BACKGROUND: Care for prehospital cardiac arrest is one of the major concerns of emergency medical services. But, in Korea, prehospital emergency medical service systems are not yet well established. We tried to offer one of the fundamental data for development of these systems. METHODS: After application of exclusion criteria, 183 patients who transferred to emergency center of our hospital after cardiac arrest in consecutive 24 months from Jan,1,1994 to Dec,31,1995 were included in this study. Retrospective review of the hospital charts of these patients was done. For statistical analysis, we divided patients to some categories. t-test or chi-square analysis was used. RESULTS: 24 patients of the 183 patients were secondary visitors(cardiac arrest was occurred during transfer from other hospitals), 159 patients were primary visitors. In the primary visitor group, only one third was ambulance visitors, and there is no statistical differences between arrest time of ambulance visitors and non-ambulance visitors(35+/-27 vs 37+/-24 min, p=NS). No organized bystander CPR was done. After arrival, 131 patients received CPR and 87 patients(66.4%) were not responded, 31 patients(23.1%) experienced transient ROSC, 13 patients(10.0%) survived until discharge, and only 2 patients(1.5%) were returned to their lives. CONCLUSION: We failed to find significant statistical survival differences between ambulance visitors and non-ambulance visitors, between presumed cardiac etiology group and non-cardiac etiology group. Survival rate was high in witnessed arrest group than unwitnessed arrest group(14.5% vs 2.1%, p=0.015).
Ambulances ; Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Survival Rate

Authors reviewed clinical records of 92 patients with tetanus from January 1974 to December 1983 at Severance Hospital and the following results wre obtained. 1) There were about 2.2 times more cases of neonatal tetanus than that of nonneonatal. The admitted cases of tetanus decreased in 1980's compared to those of 1970's. 2) The male versus female ratio was 3 : 1 not only in nonneonatal but also in neonatal teanus. 3) There was a tendency of higher mortality when the site of injury was on the central part of the body than on the distal. 4) Most cases of tetanus developed after the injury with bactrial contamination as expected, but a few cases are due to only trivial injury such as acupuncture or injection without overt contamination. 5) There was a close relationship between the incubation period and mortality in neonatal tetaus but no such definite relationship in nonneonatal tetaus. 6) The duraton of admission was about 3 weeks and the majority of deaths occureed in less than one week of admission. 7) There was no statistically significant difference in mortality between the group who used tetanus antitoxin from animal and that who used human tetanus immuneglobulin.
Acupuncture ; Animals ; Female ; Humans ; Male ; Mortality ; Tetanus Antitoxin ; Tetanus*

Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.
Anesthesia, General ; Calculi ; Child ; Death, Sudden ; Humans ; Incidence ; Intubation ; Lesch-Nyhan Syndrome ; Lithotripsy ; Movement Disorders ; Pneumonia, Aspiration ; Preschool Child ; Purines ; Renal Insufficiency ; Self-Injurious Behavior ; Uric Acid ; Urinary Tract

Authors experienced a case of A3B in a 46-year-old patient with liver cirrhosis and two cases of A3 in her children by family study. A3 subgroups were confirmed by delayed and weak positive with anti-A and anti-A,B, negative in anti-A1 lectin, adsorption-elution test, and family study. We report a family case of A3B and A3 with brief review of literatures.
Child ; Humans ; Liver Cirrhosis ; Middle Aged

PURPOSE: The effect of 0.2% cyclosporin A (CsA) as an adjuvant therapy after glaucoma-filtering surgery was the focus of this study. METHODS: A posterior lip sclerotomy was performed in 16 eyes of 8 rabbits, and 0.2% CsA was administered into the right eyes. The left eyes served as controls. The intraocular pressure (IOP) was measured 1, 3, 5, 7, 14, and 28 days after surgery. Hematoxylin-eosin (HE) and anti-bromodeoxyuridine (BrdU) immunocytochemical staining were performed at 1, 2, 4, and 8 weeks. RESULTS: The IOP at 7 and 14 days after surgery was lower in the 0.2% CsA group and statistically significant (P=0.047, P=0.48; respectively). HE staining did not show any difference between experimental and control eyes, but anti-BrdU staining showed a lower number of positive cells in the experimental eyes at 1 week. The fibroblast proliferation rate was significantly lower 1 week after surgery in the 0.2% CsA group (P=0.003). CONCLUSIONS: An effect of 0.2% CsA on early wound healing was observed. The data suggest that a low concentration of CsA can be useful when employed as adjuvant therapy in glaucoma filtering surgery.
Cyclosporine ; Eye ; Fibroblasts ; Filtering Surgery ; Glaucoma ; Intraocular Pressure ; Lip ; Pilot Projects ; Rabbits ; Wound Healing

