Five cases of histologically proven polymorphic reticulosis were examined with computed tomography(CT). CT findings were mucosal thickening along the septal and lateral walls of the nasal cavities(n=4), obliteration of the contour of the nasopharynx(n=4), involvement of the paranasal sinuses (n=2), destruction of the nasal septum and/or sinus walls(n=3) and mass in the palate, tonsil or neck (n=1). CT examination was helpful in determining the extent of the disease in the nasal cavity and paranasal sinuses. However, lesions in the palate and tonsils could not be easily evaluated with CT. CT findings of polymorphic reticulosis are nonspecific and granulomatous diseases may show similar CT findings.
Granuloma, Lethal Midline* ; Nasal Cavity ; Nasal Septum ; Neck ; Palate ; Palatine Tonsil ; Paranasal Sinuses

PURPOSE: Hormone-refractory prostate cancer(HRPC) is the terminal step in the natural history of prostate cancer, for which no chemotherapeutic agents have been shown to impact on the clinical outcomes. However, taxane-based therapies have recently appeared to have a significant efficacy on HRPC. The therapeutic effect of paclitaxel was evaluated against metastatic human prostate cancer PC-3 xenografted into athymic nude mice. MATERIALS AND METHODS: A total of 24 male nude mice subcutaneously transplanted with the PC3 cell line were divided in 2 groups. An experimental group was given paclitaxel intraperitoneally at a dose of 12.5mg/kg per injection per day for 4 consecutive days, from the 6th and 20th day following tumor injection. All mice were observed for 31 days, and sacrificed by CO2 gas asphyxiation at the end of the experiment. The mean tumor volume and body weight of both groups were compared using student's t-tests. A tumor volume of more than 200mm3 was regarded as dead. The survival rate was indirectly analyzed using the Kaplan-Meier method. RESULTS: The mean tumor volume of the paclitaxel treatment group was significantly reduced from the 20th day after tumor injection until the end of the experiment compared with the control group. The mean body weight of both groups was different significantly from the 17th day after tumor injection until the end of the experiment, but after removal of the tumor mass, at the 31st day after tumor injection, no significant difference was observed between the two groups. The survival rate of the paclitaxel treatment group was significantly higher than that of the control group. CONCLUSIONS: Our data has shown that paclitaxel is effective in suppressing the growth rate of a HRPC cell line in vivo and improved the survival rate. It is believe that further clinical assessment of the optimal dose and schedule of this drug are warranted.
Animals ; Appointments and Schedules ; Body Weight ; Cell Line* ; Heterografts* ; Humans ; Male ; Mice ; Mice, Nude* ; Natural History ; Paclitaxel* ; Prostate ; Prostatic Neoplasms ; Survival Rate ; Tumor Burden ; Xenograft Model Antitumor Assays

Occurrence of cervical spineankylosis is rare, and intubation of patients with this condition can be difficult, particularly when fiberoptic laryngoscopy is not available. We performed successful endotracheal intubation in a 64-year-old male patient using a 7-mm cuffed polyvinyl chloride (PVC) tube with the help of a laryngeal mask airway (LMA). The LMA was initially used for rapid ventilation of the patient, and the guide wire was passed into the airway from the site of puncture of the cricothyroid membrane. This wire was easily observed in the LMA tube, and the use of long forceps was not required.
Ankylosis ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks ; Laryngoscopy ; Male ; Membranes ; Middle Aged ; Polyvinyl Chloride ; Punctures ; Surgical Instruments ; Ventilation

PURPOSE: Life-threatening effects from poisonous snakebites seem to be relatively rare in Korea. Therefore, the purpose of our study is to verify a new triage system by using mainly the local effect scoring system to determine whether it may be used as a general guide for snakebite toxicity in the early injury stage. METHODS: A retrospective study of 108 snakebite patients who visited the Emergency Department of Keimyung University Dongsan Medical Center from April 2000 to December 2003 was conducted. A local effect scoring system was used to grade the toxicity, and the results was compared with those obtained using the traditional grading system. RESULTS: According to the grading system for severity, grades 0, I and II was most common ones whereas and grades III and IV were relatively rare (9.3%, 1.9%). Local effect scores of 9 to 16, which were considered to correspond to grades III & IV, were documented in 15 cases (13.9%). For the patients with scores from 9 to 16, the average length of stay and the average dosage of the antivenin were 4.54 days and 2.0 vials compared with 1.43 days and 0.73 vials for those with a score of 8 or less, and these differences were statistically significant (p<0.05). There were 9 complicated cases, but they were not considered to be life-threatening. CONCLUSION: The local effect scoring system correlated well with the traditional grading system for snakebite severity and may provide an instrument for evaluating the severity of snakebites in the early injury stage. Also, our study supports the conclusion that snakebites in Korea should be reevaluated for the severity.
Emergency Service, Hospital ; Humans ; Korea ; Length of Stay ; Retrospective Studies ; Snake Bites* ; Triage

PURPOSE: Assessment of the burn size in the Accident and Emergency Department is one of the most important aspects in the initial care of a burn victims. The purpose of this study was to examine in the Emergency Department the accuracy of burn size estimates and the adequacy of burn-patient fluid resuscitation in relationship to the Parkland formula. METHODS: A retrospective study was conducted of 52 adult burn patients who visited the Emergency Department of Keimyung University Dongsan Medical Center during 2003 year. A substratification of the data was undertaken to compare total burn surface area as estimated by the Emergency-Department staff with that determined by the Burn-Care-Unit staff. RESULTS: The average length of stay in the Emergency Department was 394.04 minutes (range: 150~1055 minutes). The average total body surface area evaluated by the Emergency-Department staff was 33.31% compared with the Burn-Care-Unit staff's average of 29.77%, and the difference was statistically significant (p<0.05). During their stays in the Emergency Department, burn patients were underresuscitated based on the fluid volume calculated by using the Parkland formula. CONCLUSION: Early communication with the Burn-Care-Unit staff in the Emergency Department and better education of Emergency-Department physicians will markedly improve the overall care of burn patients.
Adult ; Body Surface Area ; Burns* ; Education ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay ; Resuscitation* ; Retrospective Studies

