PURPOSE: Geographic problems can make it difficult for rescue teams to access emergency patients in the mountains. We developed the aeromedical relief program in conjunction with fire department helicopter EMS teams. This study describes the clinical experience of patients transported from the mountains in this program. METHODS: We reviewed the employed protocols and the medical records of patients transported to our hospital from the mountains by the aeromedical transport system from June 2006 to June 2007. RESULTS: Thirty-one patients were transported by helicopter during the study period, most of them (84%) from Mt. Bukhan. The time interval from call for help to hospital arrival was 80+/-56 min, and rescue time alone was 30+/-24 min. Eleven patients (36%) were pronounced dead on arrival, and 11 patients were admitted for management. The number of trauma patients were 24 (77%), who had an average RTS score (excluding the 11 patients who expired before arrival) of 11.7+/-0.6. When the ground team and the aeromedical team were dispatched at the same time, the total transport time was 54.0+/-22.8 min, compared to 133.0 +/-75.7 min when the aeromedical team was dispatched only upon the request of the ground team, a large and statistically significant difference. CONCLUSION: This study suggests that the helicopter transport system can be successfully employed to achieve early access to patients in the mountains. To optimize the current program, cooperation between hospital and the regional helicopter EMS is required.
Aircraft* ; Emergencies ; Emergency Medical Services ; Fires ; Humans ; Medical Records ; Mountaineering ; Seoul*

Iliacus muscle is the strongest hip flexor of gluteal region that acts with psoas muscle, whereas gluteus maximus muscle is the largest muscle engaged in extension and external rotation of the hip. Mountaineering requires strong contractile force of both flexor and extensor around the hip. A 57-year-old man presented to our hospital with severe pain in left groin after mountaineering for 5 hours without a break. Magnetic resonance imaging revealed incomplete rupture of iliacus muscle and strain of gluteus maximus muscle. Conservative treatment was done. At 3 months of follow-up, he returned to normal life. If we are going to climb mountain, it is important to start warming up with some stretches, take a break while climbing, and use climbing sticks. There have been no report about athletic injury of both iliacus and gluteus maximus after mountaineering. So we report this case with a review of the literature.
Athletic Injuries ; Buttocks ; Follow-Up Studies ; Groin ; Hip ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mountaineering ; Psoas Muscles ; Rupture

BACKGROUND: The assessment of how much people exercise needs to be analyzed in order to promote their health status. METHODS: Accordingly, 2001 Korean National Health and Nutrition Survey was performed during a two-month period beginning November 1st, 2001. Questionnaires on physical activities have been completed by 9,170 persons (88.45%) among 10,368 persons over 12 years old. We analyzed 7,838 subjects who were over 20 years old. RESULTS: Among the total, 71.8% persons of the respondents did not work out at all. Among them, 14.9% respondents were classified as lower exercise group, 6.9% middle exercise group and 6.4% as higher exercise group. The number of middle and higher exercise groups were increased on 2001 survey compared to those in 1998. Daily walking hours were 65.8 +/- 73.6 minutes. A proper amount of exercise were performed by older age groups than those in their twenties, by town residents than villagers, by unmarried people than married or divorced or bereaved ones, by higher educated people, by people with more weight, by those who were felt less stress, and by non drinkers. Favorite exercises were walking, mountaineering, jogging and working out at a fitness club which were chosen by 62.6% of the respondents. CONCLUSION: Many respondents did not work out at all and overall exercise rate was low. The rate of proper exercise was different by demographic features.
Adult* ; Child ; Surveys and Questionnaires ; Divorce ; Exercise ; Health Surveys ; Humans ; Jogging ; Motor Activity* ; Mountaineering ; Nutrition Surveys* ; Single Person ; Walking ; Young Adult

PURPOSE: Rapid ascent from low to high altitude (above 2500 m) often causes acute mountain sickness (AMS), a symptom-complex characterized by headache and other systemic symptoms (gastrointestinal upset, weakness, dizziness, and difficulty sleeping). In this study, we observed the vital signs and AMS symptoms. 13 participants in a mountain climb in order to determine correlation between AMS and risk factors such as obesity, smoking, and a previous history of AMS. METHODS: We studied 13 participants who climbed Mt.Cholatse (6440 m), and measured their vital signs and symptoms during the trekking. Standard Lake Louise questionnaires were filled out at five times during the trek: at the sea level, 2700 m, 3440 m, 4040 m, and 4700 m. With AMS scores and severity grades, we evaluate the severity of symptoms and the physical status. RESULTS: The overall AMS score was 3.7+/-.5, and headache was the most frequent symptom. As the altitude increased, oxygen saturation decreased whereas other vital signs (blood pressure, respiratory rate, and pulse rate) increased. The average AMS scores and severity grades increased more rapidly for obese men than for non-obese men (p<0.001). Smoking and previous history of AMS were also associated with the development of AMS (p<0.001). CONCLUSION: Persons who are obese or have a history of a smoking or AMS, are more likely to develop AMS symptoms. Further understanding of the natural and evolution of AMS and of the risk factors associated with AMS will educate the general population and physicians and help in its prevention and treatment.
Altitude ; Altitude Sickness* ; Dizziness ; Environmental Medicine ; Headache ; Humans ; Lakes ; Male ; Mountaineering ; Obesity ; Oxygen ; Surveys and Questionnaires ; Respiratory Rate ; Risk Factors ; Smoke ; Smoking ; Vital Signs

