To determine the incidence rate of accidents and its associated factors, a prospective survey was carried out in a rural area of a total of 1,360 residents for 1 year from January 1 to December 31, 1988 in Shin-am Ri, Jungdong Myun, Sangju Kun, Kyeongpook Province. Data for accidents were collected by the community health practitioner who is working at Primary Health Post in Shin-am Ri. A total number of accident cases was 85 among 1,360 persons during one year study period, and annual incidence rate was 62.5 per 1,000 persons. The highest incidence rate of accident was observed in the age group of 30-39 was 179.8. The incidence rate of accident in male was 86.5 which was about 2 times that in female. In male, the highest incidence rate was seen in 30-39 age group and in female, 60-69 age group. The highest incidence rate of accident was observed in spring (29.4%) and summer (29.4%), and the lowest in fall (17.7%). The highest incidence rate of accident was observed in Friday (24.5%) by day of week, and between 9 a.m. to 12 a.m. by time zone. The most frequent use of medical facilities was Primary Health Post (51.8%) and the next was clinic (38.8%). Mean duration of treatment was 9.8 days. The accident occurred in the room and kitchen (23.5%), in the yard and barn (23.5%), on the road (22.4%), and in the rice field and dry field (20.0%). The causes of accident were motor vehicle accident (20.0%), piercing or cutting (20.0%), collision or fighting (12.9%), and poisoning (11.8%) in order of frequency. The most common type of injury was open wound which was 43.5%. The most common tool of accident was farm machine which was 23.5%. The most common injured part of body was extremity 55.3%.
Agriculture ; Extremities ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Male ; Motor Vehicles ; Poisoning ; Prospective Studies ; Wounds and Injuries

BACKGROUND: Epinephrine-containing epidural test dose is used for obstetric epidural anesthesia to identify the unintentional cannulation of an epidural vessel. This study evaluated the effects of an epinephrine test dose during epidural anesthesia with 0.5% ropivacaine in ceasrean section. METHODS: Seventy healthy pregnant women, scheduled for elective cesarean section were randomly assigned to one of two groups. A lumbar epidural catheter was placed and aspirated. If aspiration was positive for blood or cerebrospinal fluid, the catheter was replaced. All patients received an 3 ml test dose of either 1.5% lidocaine with epinephrine 5microgram/ml (group E) or lidocaine only (group C). After test dose, 50microgram fentanyl and 20 ml of 0.5% ropivacaine were given to the all patients. Applying the pin prick method and a modified Bromage scoring system, senseory block level and motot block intensity were checked at 5 min intervals for the first hour following ropivacaine injection. After then, they were checked at 15 min intervals for the rest of the test period. Heart rate (HR) and blood pressure (BP) were measured as well. RESULTS: No significant difference between the two groups was detected in HR, BP, the profile of sensory block, motor scores and the onset of motor block. However, group C showed significantly shorter span of motor block (102 +/- 31 min.) than group E (134 +/- 32 min.) (P <0.05). There was no significant difference in neonatal outcome, as assessed by Apgar score at delivery. The most common adverse effect in mothers was hypotension. No serious adverse effects were detected in this study. CONCLUSIONS: We conclude that only the span of motor block by the epidural ropivacaine is affected by epinephrine-containing epidural test dose.
Anesthesia, Epidural* ; Apgar Score ; Blood Pressure ; Catheterization ; Catheters ; Cerebrospinal Fluid ; Cesarean Section ; Epinephrine ; Female ; Fentanyl ; Heart Rate ; Humans ; Hypotension ; Lidocaine ; Mothers ; Pregnancy ; Pregnant Women

No abstract available.

