No abstract available.
Meibomian Glands* ; Thermodynamics*

BACKGROUND: Headache is a common complaint in patients presenting to the emergency department(ED). Many patients suffered sustained headache even after presenting to the ED. This study investigate whether the patients were received analgesics and timely adequate. METHOD: We analyzed 131 adolescent and adult patients with non-traumatic headache without any neurologic deficit in two emergency department during 6 months period retrospectively. RESULTS: The positive and negative predictive value according to primary impression were 47% and 74% respectively. The mean time to take brain computed tomography(CT) after ED presentation was 120 minutes. The patients with primary impression of intracranial hemorrhage(mainly SAH) were the most fast(mean time 88+/- 70 minutes). 28(21%) patients were received analgesics before taking brain CT(after ED presentation), and 70(53%) patients after CT, 27(54%) patients after cerebrospinal fluid examination. The mean time interval were 43, 126 and 149 minutes on each group being received the analgesics. CONCLUSION: According to this study many patients suffered sustained headache before being classified to certain type of disorder. It may due to the reasons that there were no definite guidelines treating headache, the pain itself, or the physician treats patients as physician's way.
Adolescent ; Adult ; Analgesics ; Brain ; Cerebrospinal Fluid ; Emergencies* ; Emergency Service, Hospital* ; Headache* ; Humans ; Neurologic Manifestations ; Retrospective Studies

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

Pneumomediastinum is a relatively uncommon, infrequently reported entity, In the evaluation of these entity, it is important to exclude pathological causes, including Boerhaave's syndrome which carries a high mortality. Spontaneous pneumomediastinum is related to excessive intraalveolar pressure leading to rupture of perivascular alveoli in the setting of a Valsalva maneuver without communication to gut material. So, it has a benign self-limited course and rarely requires medical intervention. On the contrary, secondary pneumomediastinum caused by instrumental, traumatic, and spontaneous perforation of esophagus. Although the prognosis have been improved since the advent of broad-spectrum antibiotics and nutritional support, pneumomediastinum due to esophageal perforation still has a high morbidity and mortality. The most important prognostic factor is the time interval between perforation and initiation of therapy, and an awareness and a high clinical suspicion is critical in the early diagnosis and treatment. Recently, we have experienced 2 cases of pneumomediastinum, one case was spontaneous pneumomediastinum and the other may be caused by instrumental esophageal perforation. We report the clinical course of the patients with a current literature review.
Anti-Bacterial Agents ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Fibrinogen ; Humans ; Mediastinal Emphysema* ; Mortality ; Nutritional Support ; Prognosis ; Rupture ; Valsalva Maneuver

On this study, silicone intubation was performed for punctal stenois in 10 patients(group 1), incomplete nasolacrimal duct obstruction in 47 patients (group 2), and complete nasolacrimal duct obstruction in 18 patients(group 3) in adults. Silicone tube was removed between 3-6 months(mean 5.7 months) after intubation. Mean follow-up period of 9.5 months, 9 patients(90%)in group 1,39 patients(83%)in group 2,and 8 patients(44%) in group 3 showed no epiphora, and 1 patient(10%)in group 1, 8 patients (17%) in group 2, and 4 patients(22%) in group 3 showed intermittent epiphora. 6 patients(33%) in group 3 showed persistent epiphora. In summary, silicone intubation can be an alternative to dacryocystorhinostomy in selected adult patients who have punctal stenosis and incomplete obstruction of nasolacrimal duct system. It is safe, and less traumatic with high success rate in these patients.
Adult* ; Constriction, Pathologic ; Dacryocystorhinostomy ; Follow-Up Studies ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Silicones*

BACKGROUNDS: The molecular genetic characteristcs of cis-AB blood group have shown that its allele had C, G, C and C at nucleotide positions (nps) 526, 703, 796 and 803, respectively. And all cis-AB analysed and reported molecular genetically in Korea and Japan had T at np 467 (leucine at amino acid position 156). We report a first case of cis-AB with C at np 467 (proline at amino acid position 156). METHODS: Genomic DNA was extracted from peripheral blood of cis-AB patient and amplified by DS1/DS2 and DS3/DS4 allele-specific primers. After PCR, we analysed nps 261, 467, 526, 646, 703, 796, and 803 by restriction digestion, autoradiography and automatic sequencing. RESULTS: PCR-RFLP with DS1/DS2 primers and restriction enzyme KpnI showed that cis-AB had an 0 allele. The results of genomic sequencing, autoradiography and restriction digestion showed that cis-AB allele at nps 467, 526, 646, 703, 796 and 803 had C, C, T, G, C and C, respectively. CONCLUSION: This cis-AB showed characteristic molecular genetic features at nps 526, 703, 796, and 803. And this is a first case of A(Pro) cis-AB with C at np 467. (Korean J Blood Transfusion 10(1): 13-19, 1999)
Alleles ; Autoradiography ; Blood Transfusion ; Cytosine* ; Digestion ; DNA ; Humans ; Japan ; Korea ; Molecular Biology* ; Polymerase Chain Reaction

Zygomatic arch fracture is one of the most commonly seen facial bone fractures and there have been many methods of reduction designed so far. However, for a simple fracture, the Gillies temporal approach is most commonly used because of the easy reducibility, and also because the depressed fracture can be approached without a facial incision. The Gillies temporal approach starts in the temporal area, between the temporalis muscle and deep temporal fascia. We have developed a new route which starts in the postauricular hair margin area and then reaches to the periosteum of the temporal bone. An elevator is then inserted to penetrate the periosteum and subperiosteal dissection is performed toward the zygomatic process of the temporal bone. At the origin of the zygomatic process, the route of dissection changes to the posterior aspect of the zygomatic arch using a curved palate elevator or the authors' modified Langenbeck elevator. This method of approach has been used in 6 cases of zygomatic arch fracture with good results and we report this method along with written reports.
Elevators and Escalators ; Facial Bones ; Fascia ; Hair ; Palate ; Periosteum ; Temporal Bone ; Zygoma*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal*

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting