As the incidence of acute myocardial infarction been increasing with prolongation of life spans, improvement in foods and life styles in Korea, rapid diagnosis and treatment is critical in survival of acute myocardial infarction patient. Most of the acute myocardial infarction result from atherosclerotic plaque forming thrombus and occlusion of coronary artery. Because early thrombolytic therapy is important to maintain the left ventricular function and survival rate, there have been many trials to reperfuse the occluded coronary artery. We have studied the many aspects of acute myocardial infarction such as sex, age, infarction site, chief complaints, change of ECG, change of serum enzyme, time delay on emergency room arrival, and compared the effectiveness of thrombolytic therapy. Total number of patient was 212, and males were 141(66.5%) and females were 71(33.5%). The most common infarction site was ant, fuel wall(102 cases,48%)of the heart and the most common chief complaint was chest pain(204 cases,97%). Among the 106 patients who received thrombolytic therapy, 101 patients(95%) had survived and 5 patients(5%) had died. Among the 64 patients who didn't receive thrombolytic therapy, 56 patients (87.5%) were alived and 8 patients(12.5%) were dead.
Ants ; Coronary Vessels ; Diagnosis* ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Survival Rate ; Thorax ; Thrombolytic Therapy ; Thrombosis ; Ventricular Function, Left

STATEMENT OF PROBLEM: Regardless of any restoration, most of case, we used in screw connection between abutment and implant. For this reason, implant screw loosening has been remained problem in restorative practices. PURPOSE: The purpose of this study was to compare surface of coated/plated screw with titanium and gold alloy screw and to evaluate physical property of coated/plated material after scratch test in FESEM investigation. MATERIAL AND METHODS: GoldTite, titanium screw provided by 3i (Implant Innovation, USA) and TorqTite, titanium screw by Steri-Oss (Nobel Biocare, USA) and gold screw, titanium screw by AVANA (Osstem Implant, korea) - were selected for this study. Each abutment screw surface was observed at 100 times, and then screw crest, root, and slope were done more detailed numerical value, at 1000 times with FESEM. A micro-diamond needle was also prepared for the scratch test. Each abutment screw was fixed, micro-diamond scratch the surface of head region was made at constant load and then was observed central region and periphery of fine trace through 1000 times with FESEM. RESULTS: The surface of GoldTite was smoother than that of other kinds of screw and had abundant ductility and malleability compared with titanium and gold screw. The scratch test also showed that teflon particles were exfoliated easily in screw coated with teflon. Titanium screw had a rough surface and low ductility. CONCLUSION: It was recommended that the clinical use of gold-plated screw would prevent a screw from loosening.
Alloys ; Head ; Needles ; Polytetrafluoroethylene ; Titanium

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

This study was designed to assess profile preferences among Korean youths in the year 1992. Facial esthetics was evaluated by means of silhouette profiles, eliminating the influence of a number of aspects that may affect judgment when normal lateral photographs are used. The main points of preference to be clarified here are as follows: First, on facial convexity, Second, on nasion depth, Third, on mentolabial sulcus depth, Fourth, on the position of upper and lower lips, Fifth, on facial type according to Angle's classification of malocclusion, Sixth, on Song's tangents. The 54 subjects printed in questionnaire as black and white silhouettes were selected from 300 tracings from cephalometric radiographs of people whose age ranging from 11 to 20 years. Photographs of six female subjects were retouched by computer graphic software and printed in color and black/white photographs which were used for adaptation of eyes of participants in selecting profiles in silhouette. They constitute 2 questions. The 54 subjects were grouped as 22 questions, each of them composed of 6 subjects, according to the aspects to be clarified. Twenty four questions in total were asked to assess profile preferences. For the assessment, the profile line, the facial esthetic triangle, Song's tangents, and Angle's classification of malocclusion were introduced. The profile line is composed of 11 component points which are Trichion, Glabella, Nasion, Pronasale, Subnasale, Labrale superius, Stomion, Labrale inferius, Supramentale, Pogonion, and Gnathion. The facial esthetic triangle is composed of 3 tangents: A-tangent which is the tangent of dorsum of nose, B-tangent which is the line passing through Sn and Ls, and C-tangent which is drawn on the turning point of the curve which lies between mentolabial sulcus (Sm) and pogonion (Pg). Angle's classification has 3 types of malocclusion which are Class I, Class II, and Class III. Class II malocclusion is subdivided into Division 1 and Division 2. The participants of the survey were composed of 861 college students (448 male students, 413 female students) whose majors grouped as Fine Arts Liberal Arts, and Natural Sciences, and whose mean age 21.8 years. The statistics program SPSS/PC + of SPSS Inc. was used to analyze answers of participants. Crosstabulation, Chi-square test, and Kendall test were done. The conclusions are as follows: First, Korean youths have a tendency to prefer the slightly convex face to the flat or concave face. Second, they prefer a moderately deep nasion. Third, they prefer a moderately deep mentolabial sulcus. Fourth, they prefer the position of lips which are near to Ricketts' E-line. The position of the upper lip which is slightly posterior to E-line is preferred. The upper lip which lies too far anterior or posterior to the lower lip is not perferred. Fifth, they prefer most, according to Angle's Classification of Malocclusion, Class I facial profile which has a slight inclination to Class II division 2. The order of preference is Class I, Class II division 2, Class III, and Class II division 1. Sixth, they prefer the type 2 and 3 of Song's tangents. The facial profile within which A-and B-tangent meet is preferred. The facial profile which has C-tangent that meets with A-tangent slightly posterior to the crossing point of A-and B-tangent or that parallels with B-tangent is preferred.
Adolescent* ; Computer Graphics ; Esthetics ; Female ; Humans ; Judgment ; Lip ; Male ; Malocclusion ; Natural Science Disciplines ; Nose ; Surveys and Questionnaires

The studies of the occurrence and changes of experimental brain edema have been observed by calculating wet weight, volume, dry weight, per cent water content and swelling per cent in 12 normal rabbits as a control group and 24 rabbits of experimental group. The brain edema was induced by expansion of laminaria which resulted in brain compression, that was inserted into the supratentorial extradural space of rabbit. The piece of section of laminaria which is a sea weed and used for the purpose of slow expanding space-occupyin gmass has a characteristic mode of slow expansion in volume on contact with water. The average wet weight of cerebral hemisphere of normal rabbits was 3.30+/-0.19 gm. The average dry weight of unilateral hemisphere of 156 from 78 rabbits was 0.69+/-0.04 gm, while its volume was 2.97+/-0.29 ml and the percentages of water content was 78.92+/-1.36 per cent. The weight, volume and percentages of water content and swelling in the compressed sides of hemisphere showed higher values compared them to the opposite noncompressed hemisphere in the "laminaria-compression" group and showed gradually increasing tendency in the values as the time elapsed.
Brain ; Brain Edema* ; Cerebrum ; Laminaria ; Rabbits ; Water

BACKGROUND: Recently, there are many reports about the association of Diffusion Weighted Imaging (DWI) and the prognosis of hypoglycemic encephalopathy (HE), but those relationships have not yet been completely determined. As such, we researched for prognosis, according to a variety of clinical data, and the lesion's distribution on DWI. METHODS: We retrospectively reviewed 19 patients who were diagnosed as HE. In addition, those prognoses were analyzed by a variety of clinical data and characteristics of lesion's distribution, which were evaluated on DWI and Apparent Diffusion Coefficient (ADC) maps. Three months later, those prognoses were determined by each Modified Rankin Scale. Further, the time-dependent average Glasgow Coma Scale (GCS), among the groups according to the characteristics of lesion's distributions in the initial DWI, was estimated. RESULTS: In this study, the difference of prognosis was not shown, according to all the clinical data, such as the severity or duration of the hypoglycemic state, but the group that did not have any pathologic lesion on the initial DWI demonstrated a better prognosis, in comparison with the groups-that exhibited any positive lesion on the initial DWI (p = 0.006). The group that had a focal pathologic lesion on the initial DWI showed a better prognosis than the diffuse lesion's group (p = 0.045). The groups with no lesion or focal lesion showed a faster recovery of GCS than the other groups with a positive lesion or diffuse lesion within the initial 1 week. CONCLUSIONS: We can identify that the characteristics of the lesion's distribution of DWI can be more helpful to predict of prognosis in HE than a variety of clinical data, such as the severity or duration of the hypoglycemic state.
Diffusion ; Glasgow Coma Scale ; Humans ; Hypoglycemia ; Prognosis ; Retrospective Studies

We report a 58-year-old man who developed synchronous gastric non-Hodgkin`s lymphoma (NHL) and renal cell carcinoma. He presented with epigastric discomfort for 2 months. Endoscopic finding of the stomach disclosed a large inegular ulceration with nodular margin on the upper body. Constrast enhanced CT scan of the abdomen showed an ulceration and focal wall thickening in the greater curvature side of stomach, and an enhanced bulging mass in the left kidney incidentally. The tissue obtained by radical proximal gastrectomy and nephrectomy showed diffuse large B-cell lymphoma on stomach and chromophobic type of renal cell carcinoma on kidney. To our knowledge, this is the first report of synchronous gastric NHL and renal cell carcinoma in Korea.
Abdomen ; Carcinoma, Renal Cell* ; Gastrectomy ; Hodgkin Disease* ; Humans ; Kidney ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Middle Aged ; Nephrectomy ; Stomach ; Tomography, X-Ray Computed ; Ulcer

