The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2. The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Mortality ; Seasons ; Surgery, Oral ; Triage*

The subjects, under 18 old, 2,694 children who visited ER during 199H, were surveyed by the Triage and other statical data. The results were as follows : 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage : critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER : 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting ; the 20 : 00-22 : 00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%?), Mar. and May(9%) respectively, Dec. and July(6.7%) respectively. The children who visited ER in spring and autumn showed higher portion than those of summer and winter. 6. Results : admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%). The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER : 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped, was 34.4%, PS was 20.8.%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visiting : the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means ; by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.
Ambulances ; Child* ; Dermatology ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Mortality ; Seasons ; Triage* ; Child Health

Medical record of 66 eyes which had undergone pars plana vitrectomy for the treatment of proliferative diabetic retinopathy were reviewed to study their clinical features, incidences and types of complications, visual outcome, and visual prognostic factors. The final visual outcome showed the improvement in 50[76%] eyes, no change in 13[20%]eyes, and the worsening in 3[4%] eyes. Preoperative prognostic factors favoring final visual acuity included the followings:1]insulin dependent diabetes mellitus which developed before 30 years of age, 2]absence of iris neovascularization, 3]absence of tractional macular detachment. Postoperative complications included vitreous hemorrhage in 34[52%]eyes, cataract in 12[19%]eyes, increased intraocular pressure in 6[10%]eyes, rhegmatogenous retinal detachment in 4[6%]eyes, choroidal effusion in 3[5%]eyes, corneal epithelial defect in 2[3%]eyes, neovascular glaucoma in 1[2%] eye. Postoperative complications associated with poor visual outcome were rhegmatogenous retinal detachment and neovascular glaucoma.Intraoperative complication of iatrogenic retinal tear did not seem to deteriorate the final visual acuity.
Cataract ; Choroid ; Diabetes Mellitus ; Diabetic Retinopathy* ; Glaucoma, Neovascular ; Incidence ; Intraocular Pressure ; Iris ; Medical Records ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

No abstract available.
Ferritins* ; Kidney Transplantation*

No abstract available.
Humans

Procalcitonin (PCT) is a useful bacterial infection biomarker with the potential for guiding antibiotic therapy. We evaluated the concordance of three automated PCT immunoassays: Kryptor (BRAHMS GmbH, Hennigsdorf, Germany), Atellica IM 1600 (Siemens Healthcare Diagnostics, Munich, Germany), and Cobas e801 (Roche Diagnostics, Mannheim, Germany). In 119 serum samples with a PCT concentration < 5.00 μg/L, Kryptor (reference assay) was compared with the other two immunoassays by Spearman’s rank correlation, regression analysis, and concordance at two antibiotic stewardship medical decision points: 0.25 and 0.50 μg/L. The Atellica IM 1600 and Cobas e801 results showed high correlations with those of Kryptor, with correlation coefficient (ρ) values of 0.97 and 0.99, respectively. However, negative biases were observed in both immunoassays (slope/y-intercept: 0.75/–0.00 for Atellica IM 1600; 0.88/–0.01 for Cobas e801). Atellica IM 1600 and Cobas e801 demonstrated excellent concordance with Kryptor at both medical decision points, with linearly weighted κ values of 0.90 and 0.92, respectively, despite discrepancies, which were more prominent at the 0.25 μg/L medical decision point. Based on these biases and discrepancies, the alternate use of different PCT immunoassays in repeat examinations is inadvisable. Standardization is required before comparing the results of different PCT immunoassays.

This retrospective study was undertaken to investigate the current clinical trend in the management of ectopic pregnancy. 562 patients of ectopic pregnancy were admitted and managed at the Department of Obstetrics and Gynecology, Chonbuk National University Hospital from Jan. 1. 1985 to Dec. 31. 1996. All cases had a reliable medical record and were divided into two groups, of which group A includes patients admitted from Jan. 1. 1985 to Dec. 31. 1990, group B from the Jan. 1. 1991 to Dec. 31. 1996. The results were obtained as follows. 1. The number of cases of ectopic pregnancy were 248 in group A and 314 in group B. 2. The age group of 20 to 29 years of age was top ranked in group A(49.6%) as well as in group B(46.8%). The age group of 30 to 39 years was 43.2% in group A and 46.6% in group B, respectively. 3. In group A, the case who experienced two deliveries was 31.9%, and nulliparous woman was 30.6%. In group B, the case who experienced two deliveries was 33.1%, nulliparous woman was 33.1%. 4. On reviewing the past medical history, ectopic pregnancy was 11.2% in group A, 10.8% in group B, respectively. Pelvic inflammatory disease was 8.1% in group A and 11.0% in group B, respectively. 5. The interval between the last menstrual period and the onset of symptoms was prevalently in 4 to 8 weeks(64.5% in group A, 61.8% in group B). The terval of 12 weeks or more was 2.0% in group A and 6.0% in group B, respectively. 6. In considering the chief complaints, low abdominal pain was 85.9% and vaginal spotting was 69.0% in group A. On the other hand, low abdominal pain was 91.4% and vaginal spotting was 76.4% in group B, meanwhile nausea and vomitting was 8.6% and dizziness was 3.5% in group A, there were 23.4% of nausea and vomitting and 9.7% of dizziness in group B,7. In relation of the diagnostic methods, the positive rate of culdocentesis in group B was lower than the rate in group A. Diagnostic laparoscopy was done in 5.6% of group A and 14% of group B. The detection rate of adnexal mass and fluid collection in the pelvic cavity was higher in group B than in group A on the ultrasonographic examination. 8. Initial hemoglobin value of 10.1mg/dl or more was 70.9% in group A and 73.2% in group B. The value of 8.0gm/dl or less was 6.4% in group A and 7.0% of group B, respectively. Initial systolic pressure of 110mmHg or more was 74.6% in group A and 66.6% in group B. The systolic pressure of 90mmHg or less was 3.6% in group A and 8.3% in group B.9. The conceptus was almost implantd in the fallopian tube. The ampullary portion was the most common site of ectopic implantation in both groups. 10. Intraabdominal hemorrhage of 500ml or less in amount was 52.4% in group A and 61.1% in group B, individually. However transfusion was not given in 55.6% of group A and in 71.0% of group B. 11. In the therapeutic modalities, laparotomy was performed in 96.8% of group A and in 82.8% of group B, respectively. The pelviscopic operation was done in 2.4% of group A and in 22.3% of group B. In conclusion, ectopic pregnancy was diagnosed increasingly prior to the onset of the hypovolemic symptoms according to developement of high-resolution ultrasonogram, diagnostic laparoscopy and beta-hCG test, therefore the use of minimally invasive techniques in the management of ectopic pregnancy was increasing.
Abdominal Pain ; Blood Pressure ; Diagnosis* ; Dizziness ; Fallopian Tubes ; Female ; Gynecology ; Hand ; Hemorrhage ; Humans ; Hypovolemia ; Jeollabuk-do ; Laparoscopy ; Laparotomy ; Medical Records ; Metrorrhagia ; Nausea ; Obstetrics ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies ; Ultrasonography

