BACKGROUND: Unexpected deaths of the patients at ED are surprising to the medical staffs as well as the families. It may also increase the possibilities of medico-legal problems. This study was conducted to review the unexpected death in ED and find the predictive factors leading patients to unexpected death. METHODS: A retrospective study with reviewing available medical records of 183 patients who were expired at ED of Shinchon Severance Hospital from Mar. 1997 to Feb. 1998 and 103 patients of Youngdong Severance Hospital from Mar. 1996 to Feb. 1998 was done. Analyses were 4one on 30 variables of physical findings, laboratory results, procedures and therapies. We used univariate analysis, such as t-test and x2-test and multiple logistic regression analysis. RESULTS: Of the total 286 deaths in ED, 153 cases were enrolled in this analysis. The number of unexpected deaths were 76. Age, mental status, fraction of neutrophil count, BUN level, whether endotracheal incubation was done, use of inotropics were the factors with statistical ,significance on the univariate analysis, but only comatose mentality, endotracheal incubated case, and use of the inotropics were significant on logistic regression analysis. The longer the ED length of stay, the higher the rate of mortality and unexpected death. CONCLUSION: This result suggest that medical attention is needed on the patients with comatose decreased mental stylus, endotracheally intubated case and needing inotropic agents to prevent unexpected deaths. Shortening the ED length of stay may also be a factor for decrease the unexpected death rate.
Coma ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Length of Stay ; Logistic Models ; Medical Records ; Medical Staff ; Mortality ; Neutrophils ; Retrospective Studies

PURPOSE: The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS: A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS: In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 +/- 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION: Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival.
Dental Implants ; Dental Records ; Hospitals, Veterans ; Humans ; Kaplan-Meier Estimate ; Male ; Prognosis ; Prostheses and Implants ; Retrospective Studies ; Survival Rate

PURPOSE: Atopy is a state of allergic response, mediated by IgE, to common environmental allergens. In recent decades, there has been an increase in prevalence of atopic disorders in children in developed countries. The factor associated with the rise of atopy incidence may be declining exposure to some infection opportunities. The aim of this study is to determine if the immune response to Mycobacterium tuberculosis can suppress atopy by investigating the association between tuberculin responses and serum IgE. METHODS: We divided the patients into two groups according to tuberculin skin test. Group A showed positive response (induration diameter > or =10mm), while Group B showed negative response (induration diameter< l0mm). A comparison was made between the two groups in terms of age, sex, serum total IgE and allergen-specific IgE. RESULTS: Twenty-one patients comprised Group A and 72 comprised Group B. The mean serum total IgE concentration and the number of patients showing positive MAST in Group B was significantly higher than that of Group A (P<0.05). CONCLUSION: In our study, there was an inverse association between delayed hypersensitivity to Mycobacterium tuberculosis and atopy.
Allergens ; Child ; Developed Countries ; Humans ; Hypersensitivity, Delayed ; Immunoglobulin E* ; Incidence ; Mycobacterium tuberculosis ; Prevalence ; Skin Tests ; Tuberculin*

To estimate the child and infant mortality rates among Korean children, a mortality survey was carried out in the province of Kyongsangnam,buk-do. The study population are the beneficiaries of Korea Medical Insurance Coorporation (KMIC), Kyongsangnam,buk-do area, among which the 3,867 and 1767 deaths occurred from January, 1989 to December, 1990 in Kyongsangnam-do area and from January, 1991 to December, 1991 in Kyongsangbuk-do area respectively. We reviewed the data to confirm the causes of death. These were based on the death certificates and medical utilization records before dying which were available through the computerized databases on medical care utility of KMIC. The survey conducted along three steps. At first, the death certificates were examined, as a second step, medical utilization records were reviewed, and finally direct contacts to the family members of the deceased were done. As a result, 115 deaths were found under 20 years of age. Using them, age specific mortalities and causes of death were estimated. Mortality rate in this area was estimated 129 per 100,000 person-years during 1 month to 11 months of age, 67 during 1 year to 4 years of age, 23 during 5 years to 9 years of age, 10 during 10 years to 14 years of age, and 29 during 15 years to 19 years of age, respectively. And the frequent causes of death were congenital anomalies, central nervous system (CNS) diseases, certain condition originating from perinatal period during 1 months of age; accidents, congenital anomalies, malignancies, CNS diseases, and pneumonia or bronchiolitis during 1 to 4 years of age; accidents, malignancies, CNS diseases, and congenital anomalies during 5 to 14 years of age; and accidents, suicide, malignancies, and CNS diseases during 15 to 19 years of age.
Bronchiolitis ; Cause of Death ; Central Nervous System ; Central Nervous System Diseases ; Child ; Child Mortality* ; Child* ; Death Certificates ; Gyeongsangbuk-do ; Gyeongsangnam-do ; Humans ; Infant ; Infant Mortality ; Insurance ; Korea ; Mortality ; Pneumonia ; Suicide

OBJECTIVES: The purposes of this study were to estimate the effect of mandibular advancement device (MAD) and to evaluate the influence of the advancement amount of mandible in the application of MAD for obstructive sleep apnea (OSA) patients. METHODS: From the patients who were diagnosed as OSA by polysomnographic study at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as treatment option were included in this study. All the patients' data including clinical records and polysomnographic studies (both pre- and post-treatment) were reviewed and analyzed. RESULTS: Successful results were obtained in 65 patients of 86 patients (75.6%). In the follow-up period, mild discomfort of anterior teeth or temporomandibular joint (TMJ) were described in 28 patients, especially in the cases the amount of mandibular advancement were more than 7.0 mm. There was no direct relationship between the amount of mandibular advancement and clinical outcome. CONCLUSION: MAD was effective treatment option for the OSA patients regardless of severity. For the prevention of potential dental complications, the amount of mandibular advancement should be considered at the time of MAD treatment.
Adenine Nucleotides ; Follow-Up Studies ; Humans ; Mandible ; Mandibular Advancement ; Mycophenolic Acid ; Sleep Apnea, Obstructive ; Temporomandibular Joint ; Tooth