PURPOSE: To evaluate the effectiveness of non-analgesic subcutaneous suture with an adhesive agent. METHODS: We sutured lacerated wounds with an adhesive agent using a non-analgesic method and measured pain and patient satisfaction. We classified three steps (I: entering the needle, II: pulling the fiber, III: tying) in the suture sequence and evaluated the pain (painfulness, tolerance, painlessness) for each step. RESULTS: Of 276 patients admitted within the period, 111 were enrolled in this study. The mean wound characteristics were 11+/-4 mm (depth) and 23+/-18 mm (length). Overall, 83(75%) patients were sutured without additional analgesics. On a pain scale, all steps were measured at over 90% with respect to tolerance and painlessness. In step II, tolerance (63%) and painfulness (10%) was higher than in the other steps (p<0.05). The mean rate of satisfaction was 4.7 (group 1, 4.8; group 2, 4.6; group, 3; 4.6, group 4, 4.7 (p=0.673). CONCLUSION: Non-analgesic subcutaneous suture with adhesive agent was very effective for patients who were admitted to the emergency department with deep facial lacerations with a length of no more than 2 cm.
Adhesives ; Analgesia ; Analgesics ; Emergencies ; Humans ; Lacerations ; Needles ; Patient Satisfaction ; Skin ; Sutures

Tuberous sclerosis is a genetic multi-system disorder characterized by wide spread hamartomas in several organs. We present the case of a 28-year-old female patient diagnosed with tuberous sclerosis combined with life threatening complication. She developed a peri-renal hemorrhage due to an angiomyolipoma rupture and spontaneous pneumothorax at a time. In order to diagnose and treat this problem, the emergency physician should understand the clinical presentation and complication associated with tuberous sclerosis.
Angiomyolipoma ; Emergencies ; Female ; Hamartoma ; Hemorrhage ; Humans ; Pneumothorax ; Rupture ; Tuberous Sclerosis

Until now, tight-fitting material, such as a ring on a digit, has been treated primarily using ring cutter techniques. If this was not available, most physicians would attempt to pull materials out using simple instruments available in the emergency room. The material selected most often was lubricant. However, for cases in which the tight-fitting material was unusual in that the finger was fully covered so that the joint or distal part could not be located in order to check on complications, there have been no methods for consideration with references. Therefore, we treated a patient whose finger was stuck in an unusual circumstance, and removed it manually using the lubricant and compressor technique.
Emergencies ; Fingers ; Humans ; Joints

Carthamus tinctorius L. is commonly known as safflower. This plant is cultivated mainly for its seed, which is used as essential oil and hot water extract. C. tinctorius has recently been shown to have antioxidant, analgesic, and anti-inflammatory activities. C. tinctorius seed is known as a relatively nontoxic material that is not associated with fatal adverse effects. We experienced a successful outcome in a 62-year-old male patient who was a victim of poisoning due to ingestion of C. tinctorius seed and undergone fatal adverse effects. He ate C. tinctorius seed mixed with alcohol and became lethargic state. In the emergency department, cardiac arrest with pulseless ventricular tachycardia occurred. He was treated by cardiopulmonary resuscitation with cardiac defibrillation. After return of spontaneous circulation, he was managed conservatively and was discharged without deficits approximately ten days after onset.
Cardiopulmonary Resuscitation ; Carthamus tinctorius* ; Eating ; Emergency Service, Hospital ; Heart Arrest* ; Humans ; Male ; Middle Aged ; Plants ; Poisoning ; Tachycardia, Ventricular* ; Water

PURPOSE: To investigate the incidence of nitrituria and the relationship between nitrituria and metabolic syndrome (MetS). METHODS: Data from the Korean National Health and Nutrition Examination Survey V were used. A total of 19,083 participants were included. The chi-square test, the Mantel-Haenszel extension, logistic regression analysis, and multiple linear regression were used to analyze the data. RESULTS: A total of 2.0% of the participants had nitrituria. The incidence of nitrituria significantly increased with age (P trend<0.001). In addition, nitrituria in women began to significantly increase in the fifth decade, more than in men, and this difference was maintained in the 60s, 70s, and greater than 70s age groups (P<0.001). After adjusting for confounders, the odds ratio (OR) for nitrituria in the MetS group was significantly increased, as compared to the OR for nitrituria in the group without MetS (MetS: OR, 1.577; 95% confidence interval [CI], 1.134-2.192; P=0.007). The glycosylated hemoglobin of the nitrite positive group was significantly higher than the negative group (adjusted mean ±standard error: 6.108 ±0.081 vs. 5.883±0.065, P<0.001). CONCLUSIONS: An effective health policy for urinary tract infection (UTI) is needed for older age groups and women. Screening or management guidelines for UTI are needed in MetS patients.
Female ; Health Policy ; Hemoglobin A, Glycosylated ; Humans ; Incidence* ; Linear Models ; Logistic Models ; Male ; Mass Screening ; Nutrition Surveys* ; Odds Ratio ; Urinary Tract Infections