No abstract available.
Evoked Potentials, Auditory, Brain Stem* ; Humans ; Infant*

Although thrombolytic therapy is one of the most effective therapeutic option for acute ischemic stroke, hemorrhagic complication still remains major concern about its application. A patient with hemoperitoneum, who previously underwent thrombolytic therapy(intraarterial urokinase infusion, IAUK) for acute ischemic stroke was treated successfully with emergency transarterial embolization for rupture of hepatocellular carcinoma. We present a rare case of rupture of hepatocellular carcinoma after intraarterial urokinase infusion for acute ischemic stroke with brief review of the literature.
Carcinoma, Hepatocellular ; Emergencies ; Hemoperitoneum* ; Humans ; Rupture ; Stroke* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

PURPOSE: This study analyzed iodine intake by establishing an iodine database of general Korean foods eaten by Korean adults based on the data from the 1998 ~ 2014 KNHANES (Korea National Health and Nutrition Examination Survey). METHODS: Data on 56,818 subjects aged 19 years and older were obtained from health behavior interviews and a 24-hour dietary recall survey. Iodine intake of subjects was analyzed according to general characteristics, dietary lifestyle, food groups, and cooking method. RESULTS: An iodine database was established for 312 food items. The mean iodine intake of Korean adults decreased from 641.6 μg in 1998 to 236.2 μg in 2014 per day. Iodine intake of women was higher than that of men. For age distribution, those aged 30 ~ 49 years constituted more than 39 ~ 46% of subjects by survey year. Regarding iodine intake according to dietary lifestyle, the highest iodine intake was 29.4 ~ 34.4% for lunch while that of breakfast decreased. The highest iodine contribution by food group was seaweed such as kelp, sea mustard, and laver. CONCLUSION: The results of this study indicate that iodine intake of Korean adults has been decreasing, and iodine intake is associated with the prevalence of thyroid disease. This study provides basic data for the estimation of iodine intake in Korean adults.
Adult* ; Age Distribution ; Breakfast ; Cooking ; Female ; Functional Food ; Health Behavior ; Humans ; Iodine* ; Kelp ; Korea* ; Life Style ; Lunch ; Male ; Methods ; Mustard Plant ; Nutrition Surveys* ; Prevalence ; Seaweed ; Thyroid Diseases

BACKGROUND: Team-based learning is known for its effective and satisfying education methods in the study of various medical schools. This study was prepared to confirm the satisfaction of applying this team-based learning to the training course of emergency medical technician.METHODS: A total of 165 new members of the course of second grade National Emergency medical technician at 2019 were finally enrolled in the study. Data were collected with a self-administered questionnaire. The team-based learning method was organized with eight students per group to conduct pre-learning and then proceed to open book to encourage active discussion among individuals. The questionnaire consisted of questions about the satisfaction of the discussion process, such as whether the knowledge gained from the discussion was appropriate, and whether collaboration between colleagues was successful during the discussion, and about the benefits of team-based learning, how well knowledge transfer compared to existing lectures, and the replacement of existing lectures. The questionnaire used a Likert 5 point scale, and the data obtained were analyzed using the SPSS version 22.0.RESULTS: The overall rating of team-based learning was 7.8 ± 1.5 out of 10. Many students answered positively (88.5%) for benefits, while 87.9% responded positively to whether the knowledge transfer effect was better compared to existing lectures. In addition, the satisfaction of team-based learning was generally high, with more than 90 percent of education students giving positive answers to the replacement of other lectures with team-based learning.CONCLUSION: The learners gave positive answers to the satisfaction, usefulness and learning effects of team-based learning. Team-based learning is a discussion-based study, so it is a good way to improve communication skills. Since communication and teamwork are important in first aid activities, the characteristics of team-based learning could lead to improvements in first aid services, leading to high-quality emergency medical services.
Cooperative Behavior ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; First Aid ; Humans ; Learning ; Lectures ; Methods ; Schools, Medical

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection

PURPOSE: To evaluate Doppler sonographic findings of acute renal vein thrombosis in rabbit model induced by renal vein ligation, with an emphasis on the changes in resistive index (RI) on serial follow-up. MATERIALS AND METHODS: Conventional and Doppler sonographies were performed immediately after ligation and 24, 48, and 72 hours after ligation in 12 rabbits weighing 4.5-5.0 kg. We focused on changes in kidney size and echogenicity with conventional sonography and resistive index by time interval and Doppler waveforms with Doppler sonography. RESULTS: Kidney size increased markedly immediately after ligation, and increased slowly until 48 hours after ligation with no change observed afterwards. Echogenicity increased both in the renal cortex and the medulla. RI increased remarkably to an average of 1.38 immediately after ligation, and increased to a peak average of 1.64 48 hours after ligation. After 72 hours RI decreased slightly to 1.59. Reverse 'plateau-like' diastolic waveform was seen in 27 trials (56%) on follow up Doppler sonograms. CONCLUSION: The increase in RI was thought to be due to the increase in renal arterial vascular resistance caused by venous outflow obstruction. The decrease in RI with time suggested adaptation of intrarenal circulation to renal vascular change. Also, the reverse 'plateau-like' diastolic waveform was the predominant waveform.
Follow-Up Studies ; Kidney ; Ligation ; Rabbits ; Renal Veins* ; Thrombosis* ; Ultrasonography ; Vascular Resistance

