BACKGROUND: Headache is a common symptom. It has not proved useful methods that the physician evaluated the alert patient who had headache. It needs the presence of predictors of intracranial pathology(ICP) which serves as influential factors in the indication of evaluation and hospitalization of patients. METHOD: So, in order to identify such factors, patient records were retrospectively analysed. 168 patients with the chief complaint of headache presented to the Emergency Department of Chonnam University Hospital during the period from January 1, 1995 to December 31, 1997. All were in an alert mental state and had no evidence of trauma and intoxication. RESULTS: 14 cases(8.3% revealed ICP. 41 cases(24.4% revealed systemic disease. The remainder of cases were divided among unclassified headaches(61 cases, 36.3%, tension headaches(30 cases, 17.9%, and migraine(22 cases, 13.1%. Comparison of ICP-positive and ICP-positive cases revealed that ICP-Positive Patients could be categorized by the following findings: (1) Presence of the focal sign through neurological examination, (2) age greater than 55 years, (3) presence of associated symptoms, (4) acute headache. These four manifestations were proven to be statistically significant as predictors of ICP. CONCLUSION: Although the positive predictive value of the above criteria is not perfect for the prediction of ICP, they are worthy of clinical consideration in alert patients presenting with headache.
Emergencies* ; Emergency Service, Hospital* ; Headache* ; Hospitalization* ; Humans ; Jeollanam-do ; Neurologic Examination ; Retrospective Studies

PURPOSE: Simulation-based learning has become a powerful method to improve the quality of care and help students meet the challenges of increasingly complex clinical practice settings. The purpose of this study was to identify the learning effects using high-fidelity SimMan and multi-mode simulation. METHODS: Participants in this study were 38 students who were enrolled in an intensive course for a major in nursing at R college. Collected data were analyzed using Chi-square, t-test, and independent t-test with the SPSS 18.0 for Windows Program. RESULTS: There were no statistically significant differences in learning effects between high-fidelity SimMan and multi-mode simulation group. However, skills in clinical performance in the high-fidelity SimMan group were higher than in the multi-mode group (p=.014), communication in clinical performance in multi-mode simulation group was higher than in the high-fidelity SimMan group (p<.001). CONCLUSION: Multi-mode simulation with a standardized patient is an effective learning method in many ways compared to a high-fidelity simulator. These results suggest that multi-mode simulation be offered to students in nursing colleges which cannot afford to purchase a high-fidelity simulator, or offered as an alternative.
Adult ; Education, Nursing, Baccalaureate ; Emergency Medical Services ; Female ; Heart Arrest/*nursing ; Humans ; Learning ; Male ; Manikins ; *Patient Simulation ; Students, Nursing/psychology

Authors experienced a case of acute myocardial infarction confirmed by analysis of LDH isoenzyme. 53-year-old male was admitted to Sacred Heat Hospital, Chung Ang University Because of severe precordial pain radiating to both arm, shoulder and back. Chest X-ray film & electrocardiogram were within normal limit and SGOT was 110 unit/ml on the day of admission. Determination of total LDH value and analysis of LDH isoenzyme by agar gel electrophoresis were made on the second hospital day. Total LDH was 315unit/ml, but there was significant increased percentage of LDH isoenzyme(LDH1). Electrocardiogram showed ST segment elevation only on the 8th hospital day.
Male ; Humans

BACKGROUND: ST segment elevation in patient with chest pain was seen in acute myocardial infarction and in numerous other non-infarction syndrome. The causes of non-infarction syndrome were left ventricular hypertrophy, BER(benign early repolarization), and left bundle branch block in cardiac origin and were hyperkalemia and hyperventilation syndrome in metabolic origin and were others. Furthermore, the differentiation of electrocardiogram between acute myocardial infarction and non-infarction syndrome was very difficult. So, we compared and analysed characteristics of ST segment elevation of acute myocardial infarction and non-infarction syndrome that suggested the clue of early diagnosis of coronary artery disease. METHOD AND MATERIALS: We retrospectively reviewed the electrocardiogram of 961 patients with chest pain who visited the emergency center from January 1999 to December 1999. Acute myocardial infarction was diagnosed by clinical finding, electrocardiogram, cardiac enzyme, echocardiogram, and myocardial spect. Left ventricular hypertrophy, BER, and left bundle branch block in cardiac origin of non-infarction syndrome were diagnosed by electrocardiographic criteria suggested by William J. Brady. Acute myocarditis, acute pericarditis, and hyperventilation syndrome were diagnosed by clinical finding. RESULTS: Among 961 patients with chest pain, 236(24.6%) patients manifested ST segment elevation who were diagnosed acute myocardial infarction in 162(68.6%) patients and non-infarction syndrome in 74(31.4%) patients. The causes of non-infarction syndrome in 74 patients were left ventricular hypertrophy(32:13.6%), BER(28:11.9%), left bundle branch block(11:4.7%), and others(3:1.3%). Three others were acute myocarditis, acute pericarditis, and hyperventilation syndrome. Electrocardiographic characteristics of ST segment elevation of non-infarction syndrome manifested almost same finding compared to William J. Brady' criteria. CONCLUSION: ST segment elevation in patient with chest with chest pain visited emergency department was seen in acute myocardial infarction(68.6%) and the other non-infarction syndromes(31.4%). Significant number of patients were not associated with acute myocardial infarction. Therefore, we must completely understand characteristics of ST segment elevation in acute myocardial infarction and the other non-infarction syndromes to diagnose fatal early coronary artery disease and to avoid unnecessary thrombolytic therapy.
Bundle-Branch Block ; Chest Pain* ; Coronary Artery Disease ; Early Diagnosis ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Hyperkalemia ; Hypertrophy, Left Ventricular ; Hyperventilation ; Myocardial Infarction* ; Myocarditis ; Pericarditis ; Retrospective Studies ; Thorax* ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Anti-Infective Agents* ; Staphylococcus aureus* ; Staphylococcus*

No abstract available.
Cicatrix, Hypertrophic* ; Skin*

No abstract available.
Mycobacterium chelonae* ; Mycobacterium* ; Skin*

No abstract available.
Blister*

No abstract available.
Pemphigus

No abstract available.