As most medical facilities in Korea have been concentrated in large cities, the need to improve emergency medical services in islands and mountainous areas has emerged. Consequently, the Ministry of Health and Welfare and local governments have introduced emergency medical helicopters (known as helicopter ambulances or air ambulances) with doctors in medically vulnerable areas. Having been introduced in two regions in 2011, air ambulances are operational in seven regions as of the end of 2019. The flight time is from sunrise to sunset, except in Gyeonggi province, which is open all day. Although the criteria for transport vary depending on whether an ambulance is available for operation, it is basically intended for emergency critical diseases, such as severe trauma, stroke, and acute myocardial infarction. From September 23, 2011 to December 31, 2018, a total of 10,367 transfer requests were received, which included 534 (5.2%) interruptions, 2,657 (25.6%) rejects, and 7,176 (69.2%) transfers. A total of 7,209 patients were transferred during this period, which included 1,693 (23.5%) patients of severe trauma, 1,149 (15.9%) patients of stroke, 802 (11.1%) patients of acute myocardial infarction, and 3,565 (49.5%) patients suffering from other emergency diseases. Some economic research on air ambulances in Korea has been reported to be cost-effective, but additional research should be performed. In the future, it is necessary to widen the area of operation of air ambulances and find alternative means of transporting patients during unfavorable conditions such as night or bad weather.

PURPOSE: We studied the effectiveness and toxicities of 5-fluorouracil+leucovorin, combination chemotherapy in advanced or recurred colo-rectal cancer patients, who didn't have previous chemotherapy and enrolled from August 1993 to July 1998. MATERIALS AND METHODS: All patients were treated with leucovorin followed by 5-fluorouracil for 5 consecutive days every 4 weeks. Among 43 patients who were enrolled, 40 patients received treatment at least 2 courses, and they were evaluable. Male to female ratio was 21 to 19. In serum CEA level, 27 patients were greater than 5 ng/ml and 13 were less than 5 ng/ml. And primary site was colon in 21 patients and rectum in 19 patients. RESULTS: The complete response rate was 7,5% and the partial response rate was 25%. The median survival duration was 14.7 months, the median response duration was 16.0 months, and median time to progression was 7.3 months. In the analysis of response, survival duration, time to progression according to various characteristics of patients, serum CEA level and liver involvement were revealed significant difference in survival duration, time to progression (p=0.0122, 00350 & 0.0202, 0.0123) on univariate analysis, but no significant difference on multivariates. Hematologic and non-hematologic toxicities were mild and tolerable. CONCLUSION: This study indicates that the combination of 5-fluorouracil (370 mg/m) and leucovorin (20 mg/m) is effective and tolerable regimen in advanced or recurred colo-rectal cancer patients without previous chemotherapy.
Colon ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Humans ; Leucovorin* ; Liver ; Male ; Rectal Neoplasms* ; Rectum

: In order to know the species and frequency of human parasitic infection diagnosed by biopsy, 149 cases (0.18%) of parasitic infection were reviwed, which were selected from 80,947 biopsied materials submitted for routine histopathological examination during a period of 10 years from 1980 to 1989 at Department of Pathology, Chonnam National University Hospital. They consisted of 112 cases of cysticercosis, 17 paragonimiasis, 7 clonorchiasis, 4 amebiasis, 1 sparganosis, 1 enterbiasis, 1 aniskiasis, and 1 fascioliasis respectively. Based on morphological preservation of cysticercus, they could be divided into mild (20.2%), morderate (40.4%), and severe (39.4%) degeneration. Except 2 cases biopsied at the lungs, 15 cases of ectopic paragonimiasis were located at abdominal cavity (8 cases) and central nervous system (7 cases). One case of intrahepatic fascioliasis was observed. This is the 13th human fascioliasis reported in Korea. From the above results, the frequency of parasitic infections found in biopsied specimens was on the decrease as the cysticercosis and ectopic paragonimiasis.
parasitology-helminth-cestoda-nematoda-trematoda ; biopsy ; histopathology ; tissue parasite ; cysticercose ; ectopic ; Enterobius vermicularis ; Taenia solium ; Paragonimus westermani ; Clonorchis sinensis ; Entamoeba histolytica ; Anisakis ; Fasciola sp. ; paragonimiasis ; fascioliasis

PURPOSE: To evaluate the size of normal pons and cerebellum in vivo and the change in size according to age, and to compare those with measurement of the diseased pons and cerebellum. MATERIALS AND METHODS: 121 normal adults(M:F=54:67), 5 patients with OPCD and 19 patients with WallerJan degeneration were studied. The normal group was divided into 5 subgroups according to the age (ranged from 20 to 72 years). 1.5T GE Signa MR unit was used. On axial plane, the AP(A) and transverse(B) diameters of the pons, the size of the middle cerebellar peduncle(C), and transverse diameter of the posterior fossa(D) and the cerebellum(E) were measured. On midsagittal plane, the longitudinal(F) and AP(G) diameters of the basis pontis were measured. The ratios of E/D and F/G were calculated. The student t test was used for statistical analysis. RESULTS: C, E and F/G were 15.5mm+/-1.3, 99.8mm+/-4.3 and 1.63+/-.10, respectively. F/G, H/I, and H/J were larger in male(p<.01). All data of the pons showed no statistically significant differences among age groups. E of the seventh decades was shorter than that of the third decades(p<.05). C(12.7 mm+/-1.4) in OPCD and F/G(1. 81+/-.10) in Wallerian degeneration(p<.01) showed the most significant differences when they were compared to the normal. CONCLUSION: Although the cerebellum decreased in size with age, the pons maintained its size up to eighth' decades. The measurement of middle cerebellar peduncle on axial plane (C) and the ratio of basis pontis on midsagittal plane (F/G) were important in the evaluation of OPCD and WallerJan degeneration, respectively.
Cerebellum* ; Humans ; Magnetic Resonance Imaging* ; Pons*

