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

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

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 aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. METHODS: 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. RESULTS: The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. CONCLUSIONS: Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.
Abdominal Pain ; Cisapride* ; Diarrhea ; Dizziness ; Dyspepsia* ; Eructation ; Humans ; Korea* ; Retrospective Studies