BACKGROUND: The present study was performed in order to identify the possible future location of the Department of Emergency Medicine and future demand for and supply of manpower through a survey of the heads of Kwangju City and Chollanam-do hospitals. The survey covered the degrees of recognition and understanding, the necessity, the future prospects, and the direction of development of the Department of Emergency Medicine. METHODS: A total of 33 large-scale general hospitals were selected in county districts having more than 200 sickbeds as of November 1999. Among them, the heads of 29 hospitals responded to the survey. The survey had a total of 31 questions, including 6 questions on the status of the emergency room. Six(6) questions concerned the degree of recognition of the Department of Emergency Medicine. Six(6) questions concerned the degree of understanding of the Department of Emergency Medicine. Six(6) questions concerned the necessity for the Department of Emergency Medicine, and 7 questions concerned the future prospects and direction of development. The results of the survey were analyzed. RESULTS: 1) As to the question of the degree of recognition, the Department of Emergency Medicine was known to all. That is, 50% of the respondents were well aware of the department, and 50% a little. Nineteen(19) respondents(65%) answered that it was convenient to have the Department of Emergency Medicine in a university hospital, among which 16 respondents(55%) answered that it was because of the rapid treatment of emergency patients. 2) As to the question of the degree of understanding, particularly, the areas of medical examination and treatment by the Department of Emergency Medicine, 15 respondents answered that it was for the treatment of patients who needed to receive emergency treatment, while 12 respondents answered that it was for the diagnosis and treatment of all patients who visited the emergency room. Only 7 respondents(24%) answered positively as to the possibility of the Department of Emergency Medicine using thrombolysis medicine. 3) All except for one respondent had a positive view on the necessity for the Department of Emergency Medicine, and all except for 3 respondents wanted to have specialized doctors in emergency medicine work at the corresponding hospital. As to the type of schedule, 10 hospitals(34%) wanted to have only night shifts, and 11 hospitals(38%) wanted to have both day and night shifts. Most hospitals, needed two or more workers in the field. 4) As to the question of the direction of development, many respondents were of the opinion that the hiring of specialized doctors in emergency medicine would not be of greatly help to the finances of the hospital due to increased labor costs. It seems that improvement of the medical system to improve hospital financing is a required prerequisite for the development of the Department of Emergency Medicine. Also, 21 respondents(83%) were of the opinion that it would take a considerable amount of time to activate the Department of Emergency Medicine with respect to the future prospects of the department. CONCLUSION: It was shown in the present survey that the heads of hospitals in Kwangju City and Chollanam-do recognized the Department of Emergency Medicine in a positive way, but it was necessary to establish both a delivery system for emergency medicine and collaboration with and support by other medical areas for its future development. It was estimated that in the future, more than 55 doctors specializing in emergency medicine would be needed as medical manpower for the general hospitals in the districts.
Appointments and Schedules ; Cooperative Behavior ; Surveys and Questionnaires ; Diagnosis ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Emergency Treatment ; Gwangju* ; Head ; Hospitals, General ; Humans ; Jeollanam-do*

The most frequently used serodiagnostic test for syphilis in Korea is VDRL test, which is one of several flocculation tests utilizing cardiolipin-lecithin as antigen. This test remains popular because it is easily performed, inexpensive, is standard for screening purposes, and is useful for following the serologic response to treatment. A common problem is weakly reactive (or 'rough' result) VDRL test or reactive VDRL in the absence of definite evidence of present or past syphilis; the diagnosis of syphilis in these cases should be confirmed by using the specific treponemal antigen tests. The Fluorescent Treponemal Antibody-Absorption (FTA-ARS) test is the result of continued attempts to improve the original FTA procedures. This test uses virulent T. pallidum (Nichols strain) as antigen and uses fluorescein-tagged antihuman globulin as reaction indicator. The FTA-ABS test is very sensitive in all stage of syphilis, especially in early syphilis. The FTA-ABS test was carried out on 448 persons with reactive and weakly reactive VDRL tests and divided the groups of routine physical check and out patients. (countinued..)
Diagnosis ; Flocculation Tests ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Korea ; Mass Screening ; Outpatients ; Syphilis*

