The author measured the value of serum triglyceride, total cholesterol and phospholipid in normal Korean adults and patients with complicated hypertension. Sera obtained from 295 cases of normal Korean male and female, and also 109 cases of patients with hypertension were analysed for triglyceride, cholesterol and phospholipid. The patterns of serum lipoprotein fraction in 171 normal Korean and 109 patients with complicated hypertension including cerebrovascular diseases and ischemic heart disease were studied by agarose gelelectrophoresis. The results are summarized as follows; 1. The mean value of serum triglyceride, cholesterol and phospholipid in normal Korean were 85.4+/-20.5mg%, 187.9+/-16.7mg%, and 193.4+/-34.6mg% respectively. 2. Sex and age difference showed no statistical significance in the mean values of serum triglyceride, cholesterol and phospholipid in hypertensive patients. 3. The mean values of serum triglyceride in the patients with complicated hypertension such as cerebral thrombosis gave higher value than in the patients with other cerebral complications. 4. The mean value of alpha-lipoprotein, pre-beta-lipoprotein and beta-lipoprotein in normal Korean were 29.6+/-5.0% (142.6+/-30.1mg%), 13.0+/-4.3% (62.7+/-24.8mg%), and 57.4+/-30.1% (276.1+/-56.6mg%) respectively. 5. The alpha-lipoprotein fraction in normal Korean demonstrated the tendency of decreasing as age is progressing in both sex, but pre-beta and beta-lipoprotein fraction gave a tendency of increasing by progressing age in both sex, but was not confirmatory in nature. 6. The alpha-lipoprotein fraction in patients with hypertension gave lower value than in the normal subjects, but the value of pre-beta and beta-poprotein were elevated significantly among patients with complicated hypertension than in normal person. 7. The incidence of hyperlipidemia in normal Korean and patients with hypertension were 31.9% and 66.5% respectively. 8. The relative incidences of hyperlipidemic probable phenotypes in normal Korean were as follows: 7% of normal person had Type II (IIa 3.3%, IIb 3.7%), 3.5% had Type III, and 21.4% had Type IV.
Adult* ; Cholesterol ; Female ; Humans ; Hyperlipidemias ; Hypertension* ; Incidence ; Intracranial Thrombosis ; Lipoproteins* ; Male ; Myocardial Ischemia ; Phenotype ; Sepharose ; Triglycerides

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

No abstract available.
Adrenocortical Carcinoma* ; Stomach Neoplasms*

PURPOSE: Intraosseous (IO) is an alternative vascular access method for critically ill patients, especially pediatric arrest patients. This study was aimed to evaluate the effect of the education on pre-hospital IO Access of Level 1 Emergency Medical Technicians (Level-1 EMTs). METHODS: Forty four Level-1 EMTs participated in the IO educational program at Seoul Fire Academy. The IO educational program was consisted of a one-hour lecture followed by a one-hour practical training about the use of the powered device (EZ-IO) to artificial bones. Before and after the program, the knowledge and attitude about IO access were measured with 5 points-scale (1 in lowest and 5 in highest positive response) by the structured questionnaire. After the program, the participants were tested on skill performance (success rate of insertion and procedural time) of IO access. RESULTS: The mean working time and age of participants was 7.6+/-2.4 years and 32.1+/-4.2 years, respectively. Median score (5%~95%) of knowledge about indication of IO access was increased from 2(1-4) to 4(3-5) (p<0.01). Median score (5%~95%) on attitude was improved from 2(1-4) to 4(2-5) (p<0.01). Twelve EMTs (30.7%) showed negative response on IO access in the prehospital area. The success rate of insertion at first time was 84.1% and the mean time to success was 45.5+/-9.4 seconds. CONCLUSION: After 2 hour educational program for Level-1 EMTs, the knowledge and attitude of IO access improved significantly and skill performance was very excellent. We can consider the prehospital IO access of level-1 EMTs in Korea.
Critical Illness ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Fires ; Humans ; Mandrillus ; Surveys and Questionnaires

