Two cases of congenital multiple joint laxity are reported here. One was a 18-year-old boy, in whom the hypermobility of the joints was striking that 4 criterias (Carter & Wilkinson, 1964) could be observed. The other was a 18-year-old male who showed positive findings in three of the five diagnostic criterias. In both no familiar occurrence was noted.
Adolescent ; Humans ; Joint Instability ; Joints ; Male ; Strikes, Employee

Since the book "Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying" was published in 1991, there has been a worldwide increase in the number of cases of suicidal asphyxiation using helium gas. However, no domestic reports have been published thus far. Recently, we encountered a case of asphyxial suicide by inhalation of helium from inside a plastic bag. Subsequently, we reviewed the records of the Scientific Crime Analysis System of National Police Agency of Korea. There were 17 cases of helium-associated asphyxial suicides between January 1, 2000 and June 30, 2012. The average age of the deceased was 30.6 years with a male to female ratio of approximately 5:1. Thirteen of 17 such deaths occurred in the victims'houses. In all cases, the method of death involved placing a plastic bag over the head with a hose attached to helium tanks. In 6 of 17 cases, the decedents had psychiatric disorders such as depression. As neither characteristic signs of death nor conventional methods for detecting helium gas exist, a thorough investigation of the death scene and the decedents'environment is extremely vital for confirming death due to helium asphyxiation.
Crime ; Depression ; Female ; Head ; Helium ; Humans ; Inhalation ; Korea ; Male ; Plastics ; Police ; Suicide ; Suicide, Assisted

The proteins, especially the 19S globulin (IgM) and 7S globulin (IgA) in the CO2 snow-induced blister fluids of 10 male healty volunteers were analyzed immunoelectrophoretically. The fnllawing results were obtained. 1) Compared with autologous serum, all blister fluids tested lacked some protein fraction lines. 2) The 19S globulin (lgM) line was absent in all of the blister fluids except one which was contaminated with blood. 3) The 7S globulin (IgA) line was present in all of the blister fluids when undiluted. In 1 : 2 dilution, however, it was absent, or of trace amount in a few cases.
Blister* ; Humans ; Male ; Volunteers

Several immunosuppressive agents were used to prolong the survival of full-thickries skin homografts in albino rats. The grafts were squares in size of 2.0cm. The results were as follows. 1. The mean survival time of skin homografts in control group was 6.0 days. 2. Total body X-irradiation (500r) to the recipients 24 hours before grafting resulted in prolongation of survival of the grafts. (Mean, 12.5 days) 3. Administration of Imuran(azathioprine) to the recipients in a does of 5mg/kg/day for 7 days. before grafting resulted in prolongation of survival of the grafts. (Mean, 9. 6 days) 4. Spleneetomized homografted rats showed no prolongation of survival of the grafts. (Mean, 6.1days) 5. Administration of prednisolone to the recipients in a does of 2mg/kg/day for 7 days before grafting resulted in no prolongation of survival of the grafts. (Mean, 6.3 days) 6. Above results were discussed and compared with those of others.
Allografts* ; Animals ; Azathioprine* ; Immunosuppressive Agents* ; Prednisolone* ; Rats* ; Skin* ; Splenectomy* ; Survival Rate ; Transplants ; Whole-Body Irradiation*

BACKGROUND: In 1996, our emergency department(ED) had 148.4 patients per day and an average time for managing simple and uncomplicated patients was 248 minutes. To relieve congestion, delay and conflict in ED, we have developed Fast Track to treat patients with minor illness rapidly and effectively. The Fast Track area is located in a separate area in front to the main department. The efficiency and effectiveness of new system and patients satisfaction were investigated. METHODS: All ambulatory patients(> 15 years of age) were triaged and treated at Fast Track by emergency physicians. Patients, triaged as severe illness, were moved directly to main ED and the other patients with minor illness were managed in Fast Track. We analysed the patients who were managed at Fast Track from Jan. 1st 1997 through Nov. 30th 1997. The total time staying in Fast Track from beginning of trige to final decision such as discharge or admission was recorded retrospectively. A questionnaire was obtained from random patients in the same period to evaluate the patient's satisfaction. RESULTS: The number of patients who were managed in Fast Track was 13,378, and it was 55.8% of all adult patients who visited ED during the period. The average staying time was decreased significantly with time, (140.9+/-2.9 minutes in June, 125.4+/-2.8 minutes in July, and 97.7+/-1.0 minutes after July). The 75 percentile weighted average time was also decreased significantly; 196 minutes in June, 107 minutes in July, 135 minutes from August to November(p<0.01). The questionnaire were obtained from 107 patients. The results were revealed that 90 of 107 patients(84.1%) were satisfied with emergency care at Fast Track, and the remaining patients expressed unsatisfied comments such as long waiting time(4.7%), overcrowding(1.9%), unsatisfactory care(1.9%). CONCLUSION: The Fast Track system could decrease patient's staying time and improve patient's satisfaction. In addition, the efficiency and effectiveness of the acute care in ED would be enhanced by managing minor illness in Fast Track rapidly and effectively.
Adult ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Estrogens, Conjugated (USP) ; Humans ; Surveys and Questionnaires ; Retrospective Studies ; Tertiary Care Centers*

