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No abstract available.

No abstract available.
Perfusion*

Pulmonary thrombo-embolism in operating room is one of the important cause of morbidity and mortality in patients undergoing femur neck fracture surgery. However, the diagnosis of pulmonary thromboembolism may not be easy because sudden shock can have many different causes (e.g. myocardial infarction, hypovolemia, pneumothorax, non-cardiogenic pulmonary edema, pulmonary thrombo- embolism) and specialized diagnostic tools are not readily available in the operating room. Rapid and accurate diagnosis of pulmonary thromboembolism is very important in outcome of patients. We report a case in which pulmonary thromboembolism under spinal anesthesia occured just before the beginning of operation.
Anesthesia, Spinal* ; Diagnosis ; Femoral Neck Fractures ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction ; Operating Rooms ; Pneumothorax ; Pulmonary Edema ; Pulmonary Embolism* ; Shock

Abdominal oblique muscle injuries are relatively common in professional baseball players and can result in substantial loss of playing time. It is usually caused by a sudden movement of the torso in sports involving repetitive activity requiring trunk rotation and it tend to occur on the contralateral side of the dominant arm. We report a unique case of sequentially occurred bilateral abdominal internal oblique muscle rupture in a right-handed professional baseball batter over two seasons. Each internal oblique rupture had a different mechanism of the injury, the non-dominant side occurred during bat swing and the dominant side during bent leg sliding. After rest and rehabilitation, each injury was recovered to play in about 1 month.

PURPOSE: To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. MATERIALS AND METHODS: Eight 8-F straight catheters were percutaneously insertedinto the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed inall animals ten days after catheter placement, and gross and microscopic examination was carried out. RESULTS: Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. CONCLUSION: Although further study is warranted, ourstudy with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications.
Abscess ; Animals ; Autopsy ; Catheters* ; Drainage* ; Intestinal Perforation* ; Intestines ; Models, Animal ; Peritonitis ; Rabbits

BACKGROUND: Organophosphate insecticides poisoning is one of the most common toxicologic emergencies in Korea. There have been few reports of organophosphate intoxication via parenteral route, although many reports on organophosphate intoxication by oral ingestion were present in the literature. This study aimed to validate the clinical characteristics of organophosphage intoxication according to the route of administration to the body. METHOD: Data were collected retrospectively by the review of the medical records from 49 patients with organophosphate intoxication. Severity of intoxication was classified by the Namba's Classification. Collected data were analysed and compared on the clinical features and laboratory findings between the patient intoxicated by inhalation or contact(parenteral group, n=23) and the other oral ingestion(enteral group, n=26). RESULTS: Severity class by clinical features was higher in enteral group than parenteral group. Severity class by serum cholinestetrase level was not positively correlated with severity class by clinical manifestations. Cholinesterase level tended to overestimate the severity of intoxication in parenteral group. Ventilator therapy and admission to intensive care unit were more frequently needed in enteral group than parenteral group in case that the severity class by clinical features was equal. CONCLUSION: In patients with organophosphate intoxication by parenteral route, serum cholinesterase level of the patient had disparity with clinical severity of intoxication. Considering this disparity, clinical severity should be considered as a more important indicator for treatment of organophosphate intoxication including atropinization, rather than serum cholinesterase level in patients intoxicated by parenteral route.
Cholinesterases* ; Classification ; Eating ; Emergencies ; Humans ; Inhalation ; Insecticides* ; Intensive Care Units ; Korea ; Medical Records ; Plasma* ; Poisoning ; Retrospective Studies ; Ventilators, Mechanical

