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

The goals of treatment in the injuries of posterior cruciate ligament(PCL) are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to analyze the factors on posterior stability and functional result after PCL reconstruction. From March 1996 to April 1997, twenty operation on PCL reconstruction were carried out in our hospital. The functional results according to the criteria of the Lysholm knee score and stress radiograph for posterior stability were evaluated. The average functional results evaluated by Lysholm knee score was 87. There was no significant difference in functional result according to selected grafted material, combined knee injury, type of injury and arthrotomy, etc. Difference in posterior tibial translation on average were 2.8mm in acute and 7.7mm in chronic injury. In posterolateral combined injury, average posterior tibial translation in pos- terolateral repair was 3.2mm and in posterolateral reconstruction was 9.4mm. In PCL reconstruction using hamstring with repair of PCL remnant was 2mm. In conclusion, to obtain the good result on posterior sta- bility, early PCL reconstruction using hamstring with repair of PCL remnant, and appropriate treatment on combined posterolateral injury were recommended.
Knee ; Knee Injuries ; Osteoarthritis ; Posterior Cruciate Ligament* ; Transplants

No abstract available.
Blast Crisis* ; Leukemia*

No abstract available.
Blast Crisis* ; Leukemia*

BACKGROUND: There has been a concern about the incidence of the cutaneous premalignant and malignant tumors. It has increased recently and has varied according to social and environmental influence. OBJECTIVE: The purpose of our study was to clarify the recent trends in cutaneous premalignant and malignant tumors, and to compare them with other reports. METHODS: The 175 cases out of the total number of 34,333 new outpatients were diagnosed cutaneous premalignant and malignant tumors from January, 1990 to December, 2000 at the Department of Dermatology, Yeungnam University Hospital. Incidence and its change, age and sex distribution, and anatomical site were investigated. RESULT: 1. The incidence of cutaneous premalignant and malignant tumors was 0.51%, and increased lately. 2. Among the 175 cases of premalignant and malignant tumors, basal cell carcinoma(30.9%) was the most common, followed by squamous cell carcinoma(22.9%), actinic keratosis(12.6%), Bowen's disease(10.9%). 3. The premalignant lesions were increased and outnumbered squamous cell carcinoma since 1996. 4. Basal cell carcinoma was the most common skin cancer that had markedly increased in comparison with squamous cell carcinoma. 5. Actinic keratosis, Bowen's disease, basal cell carcinoma, squamous cell carcinoma, malignant melanoma on sun exposed areas were much more increased than on non exposed areas. 6. The mean age of patients was 65.3+/-15.0 years, and the age of the majority of cases(94.3%) was over 40 years. 7. The ratio of male to female was 1.01 : 1. The number of females increased relatively in comparison with previous reports. 8. The most common site was the face(55.4%), followed by scalp(12.0%), trunk (12.0%).
Actins ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Female ; Humans ; Incidence ; Keratosis, Actinic ; Male ; Melanoma ; Outpatients ; Sex Distribution ; Skin Neoplasms ; Solar System

No abstract available.
Autoantibodies* ; Humans*

PURPOSE: Unrefined tablets prepared from Aconitum tubers are occasionally used in Korean folk medicine. This study defines the potential sources, clinical toxicology, and treatment of aconitine poisoning. METHODS: A retrospective survey was conducted in 63 patients in the ED of a tertiary University Hospital with suspected toxicity from an unrefined tablet prepared from Aconitum tubers from 1999 to 2007. RESULTS: A total of 63 cases enrolled included 26 men and 37 women, aged 30 to 86 years. Forty-eight patients ingested aconitine tablets as digestives, 26 tablets on average. After a latent period of 30 to 450 minutes, patients developed a combination of neurologic (87.3%), gastrointestinal (82.5%), cardiopulmonary (41.3%), and other (28.6%) features typical of aconitine poisoning. Initial ECG abnormalities revealed dysrhythmia (61.9%), conduction disturbance (42.9%), and abnormal waveforms (39.7%), with 28.6% of patients having normal ECGs. All patients received supportive treatment or close observation regardless of ingestion amounts. Patients with hypotension or ventricular arrhythmia were treated with inotropic agents or amiodarone. CONCLUSION: Toxicologic signs and symptoms can occur after the consumption of aconitine tablets, regardless of ingestion amount. The risk occurs because of inadequately processed aconitine roots. This study will provide important data for public education and distribution regulations for Aconitum sp. in Korea.
Aconitine ; Aconitum ; Aged ; Arrhythmias, Cardiac ; Eating ; Electrocardiography ; Female ; Humans ; Hypotension ; Korea ; Male ; Medicine, Traditional ; Retrospective Studies ; Social Control, Formal ; Tablets ; Toxicology

