OBJECTIVE: Sixteen cases of blunt diaphragmatic injury were clinically reviewed during 10 years from Oct.1987 to Jun.1996 at the Kangdong sacred heart hospital. The age and sex distribution were ranged from 3 to 67-old-years. The most common age range was between third decades to fifth decades in 10 cases(62.50%) and occurred predominantly in male, the sex ratio was 4.3 : 1.(M:F 4.3:1) The modes of blunt diaphragmatic injury were due to motor vehicle accidents(MVA), motor cycle accidents(MCA), fall down(FD) and others. Most common injuries were responsible for MVA. MVA were pedestrian traffic accidents 5 cases (41.7%), driver 4 cases(33.3%) passenger 3 cases(25.0%). In the blunt diaphragmatic injury sites, the left-sided diaphragmatic injury had predominant[left-sided cases 10(62.50%), right-sided cases 6(37.50%)]. Cost common symptoms and signs were chest pain or chest discomfort(81.25%) and dyspnea(68.75%), abdominal tenderness(50.00%), decreased bowel sound and breath sound(50.00%) and others. All of 16 cases in blunt diaphragmatic injury were associated with other injuries. The associated injuries were hemopneumothorax 14(87.50%), hemoperitoneum 7(43.759o), liver injury 7(43.75%), orthopedics fracture 14(87.50%), head injury 5(31.25%) and others. The diagnostic methods were used with simple x-ray, ultrasonogram and computed tomogram. The preoperative diagnosis of blunt diaphragmatic injury were suggested in 10 cases(62.509o) and others were confirmed during operation. The thirteen cases of all of sixteen cases were performed emergency operation within eight hours. The herniated intraabdominal organs through ruptured diaphragm were presented in 10cases(62.5%) [stomach 7 cases(43.75%), spleen 6 cases(37.50%), colon 3 cases(18.75%), liver 3 cases(18.75%), small bowel and omentum 2 cases(12.50%), respectively]. The mean size of blunt diaphragmatic injury were 7.7cm, right-sided mean size were 9cm, left-sided mean size were 6.9cm. The most common site of blunt diaphragm- atic injury were presented in anteromedial site 7 cases(43.75%). Simple chest x-ray revealed abnormal finding [hemothorax 10cases(62.50%), pneumothorax 4cases(25.00%), herniated organ into thorax8 cases(50.00%), diaphragm elevation 3 cases(18.75%) and others]. The postoperative complication were associated in 10 cases(62.50%) out of 16 cases. Common complications were pleural effusion 6 cases(37.50%) and atelectasis 3 cases(18.75%). Injury severity score(ISS) value of 16 cases in the blunt trauma ranged from 10 to 59. It was presented with mean value of ISS(35.5),mean value of ISS survivors(35) and nonsurvivors(55.5). Revised trauma score(RTS) value ranged also from 4 to 12. There were revealed with mean value of RTS(9.7),mean value of RTS survivors(10) and nonsurvivors(6.5). All of the blunt traumatic injury, mortality rate was related to the values of ISS and RTS.
Accidents, Traffic ; Chest Pain ; Colon ; Craniocerebral Trauma ; Diagnosis ; Diaphragm ; Emergencies ; Heart ; Hemoperitoneum ; Hemopneumothorax ; Humans ; Liver ; Male ; Mortality ; Motor Vehicles ; Omentum ; Orthopedics ; Pleural Effusion ; Pneumothorax ; Postoperative Complications ; Pulmonary Atelectasis ; Sex Distribution ; Sex Ratio ; Spleen ; Thorax ; Ultrasonography

Intussusception is a condition of invagination of the proximal segment of bowel into the more distal receiving bowel. Intussusception is one of the common pediatric and surgical emergencies of infancy and childhood in Korea. Intussusception is the most common cause of acquired intestinal obstruction in infancy and childhood, and it needs emergency treatment. 1) On the age and sex distribution, the age under 15 month was the most common(70.6%), and the peak incidence was 3-12 months of age(60.1%). In sex distribution, male to female ratio was 1.25:1. 2) The seasonal distribution was summer(27.4%), spring, autumn and winter in order of frequency. 3) As to the etiology of Intussusception treated by surgery, idiopathic was the most common(75%). 4) The cardinal symptoms and signs were vomiting(72.5%), bloody or bloody mucoid stool(57.5%), abdominal pain(49.7%), abdominal distention(20.9%), abdominal mass(19.6%) and others in order of frequency. 5) On the hematologic finding, 60.8% revealed leukocytosis above 10,000/mm3. 6) As to the duration from the onset of the symptom to admission, 84.2% was within 24 hours, 9.8% was from 24 hours to 48 hours, and 5% was over 48 hours. 7) The common anatomical types were ileocolic(73.2%), and ileocecal(17.0%). 8) The success rate of air reduction was 84.3%. 9) In the method of operation, manual reduction was performed in 91.7% and intestinal resection in 8.3%. 10) The recurrence rate after air reduction was 12.4% and after operative manual reduction was 8.3%.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Female ; Humans ; Incidence ; Intestinal Obstruction ; Intussusception* ; Korea ; Leukocytosis ; Male ; Recurrence ; Seasons ; Sex Distribution

