Frequent anomalies causing a left-sided appendix are situs inversus and malrotation. The ectopic position of the appendix frequently causes a delay or error in diagnosis because of atypical symptoms. A physical examination is of limited value unless dextrocardia is present. A left-sided appendix is a rare anomaly, but when other diseases are ruled out, it must be considered especially at the emergency department.
Appendicitis* ; Appendix ; Dextrocardia ; Diagnosis ; Emergency Service, Hospital ; Physical Examination ; Situs Inversus

No abstract available.
Animals ; Macrophages, Peritoneal* ; Mice*

Erythema multiforme(EM) is related disorders of skin and mucous members which is typically associated with antecedent medications or infections, etc. EM is an erythematous maculopapular cutaneous eruption of variable form. However, the pathophysiology of the EM remains obscure. Treatment at present is symptomatic and supportive. In conclusion, the authors report two cases of EM that complained of the erythematous maculopapular cutaneous eruption following antibiotics treatment with the review of literatures.
Anti-Bacterial Agents* ; Erythema Multiforme* ; Erythema* ; Skin

Background: Esmolol is rapid hydrolyzed by plasma esterase but may inhibit plasma cholinesterase activity based on its structure. This study was designed to evaluate the interactions between esmolol and succinylcholine or mivacurium which are metabolized by plasma cholinesterase and to determine the inhibitory effect of esmolol on human plasma cholinesterase. Methods: Neuromuscular effects of succinylcholine (1.0 mg/kg) and mivacurium (0.15 mg/kg) with or without esmolol (0.5 mg/kg or 1.0 mg/kg) were compared in 57 adult patients (ASA class I) during O2-N2O-isoflurane anesthesia. Neuromuscular block was monitored by recording the compound electromyogram of the hypothenar muscle resulting from supramaximal train of four stimuli applied to the ulnar nerve. Also plasma cholinesterase activity was measured before and 5, 10 minutes after injection of esmolol. Results: Time from injection to onset of over 95% block, clinical duration from injection to 25% recovery of control twitch, and recovery index defined as from 25% to 75% twitch recovery of succinylcholine or mivacurium were not altered by pretreatment of esmolol. Plasma cholinesterase activity was not decreased after injection of esmolol 0.5 mg/kg, but decreased by 5% after injection of 1.0 mg/kg (p<0.05). Conclusions: It is unlikely that neuromuscular blocking effects of succinylcholine and mivacurium are prolonged by administration of clinical doses of esmolol (0.5~1.0 mg/kg) due to inhibition of plasma cholinesterase activity in human.
Adult ; Anesthesia ; Cholinesterases ; Humans ; Neuromuscular Agents ; Neuromuscular Blockade ; Plasma ; Succinylcholine* ; Ulnar Nerve

No abstract available.

Spontaneous hemo-pneumothorax, a hemothorax that occurs without trauma, is a very rare condition; however, as a result of excessive bleeding, it can be lethal. Also, if the bleeding is scanty, the physician might recognize hemothorax in case of performing invasive procedures, such as chest tube insertion, and may misunder stand as a complication of the procedure. For this reason, acknowledgement of the spontaneous hemo-pneumothorax in the emergency department is very important. We report on a case of a spontaneous hemo-pneumothorax in a healthy 18-year-old male presenting with chest pain who developed a spontaneous pneumothorax with a profuse amount of hemothorax.
Chest Pain ; Chest Tubes ; Emergencies ; Hemorrhage ; Hemothorax ; Humans ; Male ; Pneumothorax

New treatment strategies to attention deficit hyperactivity disorder (ADHD) have been introduced recently. We report and review the effect of Panax ginseng extract administration in a 7 year-old boy with drug naive ADHD. We administered Panax ginseng extract 1,800 mg/day to him for 8 weeks. There were improvement of scores in Attention Diagnostic System, Clinical Global Improvement, Conner's ADHD Rating scale and Dupaul ADHD Rating scale.
Attention Deficit Disorder with Hyperactivity ; Panax ; Polyenes

The Organ Injury Scaling Committee of the American Association for the Surgery of Trauma recently published a consensus classification of hepatic and splenic injuries. The hepatic and splenic injury scales, based on parenchymal laceration and intrahepatic hematoma include grade 1 to 6 and grade 1 to 5 respectively, representing the least to most severe injury. Forty-eight patients with hepatic and splenic injury were evaluated by abdominal CT from January 1995 to May 1996 and we compared abdominal CT grading with operative grading. Four CT grades did not correlate with operative finding. CT grading showed a sensitivity of 80%, specificity 80% in regard to operative grading. We conclude that 1) CT is an accurate technique to determine the extent of hepatic and splenic injury. 2) CT grading of hepatic and splenic trauma has a high correlation with operative grading.
Classification ; Consensus ; Hematoma ; Humans ; Lacerations ; Liver ; Sensitivity and Specificity ; Spleen ; Tomography, X-Ray Computed ; Weights and Measures

No abstract available.

STUDY OBJECTIVES: To compare the quality of CPR provided by medical students and pre-EMTs performing three-rescuer CPR with that achieved by same students trained to provide standard two-rescuer CPR and to find the most effective method of resuscitation and to educate this methods to students. MATERIAL AND METHODS: From July 1 to September 30, 1996, we had trained 60 groups consisted of the medical students, students of EMS technology and pre-EMT. Each group practiced two-rescuer CPR and three- rescuer CPR for 120 minutes with Resusci(R) Anne and performed CPR for at least 3 minutes without feedback. To eliminate any visual cues of performance the mannequin's recorder was hidden. Each actions were recorded by Resusci(R) skillmeter and Laerdal printer. To compare the Quality of two-rescuer CPR and three-rescuer CPR, we analyzed the data by SPSS with paired t-test. RESULTS: Three-rescuer teams delivered a mean minute ventilation and a mean minute cardiac compression substantially greater than that produced by two-rescuer teams(11.30 +/-.85 vs 9.09+/-.22, p<0.001, 99.22+/-2.42 vs 95.12+/-5.75, p<0.001). Three-rescuer teams produce the more correct actions in chest compression and ventilation(93.84+/-.56% vs 83.49+/-6.94%, 90.90+/-.33% vs 77.00+/-7.06%). CONCLUSION: Three-rescuers can produce better CPR than two rescuers when a bag-valve-mask devices is used and the technique is easily leaned and readily retrained, so we think that repeated education and training of this CPR methods to students is needed.
Cardiopulmonary Resuscitation* ; Cues ; Education ; Humans ; Resuscitation ; Students, Medical ; Thorax ; Ventilation