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

It had been reported by many authors that the incidence of delayed or nonunion in fracture of clavicle was higher in open reduction and internal fixation than conservative treatment. The purpose of this study is to verify the gratification of the reconstruction plate in fracture of clavicle which needed internal fixation. From March 1993 to September 1995, 32 clavicular fractures were underwent open reduction and internal fixation with reconstruction plate for the wide gap, soft tissue interposition and comminuted fracture etc. The results were as follows 1. The range of motion of the shoulder was returned to normal range within 1.5 weeks except one case who had brachial plexus injury. 2. All cases had bony union. Average time to clinical union was 2.9 weeks and the bony union 7.8 weeks. 3. By functional evaluation of shoulder by Weitzman, final results were excellent in 27, good in 4 and fair in l. 4.Fixation and maintenance of clavicular fragment by reconstruction plate was recommendable for wide separated, soft tissue interposed, comminuted fracture of the clavicle. We concluded that reconstruction plate in fracture of clavicle could be recommended as one of the device for internal fixation.
Brachial Plexus ; Clavicle ; Fractures, Comminuted ; Incidence ; Range of Motion, Articular ; Reference Values ; Shoulder

No abstract available.
Salivary Glands*

BACKGROUND: Nowadays, acute drug intoxication is a important section of emergency medicine. The purpose of this study was to determine what is the best-way to manage acutely intoxicated patients with drug in emergency department setting. METHODS: Clinical assessment were made on 135 cases of drug intoxication visited to emergency center of Hospital during one year from June 1997 to May 1998. RESULTS: 1. The total number of cases of acute drug intoxication was 135 which is 0.5% of total patients presented to emergency center. 2. There was no sexual difference in incidence, but the highest incidence of age group was in 3rd decade(23.7%) and the next was 7th decade(20.0%). 3. High frequency of acute intoxication was observed in autumn. October had the largest portion in monthly distribution. The largest portion of presumed time of poisoning was noon - 4 p.m. and of the time on arrival to emergency center was 8 p.m. -midnight. 4. Suicidal attempt was the most common motive of intoxication (72.6%). 5. The most common drug of intoxication was insecticides (35.7%) and the others were centrally active agents, herbicides in orders. 6. Mental change was observed in 20.7% of patients and the abnormal vital signs were hypertension, tachycardia, and hypotension in order on arrival to emergency center. 7. Mean duration of treatment was 36.1 hours. Mortality rate of the cases was 7.4%. CONCLUSION: The mortality rate was high in patients who ingested relatively fatal drugs (i.e. herbicides, antimicrovials, insecticides), showed mental change on arrival or received mechanical ventilatory care(p<0.05).
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Herbicides ; Humans ; Hypertension ; Hypotension ; Incidence ; Insecticides ; Mortality ; Poisoning ; Tachycardia ; Vital Signs

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

No abstract available.
Aortic Valve Insufficiency*

Bone tumor in the trochanteric area is not infrequent and it is important to differentiate the tumors in this area for diagnosis, early settings of therapeutic plans and prognostic previsions. Twenty-one cases of benign bone tumors in the trochanteric area treated at Dept. of Orthopedi Surgery, College of Medicine, Ewha Womans University Hospital, from January 1975 to December 1983 were analysed and following results were obtained. l. of 21 cases, 10 cases were fibrous dysplasia, 6 cases were simple bone cyst, 3 were giant ce tumor and 2 were aneurysmal bone cyst. 2. Pathologic fractures were accompanied in 6 cases; 3 of fibrous dysplasia, 2 of simple bone cy: and 1 of aneurysmal bone cyst. 3. After treatment with curettage, bone graft and instrumentation, 3 cases recurred; 2 cases of fibrous dysplasia and 1 of simple bone cyst. 4. As prognostic factors, completeness of curettage, amount and source of bone graft were considered to be important.
Aneurysm ; Bone Cysts ; Clinical Study ; Curettage ; Early Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Transplants

Acromioclavicular joint injuries are frequently seen with the recent increase of traffic and industrial accidents. The treatment of complete separation of the acromioclavicular joint has been, and is still, a subject of controversy. In view of a recent trend, anatomical reduction of acromioclavicular joint, and rigid internal fixation method is preferable, especially in type 3 injury. We operated on 16 cases of complete acromioclavicular separation by the technique of coracoclavicular wiring from March 1983 to Feb. 1987. The following results were obtained. 1. The functional results were excellent; 12 cases(75%), good; 3 cases(19a%), and fair ; 1 cases(6%). 2. The complications include wire reakage ; 1 case(6%), bony erosion ; 3 cases(19%) and subluxation, 1 case(6%). 3. The advantages of coracoclavicular wiring. 1) Avoids violation of acromioclavicular joint but does not restrict rotation of the clavicle. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy under local anesthesia. 5) This method corresponds to the coracoclavicular ligment biomechanically. Therefore, coracoclavicular wiring is thought to be a good operative method in the treatment of complete acromioclavicular separation.
Accidents, Occupational ; Acromioclavicular Joint ; Anesthesia, Local ; Clavicle ; Immobilization ; Methods

Gaucher's disease is an uncommon metabolic disorder, which was first described by Gaucher in 1882, characterized by accumulation of distinctive Gaucher's cells in the reticuloendothelial system such as spleen, liver, and bone marrow. The great majority of cases have been reported in Jews, and others in negros and orientals. We are presenting two cases in homozygous twins in Korea, whose clinical manifestations are hepatosplenomegaly and bone lesions due to expansion of involved bones.
African Continental Ancestry Group ; Bone Marrow ; Gaucher Disease ; Humans ; Jews ; Korea ; Liver ; Mononuclear Phagocyte System ; Spleen ; Twins

These days, the epidural administration. of morphine is commonly used for postoperative pain re lief because even small amount of morphine (3mg) is enough to have an effect on specific opiates receptors of the spinal canal. We report a prospective double blind study of the efficacy of a single epidural dose of morphine on pain after spinal decompression. Postoperative pain was assessed by a linear analogue pain score and by the additional require ment for systemic analgesics. The results obtained are as follows:l. In spinal decompression, the adminitration of epidural morphine is easy, effective and safe because the epidural space has been already exposured during operation. 2. After operation the epidural route of morphine administration will give pain relief for up to 12 hours excellently. 3. When epidural morphine is given at the time of operations, the use of systemic analgesics is much reduced. 4. The side effects of epidural morphine are much reduced due to the small amount of morphine required. This simple procedure is recommended as an effective and safe method of reducing postoperative pain.
Analgesia ; Analgesics ; Decompression ; Double-Blind Method ; Epidural Space ; Methods ; Morphine ; Pain, Postoperative ; Prospective Studies ; Spinal Canal