PURPOSE: To investigate the morphological characteristics of keratocytes and the interconnection of keratocytes with adjacent keratocytes using the flat preparation method and scanning electron microscopy with a frontal section of the human corneal stroma. METHODS: The thin, corneal collagen lamellae were carefully dissected from the cornea (n=7), which had been stained by the flat preparation method. The remaining tissue was fixed in 3% glutaraldehyde and observed by transmission electron microscopy following the frontal section. RESULTS: The flat preparation revealed the corneal fibroblasts between the lamellae of the collagen fibers and showed that the ramifying cellular processes of the keratocytes were in contact with the cytoplasmic processes or cell bodies of neighboring fibroblasts. Two types of discrete subpopulations of keratocytes were identified: a smaller, cellular type of keratocyte with spindle-shaped nucleus with heterochromatin, and a larger, cellular type with a large indented nucleus with relatively scanty cytoplasm. Collagen fibers ran parallel to each other toward the fenestration of the cytoplasmic wall of the keratocyte. CONCLUSIONS: These flat preparation method results showed that the keratocytes within the corneal stroma are interconnected with the adjacent keratocytes, which indicates the presence of a functional communicating network through the keratocyte circuits within the stroma. A smaller, cellular type of keratocyte with spindle-shaped nucleus was morphologically differentiated from a larger, cellular type with a large, indented nucleus by flat preparation and transmission electron microscopy.
Middle Aged ; Microscopy, Electron, Transmission ; Microscopy, Electron, Scanning ; Intercellular Junctions/*ultrastructure ; Infant ; Humans ; Corneal Stroma/*cytology/pathology ; Child, Preschool ; Child ; Cell Size ; Aged ; Adult ; Adolescent

PURPOSE: This study was performed to investigate the growth pattern of the retinal vessel including retinal vascular endothelial cell and pericyte. METHODS: The sensory retina was detached from the eyecup obtained from donor's eye. The retinal vessel which was separated from the sensory retina was cultured in tissue culture media for 2, 3 and 4 weeks separately and examined by transmission electron microscopy. RESULTS: On the second week of tissue culture, both the retinal vascular endothelial cells and pericyte were intact in morphology in nuclear and cytoplasmic pattern. Both cells were partially detached from the surrounding basement membrane. On the third week of tissue culture, the cytoplasm of the retinal vascular endothelial cells and pericyte were degenerated, whereas the vascular endothelial cell were intact in nuclear and cytoplasmic profiles which were still partially surrounded by the basement membrane. CONCLUSIONS: These findings suggest that the survivability of the retinal vascular endothelial cells and pericyte may be limited for 2 and 3 weeks, separatedly under the ordinary culture medium.
Basement Membrane ; Culture Media ; Cytoplasm ; Endothelial Cells ; Microscopy, Electron, Transmission ; Pericytes ; Retina ; Retinal Vessels* ; Retinaldehyde*

OBJECTIVES: The patient with alcohol dependence needs continuing care in an outpatient treatment setting. This naturalistic retrospective study is the first report investigating the long-term follow-up rate and predictors of outcome in outpatient-based alcoholism treatment in Korea. METHODS: We conducted a chart review of patients, who visited a university-affiliated hospital alcohol clinic from 2005 to 2007. All patients diagnosed with alcohol dependence were enrolled. Patients were evaluated using a customized alcoholism evaluation package. Demographic factors, clinical data and self rating scales were included in the evaluation form. RESULTS: Of 109 patients, 27 (24.8%) adhered to our outpatient-based treatment for 30 months. The mean follow-up duration of participants was 11.1 months. A Kaplan-Meier survival analysis showed that comorbidity, initial treatment on admission, previous treatment history and family history made a significant difference to follow-up duration. Age, sex, alcohol history, motivation, AUDIT-K, BDI, BAI and RTCQ-TV were not significantly associated with follow-up duration. CONCLUSION: Comparing to outcomes of previous inpatient alcohol treatment in Korea, long term follow-up rate in outpatient treatment was superior, and abstinence/controlled drinking rate is not inferior. This finding suggests that outpatient based alcoholism treatment has sufficient efficacy.
Alcoholism ; Comorbidity ; Demography ; Drinking ; Follow-Up Studies ; Humans ; Inpatients ; Korea ; Motivation ; Outpatients ; Retrospective Studies ; Weights and Measures

