It is socially fortunate that there is little chance in the civil hospital to experience the victims of high velocity missiles. However it is reasonable thought to educate doctors about the gunshot and explosive injuries who might be mobilized in emergency condition. Authors have experiences to treat the high velocity missile wounds. In order to provide valid data to be an educational material, we clinically analyzed 41cases of those injuries who were treated at the Capital Armed Forces General Hospital from 19xx to 19xx. The results obtained were as follows: 1. In 15 cases there were only soft tissue injuries, The remaining 26 cases had the bone injuries and six of them had two injury sites. 2. In 28 cases the lower extremities were injuried, and they out-numbered the injury of upper extremities. The most frequent site of injuries was the thigh (31.7%). 3. Most common associated injuries were the periphenal nerve injuries, which numbered 10 cases. 4. The early operative treatments were given in 5 out of 32 cases having bone injuries. And the secondary operations, including bone graft and intemal fixation, had to be done in 10 out of the remaining 27 cases due to delayed union or nonunion. 5. There was no infection in cases having only the soft tissue injuries. But the localized osteomyelitis occurred in 4 cases among the cases having bony injuries. 6. Factors affecting the result of high velocity missile wounds were presence of bony involvement, site and extent of injuries, associated thoracoabdominal injuries and presence of peripheral nerve injuries and infection. 7. The evacuation time, chance of early adequate wound management, site of injury and extent of injury were the important factors in deciding the method of treatment. We suggest that the more selective and aggressive measures should be taken in the management of bony injuries.
Arm ; Emergencies ; Extremities ; Hospitals, General ; Lower Extremity ; Methods ; Osteomyelitis ; Peripheral Nerve Injuries ; Soft Tissue Injuries ; Thigh ; Transplants ; Upper Extremity ; Wounds and Injuries

OBJECTIVES: This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island. METHODS: The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases. RESULTS: The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries. CONCLUSIONS: We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.
Ambulances ; Cause of Death ; Education ; Emergencies* ; Emergency Medical Services* ; Humans ; Labor Unions ; Medical Records ; Shock ; Thoracic Injuries ; Transportation

No abstract available.
Intracranial Aneurysm*

Parenteral reserpine was given intramuscularly to 32 hospitalized hypertensive patients: 10 hypertensive patients without renal insufficiency, 3 hypertensive patients with heart failure, 10 hypertensive patients of malignant phase or with uremia, and 9 hypertensive patients with cerebrovascular accident. Follwoings were the result. 1. In the majority of patients, the effective dose of reserpine was 2 to 3 mg. 2. Reserpine given intramuscularly lowered blood pressure in 2 to 4 hours, had its maximum effect in 3 to 6 hours and had a duration of 3 to more than 24 hours (average 9 hours). 3. When effective dose of reserpine was given, blood pressure was lowered significantly (more than 30mmHg in mean blood pressure) in 18 patients (81.7%) of 22 hypertensive patients without renal insufficiency, and in 4 patients (40%) of 10 hypertensive patients with renal insufficiency. 4. Major side effect was drowsiness which was more evident in the patients with renal insufficiency. 5. Reserpine administered parenterally is an effective and safe agent for the treatment of hypertensive emergencies on a short term basis especially in the patient without renal insufficiency.
Blood Pressure ; Emergencies ; Heart Failure ; Humans ; Renal Insufficiency ; Reserpine* ; Sleep Stages ; Stroke ; Uremia

PURPOSE: To report a rare case of lymphocytic hypophysitis in a 31-year-old woman who presented with gradually progressive bilateral visual loss during the third trimester of pregnancy. METHODS: Ophthalmologic examination revealed best corrected visual acuity of 0.02 OD and counting fingers at 20 cm OS. Pupil examination revealed no relative afferent pupillary defect in either eye and intraocular pressure was normal in both eyes. A visual field test revealed nearly total visual defect sparing superotemporal area OD and total defect OS. An MRI of the head was performed. RESULTS: At the time of transsphenoidal surgery following the patient's delivery, a frozen biopsy of the lesion revealed diffuse lymphocytic infilteration and fibrosis of the pituitary gland consistent with the diagnosis of lymphocytic hypophysitis. Postoperatively the patient was treated for hypopituitarism. At 5 weeks postoperative, her best corrected visual acuity was 1.0 OU, and visual field defects resolved in both eyes. On follow-up by telephone for postoperative 7 months, the patient remained visually asymptomatic. CONCLUSIONS: The clinical presentation of lymphocytic hypophysitis may mimic pituitary adenoma, lymphoma, germinoma, and histiocytosis. The diagnosis should be suspected in any pregnant or postpartum patient with an intrasellar or suprasellar mass.
Adult ; Biopsy ; Diagnosis ; Female ; Fibrosis ; Fingers ; Follow-Up Studies ; Germinoma ; Head ; Histiocytosis ; Humans ; Hypopituitarism ; Intraocular Pressure ; Lymphoma ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Neoplasms ; Postpartum Period ; Pregnancy Trimester, Third ; Pregnancy* ; Pupil ; Pupil Disorders ; Telephone ; Visual Acuity ; Visual Field Tests ; Visual Fields