BACKGROUND/AIMS: Inflammatory bowel disease (IBD) management guidelines have been released from Western countries, but no adequate data on the application of these guidelines in Asian countries and no surveys on the treatment of IBD in real practice exist. Since there is a growing need for a customized consensus for IBD treatment in Asian countries, Asian Organization of Crohn's and Colitis performed a multinational survey of medical doctors who treat IBD patients in Asian countries. METHODS: A questionnaire was developed between August 2013 and November 2013. It was composed of 4 domains: personal information, IBD diagnosis, IBD treatment, and quality of IBD care. Upon completion of the questionnaire, a web-based survey was conducted between 17 March 2014 and 12 May 2014. RESULTS: In total, 353 medical doctors treating IBD from ten Asian countries responded to the survey. This survey data suggested a difference in available medical treatments (budesonide, tacrolimus) among Asian countries. Therapeutic strategies regarding refractory IBD (acute severe ulcerative colitis [UC] refractory to intravenous steroids and refractory Crohn's disease [CD]) and active UC were coincident, however, induction therapies for mild to moderate inflammatory small bowel CD are different among Asian countries. CONCLUSIONS: This survey demonstrated that current therapeutic approaches and clinical management of IBD vary among Asian countries. Based on these results and discussions, we hope that optimal management guidelines for Asian IBD patients will be developed.
Asia* ; Asian Continental Ancestry Group* ; Colitis* ; Colitis, Ulcerative ; Consensus ; Crohn Disease ; Diagnosis ; Hope ; Humans ; Inflammatory Bowel Diseases* ; Seoul* ; Steroids

In this article, the third author's name was spelled incorrectly.

In this article, the third author's name was spelled incorrectly.

BACKGROUND AND OBJECTIVES: Dobutamine stress echocardiography (DSE) with 2D echocardiography (2DE) is one of the time-consuming procedures in the diagnosis of coronary artery disease (CAD). Moreover, the accuracy of DSE with 2DE depends on the operator's skill or bias during the image acquisition. This study was conducted to determine the feasibility and accuracy of DSE with real-time 3D echocardiography (RT3DE) for the diagnosis of CAD. SUBJECT AND METHODS: 62 patients (RT3DE: 36, 2DE: 26), suspected of angina pectoris and post-revascularization ischemia, underwent DSE and coronary angiography (CAG). Image acquisition was performed at the baseline, and at 4 times during the dobutamine infusion and recovery stages. The procedure time (from the baseline to the end of the peak dose stage) was recorded. Off-line analyses of the volumetric images acquired with RT3DE were performed using 3D computer software (TomTec, Co.). Digitized quad-screen images acquired with 2DE were analyzed using the 2DE review system (ProSolv 4.0). >50% luminal diameter stenosis of any coronary artery on CAG was defined as significant coronary artery stenosis. RESULTS: The procedure time of DSE with RT3DE was significantly shorter than that of DSE with 2DE (25+/-4 vs. 37+/-4 mins, p<0.001). There was no significant difference in the sensitivity (p>0.05) or specificity (p>0.05) between the two procedures. CONCLUSION: DSE with RT3DE seems to be a feasible and less time consuming diagnostic procedure, probably providing comparable sensitivity and specificity for the detection of coronary artery stenosis, than DSE with 2DE.
Angina Pectoris ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography* ; Echocardiography, Stress* ; Echocardiography, Three-Dimensional* ; Humans ; Ischemia ; Phenobarbital ; Sensitivity and Specificity

To clarify the mechanisms of stone formation in gallbladder and in common bile duct, the bile composition, such as cholesterol, total bile acid, major bile acids, phospholipid, protein and calcium, from patients with gallbladder stones, common bile duct stones and control groups were analyzed for comparison. The control group consisted of patients who had neither biliary stone nor biliary tract disease. The results obtained are as follows; 1. In the mean concentrations of bile cholesterol and protein from each disease group, no statistically significant difference of these compositions was observed according to sorts of stone(p > 0.05). 2. In the cholesterol stone group the mean concentration of total bile acid of bile from gallbladder stone group was higher than that of common bile duct stone group (p < 0.05). In the pigment stone group, T/D ratio of bile from gallbladder stone group tended to be higher than that of CBD stone group. But these differences were not statistically significant (p = 0.09). 3. In the pigment stone groups, the mean concentration of bile phospholipid from gallbladder stone group was significantly higher than that of CBD stone group (p < 0.05). 4. The mean concentration of bile protein from gallbladder stone group was higher than that of CBD stone group in the pigment stone group (p < 0.05). 5. The mean concentration of bile calcium was significantly higher in gallbladder stone group than that in CBD stone group (p < 0.05). In conclusion, supersaturation of cholesterol in bile may not be sufficient to explain cholesterol gallstone formation. The increase in total bile acid especially LCA, DCA, CDCA may be involved in cholesterol gallbladder stone formation, whereas pigment gallbladder stone formation is thought to be related to decreased T/D ratio of bile which means high dihydroxycholanic acid of bile. Additionally, the results suggest that phospholipid, protein and calcium contribute to pigment gallbladder stone formation by playing great roles in forming matrix as nucleus in pigment stone, but further investigation may be needed to detect calcium ion critical for calcium crystal formation.
Bile Acids and Salts ; Bile* ; Biliary Tract Diseases ; Calcium ; Cholesterol ; Common Bile Duct* ; Gallbladder* ; Gallstones ; Humans