Phenomenology was founded in the 19th century by Edmund Husserl. Apart from natural sciences and metaphysics, phenomenology is presented as a rigorous scientific discipline, which aims to provide an understanding of the subjective experiences of human beings. After the eras of descriptive and dynamic psychiatry, phenomenological methods were adopted by psychiatry, and phenomenological psychopathology suggested a new perspective for understanding the pathological experiences of psychiatric patients. However, after the development of psychopharmacology and the operational diagnostic system, the center of phenomenology in psychopathology was moved from comprehensive understanding to simple description. Thus, phenomenological psychopathology in its original meaning did not get remarkable repercussions, especially in the English-speaking world. In this article, some major concepts of phenomenology will be briefly presented and then phenomenological psychopathology in its original meaning will be introduced. Secondly, as an example of its application, symptoms of schizophrenia will be interpreted in terms of phenomenological psychopathology. Finally, the authors will present a neurobiological interpretation of the phenomenological psychopathology of schizophrenia and suggest a possible role of phenomenological psychopathology in mitigating the impasse in psychiatric genetics research.
Humans ; Metaphysics ; Natural Science Disciplines ; Neurobiology ; Psychopathology ; Psychopharmacology ; Schizophrenia

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.
Acute Kidney Injury ; Amputation ; Burns* ; Compartment Syndromes ; Compliance ; Education ; Electricity ; Emergencies ; Emergency Service, Hospital ; Extremities ; Humans ; Length of Stay ; Male ; Mortality ; Myoglobinuria

Eight patients were diagnosed as syringomyelia by MRI at the Department of Neurosurgery of Maryknoll hosptial, Pusan from April, 1990 to April, 1991. The causes were chiari type 1 malformation(2 cases), neoplasm(1 case), trauma(1 case) and idiopathic(4 cases). Six procedures were performed in the five patients. The procedures were foramen magmum decompression(1 case), formen magmum decompression combined syringosubarachnoid shunt(1 case), syringosubarachnoid(1 case), syringoperitioneal(2 cases) and syringopleural shunts(1 case). We have reviewed the modes of clinical presentations, diagnostic evaluations and surgical considerations.
Busan ; Decompression ; Humans ; Magnetic Resonance Imaging ; Neurosurgery ; Syringomyelia*

Knull phenotype completely lacks all Kell system antigens. Anti-Ku antibody is seen in immunized persons with Knull phenotype by transfusion or pregnancy. It can cause a fatal hemolytic transfusion reaction. A 66-yr-old male patient with liver cirrhosis visited emergency center due to acute bleeding. The patient was at hypovolemic shock status: his blood pressure was 80/50 mmHg, pulse rate was 110/min and hemoglobin level was 4.4 g/dL. Because of the presence of antibody against high incidence antigen, we could not find any compatible blood for the patient. Nevertheless, 4 units of packed RBCs had to be transfused. Moderate hemolytic transfusion reaction was developed after transfusion. At endoscopic examination, blood was spurting from gastric cardiac varix. Endoscopic histoacryl injection was tried, and bleeding was successfully controlled. After bleeding stopped, he was managed for anemia using steroid and other medical therapy instead of transfusion. His hemoglobin level was improved to 7.7 g/dL at the time of discharge. Later he has been proved to have a Knull phenotype, which is very rare, and anti-Ku antibody. This report is the first case of anti-Ku in a Knull phenotype person in Korea, who experienced a moderate hemolytic transfusion reaction.
Aged ; Antigens, Nuclear/*immunology ; Blood Group Incompatibility ; Blood Transfusion/*adverse effects ; DNA-Binding Proteins/*immunology ; Humans ; Isoantibodies/blood ; Kell Blood-Group System/*genetics ; Korea ; Male ; Phenotype

OBJECTIVE: We examined how psychotropic medications affected quantitative EEG (qEEG) results among patients with a schizophrenia-spectrum disorder. METHODS: The drugs were clustered into nine groups depending on their mechanism. We hypothesized that drugs would affect the relative power shown in qEEG results independently and investigated the effect of each drug group on relative power using multiple linear regression analysis and independent samples t-tests. RESULTS: We found that antipsychotics other than clozapine induced an increase in the relative power of alpha activity. Clozapine markedly increased slow waves and decreased alpha activity in the occipital area. The main findings for antidepressants and antiepileptic drugs were the beta increment and lithium increased the power of delta and theta activity. However, we found no evident changes in power due to benzodiazepine. CONCLUSION: Our results are generally consistent with previous pharmaco-EEG studies, despite some differences. Therefore, the EEG effect in each drug group could be singled out even under the polypharmacy condition, with the possible exception of benzodiazepines. Our results support using a new methodological approach to identify the qEEG effects of various psychotropic drugs in clinical settings.
Anticonvulsants ; Antidepressive Agents ; Antipsychotic Agents ; Benzodiazepines ; Clozapine ; Electroencephalography ; Humans ; Linear Models ; Lithium ; Polypharmacy ; Psychotropic Drugs