No abstract available.
Sinusitis*

BACKGROUND AND OBJECTIVES: Many authors(Simmons,1973, McGath et al.,1989) described that a small percentage(1-2 %) of patients initially complaining of vertigo was found to have bilateral vestibular failure (BLVF). This study evaluates the findings of vestibular function test (VFT) including rotating chair test (ROT) and computerized dynamic posturography test (CDP) in the patients with BLVF demonstrated by caloric test and others. Method : 400 vertigo patients were given VFT from June,1994 to October,1995. In the patients who had absent or reduced responses (total eye speed <10 degrees per second) in cold (17 C) water caloric testing or decreased responses in the range of lower fequencies during ROT, we evaluated their VFT results and clinical features. RESULTS: There were 38 cases out of total 400 patients(9.5%). Many patients with BLVF had rotational response magnitudes (at 0.04 Hz and above) that were within normal limits. CBP has shown vestibular dysfunction patterns in 32 patients. Hearing tests were normal in 9 cases and mixed hearing loss in 2 cases. Many patients experienced several episodes of acute vertigo with persistent imbalance; Only 4 patients complained of persistent oscillopsia. Viral infection (vestibuloneuronitis), immune reactions and toxic factors may play a role in the etiology of this rare BLVF. CONCLUSION: Our incidence of 9.5% is much higher than what was reported in the literature. Herb medications and frequent injections of aminoglycosides may be responsible for this higher incidence of BLVF. ROT is useful in detecting and predicting the remaining vestibular function in the BLVF patients.
Aminoglycosides ; Caloric Tests ; Electronystagmography ; Hearing Loss, Mixed Conductive-Sensorineural ; Hearing Tests ; Humans ; Incidence ; Vertigo ; Vestibular Function Tests* ; Water

PURPOSE: The separation of prescription and dispensation of drugs starting from July 2000 has led to a reduced exposure to drugs for the general population. Therefore, we hypothesize that the policy of separation the prescribing and the dispensing of drugs has decreased the actual incidence of drug intoxication from drug abuse. METHODS: Patients with acute intentional drug intoxication who were admitted to emergency centers in Seoul were retrospectively studied. The study period was subdivided into three: before, during, and after the launch of the policy of separation of prescription and dispensation, corresponding to the periods January to June, 2000; January to June 2001; and January to June 2002, respectively. RESULTS: Acute drug intoxication was associated with 0.2% of all prescriptions during the studied period. There was no significant difference in the types of intoxicating drugs whereas the most commonly abused drug was Doxylamine succinate. Prescribed medications accounted for 37.0%, 29.2%, and 32.3% of the acute drug intoxication cases in 2000, 2001, and 2002, respectively. There was no significant difference in the treatment outcomes between the three study groups although three patients died of paraquat intoxications in 2001. CONCLUSION: The launch of the policy of separation of prescription and dispension of drugs did not significantly reduce the rate of acute drug intoxication from drug abuse which questions the effectiveness of the policy in decreasing drug abuse. We suggest reassessment of sedatives, in particular, those prescribed medications, in order to decrease the incidence of acute intoxications.
Doxylamine ; Emergencies* ; Humans ; Hypnotics and Sedatives ; Incidence ; Paraquat ; Poisoning* ; Prescriptions* ; Retrospective Studies ; Seoul ; Substance-Related Disorders ; Succinic Acid

Teaching both English in medical field and bioethics to medical students in Korea is becoming more and more important. We have investigated the present status of medical English and bioethics lectures in medical schools in Korea. We have taught bioethics in medical English class and investigated its effect through questionnaire. Less than two thirds of the 35 medical schools in Korea have medical English and /or bioethics lectures. Mainly English medical terms were taught in premedical course in most of the school which needs to be improved. Evaluation of the bioethics lecture in medical English class was responded favorably by the students. In conclusion, teaching bioethics in medical English class in English appears to be an effective way of teaching both English and bioethics in medical field at the same time and a good way of saving time by teaching both simultaneously.
Bioethics* ; Humans ; Korea ; Lectures ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires

