Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.
Brain ; Child ; Community Health Services ; Decompression Sickness ; Disaster Planning ; Disasters ; Emergencies* ; Emergency Medical Services ; Emergency Medicine* ; Emergency Service, Hospital ; Heart ; Hot Temperature ; Humans ; Jurisprudence ; Resuscitation ; Specialization ; Spouse Abuse ; Substance-Related Disorders ; Triage

No abstract available.
17-alpha-Hydroxyprogesterone*

OBJECTIVE: p16INK4 and p15INK4B genes are known to be tumor suppressor genes which reside in p21 region of chromosome 9 and are related to cell cycle control as an inhibitor of cyclin-dependent-kinase. We designed this study to search for deletion and decreased expression of p16INK4 and p15INK4B genes in advanced ovarian carcinomas. METHODS: Polymerase chain reaction (PCR)-based analysis was performed to search for deletion of p16INK4 and p15INK4B using DNA extracted from frozen tissue in liquid nitrogen of thirty-one advanced ovarian carcinoma patients. The intensities of PCR bands were analyzed using an imaging densitometer to determine gene dosage in tumor samples and the relative gene dosage was calculated by comparing band intesity of p16INK4 or p15INK4B with that of beta-globin gene. Homozygous deletions were assigned to tumors in which the ratio was reduced to less than 25% in any one of exons of p16INK4 and p15INK4B. Immunohistochemical techniques were used to study the expression of p16INK4. p16-negative cells were characterized by the absence of nuclear staining, whereas cytoplasmic staining was variable. Clinico-pathologic features, complete remission rates and survivals were analyzed according to the status of p16INK4 and p15INK4B genes. RESULTS: Homozygous deletion of p16INK4 was detected in 12.9% of advanced ovarian carcinoma patients and that of p15INK4B in 35.5%. Clinico-pathologic features such as FIGO stage, histological grade, serum CA-125 levels were not different from groups with homozygously deleted p16INK4 and p15INK4B to those with normal genes. The survival of patients (13 [6-20] months) with homozygously deleted p16INK4 was significantly shorter than that (30 [8-52] months) of patients with normal p16INK4 (p=0.046; Log-rank test). CONCLUSION: These observations indicate that deletions of p16INK4 and p15INK4B gene might be involved in tumorigenesis of ovarian carcinoma and could be useful as a prognostic factor. A prospective, controlled study with more patients will be mandatory in the future.
beta-Globins ; Carcinogenesis ; Cell Cycle Checkpoints ; Chromosomes, Human, Pair 9 ; Cytoplasm ; DNA ; Exons ; Gene Dosage ; Genes, Tumor Suppressor ; Humans* ; Immunohistochemistry ; Nitrogen ; Polymerase Chain Reaction

BACKGROUND: The medicolegal problems can be occurred in all medical field, Especially ED can be more exposed to the legal claims due to the very nature of ED business and characteristics of ED patient (or their family member). All emergency physicians, as a ED manager, should be concerned about the law associated with emergency cairo for handling the medicolegal problem. So they can deal with and prevent the legally risky situations that may be occurred in ED practice. Ultimately we can reduce the risk of a malpractice lawsuit and provide good emergency care services. SUGGESTION: The authors would like to suggest several items that we have thought the ED physicians and managers always have to remember to manage the medicolegally risky situations. 1. Every member of ED health care team must be trained in understanding the patients' wants and desires. 2. The emergency physicians and nurses must realize that they are the best risk management tools in the hospital. 3. ED physician should have the knowledge of the law associated with emergency health care. 4. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care providers of every health care institutes. 5. We should never forget the time honored sentences, 'Good medicine is good law'.
Academies and Institutes ; Commerce ; Delivery of Health Care ; Emergencies ; Emergency Medical Services ; Empathy* ; Health Personnel ; Humans ; Jurisprudence ; Malpractice ; Patient Care Team ; Risk Management

BACKGROUND: Plasmodium vivax malaria was recently re-presenting infectious disease in Korea since was being controlled for about 10 years age, but has been increasing years by year in the soldiers or farmers working at the near Demilitarized Zone(DMZ). So we analyzed the Characteristics of the patients diagnosed as malaria since 1997 in Yeungnam university hospital. METHODS: From January 1997 to August 1999, the 23 patients complainted of the febrile and chilly sense were diagnosed as Plasmodium vivax malaria in Yeungnam university hospital. We analyzed the patient's records for clinical findings(i.e. clinical symptoms and signs), occupation and regions of working or visiting, laboratory findings, treatment and its results, etc. RESULTS: Male patients were 21 and female patients were 2 among the total 23 patients, the 19 of 21 male patients were soldiers discharged from military services. All patients had been visited or worked near the DMZ, as the northern part of Kyungki-do(21 cases) or Kangwon-do(2 cases). And all patients complainted of delayed onset(means 6 months) of fever and chills after working or visiting at this zones. On physical examination, liver or spleen were palpated initially at least 1 finger breadth in 9 cases(39.1%), and peripheral blood smears showed the infected RBCs(i.e. gametocyte, ring form, schizont, trophozoite) in all cases, and 21 cases(91.3%) showed thrombocytopenia. All patients were treated by the combined regimen of 2-days hydroxychloroquine and 14-days primaquine. All cases showed clinical and laboratory improvement initially, but 5 cases were recurred after 2 months and showed re-improvement. And none of 23 cases showed the significant complications and deaths after medical treatment. CONCLUSION: Plasmodium vivax malarial infection is currently re-presenting disease near the DMZ. So we should consider the active prevention and management of malaria.
Chills ; Communicable Diseases ; Female ; Fever ; Fingers ; Humans ; Hydroxychloroquine ; Korea ; Liver ; Malaria ; Malaria, Vivax* ; Male ; Military Personnel ; Occupations ; Physical Examination ; Plasmodium vivax* ; Plasmodium* ; Primaquine ; Schizonts ; Spleen ; Thrombocytopenia

No abstract available.
Rheumatic Diseases*

No abstract available.
Rheumatic Diseases*

No abstract available.

No abstract available.

No abstract available.
Spondylitis, Ankylosing*