BACKGROUND: Arterial emboli remain an important cause of acute arterial ischemia. Despite simplification of operative techniques, the substantial morbidity and mortality still associated with an acute embolus remain a challenge to the vascular surgeon. We wanted to know the adequate evaluation and treatment modality for this limb threatened condition, and to evaluate the results according to etiology, location, time interval before starting treatment, clinical conditions, and limb survival rate. MATERIAL AND METHODS: A retrospective review was conducted on 91 patients who treated for acute lower leg thromboembolism between Jan. 1992 and Dec. 1997. RESULTS: There were 73 men and 18 women and most prevalent age group was in the 5th and 6th decades (53.8%). Over all amputation rate was 25.3% and mortality rate was 5.5%. Cardiac problem was the most common etiologic factor. Associated diseases were cardiac problem (37.4%), hypertension (35.2%), cerebrovascular accident (17.6%), and diabetes (15.4%). Interval from attack to definite therapy, within 24 hours in 14 cases (15.4%), 1~3 days in 23 (25.3%), after 4 days in 54 (59.3%) were noted. The locations were aorta and iliac in 25.3%, femoral in 38.5%, popliteal in 19.8%, tibial in 4.4%, and 15.4% in graft site in other of frequency. Clinical categories were grade I in 9.9%, IIa in 40.7%, IIb in 30.8%, and III in 18.7%. According to Eagle's criteria, low risk group were 34 cases (37.4%), moderate risk group were 39 cases (42.9%), and high risk group were 18 cases (19.8%). Of the 91 patients, conservative treatment in 2 (2.2%), thrombolytic therapy in 33 (36.3%), thromboembolectomy in 56 (61.5%), bypass in 16 (17.6%), endarterectomy and vessel ligation were performed. The 1-month and 1-year limb salvage rates were 73.4% and 71.1%, respectively. Especially, salvage rates in the Department of Vascular Surgery were 84.9% and 83.7%, whereas that of Thoracic and Orthopedic Surgery were 44.4% and 33.0% (p=0.0001). CONCLUSIONS: Cardiac problem especially atrial fibrillation was the most common etiologic factor. Prompt balloon catheter embolectomy performed under local anesthesia is a safe, simple, and effective method of treatment and the preferred mode of management in the great majority of patients. Nonoperative management with thrombolytic agents or high-dose heparin therapy alone is occasionally indicated in highly selected patients. The prognosis of acute arterial thromboembolism of lower extremity can be improved by early detection, early adequate treatment, and the involvement of a qualified vascular surgeon.
Amputation ; Anesthesia, Local ; Aorta ; Atrial Fibrillation ; Catheters ; Embolectomy ; Embolism ; Endarterectomy ; Extremities ; Female ; Fibrinolytic Agents ; Heparin ; Humans ; Hypertension ; Ischemia ; Leg ; Ligation ; Limb Salvage ; Lower Extremity ; Male ; Mortality ; Orthopedics ; Prognosis ; Retrospective Studies ; Stroke ; Survival Rate ; Thromboembolism* ; Thrombolytic Therapy ; Transplants

Multiple cardiac myxomas are rare in children. However, myxomas may be lethal because of their various manifestations such as blood flow obstruction, embolization and constitutional changes. Especially, the cerebral infarction due to tumor fragmentation are more likely to be misdiagnosed of acute disseminated encephalomyelitis. We report a case of multiple cardiac myxoma complicating recurrent right hemiparesis in a 12-year-old child who at first had a wrong diagnosis of acute disseminated encephalomyelitis (ADEM). Consequently, a child who show unrepresentative symptom of ADEM, should be examined rapidly by various tools to rule out the cerebral infarction from cardiogenic cause.
Cerebral Infarction ; Child* ; Diagnosis* ; Encephalomyelitis, Acute Disseminated* ; Humans ; Myxoma* ; Paresis*

BACKGROUND: lawsuits associated with medical troubles are increasing rapidly. Beginning with 69 cases in 1989, the annual rate of increase has reached above 36%. After the system of emergency medical specialist was born in 1995, it was expected that medical lawsuit cases would increase due to the importance of the emergency medical specialist's role to the emergent patients. METHODS: A database was established for medical lawsuits(1982~1998, n=254), and lawsuits involving the emergency department(1982~1998, n=16) were selected from that database. RESULTS: In criminal cases, the prosecutor's win rate was one out of four(25%). In civil cases, the prosecutor's win rate was 8 out of 10(80%); that is, the rate was higher than in general medical cases. CONCLUSION: To reduce the number of lawsuit following medical troubles in the emergency department, we should give careful attention and appropriate cure to patients who visit the emergency center.
Criminals ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Malpractice* ; Specialization

Intracranial calcification is known to be a physiologic phenomenon and is often seen in brain CTs of patients visiting the emergency department. The pattern of a calcified lesion may be related to the pathologic condition, and calcified lesion itself may cause neurologic symptoms. The causes of pathologic intracranial calcification are infection, brain tumor, vascular disorder, endocrinologic disorders, and genetic disorder associated with calcium metabolic defects. The most common sites of intracranial calcification are the basal ganglia, subcortical tissue of the cerebrum, the thalamus, the choroid plexus, and the dentate nucleus of the cerebellum. The diagnosis of pathologic calcification can be done by using brain CT or MRI, and pathologic calcification should be differentiated from other causes of calcification by using laboratory data. We report and discuss a case of extensive intracranial calcification with idiopathic hypoparathyroidism.
Basal Ganglia ; Brain ; Brain Neoplasms ; Calcinosis ; Calcium ; Cerebellar Nuclei ; Cerebellum ; Cerebrum ; Choroid Plexus ; Diagnosis ; Emergency Service, Hospital ; Humans ; Hypoparathyroidism* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Thalamus