BACKGROUND: One of the problem in emergency room(ER) of university hospital is over-crowdedness that causes exhaustion of medical resources (personnel, device, space) and disturbes optimal treatment. METHODS: This is an evaluative research for the purpose of promoting efficient operation system in ER of university hospital. RESULTS: 1) In 387 visitors, mean age was 47.5 years, and male to female ratio 1.21:1. As the specialty in charge, 28.9%f them were internal medicine, 26.6%mergency medicine, 9.9%eurology, and 8.5%eurosurgery. 24%f visitors have come by ambulances. The patients stayed for average 16.1 hours. The admission rate of ER visitors was 33.4 %60.3 %returned home after some management. 2) The visitors had various causes without correlation between the severity of conditions and the choice of high level hospital ER. They perceived their situations emergent in 78.4% but after triage only 25.6%were classified emergent. 48.6%of the visitors were the patients of out-patient department of this hospital due to chronic diseases. 3) The patients were assessed within 9.5 minutes after arrival at ER by nurse and within 34 minutes by doctor. If they were in need of consultation to second/third department, they waited for 141.5/460 minutes respectively to see the doctor. They waited for 59.9/52.7 minutes to get routine laboratory sampling/radiologic examination respectively. 4) Every 2.3 new patients visited this ER per hour. Average 63.2 patients were taken over to next shirt of nurse duty, and 60%of them had chronic degenerative diseases. CONCLUSION: The causes of overcrowding in ER of the university hospital were (1) huge number of patients at out-patient department of the hospital, (2) shortage of beds compared to the number of patients waiting admission, (3) too many kinds of procedures performed in ER, (4) cooperation failure among doctors of different specialty, and (5) no definite criteria of admission/discharge into/from ER. To solve these problems, conversion of ER management policy from complete examination and treatment to more simple and rapid one is necessary.
Ambulances ; Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals ; Humans ; Internal Medicine ; Male ; Outpatients ; Triage

PURPOSE: The purposes of this article are to identify CT findings distinguishing nasal polyps, that are the most common cause of the nasal polypiod lesions, from other nasal cavity masses and to identify differential points between benign and malignant masses of nasal cavity. MATERIALS AND METHODS: We classified 567 cases of pathologically proved nasal cavity masses into 4 different groups on CT according to the sites of origin and surrounding bone changes. RESULT: The nasal polyps were the most common cause of nasal cavity masses(515/567). Group I had a high diagnostic specificity for the nasal polyps (513/515, 99.6%) although inverted papilloma (8/522) and malignant melanoma(1/522) showed similar CT appearances. The representitive nasal mass of Group Ila was the inverted papilloma (15/24, 66.5% of the inverted papilloma). Group III pattern was seen in 3 cases of benign minor salivary gland tumor and 2 cases of pyogenic granuloma. Group IV suggested malignancy and thus was mostly observed in malignant tumors except I case of inverted papilloma and 1 case of granulomatous necrosis. CONCLUSION: The differential diagnosis between nasal polyps and the other nasal cavity masses is possible by characteristic bone changes and their sites of origin revealed on CT. In addition, it is possible to differentiate malignant masses from benign in most cases.
Diagnosis, Differential* ; Granuloma, Pyogenic ; Nasal Cavity* ; Nasal Polyps* ; Necrosis ; Papilloma, Inverted ; Salivary Glands, Minor ; Sensitivity and Specificity

No abstract available.
Jaundice

PURPOSE: To compare histopathological and apoptotic changes of ophthalmoscopically similar subthreshold laser burns made by a low power-long duration (LD) and a high power-short duration (SD) subthreshold laser treatment. METHODS: Ophthalmoscopically invisible subthreshold laser burns with a 3.0 mm spot size were made using an 810 nm diode laser on the rabbit retina. Lasers were applied for 60 seconds in the LD group, and 1 second in the SD group. Laser power was adjusted to achieve ophthalmoscopically invisible burns just below the threshold. The rabbits were sacrificed at 6, 12, 24, and 72 hours, 1, 2, and 4 weeks after laser treatment. The eyes were processed for light microscopic examination using hematoxylin and eosin (H&E), toluidine blue, and TdT-dUTP terminal nick-end labeling (TUNEL) staining. Eyes were also processed for electron microscopic examination. RESULTS: The changes in the retina were different between the two groups. The LD group showed abundant TUNEL positive cells in all the retinal layers at 6 hours after laser treatment, and distinct histological changes in the outer nuclear layer. Conversely, in the SD group, apoptosis did not occur and histological alteration in the outer nuclear layer was minimal. CONCLUSIONS: Subthreshold laser treatment for 1 second reduced damage of the inner retinal layer and did not result in apoptosis in the neurosensory retina while maintaining a similar effect on the RPE and its adjacent region.
Apoptosis ; Burns ; Electrons ; Eosine Yellowish-(YS) ; Eye ; Hematoxylin ; In Situ Nick-End Labeling ; Lasers, Semiconductor ; Light ; Macular Degeneration ; Rabbits ; Retina ; Retinaldehyde ; Tolonium Chloride

