BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations

BACKGROUND: The Sampung Collapse took place at 17:55 June 29, 1995. The rescue operation encountered 458 dead and 477 multiply traumatized patients and 464 non traumatized peoples. We wanted to present basic data for disaster planning for example of Sampung Collapse. METHODS: We made a survey of accident field immediately after accident and interviewed with victims, victim's famaly, and rescuer. We analysed the medical record and SCL-9 (Hopkins symptom check list 90R) which was checked several list with victims, victim's family and control group. RESULT: The mean RTS was 11.9 and the mean ISS was 4.3.96 long bone fractures occurred in 76 patients. 127 case of vertebral injury occurred in 63 patients. Total number of surgical operations were 237. There are also many crushing injury and acute post-traumatic stress diseases. CONCLUSION: There are many injury types which are crushing injury, vertebral injury, blunt trauma and acute PTSD(post traumatic stress diseases). Thus, The field management, especially field triage, is very important. And, the urgent patients were 72 patients, about 5% of total patients, witch needed intensive care in tirtiary hospital. Therefore, we need to plan out the expeditious proper management. and prevention of disaster propagation.
Disaster Planning ; Disasters ; Fractures, Bone ; Humans ; Critical Care ; Medical Records ; Triage ; Wounds, Nonpenetrating

No abstract available.
Cartilage*

Background: Atrial arrhythmia is a cardiac disorder caused by abnormal electrical signaling and transmission, which can result in atrial fibrillation and eventual death. Genetic defects in ion channels can cause myocardial repolarization disorders. Arrhythmia-associated gene mutations, including KCNH2 gene mutations, which are one of the most common genetic disorders, have been reported. This mutation causes abnormal QT intervals by a gain of function in the rapid delayed rectifier potassium channel (IKr). In this study, we demonstrated that mutations in the KCNH2 gene cause atrial arrhythmia. Methods: The N588K and L532P mutations were induced in the Courtemanche-Ramirez-Nattel (CRN) cell model, which was subjected to two-dimensional and three-dimensional simulations to compare the electrical conduction patterns of the wild-type and mutant-type genes. Results: In contrast to the early self-termination of the wild-type conduction waveforms, the conduction waveform of the mutant-type retained the reentrant wave (N588K) and caused a spiral break-up, resulting in irregular wave generation (L532P). Conclusion The present study confirmed that the KCNH2 gene mutation increases the vulnerability of the atrial tissue for arrhythmia.

BACKGROUND AND PURPOSE: Arginine esterase(Ancrod), a thrombin-like enzyme, purified from the venoms of Agkistrodon halys, has known to cleave fibrinopeptide A from the fibrinogen and lead to circulation of soluble noncross-linked "ancrodfibrin', which stimulates endogenous T-PA release.Many authors have suggested clinical applicability of this enzyme,but clinical studies on its fibrinolytic action has been insufficient.Thus we studied the influence of this enzyme on fibrinolytic activity in cerebral infarction. METHOD: We observed the change of euglobulin fibrinolytic activity, t-PA antigen, t-PA activity, fibrinopeptide A, fibrinogen, FDP and D-dimer, during 12 hours after a bolus intravenous administration of 0.25 unit of the arginine esterase to the 9 patients with cerebral infarction. RESULT:There was no change of the euglobulin fibrinolytic activity, fibrinopeptide A and t-PA Ag but there was significant increase in both t-PA activity and FDP, D-dimer and significant decrease in fibrinogen. CONCLUSION: Our result suggest that arginine esterase converts fibrinogen to a fibrin polymer which has a increased susceptibility to lysis by plasmirl This enzyme seems to amplify T-PA activity through the consequent increase in FT)P, because there is no increase in the euglobulin fibrinolytic activity, fibr'mopeptide A and t-PA Ag suggesting direct T-PA release. Arginine esterase, having action of effective defibrinogenation and safe fibrinolysis,could be used for the thrombus related disease.
Administration, Intravenous ; Agkistrodon ; Arginine ; Cerebral Infarction ; Fibrin ; Fibrinogen ; Fibrinopeptide A ; Humans ; Polymers ; Snake Venoms* ; Snakes* ; Thrombosis ; Venoms

To quantify the reduction in workload during intra-aortic balloon pump (IABP) therapy, indirect parameters are used, such as the mean arterial pressure during diastole, product of heart rate and peak systolic pressure, and pressure-volume area. Therefore, we investigated the cardiac energy consumption during IABP therapy using a cardiac electromechanics model. We incorporated an IABP function into a previously developed electromechanical model of the ventricle with a lumped model of the circulatory system and investigated the cardiac energy consumption at different IABP inflation volumes. When the IABP was used at inflation level 5, the cardiac output and stroke volume increased 11%, the ejection fraction increased 21%, the stroke work decreased 1%, the mean arterial pressure increased 10%, and the ATP consumption decreased 12%. These results show that although the ATP consumption is decreased significantly, stroke work is decreased only slightly, which indicates that the IABP helps the failed ventricle to pump blood efficiently.
Adenosine Triphosphate/*metabolism ; Arterial Pressure ; Cardiac Output ; Heart Failure/pathology ; Heart Rate ; Humans ; *Intra-Aortic Balloon Pumping ; *Models, Theoretical ; Stroke Volume ; Ventricular Function, Left

