BACKGROUND: The present study was performed in order to identify the possible future location of the Department of Emergency Medicine and future demand for and supply of manpower through a survey of the heads of Kwangju City and Chollanam-do hospitals. The survey covered the degrees of recognition and understanding, the necessity, the future prospects, and the direction of development of the Department of Emergency Medicine. METHODS: A total of 33 large-scale general hospitals were selected in county districts having more than 200 sickbeds as of November 1999. Among them, the heads of 29 hospitals responded to the survey. The survey had a total of 31 questions, including 6 questions on the status of the emergency room. Six(6) questions concerned the degree of recognition of the Department of Emergency Medicine. Six(6) questions concerned the degree of understanding of the Department of Emergency Medicine. Six(6) questions concerned the necessity for the Department of Emergency Medicine, and 7 questions concerned the future prospects and direction of development. The results of the survey were analyzed. RESULTS: 1) As to the question of the degree of recognition, the Department of Emergency Medicine was known to all. That is, 50% of the respondents were well aware of the department, and 50% a little. Nineteen(19) respondents(65%) answered that it was convenient to have the Department of Emergency Medicine in a university hospital, among which 16 respondents(55%) answered that it was because of the rapid treatment of emergency patients. 2) As to the question of the degree of understanding, particularly, the areas of medical examination and treatment by the Department of Emergency Medicine, 15 respondents answered that it was for the treatment of patients who needed to receive emergency treatment, while 12 respondents answered that it was for the diagnosis and treatment of all patients who visited the emergency room. Only 7 respondents(24%) answered positively as to the possibility of the Department of Emergency Medicine using thrombolysis medicine. 3) All except for one respondent had a positive view on the necessity for the Department of Emergency Medicine, and all except for 3 respondents wanted to have specialized doctors in emergency medicine work at the corresponding hospital. As to the type of schedule, 10 hospitals(34%) wanted to have only night shifts, and 11 hospitals(38%) wanted to have both day and night shifts. Most hospitals, needed two or more workers in the field. 4) As to the question of the direction of development, many respondents were of the opinion that the hiring of specialized doctors in emergency medicine would not be of greatly help to the finances of the hospital due to increased labor costs. It seems that improvement of the medical system to improve hospital financing is a required prerequisite for the development of the Department of Emergency Medicine. Also, 21 respondents(83%) were of the opinion that it would take a considerable amount of time to activate the Department of Emergency Medicine with respect to the future prospects of the department. CONCLUSION: It was shown in the present survey that the heads of hospitals in Kwangju City and Chollanam-do recognized the Department of Emergency Medicine in a positive way, but it was necessary to establish both a delivery system for emergency medicine and collaboration with and support by other medical areas for its future development. It was estimated that in the future, more than 55 doctors specializing in emergency medicine would be needed as medical manpower for the general hospitals in the districts.
Appointments and Schedules ; Cooperative Behavior ; Surveys and Questionnaires ; Diagnosis ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Emergency Treatment ; Gwangju* ; Head ; Hospitals, General ; Humans ; Jeollanam-do*

No abstract available.
Child* ; Humans ; Infant, Newborn*

No abstract available.
Immunoglobulins* ; Lactoglobulins* ; Milk*

Growth under conditions of iron-restriction and the production of siderophore was examined in Vibrio mimicus ATCC 33653. This strain grew and multiplied in the presence of the high-affinity iron chelators ethylenediamine-di (o-hydroxyphenylacetic acid). Chrorne azurol S (CAS) agar and solution were used to detect the production of siderophore under these condition. Siderophore could be detected in the iron-rcstricted culture supernatants. The siderophore was extracted from iron-restricted culture supernatants by phenol-chloroform-ether method and purified by Dowex ion-exchange and Sephadex G-25 gel filtracton chromatography. The purified siderophore was confirmed by paper chromatography and HPLC. The Purified siderophore enhanced the growth of V. mimicus when the bacterium was grown in iron limited medium. Injection of both the siderohore and the bacteria to mice resulted in more rapid death than that of the only bacteria. However, the siderophore did not show lethality to mice and any toxicity to cell line like HeLa and U937.
Agar ; Animals ; Bacteria ; Cell Line ; Chelating Agents ; Chromatography ; Chromatography, High Pressure Liquid ; Chromatography, Paper ; Iron ; Mice ; Vibrio mimicus* ; Vibrio*

