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

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*

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

Photodynamic therapy (PDT) is a treatment modality using highly reactive oxygen intermediates generated by the interaction of light with a photosensitizer. It has been shown to be an effective treatment for the various cutaneous and noncutaneous malignancies. It is efficient for the curative and palliative treatment of epithelial skin tumors in situ, or early invasive lesions. We treated bowenoid actinic keratosis on the left hand with topical PDT using 5-aminolevulinic acid (ALA) and a low intensity (3.5 J/cm2) dye laser. After three sessions, the lesion had been completely cleared. We report a case of bowenoid actinic keratosis in 74-year-old man, who was treated with low intensity (3.5 J/cm2) dye laser following a topical application of 5-ALA.
Actins* ; Aged ; Hand ; Humans ; Keratosis, Actinic* ; Lasers, Dye* ; Oxygen ; Palliative Care ; Photochemotherapy* ; Skin

Melanoacanthoma is a variant of seborrheic keratosis which was first introduced by Mishima and Pinkus in 1960. This is a very rare and benign, epidermal tumor. Clinically, it is usually manifested in a pigmented, verrucous, round or oval plaque and nodular lesion. This is characterized histologically by nonpigmented keratinocytes and numerous large, richly dendritic melanocytes. We describe a 68-year-old man who suffered from a black-colored plaque on his right shin for 5 years. Melanoacanthoma was diagnosed by characteristic histopathologic findings.
Aged ; Humans ; Keratinocytes ; Keratosis, Seborrheic ; Melanocytes

Background: A clinician reported unusually high incidence of A. xylosoxidans isolation from aspirated tissues in outpatient clinic. Methods: A. xylosoxidans isolates from January 2002 to June 2002 were investigated. The infection control nurse reviewed medical records and observed the procedures of tissue aspiration and culture at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from dye, aspiration gun, slide alcohol sponge, tray, sink. water of sink, buffer solution, microscope, computer, and telephone. Results: A. xyloxosidans was isolated from twenty-four patients during 6 months. None of 24 cases had any typical signs or symptoms of infections by A. xylosoxidans. Observation of tissue aspiration and culture procedure revealed that buffer solution was used for prevention of specimen drying after tissue aspiration. Culture of the buffer solution yielded a heavy growth of A. xylosoxidans from four out of ten specimens. A. xylosoxidans was not isolated from any other investigational specimens. Conclusions: This was supposed to represent pseudoepidemic. Contaminated buffer solution was documented as the cause of this pseudoepidemic. The usage of buffer solution was stopped. During the follow-up period of 2 months, no additional A. Xylosoxidans was cultured from aspirated tissues.
Alcaligenes* ; Ambulatory Care Facilities ; Follow-Up Studies ; Humans ; Incidence ; Infection Control ; Medical Records ; Methods ; Porifera ; Telephone ; Water

No abstract available.
Granuloma* ; Intubation*

Purpose: Increasing levels of domestic fine dust (DFD) have emerged as a serious problem that threatens public health by causing chronic respiratory diseases and skin aging. The present study was performed to investigate the inhibitory effects of Gryllus bimaculatus (the two-spotted cricket), which has recently attracted attention as an edible insect in South Korea, on DFD-induced aging and inflammation. Methods: To verify that DFD causes skin aging and investigate the anti-aging effect of an aqueous ethanolic-Gryllus bimaculatus extract (AE-GBE), human diploid fibroblasts (HDF) were treated with 100 μg/mL of European reference material (ERM)-CZ100 dust for 24 hrs in the presence or absence of 100 μg/ml AE-GBE. Aging and cellular toxicities were assessed by measuring reactive oxygen species (ROS) levels, DNA fragmentation, and β-galactosidase activity. The protein levels of cyclooxygenase (COX) 2, matrix metalloproteinase (MMP)-1, and collagen were measured by western blot, and the mRNA expressions of inflammationrelated genes were assayed by quantitative reverse transcriptase polymerase chain reaction. Results: Treatment with ERM-CZ100 induced an aged phenotype in HDF cells, as evidenced by increased ROS levels, DNA fragmentation, and senescence-associated β-galactosidase activity, but cotreatment with AE-GBE significantly reduced these inductions. The mRNA expressions of pro-inflammatory cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α, induced by ERM-CZ100 were also reduced by AE-GBE cotreatment, which also reduced COX2 expression. Moreover, ERM-CZ100-induced MMP-1 expression and reduced collagen type I expression were recovered by AE-GBE treatment. Conclusion These results suggest that AE-GBE is a potential treatment for domestic fine dust-induced skin inflammation and inflammaging.

