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

This is a case report of intestinal eosinophilic granuloma caused by Ascaris ova and worm which is supposed to be rare in Korea. Case: A 23 year old healthy female reached Pusan Sanitation Hospital with complaints of high fever and abdominal pain on December 3 in 1966. Examination: Her temperature was 99.6 F. Pulse 80. Abdominal palpation showed muscle rigidity and tenderness. On the right side of the abdomen diagnosis due to ruptured appendix was made, and a laparotomy was performed the same day. Operation: Intestinal perforation by a Ascaris worm in the caecum about 7 cm from the ileo-caecal junction was also found. The worm was liquefied already. The intestine was edematous . Numerous rice sized nodules were seen on the intestine. The omentum was markdly inflammed and was adhered with a fist size mass. The mass and appendix were also resected in order to do a histological study. Pathology: Two kinds of tissues were examined : one a mesenteric mass, the other lymph node. Microscopically, it showed intensive and entirely necrotic tissue in which numerous parasitic ova were surrounded by granulomatous inflammatory cells with eosinophiles . The parasitic ova were degenerative and partialy necrotic although they had three layers of egg shell which are identified with Ascaris ova.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; egg granuloma-case report ; eosinophile

OBJECTIVES: Cell adhesion molecules may play a role in integrating amnionic membrane. The objective of this study was to prove E-cadherin mRNA and proteins in cultured human amnionic cells. METHODS: We cultured amnionic cells from 4 women undergoing cesarean section without labor. E-cadherin was determined by immunohistochemistry and Western ligend blotting. To demonstrate E-cadherin mRNA, reverse transcription-polymerase chain reaction was performed. RESULTS: On immunohistochemistry, E-cadherin was abundantly showed on the cytoplasm of the cells. Western ligend blotting showed clear 120 kDa bands on four specimens, and relatively weak band on one specimen. Reverse transcription-polymerase chain reaction showed 432 BP bands. CONCLUSION: We proved E-cadherin and its mRNA by immunohistochemistry, Western ligend blotting and reverse transcription-polymerase chain reaction in cultured human amnionic cells.
Amnion* ; Cadherins* ; Cell Adhesion Molecules ; Cesarean Section ; Cytoplasm ; Female ; Humans ; Immunohistochemistry ; Membranes ; Pregnancy ; RNA, Messenger

No abstract available.
Adenocarcinoma*

The fractures of the distal femur are difficult to treat due to its severity of injuries and various complications. Recently, the complications including nonunion, delayed union and joint stiffness have decreased with development of new fixation device, technics and encouraging the early joint motion. We studied 50 cases of fractures treated at our hospital from January, 1980 to July, 1988 and the results obtained from this study were as follows:1. The age distribution was between 11 and 77 year-old, and the 3rd. 4th. decades were 64 % of total patients. 2. The most common cause of injuries was traffic accident(62%), and the open fractures were more common than the fractures of other reports(48%). 3. The types of fracture were unicondylar(21 cases), simple supracondylar(8), and intercondylar (21), according to Chiron's classification, and the intercondylar fractures were subdivided into type I (2 cases), type II A(6), type II B(10) and type III (3) by Neer's. 4. Among the 50 cases, the conservative treatments were done in 19 cases and the surgical one in 31 cases. The conservative treatments were done for undisplaced or minimal displsced fractures and the cases whose general conditions were so poor that operation were impossible. 5. In surgical treatments, the open reduction and the internal fixation(25 cases), the externsl fixation(4), the knee fusion(1) and the A-K amputation(1) were done. 6. The postoperative complications were joint stiffness(11 cases), malunion(3), delayed union(3) and infection(3). 7. The satisfactory results could be obtained by the open reduction and rigid internal fixation followed by early continous passive motion exercise of knee joint.
Age Distribution ; Classification ; Clinical Study ; Femur ; Fractures, Open ; Humans ; Joints ; Knee ; Knee Joint ; Postoperative Complications

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.
Thorax* ; Ventilators, Mechanical*