PURPOSE: As emergency ultrasound (EUS) can improve the management of emergency department patients, education in EUS has become an essential part of emergency medicine resident training. This study examined the efficacy of pediatric EUS education for resident physicians 6 months after training. METHODS: A survey was conducted on emergency medicine resident physicians who participated in the Pediatric Emergency Ultrasound Course in November 2014, which is a training program of pediatric EUS generated by Korean Society of Pediatric Emergency Medicine and Society of Emergency and Critical Care Imaging. The instructor checked the list to evaluate attendee after the course. After the course, resident physicians have been encouraged to use EUS at the patient's bedside, and the same list was checked 6 months after the course. At the same time, a survey of the number of experience of EUS during the 6 months was performed. RESULTS: Ten emergency resident physicians of Seoul National University of Hospital participated in the course and all attendees were re-evaluated 6 months after the course. The mean initial score immediately after the course and that at the 6 months follow-up was 28.6±3.13 and 20.8±3.79, respectively (p < 0.05). No significant relationship was observed between the difference score and the EUS experience number, including the observations of the other physician's EUS (p=0.603) and hands-on by themselves (p=0.771). CONCLUSION: Although a EUS education program could improve the resident physician's ability, the effect decreased with time. Hence, the resident physician's EUS ability cannot be maintained via simple emergency department duty. Therefore, the education program should be repeated regularly.
Critical Care ; Education* ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Seoul ; Ultrasonography*

BACKGROUNDS: As Korea has advanced into the aging society, Acute Coronary Syndrome is increased in number, especially elderly age group. The symptoms of acutecoronary syndrome in eldery were presented in atypical feature frequently. We studied the relation of the first symptom and diagnosis of acutecoronary syndrome and distribution of risk factor and coronary angiographic finding in elderly patient of korea society. METHODS: The subjects who were under went coronary angiography between 2002.5 and 2003.8 were dividedunder 65 years old group and over 65 years old group. And each group described diagnosis, risk factor, first symptom and coronary angiographic finding retrospectively. RESULTS: The diagnosis of unstable angina are more higher(46.5% vs. 26.1%, p<0.01) in the over 65 years old group and the first significant symptom of typical chest pain was more higher(57.4% vs. 47.6%, p<0.01) in the under 65 years old group and dyspnea was more higher(22.8% vs. 9.2%, p<0.01) in the over 65 years old group. The number of abnormal vessel were more higher(66.3% vs. 46.9%, p<0.01) in the over 65 years old group. CONCLUSION: Over 65 years old group compared with younger age group were prewented more frequently angina equivalent symptom than typical chest pain. And at the diagnosis of Acute Coronary Syndrome, over 65 years old group showed more severe coronary angiographic finding. Consequently, early stage of diagnostic approach and treatment need scrupulous attention in the elderly patients.
Acute Coronary Syndrome* ; Aged* ; Aging ; Angina, Unstable ; Chest Pain ; Coronary Angiography ; Diagnosis* ; Dyspnea ; Humans ; Korea* ; Retrospective Studies ; Risk Factors

BACKGROUND: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, over- weight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent de- velopment of type 2 diabetes mellitus and cardiovascular disease, especially coronary heart disease. The aim of the study is to assess the relationship between metabolic syndrome and coronary heart disease in elderly greater than 65 years old. METHODS: Eighty two elderly patients greater than 65 years old who underwent coronary angiography were divided into two groups with metabolic syndrome or without metabolic syndrome, and assessed the association with coronary angiographic finding. The metabolic syndrome factors and cardiovascular risk factors of JNC 7 were investigated to assess the relationship with coronary heart disease in elderly. Coronary heart disease was defined as 50% or greater diameter in stenosis of coronary artery in coronary angiography. RESULTS: In elderly patients with metabolic syndrome, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p<0.05) were presented significantly higher than non metabolic syndrome patients. In elderly patients with 3 and more cardiovascular risk factors of JNC 7, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p=0.059) were presented more than the other patients. Diabetes mellitus was related significantly with coronary heart disease(p value 0.044). CONCLUSION: In elderly patients, metabolic syndrome was significantly related with coronary heart disease and diabetes mellitus had strong relationship with coronary heart disease. Metabolic syndrome and cardiovascular risk factors of JNC 7 should be further evaluated to assess the relationship with coronary heart disease in the future.
Abdominal Fat ; Aged* ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease* ; Coronary Vessels ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Glucose ; Heart ; Humans ; Hypertension ; Insulin ; Metabolism ; Risk Factors