Pulmonary embolism (PE) is generally thought to occur between days 5 to 7 after acute injury. However, PE can occur early after injury and the features of early PE after injury have not been well studied. We report on two cases of acute PE within two days after thoracic and lower extremity injury. First, a 39-year-old female presented to the emergency department complaining of chest pain and dyspnea. Fifteen hours earlier, she had fallen from a 1 m height drawer at home. She had a history of idiopathic pulmonary arterial hypertension. Initial blood pressure was normal; however, oxygen saturation was 83% on room air. Chest computerized tomography (CT) showed a low density filling defect in the left main pulmonary artery. However, no deep vein thrombus was observed on low extremity CT angiogram. Second, a 21-year-old male was transferred from a local clinic to the emergency department. He had pelvic ramus, right femur shaft and ankle fracture from a motorcycle accident, which had occurred 36 hours ago. Initial vital signs were stable and he had no symptoms related to PE, except leg pain. We performed CT scan in order to rule out injury associated with pelvic bone fracture. CT scan showed filling defects in the segmental pulmonary artery of the left lower lobe. We did not find deep vein thrombus on low extremity CT angiogram. PE related to trauma can occur in early days after injury and is not commonly associated with deep vein thrombus. Emergency physicians should consider PE in the differential for patients with unexplained dyspnea, even early after injury.
Adult ; Ankle Fractures ; Blood Pressure ; Chest Pain ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Extremities ; Female ; Femur ; Humans ; Hypertension ; Leg ; Lower Extremity ; Male ; Motorcycles ; Oxygen ; Pelvic Bones ; Pulmonary Artery ; Pulmonary Embolism* ; Thorax ; Thrombosis ; Tomography, X-Ray Computed ; Veins ; Venous Thromboembolism ; Vital Signs ; Young Adult

Fluoropolymer compounds (polytetrafluoroethylene-PTFE, Teflon(R)) can produce a clinical syndrome, polymer fume fever, when the products from their thermal decomposition are inhaled. Polymer fume fever is characterized by fever, dyspnea, a non-productive cough, and headaches after exposure to the pyrolytic products. We report a case of acute respiratory distress syndrome after the inhalation of fumes produced from overheated fluoropolymer compounds. A 60-year-old male came to the emergency department complaining of severe dyspnea, nausea, coughing. Just one day ago, he worked in a fluoropolymer-processing factory without any protective mask device. Initial arterial blood gas analysis showed a composition of pH 7.4, arterial partial oxygen pressure 46.0 mmHg and oxygen saturation 79% of room air. Chest computerized tomography revealed a bilateral diffuse consolidation and ground glass appearance. Polymer fume fever and acute respiratory distress syndrome was suspected by the symptoms, history of exposure, and radiologic findings. The patient received ventilatory support with a mechanical ventilator, intravenous corticosteroids, and intravenous N-acetylcysteine. His symptoms and oxygen saturation completely resolved over 6 days. In summary, when fluoropolymers compounds are heated the fumes generated can cause polymer fume fever with severe toxic effects, such as acute respiratory distress syndrome, pulmonary edema, and pneumonitis. The clinical presentation, radiologic findings, and the management of polymer fume fever are reviewed here.
Acetylcysteine ; Adrenal Cortex Hormones ; Blood Gas Analysis ; Cough ; Dyspnea ; Emergency Service, Hospital ; Fever ; Glass ; Headache ; Hot Temperature ; Humans ; Hydrogen-Ion Concentration ; Inhalation* ; Male ; Masks ; Middle Aged ; Nausea ; Oxygen ; Pneumonia ; Polymers ; Polytetrafluoroethylene ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult* ; Thorax ; Ventilators, Mechanical

Chordomas are congenital tumor which develop from remnant of the notochord. Most of them arise at the clivus Blumenbachii, at the junction of the sphenoidal and occipital bones or sacrococcygeal region. Rarely chordomas arise at the thoracic spine, which compress the spinal cord epidurally and sometimes invade the substance of the spinal cord. The authors report a case of chordoma at T9-T10 vertebral level in which the characteristic "physaliferous" cells were found in the slides of operative specimen. The tumor was compressing the spinal cord and extending into body and lamine of the vertebra, which resulted the patient, 52 year-old Korean male, in paraplegia.
Chordoma* ; Cranial Fossa, Posterior ; Humans ; Male ; Middle Aged ; Notochord ; Occipital Bone ; Paraplegia ; Sacrococcygeal Region ; Spinal Cord ; Spine*