, an absolute difference was found to exist between the heath policies and management systems. CONCLUSION: In North Korea, the concept of preventive medicine functions as the basic philosophic strategy of the national health care system. It differs greatly from the South Korean system in both practice and educational content. Its contribution to society is simply incomparable to that of South Korea. More communication and further study is called for in order to improve the preventive medicine practices in the future.
Delivery of Health Care ; Democratic People's Republic of Korea* ; Epidemiology ; Hygiene ; Korea ; Occupational Health ; Occupational Medicine ; Philosophy ; Plants, Medicinal ; Poisoning ; Preventive Medicine* ; Public Health ; School Health Services ; Schools, Medical

No abstract available.
Pregnancy* ; Primary Ovarian Insufficiency*

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

Aneurysms arising from ICA bifucation are relatively rare. But they are paticulary difficult to treat surgically because of perforating arteries surrounding and adherent to the aneurysm. In an effort to determine their best management policy, and to improve their surgical outcome, a retrospective clinical analysis of 30 patients who underwent direct surgery from ICA bifucation aneurysm between January, 1984 and December, 1994 was performed. In the same period, total 990 patients with intracranial aneurysms were admitted in our department. The result of carotid bifucation aneurysm surgery was worse than the total surgical result. Motality and morbidity rates were 3/30(10%), 5/30(16%). Surgical complications in this group of aneurysms usually came from injury of perforating arteries, and the causes of death were intraoperative premature rupture and vasospasm. The surgical treatment of aneurysms of internal carotid bifucation is discussed, emphasizing the importance of avoiding damage to perforating vessels and premature rupture. A classification of these aneurysms, according to angiographic and anatomical considerations, is proposed. We suggest that four types of aneurysmal orientation at the bifucation of the internal carotid artery be distinguished:either projecting superiorly, anteriorly, inferiorly, or posteriorly. Posterior orientation was found in 13 cases(43.3%). Superior orientation was found in 11 cases(36.7%), inferior orientation was found in 4 cases(13.3%), and anterior orientation was found in 2 cases(6.7%). From an analysis of these cases and a review of the literature, some characteristics of these aneurysms and their surgical strategies are described.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Cause of Death ; Classification ; Humans ; Intracranial Aneurysm ; Retrospective Studies ; Rupture

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

Purpose: Herein is reported our initial experience of the CyberKnife to show its safety and feasibility as a treatment modality for non-metastatic prostate cancer. Materials and Methods: Twenty patients, with biopsy-proven prostate cancers, were recruited into a phase I clinical trial using the CyberKnife. The distribution of clinical risks, as assessed using the ASTRO criteria, was as follows: low (4), intermediate (5) and high (11). The mean age and follow up of the patients were 71.4 years and 15 months, respectively. The patients received 7.5-9Gy of radiation in a single fraction for 4-5 days. The total radiation dose to the prostate was 34-37.5Gy, which approximates to 86.4Gy in 2Gy fractions. The rectal and bladder acute toxicities were graded using the criteria of the Radiation Therapy Oncology Group (RTOG). The results of acute toxicities were compared to those of the historical control, which had been treated with conventional four field box techniques (received median dose 70.2Gy). The prostate-specific antigen (PSA)- based short-term efficacy was described. Results: The acute rectal toxicity scores were 0, 1 and 2 in 13, 5, and 2 patients, respectively. The acute bladder toxicity scores were 0, 1 and 2 in 16, 3 and 1 patient, respectively. No grade 3 or 4 acute toxicity was noted. These figures contrast sharply with those found for the historical control. All toxicities spontaneously subsided within 3 months after treatment. Continuous PSA reduction was noted in all patients, and no PSA failure was noted during the follow up period. Conclusions: Our data show the feasibility of the CyberKnife in terms of its efficacy and acute toxicity. Moreover, the capability of using a hypo-fractionation schedule lead to marked improvement in patient convenience, with substantial resource savings.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Income ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Urinary Bladder

The characteristic pathological lesions in ankylosing spondylitis are vertebral body osteoporosis, ankylosis of the apophyseal joints, intervertebral disc calcification, and ligamentous ossification. Calcification of the annulus fibrosis reduces the movement and elasticity of the intervertebral disc, causing this point to be the site of least resistance when the spine is subjected to trauma. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. The ligamentous fragility and multiple fused vertebral segments cause the fractured ankylosing spondylitic spine to resemble a long-bone fracture. In ankylosing spondylitis patient who have sustained minor trauma, a complete radiological study of the entire spine and not just the symptomatic region must be performed for an accurate diagnosis, so that any fracture possible along the spine can be detected and thus prevent any medicolegal problems. The authors report 4 cases of ankylosing spondylitis including 2 cases with severe neurological abnormalities that had occurred after minor trauma.
Ankylosis ; Diagnosis ; Elasticity ; Fibrosis ; Humans ; Intervertebral Disc ; Joints ; Ligaments ; Osteoporosis ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*