BACKGROUND:Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation (CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and the speed of ventilation may have crucial effect on the quality of ventilation. We compared three different metronome rates (100, 110, 120 ticks/minute) to investigate its effect on the quality of ventilation during metronome-guided 30:2 CPR. METHODS:This is a prospective, randomized, crossover observational study using a RespiTrainer?r. To simulate 30 chest compressions, one investigator counted from 1 to 30 in cadence with the metronome rate (1 count for every 1 tick), and the participant performed 2 consecutive ventilations immediately following the counting of 30. Thirty physicians performed 5 sets of 2 consecutive (total 10) bag-mask ventilations for each metronome rate. Participants were instructed to squeeze the bag over 2 ticks (1.0 to 1.2 seconds depending on the rate of metronome) and deflate the bag over 2 ticks. The sequence of three different metronome rates was randomized. RESULTS:Mean tidal volume significantly decreased as the metronome rate was increased from 110 ticks/minute to 120 ticks/minute (343±84 mL vs. 294±90 mL, P=0.004). Peak airway pressure significantly increased as metronome rate increased from 100 ticks/minute to 110 ticks/minute (18.7 vs. 21.6 mmHg, P=0.006). CONCLUSION:In metronome-guided 30:2 CPR, a higher metronome rate may adversely affect the quality of bag-mask ventilations. In cases of cardiac arrest where adequate ventilation support is necessary, 100 ticks/minute may be better than 110 or 120 ticks/minute to deliver adequate tidal volume during audio tone guided 30:2 CPR.

PURPOSE: The optimal surgical technique for inguinal hernia repair continues to be debated. This study was designed to investigate optimal surgical procedures in inguinal or femoral hernia. METHOD: We analyzed 153 cases of herniorrhaphy on inguinal or femoral hernias between August 1996 and November 2000. We divided patient into four groups according to the methods of hernia repair, i.e., 1) 78 cases of laparoscopic herniorrhaphy, 2) 42 cases of Lichtenstein herniorrhaphy, 3) 24 cases of Bassini herniorrhaphy and 4) 9 cases of McVay herniorrhaphy. RESULTS: The patient in the laparoscopic and Lichtenstein herniorrhaphy groups needed shorter hospital stays than those in the Bassini or McVay herniorrhaphy groups. The severity of pain was assessed by the total amount and duration of nonsteroidal anti-inflammatory drug injections, which was minimal in the laparoscopic group. There were no differences in complications between the groups. One patient in the laparoscopy group had a hernia recurrence and was reoperated with Lichtenstein herniorrhaphy. We compared two tension-free herniorrhaphies with each other. The numbers of patients not needing analgesic injections were more in the laparoscopic than the Lichtenstein herniorrhaphy group, reflecting less pain in the former group. Hospital stays were also shorter in the laparoscopic than the Lichtenstein herniorrhaphy group. CONCLUSION: We concluded that tension-free herniorrhaphy is superior to tension herniorrhaphy in terms of postoperative pain & recovery. Of the tension-free herniorrhaphies, laparoscopic herniorrhaphy is associated with less postoperative pain and shorter hospital stays than Lichtenstein herniorrhpahy.
Hernia ; Hernia, Femoral ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy* ; Length of Stay ; Pain, Postoperative ; Recurrence

Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renalmedulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal corticalnecrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is auseful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following anoperation for abdominal trauma.
Acute Kidney Injury ; Biopsy ; Diagnosis ; Early Diagnosis ; Humans ; Kidney Cortex Necrosis* ; Tomography, X-Ray Computed*

