BACKGROUND: Trauma is a major cause of death for individuals under the age of 45 years and the third leading cause of death for all ages. So, it has been recognized as an important socioeconomic problem. The purpose of this study was to evaluate the outcome of surgical care of traumatized parients. METHODS: We retrospectively analyzed data of patients who had undergone surgical operation on head, abdomen, or chest trauma from January 1, 1995 to December 31, 1995. TRISS method and W- and Z- statistics were used to evaluate the trauma outcome and the quality assurance of surgical treatment. RESULTS: Two hundred and sixty eight patients were enrolled in this study. Traffic accident in injury mechanisms was the most common(n=185, 69.2%), and severely injured patients with over ISS 16 were 205 of total 268 patients(76.5%). Crude mortality rate was 11.6% (non-survivors/number of patients : 31/268). By TRISS method, predicted mortality rate was 10.1%, excess mortality rate was 14.2%, and W value was - 1.43 indicating less actual survivors than predicted, but absolute Z score was 0.91 and it was statistically not significant. CONCLUSION: These data show that trauma outcome and quality of surgical care in our hospital is adequate. We also suggest that it will provide a valuable data for further studies.
Abdomen ; Accidents, Traffic ; Cause of Death ; Head ; Humans ; Injury Severity Score* ; Mortality ; Retrospective Studies ; Survivors ; Thorax

BACKGROUND: The current recommendation of rescue breathing techniques in the infant is to blow both the nose and mouth of infants by caregiver's mouth but recent studies suggest some caregivers may have trouble sealing a infant's mouth and nose. The purpose of this study is to estimate the ability of mothers to create a seal to their infants for the provision of rescue breathing according to current recommendation. METHODS: Infants up to 1 year of age(n=98) and their mothers were enrolled from emergency department of Chonbuk National University Hospital. We measured the facial lengths of the infants and the width of mouth in their mothers and compared mouth widths of mothers with their infant's nose-to-mouth lengths. RESULTS: In infants between 0 to 6 months, Mother transverse lengths were significantly larger than mouth, nose and nose-to-mouth lengths of the infants. In infants between 7 to 12 months, Mother transverse lengths were significantly larger than mouth and nose lengths of the infants but there was no statistically significant difference between mother transverse lengths and nose-to-mouth lengths of infants. CONCLUSION: The finding indicate that the present recommendation to cover mouth and nose is partly not possible. We recommend that the mouth-to-nose ventilation of rescue breathing techniques for the infants who have respiratory arrest be taught to mothers.
Caregivers ; Emergency Service, Hospital ; Humans ; Infant* ; Jeollabuk-do ; Mothers ; Mouth ; Nose ; Respiration* ; Ventilation

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

No abstract available.
Animals ; Bacteria* ; Carcinoma, Lewis Lung* ; Lactic Acid* ; Mice* ; Sarcoma 180* ; Sarcoma*

No abstract available.
Bone Marrow Examination* ; Bone Marrow*

No abstract available.
Bacteria* ; Ulsan*

The etiologies of intracranial artery dissection are various, the exogenous as well as inherited connective tissue disorders. We report on a patient who presented with diffuse subarachnoid hemorrhage who had been suffered from essential thrombocythemia. He was diagnosed to multiple dissecting aneurysms of left superior cerebellar artery, left posterior inferior cerebellar artery and right pericallosal artery and treated with endovascular coil embolization.
Aneurysm ; Aneurysm, Dissecting* ; Arteries ; Connective Tissue ; Embolization, Therapeutic ; Humans ; Subarachnoid Hemorrhage ; Thrombocythemia, Essential*

