BACKGROUND: Acute appendicitis is very not uncommon disease and has many difficulties in the diagnosis of disease. So we should evaluate the significance of diagnosis by "MANTRELS" score which is very simple and easily accessible tools in patients of right lower quadrant abdominal pain. METHODS: We studied 164 patients initially complainted of right lower quadrant abdominal pain from Jan 1 to Jun 30. 1997 in emergency department of Yeungnam university hospital. At first, "MANTRELS" scores was calculated and we evaluated the final diagnosis, surgically operated or not, transferred or not, etc, retrospectively. Next, two groups were divided each that group A was surgically operated, group B was not surgically operated. And then the statistical significance and accuracy rate according to scores and cut-off values in each groups were evaluated. RESULTS: All 164 patients was admitted in emergency department of Yeungnam University hospital and male to female ratio was 1:0.98, mean ages was 35.3 years old. The incidences according to each items of "MANTRELS" were as follows; most in Tenderness and Shift to left, Migration of pain in group A and most in Tenderness and Anorexia. Nausea in group B. As the results according to each scores in both group, score 8; 25 cases, score 7; 14 cases in group B were showed and the correlation coefficients was 0.979. And as the results according to cut-off value in both groups. it's sensitivity and negative predictability. false negative, positive joint probability were decreased and others were increased as the cut-off values, respectively. The diagnostic weight was most highest(75.0%) when the cut-off value was 7. CONCLUSION: The authors would authorize that "MANTRELS" score is very simple scoring system and have diagnostic values in differentiating between acute appendicitis and other diseases complaining of right lower quadrant abdominal pain.
Abdominal Pain ; Anorexia ; Appendicitis* ; Diagnosis* ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Joints ; Male ; Nausea ; Retrospective Studies

STUDY OBJECTIVES: To compare the quality of CPR provided by medical students and pre-EMTs performing three-rescuer CPR with that achieved by same students trained to provide standard two-rescuer CPR and to find the most effective method of resuscitation and to educate this methods to students. MATERIAL AND METHODS: From July 1 to September 30, 1996, we had trained 60 groups consisted of the medical students, students of EMS technology and pre-EMT. Each group practiced two-rescuer CPR and three- rescuer CPR for 120 minutes with Resusci(R) Anne and performed CPR for at least 3 minutes without feedback. To eliminate any visual cues of performance the mannequin's recorder was hidden. Each actions were recorded by Resusci(R) skillmeter and Laerdal printer. To compare the Quality of two-rescuer CPR and three-rescuer CPR, we analyzed the data by SPSS with paired t-test. RESULTS: Three-rescuer teams delivered a mean minute ventilation and a mean minute cardiac compression substantially greater than that produced by two-rescuer teams(11.30 +/-.85 vs 9.09+/-.22, p<0.001, 99.22+/-2.42 vs 95.12+/-5.75, p<0.001). Three-rescuer teams produce the more correct actions in chest compression and ventilation(93.84+/-.56% vs 83.49+/-6.94%, 90.90+/-.33% vs 77.00+/-7.06%). CONCLUSION: Three-rescuers can produce better CPR than two rescuers when a bag-valve-mask devices is used and the technique is easily leaned and readily retrained, so we think that repeated education and training of this CPR methods to students is needed.
Cardiopulmonary Resuscitation* ; Cues ; Education ; Humans ; Resuscitation ; Students, Medical ; Thorax ; Ventilation

The Organ Injury Scaling Committee of the American Association for the Surgery of Trauma recently published a consensus classification of hepatic and splenic injuries. The hepatic and splenic injury scales, based on parenchymal laceration and intrahepatic hematoma include grade 1 to 6 and grade 1 to 5 respectively, representing the least to most severe injury. Forty-eight patients with hepatic and splenic injury were evaluated by abdominal CT from January 1995 to May 1996 and we compared abdominal CT grading with operative grading. Four CT grades did not correlate with operative finding. CT grading showed a sensitivity of 80%, specificity 80% in regard to operative grading. We conclude that 1) CT is an accurate technique to determine the extent of hepatic and splenic injury. 2) CT grading of hepatic and splenic trauma has a high correlation with operative grading.
Classification ; Consensus ; Hematoma ; Humans ; Lacerations ; Liver ; Sensitivity and Specificity ; Spleen ; Tomography, X-Ray Computed ; Weights and Measures

