BACKGROUND: To collect the data related to the prevention of death in pediatric patients in the emergency center, the authors made a clinical analysis of pediatric death patients who visited the emergency center of Wonkwang University Hospital. METHODS: The authors performed a retrospective analysis of 49 pediatric deaths under the age of 16 years, observed in the Wonkwang University Hospital emergency center from January 1st, 1995 to December 31th, 1996. RESULTS: 1) Among a total of 49 pediatric patients who died (24 patients in 1995 and 25 patients in 1996), 19 patients were dead on arrival and 30 were died after arrival. 2) The cause of death of all the patients of 1 to 5 years old was the accident, and that of the majority patients of less than 1 year was disease. 3) We observed the diurnal variation in pediatric death and the rate was higher between 12:00 to 6:00. P.M. 4) Iksan city was the most common place of residency of the patients(71.4%) 5) 36 patients (73.5%) died from traffic accidents and 29 of them were victims of pedestrian traffic accidents. 6) The most common cause of death in accidents was head injury(54%). CONCLUSION: The majority of the pediatric death patients observed in our emergency center was involved in pedestrian traffic accident, head injury, so we conclude that team approach with pediatric trauma specialist could decreased unwanted pediatric deaths.
Accidents, Traffic ; Cause of Death ; Child, Preschool ; Craniocerebral Trauma ; Emergencies* ; Head ; Humans ; Internship and Residency ; Jeollabuk-do ; Retrospective Studies ; Specialization

BACKGROUND: To collect the data related to the clinical analysis of suicidal attempters who visited the emergency center of WonKwang University Hospital. METHODS: The authors performed a retrospective analysis of 306 suicide attempters, observed in the WonKwang University Hospital Emergency Center from January 1st, 1998 to December 31th, 1998. RESULTS: 1) Factors related to increased occurrence were male(1.1:1), age of 2nd, 3rd & above 6th decade. 2) Poisoning was the most common method of suicidal attempt(90.8%). 3) The average observation time was 18.76+/-23.3 hour and average staying time in admitted patients were 40.4+/-32.3 hour. 4) Mortality rate was in male 23.1%(37/160) and in female 10.0%(15/146). 5) Among the suicidal attempters who admitted, 56 patients were admission(11.8%). 6) Consultant of neuropsychiatric department was only 10.5%(18/172), and most common underlying psychiatric disorder was depression(10/18). CONCLUSION: 1) To develope observation room decrease staying time in suicidal attempters. 2) All suicidal attempters were necessarily neuropsychiatric consultant and continuously follow-up.
Consultants ; Emergencies* ; Female ; Follow-Up Studies ; Humans ; Male ; Mortality ; Poisoning ; Retrospective Studies ; Suicide

BACKGROUND: It has been well known that cFos protein, one of the immediate-early gene proteins, was a cellular marker to characterize physiological or anatomical property of neural networks in mammalian brain. The purpose of this study was to evaluate quantitative change of cFos protein expression in rat brain nuclei concerned with regulation of blood pressure according to severity of hypotension and compare the spatial pattern of cFos between hemorrhagic hypotension and non-hemorrhagic hypotension elicited by vasodilatation. METHODS: The mean blood pressure (MBP) in the femoral artery was recorded by using pressure transducer and polygraph. Nitroprusside was injected into the femoral vein with constant flow rate by means of osmotic pump in which the dosage was 5microgram Per kg a minute. Immunohistochemical staining was Performed by using conventional ABC method to visualize cFos-like immunoreactive (cFLI) neurons in many brain nuclei and FLI cells were counted by image analyser. RESULTS: Mild hemorrhage group with MBP of 70-80 mmHg showed significant increase of cFLI expression in the paraventricular nuclei and supraoptic nuclei. In contrast, severe hemorrhage group with MBP of 50 mmHg increased significantly cFLI expression in the rostral ventrolateral medulla, periventricular thalamic nucleus, central gray matter, medial vestibular nuclei as well as the nuclei seen in mild hemorrhage group. Nitroprusside induced hypotension exhibited a similar spatial pattern of ctrl expression to severe hemorrhage group. CONCLUSION: These results suggest that severe reduction of blood pressure induces expression of cFLI neurons in the neural network systems that control vital organs.
Animals ; Blood Pressure ; Brain* ; Femoral Artery ; Femoral Vein ; Genes, Immediate-Early ; Hemorrhage ; Hypotension* ; Neurons ; Nitroprusside ; Rats* ; Transducers, Pressure ; Vasodilation ; Vestibular Nuclei

PURPOSE: The purpose of this study was to investigate the effect of systemic treatment of melatonin known as a potent free radical scavenger on expression of c-Jun proteins and brain-derived neurotrophic factor (BDNF) mRNA in transient global ischemia-reperfusion injury of rat brain. METHODS: Spargue-Dalwey rats were used and divided into three groups: ischemia group, ischemia group pretreated with melatonin, ischemia group posttreated with melatonin. Brain ischemia-reperfusion injury induced by occlusion of bilateral carotid and vertebral arteries (4-vessel occlusion) for 15 min followed by recirculation of cerebral blood flow. Animals were received intraperitoneal injection of melatonin (10 mg/kg) either 30 min before ischemia (pretreatment) or 0 min after reperfusion (posttreatment). Four vessel occlusion-reperfusion produced ischemic injury in major forebrain structures such as striatum, cortex, hippocampus in the finding of triphenyltetrazolium chloride (TTC) staining. Spectrophotometric assay for formazan, an end-product of TTC showed increased value of formazan formation in ischemic area of the brain posttreated with melatonin 24 hours after the ischemia-reperfusion injury. RESULTS: Posttreatment with melatonin caused a significant decreased in number of c-Jun immunoreactive neurons in CA1 region of the hippocampus after ischemia-reperfusion insult. Furthermore, autoradiographic density for BDNF mRNA in the hippocampus and cortex was increased by systemic treatment with melatonin especially in posttreatment group. CONCLUSION: These results suggest that melatonin treatment results in an attenuation of ischemic damage caused by ischemia-reperfusion in nueronal cells of the sensitive areas of rat brain.
Animals ; Brain* ; Brain-Derived Neurotrophic Factor* ; Hippocampus ; Injections, Intraperitoneal ; Ischemia ; Melatonin* ; Neurons ; Prosencephalon ; Proto-Oncogene Proteins c-jun* ; Rats* ; Reperfusion ; Reperfusion Injury* ; RNA, Messenger* ; Vertebral Artery

BACKGROUND: Despite the high suicide rate among the elderly, there is a relative lack of information on the outcomes for elderly people who have attempt suicide. METHODS: The authors performed a retrospective analysis of 260 elderly suicide cases observed in the WonKwang University Hospital Emergency Center from January, 1997 to December, 2000. RESULTS: 1) The male-to-female ratio was 1.71:1. 2) The major cause of the attempt was chronic pain or disease. 3) Poisoning was the most common method of suicidal attempt. 4) The mortality rate was 23.1%. CONCLUSION: Chronic pain or disease in the elderly indicates the need for mental health services.
Aged* ; Chronic Pain ; Emergencies ; Humans ; Mental Health Services ; Mortality ; Poisoning ; Retrospective Studies ; Suicide ; Suicide, Attempted*