This study was done on 171 volunteers in order to investigate the present status of cutaneous normal flora of Candida species and the distribution of Candida species on the normal human skin in dermatologic clinic of Korea University Hospital from January, ]984 to December, 1984. Among the 171 volunteers, 115 strains of Candida species were identified by culture on the Sabouraud's dextrose agar media, germ tube test, sugar assimilation test, sugar fermentaion test and culture on corn meal with Tween 80 media, The results were summarized as follows: 1. The incidence of cutaneous normal flora of Candida species was 13, 5,5 (115 species among 855 sites) 2. Candida species were distributed in oral cavity(45 species), 4th interdigital toe web(39 species), groin(12 species), axilla(11 species) and 4th interdigital finger web(8 species) in order of frequency. 3, Of ll5 species, 45 species were cultured in summer, 27 species in autumn, 18 species in winter and 14 species in spring. 4 Of 115 Candida species, C. albicans(88 species), C. parapsilosis(12 species), C, tropicalis(8 species), C. guilliermondii(3 species) and C. stellatoidea(2 species) were identified. Two species could not be identified.
Agar ; Candida* ; Fingers ; Glucose ; Humans* ; Incidence ; Korea ; Meals ; Polysorbates ; Skin* ; Toes ; Volunteers ; Zea mays

BACKGROUND: Arterial blood gas analysis are highly susceptible to preanalytic error due to improper method of obtaining or handling the blood sample before analysis. The error in measurement of blood gas analysis are loss of CO2 by exposure to atmospheric air, effect of anticoagulant itself, temperature difference between the experimental subject and the measuring electrode and metabolic change which occur between blood sampling and measurement. METHOD: To study the effect of the delay in estimation of blood gas and drawn blood on values of blood gas partial pressure and pH. Blood sample were divided into 2 groups according to the method of storage, group I stored at 24~25degrees C(room temperature) under anaerobic condition. ;group II stored at 0~4degrees C(refrigerator) under anaerobic condition. The samples were analyzed by time interval through 180 minutes in each group. RESULTS: The result were as follows: 1) PaO2 decreased significantly after 10 mins in group I, whereas it decreased significantly after 20 mins in group II. 2) PaO2 increased significantly after 20 mins in group I, whereas it increased significantly after 120 mins in group II. 3) pH decreased significantly after 60 mins in group I, whereas it decreased significantly after 120 mins in group II. 4) No significant changes of bicarbonate and SaO2 were noted in each group CONCLUSION: From above results, it would be advisable to analyze the sample in a short period of time or to store in a refrigerator when the measuring will be delayed. So we highly recommend that blood gas analysis should be performed as soon as possible after sampling, especially within 10 minutes.
Blood Gas Analysis ; Electrodes ; Hydrogen-Ion Concentration ; Partial Pressure

BACKGROUND: The concentration of the blood including ACTH, catecholamine, serum prolactine, cortisol is increased due to responding on stress by carrying out endotracheal intubation upon the mutiple trauma patients who were taken to the emergency room. Diazepam is a kind of benzodiazepine pharmacon and common pharmacon used for stability of the patients, relief and pretreatment as a booster for the relaxation of skeletal muscle. This research aims to know how effectively medication of diazepam before endotracheal intubation helps to constrain the reaction on the part of cardiovascular system due to laryngoscopy and endotracheal intubation, and makes concentration of catecholamine in blood changed. METHODS: The subjects are consisted of the patient asked for endotracheal intubation instantly, suffering from caput trauma (GCS 8.0) among the multiple trauma patient, more than 20-year-old who were taken to the emergency room in Chosun university hospital from October 1, 1995 to September 30, 1996. They were decided into 2 classes, 30 people each class, and one (group I ) was carried out endotracheal intubation without injecting diazepam,0.3 mg/kg, and the other (group II) was done with the endotracheal intubation by injecting diazepam, 0.3mg/kg. Group I and group II were measured blood pressure and heart rate before intubation and at 1, 3, 5, 7 minute after endotracheal intubation, sampled arterial blood from femoral artery, and then compared and analyzed. All of the data were recorded by mean, standard deviation, and percentage and repeated measures ANOVA test was used for the statistical test and the data was regarded as statistically significant when p value is below 0.05. RESULTS: 1) They were no significant differences statistically between 2 groups in the distribution of the age, weight, sex of the patients. 2) The changes in the systolic blood pressure had no statistical significance in the comparison between group I and group II, but diastolic blood pressure and the change of heart rate had statistical significance because p value was shown below 0.05. 3) Norepinephrine of blood was significantly lower in group II than group I. 4) Epinephrine of blood was significantly lower in group II than group I. CONCLUSION: It was shown that medication of diazepam before endotracheal intubation made stability of the patients and it changed significantly the reaction on the part of cardiovascular system from stress caused by laryngoscopy and endotracheal intubation. So it will be a good thing to inject diazepam for pretreatment to bring relief of the patients and cardiovascular stability before endotracheal intubation.
Adrenocorticotropic Hormone ; Benzodiazepines ; Blood Pressure ; Cardiovascular System ; Diazepam* ; Emergency Service, Hospital ; Epinephrine ; Femoral Artery ; Heart Rate ; Humans ; Hydrocortisone ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Multiple Trauma* ; Muscle, Skeletal ; Norepinephrine ; Prolactin ; Relaxation ; Young Adult

BACKGROUND: We reviewed retrospectively the clinical features and contrast material-enhanced computed tomography(CT) after blunt abdominal trauma demonstrated a characteristic hypoperfusion complex. Our purpose were to evaluate the hypothesis that children with this 'hypoperfusion complex' CT finding were associated with a tenuous hemodynamic state, severe injury and a poor outcome. METHODS: Between January 1996 and December 1999, 39 consecutive children who sustained blunt trauma and were suspected clinically of having intraabdominal injury underwent CT. Demographic data, blood pressure, indication for CT, pediatric trauma score(PTS) and Glasgow coma score(GCS) were recorded at the time of the initial examination. RESULTS: Three of the 39 children(8%) demonstrated a characteristic finding at CT which was described as the hypoperfusion complex. The 'hypoperfusion complex' was present in the 3 of the 39 traumatized children(8%), but was the main radiographic finding in the 3 of the 14 children with a severe pediatric trauma score(PTS<8) and in the 3 of the 6 children with a Glasgow coma score(GCS<8) who were examined with CT. CONCLUSION: The CT finding in all children with the hypoperfusion complex by definition included marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidney and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava(IVC); and moderate to large peritoneal fluid collection. This 'hypoperfusion complex' is a relatively rarely observed in injured children but appears to be associated with severe injury and a poor outcome. The pediatric trauma score provides a useful profile of injury severity in children. Prompt diagnosis of hypovolemic shock is important so that supportive therapy can be instituted to prevent further metabolic abnormalities and their potential cardiotoxic effects. In summary, the intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability and is associated with a poor outcome.
Aorta, Abdominal ; Ascitic Fluid ; Blood Pressure ; Child* ; Coma ; Diagnosis ; Dilatation ; Hemodynamics ; Humans ; Hypovolemia* ; Intestines ; Kidney ; Mesentery ; Pancreas ; Retrospective Studies ; Shock* ; Tomography, X-Ray Computed*

No abstract available.
Appendectomy* ; Lymphocyte Subsets* ; Lymphocytes*

A case of cutaneous sarcoidosis in the 66 year-old Korean female patient is presented. She shows typical skin manifestations of plaque type in the absence of other common objective evidence of systemic involvement. Diagnosis was confirmed by charcteristic histological findings and positive Kveim test with the support of other compatible clinical and biochemical findings. She had been followed up for 3 years since the first visiting. Recently chest X-ray, slit lamp examination and skin biopsies were taken again, but failed to reveal any significant interval changes.
Aged ; Biopsy ; Diagnosis ; Female ; Humans ; Kveim Test ; Sarcoidosis* ; Skin ; Skin Manifestations ; Thorax

BACKGROUND: The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. METHODS: We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. RESULTS: The results were as follows:- 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%),dyspnea(40.2%), sputum(38.0%), chest pain(12.0%), anorexia(10.9%), and fever(9.8%). 3) 38(41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were:-COPD, 25 cases(27.2%);pneumonia, 17 cases(18.5%);DM, 13 cases(14.1%);and malignancy, 10 cases(10.9%). 5) The positivity of Mantoux test(5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB(M.Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases;RLLF, 50 cases, mostly, then LLLF;26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows:cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. CONCLUSION: The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.
Aged* ; Chronic Disease ; Cough ; Developed Countries ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Polymerase Chain Reaction ; Poverty ; Prevalence ; Retrospective Studies ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

No abstract available.
Korea* ; Tuberous Sclerosis*