PURPOSE: To determine the feasibility of MR spectroscopy in the living human liver, and to evaluate thecorresponding proton MR spectroscopic features. MATERIALS AND METHODS: In fifteen normal volunteers with neitherprevious nor present liver disease the proton MR spectroscopic findings were reviewed. Twelve subjects were maleand three were female ; they were aged between 28 and 32 (mean, 30) years. MR spectroscopy involved the use of a1.5T GE Signa Horizon system with body coil (GE Medical System, Milwaukee, U.S.A). We used STEAM (STimulatedEcho-Aquisition Mode) with 3000/30 msec of TR/TE for signal acquisition, and the prone position withoutrespiratory interruption. Mean and standard deviation of the ratios of glutamate + glutamine/lipids,phosphomonoesters/ lipids, and glycogen + glucose/lipids were calculated from the area of their peaks. RESULTS:The proton MR spectroscopic findings of normal human livers showed four distinctive peaks, i.e. lipids, glutamateand glutamine complex, phosphomonoesters, and glycogen and glucose complex. The mean and standard deviation of theratios of glutamate + glutamine/lipids, phosphomonoesters/lipids, and glycogen + glucose/lipids were 0.02 +/- 0.01,0.01 +/- 0.01, and 0.04 +/- 0.03, respectively. CONCLUSION: In living normal human livers, MR spectroscopy can besuccessfully applied. When applied to a liver whose condition is pathologic, the findings can be used as astandard.
Female ; Glucose ; Glutamic Acid ; Glutamine ; Glycogen ; Healthy Volunteers ; Humans* ; Liver Diseases ; Liver* ; Magnetic Resonance Spectroscopy ; Prone Position ; Protons* ; Steam

Slowly growing brain tumors may not present specific symtoms or signs related to increased intracranial pressure due to volume-spacial compensation. So we may not find brain tumors in patients in preoperative evaluations. But patients with unknown brain tumors may have severe complications after anesthesia. We experienced a patient whose emergence was delayed from general anesthesia for laparascopic urinary incontinence surgery (Burch's operation). The patient had such neurologic signs as deeply confused mentality, loss of pupil reflex and anisocoria. A large brain tumor in the left parietal lobe was revealed by brain MRI and it was resected. After further evaluation we found that it had originated from pulmonary adenocarcinoma, so the patient was designated for radiation therapy.
Adenocarcinoma ; Anesthesia ; Anesthesia, General* ; Anisocoria ; Brain ; Brain Neoplasms ; Compensation and Redress ; Depression* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Parietal Lobe ; Pupil ; Reflex ; Urinary Incontinence

Lung volume reduction surgery(LVRS) has recently been advocated as an alternative or a bridge to lung transplantation for patients with severe diabling emphysema. This procedure is a palliative treatment performed to alleviate the dyspnea of patients with emphysema and improve performance in the activities of daily living. The rationale of lung volume reduction for generalized emphysema is that the removing of the diseased and functionless lung may improve the function of remaining, less diseased lung. The factors critical to the success of LVRS are careful patient selection, accurate localization of target areas, meticulous anesthetic and operative technique, and intensive postoperative support. We have experienced a case of severe emphysema in a 59-year-old male patient. After selection process and pulmonary rehabilitation, the patient was treated with video-assisted thoracoscopic LVRS and the post-operative course was uneventful.
Activities of Daily Living ; Dyspnea ; Emphysema* ; Humans ; Lung Transplantation ; Lung* ; Male ; Middle Aged ; Palliative Care ; Patient Selection ; Pneumonectomy* ; Rehabilitation