No abstract available.
Cervix Uteri* ; Female

Ventriculitis is one of the most serious complication of the ventriculoperitoneal shunt, which may cause intelligence deterioration in children. The purpose of this study is to investigate the mechanism of the neural damage in lipopolysacciride(LPS)-induced ventriculitis in rat. Ventriculitis was induced by intraventricular injection of 1mg/Kg LPS in rat. H & E and Tunel stains were done on the day 1, 2 and 14 to access the microscopic changes of the periventricular tissue and apoptosis, respectively. TNF-alpha and IL-1beta mRNA expressions were studied using RT-PCR. HRP was injected into the femoral vein and electron microscopic examinations were performed to access the BBB changes. Light microscopic examination one day after LPS injection revealed neutrophilic infiltration, which diminished on day 4, and disappeared on 14. Tunel stain revealed apoptosis on day 1 and 4. TNF-alpha and IL-1beta were expressed on day 1, and diminished progressively thereafter. HRP histochemical electron microscopic examination revealed accumulation of HRP reaction in the interstitial space around the brain parenchyma. These findings suggest the opening of the BBB and increased capillary permeability in the periventricular tissue in the LPS induced ventriculitis. This can possibly damage the periventricular neural tissue. TNF-alpha and IL-1beta seemed to play an important role in the opening of the BBB.
Animals ; Apoptosis ; Blood-Brain Barrier ; Brain ; Capillary Permeability ; Child ; Coloring Agents ; Femoral Vein ; Humans ; In Situ Nick-End Labeling ; Injections, Intraventricular* ; Intelligence ; Interleukin-1 ; Neutrophils ; Rats ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Ventriculoperitoneal Shunt

This is a report revealing statical cause of death brought to the department of forensic medicine, Kyungpook National University School of Medicine based on the result of autopsy. The summary of result is as follows. 1. The number of autopsy made during 1998 were 356, of these 225 cases (63.2%) were male, and 131 (36.8%) were female. 2. 30's, 40's, 20's and 50's was the order according to the number of violent death, and in case of natural death, 30's, 50's, 40's was the oder. 3. August is the period during which autopsies are made most, with December placing second, and the other months are similar. 4. In distributing deaths by cases, violent deaths were 241 cases (67.7%), natural deaths were 105 (29.5%) and unknown cases were 10 (2.8%). 5. For the violent deaths, deaths due to injury were 128 cases (53.1%), asphyxia were 63 (26.1%), intoxications were 30 (12.4%) and abnormal temperature were 19 (7.9%). According to relationship with deaths, homicide is outstanding with 101 cases (41.9%), while suicide and accidental death was the same with 62 cases (25.7%). 6. For death due to injury, death due to blunt injury were 48 cases, sharp force injury which was used most in case of homicide were 43. 7. For the asphyxia, drowning is the most 20 cases, 13 cases of which is accidental death. 8. The deaths of intoxication is the largest part of suicide, and most of intoxication were involved in agrochemical. 9. Of 105 cases of natural death, deaths due to the disease of cardiovascular system were 51 cases (48.6%), of which deaths due to myocardial infraction were 35 cases. 10. Of all autopsy, alcohol intake were checked out in 90 cases and 21 cases of medical controversy took places. 11. Of all violent deaths, the cases involved in the discord between man and woman occupied percentage of 9.6. Of these, homicides were 18 cases, with all sacrificed being females, and of 16 cases of suicide, 13 cases were female.
Asphyxia ; Autopsy* ; Cardiovascular System ; Cause of Death ; Daegu* ; Drowning ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Homicide ; Humans ; Male ; Suicide ; Wounds, Nonpenetrating

Trichobezoars are gastric concretions that are composed of hair or fibers. They are more common in children and adolescents and are usually associated with a pica, emotional disturbance, or mental retardation. Trichobezoar is quite rare in Korea. In most cases, trichobezoars tend to form a cast of the stomach. However, in rare cases, portions of the trichobezoar may separate from the gastric mass, migrate distally, and obstruct the small bowel. We report a case of small bowel obstruction due to multiple trichobezoars in a 14 year-old-girl who had a habit of swallowing hairs until 12 years of age. The patient was treated successfully surgically.
Adolescent ; Affective Symptoms ; Bezoars* ; Child ; Deglutition ; Hair ; Humans ; Intellectual Disability ; Korea ; Pica ; Stomach

Hypoganglionosis is a rare form of intestinal neuronal malformation, which is characterized by scarce ganglia and a reduced number of parasympathetic nerves in the intestinal wall. The pathogenesis of intestinal neuronal malformation is mainly attributed to developmental disorders of the enteric nervous system (ENS). Furthermore, the ENS can be damaged during the postnatal period by ischemic, inflammatory, autoimmunological process or neurotoxic agents. Subsequently abnormalties of the ENS may cause chronic constipation or ileus. Intestinal neuronal malformation should be suspected in patients with a history of chronic stool retention and appropriate radiographic findings. Hypoganglionosis is extremely difficult to establish the diagnosis histochemically unless full-thickness biopsies are performed. Recently we experienced a case of adult type hypoganglionosis, which is assumed to be an acquired type. It was treated with right hemicolectomy.
Adult* ; Biopsy ; Colon* ; Constipation ; Diagnosis ; Enteric Nervous System ; Ganglia ; Humans ; Ileus ; Neurons

BACKGROUND/AIMS: The prevalence of gastroesophageal reflux disease (GERD) in Korea was believed to be low until now. Korea is now believed to be on the evolving stage of GERD in its' prevalence. The aims of this study were to evaluate the epidemiologic and clinicopathologic characteristics among the subgroups of GERD i.e. non-erosive GERD (NERD), erosive GERD (ERD) and Barrett's esophagus (BE), and the role of Helicobacter pylori (H. pylori) infection in the pathogenesis of GERD. METHODS: A total of 253 patients with typical symptoms of GERD who underwent EGD were enrolled from October 2002 to January 2004. Patients were grouped as NERD, ERD or BE based on the symptoms and endoscopic findings. BE was histologically confirmed if necessary. Various clinical parameters including the status of H. pylori infection were analyzed. RESULTS: Among 253 patients, 106 patients were classified as NERD while 116 and 31 patients were classified as ERD and BE group respectively. BE and ERD group showed no gender predilection while NERD showed female preponderance (2.31:1, p<0.05). NERD group were younger (49.57 y.o.) than BE (57.87 y.o.) and ERD (52.30 y.o.) group. About three quarters of the patients of erosive esophagitis were LA-A (74.2%) grade. This suggests the mild nature of erosive esophagitis in Korea. ERD showed significantly higher BMI (kg/m2) compared to NERD (p<0.05). Hiatal hernia was frequently associated with BE and ERD (p<0.05), but less frequently in NERD. Overall H. pylori positivity among GERD was significantly lower than the age and gender matched control group (p<0.05). CONCLUSIONS: Subgroups of GERD in Korea showed different epidemiologic and clinical characteristics. Lower rate of H. pylori infection among GERD group may reflect the protective role of H. pylori infection regarding GERD prevalence in Korea.
Aged ; Barrett Esophagus/diagnosis/drug therapy/microbiology ; Female ; Gastroesophageal Reflux/diagnosis/drug therapy/*microbiology ; Helicobacter Infections/*complications/drug therapy/epidemiology ; *Helicobacter pylori ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence

This study was carried out to investigate an enhancing effect of black ginseng extract (BGE) on exercise capacity in an endurance exercising animal model. Fifty Sprague-Dawley rats were assigned to 5 experimental groups including non-training control, training control, and 3 treated groups (BGE at doses of 75, 150 and 300 mg/kg). The animals were treated with BGE for 6 weeks and their exercise ability in the maximal running distance test was determined using a treadmill every week. The blood lactic acid (LA) level and the activity of citrate synthase (CS) in the muscle were also measured after the exercise. The levels of glucose and glucose-6-phosphate (G-6-P) in the liver and muscle were determined using commercial assay kits. BGE treatments at the doses of 150 and 300 mg/kg significantly increased the exercise capacity compared with the non-training control or training control groups (P<0.05). The level of blood LA was decreased but the activity of CS was increased by the treatment of BGE at the dose of 300 mg/kg compared with the training control group. The level of G-6-P in the liver was elevated by the treatment of BGE at the dose of 300 mg/kg, compared to the training group. As compared with non-training control group, the treatments of BGE increased the levels of glucose and G-6-P in the liver and soleus muscle of rats. These results indicate that BGE have a potential for promoting exercise capacity by increasing CS activity in the muscle and decreasing LA in the serum of rats. These results also suggested that BGE can be used as a candidate supplement of health food products for promoting endurance exercise capacity in human athletes.
Animals ; Athletes ; Citrate (si)-Synthase ; Exercise ; Glucose ; Glucose-6-Phosphate ; Food, Organic ; Humans ; Lactic Acid ; Liver ; Models, Animal ; Muscle, Skeletal ; Muscles ; Panax ; Rats ; Rats, Sprague-Dawley ; Running