Diabetic complications such as cystopathy and retrograde ejaculation are slowly progressive disease without any specific signs and symptoms so it is difficult to diagnose its complication and prevent it. Diabetic autonomic neuropathy is known as a neurologic lesion with combined involvement in cardiovascular and genitourinary systems. The purpose of this study is to assess correlation between diabetic cystopathy and heart rate variation on consecutive EKG waves and to detect early cystopathy in patients with decreased heart rate variation. We have studied 12 cases of diabetic cystopathy and 9 cases of retrograde ejaculation who were managed in Seoul Eulji Hospital from Mar. 1992 to Aug. 1993 and concluded as follows. Diabetic patients with autonomic neuropathy shows decreased heart rate variability(HRV) (CV%: 2.16+/-0.97) than diabetic patients without autonomic neuropathy (CV%: 3.29+/-0.58, P <0.0001 ), it means that decreased HRV on consecutive EKG waves well correlates to diabetic autonomic neuropathy such as cystopathy and retrograde ejaculation so we think that the measurement of HRV provides a simple test to be concerned urologic complications such as cystopathy or retrograde ejaculation.
Diabetes Complications ; Diabetes Mellitus ; Diabetic Neuropathies ; Ejaculation ; Electrocardiography* ; Heart Rate ; Humans ; Male ; Seoul ; Urogenital System

PURPOSE: For proper operation of the Seoul Emergency Medical Service Information Center, We analyzed the contents of the phone-calls made to the center. METHODS: We retrospectively analyzed phone calls made to the center from Jul. 1 to Sep. 30, 2001. RESULTS: The total number of phone calls made to the center during the above-mentioned period was 42,143, and the average number of calls was 458.1+/-32.3 per day. Most calls came between 09:00 and 12:00 (85 calls, 18.6%), and hours with the fewest calls were from 03:00 to 06:00 (18 calls, 3.9%). The average length of the calls was 2 minutes 38 seconds. Most callers(25,454 calls, 60.4%) asked questions about a disease or first aid which were considered as non-urgent, and 9,586 (22.7%) asked for simple advice about a hospital or a clinic and also considered as non-urgent. There were 885 (2.1%) calls that were considered as emergent situations and there were 1,686 cases (6.7%) connected to the Rescue system 1-1-9 for the rapid evacuation. CONCLUSION: The results show that the Seoul Emergency Medical Information Center does not perform the proper functions that it should in emergent situations.
Emergencies* ; Emergency Medical Services* ; First Aid ; Information Centers* ; Retrospective Studies ; Seoul*

We experienced a rare case of sparganosis developed in the left dorsum of penile shaft. The patient, a 72 year-old, had nontender, mobile thread-like linear subcutaneous palpable mass on the left dorsal aspect of penile shaft for l week. He had experience of intaking non- boiling water intermittently since 8 years ago. During circumcision, the mass which was a Whitish yellow colored parasite measuring about 21cm in length, 0.4cm in width, 0.2cm in Thickness could be extracted.
Aged ; Circumcision, Male ; Female ; Humans ; Male ; Parasites ; Penis ; Sparganosis* ; Water

Pelvic lipomatosis is a condition characterized by a nonmalignant overgrowth of normal fat in the perirectal and perivesical spaces in the pelvis which may be to occur obstructive uropathy. On cystography the full bladder has an abnormal shape as a gourd, banana, pear or inverted tear-drop. Compulerized tomography shows the bladder and rectosigmoid surrounded and displaced by homogeneous tissue with a low attenuation coefficient and the CT features provide diagnostic proof or pelvic lipomatosis. We present a case of pelvic Lipomatosis.
Lipomatosis* ; Musa ; Pelvis ; Pyrus ; Urinary Bladder

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

Churg-Strauss syndrome is also known as allergic granulomatosis, and it is a rare systemic vasculitis that may affect multiple organ systems, and particularly the lungs.A 42-year-old woman with Churg-Strauss syndrome underwent endoscopic sinus surgery under total intravenous anesthesia with propofol and remifentanil. Anesthesia was performed uneventfully, but there were several issues of concern that evolved regarding the perioperative management of a patient with this syndrome.
Adult ; Anesthesia ; Anesthesia, Intravenous ; Churg-Strauss Syndrome ; Female ; Humans ; Piperidines ; Propofol ; Systemic Vasculitis

