BACKGROUND: To comparatively analysis the epidemiological changes in the acute drug intoxication between 1980s and 1990s. METHODS: We reviewed retrospectively the medical records of the patients with acute drug intoxication in the emergency department of the Inha hospital from June 1986 to April 1987 and from June 1996 to May 1997. And we performed comparative analysis between two result. RESULTS: The ratio of the acute drug intoxication in the emergency medical center was reduced significantly in 1990s against 1980s. Sexual ratio and prevalent age group has no significant interval changes between 1980s and 1990s. The prevalent seasons were Spring in 1980s and Summer in 1990s but has no significance. The most commonly used drugs was rodentides in 1980s and hypnosedatives in 1990s and shown significant interval changes. The most common motive was suicidal attempts in both 1980s and 1990s, but significantly reduced. After emergency treatment the rate of curative-discharge has improved and the rate of admission has decreased significantly in 1990s against 1980s. The most critical agent was agricultural chemicals in both 1980s and 1990s. The mortality rate has no significant interval changes. CONCLUSION: There were some significant interval changes of the acute drug intoxication in prevalence rate, commonly used drugs, ratio of suicidal attempt and curative-discharge rate between 1980s and 1990s. New education programs far preventing acute drug intoxication and strict legal control of drugs are important and necessary.
Agrochemicals ; Education ; Emergencies ; Emergency Service, Hospital ; Emergency Treatment ; Humans ; Medical Records ; Mortality ; Prevalence ; Retrospective Studies ; Seasons

Eczema herpeticum occurred in a patient with pemphigus foliaceus and esophageal cancer. The patient's initial skin lesions composed of large flaccid bullaes showed subcorneal bullae with typical acantholytic cells. Subsequent grouped small vesicles appeared widely on the erythematous base were diagnosed herpes simplex virus infection by Tzanck smear and histopathological findings. The patient died one week after the development of the widespread herpes virus infection.
Eczema* ; Esophageal Neoplasms ; Humans ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Simplexvirus ; Skin

BACKGROUND: Dizziness is a common complaint in patients presenting to the emergency room and that has various pathologic causes. This study investigate the clinical differences in dizziness between the central origin and the peripheral origin and to provides the clues far diagnosis and proper treatment. METHODS: We analysed 290 patients with dizziness during 12 months period prospectively, who visited in ED, Inha University Hospital from Jan. 1997 to Dec. 1997. We analysized sex ratio, characteristics of the dizziness, associated past illness, associated symptoms, severity, results of the special radiologic study, nystagmus type, and causes of central origin and peripheral origin dizziness. RESULTS: Male to female ratio was 1:1.4 in central origin(n=165) and 1:2.0 in peripheral origin(n=125). Most common age group was 11th decade in both groups. According to the characteristics of the dizziness, rotation sense was the main complaint of the peripheral origin dizziness. Most common past illness was hypertension in both groups. MRI has diagnostic priority than CT scan in central origin dizziness. Types of nystagmus has some significant differences between two groups. CONCLUSION: Dizziness may represented as a sign of significant pathological neurologic status especially in central origin. So we must precisely evaluate the patient history, neurologic examination of the inner ear and CNS, and special radiologic study incliding MRI.
Diagnosis ; Dizziness* ; Ear, Inner ; Emergency Service, Hospital ; Female ; Humans ; Hypertension ; Magnetic Resonance Imaging ; Male ; Neurologic Examination ; Prospective Studies ; Sex Ratio ; Tomography, X-Ray Computed

Pilot's complacency and confidence have been implicated as a contributing factors in numerous aviation accidents and incidents. It is related to ones belief that one is capable of performing in a certain manner to attain certain goals which is called 'Self-Efficacy' as a psychological concept. The purpose of this study was to construct and validate pilot's self-efficacy scale. This study examined the necessity of pilot efficacy in terms of pilot's confidence and complacency, and considered what is components and processes of pilot self-efficacy through the reference to literature. This Study newly defined 'pilot-efficacy' as vocational self-efficacy in flight operation field. Based on literature review and advisory group's review, there made 3 factors of Pilot-Efficacy:Flight-Efficacy, Relational/Communication Efficacy, and physical and psychological Stress-Coping Efficacy. Preliminary pilot-efficacy scale was administered to pilot group analysis Item analysis was conducted to select appropriate items and common factor analysis was done to identify the subcomponents of pilot efficacy scale. In result, 35 items were selected. The measurement of pilot efficacy for individual makes it possible to predict pilots' behavior when they make decision both normal and non-normal situation. This scale is expected to be not only predictable but also useful to enhance aviation safety. Finally, suggestion for following studies were discussed.
Accidents, Aviation ; Aviation

