BACKGROUND: To provide basic data to help construct regional EMSS. METHOD: Using preformed questionnaire, authors investigated prospectively data of 214 patients transferred directly to emergency medical center from other hospitals from May 11 to june 10,1998. RESULTS: 1. Total 214 patients were transferred directly to the emergency medical center of KNUH (14.4% of total), and 63.5% of patients excluding children were non-traumatic patients. 2. The peak age group was 5th decade (19.6%) with mean age of49.6 years old. The male to female ratio was 1.8 : 1. 3. The period between 08 : 00 to 16 : 00 was the most frequent arrival time of transfer patients (42.5%), and the proportion of patients for surgical departments were more common than those for other departments (53.7%). 4. the majority of patients were transferred from secondary hospitals (91.6%), but among them the proportion of mild non-traumatic and mild traumatic patients was 52.3%, and 72.0%. 5. The decision-maker for transfer was a patient himself or family members in 32.3% of severe and 26.8(/) of mild non-traumatic patients, compared with 37.5% of severe and 26.8% of mild traumatic patients. 6. The physician-to-physician communication prior to the patient's transfer was not carried out in 90.8% of severe and 85.9% of mild non-traumatic patients, compared with 75.0%of severe and 67.0%of mild traumatic patients. 7. The hospital ambulance was the most common mode of transfer (64.5%), but non-emergency vehicles such as a taxi or a private car was used for transfer in 21.5% of severe non-traumatic patients, and 12.5% in severe traumatic patients. 8. Transfer accompanied by medical personnel took place in 15.4% of severe non-traumatic patients, 25.0% in severe traumatic patients, and in 27.0% of severe non-traumatic patients, and 44.4% in severe traumatic patients transferred 4 by hospital ambulance. 9. Transfer took less than 1 hour in 66.9% of non-traumatic patients, and 45.2% of traumatic patients, but it took 1 hour or more in 27.7% of severe non-traumatic patients, and 43.7% of severe traumatic patients. 10. Transfer record accompanied the patient in 90.2% of total, but radiologic film and results of laboratory tests did not in 36.9% and 56.9% of severe non-traumatic patients, and in 12.5% and 43.7% of severe traumatic patients. CONCLUSION: It is considered that an appropriate triage system, interhospital transfer guidelines, good transfer records, cooperative interhospital communication, emergency medical information center, public information with education about regional EMSS, improvement of equipment in ambulance, and training of emergency personnel are necessary for effective and well-organized EMSS.
Ambulances ; Child ; Education ; Emergencies* ; Female ; Humans ; Information Centers ; Male ; Prospective Studies ; Surveys and Questionnaires ; Triage

No abstract available.
Thyroidectomy*

The authors have reviewed 46 cases (38 males and 8 females) with ligamentous injuries of the knee in the Department. of Orthopaedic Surgery, St. Mary's Hostpital, Catholic Medical College and Center, during the period from Feb. 1983 to May 1985. The patients were divided into two groups according to the two different postoperative rehabilitation programs. In one group, rehabilitation was begun with limited motion brace from 2nd week postoperatively (Group I). In another group, a long leg circular cast was applied for 6 weeks postoperatively, followed by rehabilitation (Group II). All patients were allowed to bear full weight in 12 weeks postoperatively and were recommended to keep appling braces for at least 6 months postoperatively. Sports or other vigorous activities were allowed in one year postoperatively. Primary repair was performed in 14 cases in Group I (66.7%) and in 17 cases in Group II (68.0%). Reconstruction of ligament was performed in 7 cases in Group I (33.3%) and in 8 cases in Group II (32.0%). The results were analyzed in terms of range of motion, pain, instability and muscle power in each group according to O'Donoghue. The results were as follows: 1. Three months after operation, over 120 degrees in flexion was achieved in 18 cases in Group I (85.7%) and in 7 cases in Group II (28.0%). The recovery of range of motion was achieved earlier in Group I than in Group II. 2. Three months after operation, extension lag was seen in only 2 cases in Group I, all of which were below 10 degrees, and 13 cases in Group II of which 10 cases had extension lag of over 10 degrees. The recovery of muscle power was achieved earlier in Group I than in Group II. 3. Overall results showed “excellent” in 17 out of 21 cases in Group I (80.9%) and in 12 out of 25 cases in Group II (48.0%). In conclusion, the limited motion brace was effective in early recovery of range of motion and muscle power, without any significant loss of stability, after repair or even reconstruction of theligamenta of the knee, regardless of the type of injury, although the number of posterior cruciate ligament tears were too small to come to a concrete conclusion.
Braces ; Humans ; Knee ; Leg ; Ligaments ; Male ; Posterior Cruciate Ligament ; Range of Motion, Articular ; Rehabilitation ; Sports ; Tears

Recently the internal rigid fixation with plates and screws became popular procedure. In the cases of the zygomatic fracture, it is sufficient to fix more than 2 point in many studies. Therefore, the internal rigid fixation requires the aggressive incision to expose the zygoma, such as coronal incision. Since many patients are afraid of this aggressive operation, we have provided a simple and effective method which is a 3-dimensional one point fixation on the zygomaticofrontal suture with X-shaped(6-hole) miniplate for the treatment of zygomatic fractures. From March 1995 to september 1995, we treated 13 cases of zygomatic fractures by open reduction and X-shaped miniplate fixation on the zygomaticofrontal suture. The results were as follows: 1) plane to plane contact on each side of the fracture with one point X-shaped miniplate. 2) 91.8% correction on Water's views, and 93.3% correction on zygomatic arch view with one point fixation. 3) patients were satisfied with these procedures because of minimal incision, mild edema and low operation price (short operation & anesthetic time, one plate & 6 screws cost).
Edema ; Humans ; Sutures ; Zygoma ; Zygomatic Fractures*

No abstract available.

We have examined the regenerative capabilities of the human scalp hair follicle after grafting the lower half of the follicle. Twenty-eight of 32 intact whole-hair follicles isolated from the human scalp regenerated hairs when grafted onto the forehead of the same person. Seven of the 15 lower-half follicles regenerated complete hair follicles 8 months after grafting showed that the lower-half follicle implant reconstituted the complete hair follicle. The sebaceous gland was not regenerated, but there was an outgrowth in the sebaceous gland regPark ion. Some grafts formed epithelial cysts. Two years after grafting, the histological examination of the regenerated follicle from the lower-half implant showed that the sebaceous gland was completely regenerated. While an intact follicle shows prominent naked shaft outgPark Park Parkrowth, the sheath grows concomitantly with the shaft in lower-half follicles in culture. If grafted lower-half follicles were located too deep, the regrown sheath could not reach the epidermal layer. In this situation, the formation of an epidermal cyst was likely.
Epidermal Cyst ; Forehead ; Hair Follicle* ; Hair* ; Humans ; Scalp ; Sebaceous Glands ; Transplants*

It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital hypothyroidism can ameliorate and possibly reverse its consequences. Treatment with L-thyroxine is started in case of suspicious hypothyroidism at the first visit. Serum concentration of total and free thyroxine become normal within 1week after start of therapy but TSH values become normal from 2 months to 6 months after L-thyroxine therapy. The possible explanations for prolonged TSH elevation in congenital hypothyroidism are poor compliance for therapy, an inadequate dose of L-thyroxine, elevated threshold for thyrotropin suppression and two novel mutations in the thyrotropin (TSH) receptor gene in a child with resistance to TSH. Authors have experienced two cases of prolonged TSH elevation with normal T3 and T4 levels till 18months and 27 months of age after optimal L-thyroxine therapy and literature were reviewed.
Child ; Compliance ; Congenital Hypothyroidism* ; Humans ; Hypothyroidism ; Infant, Newborn ; Mass Screening ; Thyrotropin ; Thyroxine

No abstract available.
Polyps*

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

We present a family of FSP with review of literatures. Seeligmuller (1876) and Strumpell (1880) were the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogenous in inheritance, age of onset, severity and associated signs. A pure type without complications has been named "Strumpell's FSP". We have recently experienced a case of 17 years old male who had bilateral weakness and stiffness of lower extremities, and gait disturbance with family history. Differential diagnosis, particularly with familial amyotrophic lateral sclerosis, is discussed.
Adolescent ; Age of Onset ; Amyotrophic Lateral Sclerosis ; Diagnosis, Differential ; Gait ; Humans ; Lower Extremity ; Male ; Muscle Spasticity* ; Paraplegia* ; Upper Extremity ; Wills