In this paper, we report a case of bilateral inferior and middle turbinate agenesis, a rare anomaly. A 27-year-old woman presented with nasal obstruction, crust formation, anosmia, and foul odors. Anterior rhinoscopic examination revealed the absence of the middle and inferior turbinates on both sides. The patient had no history of nasal or sinus surgery. She denied over having expelled anything of significance from her nasal cavity. She had no history of infectious disease-including tuberculosis and syphilis, granuolomatous diseases, sarcoids, Wegener's disease, and radiation therapy. There have been few reports on bilateral turbinate agenesis.
Adult ; Female ; Humans ; Nasal Cavity ; Nasal Obstruction ; Odors ; Olfaction Disorders ; Rhinitis ; Rhinitis, Atrophic* ; Syphilis ; Tuberculosis ; Turbinates*

In this paper, we report a case of bilateral inferior and middle turbinate agenesis, a rare anomaly. A 27-year-old woman presented with nasal obstruction, crust formation, anosmia, and foul odors. Anterior rhinoscopic examination revealed the absence of the middle and inferior turbinates on both sides. The patient had no history of nasal or sinus surgery. She denied over having expelled anything of significance from her nasal cavity. She had no history of infectious disease-including tuberculosis and syphilis, granuolomatous diseases, sarcoids, Wegener's disease, and radiation therapy. There have been few reports on bilateral turbinate agenesis.
Adult ; Female ; Humans ; Nasal Cavity ; Nasal Obstruction ; Odors ; Olfaction Disorders ; Rhinitis ; Rhinitis, Atrophic* ; Syphilis ; Tuberculosis ; Turbinates*

Objective: Helicopter emergency medical services (HEMS) have been used for prompt and appropriate transport of trauma patients. South Korea operates a dual HEMS system consisting of the Doctor-HEMS and the EMS-HEMS. This study compared the relevance of evaluation and treatment during transport using the two HEMS systems. Methods: This was a retrospective, single-center cohort study, and 180 trauma patients transported via HEMS from July 2013 to June 2021 were enrolled in the analysis. We compared the appropriateness of evaluation and management between the Doctor-HEMS and the EMS-HEMS using a newly developed checklist based on Advanced Trauma Life Support protocol. Results: In terms of the performance score, the EMS-HEMS was higher with respect to basic management at the scene, especially cervical immobilization and warming (P<0.001). On the other hand, the Doctor-HEMS showed a higher score with respect to monitoring and procedures during transport (P<0.001). The total performance score was higher in the Doctor-HEMS group than in the EMS-HEMS group (P=0.022). Conclusion The Doctor-HEMS generally showed better performance in the transport of trauma patients, although it showed relatively lower performance with respect to basic care at the scene. The EMS-HEMS displayed a lower performance in monitoring and management during air transport. It is necessary to develop a common checklist for both the Doctor-HEMS and the EMS-HEMS. Through continuous efforts and feedback, the transportation of trauma patients can be improved.

No abstract available.
Cardiopulmonary Resuscitation*

BACKGROUND: Hyperhomocysteinemia as a risk factor for cerebrovascular disease is well known. Our aim of this study was to demonstrate positive association between elevated homocysteine levels and cerebrovascular diseases in Koreans. METHODS: With a case-control design, 186 stroke (infarction 134, hemorrhage 52) patients, diagnosed by brain CT or MRI and 359 control patients were evaluated. We used multiple logistic regression analyses conditioned on the matching variables (sex, age, hypertension, DM, smoking, hyperlipidemia, hyperhomocysteinemia) and calculated odds ratio and 95% CIs. RESULTS: Multivariated adjusted odds ratios (OR) for cerebrovascular diseases associated with hypertension compared with normal blood pressure were 2.45 (95% CI, 1.16 to 5.15) in prehypertension and 3.33 (95% CI, 1.56 to 7.10) in stage 1 hypertension and 3.77 (95% CI, 1.32 to 10.74) in stage 2 hypertension. OR for cerebrovascular diseases associated with hyperhomocysteinemia compared with <10micromol/L were 2.06 (95% CI, 1.09 to 3.91) in 13.0 to 16.9micromol/L and 3.17 (95% CI, 1.70 to 5.90) in > or =17 micromol/L. CONCLUSION: Not only hypertension but also hyperhomocysteinemia was a significant risk factor for cerebrovascular diseases in Koreans.
Asian Continental Ancestry Group ; Blood Pressure ; Brain ; Case-Control Studies ; Hemorrhage ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Hyperlipidemias ; Hypertension ; Logistic Models ; Magnetic Resonance Imaging ; Odds Ratio ; Prehypertension ; Risk Factors ; Smoke ; Smoking ; Stroke

No abstract available.
Dislocations* ; Shoulder*

PURPOSE: Snowboarding accidents may cause severe injury due to the advanced skills required of Olympic athletes and the faster speed compared to many other sports. The aim of this study was to describe environmental characteristics of snowboarding injuries and to determine the level of medical support using injury analysis. METHODS: A descriptive epidemiology study was conducted with collection of data from the Federation Internationale de Ski (FIS) Snowboard Competition from January 14 to 24 in 2009. Data from the Competition Operation Committee records, medical records and competition regulations were selected for analysis. RESULTS: In this study, 31/524 competitors reported injuries, predominantly sprains and contusions (21 cases), including eight fractures. Analysis of the physical distribution of these injuries indicated ten injuries of an upper extremity (32%), seven of a lower extremity (23%), six in the head/neck region (19%), and five spinal injuries (16%). The majority (23/31) of these injuries occurred during the snowboard cross (SBX) events. Environmental factors including the course visibility and slope conditions impacted the frequency of injury during the competition. In addition, the arrival times of medical teams were longer for the SBX events (260+/-92 sec) than for the Parallel Giant Slalom (202+/-54 sec) and other snowboarding events (<60 sec). CONCLUSION: The frequency and severity of injuries were highest in the SBX competition. For injury prevention, we recommend increased focus on safety on the SBX course, consideration of weather and other environmental conditions, and a rapid emergency medical support response for injury management.
Athletes ; Contusions ; Emergencies ; Epidemiology ; Humans ; Lower Extremity ; Medical Records ; Medical Staff ; Skiing ; Social Control, Formal ; Spinal Injuries ; Sports ; Sprains and Strains ; Upper Extremity ; Weather ; Wounds and Injuries

PURPOSE: The purpose of this study was to perform a comparative analysis of training methodology between accessibility and needs for cardiopulmonary resuscitation (CPR) in the community. METHODS: This population-based nationwide study used a structured questionnaire via telephone survey in 2011-2012. The study was conducted by stratified cluster sampling to assess the impact of age, gender, and geographic regions (n=1,000). The contents of the questionnaire consisted of awareness, prior training status, and willing methodology of public CPR training. RESULTS: Thirty-eighty percent of respondents (n=381) had previously been taught CPR. Military service, education facility/ school, and workplace were 3 major resources of public CPR training among previously educated subjects (45%, 23%, and 9%, respectively). Seventy-two percent of trainees had been taught less than an hour and only 60% were trained using an individual manikin for CPR practice. Fifty-nine percent (n=593) had willingness to participate in CPR education and 40% of subjects wished to learn in a hospital or health care facility. Place of CPR training showed a major difference between previous experiences and willing groups in the community. Women and elders were more likely to learn CPR. Almost all respondents wanted short-duration learning (<1 hour), however, it was similar in the groups. CONCLUSION: In the scope of the public, training site showed a significant discrepancy between previous accessibility and needs of layperson. They prefer a highly accessible location and method with relatively short-practice programs.
Cardiopulmonary Resuscitation* ; Surveys and Questionnaires ; Delivery of Health Care ; Education ; Female ; Health Services Needs and Demand ; Humans ; Learning ; Manikins ; Military Personnel ; Telephone

Acute scrotal pain is a common urologic presentation and critical pathology due to the possibility of organ loss in the emergency department. Referred pain in the lower quadrant of the abdomen may accompany testicular torsion. Of 58 patients with testicular torsion between January 2001 and March 2011, three visited the emergency department with abdominal pain alone. The median age of the patients was 16 years (range, 13-19). Median duration of abdominal pain to first medical examination and proper diagnosis by an urologist was 14 hours (range, 2-168) and 77 hours (range, 57-240), respectively. All patients underwent orchiectomy. Due to symptomatic variations for testicular torsion, all clinicians providing emergency care to patients who have referred pain in the lower abdomen without scrotal pain should consider the constellation of symptoms in order to avoid superfluous diagnostic delay.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Diagnosis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Orchiectomy ; Pain, Referred ; Pathology ; Spermatic Cord Torsion*

Acute scrotal pain is a common urologic presentation and critical pathology due to the possibility of organ loss in the emergency department. Referred pain in the lower quadrant of the abdomen may accompany testicular torsion. Of 58 patients with testicular torsion between January 2001 and March 2011, three visited the emergency department with abdominal pain alone. The median age of the patients was 16 years (range, 13-19). Median duration of abdominal pain to first medical examination and proper diagnosis by an urologist was 14 hours (range, 2-168) and 77 hours (range, 57-240), respectively. All patients underwent orchiectomy. Due to symptomatic variations for testicular torsion, all clinicians providing emergency care to patients who have referred pain in the lower abdomen without scrotal pain should consider the constellation of symptoms in order to avoid superfluous diagnostic delay.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Diagnosis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Orchiectomy ; Pain, Referred ; Pathology ; Spermatic Cord Torsion*