PURPOSE: We conducted a prospective comparative clinical study to determine the field efficacy of the 2010-2011 influenza vaccines [Influenza virus strains; A/California/7/2009 (H1N1), A/Perth/16/2009 (H3N2), B/Brisbane/60/2008] in healthy Korean children under 18 years of age. METHODS: In this study, we enrolled subjects aged between 6 months and 18 years and divided them into 2 study groups: a group who received the influenza vaccines (407 subjects), and a control group who did not receive the influenza vaccines (230 subjects). Ours was a multicenter study that involved 7 hospitals, including the Korea Cancer Center Hospital. The study was conducted between September 2010 and February 2011. We collected nasal wash or throat swab samples from subjects who presented with acute febrile respiratory or influenza-like illnesses at the hospital. We used PCR to confirm the presence of the influenza virus in the respiratory samples and characterize the virus type. RESULTS: In this study, we collected 22 respiratory samples from the influenza-vaccinated group and found 3 cases of influenza virus infection. Similarly, we collected 21 samples from the control group and found 12 cases of influenza virus infection among 10 subjects during the study period. We determined the field efficacy of the 2010-2011 seasonal influenza vaccines to be 83.2% in healthy Korean children and adolescents. CONCLUSION: In this study, we determined the field efficacy of the 2010-2011 seasonal influenza vaccines in healthy Korean children and adolescents. We found that the field efficacy of 2010-2011 seasonal influenza vaccines was adequate.
Adolescent ; Aged ; Child ; Humans ; Influenza Vaccines ; Influenza, Human ; Korea ; Orthomyxoviridae ; Pharynx ; Polymerase Chain Reaction ; Prospective Studies ; Seasons ; Viruses

A survey was conducted to determine the perception of youku meat among college students majoring in food and/or nutrition. The survey participants were located nationwide, and the responses from the 2,454 students were analyzed. More male and higher grade students answered that they had heard about youku while only 20.0% had learned about Youku from class. Approximately 37.8% of the subjects recognized youku as 'dairy cattle which are too old to produce milk', 54.0% as 'all cattle grown for the purpose of meat', and 23.1% as 'all cattle except for Hanwoo'. Only 37.4% recognized youku correctly. Compared with the same quality grade, 25.3% recognized youku meat as being cheaper than imported beef, and only 25.6% of them recognized that youku meat has less fat than imported beef. As much as 83.3% of subjects did not know whether or not they were served youku meat, and 23.7% of subjects wanted increased availability of youku meat. As much as 22.9% of subjects opposed the increased use of youku meat, and the reasons were "it does not taste good" (18.1%), "it is not Hanwoo" (15.1%), "it is not sanitary" (13.1%), and "it is imported" (6.0%). The findings provide basic information on barriers regarding youku meat promotion among subjects who will be dieticians in food service or managers in purchase departments of catering companies in the future.
Animals ; Cattle ; Food Services ; Humans ; Male ; Meat* ; Nutritionists

PURPOSE: The objective of the present study was to determine whether fermentation can increase the protective effects of blueberry liquid in a high-fat diet-induced obese mice model. METHODS: Male C57BL/6J mice were fed a high-fat diet (HD, 60% fat, w/w,), HD supplemented with 10 ml/kg BW/day of blueberry liquid (BHD, blueberry high-fat diet), or HD supplemented with 10 ml/kg BW/day of fermented blueberry liquid (FBHD, fermented blueberry high-fat diet) for 10 weeks. RESULTS: There were significant decreases in the body, epididymal adipose tissue, and liver weights of blueberry-fed groups compared to HD, whereas there were no significant differences in food intake among the groups. Furthermore, blueberry liquid groups, especially fermented blueberry liquid, significantly attenuated the contents of hepatic triglycerides and total cholesterol induced by HD. Serum LDL-cholesterol was significantly lower in the BHD and FBHD-fed groups, whereas FBHD significantly increased the serum HDL-cholesterol level compared to the control. Concentrations of aspartate transaminase, alanine transaminase, and leptins in serum were also reduced by blueberry liquid supplementation. The mRNA expression of hepatic acetyl CoA carboxylase was significantly reduced in both the BHD and FBHD groups compared to HD. Furthermore, FBHD altered the mRNA expression level of hepatic lipolysis genes. CONCLUSION: In conclusion, these results suggest that blueberry, especially fermented blueberry liquid, may improve obesity-related abnormalities.
Acetyl-CoA Carboxylase ; Adipose Tissue ; Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Blueberry Plant* ; Cholesterol ; Diet, High-Fat ; Eating ; Fermentation ; Humans ; Leptin ; Lipolysis ; Liver ; Male ; Mice* ; Mice, Obese ; RNA, Messenger ; Triglycerides ; Weights and Measures

