BACKGROUND: Trauma is a major cause of death for individuals under the age of 45 years and the third leading cause of death for all ages. So, it has been recognized as an important socioeconomic problem. The purpose of this study was to evaluate the outcome of surgical care of traumatized parients. METHODS: We retrospectively analyzed data of patients who had undergone surgical operation on head, abdomen, or chest trauma from January 1, 1995 to December 31, 1995. TRISS method and W- and Z- statistics were used to evaluate the trauma outcome and the quality assurance of surgical treatment. RESULTS: Two hundred and sixty eight patients were enrolled in this study. Traffic accident in injury mechanisms was the most common(n=185, 69.2%), and severely injured patients with over ISS 16 were 205 of total 268 patients(76.5%). Crude mortality rate was 11.6% (non-survivors/number of patients : 31/268). By TRISS method, predicted mortality rate was 10.1%, excess mortality rate was 14.2%, and W value was - 1.43 indicating less actual survivors than predicted, but absolute Z score was 0.91 and it was statistically not significant. CONCLUSION: These data show that trauma outcome and quality of surgical care in our hospital is adequate. We also suggest that it will provide a valuable data for further studies.
Abdomen ; Accidents, Traffic ; Cause of Death ; Head ; Humans ; Injury Severity Score* ; Mortality ; Retrospective Studies ; Survivors ; Thorax

Dyke-Davidoff-Masson syndrome is a rare clinical syndrome consisting of hemiatrophy of cerebral hemisphere, enlargement of ventricles and prominent pneumatization of petrous pyramid of the temporal bone. Its clinical manifestations are hemiparesis, several types of seizure, mental retardation and other neurologic deficits. We experienced a case of Dyke-Davidoff-Masson syndrome in a four months old boy who visited to our department due to right side upper extremity weakness and infantile spasm. The brain magnetic resonance imaging showed marked hemiatrophy of left cerebral hemisphere and enlargement of left lateral ventricle. So with the review of literatures, we report a case of Dyke-Davidoff-Masson syndrome with infantile spasm.
Brain ; Cerebrum ; Humans ; Infant ; Infant, Newborn ; Intellectual Disability ; Lateral Ventricles ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Paresis ; Petrous Bone ; Seizures ; Spasms, Infantile* ; Temporal Bone ; Upper Extremity

BACKGROUND: The current recommendation of rescue breathing techniques in the infant is to blow both the nose and mouth of infants by caregiver's mouth but recent studies suggest some caregivers may have trouble sealing a infant's mouth and nose. The purpose of this study is to estimate the ability of mothers to create a seal to their infants for the provision of rescue breathing according to current recommendation. METHODS: Infants up to 1 year of age(n=98) and their mothers were enrolled from emergency department of Chonbuk National University Hospital. We measured the facial lengths of the infants and the width of mouth in their mothers and compared mouth widths of mothers with their infant's nose-to-mouth lengths. RESULTS: In infants between 0 to 6 months, Mother transverse lengths were significantly larger than mouth, nose and nose-to-mouth lengths of the infants. In infants between 7 to 12 months, Mother transverse lengths were significantly larger than mouth and nose lengths of the infants but there was no statistically significant difference between mother transverse lengths and nose-to-mouth lengths of infants. CONCLUSION: The finding indicate that the present recommendation to cover mouth and nose is partly not possible. We recommend that the mouth-to-nose ventilation of rescue breathing techniques for the infants who have respiratory arrest be taught to mothers.
Caregivers ; Emergency Service, Hospital ; Humans ; Infant* ; Jeollabuk-do ; Mothers ; Mouth ; Nose ; Respiration* ; Ventilation