PURPOSE: To review the outcomes of surgical treatment for superficial peroneal nerve entrapment. MATERIALS AND METHODS: Ultrasonogram was used for diagnosis and surgical treatment. Seven superficial peroneal nerve entrapment were surgically treated with follow up of average 16 months (range, 6~29 months). Three patients were male and four patients were female with mean age 36.7 years (range, 19~51 years). Four cases developed after repetitive ankle sprain and three cases had no etiology. RESULTS: Operation was performed mini-open and subcutaneous fasciotomy under local anesthesia. The results were excellent in two cases, good in four cases, fair in one case. CONCLUSION: Ultrasonogram was useful for diagnosis and surgical treatment of superficial peroneal nerve entrapment syndrome.
Anesthesia, Local ; Animals ; Ankle ; Female ; Follow-Up Studies ; Humans ; Male ; Peroneal Nerve ; Sprains and Strains

On 26 December 2004, a huge tsunami struck the coasts of South Asian countries and it resulted in 29,729 deaths and 16,665 injuries in Sri Lanka. This study characterizes the epidemiology, clinical data and time course of the medical problems seen by a Korean disaster medical assistance team (DMAT) during its deployment in Sri Lanka, from 2 to 8 January 2005. The team consisting of 20 surgical and medical personnel began to provide care 7 days after tsunami in the southern part of Sri Lanka, the Matara and Hambantota districts. During this period, a total of 2,807 patients visited our field clinics with 3,186 chief complaints. Using the triage and refer system, we performed 3,231 clinical examinations and made 3,259 diagnoses. The majority of victims had medical problems (82.4%) rather than injuries (17.6%), and most conditions (92.1%) were mild enough to be discharged after simple management. There were also substantial needs of surgical managements even in the second week following the tsunami. Our study also suggests that effective triage system, self-sufficient preparedness, and close collaboration with local authorities may be the critical points for the foreign DMAT activity.
Adolescent ; Adult ; Aged ; Asia, Southeastern ; Child ; Child, Preschool ; Emergency Medical Services/organization & administration/statistics & numerical data ; Female ; Geography ; Humans ; Infant ; Infant, Newborn ; International Cooperation ; Korea ; Male ; *Medical Assistance ; Middle Aged ; *Natural Disasters ; Patients/classification/*statistics & numerical data ; *Relief Work ; Retrospective Studies ; Sri Lanka

It would be possible to manage the intestinal anastomotic failure with intraluminal stenting, but its reports are very rare. We experienced a effective and dramatic improvement of esophago-jejunal anastomotic leak in a esophageal and gastric double cancer patient with intraluminal stenting. The intraluminal stenting was tried at the 28th postoperative day and the anastomotic leak and inflammatory signs were disappeared about 3 weeks later. Postoperative 11th months now, the stent was moved about 1 cm downward but not changed further, and he enjoys regular diet without any problems. And we think the stenting would be helful with some limitations in the intestinal anastomotic leak patient.
Anastomotic Leak ; Diet ; Esophageal Neoplasms ; Fistula ; Humans ; Stents*

PURPOSE: The aim of this study was to evaluate the clinical features of emergency department (ED) visits by patients infected with human immunodeficiency virus (HIV) and the need for infection control strategies. METHODS: We retrospectively reviewed electronic ED logs and medical records to find all ED visits by HIV-infected patients from November 1999 to May 2004. The demographic data, the ED disposition, and the length of ED or hospital stay were collected from the ED logs. Clinical and laboratory data were obtained from the medical records. RESULTS: A total of 91 ED visits by HIV-infected 57 patients were considered. The mean age of the patients was 40.7+/-10.9 years, and 91.2% of the patients were male. Among these visits, 53 (58.2%) involved AIDS-related conditions (the AIDS-related group); the other 38 visits by HIV-infected patients were for non-AIDS-related reasons (the non-AIDSrelated group). There was no statistical difference between AIDS-related and non-AIDS-related groups in the length of ED stay (33.2 vs. 39.8 hours, p=.458). Fever was the most common complaint (n=23, 16.0%). As categorized diagnoses, constitutional symptoms were the most common (n=38, 26.4%). A total of 51 patient-visits (56.0%) were admitted to the hospital, and the most common final diagnosis was pulmonary disease (n=22, 43.1%). The number of ED visits by patients with active pulmonary tuberculosis was 15 (16.5%), which represented 22.4% of ED visits by patients with constitutional or respiratory symptoms. CONCLUSION: Fever was the most common cause of ED visits by HIV-infected patients, and pulmonary disease was the most common diagnosis. Patients with the active pulmonary tuberculosis who need respiratory isolation are common among HIV-infected patients.
Diagnosis ; Electronics ; Emergencies* ; Emergency Service, Hospital* ; Fever ; HIV* ; Humans ; Humans* ; Infection Control* ; Length of Stay ; Lung Diseases ; Male ; Medical Records ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary