No abstract available.
Umbilical Cord*

PURPOSE: To identify work stress and job satisfaction of the emergency medical technician (EMT) and to contribute to the improvement of emergency care under the current emergency medical law. METHODS: The data were collected by questionnaire from the total 849 EMTs (635 National emergency management agency (119) workers and 214 hospital workers) throughout the whole country from January 5, to March 5, 2012. Each level of indicator calculated under 100-point-scale was compared by t-test and ANOVA. Factors affecting stress and satisfaction were analyzed by Multiple Linear Regression Analysis (alpha=.05). RESULTS: Mean level of job stress was markedly higher among 119 workers (76.9) than those in the hospital (56.6) (p<.001). Mean level of job satisfaction was higher among 119 workers (63.2) than those in the hospital (60.2) (p<.001). CONCLUSION: To diminish work stress and to increase job satisfaction, efforts to support the pride and to improve working condition considering the situations of the agency and to offer more education chance to keep and strengthen the specialty are needed.
Education ; Emergencies* ; Emergency Medical Services ; Emergency Medical Technicians* ; Humans ; Job Satisfaction ; Jurisprudence ; Linear Models ; Surveys and Questionnaires

PURPOSE: To identify work stress and job satisfaction of the emergency medical technician (EMT) and to contribute to the improvement of emergency care under the current emergency medical law. METHODS: The data were collected by questionnaire from the total 849 EMTs (635 National emergency management agency (119) workers and 214 hospital workers) throughout the whole country from January 5, to March 5, 2012. Each level of indicator calculated under 100-point-scale was compared by t-test and ANOVA. Factors affecting stress and satisfaction were analyzed by Multiple Linear Regression Analysis (alpha=.05). RESULTS: Mean level of job stress was markedly higher among 119 workers (76.9) than those in the hospital (56.6) (p<.001). Mean level of job satisfaction was higher among 119 workers (63.2) than those in the hospital (60.2) (p<.001). CONCLUSION: To diminish work stress and to increase job satisfaction, efforts to support the pride and to improve working condition considering the situations of the agency and to offer more education chance to keep and strengthen the specialty are needed.
Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Humans ; Job Satisfaction ; Jurisprudence ; Linear Models ; Surveys and Questionnaires

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

Most esophageal lipomas are discovered incidentally and are small and asymptomatic. However, large (>4 cm) lipomas may cause various symptoms, including dysphagia, regurgitation, or epigastric discomfort. We present a 45-year-old woman with intermittent sudden choking and globus pharyngeus. Upper gastrointestinal endoscopy and endoscopic ultrasound revealed an approximately 10.0×1.5 cm pedunculated subepithelial tumor in the upper esophagus, identified as the cause of her symptoms. A thoracic computed tomography scan revealed a fat attenuated longitudinal mass along the upper esophagus, suggestive of a lipoma. Endoscopic resection of the lesion was performed with a detachable snare to relieve her symptoms, and the pathologic findings were consistent with a lipoma.
Airway Obstruction* ; Deglutition Disorders ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophagus ; Female ; Humans ; Lipoma* ; Middle Aged ; SNARE Proteins ; Ultrasonography

Drainage of pancreatic abscesses is required for effective control of sepsis. Endoscopic ultrasound (EUS)-guided endoscopic drainage is less invasive than surgery and prevents local complications related to percutaneous drainage. Endoscopic drainage with stent placement in the uncinate process of the pancreas is a technically difficult procedure. We report a case of pancreatic abscess treated by repeated EUS-guided aspiration and intravenous antibiotics without an indwelling drainage catheter or surgical intervention.
Abscess* ; Anti-Bacterial Agents ; Catheters ; Drainage ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Pancreas ; Sepsis ; Stents ; Ultrasonography

Duodenal diverticulitis is difficult to diagnose because it can mimic other common diseases such as cholecystitis and perforated ulcer. Recently, we experienced a rare case of duodenal diverticulitis that was initially suspected on abdominal computed tomography as focal pancreatitis. Although duodenal diverticulitis has been increasingly recognizable before surgery, with the advent of multi-detector computed tomography, misdiagnosis remains problematic since duodenal diverticulitis is commonly not considered in the differential diagnosis of acute abdominal pain. We have to consider this rare disease entity because delayed diagnosis might be a cause of substantial morbidity and mortality.
Abdominal Pain ; Cholecystitis ; Delayed Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Diverticulitis ; Diverticulum ; Duodenum ; Hydrazines ; Pancreatitis ; Rare Diseases ; Ulcer

PURPOSE: To describe the MR imaging findings of traumatic spinal subdural hematoma. MATERIALS AND METHODS: We retrospectively reviewed the MR images of six patients, with symptoms of acute spinal cord or cauda equena compression after trauma, together with spinal subdural hematoma. We analysed the extent, location, configuration and signal intensity of the lesions. RESULTS: In five of six cases, hematomas were distributed extensively throughout the thoracolumbosacral or lumbosacral spinal levels. In five cases they were located in the dorsal portion of the thecal sac, and in one case, in the ventral portion. On axial images, hematomas showed a concave or convex contour, depending on the amount of loculated hematoma. A lobulated appearance was due to limitation of free extension of the hematoma within the subdural space at the lateral sites (nerve root exist zone) at whole spine levels, and at the posteromedian site under lumbar 4-5 levels. CONCLUSION: In cases of spinal subdural hematoma, the lobulated appearance of hematoma loculation in the subdural space that bounds the lateral sites at all spinal levels and at the posteromedian site under L4-5 levels is a characteristic finding.
Hematoma ; Hematoma, Subdural, Spinal* ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spinal Cord ; Spine ; Subdural Space

Actinomycosis is a chronic suppurative and granulomatous disease, characterized by the formation of abscess, draining sinuses, abundant granulation, and dense fibrous tissue. Actinomycosis of the gallbladder is extremely rare. We report a case of an 56-years old man who abruptly presented with right upper quadrant abdominal pain. Abdominal CT showed that the gallbladder had 2 cm sized stone and an edematous thick wall. Our preoperative diagnosis was acute calculous cholecystitis. After the management of acute cholecystitis, laparoscopic cholecystectomy was performed but converted to open surgery due to severe adhesion to liver and greater omentum. Partial cholecystectomy was performed. Histologic section of the gallbladder showed sulfur granule with gram-positive branching bacilli compatible with actinomyces. After cholecystectomy, the patient received intravenous penicillin G for 2 weeks, followed by oral penicillin for 3 months.
Actinomycosis/*diagnosis/drug therapy/pathology ; Cholecystectomy ; Cholecystitis, Acute/*diagnosis/surgery ; Gallbladder Diseases/*diagnosis/drug therapy/pathology ; Humans ; Male ; Middle Aged ; Penicillins/administration & dosage ; Tomography, X-Ray Computed

PURPOSE: The large disparity in outcomes of out-of-hospital cardiac arrest (OHCA) between communities makes it important determine pre-hospital factors associated with outcome of OHCA. The study evaluated pre-hospital care performed by 119 rescuers in OHCA and investigated pre-hospital factors that influenced return of spontaneous circulation (ROSC) and automated external defibrillator (AED) use. METHODS: We retrospectively analyzed 119 OHCA patients with presumed cardiac origin admitted to our emergency department transported by 119 rescuers from May 2007 to April 2010. Patients were divided according to achievement of ROSC and AED use prior to comparative analysis. RESULTS: Twenty six patients (21.8%) experienced ROSC and only five patients (4.2%) survived to discharge. In the study area, scene-to-hospital arrival time was significantly shorter in the ROSC group (15.0+/-5.8 minutes) than the non-ROSC group (19.4+/-9.1 minutes) (p=0.02) and electrocardiography (ECG) application was associated with non-AED use. CONCLUSION: Cooperation of emergency medical services and hospitals in the community to reduce hospital arrival time is needed to improve ROSC in OHCA patients. AED use on scene prior to ECG application will be encouraged and higher level training and continuous education of 119 rescuers for AED use will be needed to enhance AED application.
Achievement ; Defibrillators ; Electrocardiography ; Emergencies ; Emergency Medical Services ; Humans ; Out-of-Hospital Cardiac Arrest ; Retrospective Studies