Acute mountain sickness (AMS) occurs commonly in hikers who are rapidly exposed to high altitude environments. Despite the numerous reports of AMS, few studies have reported pallidal lesions associated with altitude sickness. A previously healthy 49-yr-old Korean patient, after ascent to 4,700 m, suffered symptoms consistent with AMS. After returning home, the patient showed changes in personality characterized by abulia, indifference, and indecisiveness. T2 weighted brain magnetic resonance imaging showed high signal lesions involving bilateral globus pallidus. Our case suggests that globus pallidus injury should be included in the differential diagnosis of patients with personality or cognitive change after recovery from AMS.
Altitude ; Altitude Sickness/*complications ; Behavior ; Brain/pathology ; Brain Damage, Chronic/*etiology/pathology ; Environment ; Globus Pallidus/*pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mountaineering

AIMTo investigate the relationship between glutathione S-transferases gene polymorphism and susceptibility response to hypoxia.

METHODSIn the case-control study, the gene polymorphisms of glutathione S-transferases were tested in Tibetan mountaineers and sea-level Han Chinese by multiple-PCR and PCR-RELP.

RESULTSThe frequency of GSTT1 null genotype was significant different between Tibetan mountaineers and sea-level Han Chinese (P < 0.05), OR = 1.86 (95% CI = 1.01-3.39), and also for GSTP(1-105) mutant genotype in two groups (P < 0.01), OR = 2.19 (95% CI = 1.16-4.13). There was significant difference between A allele and G allele of GSTP(1-105) groups (P < 0.01). There was no difference for GSTM1 null genotype between two groups (P > 0.05), OR = 0.78 (95% CI = 0.43 - 1.42).

CONCLUSIONGSTT1 and GSTP(1-105) genotype may be associated with susceptibility response to altitude hypoxia.

Adult ; Alleles ; China ; Genotype ; Glutathione S-Transferase pi ; genetics ; Glutathione Transferase ; genetics ; Humans ; Hypoxia ; genetics ; Male ; Mountaineering ; Polymorphism, Genetic ; Reactive Oxygen Species ; metabolism ; Young Adult

Acclimatization ; physiology ; Altitude ; Altitude Sickness ; prevention & control ; Humans ; Hypoxia ; physiopathology ; Male ; Military Personnel ; Mountaineering ; physiology ; Oxygen Consumption ; physiology ; Physical Fitness ; physiology ; Young Adult

AIMTo evaluate the effect of chronic hypoxia on human spermatogenic parameters and their recovery time.

METHODSSeminological parameters of six male healthy mountain trekkers were evaluated in normoxia at sea level. After 26 days exposure to altitude (ranging from 2 000 m to 5 600 m, Karakorum Expedition) the same parameters were again evaluated after returning to sea level. These parameters were once again evaluated after 1 month and then again after 6 months.

RESULTSSperm count was found to be lower immediately after returning to sea level (P = 0.0004) and again after a month (P = 0.0008). Normal levels were reached after 6 months. Spermatic motility (%) shows no reduction immediately after returning to sea level (P = 0.0583), whereas after 1 month this reduction was significant (P = 0.0066). After 6 months there was a recovery to pre-hypoxic exposure values. Abnormal or immature spermatozoa (%) increased immediately after returning to sea level (P = 0.0067) and then again after 1 month (P = 0.0004). After 6 months there was a complete recovery to initial values. The total number of motile sperm in the ejaculate was found to be lower immediately after returning to sea level (P = 0.0024) and then again after 1 month (P = 0.0021). After 6 months there was a recovery to pre-hypoxic exposure values.

CONCLUSIONChronic hypoxia induces a state of oligospermia and the normalization of such seminological parameters at the restoration of previous normoxic conditions after 6 months indicate the influence of oxygen supply in physiological mechanisms of spermatogenesis and male fertility.

Adaptation, Physiological ; physiology ; Adult ; Aged ; Altitude ; Humans ; Hypoxia ; complications ; Infertility, Male ; etiology ; pathology ; physiopathology ; Male ; Middle Aged ; Mountaineering ; Oligospermia ; etiology ; pathology ; physiopathology ; Sperm Count ; Sperm Motility ; physiology ; Spermatogenesis ; physiology