The authors experienced a case of choroidal expansion which occurred after trabeculectomy in glaucoma with Sturge-Weber syndrome. She had right facial nevus flammeus and prominent episcleral vessels. Intraocular pressure was measured to be 45mmHg(OD). Gonioscopy showed wide open angle. Fundus examination revealed tortous retinal vessels and glaucomatous optic atrophy. We performed trabeculectomy and mitomycin-C soaking. There were no serious intraoperative complications. Choroidal expansion and detachment occurred at entire peripheral fundus postoperatively. It disappeared when intraocular pressure was maintained high(24-36mmHg), but recurred when intraocular pressure maintaned low(15-20mmHg). Indocyanine green angiography revealed chroidal hemangioma at posterior pole of fundus.
Angiography ; Choroid* ; Glaucoma* ; Gonioscopy ; Hemangioma ; Indocyanine Green ; Intraocular Pressure ; Intraoperative Complications ; Mitomycin ; Optic Atrophy ; Port-Wine Stain ; Retinal Vessels ; Sturge-Weber Syndrome* ; Trabeculectomy

The authors experienced a case of choroidal expansion which occurred after trabeculectomy in glaucoma with Sturge-Weber syndrome. She had right facial nevus flammeus and prominent episcleral vessels. Intraocular pressure was measured to be 45mmHg(OD). Gonioscopy showed wide open angle. Fundus examination revealed tortous retinal vessels and glaucomatous optic atrophy. We performed trabeculectomy and mitomycin-C soaking. There were no serious intraoperative complications. Choroidal expansion and detachment occurred at entire peripheral fundus postoperatively. It disappeared when intraocular pressure was maintained high(24-36mmHg), but recurred when intraocular pressure maintaned low(15-20mmHg). Indocyanine green angiography revealed chroidal hemangioma at posterior pole of fundus.
Angiography ; Choroid* ; Glaucoma* ; Gonioscopy ; Hemangioma ; Indocyanine Green ; Intraocular Pressure ; Intraoperative Complications ; Mitomycin ; Optic Atrophy ; Port-Wine Stain ; Retinal Vessels ; Sturge-Weber Syndrome* ; Trabeculectomy

No abstract available.
Fertilization in Vitro* ; Gonadotropin-Releasing Hormone*

BACKGROUND: Previous studies suggested that Pityrosporum may play an important role in the pathogenesis of dandruff. OBJECTIVE: Our purpose was to study the statistical and mycobgic findings of dandruff in normal subjects for better understanding of this condition. MEHTODS: Scales frorn the scalp of 384 students were studied stastistically by answer sheets and clinically by a dermatologist. Mycologic studies of Pityrosporum were also performed by direct smear, culture and inoculation to guinea pigs. RESULTS: There were 76.0% subjects with dandruff. Clinically grading the subjects by Kligrnan's scale, grade III and IV(mild caling) were the most. Dandruff developed commonly at the age of 14 to 16, and no seasonal change was observed. Spores of Pityrosporum were observed in all subjects by KOH microscopic examination with Cohens method, and the grading of the dandruff was not related with the number of the spores. In most subjects, P. orbiculare and P. ovae were found together. Positive culture colonies were observed in 93.7%. Inoculation of the cultured colonies to guinea pigs resulted in an experimental dermatitis. CONCLUSION: Our study shows that Pityrosporum may involve in the pathogenesis of dandruff; however, it is still unclear whether Pityrosporum is a main causative agent of dandruff.
Animals ; Dandruff* ; Dermatitis ; Guinea Pigs ; Humans ; Malassezia ; Ovum ; Scalp ; Seasons ; Spores ; Weights and Measures

No abstract available.
Breast Neoplasms* ; Breast*