No abstract available.
Animals ; Guinea Pigs* ; Guinea* ; Perilymph*

No abstract available.
Mouth* ; Oropharynx*

No abstract available.
Head* ; Killer Cells, Natural* ; Lymphocytes* ; Neck*

PURPOSE: To evaluate the functional and cosmetic results of trichiasis treatment between the argon laser epilation(Group A) and tarsotomy(Group B). METHODS: Twenty-seven patients with diffuse lower lid trichiasis, whose post-treatment follow-up periods were longer than 3 months, were reviewed retrospectively. Functionally, 14 of 16 patients(89.6%) in group A were satisfied, whereas 9 of 11 patients(84.0%) were in group B. And cosmetically, 10 of 16 patients(62.9%) in group A were satisfied, whereas 8 of 11 patients(79.0%) were in group B. The functional results were similar between the two groups(p>0.05), but the cosmetic results were better in group B than in group A(p<0.05) CONCLUSIONS: The inferior tarsotomy appears to be an effective surgical procedure in patients with diffuse lower lid trichiasis.
Argon ; Follow-Up Studies ; Humans ; Retrospective Studies ; Trichiasis*

PURPOSE: Glyphosate-surfactant herbicide (GSH) is a widely used herbicide that is generally thought to be safe. When ingested in large quantities, however, it can result in serious toxicity and even lethality. The purpose of this study was to identify predictive factors for early hospital discharge in GSH poisonings. METHODS: GSH poisoning patients were divided into two groups. Group A consisted of patients who were discharged earlier, within 48 hours, without any complication since ED admission. Group B included patients who were admitted to the ED more than 48 hours earlier and/or who died within 48 hours of ED admission. Patient demographics, drug intoxication information, chest X-ray (CXR) findings and laboratory data during the first 24 hours on ED admission were collected. Those data were analyzed for their effect on the two groups. Univariate and odds ratio analysis were done. Predictive factors for early hospital discharge were then determined using logistic regression analysis. RESULTS: Seventy three patients (51 males, 22 females) were enrolled in our study; 39 patients in group A, and 34 patients in group B. By univariate and odds ratio analysis, the following variables showed statistically significant differences between groups A and B: estimated amount of poison ingested?, GSC score, CXR findings, arterial pH, PO2, bicarbonate, BUN, creatinine, amylase and potassium. In the analysis of clinical symptoms and signs, mental change, dyspnea and voice change were the significant findings in group B (p<0.05). In multivariate logistic regression analysis to predict early discharge in GSH poisonings, 3 variables (normal CXR finding, no metabolic acidosis, BUN level < or = 23) were found to be highly associated with early discharge. We established the following multiple logistic regression model: Log(p/1-p) = -3.02+1.85(normal CXR)+1.98(no metabolic acidosis)+1.46(BUN< or =23) CONCLUSION: Although GSH poisoning causes multi-organ toxicity, its mortality rate is relatively low (5.5%). Acid-base status, chest X-ray finding, and serum BUN level during the first 24 hours are useful predictive factors for early discharge from the hospital in GSH poisonings.
Acidosis ; Amylases ; Creatinine ; Demography ; Dyspnea ; Glycine ; Herbicides ; Humans ; Hydrogen-Ion Concentration ; Logistic Models ; Male ; Odds Ratio ; Potassium ; Thorax ; Voice

PURPOSE: Various electrocardiogram (ECG) changes can occur in patients with acute organophosphate poisoning (OPP) and may be associated with the clinical severity of poisoning. The present study aimed to evaluate the extent and frequency of ECG changes and cardiac manifestations, and their association with acute OPP clinical severity. METHODS: Seventy-two adult patients admitted to our emergency department with a diagnosis of acute OPP were studied retrospectively. ECG changes and cardiac manifestations at admission were evaluated. ECG changes between respiratory failure (RF) group and no respiratory failure (no RF) groups were compared. RESULTS: Prolongation of QTc interval (n=40, 55.6%) was the most common ECG change, followed by sinus tachycardia (n=36, 50.0%). ST-T wave changes such as ST segment elevation or depression and T wave change (inversion or non-specific change) were evident in 16 patients (22.2%). Prolongation of QTc interval was significantly higher in the RF group compared with the no RF group (p=0.03), but was not an independent predictor for RF in acute OPP (OR; 4.00, 95% CI; 0.70-23.12, p=0.12). CONCLUSION: While patients with acute OPP can display ECG changes that include prolongation of QTc interval, sinus tachycardia, and ST-T wave changes at admission, these changes are not predictors of respiratory failure.
Adult ; Depression ; Electrocardiography ; Emergencies ; Humans ; Organophosphate Poisoning ; Phenylpropionates ; Respiratory Insufficiency ; Retrospective Studies ; Tachycardia, Sinus