Injuries in the industries has been steadily increasing in this country in recent years. Injuries in the industries intricate in accoriance with the industrial environment, mechanism of injuries and the other factors of employees. In 6 years 201 patients with industrial injuries underwent treatment in the Department of Orthopaedic Surgery of the National Medical Center, and the result of treatment is reported in this paper. 1. 70 cases out of 201 cases were in the age group between 21 to 30 year. 186 cases were male and 15 were female. The incidence is remarkably higher in male. 2. In 80 cases the injuries were caused by machinery with pressor parts. The patients were chiefly manual workers in factories. 3. Of 280 injuries, 148 (62.8%) were upper extremities, 105 (37.5%) were lower extremities and 27 (96%) were trunks. The most common site of injuries was hand. 4 Of 146 injuries with fractures, 94 were treated by manual reduction and cast, and 52 were treated by open reduction. 5. Treatment for open wounds was debridement followed by delayed primary closure and/or skin graft. The primarily closed open wounds by local clinics were observed and treated according to wound condition. 6, 17 cases out of 22 phalangeal bone fractures were treated by manual reduction and splint. 5 cases were treated by K-wire internal fixation, among them 3 cases had to be treated by amputation. 7. Incidence of early camplication was considerably high with 137 sites out of 280 sites and the late complication was 79 sites after treatment of the early complications.
Amputation ; Debridement ; Female ; Fractures, Bone ; Hand ; Humans ; Incidence ; Lower Extremity ; Male ; Skin ; Splints ; Transplants ; Upper Extremity ; Wounds and Injuries

OBJECTIVE: Immune hemolytic jaundice is caused by the destruction of antibody-sensitized erythrocytes and is associated with antibody-dependent cellular cytotoxic effects mediated by Fc receptor-bearing cells of the reticuloendothelial system. Intravenous immune globulin(IVIG) may have exerted its effect through Fc receptor blockade. We studied the effect of high-dose intravenous immune globulin(HDIVIG) in neonatal hemolytic jaundice unresponsive to phototherapy. METHODS: We selected only those with Coombs test(+) immune hemolytic jaundice who had admittcd at the NICU of the Dcpartment of Pediatzics of Dongsan Medical Center, Keimyung University between January 1995 and December 1998. They were unresponsive to phototherapy. Ten newborn infants(9 ABO incomplatibilities, l minor group incompatabillity due to anti-E) received HDIVIG therapy combined with phototherapy. IVIG was given as a dose of lg/kg for 6 hours, and serial hemoglobin, reticulocyte count, and bilirubin levels were evaluated. If the serum bilirubin level went up and reached the level above 22mg/dl, we conducted exchange transfusion for the patient. RESULTS: HDIVIG induced a significant decrease of serum billirubin levels in 8(80%, group I, HDIVIG responsive poup) of 10 cases and only 2 cases(group II, HDIVIG unreponsive group) required exchange tnnsfusions. No side effect was observed after HDIVIG therapy. CONCLUSION: We suggest HDIVIG may be effective in the treatment of phototherapy-resistant hyperbilirubinemia due to blood group incompatibility. More studies are needed to confirm the optimal dosage and therapeutic indication of HDIVIG in the therapy of neonatal immune hemolytic jaundice.
Bilirubin ; Blood Group Incompatibility ; Erythrocytes ; Humans ; Hyperbilirubinemia ; Immunoglobulins, Intravenous ; Infant, Newborn ; Jaundice* ; Mononuclear Phagocyte System ; Phototherapy* ; Receptors, Fc ; Reticulocyte Count

No abstract available.
Duodenal Ulcer* ; Vagotomy*

No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

Overexpression of the nuclear phosphoprotein p53 is the most common genetic anomaly found in primary human cancer and mutation of the tumor suppressor gene p53 has been identified in breast cancer cell lines. In this study, we evaluated the prognostic significance of p53 protein expression in patients with mammary infiltrating ductal carcinoma and its correlation with histopathologic grade, lymph node status, tumor size, p53 protein expression and survival. Among 53 cases, p53 protein expression was detected in 26(49.1%) cases by immunohistochemistry. There was no correlation between p53 protein overexpression and histopathologic grade(p=0.09) or lymph node status(p=0.38) and between survival and histopathologic grade (p=0.68) or lymph node status(p=0.52). However, p53 protein expression was significantly correlated with survival(p=0.01) and patients with p53 protein-positive tumors showed poorer survival times. But Cox multivariate analysis showed the lymph node status is significant(p=0.01). The authors conclude that the presence of mutant p53 protein and lymph node status may serve a prognostic role, in a subset of mammary infiltrating ductal carcinoma cases.
Humans ; Genes, Tumor Suppressor ; Breast Neoplasms

No abstract available.
Peptic Ulcer*