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*

OBJECTIVE: The authors report our experience of urokinase thrombolysis in treating patients harboring nonaneurysmal spontanesous intraventricular hemorrhage(IVH) and evaluated complications, safety and feasibility of this procedure retrospectively. METHODS: Fifty-three patients with nonaneurysmal IVH>15mL without underlying structural etiology or coagulopathy were recruited. The patients with Glasgow Coma Scale(GCS)<5 were excluded. A catheter was directed into the IVH. Hematoma aspiration was followed by instillation of urokinase at the ear level of drainage bag under intracranial pressure monitoring system. This was repeated every 6hours until half of its initial volume. For analysis of prognostic factors, we classified the patients into two groups by Glasgow outcome scale(GOS); good (GOS > or =3) and bad (GOS<3) prognosis group, and performed comparative analysis between two groups. RESULTS: Mean age was 60.2 years. The baseline hematoma size ranged 16 to 72mL. IVH volume reduction was done by an average of 74.2%. As complications, there were 3cases of rebleeding and 2cases of ventriculitis. No intracranial adverse effects were observed during thrombolytic theraphy. At 6months after the procedure, 29patients had achieved a good recovery, 15remained vegetative. 9patients died in hospital. The main good prognostic factors were young age, small IVH volume, and high GCS. CONCLUSION: The results of this study suggest that this relatively easy and safe method of treatment will improve the prognosis. However, further clinical studies also must assess optimal thrombolytic dosage, frequency, and timing of urokinase instillation for safety and effectiveness and must include controlled comparisons of mortality, disability outcome, quality of life, time until convalescence, and cost of care in treated and untreated patients.
Catheters ; Coma ; Convalescence ; Drainage ; Ear ; Hematoma ; Hemorrhage* ; Humans ; Intracranial Pressure ; Mortality ; Prognosis ; Quality of Life ; Retrospective Studies ; Urokinase-Type Plasminogen Activator*

PURPOSE: Airways hyperresponsiveness is a hallmark of asthma. Inhaled corticosteroids improve hyperresponsiveness, but the extent of improvement may vary considerably between patients. This study was designed to determine which patient characteristics predict these differences in response. METHODS: Children with atopic asthma(n=71) received inhaled budesonide(800microgram per day) regularly for 12 weeks, and methacholine PC20 was measured before and after the treatment. Baseline clinical characteristics of children were analyzed with regard to their response to budesonide therapy. RESULTS: The children were divided into high(n=36) and low responder(n=35) on the basis of the median value of the doubling doses(change in PC20). There were no differences observed between the two groups with respect to age, sex, eosinophil counts, and pretreatment FEV1 or methacholine PC20. Among the allergic parameters, serum total IgE was higher in the high responder group than in the low responder group, whereas Dermatophagoides-specific IgE levels or skin test wheal sizes were not different between the two groups. There was a significant correlation between total IgE level and change in PC20. CONCLUSION: Total serum IgE was found to be the most important and single predictor of change in PC20 with inhaled corticosteroids.
Adrenal Cortex Hormones* ; Asthma ; Budesonide ; Child* ; Eosinophils ; Humans ; Immunoglobulin E* ; Methacholine Chloride ; Skin Tests

Changes occurred in the patterns of utilization of emergency medical services during the Middle East respiratory syndrome (MERS) outbreak. The purpose of this study was to analyze the patterns of adult and pediatric patients who visited the emergency department (ED) during the outbreak. This retrospective study was conducted by analyzing changes in the patterns of visits among adult and pediatric patients in the ED at one tertiary teaching hospital in Korea. The study was performed from June 1, 2013 to July 31, 2015. The MERS outbreak period was from June 1 to July 31, 2015, and we compared that period to the same periods in 2013 and 2014. We compared and analyzed the patients' characteristics, emergency severity index (ESI) level at the visit, cause of visit, diagnosis, final dispositions, injury/non-injury, length of stay at the ED (EDLOS), and hospitalization rate. A total of 9,107 patients visited the ED during this period. Of these patients, 2,572 (28.2%) were pediatric patients and 6,535 (71.8%) were adult patients. The most common cause of an ED visit was fever (adult patients: 21.6%, pediatric patients: 56.2%). The proportion of non-urgent visits involving an ESI level of 4 or 5 and the EDLOS decreased significantly in pediatric and adult patients in comparison to that during the past two years. This change was significant in pediatric patients. Among adult patients, the rate of injury decreased, whereas it increased among pediatric patients. During the MERS outbreak period, pediatric ED visits due to non-urgent cases decreased significantly and there were more pronounced differences in ED utilization patterns in pediatric patients than in adult patients.
Adult ; Coronavirus Infections* ; Diagnosis ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Fever ; Hospitalization ; Hospitals, Teaching ; Humans ; Korea ; Length of Stay ; Middle East* ; Retrospective Studies

PURPOSE: This study attempted to examine parental satisfaction with pediatric emergency care (PEC) in Korea and investigate the features influencing overall satisfaction. METHODS: A nationwide, cross-sectional survey was conducted among parents who had taken their children to an Emergency Department (ED) in the three years prior to the study. A 21-item, structured questionnaire was administered to the parents through a web-based system. Participants' satisfaction levels and the strength of the association between PEC components and overall satisfaction were rated using a 7-point Likert scale. RESULTS: In total, 1,000 parents participated in the survey, of which 402 (40.2%) stated that they were generally satisfied with the delivered PEC. Female participants, mothers, and parents with low-acuity patients were more likely to be dissatisfied with the delivered PEC. Although the ED environment was the lowest level of satisfaction, it did not significantly influence the respondents' overall levels of satisfaction. The most influential factors in terms of overall satisfaction were "nurses' professionalism" and "doctors' attitude and proper explanation". CONCLUSION: Parents' overall level of satisfaction with PEC is relatively low and is closely related to factors associated with ED personnel.
Child ; Cross-Sectional Studies* ; Emergencies* ; Emergency Medical Services* ; Emergency Service, Hospital ; Female ; Humans ; Korea* ; Mothers ; Parents* ; Personal Satisfaction

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