STUDY OBJECTIVE: determine the level of medical care required for mass gatherings and describe the types of medical problems encountered in a religious mass gathered ceremony. DESIGN: Standard charts and a four-tiered triage system(minor, moderate, urgent, and emergent) were developed before the event. The triage system was applied to each chart retrospectively by a single emergency physician. SETTING: Medical staff(10 physicians,13 nurses,1 pharmacist, and 54 first-aid attendants) were based in 8 advanced life support (ALS) clinics. INTERVENTIONS: First-aid attendants referred patients to the clinics, where nurses conducted initial assessments and referred patients to physicians at the venue. Three ambulances were stationed at the venues. RESULT: 22 trauma patients were developed and 183 medical complaints were encountered. Only 7 urgent medical problems were encountered.
Ambulances ; Emergencies* ; Humans ; Pharmacists ; Retrospective Studies ; Triage

No abstract available.
Aneurysm* ; Humans ; Hydrocephalus*

No abstract available.

The myocardial infarction is usually associated with the coronary artery disease in adults. It is unusual in chilhood and young adult but occasionally associated with coronary vasculitis. Takayasu's arteritis produces a panaortits with thickening of the adventitia and narrowing of aorta. Narrowing of coronary arteries is due to extension into these arteries of the processes of inflammation that occur in aorta. We report here two cases of Takayasu's aortitis causing acute myocardial infarction. Case 1 is a 17-year-old girl presented with the inferior myocardial infarction and the cerebral infarction. Digital subtraction aortography showed a diffuse narrowing of the aorta and the obstruction of both subclavian arteritis, right carotid artery and both femoral arteries. Case 2 is a 19-year-old male patient with anterior myocardial infarction. Coronary cineangiogram showed the beak like appearance of the left main coronay artery.
Adolescent ; Adult ; Adventitia ; Animals ; Aorta ; Aortitis* ; Aortography ; Arteries ; Arteritis ; Beak ; Carotid Arteries ; Cerebral Infarction ; Coronary Artery Disease ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Inferior Wall Myocardial Infarction ; Inflammation ; Male ; Myocardial Infarction* ; Takayasu Arteritis ; Vasculitis ; Young Adult

The most important basic requirements for successful skin grafting are the accurate approximation of the edge of the skin graft to that of the wound and the application of even pressure to the graft by a carefully designed dressing. Pressure dressing is indicated for the protection of the graft and the prevention of shearing between the graft and its bed. One of the most widely used methods of pressure dressing is tie-over dressing. The traditional technique is based on the application of long silk sutures along the margin of the graft that are tied over bolus of antibiotics oint-impregnated nonadherent fluffed gauze. With the traditional tie-over dressing, it is impossible to inspect the graft bed for possible hematoma and seroma during the application of dressing. So we adopted another modification of the previously described tie-over dressing methods. From January 1997 to July 1997, we had performed 27 skin graft surgeries and 8 subdermal shavings in 35 patients with our new method of tie-over dressing. We can apply even pressure to the grafts by twisting the long silk sutures instead of typing.In comparison with the plethora of devices and techniques described previously in tie-over dressing construction, our technique offers simplicity and reliable fixation of the graft to the bed and allows further adjustment of the dressing by individual tightening of the threads. Other particularly attractive features are the ability to inspect the graft at any time with little difficulty and the reapplicability of tie-over dressing with the remaining long threads if needed.
Anti-Bacterial Agents ; Bandages* ; Hematoma ; Humans ; Seroma ; Silk ; Skin ; Skin Transplantation ; Sutures ; Transplants ; Wounds and Injuries

Hurthle cell tumors are an infrequent neoplasm of the thyroid gland in adults. Hurthle cell tumors represent 4. 5% to 10% of all primary thyroid epithelial neoplasms in the foreign literature. It has been known as Hurthle cell tumor since Ewing was the first to use this term in 1928. Tumor occurring in an infant was described by Symmers(1941) and Morrow(1945). The authors experienced a case of congenital Hurthle cell tumor of the thyroid gland in a 2 months old boy. He was admitted to the pediatric surgical department because of a growing mass in the neck since birth. Ultrasonogram showed a huge lobulated homogenous solid mass with medium level echogenicity in the region of the thyroid gland. Subtotal thyroidectomy of right lobe and total thyroidectomy of left lobe were done. The specimen measures 2x3x1.5 cm and 7x3x3 cm, respectively. It was an encapsulated, yellow gray firm and solid mass. The cut surface was smooth, glistening and homogenous. Microscopicully, the tumor was composed of tightly packed regular follicles lined by polyhedral, cuboidal, large cells with a granular acidophilic cytoplasms. The nuclei are vesicular, usually only a little bit larger than those of normal thyroid cells.
Infant ; Adult ; Male ; Female ; Humans

BACKGROUND: Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported. METHODS: We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group. RESULTS: In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment. CONCLUSIONS: These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.
Adult* ; Aged ; Blood Urea Nitrogen ; C-Reactive Protein ; Child ; Comorbidity ; Cross Infection ; Heart Failure ; Hospitalization ; Humans* ; Korea ; Metapneumovirus* ; Mortality* ; Pneumonia ; Real-Time Polymerase Chain Reaction ; Respiratory Distress Syndrome, Adult* ; Respiratory Syncytial Viruses ; Retrospective Studies* ; Risk Factors ; Tertiary Care Centers ; Thorax

No abstract available.
Infant, Newborn ; Jaundice, Neonatal* ; Radionuclide Imaging* ; Technetium Tc 99m Disofenin*

No abstract available.

In 2007, the Public Sanitation Administration Law in Korea was partially amended to subdivide cosmetology into general and skin cosmetology. Thus starting from 2008, a skin cosmetology qualification requirement license was newly created in Korea. Instead of improving the health standards concerning public health, the amendments have exaggerated the monopolistic right of trade of the Korean Central Esthetician's Association with the assistance of the Division of Sanitary Policy in the Korean Ministry for Health. In addition, the amended ordinances stipulate that cosmetologists can analyze skin conditions, hence allowing medical diagnostic procedures by non-medical personnel which has serious health problems causing serious conflict with Korean Medical Law. Legislation precedents from around the world demonstrate that medical supervision by physicians is absolutely necessary with fastidious requisitions in order to safeguard public health. However, in Korea there is a subversive attempt by some esthetician groups to limit the employment of estheticians by medical institutions in order to safeguard their private privileges. The newly amended Public Sanitation Administration Law should be revised in order to preserve the fundamental rights of the people, to enhance public health, and to uphold the well being of the people instead of catering to special interest groups.
Employment ; Human Rights ; Jurisprudence ; Korea ; Licensure ; Organization and Administration ; Public Health ; Public Opinion ; Sanitation ; Skin