Medicolegal autopsy is a vital tool for obtaining reliable injury mortality data. This study statistically analyzed data obtained from medicolegal autopsies performed in Korea in 2013. The aim of this study was to analyze various aspects of the 4,861 deaths that were categorized as unusual in Korea in 2013. A total of 4,861 deaths were analyzed by gender, age, manner of death, and cause of death. Of the 4,861 deaths, 3,542 (73.3%) were of men and 1,302 (26.7%) were of women. With respect to the manner of death, 54.4% were recorded as unnatural deaths, 38.8% were natural deaths, and 6.9% had unknown causes. Of the 2,642 unnatural deaths, 45.0% were determined to be accidental deaths, 26.3% suicidal, 16.9% homicidal, and 11.8% undetermined. Of the total number of unnatural deaths, 42.1% were trauma-related deaths, for which falling down accounted for 33.8%. Asphyxiation accounted for 16.0% of unnatural deaths, and of these, the predominant cause was hanging (58.8%). In addition, 14.4% of deaths were due to drowning, 12.9% poisoning, 11.0% thermal injuries, 1.8% complications arising from medical procedures, and 0.8% electrocution, starvation, or neglect. Among the 1,886 natural deaths, heart diseases accounted for 52.0% and vascular diseases accounted for 16.9%. Of the 196 deaths among children under the age of 10 years, 41.8% were recorded as unnatural deaths, 45.1% were natural deaths, and 1.5% had unknown causes.
Autopsy* ; Cause of Death ; Child ; Data Interpretation, Statistical ; Drowning ; Female ; Heart Diseases ; Humans ; Korea ; Male ; Mortality ; Poisoning ; Starvation ; Vascular Diseases

No abstract available.
Acute Kidney Injury* ; Fever* ; Nephritis, Interstitial*

OBJECTS: Event related potential(ERF) has been recently applied to examine the neurophysiological disturbance in attention deficit hyperactivity disorder(ADHD), particularly with regard to N100 and P300 which are known as one of ERP components closely linked with cognitive function. On the basis of these aspects, this study was designed to evaluate electrophysiologic characteristics and its availability for diagnosis and treatment of ADHD children by comparison of ERP between normal controls and ADHD children before and after methylphenidate (MFD) administration. METHODS: We examined the topographic auditory ERF and T.O.V.A.(Test of variables of attention), a standardized computerized visual continuous performance test following administration of stimulant drug, MPD 10mg in 13 ADHD children and compared these results with those of 11 normal controls. RESULTS: The results were as follows: 1) Thought the difference was not spastically significant(P=0.0548), N100 latencies seemed to be longer in ADHD children than in normal controls. N100 amplitudes also seemed to be larger in ADHD children than in normal controls(P=0.0629). 2) The F300 latencies significantly shortened after MFD administration when compared with those before MPD administration in ADHD group(P<0.01). 3) ADHD group performed significantly less well than normal controls in T.O.V.A.(P<0.05). And T.O.V.A. scores significantly improved after MFD administration in ADHD group(P<0.01). 4) The N100 and P300 latencies and the T.O.V.A. scores were significantly correlated before MPD administration in ADHD group(P<0.05). 5) The F300 latencies before MFD administration were significantly correlated with the amplitudes of changes of T.O.V.A. scores after MFD administration(P<0.05). CONCLUSION: It seems that prolonged N100 latency of ADHD children can be regarded as a relatively enduring trait marker and that F300 latency may reflect attentional response ability along with therapeutic effect by stimulant.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Diagnosis ; Evoked Potentials* ; Humans ; Methylphenidate* ; Muscle Spasticity

No abstract available.
Adult* ; Cholesterol* ; Gyeongsangbuk-do* ; Humans ; Jeollanam-do* ; Triglycerides*

