BACKGROUND: Care for prehospital cardiac arrest is one of the major concerns of emergency medical services. But, in Korea, prehospital emergency medical service systems are not yet well established. We tried to offer one of the fundamental data for development of these systems. METHODS: After application of exclusion criteria, 183 patients who transferred to emergency center of our hospital after cardiac arrest in consecutive 24 months from Jan,1,1994 to Dec,31,1995 were included in this study. Retrospective review of the hospital charts of these patients was done. For statistical analysis, we divided patients to some categories. t-test or chi-square analysis was used. RESULTS: 24 patients of the 183 patients were secondary visitors(cardiac arrest was occurred during transfer from other hospitals), 159 patients were primary visitors. In the primary visitor group, only one third was ambulance visitors, and there is no statistical differences between arrest time of ambulance visitors and non-ambulance visitors(35+/-27 vs 37+/-24 min, p=NS). No organized bystander CPR was done. After arrival, 131 patients received CPR and 87 patients(66.4%) were not responded, 31 patients(23.1%) experienced transient ROSC, 13 patients(10.0%) survived until discharge, and only 2 patients(1.5%) were returned to their lives. CONCLUSION: We failed to find significant statistical survival differences between ambulance visitors and non-ambulance visitors, between presumed cardiac etiology group and non-cardiac etiology group. Survival rate was high in witnessed arrest group than unwitnessed arrest group(14.5% vs 2.1%, p=0.015).
Ambulances ; Cardiopulmonary Resuscitation ; Emergencies ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Survival Rate

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

Fetal teratomas rarely complicate pregnancy,having an incidance of only 20,000:1 to 40,000:1 of live births. Overthere, cervical teratomas are rare and accounts for only 5.5% of all neonatal teratomas. We have experienced a large cervical immature teratoma and present this case with a brief review of literatures.
Live Birth ; Teratoma*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

BACKGROUND: Direct wet mount examination of vaginal secretion, widely applied for the diagnosis of Trichomonas vaginalis infection in woman patients, is rapid and economical. However, the sensitivity of this technique is not so high. In this study enzyme-linked immunosorbent assay(ELISA) was employed for the detection of serum anti-T. vaginalis IgG antibodies from vaginal trichomoniasis patients. METHODS: Eighty sera from trichomonoasis patients who visited a Dr. Yoon Kyong's Obstetric & Gynecologic Clinic in Songnam and 30 non-infected healthy men were tested for detection of anti-T. vaginalis IgG antibody. Soluble lysate and excretory-secretory antigen prepared by mixing of six isolates of T. vaginalis, and lysate from one isolate(KT4) were used as antigen for ELISA. RESULTS: The sensitivity of ELISA using lysate of six isolates was 95.0%, and the sensitivity of the lysate from KT4 and mixed excretory-secretory antigen from 6 isolates were 86.4% and 76.3%, respectively. Specificities of ELISA by three 93.3%, 96.3% and 92.0%, respectively. CONCLUSION: It is suggested that ELISA using mixed lysate of T. vaginalis six isolates could be useful tools for the diagnosis of trichomoniasis.
Antibodies ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Gyeonggi-do ; Humans ; Immunoglobulin G* ; Male ; Trichomonas vaginalis ; Trichomonas*

The purpose of this study was to compare the bracket placement and the shear bond strength of indirect-bonded brackets with those of direct-bonded ones. Forty eight extracted human teeth were collected and attached with brackets and tested on shear bond strength, using Instron. Fourteen patients from Wonkwang University Dental Hospital were selected for direct bonding of brackets and their teeth were measured on bracket angulation and bracket height. The obtained results were as follows: 1. The shear bond strengths of incisors were higher in direct-bonding,group, rather than in-direct-bonding group. But, the shear bond strength of premolars showed no significant differences between groups. 2. The bracket angulations of indirect-bonding group were preciser than those of direct-bonding group, especially in upper first premolars, lower lateral incisors, canines, premolars. 3. In bracket height, there were no significant differences between groups.
Bicuspid ; Humans ; Incisor ; Shear Strength* ; Tooth

High-intensity focused ultrasound (HIFU) is an emerging therapeutic tool for the effective thermal ablation of pathological tissue. For accurate localization of the target and safe control of the HIFU dosage, real-time imaging guidance during the HIFU exposure is desired. Ultrasound imaging has the capability to guide clinicians toward a lesion in real time, but is not an ideal option, as HIFU application causes strong interference, thereby substantially distorting the images used for guidance. Thus, this study introduces singular value decomposition–based filtering capable of restoring ultrasound harmonic images from HIFU interference without undesirable spectral distortion. The results were experimentally validated with a custom-made phantom, indicating that this approach effectively eliminates HIFU-induced artifacts, which is essential for real-time monitoring of the therapeutic process.

