BACKGROUND: Diabetic ketoacidosis(DKA) is serious acute metabolic complication and the most important cause of high morbidity and mortality of diabetes. The object of this study is to examine the clinical characteristics of patients with DKA who had a prior history of diabetes or not. METHOD: Authors reviewed retrospectively the medical records of 49 cases adimitted to Kyungpook National University Hospital from January 1991 to June 1997 with a diagnosis of DKA and classified cases as type I, type II and newly diagnosed diabetics according to prior history of diabetes. RESULTS: 1. Of 49 cases of DKA, 24(49%) were classified as type I, 17(35%) as type II from data available in the medical records, and 8(16%) had DKA as the initial manifestation of the disease. 2. The male to female ratio was 0.5 : 1 in type I, 1.1 : 1 in type II and 1.7 : 1 in newly diagnosed diabetics, and the mean age was 24.4 in type I, 57.9 in type II and 23.9 years old in newly diagnosed diabetics. 3. The mean duration between initial diagnosis of diabetes and the occurrence of DKA was 2.6 in type I and 6.9 years in type II diabetes. The occurrence of DKA within 2 years of initial diagnosis of diabetes was 54% in type I and 18% in type II diabetes, but the occurrence of DKA after 5 years of initial diagnosis of diabetes was 17% in type I and 47% in type II diabetes. 4. The precipitating factors of DKA were identified in 88% in type I, 76% in type II and 38% in newly diagnosed diabetics, and the most common precipitating factor was omission of treatment in both type I and type II(type I: 56%, type II: 35%). 5. The altered mental status was correlated with increased osmolality (p<0.05), but not with other laboratory values such as pH, bicabonate, glucose, anion gap and dehydration status(p>0.05). CONCLUSION: It is necessary to conduct early aggressive evaluation for early diagnosis and proper treatment of DKA, because DKA occurs in patients with prior history of type II diabetes and without prior diabetic history as well as patients with prior history of type I diabetes.
Acid-Base Equilibrium ; Dehydration ; Diagnosis ; Early Diagnosis ; Female ; Glucose ; Gyeongsangbuk-do ; Humans ; Hydrogen-Ion Concentration ; Male ; Medical Records ; Mortality ; Osmolar Concentration ; Precipitating Factors ; Retrospective Studies

No abstract available.

OBJECTIVES: The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do. METHODS: Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC. RESULTS: Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications. CONCLUSIONS: As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Centers for Disease Control and Prevention (U.S.) ; Chickenpox Vaccine ; Chickenpox* ; Child* ; Humans ; Immunization ; Incidence ; Jeju-do ; Korea* ; Vaccination*

OBJECTIVES: The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do.METHODS: Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC.RESULTS: Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications.CONCLUSIONS: As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Centers for Disease Control and Prevention (U.S.) ; Chickenpox Vaccine ; Chickenpox ; Child ; Humans ; Immunization ; Incidence ; Jeju-do ; Korea ; Vaccination

PURPOSE: To assess relative diagnostic value of Ga-67 planar, Ga-67 SPECT, and CT images for detection of head and neck tumors and cervical lymph node metastasis. MATERIALS AND METHODS: Thirty eight patients of pathologically proven head and neck tumors including squamous cell carcinomas(n=32), malignant lymphomas(n=3), undifferentiated carcinomas(n=2), adenocarcinomas(n=l) were enrolled in this study. Ga-67 planar and SPECT images were obtained with intravenous injection of 5mCi of Ga-67 citrate. On the basis of 30 and 20 mm in the greatest diameter of cervical lymph nodes, we compared lesion detectability of Ga-67 planar, SPECT, and CT. RESULTS: Thirty eight cases of head and neck tumors were detected in 29 cases(76.3%) with Ga-67 planar image, 37 cases(97.3%) with Ga-67 SPECT, and 32 cases(84.2%) with CT. 25 of 32 squamous cell carcinomas were positive with Ga-67 planar image and all of 32 cases with Ga-67 SPECT. Both of two undifferentiated carcinomas were positive with Ga-67 planar and SPECT images. Two of three malignant lymphomas were positive with Ga-67 planar image and all of three with Ga-67 SPECT. Eight of nine tumors were negative with Ga-67 planar image and those were less than 30ram. One case of adenocarcinoma was negative with Ga-67 planar and SPECT images. Seven of nine lymph nodes greater than 30mm were positive with Ga-67 planar image and all of nine with Ga-67 SPECT. On the basis of 20mm in greatest diameter, 16 of 21 lymph nodes greater than 20 mm were positive with Ga-67 planar and SPECT images. CONCLUSION: CT providing better resolution than Ga-67 scan permitted analysis of size and location of metastatic cervical nodes, however primary tumors of oral cavity, vocal cord, and nasopharynx were often not detected on CT when metallic and motion artifacts were present, where Ga-67 SPECT was useful. Ga-67 SPECT enabled better anatomical localization than Ga-67 planar image and was useful in detection of lymph nodes greater than 30 mm.
Adenocarcinoma ; Artifacts ; Carcinoma ; Carcinoma, Squamous Cell ; Citric Acid ; Head* ; Humans ; Injections, Intravenous ; Lymph Nodes ; Lymphoma ; Mouth ; Nasopharynx ; Neck* ; Neoplasm Metastasis* ; Tomography, Emission-Computed, Single-Photon ; Vocal Cords