Paul D. Choy was born on February 26th. 1896. He spent his childhood in Japan and America, and he returned to Korea when he turned twenty one years old. He graduated from Severance Union Medical College in 1921. After graduating the college, he went to Peking Union Medical College to study parasitology. He came back to Korea after one year as the first parasitologist in Korea. On returning, he took the charge of the clinical laboratory of Severance Hospital. Before long he made another journey for study to Canada. He spent two years in Toronto University studying pathology. After studying pathology, he challenged a new field of medicine. It was medical jurisprudence. He stayed two years in Japan in order to earn his doctorate in medical jurisprudence in Tohoku Imperial College. This time he returned as the first specialist in medical jurisprudence in Korea. His field of study was not confined to medical field. He had deep interest in current situation in Manchuria and Mongol, and wrote a book on this matter. His interest also extended to the history of ancient Korean people. He made extensive studies on this subject, which resulted in publishing a huge work on the origin of Korean people and its ancient history. He was a true pioneer of medicine in Korea and his life was characterized by endless quest for learning.
Education, Medical/*history ; English Abstract ; History, 20th Century ; Travel/*history

The calcar femorale is a specific anatomic entity which is often confused with the medial trabecular system or posteromedial cortex of the neck of the femur. The clinical significance of its architecture is evident when one considers the great number of operative procerdures performed in the upper end of the femur. This study deals with 45 cases of the Korean Dry femur(male: 27, female: 12, useless: 6) and two pairs of the femur from the cadavers. The authors observed the three dimensional structure of the calcar femorale and studied the relation between anteversion and calcar femorale. The results obtained were as follows: 1. The calcar femorale was a vertical plate of the thickened bone that lay deep to the lesser trochanter. The length in the vertical axis of the calcar femorale was 44.82±3.59mm. The calcar femorale was thickest medially where it joins the medial trabecular system of the femoral neck (maximal thickness: 2.65±0.65, width: 8.90±1.82mm). 2. The calcar femorale lay in one plane, which inclined 30.02±7.80 degree to the discondylar axis of the femur. By using this inclination of the calcar plane, it could be best visualized with about 60° external rotation of femur in a simple X-ray. 3. The angle between the calcar plane and the diacondylar axis was proportionate to the anteversion of the femoral neck. Correlation coefficient(r=0.80) was calculated. The regression line of y (anteversion) on x(calcar angle) was y=0.75X−8.53(slope). With this proportion, the angle of the femoral anteversion could be determined. 4. Microscopic features of the calcar femorale was revealed in the scanning electron microscopic studies. The medial side of the calcar was a cortical extension and it became thinner posterolaterally and than it was composed of fused or thickened trabeculae.
Cadaver ; Female ; Femur Neck ; Femur ; Humans ; Neck

We have cloned a alpha-COP homolog, ancop, from Aspergillus nidulans by colony hybridization of chromosome specific library using alpha-COP homologous fragment as a probe. The probe DNA was amplified with degenerated primers designed by comparison of conserved region of the amino acid sequences of Saccharomyces cerevisiae alpha-COP, Homo sapiens HEP-COP, and Drosophila melanogaster alpha-COP. Full length cDNA clone was also amplified by RT-PCR. Comparison of genomic DNA sequence with cDNA sequence obtained by RT-PCR revealed 7 introns. Amino acid sequence similarity search of the anCop with other alpha-COPs gave an overall identity of 52% with S. cerevisiae, 47% with human and bovine, 45% with Drosophila and Arabidopsis . In upstream region from the transcription start site, a putative TATA and CAAT motif were also identified.
Amino Acid Sequence ; Arabidopsis ; Aspergillus nidulans* ; Aspergillus* ; Base Sequence ; Clone Cells ; Coatomer Protein* ; DNA ; DNA, Complementary ; Drosophila ; Drosophila melanogaster ; Humans ; Introns ; Saccharomyces cerevisiae ; Sequence Homology ; Transcription Initiation Site

PURPOSE: Febrile seizure is the most common type of seizure affecting 3-4% of children. The recurrence rate of febrile seizure is approximately 33%. About 16% of children with a febrile seizure during the febrile illness have a recurrent seizure attack within 24 hours. This study aimed to investigate the optimum dose of diazepam to reduce the recurrence of febrile seizures in children who have had a febrile seizure attack. METHODS: The children with febrile seizure who were admitted to the Maryknoll hospital for in vestigation and treatment were retrospectively reviewed. The study group compromised 306 children. The febrile seizure was defined as seizure attack with fever(above 38degreeC) without evidence of intracranial infection or defined cause in children aged 6 months to 5 years. The children were divided into four groups according to dose of diazepam. Group I, 72 patients, received no diazepam therapy. Group II, 78 patients, received oral diazepam in a dose of 0.1 mg/kg every eight hours during the febrile illness, Group III, 87 patients, 0.2 mg/kg, and Group IV, 69 patients, 0.3 mg/kg, respectively. RESULTS: The seizure attack rate and the duration of admission were reduced in both Group III and Group IV. However, there was no difference in the side effects of the diazepam between group III and IV. CONCLUSION: Oral diazepam in a dose of 0.2 mg/kg effectively decreases both the seizure attack rate and the duration of admission.
Child ; Diazepam* ; Humans ; Recurrence ; Retrospective Studies ; Seizures* ; Seizures, Febrile*