PURPOSE: For evaluating the immunogenicity of an influenza vaccine, the microneutralization (MN) test has a higher sensitivity and specificity as compared to the hemagglutination inhibition (HI) test. However, the MN test is more time consuming and is difficult to standardize. We performed the MN test to determine its usefulness as an alternative or complementary test to the HI test for evaluating the immunogenicity of influenza vaccines. METHODS: We compared the MN test with the HI test using 50 paired samples taken from a previous clinical study (2008-2009) in Korean children under 18 years of age. RESULTS: The linear correlation coefficients of the 2 tests for H3N2, H1N1, and influenza B were 0.69, 0.70, and 0.66, respectively. We identified a high index of coincidence between the 2 tests. For an influenza vaccine, the postvaccination seroprotection rates and seroconversion rates determined by the MN test were 78.0% and 96.0%, 90% and 42.0%, and 42.0% and 48.0% for H3N2, H1N1, and influenza B, respectively. Geometric mean titer fold increases of H3N2, H1N1, and influenza B were 2.89, 5.04, and 4.29, respectively, and were 2.5-fold higher. We obtained good results in the evaluation of the immunogenicity of the 2008-2009 seasonal influenza vaccines. CONCLUSION: We found that the MN test was as effective as the HI test. Therefore, we suggest that the MN test can be used as an alternative or complementary test to the HI test for evaluating the immunogenicity of influenza vaccines.
Child ; Hemagglutination ; Hemagglutination Inhibition Tests ; Humans ; Influenza Vaccines ; Influenza, Human ; Neutralization Tests ; Seasons ; Sensitivity and Specificity

Exclusively dopamine producing retroperitoneal paragangliomas are extremely rare. We have experienced the first Korean case managed successfully based on the proper evaluation. A 26-year-old female patient came to our attention after the accidental detection of an adrenal mass. She had no symptoms and denied any family history. Laboratory evaluations were normal but serum dopamine (425 ng/L) and 24-hour urine dopamine levels (1,565.3 microg/day) were elevated. She underwent laparoscopic right adrenalectomy. Histopathological diagnosis was a paraganglioma. After operation, dopamine levels in serum and 24-hour urine dropped to 0.09 ng/L and 388.4 microg/day. Dopamine producing paraganglioma elicit no clinical symptoms. Only the dopamine level is elevated in serum and 24-hour urine samples. Surgical resection without using preoperative alpha blockage is the treatment of choice. The prognosis for patients with this tumor tends to be poor because the diagnosis is usually delayed due to lack of symptoms.
Adrenal Glands ; Adrenalectomy ; Adrenergic alpha-Antagonists ; Adult ; Dopamine ; Female ; Humans ; Korea ; Paraganglioma ; Pheochromocytoma ; Porphyrins ; Prognosis

PURPOSE: The effects of an oral hygienic care program (OHCP) have been reported in several diseases. However, no study exists investigating the influence of an OHCP on stroke patients or patients in the intensive care unit (ICU) has been reported, thus we sought to investigate the potential effect of an OHCP. MATERIALS AND METHODS: Fifty-six consecutive stroke patients who were admitted to the ICU were randomly assigned to two groups: the intervention (29 patients) and control groups (27 patients). The OHCP included tooth brushing with an inter-dental brush and tongue cleaner and cleaning with chlorhexidine was administered to patients by one dentist once per day during admission in the ICU (mean, 2.2 weeks). The plague index, gingival index, clinical attachment loss, and colonization degree of candida albicans were assessed. RESULTS: After OHCP, the plaque index, gingival index, and colonization degree of candida albicans in saliva showed a significant decrease in the intervention group compared to those of the control group (p<0.05). However, no significant difference was observed in clinical attachment loss and the colonization degree of candida albicans on the tongue (p>0.05). CONCLUSION: Our OHCP was effective in improving the oral hygienic status and periodontal health of stroke patients during their stay in the ICU. Therefore, we recommend administration of the OHCP for stroke patients during their stay in the ICU.
Adult ; Aged ; Dental Plaque Index ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Oral Hygiene/*methods ; *Stroke