BACKGROUND: To examine whether nonemergency patients can be identified and be safely triaged out of the emergency department. METHODS: Adult patients(16 years or older) who visited to the emergency department were prospectively studied from July 1 to August 31, 1997. Authors developed a new triage composed of vital signs, mental status, chief complaints, etiology, and a mode of transfer. Chi-square test and a discriminant analysis were applied for statistical analysis. RESULTS: In a discriminant analysis, mode of transfer, chief complaint, age, heart rate, mental status, etiology, and body temperature were significant variables in order. In a canonical discriminant value at group mean, a nonemergent value is 0.450 and a emergent value -0.219. CONCLUSIONS: In simply applicable triage method, mode of transfer and chief complaints are more important than vital sign and mental status. This method is useful in disaster situation and non-medical personnel may use this triage method easily. But some patients are not triaged by this triage method, thus more studies and discussions are necessary.
Adult ; Body Temperature ; Disasters ; Emergencies* ; Emergency Service, Hospital* ; Heart Rate ; Humans ; Prospective Studies ; Triage* ; Vital Signs

BACKGROUND: The goal of this study is to identify the factors that predict mortality in elderly trauma patients. METHOD: We reviewed retrospectively the medical record of 144 cases of geriatric trauma admitted to Kyungpook National University Hospital firm January 1998 to December 1998. We evaluated the general characteristics, mechanisms of injury, Revised Trauma Score(RTS), Injury Severity Score(ISS), Probability of survival(Ps) by TRISS(Trauma and Injury Severity Score) method, amount of blood transfused, preexisting disease, complications, length of stay, and mortality. RESULTS: 1. The mean age was 75.39+/-7.89 years old, and male to female ratio was 0.89 : 1. 2. The mechanisms of injury were primarily frills(56.3%) followed by bicycle or motorcycle(13.9%), and pedestrian injuries(13.2%) and motor vehicle accidents(6.9%). 3. The mean Glasgow Coma Scale(GCS), RTS and ISS ate 13.3+/-3.5, 7.2+/-1.4 and 14.2 +/-11.6 respectively. 4. The actual mortality rate was 18.1% (26/144). But by TRISS method, predicted mortality rate was 9.3%(12.5/144), excess mortality rate was 108% and Z score was 3.99 indicating that actual number of death exceed predicted number of death. 5. Between the survivors and nonsurvivors, the insults were significantly different as follows ; systolic blood pressure(141.9+/-28.3 vs. 116.8+/-48.7 mmHg), GCS(14.3+/-2.0 vs. 9.0 +/-5.1), RTS(7.8+/-0.7 vs 5.4+/-2.3), ISS(11.3+/-5.6 vs 27.2+/-20.2), Ps by TRISS(0.97+/-0.06 vs 0.65+/-0.37), preexisting diseases(50.8 vs 69.8%). CONCLUSION: Geriatric patients are more likely to die after trauma than other age groups. The cause of higher actual mortality rate compared to predicted mortality rate was considered as the higher incidence of delayed death due to sepsis or multiple organ failure. In order to reduce the mortality, even with relatively stable initial vile sign, invasive hemodynamic monitoring and intensive treatment are recommended and also, prevention and treatment of nosocomial infection are very important.
Aged ; Coma ; Cross Infection ; Female ; Gyeongsangbuk-do ; Hemodynamics ; Humans ; Incidence ; Length of Stay ; Male ; Medical Records ; Mortality* ; Motor Vehicles ; Multiple Organ Failure ; Preexisting Condition Coverage ; Retrospective Studies ; Sepsis ; Survivors