We made a clinical observation of 17 cases of congenital Hypothyroidism at the Pediatric department of Yonsei University hospital in Seoul, Korea during the period from January, 1969 to August, 1979. The results were as followings : 1) Male to female sex was about 1 : 1.1, and 6 cases (35%) of congenital hypothyroid-sm were diagnosed under 1 year old. 2) In etiological classificattion, aplastic or hypoplastic glands was 7 cases (41.2%) and normal or enlarged gland, 6 cases (35.3%) and ectopic thyroid tissue, 4 cases (23.5%). 3) In all cases, height and bone age retarded below normal range. 4) All cases were improved slightly after receiving dessicated thyroid and sodium-1 thyroxin therapy. Three cases had regalned normal growth and development after 6 months of treatment.
Congenital Hypothyroidism* ; Female ; Growth and Development ; Humans ; Korea ; Male ; Reference Values ; Seoul ; Thyroid Dysgenesis ; Thyroid Gland ; Thyroxine

PURPOSE: The purpose of this study was to determine the proton MR spectroscopic features of liver cirrhosis and the different proton MR spectroscopic features between liver cirrhosis and the normal human liver by comparing the two different conditions. MATERIALS AND METHODS: The investigation involved 30 cases of in-vivo proton MR spectra obtained from 15 patients with liver cirrhosis demonstrated on the basis of radiologic and clinical findings, and from 15 normal volunteers without a past or current history of liver disease. MR spectroscopy involved the use of a 1.5T GE Signa Horizon system (GE Medical Systems, Milwaukee, U.S.A.) with body coil. STEAM (STimulated Echo-Aquisition Mode) with 3000/30 msec of TR/TE was used for signal acquisition; patients were in the prone position and respiration was not interrupted. Cases were assigned to either the cirrhosis or normal group, and using the proton MR spectra of cases of in each group, peak changes occurring in lipids (at 1.3ppm), glutamate and glutamine (at 2.4 -2 .5ppm), phosphomonoesters (at 3.0 -3 .1ppm), and glycogen and glucose (at 3.4 -3 .9ppm) were evaluated. Mean and standard deviation of the ratio of glutamate + glutamine/lipids, phospho-monoesters/lipids, glycogen + glucose/lipids were calculated from the area of their peaks. The ratio of various metabolites to lipid content was compared between the normal and cirrhosis group. RESULTS: The main characteristic change in proton MR spectra in cases of liver cirrhosis compared with normal liver was decreased relative intensity of lipid peak. Mean and standard deviation of ratio of glutamate + g-lutamine/ lipids, phosphomonoesters/lipids, glycogen + glucose/lipids calculated from the area of their peaks of normal and cirrhotic liver were 0.0204 +/-0.0067 and 0.0693 +/-0.0371 (p<0.05), 0.0146 +/-0.0090 and 0.0881 +/-0.0276 (p<0.05), 0.0403 +/-0.0267 and 0.2325 +/-0.1071 (p<0.05), respectively. The other character-istic feature of proton MR spectra of liver cirrhosis was the peak detected at 3.9 - 4.1 ppm with unknown nature. Mean and standard deviation of area ratio of the unknown peak to lipid peak in proton MR spectra of liver cirrhosis was 0.1504 +/-0 . 0 3 5 5 . CONCLUSION: Proton MR spectra of liver cirrhosis revealed decreased intensity of lipid with statistical signifi-cance compared with that of normal liver, and peak at 3.9 -4.1 ppm with unknown nature. In conclusion, liver cirrhosis can be diagnosed non-invasively by the analysis of observed proton MR spectroscopic features.
Fibrosis ; Glucose ; Glutamic Acid ; Glutamine ; Glycogen ; Healthy Volunteers ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Magnetic Resonance Spectroscopy ; Prone Position ; Protons* ; Respiration ; Steam