PURPOSE: To evaluate accuracy of magnetic resonance(MR) imaging for staging of lung cancer and to compare the accuracies of CT and MRI. MATERIALS AND METHODS: We retrospectively analyzed 25 cases of lung cancer, which were confirmed surgically and pathologically. Five experienced radiologists participated in the receiver operating characteristic (ROC) analysis to evaluate and compare accuracies of the CT and MR imaging in preoperative staging of non small cell lung cancer by assessing tumor invasion of bronchus, mediastinum, chest wall, and hilar or mediastinal lymph node metastasis. Imaging results were evaluated against "truth" data based on both surgery and pathologic examination. RESULTS: Sensitivity of CT in distinguishing T3-T4 tumors was 60% ;specificity was 76%. These values for MR imaging were not significantly different(53% and 72%). With ROC analysis, no difference existed between accuracies of CT and MR imaging in diagnosis of bronchial involvement, but MR imaging was significantly more accurate than CT(p<0.05) in diagnosis of mediastinal invasion. There was no significant difference between accuracies of CT and MR imaging in detecting mediastinal node metastasis(N2 or N3); sensitivities were 64% and 78%, respectively, and specificities were 64% and 66%. CONCLUSION: There was no significant difference in accuracies of CT and MR imaging in preoperative tumor classification and assessment of mediastinal node metastasis, but MR imaging was more accurate than CT in assessment of mediastinal invasion.
Bronchi ; Carcinoma, Bronchogenic* ; Classification ; Diagnosis ; Lung Neoplasms ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mediastinum ; Neoplasm Metastasis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thoracic Wall

PURPOSE: To evaluate accuracy of magnetic resonance(MR) imaging for staging of lung cancer and to compare the accuracies of CT and MRI. MATERIALS AND METHODS: We retrospectively analyzed 25 cases of lung cancer, which were confirmed surgically and pathologically. Five experienced radiologists participated in the receiver operating characteristic (ROC) analysis to evaluate and compare accuracies of the CT and MR imaging in preoperative staging of non small cell lung cancer by assessing tumor invasion of bronchus, mediastinum, chest wall, and hilar or mediastinal lymph node metastasis. Imaging results were evaluated against "truth" data based on both surgery and pathologic examination. RESULTS: Sensitivity of CT in distinguishing T3-T4 tumors was 60% ;specificity was 76%. These values for MR imaging were not significantly different(53% and 72%). With ROC analysis, no difference existed between accuracies of CT and MR imaging in diagnosis of bronchial involvement, but MR imaging was significantly more accurate than CT(p<0.05) in diagnosis of mediastinal invasion. There was no significant difference between accuracies of CT and MR imaging in detecting mediastinal node metastasis(N2 or N3); sensitivities were 64% and 78%, respectively, and specificities were 64% and 66%. CONCLUSION: There was no significant difference in accuracies of CT and MR imaging in preoperative tumor classification and assessment of mediastinal node metastasis, but MR imaging was more accurate than CT in assessment of mediastinal invasion.
Bronchi ; Carcinoma, Bronchogenic* ; Classification ; Diagnosis ; Lung Neoplasms ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mediastinum ; Neoplasm Metastasis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thoracic Wall

PURPOSE: Percutaneous pin fixation is commonly applied for pediatric diaphyseal forearm fractures. We analyzed the results of percutaneous transphyseal intramedullary K-wires fixation for pediatric forearm fractures and evaluated the safety of this procedure in terms of growth. MATERIALS AND METHODS: Thirty-six pediatric patients with forearm diaphyseal fractures treated with transphyseal intramedullary K-wire fixation were reviewed retrospectively. Authors analyzed size and number of fixed K-wires and evaluated postoperative complications, bone length discrepancy and any deformity at the last follow-up. We also evaluated range of motion of wrist and forearm as a functional result. RESULTS: The mean age was 9.5 years old and the average period of follow-up was 53 months (range: 23-85 months). Single wire was applied in each bone, and 1.6 mm sized K-wire was most commonly used for radius fractures and 1.1 mm K-wire for ulnar fractures. There was one superficial pin site infection which was healed by conservative treatment. There were no other complications such as premature epiphyseal closure, discrepancy of forearm length or any deformity. All patients showed no significant difference in range of motion compared to opposite side at the last follow-up. CONCLUSION: Percutaneous transphyseal intramedulaary K-wire fixation is one of the effective and safe operative treatment for pediatric forearm fractures without any deleterious effects on subsequent growth of radius and ulna.
Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Humans ; Postoperative Complications ; Radius ; Radius Fractures ; Range of Motion, Articular ; Retrospective Studies ; Ulna ; Wrist