To observe the role of oxygen free radical and enzymatic scavengers in cerebral ischemia, an infarction model was made using transorbital occlusion of the middle cerebral artery in cats. The changes of the superoxide radical production and the activities of superoxide dismutase and catalase were measured. The results were as follows ; 1) The infarction of the left middle cerebral artery(MCA) territory was identified with intracardiac perfusion of a TTC solution after transorbital occlusion. 2) The superoxide radical activities after occlusion of the left MCA were not changed in all groups except for the decrease in 6 hours group of the right side compared to the control group(p<0.05). 3) The Mn-superoxide dismutase activities of the left side in the 12 hours group were significantly higher than those of the right side(p<0.01) and those in the control group(p<0.05). 4) The Cu, Zn-superoxide dismutase activities of the left side in the 3 hours group after occlusion of the left MCA were significantly higher than those in the control group(p<0.05). 5) The catalase activities of the left side in the 3 hours, 6 hours and 12 hours groups after occlusion of the left MCA were significantly higher than those of the right side(p<0.05). 6) The catalase activities of the left side in the 12 hours group after occlusion of the left MCA were significantly higher than those in the control group(p<0.05). The authors suggest that the enzymatic scavangers such as Mn-SOD, Cu, Zn-SOD and catalase increased in the infarcted brain, which means an involvement of free radicals in cerebral infarction.
Animals ; Brain ; Brain Ischemia ; Catalase* ; Cats ; Cerebral Infarction* ; Free Radicals ; Infarction ; Middle Cerebral Artery ; Oxygen ; Perfusion ; Superoxide Dismutase* ; Superoxides*

CD44 is a cell adhesion molecule with numerous isoforms created by mRNA alternative splicing. Expression of CD44 variants has been suggested to play a potential role in tumor progression and metastasis. We designed primers CD44V, CD44V6/7, CD44R1 and CD44V6-10 to analyze and compare the roles of each CD44 variants. Expressions of CD44 variants were investigated in normal colonic mucosa, the lymph nodes which was histopathologically free of cancer cell, and cancer tissues of 44 human colorectal cancer patients by RT-PCR method. The expression of CD44V was observed in 28 out of 39 (71.8%) tumors and 7 out of 11 (63.6%) N1 normal regional lymph nodes, and CD44V6/7 was observed in 28 out of 39 (71.8%) tumors and 9 out of 11 (81.8%) N1 normal regional lymph nodes. The expressions of CD44V and CD44V6/7 were most frequently observed compared with any other CD44 variants. In normal colonic mucosa, the expression of CD44 variants are low but in cancer tissue and its regional lymph node, the expression of CD44V and CD44V6/7 were significantly higher and more frequent than any other CD44 variants (p<0.05). These results suggest that CD44V and CD44V6/7 can be a molecular marker for colorectal cancer and its micrometastasis to the regional normal lymph node.
Alternative Splicing ; Antigens, CD44/genetics* ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/immunology* ; Gene Expression ; Human ; Lymph Nodes/pathology ; Lymph Nodes/immunology* ; Protein Isoforms/genetics

PURPOSE: To compare the results of cataract surgery between continuous mode and WhiteStar mode the latter is known to induce less heat production in the anterior chamber METHODS: The patients were recruited prospectively since May 2003. They were consecutively assigned to the continuous mode group and the WhiteStar mode group according to preoperative lens color grading in order to equally distribute the lens color grading in both groups. Ultrasound time, operating time, and loss of endothelial cells were evaluated. RESULTS: There was a positive correlation between lens color and ultrasound time and between lens color and operating time (p<0.01). There was no significant difference between the two groups in ultrasound time, operating time or loss of endothelial cells. CONCLUSIONS: There was no remarkable advantage in cataract surgery using WhiteStar mode compared with using conventional continuous mode.
Anterior Chamber ; Cataract ; Endothelial Cells ; Humans ; Phacoemulsification* ; Prospective Studies ; Thermogenesis ; Ultrasonography