BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.
Anesthesia, General ; Anesthesia, Local ; Catheters ; Cicatrix ; Diagnosis ; Orbit* ; Orbital Fractures ; Silicones

Pigmented photoallergic contact dermatitis is a disease usually resulting from recurrent cutaneous exposure to cosmetic photoallergens which produce bizarre dark brown hyperpigmentation. Histologicnl examination of this condition reveals liquefaction of the basal cells of the epidmis and melanophages in the upper dermis. A 50-year-female developed dark brownish mottled hyperpigmented patches on her face after using a soap named O.E. and taking a nap every afternoon for 4 years. The histological fmding on the lesion site was consistent with pigmented photoallergic contact dermatitis. The cosmetic photopatch test with, O.E. soap, and the Scandinavian scries resulted in a positive reaction only on one side where 5 J/cm2 lights were applied by using Waldman 800UV machine. The other side howed a negative finding. We fmally diagnosed pigmented photoallergic contact dermatitis based on the patients histoty of using the soap containing musk ambrette, a histological examination of a biopsy and the results of photopatch tests. We report rare case of pigmented photoallergic contact dermatitis.
Biopsy ; Dermatitis, Photoallergic* ; Dermis ; Humans ; Hyperpigmentation ; Soaps

Adenosquamous cell carcinoma (Ad-SCC) of the colon is rare. The pathogenesis of Ad-SCC is unclear, however, several hypotheses have been suggested. The clinical presentation and gross findings of Ad-SCC of the colon are similar to those of adenocarcinoma of the colon, but Ad-SCC has a more aggressive clinical course and a poorer prognosis. We report on two cases of Ad-SCC of the colon with obstruction; a collision-type Ad-SCC that has not only obstruction but also numerous hepatic metastases, and a composite-type Ad-SCC treated with left hemicolectomy followed by an adjuvant chemotherapy.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Chemotherapy, Adjuvant ; Colon ; Colonic Neoplasms ; Neoplasm Metastasis ; Prognosis

Atropine is a commonly used eye drug due to the effect of mydrasis and cycloplegia. The true allergic contact dermatitis to atropine is rarely reported. A case of allergic contact dermatitis due to atropine sulfate in a 35-year-old woman was confirmed by the patch test.
Adult ; Atropine* ; Dermatitis, Allergic Contact* ; Female ; Humans ; Patch Tests

Linear IgA bullous dermatoses(LABD) occurring in childhood is considered to be a childhood counterpart of LABD,rather than chronic bullous dermatosis of childhood. This disease characteristically involves the perioral area,lower trunk,pelvic region and the lower extremities. Immunopathologically,it is characterized by the linear deposits of IgA at the dermoepidermal junction of the perilesional skin. A 20-month-old female infant presented with multiple pruritic tense bullae on the face, lower trunk, both extremities and pelvic region of 2 weeks duration. She had no oral lesions or any specific signs or symptoms referable to the disease of the gastrointestinal tract. A skin biopsy revealed subepidermal blisters infiltrated with many neutrophils and a few eosinophils. Direct immunofluorescence demonstrated linear deposition of IgA at the dermoepidermal junction. An indirect immunofluorescence study using NaC1-split skin as the substrate revealed fluorescence for IgA in a linear pattern on the roof of the split at a titer of 1:40. The clinical diagnosis of LABD of childhood was confirmed and we started with a combined remedy of dapsone and corticosteroids; 10 weeks later almost all of the lesions had disappeared.
Adrenal Cortex Hormones ; Biopsy ; Blister ; Dapsone ; Diagnosis ; Eosinophils ; Extremities ; Female ; Fluorescence ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Gastrointestinal Tract ; Humans ; Immunoglobulin A ; Infant ; Linear IgA Bullous Dermatosis* ; Lower Extremity ; Neutrophils ; Pelvis ; Skin ; Skin Diseases ; Transcutaneous Electric Nerve Stimulation

The purpose of this study was to clarify the histologic changes in the expansion of midpalatal suture by the tensile forces. 39 Sprague-Dawley rats were divided into a control group (3 rats) and three experimental groups (36 rats)-group 1, pressured with a light force (50-75g), group 2, with a heavy force (250-300g) and group 3, with a heavy force (250-300g) plus laser irradiation. Autoradiographic and histopathologic observations were performed in 12, 24, 48 and 96 hours after force delivery. The results were as follows: 1. The anterior portion of midpalatal suture was more separated than the posterior portion in all experimental groups. Group 2 showed more separation than group 1 and no difference to group 3. 2. Ligament tearing appeared intensively in 24 hours, but the sutural matrices increased with times.: Group 2 showed more tearing than group 1, and active regeneration of sutural matrices was observed in group 3. 3. Vascular dilatation appeared intensively in 24 hours and decreased with times. : The anterior portion of midpalatal suture showed more dilatation than the posterior portion.: The changes was the greatest in group 3, group 2, group 1, in that order. 4. New bone formation and the new capillary prolieferation began to appear in 12 hours and increased with times.; Group 2 showed more changes than group 1 and no difference to group 3. 5. Infiltration of inflammatory cells was little observed and was the greatest in group 2, group 1, group 3, in that order. 6. Positive reaction of cells to [3H] thymidine was the greatest in 24 hours, and decreased with times: The reaction was the greatest in group 3, group 2, group 1, in that order.
Animals ; Capillaries ; Dilatation ; Ligaments ; Osteogenesis ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Sutures ; Thymidine

In the East, Probably one of the most commonly performed esthetic operation is the piercing of the earlobes for earring. the complication of this procedure includes infection, the formation of the hypertrophic scar or keloid, and tearing. Keloid formation is one of the disaterous common complications of the ear piercing. the patients regard the keloid as a cosmetic blemish and they complain that they cannot wear earrings. We have experienced 5 patients of earlobe keloid complicated from piercing of the earlobes. We used intralestional steroid njection, in conjunction with surgical excision and pressure therapy for treatment of the keloid. Among various techniques for reconstructing a piercing, we chose modified Pardue's method for artificial earlobe cleft after wide excision of the keloid. the result was good and satisfactory without any complication after 4 to 24 months of follow-up. the purpose of this paper is to present a simple method of treatment of the earlobe keloid with preservation of the perforation for an earring.
Body Piercing ; Cicatrix, Hypertrophic ; Ear* ; Follow-Up Studies ; Humans ; Keloid*

Cat liver fluke (Platynosomum fastosum) was identified upon necropsy of a Felis catus (domestic cat). This trematode has not been reported in domestic cats previously in Korea. Diagnosis of this fluke was made by the presence of eggs in the feces of the cat through the fecal sedimentation method. Flukes in the gallbladder, bile duct, and liver parenchyma were revealed by the necropsy findings. This report describes as the first case of a domestic cat with Platynosomum fastosum in Korea.
Animals ; Bile Ducts ; Cats ; Eggs ; Fasciola hepatica ; Feces ; Gallbladder ; Korea ; Liver ; Ovum ; Trematoda

Cat liver fluke (Platynosomum fastosum) was identified upon necropsy of a Felis catus (domestic cat). This trematode has not been reported in domestic cats previously in Korea. Diagnosis of this fluke was made by the presence of eggs in the feces of the cat through the fecal sedimentation method. Flukes in the gallbladder, bile duct, and liver parenchyma were revealed by the necropsy findings. This report describes as the first case of a domestic cat with Platynosomum fastosum in Korea.
Animals ; Bile Ducts ; Cats ; Eggs ; Fasciola hepatica ; Feces ; Gallbladder ; Korea ; Liver ; Ovum ; Trematoda