We are calling the erupting ground water as drug water or mineral water in Korea and thinking those water and food making water. Authors tried to investigate the evidence of contamination by user on the 10 erupting ground water and gained following results: 1. All of the mineral waters on 10 area in Seoul were unfittable to drinking water standard. 2. In the view of the bacteriology 80% were contaminated by coliform group. 3. The highest value of the free carbon dioxide contents were 652.96 ppm at Sam Sun Mineral Water.
Bacteriology ; Carbon Dioxide ; Drinking Water ; Groundwater ; Korea ; Mineral Waters* ; Seoul* ; Solar System ; Thinking ; Water

To determine Pb level in blood, we usually used to pull out about 5ml blood from venous vessel and this sample was digested with acids to decompose organic matter and then determined the Pb contents by Atomic Absorption Spectrophotometer with flame. But recent trend in quan titating Pb in small amount of sample is very much recommended in clinical chemistry specially pediatrics, and industrial hygiene and occupational health area. Authors tried to determine Pb contents in small amount blood of 25 microliter by using capillary tube method and got the possibility of determination of ng amount of Pb in 25yl whole blood sample without any pretreatment of sample.
Absorption* ; Capillaries ; Chemistry, Clinical ; Nebulizers and Vaporizers* ; Occupational Health ; Pediatrics

PURPOSE: This study was aimed to develop secondary triage rule for decision of interfacility transfer to higher level of trauma center for patients with traumatic brain injury (TBI). METHODS: In a prospective observational study from August 2006 to December 2007 conducted in an urban tertiary emergency department, data were obtained from patients more than 15 years old and with TBI. Primary outcome was defined as meaningful positive CT findings. Secondary outcome was defined as meaningful intervention. Non-adjusted univariated logistic regression model was derived from result of chi-square test and adjusted model was derived using stepwise selection manner. Hosman-Lemeshow test for the goodness of fit was used. RESULTS: Total number of eligible patients with traumatic brain injury was 653. Primary outcome was positive in 103 patients and secondary outcome was positive in 42 patients. In univariate logistic regression, risk factors were age over 65(OR: 2.40), history of cerebrovascular disease(OR: 7.08), fall over two meter(OR: 6.28), pedestrian struck(OR: 18.5), headache(OR: 2.18), vomiting(OR: 3.03), disorientation(OR: 5.37), any evidence of open fracture(OR: 24.03), Glasgow coma sacle less than 13(OR: 4.97), Racoon's eye sign (OR: 2.50). These 10 risk factors were statistically significant in adjusted model which was derived using stepwise selected manner. Hosman-Lemeshow test for the goodness of fit was used and chi-square was 1.307(p=0.86). This decision rule had a sensitivity of 93.48%, a specificity of 41.13%, and a negative predictive value of 97.32%. CONCLUSION: A sensitive clinical decision rule with high negative predictive value for detection of abnormal CT lesions which need transfer to higher level of trauma center was developed.
Brain Injuries ; Coma ; Emergencies ; Eye ; Humans ; Logistic Models ; Prospective Studies ; Risk Factors ; Sensitivity and Specificity ; Trauma Centers ; Triage

In the determination of organic solvents in workplaces direct reading tube method have been in Korea for decades. But this method is less accurate and couldn't measure TWA (Time Weighted Average) for 8 hours. Authors tried to detect Toluene concentration in S factory by using charcoal tube according to NIOSH method. The concentration was 158.8ppm. We propose this charcoal tube method should be substituted to get accurate results and to protect employee in workplaces related with solvents.
Charcoal* ; Korea ; National Institute for Occupational Safety and Health (U.S.) ; Solvents ; Toluene*

BACKGROUND: we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. METHOD: In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. RESULTS: The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia(PaCO2> 45mmHg) have more increased postoperative complications. The preoperative FEVl less than 1 liter, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. CONCLUSION: Age 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia (> or=45mmHg) on preoperative arterial blood gas analysis were predictivd of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.
Aged* ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Humans ; Lung Diseases ; Postoperative Complications ; Smoke ; Smoking ; Spirometry

Acute abdomen caused by abdominal tuberculosis is a rare manifestation, and includes bleeding of a gastric or ileal ulcer, obstruction of the small bowel by an adhesive band, perforation of the ileum, ileocolic intussusception and fistula, and mesenteric abscesses caused by necrotic lymph nodes. The clinical and radiologic features of these complicated tuberculosis may mimic other acute abdominal diseases. Although not definitive, careful evaluation of the radiologic findings of the bowel wall, mesenteric fat infiltration, and lymph node enlargement may provide useful diagnostic clues to the presence of acute abdomen due to tuberculosis.
Abdomen, Acute* ; Abscess ; Adhesives ; Fistula ; Hemorrhage ; Ileum ; Intussusception ; Lymph Nodes ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Ulcer

OBJECTIVES: Ciprofloxacin, one of the most widely used fluoroquinolone, has been used for some abdominal and genitourinary infections in emergency departments (EDs). This investigation was performed to identify the risk factors of inappropriate use of ciprofloxacin in the ED. METHODS: We retrospectively reviewed the medical records of patients who had visited the ED of Seoul National University Hospital from January 2002 to December 2002 and who had been prescribed ciprofloxacin as an initial empirical antibiotic. The appropriateness of ciprofloxacin use was judged according to existing institutional guidelines. RESULTS: Of the total 577 patients (219 males, mean age 53.0+/-17.1; 358 females, mean age 50.3+/-18.7), ciprofloxacin was used appropriately in 289 (50.1%). In the univariate analysis, gender, site of suspected infection, route of administration, and disposition were significantly different between the appropriate and the inappropriate use groups (p<0.005). In multivariate analysis, the adjusted odds ratio for related factors for inappropriate ciprofloxacin use was significantly higher in old age patients (>65 years old) than in younger patients (under 30 years old; OR=2.02, 95% CI=1.01-4.03), in patients having the GI tract infections than in patients having genitourinary tract infections (OR=14.28, 95% CI=8.76-23.29), in patients who were administered orally than intravenously (OR=2.45, 95% CI=2.08-5.71), and in patients who stayed in the ED than in those who were admitted (OR=4.29, 95% CI=1.98-9.34). CONCLUSION: Inappropriate use of ciprofloxacin in the ED is very common. If the emergence of ciprofloxacin resistance is to be avoided, education and efforts for judicious use of ciprofloxacin are warranted.
Adult ; Ciprofloxacin* ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Gastrointestinal Tract ; Humans ; Male ; Medical Records ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Risk Factors* ; Seoul

BACKGROUND: Topical nasal corticosteroid therapy produces clinical improvement in patients with nasal polyposis, but there are lots of controversy about the pathogenesis of nasal polyps and the mode of action of steroid therapy. OBJECTIVES: To examine the mechanism of steroid effect, we investigated the histological change in apex, body and stalk of nasal polyps individually after topical steroid therapy. MATERIALS AND METHODS: Ten patients with nasal polyposis were treated with budesonide nasal spray, 100ng(50ng/puff) twice daily in each nostril for 4 weeks. we quantified the number of inflammatory cell types and compared the histologic types and structures in each portion of nasal polyps from the patients. RESULTS: Administration of topical corticosteroid over 2 weeks caused changes in each portion of nasal polyps histologically. The histologic changes showed decreased edema and increased fibrosis under light microscope and it was evident with longer administration of the topical corticosteroid. The number of plasma cells in body portion was decreased after treatment. Electron microscopy showed that the number of degranulated granules of mast cell was increased in 2 weeks after treatment and then decreased in 4 weeks at pedicle portion of nasal polyps. CONCLUSION: The results of this study suggest that the administration of topical corticosteroid may cause activation of healing process histologically.
Budesonide ; Edema ; Fibrosis ; Humans ; Mast Cells ; Microscopy, Electron ; Nasal Polyps* ; Plasma Cells

We have studied the effects of excitatory amino acids on the expression of the c-fos and c-jun mRNA in rat C6 glioma cells. The glutamate, N-methyl-D-aspartate (NMDA), and kainic acid (KA) increased c-fos mRNA level in a concentration-dependent manner. However, they did not affect c-jun mRNA level. In addition, forskolin and phorbol 12-myristate 13-acetate (PMA) increased c-fos mRNA level. Furthermore, PMA increased c-jun mRNA level whereas forskolin downregulated c-jun mRNA level. The glutamate, NMDA and KA, at a concentration of 0.25 mM, did not affect the basal c-fos and c-jun mRNA levels, and also did not affect forskolin- and PMA-induced responses. Furthermore, both forskolin and PMA itself increased the phosphorylation of ERK (extracellular signal regulated kinase) and CREB (cyclicAMP responsible element binding protein) proteins. The KA, NMDA, and glutamate did not affect forskolin-induced increase of ERK and CREB phosphorylation. The KA decreased PMA-induced increase of phosphorylation of ERK and CREB proteins, whereas glutamate and NMDA did not affect the phosphorylation of ERK and CREB proteins induced by PMA. These findings suggest that, in C6 glioma cells, c-fos mRNA induction induced by EAAs is not mediated by phosphorylation of ERK and CREB proteins.
Animals ; Colforsin ; Cyclic AMP Response Element-Binding Protein ; Excitatory Amino Acids ; Gene Expression* ; Glioma* ; Glutamic Acid* ; Kainic Acid ; N-Methylaspartate ; Phosphorylation ; Rats* ; Receptors, Glutamate* ; RNA, Messenger

High-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was applied to improve the prognosis of patients with high-risk stage 3 neuroblastoma. From January 1997 to December 2006, 28 patients were newly diagnosed as stage 3 neuroblastoma. Nine of 11 patients with N-myc amplification and 5 of 17 patients without N-myc amplification (poor response in 2 patients, persistent residual tumor in 2 and relapse in 1) underwent single or tandem HDCT/ASCR. Patients without high-risk features received conventional treatment modalities only. While 8 of 9 patients underwent single HDCT/ASCR and the remaining one patient underwent tandem HDCT/ASCR during the early study period, all 5 patients underwent tandem HDCT/ASCR during the late period. Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality. While the tumor relapsed in two of eight patients in single HDCT/ASCR group, all six patients in tandem HDCT/ASCR group remained relapse free. The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%. In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR. The present study demonstrates that HDCT/ASCR may improve the survival of patients with high-risk stage 3 neuroblastoma.
Adolescent ; Adult ; Child ; Combined Modality Therapy ; Female ; Granulocyte Colony Stimulating Factor, Recombinant/therapeutic use ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neuroblastoma/drug therapy/mortality/*therapy ; *Peripheral Blood Stem Cell Transplantation ; Proto-Oncogene Proteins c-myc/analysis/genetics ; Survival Rate ; Tomography, X-Ray Computed ; Transplantation, Autologous