BACKGROUND: Trauma is a major cause of death for individuals under the age of 45 years and the third leading cause of death for all ages. So, it has been recognized as an important socioeconomic problem. The purpose of this study was to evaluate the outcome of surgical care of traumatized parients. METHODS: We retrospectively analyzed data of patients who had undergone surgical operation on head, abdomen, or chest trauma from January 1, 1995 to December 31, 1995. TRISS method and W- and Z- statistics were used to evaluate the trauma outcome and the quality assurance of surgical treatment. RESULTS: Two hundred and sixty eight patients were enrolled in this study. Traffic accident in injury mechanisms was the most common(n=185, 69.2%), and severely injured patients with over ISS 16 were 205 of total 268 patients(76.5%). Crude mortality rate was 11.6% (non-survivors/number of patients : 31/268). By TRISS method, predicted mortality rate was 10.1%, excess mortality rate was 14.2%, and W value was - 1.43 indicating less actual survivors than predicted, but absolute Z score was 0.91 and it was statistically not significant. CONCLUSION: These data show that trauma outcome and quality of surgical care in our hospital is adequate. We also suggest that it will provide a valuable data for further studies.
Abdomen ; Accidents, Traffic ; Cause of Death ; Head ; Humans ; Injury Severity Score* ; Mortality ; Retrospective Studies ; Survivors ; Thorax

No abstract available.
Ear* ; Humans ; Tissue Donors* ; Transplants*

Basta(R) is one of the Phospho-amino acid group herbicide. It consist of glufosinate ammonium (18.5%), alkylether sulfate as surfactant (30%) and some solvents. Although it's WHO classification is Bade III, the intoxicated patient appears an serious clinical findings and have a 20% mortality rate. Nowadays, in Korea the ingestion of herbicidal agents for suicidal attempts is Sequent. The literature for intoxication of bipyridilium (Gramoxon(R)) as herbicide is varied, but the information for Basta(R) is poor even though the use of it tends to increase. Recently, We experienced six cases of Basta(R) intoxication and found that the patient expressed a gradually progressed depression of mentation, recent memory disturbances, convulsions, hypotension, or bradycardia because of CNS or cardiovascular effects of Basta(R) We report these cases with literature review.
Ammonium Compounds* ; Bradycardia ; Classification ; Depression ; Eating ; Humans ; Hypotension ; Korea ; Memory ; Mortality ; Seizures ; Solvents

BACKGROUND: The current recommendation of rescue breathing techniques in the infant is to blow both the nose and mouth of infants by caregiver's mouth but recent studies suggest some caregivers may have trouble sealing a infant's mouth and nose. The purpose of this study is to estimate the ability of mothers to create a seal to their infants for the provision of rescue breathing according to current recommendation. METHODS: Infants up to 1 year of age(n=98) and their mothers were enrolled from emergency department of Chonbuk National University Hospital. We measured the facial lengths of the infants and the width of mouth in their mothers and compared mouth widths of mothers with their infant's nose-to-mouth lengths. RESULTS: In infants between 0 to 6 months, Mother transverse lengths were significantly larger than mouth, nose and nose-to-mouth lengths of the infants. In infants between 7 to 12 months, Mother transverse lengths were significantly larger than mouth and nose lengths of the infants but there was no statistically significant difference between mother transverse lengths and nose-to-mouth lengths of infants. CONCLUSION: The finding indicate that the present recommendation to cover mouth and nose is partly not possible. We recommend that the mouth-to-nose ventilation of rescue breathing techniques for the infants who have respiratory arrest be taught to mothers.
Caregivers ; Emergency Service, Hospital ; Humans ; Infant* ; Jeollabuk-do ; Mothers ; Mouth ; Nose ; Respiration* ; Ventilation

