BACKGROUND: To provide basic data to help construct regional EMSS. METHOD: Using preformed questionnaire, authors investigated prospectively data of 214 patients transferred directly to emergency medical center from other hospitals from May 11 to june 10,1998. RESULTS: 1. Total 214 patients were transferred directly to the emergency medical center of KNUH (14.4% of total), and 63.5% of patients excluding children were non-traumatic patients. 2. The peak age group was 5th decade (19.6%) with mean age of49.6 years old. The male to female ratio was 1.8 : 1. 3. The period between 08 : 00 to 16 : 00 was the most frequent arrival time of transfer patients (42.5%), and the proportion of patients for surgical departments were more common than those for other departments (53.7%). 4. the majority of patients were transferred from secondary hospitals (91.6%), but among them the proportion of mild non-traumatic and mild traumatic patients was 52.3%, and 72.0%. 5. The decision-maker for transfer was a patient himself or family members in 32.3% of severe and 26.8(/) of mild non-traumatic patients, compared with 37.5% of severe and 26.8% of mild traumatic patients. 6. The physician-to-physician communication prior to the patient's transfer was not carried out in 90.8% of severe and 85.9% of mild non-traumatic patients, compared with 75.0%of severe and 67.0%of mild traumatic patients. 7. The hospital ambulance was the most common mode of transfer (64.5%), but non-emergency vehicles such as a taxi or a private car was used for transfer in 21.5% of severe non-traumatic patients, and 12.5% in severe traumatic patients. 8. Transfer accompanied by medical personnel took place in 15.4% of severe non-traumatic patients, 25.0% in severe traumatic patients, and in 27.0% of severe non-traumatic patients, and 44.4% in severe traumatic patients transferred 4 by hospital ambulance. 9. Transfer took less than 1 hour in 66.9% of non-traumatic patients, and 45.2% of traumatic patients, but it took 1 hour or more in 27.7% of severe non-traumatic patients, and 43.7% of severe traumatic patients. 10. Transfer record accompanied the patient in 90.2% of total, but radiologic film and results of laboratory tests did not in 36.9% and 56.9% of severe non-traumatic patients, and in 12.5% and 43.7% of severe traumatic patients. CONCLUSION: It is considered that an appropriate triage system, interhospital transfer guidelines, good transfer records, cooperative interhospital communication, emergency medical information center, public information with education about regional EMSS, improvement of equipment in ambulance, and training of emergency personnel are necessary for effective and well-organized EMSS.
Ambulances ; Child ; Education ; Emergencies* ; Female ; Humans ; Information Centers ; Male ; Prospective Studies ; Surveys and Questionnaires ; Triage

BACKGROUND: During the past eight years, we have been performing partial autonomic nerve preservation surgery (PANP) for the treaolent of advanced rectal cancer in order to reduce the postoperative male sexual dysfunctions. METHODS: This is a prospective study of 25 rectal cancer patients who underwent PANP from 1990 to 1997. All patient were in Duke C stage and their ages were between 30 and 55. Patients were divided into four types: 1) Partial sacrifice of inferior mesenteric plexus (PSIP). 2) Partial sacrifice of preaortic nerve (PSPN). 3) Complete sacrifice of preaortic nerve with complete pelvic nerve preservation (CSPN). 4) Unilateral sacrifice of pelvic autonomic nerve (USPN). RESULTS: The percentage of ejaculation and erection difficulties at each surgery was as follows: PSIP 0/5 (0%) for ejaculation vs. 0/5 (0%) for erection, respectively, PSPN 5/7 (71.4%) vs. 2/7 (28.6%), CSPN 6/7 (85.7%) vs. 0/7 (0%) and USPN 6/6 (100%) vs. 5/6 (83.3%). Summary: PANP is possible for the treatment of advanced rectal cancer.
Autonomic Pathways* ; Ejaculation ; Humans ; Male* ; Prospective Studies ; Rectal Neoplasms*

No abstract available.

We studied the expressions of E-cadherin, MMP-7 and CD44V in colorectal cancer and their corresponding normal mucosa using RT-PCR. From the 26 patients whom a com parative study of clinical and histopathological data is available, MMP-7 and CD44V were significantly enhanced in cancer and their metastatic tissues, compared with their normal mucosa. E-cadherin did not reveal any difference between cancer and normal mucosa. The relashionship between these genes and colorectal cancer development can not be confirmed by this study, however CD44v and MMP-7 may be associated with metastasis of colorectal cancer.
Cadherins ; Cell Line* ; Colorectal Neoplasms* ; Humans ; Mucous Membrane ; Neoplasm Metastasis*

No abstract available.
Hemorrhage* ; Humans ; Infant, Newborn*

No abstract available.
Animals ; Bacteria* ; Carcinoma, Lewis Lung* ; Lactic Acid* ; Mice* ; Sarcoma 180* ; Sarcoma*

BACKGROUND: White coat effect (WCE) and white coat hypertension (WCH) are relatively prevalent in clinical situation (20 - 57% of WCH in the hypertensive population). The aim of this study was to analyze the determinant factors of WCE. METHODS: A prospective study was carried out in outpatient clinic in a consecutive hypertensives without receiving pharmacologic treatment. Twenty-four hour ambulatory blood pressure monitoring (ABPM) was performed following more than two resting blood pressure (BP) determinations carried out with the interval of 1 - 2 weeks by mercury sphygmomanometer. WCE was calculated for systolic and diastolic BP as the difference between a clinic BP (CBP) and an average daytime ambulatory BP (ABP). WCH was defined as;BP in the clinic > or = 140/90 mmHg with a mean daytime BP by ABPM < or =137/< or =89 mmHg. RESULTS: 1) Two hundred thirty-five patients (mean age 49.7 years, females 74%) were studied. Thirty-seven percent in male and forty-six percent in female patients fulfilled WCH criteria. 2) CBP was significantly correlated to daytime ABP (systolic BP;r=.47, p<.001 and diastolic BP;r=.65, p<.001). 3) The magnitude of WCE was greater in the group of WCH (28.9+14.6/19.3+6.9 mmHg) than ambulatory hypertensives (15.1+15.7/13.0+8.2 mmHg) (p<.001). 4) The magnitude of WCE is significantly correlated with female (r2=.12, p<.001) and the stage of CBP according to JNC-V (r2=.23, p<.001) in systolic BP, the stage (r2=.08, p<.001) in diastolic BP, and the stage (r2=.09, p<.001) and weight (r2=.15, p<.01) in mean BP. CONCLUSIONS: The magnitude of WCE in essential hypertension diagnosed at the clinic is significantly correlated with female, the magnitude of clinic BP, and weight.
Ambulatory Care Facilities ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension* ; Male ; Prospective Studies ; Sphygmomanometers ; White Coat Hypertension

Acute osteomyelitis is usually shown as a localized area of increased activity (hot uptake) in the infectious focus on bone scintigraphy. In our patient, absence of radioactivity (cold lesion) was noted in the distal metaphyseal and diaphyseal regions of his right femur. Initial x-ray was interpreted as normal except for mild soft tissue swelling in the right thigh. The lesion was confirmed as an acute osteomyelitis with subperiosteal abscess on surgery. Staphylococcus aureus was the etiologic organism. We describe a case of acute osteomyelitis in a one-year-old boy shown as a cold lesion on bone scan.
Abscess ; Femur ; Humans ; Male ; Osteomyelitis* ; Radioactivity ; Radionuclide Imaging ; Staphylococcus aureus ; Technetium Tc 99m Medronate ; Thigh

No abstract available.
Stomach Neoplasms* ; Stomach*

No abstract available.
Intestinal Atresia*