Basta(R) is one of the Phospho-amino acid group herbicide. It consist of glufosinate ammonium (18.5%), alkylether sulfate as surfactant (30%) and some solvents. Although it's WHO classification is Bade III, the intoxicated patient appears an serious clinical findings and have a 20% mortality rate. Nowadays, in Korea the ingestion of herbicidal agents for suicidal attempts is Sequent. The literature for intoxication of bipyridilium (Gramoxon(R)) as herbicide is varied, but the information for Basta(R) is poor even though the use of it tends to increase. Recently, We experienced six cases of Basta(R) intoxication and found that the patient expressed a gradually progressed depression of mentation, recent memory disturbances, convulsions, hypotension, or bradycardia because of CNS or cardiovascular effects of Basta(R) We report these cases with literature review.
Ammonium Compounds* ; Bradycardia ; Classification ; Depression ; Eating ; Humans ; Hypotension ; Korea ; Memory ; Mortality ; Seizures ; Solvents

Ae opposed to most other drug eruptions, drug-induced pemphigus may not develop for at least several months following the initiation of therapy with the offending agent. Unlike sporadically occuring pemphigus, the clinical and hietopathologic patterns of drug-induced pemphigus are most often those of pemphigus foliaceus. We report a case of diphenylhydantoin-induced pemphigus occuring in 30-year-old male with epilepsy. A few coinsized erythematous scaly patches developed on his fae, chest, snd left wrist, and two flaccid bullae on erythemstous base developed on his abdomen after three years snd nine months of therapy with diphenylhydantcin. Histopathologicslly, a biopsy specimin taken from a bullous lesion revealed that bulla is formed just beneath the granular layer and aeaitholytic cells are seen within the bulla. Direct and indirect irnmunofluorescence studies showed regitive findings. Administration of diphenylhydantoin was discontinued and he was treated with systemi and topical corticoeteroid. After 4 weeks, the skin lesions were healed with postinflammatory hysroigmentation and no new lesions were developed thereafter.
Abdomen ; Adult ; Biopsy ; Blister ; Drug Eruptions ; Epilepsy ; Humans ; Male ; Pemphigus* ; Phenytoin* ; Skin ; Thorax ; Wrist

No abstract available.
Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome*

No abstract available.
Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome*

Septo-optic dysplasia, as first described by de Morsier, is a rare developmental anomaly of absent or hypoplastic septum pellucidum, a primitive optic vesicle, and dysplasia of the optic nerve, chiasm, and optic tracts. It is a common cause of hypopituitarism in children and has variable hypothalamic-pituitary dysfunction. We experienced a case of septo-optic dysplasia in 5 month old female baby who presented with developmental delay and seizure. A magnetic resonance imaging of the brain showed absence of the septum pellucidum and the fundoscopic examination disclosed the absence of left optic disc and atrophy of right optic disc.
Atrophy ; Brain ; Child ; Female ; Humans ; Hypopituitarism ; Infant ; Magnetic Resonance Imaging ; Optic Nerve ; Seizures ; Septo-Optic Dysplasia* ; Septum Pellucidum ; Visual Pathways

PURPOSE: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. MATERIALS AND METHODS: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. RESULTS: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. CONCLUSIONS: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.
Braces ; Femur* ; Fibula* ; Follow-Up Studies ; Fractures, Stress ; Humans ; Tibia* ; Transplants*

BACKGROUND: The mechanically ventilated patient's stay in the emergency department (ED) is brief but ventilatory management and intervention must be optimal. Agitation, anxiety, distress, and discomfort are common complications far the ventilated patient. So, sedation is necessary to reduce these complications. METHODS: Patients were monitored and mechanically ventilated. Midazolam was intravenously administered as loading dose(3-5mg), followed by continuous infusion at a rate of 0.06mg/kg/hr, titrated to achieve a predetermined sedation level (Ramsay's sedation score: 2-5 points, Glasgow coma score scathe : 8-11 points). RESULTS: After onset of predetermined sedation, systolic and diastolic blood pressure and heart rate remained stable during continuous infusion when compared with those of the initial state. Arterial blood gas and peak inspiratory pressure remained unchanged but respiratory rate was decreased to allowable ranges. CONCLUSION: A short-term continuous infusion of midazolam was a safe and erective method for sedation of ventilated patients in ED.
Anxiety ; Blood Pressure ; Coma ; Dihydroergotamine ; Emergency Service, Hospital ; Heart Rate ; Humans ; Midazolam* ; Respiratory Rate