The reliability of emergency ultrasonographic(US) detection of hemoperitoneum and solid organ injury in blunt abdominal trauma was evaluated retrospectively. From October 1,1995 to August 31,1996,90 patients were included in the study. Ultra- sonographic findings showed a sensitivity, specificity, and accuracy of 97.6%, 97.9%, and 98.1%, respectively, in detecting intraabdominal fluid collection. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. In our department, US has replaced diagnostic peritonaeal lavage(DPL) and computed tomography(CT) as the screening study of first choice.
Emergencies* ; Hemoperitoneum* ; Humans ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

Jimson weed, also known as Datura stramonium, is a member of the Solanaceae family. Jimson weed was used by American Indians for medicinal and religious purposes. All parts of the Jimson weed plant are poisons, containing the alkaloids atropine, hyoscyamine and scopolamine. So, it is caused by these components to make a anticholinergic toxicity within 6h after ingestion. Initial manifestations include dry mucus membrane, blurred, vision, thirst, difficulty swallowing and speaking, and photophobia, and may be followed by hyperthermia, confusion, agitation, combative behavior, hallucination, urinary retention, seizure and coma. We experienced two patients who developed combative behavior and agitation with pupil dilation caused by Jimson weed. They discharged with improvement after supportive for 2days.
Alkaloids ; Animals ; Atropine ; Coma ; Comb and Wattles ; Datura stramonium* ; Deglutition ; Dihydroergotamine ; Eating* ; Fever ; Hallucinations ; Humans ; Hyoscyamine ; Indians, North American ; Membranes ; Mucus ; Photophobia ; Plants ; Poisons ; Pupil ; Scopolamine Hydrobromide ; Seizures ; Solanaceae ; Thirst ; Urinary Retention

No abstract available.
Wolf-Hirschhorn Syndrome*

BACKGROUND: The prompt detection of bacteremia continues to be one of the most important responsibilities of clinical microbiology. But clinical diagnosis of bacteremia remains difficult, particularly in the neonates and young children. And fastidious bacteria with specific growth requirements or bacteria requiring longer incubation period are apt to be negative results in blood cultures. Therefore, polymerase chain reaction (PCR) amplification which targets the highly conserved DNA sequences found in all eubacteria would permit fast and sensitive determination of the presence of bacteria in blood. METHODS: A primer pair (DG74, RW01) for highly conserved regions of bacterial DNA encoding 16S ribosomal RNA (rRNA) was utilized for PCR amplification. PCR results were compaired with blood cultures and PCR products were digested with SmaI restriction enzyme for cutting of recognition site. RESULTS: Among 44 blood specimens which organisms were isolated by blood culture, 41 samples were positive for PCR, and 3 samples which C. albicans, P. aeruginosa, and gram- positive bacillus isolated were negative. No signal was observed when blood obtained from person without clinical sign and or symptoms of bacteremia. All 41 PCR products (371 bp) were cutted in two DNA fragments (161 bp, 210 bp) by SmaI enzyme. CONCLUSIONS: We concluded that a single primer pair designed to anneal to a highly conserved region of bacterial DNA can amplify DNA specimens from different bacteria, while not amplifying human DNA. Because of early detection, molecular trial of patients with signs and symptoms of possible bacterial infection will decrease morbidity and mortality with bacteremia, this approach may make it possible to identify new, nonculturable bacterial pathogens. Furthermore, if we use the specific primers for gram positive or negative bacteria in PCR method, it would be a more useful diagnostic tool for the clinicians.
Bacillus ; Bacteremia* ; Bacteria* ; Bacterial Infections ; Base Sequence ; Child ; Diagnosis* ; DNA ; DNA, Bacterial ; Humans ; Infant, Newborn ; Mortality ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S

A 44-year-old woman underwent a breast cancer operation under general anesthesia. We performed bronchoscope guided intubation along with a jaw thrust maneuver on the patient to achieve a good visual field. The patient complained of left lower lip weakness after the operation. The lower lip of the patient was deviated to the right. The cause might have been a temporary compression of the left facial nerve at the mandibular angle during performance of the jaw thrust maneuver. Fortunately, the patient's palsy recovered completely during the following one month. We report here on a case of transient facial nerve palsy after general anesthesia, and this occurred despite performing a very short duration of jaw thrust.
Adult ; Anesthesia, General ; Breast Neoplasms ; Bronchoscopes ; Facial Nerve ; Female ; Humans ; Intubation ; Jaw ; Lip ; Paralysis ; Visual Fields