BACKGROUND: Generalized aggressive periodontitis (GAP) is a destructive periodontal disease that can develop in young age. Only a few cases of full mouth rehabilitation, using dental implants, have been reported in a patient with aggressive periodontitis. CASE DESCRIPTION: This clinical report describes the treatment procedures and results of full mouth rehabilitation in a patient with aggressive periodontitis. After all teeth were extracted, 6 implants were placed in the maxilla and mandible, respectively. Fixed detachable implant prostheses were made. The patient was satisfied with the final results. She was followed for 10 months postloading. CLINICAL IMPLICATION: For a long-term success, continuous maintenance care is critical, as the contributing factors of the disease (such as immune factors or periodontal pathogens) may not be controlled adequately.
Aggressive Periodontitis ; Dental Implants ; Humans ; Immunologic Factors ; Mandible ; Maxilla ; Mouth ; Mouth Rehabilitation ; Periodontal Diseases ; Prostheses and Implants ; Tooth

Cauda equina syndrome (CES) is often defined as a complex of symptoms and signs consisting of low back pain, bilateral sciatica, lower extremity weakness, saddle anesthesia, and bowel and bladder dysfunction. CES is considered to be neurosurgical emergency. Delayed or missed diagnosis of CES can result in serious morbidity and neurological sequelae. However, the diagnosis of CES is often difficult when one or more of these symptoms are absent or when these symptoms develop asymmetrically or incompletely. We report a case of urinary retention and sphincter dysfunction without sciatica or motor weakness following an L3 burst fracture in a 52-year-old male and discuss the atypical presentation of CES and treatment of traumatic CES.
Anesthesia ; Cauda Equina* ; Diagnosis ; Emergencies ; Humans ; Low Back Pain ; Lower Extremity ; Lumbar Vertebrae ; Male ; Middle Aged ; Polyradiculopathy* ; Sciatica ; Spine* ; Urinary Bladder ; Urinary Retention

OBJECTIVES: We sought to describe the perioperative and postoperative adverse events associated with sacral colpopexy and evaluate the surgical outcome, complications, and benefits of laparoscopic sacral fixation for patients with pelvic prolapse. METHODS: Ninety-two women with uterine prolapse underwent sacral colpopexy between January 2011 and September 2016 at Chosun University Hospital. Patients' electronic medical records were investigated for demographic, intraoperative, and postoperative data. Strict definitions were used for all clinically relevant adverse events. Patients' outcomes were documented with 1 self-administered quality of life questionnaires: the Pelvic Floor Distress Inventory-20 focused on symptom distress. The primary analysis looking at perioperative and postoperative adverse events was descriptive and statistics were reported for all groups as n/N (%) with 95% confidence intervals for categorical variables and as mean ± standard deviation and mean (range) for all continuous variables. RESULTS: Their mean age was 69 ± 8.1 years, mean follow-up duration was 12 months, and mean operating time was 61 minutes. There were seven conversions due to anesthetic or surgical difficulties. Follow-up was performed using a telephone questionnaire and physical examination at 12 months. There were three cases of sacral pain with strong analgesics, one of vaginal erosion, two of transient urinary retentions, one of spondylitis, and two of mesh infection. Of the patients, 98.9% were satisfied with the surgical results, while none complained of sexual dysfunction or problems performing her usual activities. CONCLUSIONS: Laparoscopic sacral colpopexy is a feasible and highly effective technique that offers good long-term results with complication rates similar to those of open surgery with the added benefit of being minimally invasive.
Analgesics ; Electronic Health Records ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Pelvic Floor ; Physical Examination ; Postoperative Complications ; Prolapse ; Quality of Life ; Spondylitis ; Telephone ; Uterine Prolapse*

Experimental brain infarcts in rats were studied light and electron microscopically to investigate the factor(s) controlling contrast enhancement on CT scans of the infarcts. Brain infarction was induced by injection of fine autologous blood clots through the right internal carotid artery and the affected brain was processed for examination 1 day, 2 day, and 1, 2, 4, 6 and 8 weeks after the injection. The lesion of early, necro - degenerative stage(1 day to 1 week) showed structural disintegration of capillary endothelial cells with dissolution of tight junctions. The lesion of middle, regenerative stage(2 to 4 weeks) was characterized by proliferation of new capillaries, They had well - formed tight junctions and continuos basement membrane. The endothelial cells, however, had intraluminal villous projections and many pinocytotic vesicles, suggesting an increased permeability. The capillaries matured at late, reparative stage(8 weeks), appearing similar to those in normal brain tissue except that they were loosely surrounded by astrocytic foot processes. It was presumed that the ncreased permeability of new capillaries might play an important role for contrast enhancement observable clinically during the middle stage(2 to 4 weeks).
Animals ; Basement Membrane ; Brain Infarction ; Brain* ; Capillaries* ; Carotid Artery, Internal ; Endothelial Cells ; Foot ; Permeability ; Rats* ; Tight Junctions ; Tomography, X-Ray Computed

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndromes(TS). In this case, 14 years old boys developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.
Adolescent ; Anxiety, Separation ; Haloperidol* ; Humans ; Imipramine ; Tics ; Tourette Syndrome*