Epileptic nystagmus(EN) refers to recurrent attacks of nystagmus caused by a cortical seizure activity. There have been a few reports of EN associated with stroke and tumor. But EN associated with a cavernous angioma has never been reported. We report, therefore, clinical, electroencephalographic, radiologic and pathologic findings of a patient with EN associated with a cavernous angioma.
Hemangioma, Cavernous* ; Humans ; Seizures ; Stroke

PURPOSE: We developed a numerical model that predicts cardiovascular system response to hemodialysis, focusing on the effect of sodium profile during treatment. MATERIALS and METHODS: The model consists of a 2-compartment solute kinetics model, 3-compartment body fluid model, and 12-lumped-parameter representation of the cardiovascular circulation model connected to set-point models of the arterial baroreflexes. The solute kinetics model includes the dynamics of solutes in the intracellular and extracellular pools and a fluid balance model for the intracellular, interstitial, and plasma volumes. Perturbation due to hemodialysis treatment induces a pressure change in the blood vessels and the arterial baroreceptors then trigger control mechanisms (autoregulation system). These in turn alter heart rate, systemic arterial resistance, and cardiac contractility. The model parameters are based largely on the reported values. RESULTS: We present the results obtained by numerical simulations of cardiovascular response during hemodialysis with 3 different dialysate sodium concentration profiles. In each case, dialysate sodium concentration profile was first calculated using an inverse algorithm according to plasma sodium concentration profiles, and then the percentage changes in each compartment pressure, heart rate, and systolic ventricular compliance and systemic arterial resistance during hemodialysis were determined. A plasma concentration with an upward convex curve profile produced a cardiovascular response more stable than linear or downward convex curves. CONCLUSION: By conducting numerical tests of dialysis/cardivascular models for various treatment profiles and creating a database from the results, it should be possible to estimate an optimal sodium profile for each patient.
Blood Pressure/drug effects ; Cardiovascular System/*drug effects ; *Computer Simulation ; Models, Cardiovascular ; *Renal Dialysis ; Sodium/*pharmacology

We report a case of transfusion-associated hemochromatosis in a 38-year-old female who had severe aplastic anemia. She had undergone conservative treatment consisting of multiple transfusions because she had no suitable HLA-matched bone marrow donor. She had received 400 units of red blood cells (RBCs) over 10 years. The transferrin saturation and serum ferritin were increased to 88.4% and 29,905 ng/mL, respectively. Abdominal computed tomography (CT) showed increased densities in the liver and myocardium, suggesting iron deposits in those organs. In general, transfusional iron overload results in primarily reticuloendothelial iron accumulation, which is considered to be less harmful than parenchymal iron accumulation. Nevertheless, our patient had many striking complications associated with hemochromatosis, such as skin pigmentation, hypogonadotropin hypogonadism, insulin-requiring diabetes mellitus, impaired liver function, and left ventricular dysfunction.
Adult ; Anemia, Aplastic ; Bone Marrow ; Diabetes Mellitus ; Erythrocytes ; Female ; Ferritins ; Hemochromatosis ; Humans ; Hypogonadism ; Iron ; Iron Overload ; Liver ; Myocardium ; Skin Pigmentation ; Strikes, Employee ; Tissue Donors ; Transferrin

Background/Aims: Despite the prominence of denosumab as the number one prescribed anti-osteoporosis drug in Korea, the effects of denosumab in male osteoporosis patients were not researched sufficiently. Moreover, concerns on rebound vertebral fractures associated with poor denosumab adherence exist. Methods: We retrospectively evaluated 147 Korean male osteoporosis patients treated with denosumab. After 12 months of treatment, 60 patients were lost during follow-up, and eight were excluded due to missing data. Out of the initial 147 patients, 79 were considered eligible for the analysis of the efficacy of denosumab. 54 patients were initially drug-naïve, and 25 had previously received bisphosphonate therapy. Results: In 54 drug-naïve patients, significant increases in bone mineral density (BMD) were observed in all measurement sites: 5.2% ± 3.7% in the lumbar spine, 2.3% ± 2.8% in the femoral neck, and 1.9% ± 2.8% in the total hip (p < 0.01, respectively). Trabecular bone score showed an increase of 0.5% ± 5.8% in drug-naïve patients. Likewise, in 25 patients with previous bisphosphonate treatment, increase in BMD were observed as well: 4.8% ± 3.5% in the lumbar spine, 1.4% ± 3.6% in the femoral neck, and 0.8% ± 2.1% in the total hip (p < 0.01, p = 0.06, p = 0.06, respectively). Significant declines of –55.1% ± 31.8% in C-terminal telopeptide of type 1 collagen (CTX), and –62.9% ± 21.3% in total procollagen 1 N-terminal propeptide (P1NP), in drug-naïve patients; and –37.7% ± 41.5%, in CTX and –55.4% ± 30.1%, in P1NP in patients with previous bisphosphonate treatment were exhibited after 12 months of treatment. The adherence rates of the second and third dosing schedules were 79.9% and 56.8%, respectively. Conclusions Our study indicates that denosumab is effective in increasing BMD in Korean osteoporosis males regardless of prior bisphosphonate treatment.