The chin plays a decisive role in the contour of the lower face. And harmonious jaw will correspond to good facial profile and positive image. Osseous genioplasty is a widely used method to correct the 3-dimensional(sagittal, vertical, tranverse) deformity of the chin with minimal complications. During an 8 year period from 1988, the authors at the In-Je University Seoul Paik Hospital experienced 198 patients of osseous genioplasty. Results of clinical analysis are as follows : 1) Male to female ratio was 1 : 3 with female being predoniment. The average age was 24.9 years. 2) Horizontal advancement genioplasty in 169 cases was the most common procedure with 7.0mm of average advancement. There was 4 cases of horizontal retrusion with average retrusion of 4.3mm. 52 cases had vertical augmentation with average of 7.5mm increase. 9 cases had vertical reduction with average redution of 4.9mm. 3) Although malocclusion is not necessarilly contraindication to genioplasty alone, genioplasty following surgical with or without orthodontical correction of malocclusion is the way to get better result with patient satisfaction. 4) 77% of the patients had adjunctive procedures simultaneously to acheive a better contour and profile 5) Complications such as hematoma, infection, fracture, nerve damage were minimal.
Chin ; Congenital Abnormalities ; Female ; Genioplasty* ; Hematoma ; Humans ; Jaw ; Male ; Malocclusion ; Patient Satisfaction ; Seoul

The neuroleptic malignant syndrome(NMS) results primarily from an imbalance of central neurotransmitters and typically occurs after acute or chronic neuroleptic drug use rather than after neuroleptic overdosage. It is a rare and serious iatrogenic syndrome that is characterized by hyperthermia, muscle rigidity, autonomic dysfunctions and altered mental status. We have observed a case of NMS-like state due to depot of chlorpromazine(CPZ) and have experienced symptomatic and supportive treatment, which including body surface cooling, fluid administration, diuretics, and diazepam. So, in order to provide interests with this clinical situation for emergency physician, pathophysiology is discussed with references to the possibility of NMS in our case and symptomatology and managements are also reviewed.
Chlorpromazine* ; Diazepam ; Diuretics ; Emergencies ; Fever ; Muscle Rigidity ; Neuroleptic Malignant Syndrome ; Neurotransmitter Agents

BACKGROUND: The self-inflating bag-valve resuscitator is an useful breathing support equipment in the cardiopulmonary resuscitation, the transportation of patients who required ventilation assist, or respiratory therapy. The inspiratory oxygen concentration (FiO2) or tidal volume (VT) delivered to the patient depends on various conditions during bag-valve ventilation. METHODS: During bag-valve ventilation without a reservoir at oxygen flow rates of 10 l/min, we evaluated fifty six volunteers to determine the FiO2 and VT at ventilatory frequencies of 10, 12 and 15 cycles per minute and to observe the effect of hand size and grasp power on FiO2 and VT in two-hand compression methods. RESULT: The FiO2 at frequency of 10 cycles/min were 50.1% and it was higher than other ventilatory frequencies. However, the VT was not statistically different among the changes of ventilatory frequency. In the change of VT according to characteristics of the hand, the operator's hand size exerted influence on VT(larger vs. smaller ; 942ml vs. 885ml, p<0.05), but the grasp power of the hand did not significantly affect. Separate analyses with size or grasp power of the hand failed to reveal significant differences of the FiO2. CONCLUSION: The results suggest that a slowing of ventilatory frequency within the allowable ranges for adequate gas exchange increase the FiO2 during bag-valve ventilation without reservoir, and that hand size may exert influence on the VT without FiO2 changes but grasp power may not be a contributing factor to the VT or FiO2 changes.
Cardiopulmonary Resuscitation ; Hand Strength ; Hand* ; Humans ; Oxygen* ; Respiration ; Respiratory Therapy ; Tidal Volume* ; Transportation of Patients ; Ventilation* ; Volunteers

BACKGROUND: The mechanically ventilated patient's stay in the emergency department (ED) is brief but ventilatory management and intervention must be optimal. Agitation, anxiety, distress, and discomfort are common complications far the ventilated patient. So, sedation is necessary to reduce these complications. METHODS: Patients were monitored and mechanically ventilated. Midazolam was intravenously administered as loading dose(3-5mg), followed by continuous infusion at a rate of 0.06mg/kg/hr, titrated to achieve a predetermined sedation level (Ramsay's sedation score: 2-5 points, Glasgow coma score scathe : 8-11 points). RESULTS: After onset of predetermined sedation, systolic and diastolic blood pressure and heart rate remained stable during continuous infusion when compared with those of the initial state. Arterial blood gas and peak inspiratory pressure remained unchanged but respiratory rate was decreased to allowable ranges. CONCLUSION: A short-term continuous infusion of midazolam was a safe and erective method for sedation of ventilated patients in ED.
Anxiety ; Blood Pressure ; Coma ; Dihydroergotamine ; Emergency Service, Hospital ; Heart Rate ; Humans ; Midazolam* ; Respiratory Rate

No abstract available.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis*

No abstract available.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis*