No abstract available.
Humans

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

No abstract available.
Bacteroides fragilis* ; Bacteroides* ; Enterotoxins* ; Epithelial Cells* ; Gene Expression* ; Humans* ; Intestinal Mucosa*

No abstract available.
Diagnosis* ; Humans ; Thoracic Injuries* ; Thorax* ; Tomography, X-Ray Computed*

No abstract available.
Myocardial Infarction*

No abstract available.
Disasters*

No abstract available.
De Lange Syndrome*

No abstract available.
Ambulances* ; Emergencies* ; Gangwon-do*

PURPOSE: To evaluate the clinical significance of the screening mammography in the detection of the breast diseases, especially breast carcinoma. MATERIALS AND METHODS: We analyzed 1,800 cases of mammography retrospectively. The mammography was done as a part of routine check in Health Counselling Center, Korea University Medical Center, during 9 months from November 1993 to July 1994. The age range was from 23 years to 76 years, mean 49.8 years, and the largest age group was 6th decade(31.4%). According to the mammographic findings, we divided the subjects into three groups; normal group, abnormal group in need of follow up study, abnormal group requiring biopsy. RESULT: On mammography, the normal group consisted of 1,534 cases(85%), and the abnormal group consisted of 266 cases(15%). The abnormal findings were benign-looking calcification(n=140), fibroadeno ma (n=29), fibrocystic changes (n=27), cyst(n=23), malignant lesion(n=15), lipoma(n=7), and others. In four of 15 cases, which were suspected to be malignant on mammograms, breast carcinoma was confirmed pathologically. In four cases of breast carcinoma, one was under 40 and the other 3 were over 50 years of age. All of the breast cancers were under 3cm in size, and the mammographic findings of breast cancer included spiculated margin(n=3), parenchymal disortion(n=3), malignant calcification(n=2) and enlarged axillary node (n=l). CONCLUSION: Screening mammogram is helpful for early detection of non-palpable breast cancer, especially for women over 50 years of age.
Academic Medical Centers ; Biopsy ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Female ; Follow-Up Studies ; Humans ; Korea ; Mammography* ; Mass Screening* ; Retrospective Studies

No abstract available.
Emergencies* ; Humans ; Prospective Studies*