We successfully closed the isolated patent ductusarteriosus(PDA) in 2 female patients using the Rashkind Double-Disc Occlusion system. nonsurgical closure of PDA usin plug was introduced by Porstmann in 1968 through transfemoral artery catheter and using umbrella by Rashkind in 1977 througth venous site. There has been continued improvement and simplification of the equipment as well as in the implantation technique. Nowaday, a multicenter study was conducted to test the safety and effectiveness of this interventioal method in States. Successful closure rate was high but some problems were reported such as embolization, abnormal deployment and residual shunt. Residual shunt was visualized by aortography in our both cases immediately after intervention but continuous murmur could not be heard in both cases. Oxygen step-up disappeared immediately after occluder implantation in both cases. Complete occlusion was expected with thrombus in near future.
Aortography ; Arteries ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Humans ; Oxygen ; Thrombosis

Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. The absolute number of reported cases of double primary malignant tumors has increased in recent years diagnostic procedures. Primary adenocarcinoma of duodenum is a rare disease and represents less than 0.5% of all gastrointestinal malignancies. Therefore, synchronous multiple primary cancers of the stomach and duodenum are very rare. Recently, we experienced a case of triple primary malignant tumors of different site originating from the stomach, duodenum and cervix in 71- year-old woman. She had had radiation therapy and chemotherapy for squamous cell carcinoma of the uterine cervix 8 years previously. We performed subtotal gastrectomy and pancreaticoduodenectomy with radical lymph node dissection. She remained healthy without any evidence of recurrence 12 months after the operation.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Pancreaticoduodenectomy ; Rare Diseases ; Recurrence ; Stomach ; Stomach Neoplasms* ; Uterine Cervical Neoplasms*

In spite of vigorous efforts to enhance appropriateness of blood usage in surgery, it is recognized that there are still not a few overuse and misuse of blood products in Korean hospitals. To assure appropriate use of blood, continuous monitoring and controlfling blood orders, particularly for surgical operations, should be implemented. The indicator of 'ratio of crossmatching to transfusion' (C/T ratio) has been focalized on in this regard. The authors investigated C/T ratio for eight hospitals, evenly distributed in their geographical location as well as size. Only elective surgeries operated from March 1 to May 31, 1995 were included for analysis. Standardized survey format was distributed, and retrospective reviews of medical records were performed by volunteer surveyors from each hospital after two sessions of pre- survey education. The results were as follows. Average C/T ratio, for all hospitals and all surgeries, was 1.76. Differences in C/T ratio by sex, months, clinical departments, blood components were not significant. However, the ratio showed increasing tendency with ages. The C/T ratio on the average was not higher, compared with the recommended guideline. However, due to study' s limitations ini standardization of survey method and verification of data, we could not conclude that current status of appropriateness of blood use is satisfactory. In addition, to pervasively use the C/T ratio as a quality indicator for blood use management, supplementary measures, such as standardization of data, should be adopted.
Surveys and Questionnaires ; Education ; Medical Records ; Quality Indicators, Health Care* ; Retrospective Studies ; Volunteers

No abstract available.
Aortography* ; Echocardiography* ; Humans ; Infant, Newborn* ; Radial Artery*

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

PURPOSE: The increased prevalence of dyslipoproteinemia in obese children probably contributes to the high risk of cardiovascular disease associated with being overweight. The genetic makeup is possible one of the factors that influence the impact of obesity on lipid metabolism. A relation between apolipoprotein E (Apo E) polymorphism and lipid metabolism has been convincingly demonstrated in large population. The purpose of this study was to determine whether Apo E polymorphism also influences the risk of dyslipidemia in obese children. METHODS: We studied 89 obese children with weight-for-height excess of 40% by obesity index. We measured the serum concentration of total cholesterol, triglyceride, HDL-cholesterol, LDL- cholesterol, Lipoprotein (a) (Lp(a)), apolipoprotein A (Apo A) and Apo B after overnight fasting. Apo E gene polymorphism of the 89 obese children and 30 control students were analyzed by ARMS (amplication refractory mutation system) method. RESULTS: The frequency of etsilon2, etsilon3, and etsilon4 allele were 9.7%, 82.3% and 8.0%, respectively in children. There was no significant difference between Apo E allele frequency of obese children and those of nonobese children. The serum concentrations of total cholesterol, LDL-cholesterol and Apo B were lower in etsilon2 genotype. The obese children with etsilon4 genotype had higher frequency of hypertriglyceridemia, increased level of Lp(a) and decreased level of HDL-cholesterol than other types. There was no evidence of EKG abnormality and cardiovascular complications in obese children. CONCLUSION: Our data demonstrated that obesity is associated with an increase in the risk of lipoprotein abnormalities and that the serum concentrations of total cholesterol, LDL-cholesterol and Apo B were influenced by Apo E genotypes.
Alleles ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Arm ; Cardiovascular Diseases ; Child* ; Cholesterol ; Dyslipidemias ; Electrocardiography ; Fasting ; Gene Frequency ; Genotype ; Humans ; Hypertriglyceridemia ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins ; Obesity ; Overweight ; Plasma* ; Prevalence ; Triglycerides