BACKGROUND: Victims of trauma in the emergency room(ER) suffer from kinds of discomforts derived from their physical injury and psychological instability. Although discomforts may be varied by the patient's characteristics and environmental factors such as medical personnel or facilities in ER, an active control for the discomfort should be required because it may affect an outcome of treatment and prognosis of illness. The purpose of this study is to analyze the distressing factors which traumatized patients have been experienced in the ER and to improve the management of trauma patients in the future. METHODS: From January 1, 1996 to June 30, 1996, we tried to interview patients about the painful experiences in ER before the decision of his or her discharge from ER. We analyzed the data on age, sex, religion, educational level, injury severity score(ISS), the most unpleasant experience, sleep deprivation, and friar for death. RESULTS: The 126 patients were enrolled in this study. The patients consisted of 93 male and 33 female, their mean age was 45 years old and mean ISS was 7.86. About seventy one percent of the patients complained unpleasant experiences during the stay in the ER. Of these, pain at the injury sites was the most frequent complaint (66.7%). The sleep deprivation was showed about sixty percent of the total patient and the most common cause of this was also due to pain(40%). Nineteen percent of the patients answered that they have felt the fear for death. There were statistically significant differences in degree of the ISS whether the fear for death and unpleasant experience were or not. When the patients demarked with whether the presence of pain, the occurrence of sleep deprivation, and fear for death were statistically related to the pain. However, the data was denoted no direct relationship with pain according to sex, educational level, or religion. CONCLUSION: The trauma patient admitted to ER suffered from various stressful conditions including not only their physical injury but care personnel or unstable environmental factors in ER. Therefore, emergency medical personnel has to understand some possible distresses of the patients and need to reduce them to provide more careful and proper managements.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Sleep Deprivation

BACKGROUND: The goal of this study was to demonstrate the effect of esmolol to prevent reflex tachycardia occurred during sodium nitroprusside(SNP) induced hypotension. METHODS: Thirty patients were randomly assigned to the SNP group(n=15) received continuous infusion of SNP at 2.72+/-0.56 mcg/kg/min or combined SNP and esmolol(SNP-ESM) group(n=l5) received combined continuous infusion of SNP at 1.54+/-0.34 mcg/kg/min and esmolol at 200 mcg/kg/min for 1 hour to maintain a 20~25% reduction of mean arterial pressure(MAP) from baseline. Heart rate(HR) and MAP were measured at baseline, during hypotensive period(5, 10, 20, 30, 60 min) and after hypotensive period(70, 80, 90,1 20 min). RESULTS: SNP-induced hypotension resulted in significant(P<0.001) increases in heart rate during hypotensive period and MAP after the end of SNP infusion. However, infusion of SNP-ESM resulted in significant(p<0.05) reduction in heart rate and SNP requirement during hypotensive period, and rebound hypertension was not observed after the end of induced hypotension. CONCLUSIONS: SNP-ESM infusion is a safe and effective pharmacologic means and provides several advantages over single SNP that include reduction in SNP requirement, no reflex tachycardia during induced hypotension and no rebound hypertension following hypotensive period.
Heart Rate* ; Heart* ; Humans ; Hypertension ; Hypotension* ; Nitroprusside* ; Reflex ; Sodium* ; Tachycardia

BACKGROUND: The goal of this study was to demonstrate the effect of esmolol to prevent reflex tachycardia occurred during sodium nitroprusside(SNP) induced hypotension. METHODS: Thirty patients were randomly assigned to the SNP group(n=15) received continuous infusion of SNP at 2.72+/-0.56 mcg/kg/min or combined SNP and esmolol(SNP-ESM) group(n=l5) received combined continuous infusion of SNP at 1.54+/-0.34 mcg/kg/min and esmolol at 200 mcg/kg/min for 1 hour to maintain a 20~25% reduction of mean arterial pressure(MAP) from baseline. Heart rate(HR) and MAP were measured at baseline, during hypotensive period(5, 10, 20, 30, 60 min) and after hypotensive period(70, 80, 90,1 20 min). RESULTS: SNP-induced hypotension resulted in significant(P<0.001) increases in heart rate during hypotensive period and MAP after the end of SNP infusion. However, infusion of SNP-ESM resulted in significant(p<0.05) reduction in heart rate and SNP requirement during hypotensive period, and rebound hypertension was not observed after the end of induced hypotension. CONCLUSIONS: SNP-ESM infusion is a safe and effective pharmacologic means and provides several advantages over single SNP that include reduction in SNP requirement, no reflex tachycardia during induced hypotension and no rebound hypertension following hypotensive period.
Heart Rate* ; Heart* ; Humans ; Hypertension ; Hypotension* ; Nitroprusside* ; Reflex ; Sodium* ; Tachycardia