PURPOSE: Approximately 29% of patients visiting the emergency department are children and teens. Training emergency medicine (EM) residents for treatment of pediatric emergency patients is essential. We conducted a survey of the status of pediatric emergency medicine (PEM) education and made recommendations with regard to the direction of educational programs for PEM using the Delphi method. METHODS: We conducted a survey of 93 emergency medicine training hospitals and conducted the Delphi study with the first and second round. Variables of educational status included general information on the hospital, educational contents, and method for PEM. The Delphi method was used to obtain the consensus of experts with regard to which objectives, essential procedures, and necessary components for PEM training should be included. RESULTS: The rate of response for PEM educational status was 60(62.4%). The type of pediatric department rotation was essential 40.5%, optional 21.4%, and no rotation 38.1%. Capability of EM residents was 33.3% in PEM objectives and 45% in PEM procedures. Each rate of response for the Delphi study was 65% in the first round and 56.9% in the second round. We obtained the consensus of experts, with 52 of 59 objectives and 18 of 20 procedures. The appropriate period for pediatric emergency rotation was three months and the appropriate staff members for pediatric emergency education were the pediatric emergency physician, pediatric physician, and emergency physician, in order. CONCLUSION: Pediatric emergency training was not appropriate for an EM residency program. Experts agreed with 52 objectives and 18 procedures for PEM training of EM residents. We recommended a training period of three months and the appropriate staff member for PEM was the pediatric emergency physician.
Adolescent ; Child ; Consensus ; Curriculum ; Delphi Technique ; Educational Status ; Emergencies ; Emergency Medicine ; Humans ; Internship and Residency ; Pediatrics

A 51-year old woman was admitted to our hospital because of Exertional dyspnea, Palpitation, Headache, upper-limb hypertension, and lower-limb claudication. A loud systolic bruit was audible along Lt. carotid artery. Upper limb hypertension was responsed to drug moderately (included ACEI, alpha, beta-blocker, Ca++-channel blocker), but claudication of lower limb was aggravated, also on exertion, Blood Pressure of upper-limb was elevated to 180 mmHg. So, chest CT and Aortogram was performed, we confirmed long segmental stenosis from thorasic Aorta to the renal a. bifurcation level. Finally, We performed after axillo-femoral bypass surgery. After surgery, upper limb hypertension and lower limb claudication was improved.
Aorta ; Blood Pressure ; Carotid Arteries ; Constriction, Pathologic ; Dyspnea ; Female ; Headache ; Humans ; Hypertension ; Lower Extremity ; Middle Aged ; Takayasu Arteritis ; Tomography, X-Ray Computed ; Upper Extremity

Injury is a leading cause of death and disability in children and adolescents worldwide. The purpose of the current study was to investigate the epidemiologic characteristics of the pediatric unintentional injuries presenting to the Korean emergency department (ED). We included unintentional injuries in patients aged < 20 yr. Data collected from January 2010 to December 2011 was extracted from the National Emergency Department Information System (NEDIS) of Korea. The NEDIS data included information on patient's age and gender, geographic location of the ED visits, mechanism of injuries; and clinical outcomes. Most (94.1%) injuries were unintentional while 5.9% were intentional. The rate of ED visit for pediatric unintentional injury was 6,097 per 100,000 and critical injury was 59.8 per 100,000 (< 20 yr habitants). The mortality rate was 5.4 per 100,000. The mortality rate of pediatric unintentional injuries was 0.1% including the prehospital death and ED death. Unintentional pediatric injuries occurred most commonly in those age 0-4 boys and girls and were predominantly caused by collisions. Male motorcyclists aged 15-19 yr formed a critical injury high-risk group. The rates of critical injury and mortality were highest in Jeju, Gangwon, Gwangju, and Jeonbuk than those in other regions. High-risk groups by age, gender, mechanism and region should be targeted to prevent pediatric injuries in Korea.
Accidents, Traffic/*mortality ; Adolescent ; Age Distribution ; Child ; Child, Preschool ; Emergency Service, Hospital/*statistics & numerical data ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Regional Medical Programs/*statistics & numerical data ; Risk Assessment ; Risk Factors ; Sex Distribution ; Survival Rate ; Wounds and Injuries/diagnosis/*mortality/*therapy ; Young Adult