No abstract available.
Hysterectomy* ; Lymph Node Excision* ; Lymph Nodes*

No abstract available.
Hysterectomy* ; Lymph Node Excision* ; Lymph Nodes*

BACKGROUND: Ureteral stone(UTS) and acute pyelonephritis are the most common causes of nontraumatic acute flank pain in adults. Urography(IVU) is known as the most ideal diagnostic modality of obstructive uropathy to date. However, it has many practical limitations in overcrowding Korean emergency department to perform IVU as the diagnostic test of UTS. So we have performed prospective analytic study to compare IVU with its alternative diagnostic modalities. METHOD AND RESULTS: Our study was performed at Asan Medical Center from March, 1998 to July, 1999. We performed urinalysis, KUB, grayscale ultrasonography, and IVU in 243 patients, suspected to have UTS, based on histories, physical examination. After excluding patients with undetermined results(n=7) or spontaneous passage of stone before IVU(n=24), 212 patients were enrolled in our study. All of the other diagnostic tests were performed within one hour after emergency room presentation except IVU (53+/-24 hours). Diagnostic agreement among tests are as follows: Urinalysis shows good agreements with KUB(0.53) and IVU(0.62). KUB shows good agreement with IVU(0.48). Ultrasonography shows good agreement with IVU(0.58). Sensitivity(%), specificity(%), positive predicitive value(%), negative predicitive value(%), accuracy(%), and odds ratio of each diagnostic methods are as follows: Urinalysis is 91, 19, 78, 42, 74, 3.88; KUB is 55, 33, 72, 19, 50, 2.49; ultrasonography is 58, 92, 96, 41, 66, 45.61, and IVU is 81, 96, 98, 62, 84, 107.72. CONCLUSION: Although IVU seems to be the most ideal diagnostic modality for the UTS to date, it takes too long time for emergency physicians to confirm the diagnostic using IVU. We can performed other diagnostic modalities within one hour. However, emergency physicians suffer from poor diagnostic accuracy. Therefore, it is concluded that we are in need of more accurate alternative diagnostic modalities for UTS.
Adult ; Chungcheongnam-do ; Diagnosis* ; Diagnostic Tests, Routine ; Emergencies* ; Emergency Service, Hospital* ; Flank Pain ; Humans ; Odds Ratio ; Physical Examination ; Prospective Studies ; Pyelonephritis ; Ultrasonography* ; Ureter* ; Urinalysis

BACKGROUND : The proportion and absolute number of older patients admitted through the emergency department (ED) are increasing yearly. As people getting older, they are more likely to suffer from emergency situation of disease, disability, and trauma. Combining with the decrease in physiologic reserve, these added burdens make the elderly more vulnerable to any of the additional situations. Understanding the implications of these facts is crucial to one who is providing optimal triage and emergency care to elderly (aged 65 years or older) and adults (between 15year of age and 64 years of age). METHODS : We conducted an observational survey of emergency patients age 15 or older who admitted to emergency department of Asan Medical Center. A convenience sample of 3,481 were divided into 2 groups by 65 years of age, and final results (admission vs. discharge) after emergency care was compared. The admission rate according to between two groups. We calculated odds ratios of important outcomes by pooling data from individual trials using logistic regression analysis. RESULTS : Admission rate of elderly was higher than adults as 59.2% versus 36.4% (odds ratio=2.32) 95% CI=1.21~3.24). Although vital signs were within normal ranges, admission rate of elderly was significantly higher than adults as follows; normal range of systolic blood pressure (56.0% vs. 35.5%), normal range of respiration rate per minute (55.4% vs. 36.4%), alert status of mentality (34.2% vs. 54.7%). CONCLUSION : We could not define the severity of emergency patients only by using vital signs and/or clinical symptoms, especially to the elderly patients. Even though the vital signs of elderly patients. emergency physician should manage them carefully because of the high severity of clinical condition in elderly then we expected. Emergency Geriatric Assessment tools must be developed differently from general triage tools.
Adult ; Aged* ; Blood Pressure ; Chungcheongnam-do ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Geriatric Assessment ; Humans ; Logistic Models ; Odds Ratio ; Reference Values ; Respiratory Rate ; Triage ; Vital Signs