PURPOSE: Brush cytology is one of useful methods for establishing a diagnosis of lung cancer. There are two methods of retrieving the specimen of brush cytology. One is to withdraw the brush through the working channel of the bronchoscope (withdrawn brush) and the other is to withdraw the brush and bronchoscope as a unit, with brush remaining protruded through the distal tip of the bronchoscope (nonwithdrawn brush). We tried to compare two methods in the cellularity of the specimen and the diagnosis of lung cancer. MATERIALS AND METHODS: Thirty-one patients with suspected lung cancer were studied prospectively. The sequence of sampling (withdrawn or nonwithdrawn brush) was assigned randomly. The specimens were interpreted by two cytopathologists about cellularity (1-4) and presence of recognizable malignant cells. RESULTS: Cellularity was significantly greater for nonwithdrawn brush (p<0.05). There was no significant difference of diagnostic rate between both methods in the diagnosis of lung cancer. CONCLUSION: Withdrawing the brush through the bronchoscope decreases the cellularity, but it does not affect the diagnostic rate for lung cancer.
Bronchoscopes ; Diagnosis* ; Humans ; Lung Neoplasms* ; Lung* ; Prospective Studies

BACKGROUND: Coronary artery target lesion calcification may be an important determinant of the arterial response to catheter therapy for coronary arterial disease. The excimer laser coronary angioplasty(ELCA) has been reported to be a promising treatment for complex coronary artery disease. However, the effects of ELCA is not well known against the calcified target lesion. METHODS: To assess the arterial and plaque remodeling in calcified lesions after excimer laser coronary angioplasty, we used a comprehensive intravascular ultrasound(IVUS) imaging system(25MHz rotation transducer, 3.9 Fr monorail imaging sheath, motorized transducer pull back at 0.5mm/sec and quantification) to study 23 patients(1 left main, 10 LAD, 4 LCX, 6 RCA, 2 SVG) before and immediately after ELCA(the AIS 308nm XeCl excimer laser, pulse width >200nsec, pulse frequency 20Hz, energy density 35-65mJ/mm2). Paired before and after ELCA image slices were analysed ; and extermal elastic membrane, lumen, plaque+media(P+M) and calcium cross-sectional area(CSA) measured; and their differences after ELCA calculated. RESULTS: The IVUS results about the therapeutic effects of ELCA showed the enlargement of lumen CSA from 1.5+/-0.4 to 3.2+/-0.9mm2(p<0.001) and decreased of P+M CSA from 14.6+/-3.8 to 13.4+/-3.6mm2(p<0.001) without arterial expansion. The decrease of calcium CSA from 1.8+/-0.7 to 1.5+/-0.6mm2(p<0.001) and the formation of small, superficial fissures within the calcified plaque(15/23 lesions) were noted. The number of small fissures correlate with the calcium CSA significantly(r=0.61, p<0.001). CONCLUSION: The plaque and calcium ablation is the main effects of ELCA in calcified lesion, and the calcium ablation and fissure formation after ELCA may contribute to decrease the dissection and improve the success after ajunctive PTCA.
Angioplasty* ; Calcium ; Catheters ; Coronary Artery Disease ; Coronary Vessels ; Lasers, Excimer* ; Membranes ; Transducers ; Ultrasonography*