Snake bite during pregnancy is rare condition, and when it occurs there are two patients, mother and fetus. Timing is particularly important for pregnant women bitten by a snake. The earlier in the pregnancy the bite occurs, the more hazard to the fetus there is, and there are case reports of snake-bite-induced abortion and malformation of the fetus. The usefulness of antivenin during pregnancy is debatable. We report a case of snake bite during thirdtrimester pregnancy in a patient with general symptoms of envenomation and progressing edema in the bitten leg who was successfully treated with an emergency Caesarian section following the administration of antivenin.
Antivenins ; Bites and Stings ; Edema ; Emergencies ; Female ; Fetus ; Humans ; Leg ; Mothers ; Pregnancy ; Pregnant Women ; Snake Bites ; Snakes

In 1932, Loffler described a syndrome of self-limiting, transient pulmonary infiltrates associated with peripheral blood eosinophilia and mild pulmonary symptoms. A number of conditions are related to pulmonary eosinophilia or pulmonary infiltration with eosinophilia. Especially, parasitic infestations are often related to pulmonary eosinophilia, but only two cases associated with Clonorchis sinensis have been anecdotally reported in English literature. Here we report a case of migrating pulmonary eosniophilic infiltrations associated with Clonorchis sinensis that was successfully treated with praziquantel. Clonorchiasis should be considered in patients with marked eosinophilia and pulmonary infiltrations.
Animals ; Biopsy ; Clonorchiasis/*complications/*diagnosis ; Clonorchis sinensis/*isolation & purification ; Human ; Male ; Middle Aged ; Pulmonary Eosinophilia/*etiology/pathology/radiography ; Syndrome

The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems such as asphyxia, meconium aspiration syndrome and various perinatal infections. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to develop the objective method for quantitative measurement of meconium content in AF. Absorption spectra and meconium-crit of the solutions with various concentrations of meconium were measured. EfFects of filtration and blood contamination on the measurement of meconium content were also estimated by the same methods. Optical densities(OD) were correlated with concentrations of meconium in the whole range of scanned wavelengths. A specific peak of meconium was not available but the highest OD around 410 nm was shown. OD were linearly related to the concentrations of meconium. Meconium-crits were also well-correlated with the concentrations of meconium. Filtration of AF as well as blood contamination in AF severely affected the measurement of meconium content in AF. From the results of this study, both the spectrophotometric method and meconium-crit couid be objective methods for measuring meconium content. Both methods had merits and shortcomings. Filtration and blood contamination should be avoided for the measurement of meconium content in AF. We hope that both or either one of the two methods will be clinically used.
Absorption ; Amniotic Fluid* ; Asphyxia ; Female ; Filtration ; Hope ; Infant, Newborn ; Meconium Aspiration Syndrome ; Meconium*

BACKGROUND: In Korea, a screening panel of cells from abroad without Di(a) positive cells has been commonly used when a patient has an unexpected antibody screening test. It has been reported that Di(a) occurs with a frequency of 6.14 to 14.5% among Koreans. However, the current popular antibody screening panels contain no Di(a) positive cells. In this study, we evaluate the clinical usefulness of the Di(a) Cell Panel (Diagnostic Grifols, Barcelona, Spain) for Koreans. METHODS: A total of 3,372 pretransfusion samples were employed for unexpected antibody screening testing using panels of cells by the DG Gel microtube column agglutination system, including additional Di(a) cells (Diagnostic Grifols, Barcelona, Spain). The positive cases in this system were confirmed again with DiaMed Di(a) antigen positive panel cells (DiaMed Ag, Cresssier, Morat, Switzerland) and this was followed by sequence- based Diego genotyping. RESULTS: The positive detection rate of an unexpected antibody screening test using SeraScan Diana I and II was 1.07% (36/3372), and seven samples were reactive (1+~2+) with the SeraScan Di(a) panel cells (0.21%). However, among the 5 available genotyped samples, two cases were typed as Di(a-b+). CONCLUSION: Even though there is discrepancy between the genotype and the two antibody screening kits, the addition of Di(a) positive cells as unexpected antibody screening panel cells is recommended.
Agglutination ; Genotype ; Humans ; Korea ; Mass Screening

An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different difinition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma
Breast Neoplasms ; Carcinoma, Hepatocellular* ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Parotid Gland ; Stomach Neoplasms ; Thyroid Neoplasms ; Urinary Bladder Neoplasms

PURPOSE: We investigated current dispatcher education requirements and proposed how to further improve and develop the EMD education curriculum in Korea. METHODS: The contents of EMD training programs from the US were used in the development of the questionnaire used to investigate the status of EMD education in Korea. The Delphi method was used to obtain expert consensus on which specific training objectives to include, how many hours would be required, who was qualified to receive the training, and how to confirm their successful qualification. RESULTS: A consensus of the experts was made for core educational objectives, the appropriate number of education hours, qualifications for trainers, passing marks for the exams, and the format of re-education as follows: The didactic education time requirement was 18 hours and the experiential education time requirement was 10 hours. The target qualification requirement for trainees was EMT level 1, and they were required to have an experience of firstaid as a prerequisite. The minimum annual re-education time was 8 hours (61.1%). The passing mark for examinations was 70.0 (median, IQR: 65.0 - 70.0) for the didactic test and 70.0 (median, Interguatile range [IQR]: 60.0 - 80.0) for the experiential test. The format of the required re-education included both comprehensive and individual forms. CONCLUSION: We propose the core contents of EMD education should be based on the results of the expert consensus.
Consensus ; Curriculum ; Emergencies ; Emergency Medical Services ; Korea ; Surveys and Questionnaires

PURPOSE: We investigated current dispatcher education requirements and proposed how to further improve and develop the EMD education curriculum in Korea. METHODS: The contents of EMD training programs from the US were used in the development of the questionnaire used to investigate the status of EMD education in Korea. The Delphi method was used to obtain expert consensus on which specific training objectives to include, how many hours would be required, who was qualified to receive the training, and how to confirm their successful qualification. RESULTS: A consensus of the experts was made for core educational objectives, the appropriate number of education hours, qualifications for trainers, passing marks for the exams, and the format of re-education as follows: The didactic education time requirement was 18 hours and the experiential education time requirement was 10 hours. The target qualification requirement for trainees was EMT level 1, and they were required to have an experience of firstaid as a prerequisite. The minimum annual re-education time was 8 hours (61.1%). The passing mark for examinations was 70.0 (median, IQR: 65.0 - 70.0) for the didactic test and 70.0 (median, Interguatile range [IQR]: 60.0 - 80.0) for the experiential test. The format of the required re-education included both comprehensive and individual forms. CONCLUSION: We propose the core contents of EMD education should be based on the results of the expert consensus.
Consensus ; Curriculum ; Emergencies ; Emergency Medical Services ; Korea ; Surveys and Questionnaires

BOOP(Bronchiolitis Obliterans Organizing Pneumonia) is an inflammatory reaction that follows damage to the bronchiolar epithelium of the small conducting airways. BOOP is characterized by the pathologic finding of excessive proliferation of granulation tissue within the respiratory bronchioles, alveolar duct and spaces, accompanied by organizing pneumonia. BOOP may result from diverse causes such as toxic fumes, connective tissue disorders, infections, organ transplantation and drugs or appear idiopathically. Drug induced BOOP has been described in association with acebutolol, amiodarone, cephalosporin, bleomycine, tryptophan, gold salts, barbiturates, sulfasalazine, and carbamazepine. Carbamazepine is an iminostilbene derivative that is used as both and anticonvulasnt and pain reliever for pains associated with trigeminal neuralgia. It is structually related to the tricyclic antidepressants. To our knowledge, there have been no previously reported case that has described development of BOOP during carbamazepine treatment in Korea, and only two cases have been reported in the world. We report a case of carbamazepine-induce BOOP with a brief review of literature.
Acebutolol ; Amiodarone ; Antidepressive Agents, Tricyclic ; Barbiturates ; Bleomycin ; Bronchioles ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Carbamazepine* ; Connective Tissue ; Cryptogenic Organizing Pneumonia* ; Epithelium ; Granulation Tissue ; Korea ; Organ Transplantation ; Pneumonia ; Salts ; Sulfasalazine ; Transplants ; Trigeminal Neuralgia ; Tryptophan

BACKGROUND: Vacuum tubes are widely used in the clinical laboratory for routine tests. We compared a newly developed Green Vac-Tube (SPM, Gimje, Korea) with Vacutainer (BD, Franklin Lakes, NJ, USA) and Vacuette (Greiner Bio-One, Frickenhausen, Germany) in routine chemistry and hematology tests. METHODS: A total of 101 volunteers, 81 patients and 20 healthy volunteer, were recruited and we had collected blood samples with three kinds of EDTA tubes and those of serum separating tubes. The samples were evaluated for chemistry and hematology tests using TOSHIBA 200FR (Toshiba, Tokyo, Japan) and ADVIA (Siemens, Deerfield, IL, USA) respectively. Their results were statistically analyzed by paired t-test and Bland-Altman plot. RESULTS: Their clinical utilities were examined by CLIA'88 programs. Paired t-test analysis revealed that the results of ALP, AST, total bilirubin, CO2, Hct and MCV showed statistically significant differences between Green Vac-Tube and previously used two vacuum tubes. Similar significant differences were also observed between previous two vacuum tubes. And 194 (4.37%) cases among 5,151 cases were in the critical region by Bland-Altman plot. All different cases, except Na+, K+ however, were clinically acceptable by CLIA'88 programs. CONCLUSIONS: Green Vac-tube has good analytical performance compared to previously-used tubes.
Bilirubin ; Edetic Acid ; Hematology ; Humans ; Lakes ; Tokyo ; Vacuum

BACKGROUND: Pre-transfusion tests are important for performing safe transfusion and there is a need to standardize the process of these tests. In blood banks, automation of tests is under developed and there is always a high risk of error. Automatic instruments for blood bank tests are used in blood centers where a great volume of tests are performed. However, other small scale hospitals have little experience with automatic blood bank instruments. Here, we evaluated the newly developed automatic instrument, the AutoVue Innova (Ortho-Clinical Diagnostics, Raritan, NJ, USA), for performing unexpected antibody screening tests and we compared this to other well known systems. METHODS: In a comparative study, a total of 136 samples, including 28 antibody screening positive samples and 108 negative samples, were tested in parallel by the LISS/Coombs card (DiaMed Ag, Cresssier, Morat, Switzerland) and the AutoVue Innova. The positive samples that were proven by the LISS/Coombs card and the AutoVue Innova were identified by the ID-DiaCell panel (DiaMed Ag, Cresssier, Morat, Switzerland) and the 0.8% Resolve Panel A (Ortho, Raritan, NJ, USA), respectively. Discrepant samples were rechecked by the Identisera Diana (Diagnostic Grifols, Barcelona, Spain). RESULTS: Among the 136 samples, 134 results (98.5%) of the AutoVue Innova agreed with those of the LISS/Coombs card and 2 results were discrepant. These two results were antibody screening positive only on the AutoVue and they were identified as being anti-Lewis(a). CONCLUSION: The unexpected antibody screening tests using the AutoVue Innova showed reliable results for general accuracy and they were useful in aspect of a decreased workload and increased safety, and even for less experienced persons.
Automation ; Blood Banks ; Mass Screening