PURPOSE: This study analyzed the correlation between grade point average (GPA) of medical school and the score of Korean Medical Licensing Examination (KMLE). METHODS: This study based on the results of 67th KMLE applicants who graduated from a college of medicine in 2003. We also gathered data of these applicants from the college of medicine: gender, age, type of entrance, GPA of basic medicine, clinical medicine, clinical clerkships and final test scores. We analyzed whether there was discrimination between achievement of KMLE passed and that of KMLE failed, which of variables affected the results of KMLE. RESULTS: 173 applicants passed KMLE among 189. There were significant correlations between basic medicine, clinical medicine, final test score and the score of KMLE (respective p-value; < 0.0001). There were also significant differences of GPA between KMLE passed applicants and failed. Final test scores were the most correlated with those of KMLE. If the GPA of 2nd grade was below 2.5 and the GPA of 3rd year grade was below 2.3, they was a high-risk group for failing KMLE (sensitivity 100%, specificity 90%). CONCLUSION: There were significant correlations between the GPA of medical school and the score of KMLE, and significant differences between KMLE passed applicants and failed. A high-risk group of failing KMLE was the students that the GPA of 2nd grade was below 2.5 and the GPA of 3rd grade was below 2.3.
Clinical Medicine ; Discrimination (Psychology) ; Humans ; Licensure* ; Schools, Medical* ; Sensitivity and Specificity

Obstetrical procedures such as prolonged obstructed labour are responsible for the majority of vesicovaginal fistula(VVF) in developing countries, while gynecological procedures are more common causes in developed countries with hysterectomy accounting for 75% of fistulae. Other less common causes of VVF include uterine cancer, pelvic irradiation, gastrointestinal pelvic surgery, tuberculosis, intra-uterine device or Bechet's disease. Although radiation techniques are being advanced, several recent studies have shown the incidence of VVF after pelvic radiation therapy for cervical cancer to range from 0.6~2%. We report, a case of 47-year-old female with VVF after pelvic radiation therapy, which was treated by neurovascular pudendal-thigh flap.
Developed Countries ; Developing Countries ; Female ; Fistula ; Humans ; Hysterectomy ; Incidence ; Middle Aged ; Tuberculosis ; Uterine Cervical Neoplasms ; Uterine Neoplasms ; Vesicovaginal Fistula*

PURPOSE: The unrestricted use of endosulfan results in many cases of intentional and unintentional poisoning, mainly in developing countries. We report our experience with the clinical features of endosulfan poisoning. METHODS: Fifteen patients with endosulfan exposure who came to our emergency department (ED) during the study period were retrospectively enrolled. Toxicological history, toxic symptoms and signs, and laboratory test results were collected from the ED medical records. The patients were classified into two groups according to the presence or absence of seizures. The quantitative data and dichotomous variables were compared between the two groups. RESULTS: The 15 patients, 9 women and 6 men, had a mean age of 54.7 years. Most of the poisonings (13 patients, 86.7%) stemmed from deliberate self-harm, while the other two were unintentional. The patients were categorized into seizure (10 patients) and no-seizure (5) groups. After the acute phase of toxicity, complications were observed in 9 patients and all of them belonged to the seizure group. Eight patients in the seizure group progressed to status epilepticus and needed mechanical ventilatory support. Four of these patients (50%) subsequently died. The duration of hospital stay was 8.5 days in the seizure group and 3.0 days in the no-seizure group. White blood cell counts, blood glucose, and enzyme function tests for the liver, pancreas, heart, and muscles were abnormally increased in the seizure group, all occurring within the initial 24 hours after the onset of seizure. Severe metabolic acidosis was also present in the seizure group. CONCLUSION: Seizure or status epilepticus accompanied by involvement of several organs was distinctive feature of endosulfan exposure/poisoning. Therefore, emergency physicians who practice in agricultural areas should have a high index of suspicion when treating patients presenting with acute repetitive seizure, accompanied by gastrointestinal complaints and laboratory evidence of multiple organ dysfunction including metabolic acidosis.
Acidosis ; Blood Glucose ; Developing Countries ; Emergencies ; Endosulfan ; Female ; Heart ; Humans ; Length of Stay ; Leukocyte Count ; Liver ; Male ; Medical Records ; Muscles ; Pancreas ; Porphyrins ; Retrospective Studies ; Seizures ; Self-Injurious Behavior ; Status Epilepticus