The anthors studied the 152 cases of primary bone tumors statistically during the period of 7 years and 4 months from Janusry, 1980 to April, 1987 at the department of orthopaedic surgery, St. Benedict Hospital, Pusan and the department of anatomic pathology, Pusan National University Hospital. The results of the study were summsrized as follows; l. Of the 152 cases of primary bone tumors, benign tumors were 128 cases(84.2%) and malignant tumors were 24 cases(15.8%). 2. Of benign bone tumors, the most common type was osteochondroms(34 cases, 26.6%), followed by fibrous dysplasia(25 cases, 19.5%), giant cell tumor(14 cases, 10.9%) and enchondroma(11 cases, 8.6%). 3. Of malignant bone tumors, the most common type was osteosarcoma(14 cases, 58.3%), followed by chondrosarcoma(5 cases, 20.8%), Ewing's sarcoma(3 cases, 12.5%) and myeloma(1 case, 4.2%). 4. Age distribution of benign bone tumors showed that most cases(76.4%) occured under 30-years old. Among malignant bone tumors, most of osteosarcoma and Ewing's sarcoma occured between 10-and 20-yesrs old. 5. The male to female ratio of overall benign bone tumors was 1.1: 1, and that of maligant bone tumors was 1.2: 1. There was no sexual difference. 6. The favorite sites of benign bone tumors were femur(31 cases, 23.1%), maxilla or mandible(31 cases, 23.1%), tibia(22 cases, 16.4%) and rib(11 cases, 8.2%) and those of malignant bone tumors were freguently femur(12 cases, 50.0%), followed by tibia(5 cases, 20.8 %) and pelvis(4 cases, 16.7%). 7. The most frequent manifestations in benign bone tumors were mass or swelling(62.7%), followed by pain or tenderness(33.9%) and disturbed motion or function(10.2%), but those were mostly pain or tenderness(73.9%), followed by mass or swelling(52.2%) and pathologic fracture(13.0%) in malignsnt bone tumors.8. The duration of symptoms in benign bone tumors was less than 6 months in 39.1% and less than 1 year in 44.6%, but less than 6 months in 70.9% and less than 1 year in 87.6% in malignant bone tumors. The duration of symptoms in malignant bone tumors was much shorted than that of benign bone tumors.
Age Distribution ; Busan ; Female ; Giant Cells ; Humans ; Male ; Maxilla ; Osteosarcoma ; Pathology ; Sarcoma, Ewing ; Statistics as Topic

To evaluate the influence of intraoperative irradiation on the healing of jejunal anastomosis, an experimentalstudy was undertaken using a total of 150 rats. The bursting pressure of the normal jejunum was obtained in groupI. Group II was subjected to resection and anastomosis, and group III was irradiated on the anastomosed jejunumwith a single dose of 1,000 rads. Healing process was evaluated by measuring bursting pressure of the anastomosedjejunum on each postoperative day from 2nd to 14th, and on 21 th day. Bursting pressure was tested by inflatingthe loop of gut with water, and bursting sites were observed. The resuls obtained are summarized as follows; 1.The bursting pressure of the anastomosed jejunum retained normal strength by the 7th postoperative day in thenonirradiated group, whereas by the 11th postoperative day in the irradiated group. 2. Irradiation caused delay inthe healing of anastomosis of the jejunum until the 10th postoperative day; but after then, there was nosignificant difference in bursting pressure between both groups. 3. In the jejunal segments with normal strength,bursting occurred exclusively at the non-anastomotic site in both groups; Bursting started along the mesentericborder in the non-irradiated group, whereas rupture usually occurred on the antimesenteric border in theirradiated group. in the jejunal segments with subnormal strength, bursting usually started on the mesentericborder of the anastomotic site in both groups. The results indicate that intraoperative irradiation with a singledose of 1,000 rads causes no harmful effect on the healing of anastomosis of the jejunum in rats. Therefore, thisstudy suggests the possibility of more effective clinical application of intraoperative irradiation.
Animals ; Intestine, Small ; Jejunum ; Rats ; Rupture ; Water

Purpose: : The purpose of this study is to examine the relationship between burnout, nursing work environment, patient-centered communication, and person-centered care nursing among intensive care unit (ICU) nurses and to identify factors related to person-centered care nursing. Methods: : This is a descriptive study involving 156 ICU nurses. A structured questionnaire was used to assess burnout, nursing work environment, patient-centered communication, and person-centered critical care nursing performance. Data were collected from February to March 2020, and descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis were conducted using SPSS/WIN 25.0 program. Results: : The mean scores for person-centered care nursing, burnout, nursing work environment, and patient-centered communication of ICU nurses were 3.52±0.42, 3.00±0.76, 2.62±0.34, 4.06±0.64, respectively. Person-centered nursing showed a statistically significant negative correlation with burnout (r=-.20, p=.013) and a statistically significant positive correlation with patient-centered communication (r=.49, p<.001). In addition, patient-centered communication (β=.47, p<.001) was significantly correlated with person-centered nursing. Conclusion : The results of this study showed that the factors affecting the person-centered care nursing of ICU nurses were patient-centered communication. Therefore, it is necessary to develop and apply patient-centered communication programs for improving the person-centered nursing performance of ICU nurses.