PURPOSE: Hospitals should be prepared for out-of-hospital (external) and in-hospital (internal) disasters. Mapping is vital for disaster management. Disaster situations can be quickly and comprehensibly understood through the use of disaster mapping. The purpose of this article is to design an internal disaster map for the Asan Medical Center (AMC). We expect this mapping to be helpful in making an internal disaster plan and in controlling an internal disaster. METHODS: Internal disasters were classified into three categories according to the disaster size and the response level, and the three categories were AMC Code I, II, and III. The triage was divided into 6 groups. AMC and its surrounding area were latticed at the interval of 50 meters. The essential elements of the internal disaster plan were drawn on the latticed map by using the procedures in the internal disaster plan. RESULTS: Internal disaster maps were designed for Code II and III internal disaster. Primary and secondary control lines enclosed the hospital area and the disaster site. A command post, a treatment area with a triage area, and a transport area were positioned in each disaster code map. Evacuation roots and traffic flow were drawn. Evacuation maps for intensive-care-unit and high-floor patients were designed in light of their limited mobility. Disaster ID cards and parking cards were also made. CONCLUSION: The internal disaster mapping of AMC will allow emergency medical personnel to visualize and verify their disaster plan and to quickly access critical information on the disaster situation. Also, it can be used for interagency communication.
Chungcheongnam-do* ; Disaster Planning ; Disasters* ; Emergencies ; Humans ; Triage

PURPOSE: Effective triage at the emergency department entrance is the key to dealing with mass casualty incidents. However, in Korea, triage has been accomplished at the disaster scene or at the hospital in only a few cases. Thus, we report on the planning and preparation for triage at Asan Medical Center (AMC) for mass casualty incidents. METHODS: We review the AMC disaster plan and the triage systems used in previous disasters. Also, we review triage principles appearing in the literature. We describe basic hospital triage principles, which include the treatment site, the triage site, the triage officer, triage categories, and triage tags. RESULTS: 1) For external disaster, the emergency department is reassigned to four treatment sites before patients arrive. At the triage site, an emergency medicine specialist classifies patients into six groups according to treatment priority and resources. After classification, a triage tag is attached to each patient, and patients are moved to the previously designated treatment site. 2) For internal disaster, the head nurse (or senior nurse) classifies patients into three groups: urgent, minor, and delayed. The minor group is sent to the casualty collection point while the urgent and delayed groups are moved to the triage site. CONCLUSION: Hospitals should prepare a disaster plan. In particular, preplanning for triage is essential to cope with internal and external disasters. In addition, emergency medicine specialists should play a key role in disaster planning and are essential for successful implementation of the disaster plan.
Chungcheongnam-do ; Classification ; Disaster Planning ; Disasters ; Emergency Medicine ; Emergency Service, Hospital ; Humans ; Korea ; Mass Casualty Incidents* ; Nursing, Supervisory ; Specialization ; Triage*

Objective: The aim of the study was to compare the mortality rates of patients with early-identified (EI) sepsis and late-identified (LI) sepsis. Methods: We performed a retrospective chart review of patients admitted to the emergency department and diagnosed with sepsis. EI sepsis was defined as patients with a Sequential Organ Failure Assessment (SOFA) score ≥2, based on 3 parameters of the SOFA score (Glasgow coma scale, mean arterial pressure, and partial pressure of oxygen/fraction of inspired oxygen ratio), measured within an hour of emergency department admission. The remaining patients were defined as LI sepsis. The primary outcome was in-hospital mortality. Results: Of the total 204 patients with sepsis, 113 (55.4%) had EI sepsis. Overall mortality rate was 15.7%, and EI sepsis group had significantly higher mortality than LI sepsis (23.0% vs. 6.6%, P=0.003). The patients with EI sepsis, compared to those with LI sepsis, had higher SOFA score (median: 4 vs. 2, P<0.001); Acute Physiology and Chronic Health Evaluation (APACHE) II score (median: 14 vs. 10, P<0.001); were more likely to progress to septic shock within 6 hours after admission (17.7% vs. 1.1%, P<0.001); were more likely to be admitted to the intensive care unit (2.2% vs. 1.1%, P=0.001). Conclusion Mortality was significantly higher in the EI sepsis group than in the LI sepsis group.

A 62 year old female patient was transferred to the operating room for open reduction and internal fixation of the left femur fracture under general anesthesia. At 15min. after femur tourniquet application, there were suddenly decreased oxygen saturation, end-tidal CO2 concentration and blood pressure. We suspected a pulmonary embolism, and attempted vigorous emergency treatment and intensive care including ventilator care, vasopressor drug use, pulmonary artery pressure monitoring. At the 5th day after intensive care unit, she was transferred to general ward and she discharged without any sequelae after 17th day postoperatively.
Anesthesia, General ; Blood Pressure ; Embolism ; Emergency Treatment ; Female ; Femur ; Humans ; Critical Care ; Intensive Care Units ; Middle Aged ; Operating Rooms ; Oxygen ; Patients' Rooms ; Pulmonary Artery ; Pulmonary Embolism* ; Tourniquets ; Ventilators, Mechanical