The indirect fluorescent antibody(IFA) test was used to detect serum IgG and IgM antibodies to Trichomonas vaginalis in 31 vaginal trichomoniasis, 7 candidiasis and in 20 non-infected healthy wonem with antigen prepared from axenic culture of Trichomonas vaginalis isolated from vulvovaginitis patient. The results were as follows: In 31 vaginal trichomoniasis the positive reactions of IgG antibody were 27 in the 1/8 dilution or higher and 4 in the 1/4 dilution whereas in healthy women the reaction showed signigicantly low as in the 1/4 dilution of below. The sensitivity and specificity of IFA test for IgG antibody to trichomonad antigen in this study were 87.1% and 100%, respectively. No significant difference of IgM antibody levels between vaginal trichomoniasis and healthy women was observed. No relation between the levels of IgG and IgM antibodies to trichomonad antigen by IFA test was observed. No relation between the time lapse and the level of serum IgG antibodies in IFA test of vaginal trichomoniasis was regarded. In conclusion the present study suggests that IFA test in trichomoniasis could be a useful tool for detection of anti-trichomonad IgG antibodies and applicable as an immundiagnostic method.
parasitology-protozoa ; Trichomonas vaginalis ; trichomoniasis ; diagnosis ; IgM ; IgG ; immunology

PURPOSE: The purpose of this study is to assess if extracorporeal magnetic innervation (ExMI) can be successful in treating stress urinary incontinence (SUI). MATERIALS AND METHODS: We studied 38 women with demonstrable stress urinary incontinence. Evaluation before treatment included history, physical examination, voiding diary, perineometer that measures the strength and endurance of pelvic floor muscle contractions, urodynamic study and quality of life questionnaires. Treatments were performed for 20 minutes (10Hz for 10 minutes and 50Hz for 10 minutes), twice a week for 6 weeks. After ExMI therapy, all of the evaluations were repeated at the eighth week. RESULTS: The follow up care was continued on the patients for longer than 2 months. Fourteen out of the 38 patients (36%) were dry after the ExMI treatment. The frequency of leak episodes was reduced from 2.8 to 1.7 in 2 months. Pelvic floor muscle contraction (PMC) pressure was increased from 10.42 4.35 to 17.02 4.04mmHg. CONCLUSIONS: Our early results suggest that ExMI therapy is an effective approach for the treatment of SUI. However, longer follow-up is required to determine how long the benefits of treatment last, whether re-treatment will be necessary, and what the effective treatment strategies are.
Female ; Follow-Up Studies ; Humans ; Muscle Contraction ; Pelvic Floor ; Physical Examination ; Quality of Life ; Surveys and Questionnaires ; Urinary Incontinence* ; Urodynamics

PURPOSE: The purpose of this study was to examine the effects of cerebral ischemia on Type I(soleus) and Type II(plantaris, gastrocnemius) muscles, and to determine the effects of isometric contraction training by electrostimulation on Type I andII muscles in cerebral ischemia model rats. METHOD: Twenty-five male Sprague-Dawley rats were randomly divided into four groups: ST(stroke), STES(stroke+electrostimulation), SH(sham) and SHES (sham+electrostimulation). The ST and STES groups received a transient right middle cerebral artery occlusion operation. The SH and SHES groups received a sham operation. The STES and SHES groups had daily isometric contraction training by electrostimulation(100Hz, 45mA, 7.5V) on hindlimb muscles for 7days. RESULT: Plantaris and gastrocenmius muscle weight, myofibrillar protein contents of soleus and gastrocnemius, and the muscle fiber cross-sectional area of gastrocnemius in the ST group significantly decreased compared with the SH group. Soleus, plantaris, gastrocnemius muscle weight, myofibrillar protein contents of soleus and gastrocnemius, and the Type I muscle fiber cross-sectional area of soleus and the Type II muscle fiber cross-sectional area of gastrocnemius in the STES group significantly increased compared with the ST group. CONCLUSION: Hindlimb muscle atrophy occurs after acute stroke and isometric contraction training by electrostimulation during early stages of a stroke attenuates muscle atrophy of Type I and Type II muscles.
Animals ; Body Weight ; Brain Ischemia/*complications ; Disease Models, Animal ; Electric Stimulation ; Hindlimb ; *Isometric Contraction ; Male ; Muscle Proteins/analysis ; Muscle, Skeletal/metabolism/pathology/*physiopathology ; Muscular Atrophy/*etiology/pathology/physiopathology ; Myofibrils/chemistry ; Rats ; Rats, Sprague-Dawley ; Stroke/*complications