OBJECTIVE: The purpose of this study was to compare the biomedical demands between a manual stretcher cart (Manual Cot) and a novel powered stretcher cart (Power Cot) during simulated routine stretcher handling activities. METHODS: A randomized cross-over design mannequin simulation study was planned. Fourteen participants sequentially performed routine stretcher handling tasks, including unloading, lowering, raising, and loading tasks with the Manual Cot and Power Cot. The biomechanical workload of each participant was assessed by measuring the muscle activity of four muscles (bilateral L4/5 erector spinae and rectus femoris) through an 8-channel electromyogram (EMG) measurement system by attaching the surface EMG. The time required to perform each task was measured, and after the end of the simulation, the participants were given a subjective questionnaire consisting of seven items (five-point Likert scale) on the usefulness and usability of the two stretcher carts. RESULTS: Fourteen participants, six males and eight females, performed four routine stretcher handling scenarios. The median total task times for the Manual Cot and Power Cot were similar (95 seconds; range, 49-105 vs. 94 seconds; range, 84–140; P=0.063). For the lowering, raising, and loading tasks, the effects of Power Cot were significantly lower than the normalized muscle voluntary contraction (%) cumulative sum of the back or thigh (P<0.05). Compared to Manual Cot, the use of Power Cot resulted in a decrease in total muscle activity of 18.0–63.5% in the back muscles and 6.7-83.9% in the thigh muscles during the task simulation. The participants preferred the Power Cot in terms of usefulness in subjective perceptions. CONCLUSION This simulation study identified that the Power Cot reduced the physical stress of emergency medical services workers without any significant performance time delay when performing stretcher-handling activities.

Huge hepatic cysts are rarely encountered in autosomal dominant polycystic kidney disease. Huge hepatic cyst bothers the patient either by compression or complications such as intracystic infections or hemorrhages. We report, here, alcohol instillation to treat a huge hepatic cyst causing compression symptom with improvement in size & symptom. A 49-year-old female patient presented with a 4-week history of indigestion and epigastric discomfort. Physical examination was remarkable for tender hepatomegaly. Computerized tomography revealed huge hepatic and kidney cysts. Ultrasonographic guided percutaneous drainage and four times alcohol sclerotherapy of the huge heptic cyst was successful. Relief of the symptoms was maintained after 18 days. This case shows that alcohol sclerotherapy can be a effective nonsurgical method of treating symptomatic huge hepatic cysts.
Alcoholics* ; Drainage ; Dyspepsia ; Female ; Hemorrhage ; Hepatomegaly ; Humans ; Kidney ; Middle Aged ; Physical Examination ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Dominant* ; Sclerotherapy*

No abstract available.
Herpesvirus 1, Suid* ; Pseudorabies*

The immunosuppression significantly increases the risk for acquiring opportunistic infections due to bacteria, viruses, fungi, and protozoa. These opportunistic infections are the major source of morbidity and mortality in transplanted patients. Cytomegalovirus and Aspergillus are important infectious agents in renal transplant recipients. The onset of these diseases follows the period of maximal immunosuppression for the prevention and treatment of acute rejection. Cytomegalovirus infection can suppressed immunity in renal transplant recipient and associated with other opportunistic infections. We experienced a case of Aspergillus and Cytomegalovirus pneumonia after renal transplantation. This 45-year-old woman had undergone renal transplantation. About 1 months later, she presented with dry cough and mild fever. Chest radiographs revealed multifocal patchy and conglomerated consolidation on both lung field, especially lower lung field. The invasive aspergillosis and cytomegalovirus pneumonia was diagnosed by open lung biopsy. Her condition was progressively aggravated despite amphotericin B and ganciclovir therapy and expired 53 days after renal transplantation.
Amphotericin B ; Aspergillosis ; Aspergillus ; Bacteria ; Biopsy ; Cough ; Cytomegalovirus Infections ; Cytomegalovirus* ; Female ; Fever ; Fungi ; Ganciclovir ; Humans ; Immunosuppression ; Kidney Transplantation* ; Lung ; Middle Aged ; Mortality ; Opportunistic Infections ; Pneumonia* ; Radiography, Thoracic ; Transplantation

BACKGROUND AND OBJECTIVES: After the first acute myocardial infarction (AMI), a considerable proportion of patients are newly diagnosed with diabetes mellitus (DM). However, in AMI, controversy remains regarding the disparity in prognosis between previously diagnosed DM (known-DM) and newly diagnosed DM (new-DM). METHODS: The study included 10,455 patients with AMI (non-DM, 6,236; new-DM, 659; known-DM, 3,560) admitted to one of 15 participating centers in Korea between November 2011 and January 2016 (average follow-up, 523 days). We compared the characteristics and clinical course of patients with known-DM and those with new- or non-DM. RESULTS: Compared to patients with known-DM, those with new-DM or non-DM were younger, more likely to be male, and less likely to have hypertension, dyslipidemia, prior stroke, angina, or myocardial infarction. Compared to patients with new-DM or non-DM (reference), those with known-DM had higher risks of major adverse cardiac events (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.06–1.35; p=0.004), cardiac death (HR, 1.26; 95% CI, 1.01–1.57; p=0.042), and congestive heart failure (HR, 1.58; 95% CI, 1.20–2.08). Unlike known-DM, new-DM did not increase the risk of cardiac events (including death). CONCLUSIONS: Known-DM was associated with a significantly higher risk of cardiovascular events after AMI, while new-DM had a similar risk of cardiac events as that noted for non-DM. There were different cardiovascular outcomes according to diabetes status in patients with AMI.
Death ; Diabetes Mellitus ; Dyslipidemias ; Follow-Up Studies ; Heart Failure ; Humans ; Hypertension ; Korea ; Male ; Myocardial Infarction ; Prognosis ; Stroke

BACKGROUND AND OBJECTIVES: After the first acute myocardial infarction (AMI), a considerable proportion of patients are newly diagnosed with diabetes mellitus (DM). However, in AMI, controversy remains regarding the disparity in prognosis between previously diagnosed DM (known-DM) and newly diagnosed DM (new-DM). METHODS: The study included 10,455 patients with AMI (non-DM, 6,236; new-DM, 659; known-DM, 3,560) admitted to one of 15 participating centers in Korea between November 2011 and January 2016 (average follow-up, 523 days). We compared the characteristics and clinical course of patients with known-DM and those with new- or non-DM. RESULTS: Compared to patients with known-DM, those with new-DM or non-DM were younger, more likely to be male, and less likely to have hypertension, dyslipidemia, prior stroke, angina, or myocardial infarction. Compared to patients with new-DM or non-DM (reference), those with known-DM had higher risks of major adverse cardiac events (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.06–1.35; p=0.004), cardiac death (HR, 1.26; 95% CI, 1.01–1.57; p=0.042), and congestive heart failure (HR, 1.58; 95% CI, 1.20–2.08). Unlike known-DM, new-DM did not increase the risk of cardiac events (including death). CONCLUSIONS Known-DM was associated with a significantly higher risk of cardiovascular events after AMI, while new-DM had a similar risk of cardiac events as that noted for non-DM. There were different cardiovascular outcomes according to diabetes status in patients with AMI.