BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations

BACKGROUND: The Sampung Collapse took place at 17:55 June 29, 1995. The rescue operation encountered 458 dead and 477 multiply traumatized patients and 464 non traumatized peoples. We wanted to present basic data for disaster planning for example of Sampung Collapse. METHODS: We made a survey of accident field immediately after accident and interviewed with victims, victim's famaly, and rescuer. We analysed the medical record and SCL-9 (Hopkins symptom check list 90R) which was checked several list with victims, victim's family and control group. RESULT: The mean RTS was 11.9 and the mean ISS was 4.3.96 long bone fractures occurred in 76 patients. 127 case of vertebral injury occurred in 63 patients. Total number of surgical operations were 237. There are also many crushing injury and acute post-traumatic stress diseases. CONCLUSION: There are many injury types which are crushing injury, vertebral injury, blunt trauma and acute PTSD(post traumatic stress diseases). Thus, The field management, especially field triage, is very important. And, the urgent patients were 72 patients, about 5% of total patients, witch needed intensive care in tirtiary hospital. Therefore, we need to plan out the expeditious proper management. and prevention of disaster propagation.
Disaster Planning ; Disasters ; Fractures, Bone ; Humans ; Critical Care ; Medical Records ; Triage ; Wounds, Nonpenetrating

BACKGROUND: Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department. METHODS: From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined. RESULTS: Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35-4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01-1.08), leukopenia (OR, 3.63; 95% CI, 1.48-8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41-4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30-6.38). CONCLUSIONS: A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.
Anoxia ; APACHE ; Cause of Death ; Communicable Diseases ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Korea ; Leukopenia ; Mortality ; Pneumonia* ; Prognosis ; Retrospective Studies ; Shock, Septic*

BACKGROUND: Head injury is one of the most common causes of emergency department visits and hospital admission in the pediatric populations, and most injuries are mild. In mild head injury, grading of severity and decision of hospital admission are difficult in the emergency department. Recent studies have suggested that patients with a normal head CT scan and neurologic exam following head injury can be safely discharged from the emergency department. However, previous studies have relied on incomplete patient follow-up and been limited for the most part to adult population. So we performed this study to assess clinical course and the incidence of significant CNS sequelae in children with a normal head CT scan and no focal neurologic sign after mild head injuries during hospital admission and follow-up for 1 month. METHODS: We reviewal the records of children(n=209) admitted to the department of emergency medicine with closed head injuries from Jan. 1, 1996 to Dec. 31, 1996, who's initial Glasgow Coma Scale was 13 to 15, and have no focal neurologic sign and a normal head CT scan. RESULT: 209 patients were studied with a mean age of 6.8(range 3 months to 15years), and 66.5% were male. The most common mechanisms of injury were pedestrian T.A(50.2%) and fall(11.5%). Patients had a mean Glasgow coma scale of 14.8 and mean Abbreviated Injury Score of 1.3. Patients had clinical symptoms of headache(49.3%), vomiting(44.5%), loss of consciousness(LOC)(29.6%), amnesia(10.0%), sleepiness(8.6%), irritability(8.6%), confusion(2.9%) and seizure(1.9%). The mean duration of admission was 4.3 days(range: 6 hours-20 days) and the mean duration of symptom was 36.4 hours. No child developed significant CNS sequelae during hospital admission. However, during hospital admission, aye children(all were preschooler) had psychologic complication ; one child developed post-traumatic stress disorder requiring psychologic treatment for 3 months. Three children developed enuresis and two children developed night terror. During 1 month fallow-up, one child developed a symptomatic hemorrhagic contusion 5 days after the head injury, not requiring neurosurgical treatment. CONCLUSION: Among children with an initial Glasgow Coma Scale of 13 to 15, a normal head CT scan and no focal neurologic sign after mild head injuries, delayed intracranial sequelae are extremely uncommon. So these patient may be discharged home with parental supervision and education for dose observation.
Adult ; Child* ; Contusions ; Craniocerebral Trauma* ; Education ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Enuresis ; Follow-Up Studies ; Glasgow Coma Scale ; Head Injuries, Closed ; Head* ; Humans ; Incidence ; Male ; Neurologic Manifestations ; Organization and Administration ; Parents ; Stress Disorders, Post-Traumatic ; Tomography, X-Ray Computed

OBJECTIVE: The aim of this study is to evaluate the clinical course of intracranial aneurysm in patients aged 65 years and older and the immediate outcome after its aggressive management. MATERIALS AND METHODS: We performed a retrospective analysis using the medical records of 159 elderly patients managed at our institute from September 2008 to December 2013. Obtained clinical information included age, sex, Hunt and Hess grade (HHG), aneurysm location, Fisher grade (FG) and the treatment modality. Concomitant clinical data aside from cerebrovascular condition (hypertension, diabetes, previous medication) were evaluated to determine risk factors that might affect the functional outcomes. RESULTS: A total of 108 patients (67.9%) presented with subarachnoid hemorrhage (SAH), and 51 (32.1%) with unruptured intracranial aneurysms (UIAs). Coiling was performed in 101 patients and 58 patients underwent clipping. In the SAH population, 62 patients (57.4%) showed favorable outcomes, with a mortality rate of 11.3% (n = 18). In the UIAs population, 50 (98%) patients achieved 'excellent' and one (2%) achieved 'good' outcome. Factors including high-grade HHG (p < 0.001), advanced age (p = 0.014), and the presence of intraventricular hematoma (IVH) (p = 0.017) were significant predictors of poor outcome. CONCLUSION: SAH patients with high grade HHG and IVH are associated with poor outcome with statistical significance, all the more prominent the older the patient is. Therefore, the indication for aggressive therapy should be considered more carefully in these patients. However, as the outcomes for elderly patients with UIAs were excellent regardless of the treatment modality, aggressive treatment could always be considered in UIAs cases.
Aged* ; Aneurysm ; Hematoma ; Humans ; Intracranial Aneurysm* ; Medical Records ; Mortality ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage

Cosmetic lateral canthoplasty, in which the size of the eye is increased by extending the palpebral fissure and decreasing the degree of the eye slant, has become a prevalent procedure for East Asians. However, it is not uncommon for there to be complications or unfavorable results after the surgery. With this in mind, the authors have designed a surgical method to reduce complications in cosmetic lateral canthoplasty by preserving the lateral canthal angle. We discuss here the anatomy required for surgery, the surgical methods, and methods for reducing complications during cosmetic lateral canthoplasty.
Asian Continental Ancestry Group ; Humans ; Lacrimal Apparatus ; Methods

BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume*

No abstract available.
Smoking* ; Tobacco Products*

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We report a case of pseudoaneurysm formation after aneurysmal clipping. An aneurysm, which was located on the beginning of orbitofrontal artery, was clipped and wrapped with Surgicel(R) and fibrin glue. Four weeks later, an enlarged aneurysm was detected at the same site on postoperative angiography. We could not find a new aneurysm in the second operation except inflated wrapping region. And clip had been slipped from the original aneurysmal neck. So we concluded that a new aneurysm was a pseudoaneurysm made with surgicel and fibrin glue. And it had been formed from continuous minor leakage caused by slipped clip.
Aneurysm* ; Aneurysm, False* ; Angiography ; Arteries ; Fibrin Tissue Adhesive ; Neck