BACKGROUNG AND OBJECTIVES: To evaluate the clinical and prognostic significance of precordial ST segment depression in precordial leads on admission electrocardiogram (ECG) in acute inferior myocardial infarction treated with intravenous thrombolytic therapy. We analysed about clinical and angiographic characters. MATERIALS AND METHOD: ECG findings in 50 patients with acute inferior myocardial infarction were retrospectively studied with results of coronary angiography and clinical informations. We classified all patients in two group according to the admissional ECG. Twenty nine patients (Group A) had no or <1.0 mm ST depression in precordial lead and Twenty one patients (Group B) had > or =1.0 mm ST depression in two or more precordial (V1-V6) leads were included in this group. RESULTS: In precordial ST segment depression in acute inferior myocardial infarction patients had higher plasma peak mean CK levels (1945+/-1419 vs 3547+/-2728 IU/L, p=0.027) and lower LV ejection fraction (62+/-10% vs 53+/-11%, p=0.008) and lower left ventricle global chordal shortening (0.89+/-0.71 vs -1.39+/-0.94, p=0.046) and inferior wall chordal shortening (-1.68+/-1.11 vs -2.43+/-0.74, p=0.014) and higher Killip class (1.3+/-0.8 vs 2.4+/-1.4, p=0.002) than without precordial ST segment depression patients. CONCLUSION: In conclusion acute inferior myocardial infarction with precordial ST depression patients had more extensive myocardial damage with global and inferior left ventricle severe wall motion dysfunction. Therefore, this suggests a worse prognosis in acute inferior myocardial infarction with precordial ST depression than without precordial ST depression patients. We need more aggressive diagnosis and treatment in this patients to prevent extending myocardial damage.
Coronary Angiography ; Depression* ; Diagnosis ; Electrocardiography ; Heart Ventricles ; Humans ; Inferior Wall Myocardial Infarction* ; Plasma ; Prognosis ; Retrospective Studies ; Thrombolytic Therapy

BACKGROUND/AIMS: Few studies have evaluated the use of a smartphone application (app) for educating people undergoing colonoscopy and optimizing bowel preparation. Therefore, this study was designed to develop a smartphone app for people to use as a preparation guide and to evaluate the efficacy of this app when used prior to colonoscopy. METHODS: In total, 142 patients (male:female=84:58, mean age=43.5±9.3 years), who were scheduled to undergo a colonoscopy at Myongji Hospital, were enrolled in this study. Seventy-one patients were asked to use a smartphone app that we had recently developed to prepare for the colonoscopy, while the 71 patients of the sex and age-matched control group were educated via written and verbal instructions. RESULTS: The quality of bowel cleansing, evaluated using the Boston Bowel Preparation Scale, was significantly higher in the smartphone app group than in the control group (7.70±1.1 vs. 7.24±0.8, respectively, p=0.007 by t-test). No significant differences were found between the two groups regarding work-up time and the number of patients with polyps. CONCLUSIONS: In this study, targeting young adults (≤50 years), the bowel preparation achieved by patients using the smartphone app showed significantly better quality than that of the control group.
Colonic Neoplasms ; Colonoscopy* ; Enema ; Humans ; Mass Screening* ; Mobile Applications ; Patient Education as Topic* ; Polyps ; Smartphone* ; Young Adult

PURPOSE: We prospectively evaluated the usefulness of unenhanced helical computerized tomography (UCT) in patients with acute flank pain in the emergency room. MATERIALS AND METHODS: Between March and July 2001, 57 patients, visiting the emergency room with acute flank pain suggestive of urinary stone by physical examination, urine analysis, plain abdominal radiology (KUB) and clinical history, underwent UCT. This UCT study was evaluated for the presence or absence of urinary stones and secondary signs of ureteral obstruction on UCT (tissue-rim sign, hydronephrosis, hydroureter, strands of perinephric fat). The findings of UCT and intravenous pyelography (IVP) were compared for the presence or absence of ureteral obstruction and delineation of urinary stones according to their sizes and locations. The reading accuracy of urinary stones on UCT of one urologic resident was compared with that of one member of the radiologic staff. RESULTS: Fifty-two of the 57 patients had one or more urinary stones. UCT depicted 66 of 68 stones in the 52 patients. The sensitivity and specificity of UCT were 97% and 100%, respectively. Two cases of urinary stones, which were identified by ureteroscopy and spontaneous passing, couldn't be found on UCT, but hydronephrosis was identified. IVP disclosed 55 of 68 stones, with a sensitivity and specificity of 80% and 83%, respectively. In secondary signs of ureteral obstruction on UCT, stones above 4mm in size showed more frequent secondary signs of ureteral obstruction on UCT than those below 4mm in size. The reading accuracy of the urologic resident improved during the period, being 57% in the first half and 83% in the second half. CONCLUSIONS: UCT was an accurate, safe, and rapid technique to assess acute flank pain in the emergency room. The reading ability to diagnose ureter stones in UCT films required an adequate learning curve. Because not all stones could be identified with UCT, it would not completely replace IVP.
Calculi ; Emergencies* ; Emergency Service, Hospital* ; Flank Pain* ; Humans ; Hydronephrosis ; Learning Curve ; Physical Examination ; Prospective Studies ; Reading ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Ureter ; Ureteral Obstruction ; Ureteroscopy ; Urinary Calculi ; Urinary Tract ; Urography