BACKGROUND: Platelet activating factor (PAF) has been known to implicate one of potent inflammatory mediators and is reported to be involved in many pathologic processes, especially in inflammation and allergy. PAF has induced cytotoxic effects on the human paranasal sinus mucosa in vitro, showing ciliary inhibition, ciliostasis and cellular damage to the mucosal epithelium, in both dose and time dependent manners. However, the exact role of PAF in the pathogenesis of sinusitis is not yet known. OBJECTIVE: The purpose of this study was to provide a new model of acute sinusitis by application of PAF into the maxillary sinus in rabbits. MATERIALS AND METHODS: Rabbits were divided into 2 groups. Experimental groups were applied with 16 ng/ml of PAF into the maxillary sinus percutaneously. Control groups were applied with normal saline using the same technique as in the experimental groups. The presence of purulent secretion was observed in the nostril of rabbits, and the culture and smears of the secretions were performed. All of the mucosae were taken from the inferomedial wall of each sinus for light microscopy. RESULTS: Mucoid and purulent discharges were observed in rabbits of the experimental groups at 5 and 7 days after the application of PAF, respectively. Pasteurella multocida was found in the sinus content of experimental groups at 5 and 7 days. The prominent epithelial disruption and the infiltration of the inflammatory cells (predominantly eosinophils) into the epithelium and lamina propria were observed at 7 days in PAF-applied group. CONCLUSION: In this study, PAF induced sinusitis without occlusion of the natural ostium of the maxillary sinus in rabbits, therby providing another animal model of sinusitis for the understanding of the pathogenesis of sinusitis caused by inflammatory mediators.
Blood Platelets* ; Epithelium ; Humans ; Hypersensitivity ; Inflammation ; Maxillary Sinus* ; Maxillary Sinusitis* ; Microscopy ; Models, Animal ; Mucous Membrane ; Pasteurella multocida ; Pathologic Processes ; Platelet Activating Factor* ; Rabbits* ; Sinusitis

PURPOSE: The internet is a vast resource for consumers. The internet is a decentralized, global medium, so quality management of health information is difficult for the lay person. Basic Life Support (BLS) is basic information provided for the lay person in the province of emergency medicine. The writers searched for BLS information on Korean and Japanese Web sites and assessed the quality of that information. METHODS: We used the search engine 'Yahoo! Korea' in Korea and 'Yahoo! Japan' in Japan. The search references were 'Basic Life Support' and 'Cardiopulmonary Resuscitation (CPR)'. The assessment was based on three 'Credibility' and seven 'Content' factors. 'Credibility' factors composed of 'Source', 'Context' and 'Currency'. 'Content' factors composed of six factors of accuracy of six course of BLS and one factor of 'Original Source Stated'. We make our own criteria for each factors. And, If the web site fitted the criteria, we give 1 point, if not, give 0point. So, 'Credibility' factors point is 3 points full mark and 'Content' factors point is 7 points full mark. RESULTS: Eight Korean and fifteen Japanese sites were found as a result of the search. No difference in 'Credibility' factors existed between the two nations' web sites. There was, however, a statistical difference in the 'Content' factors between the two nations' web site. The mean of 'Content' factors points is 3.75 and 5.06 in 7 points full mark, Korean web site and Japanese web site respectively. CONCLUSION: Improvement in the quality of BLS on internet web sites is needed, especially BLS on 'Recovery position', 'Assessment of circulation', and 'Cardiac comp ression'.
Asian Continental Ancestry Group ; Emergency Medicine ; Humans ; Internet* ; Japan* ; Korea* ; Resuscitation ; Search Engine

PURPOSE: Central venous catheterization (CVC) is a common procedure in the emergency department (ED) and the intensive care unit (ICU) settings. There are some complications of this procedure, and one of those is a cardiac arrhythmia. But, it's risk factors have not been clearly defined compared with other complications of the procedure. Thus, we analyzed the frequency of arrhythmia occurrence and the factors that induced arrhythmia. METHODS: We performed a prospective study on all adult (>15 years old) patients who underwent a central venous catheterization using the right subclavian approach in the ED and the medial part ICU at Samsung Medical Center (SMC) during the period from May 1, 2004 to July 31, 2004. We excluded patients who experienced other complications of CVC (e.g, pneumothorax, hemothorax, etc.), or underwent a replacement of old catheter with new one, failed procedures also were excluded. Overall, 85 patients were included in study. We collected the data on patient's age, sex, body weight, height, use of catecholamines, place of the procedure, and length of guidewire insertion. The number of arrhythmia occurred was checked and later compared to the data collected previously. RESULTS: Among the 85 patients included in study, arrhythmia occurred in 31 patients. The length of guidewire insertion had statistical significance in induced arrhythmia during the procedures of CVC (p value=0.01). CONCLUSION: The length of guidewire insertion is a important risk factor of the arrhythmia occurrence during the procedure of central venous catheterization.
Adult ; Arrhythmias, Cardiac* ; Body Weight ; Catecholamines ; Catheterization, Central Venous* ; Catheters ; Central Venous Catheters* ; Emergency Service, Hospital ; Hemothorax ; Humans ; Intensive Care Units ; Pneumothorax ; Prospective Studies ; Risk Factors*

BACKGROUND: The aim of the present study was to identify chromosomal loci that contribute to the pathogenesis of aortic dissection (AD) in a Korean population using array comparative genomic hybridization (CGH) and to confirm the results using real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: Eighteen patients with ADs were enrolled in this study. Genomic DNA was extracted from individual blood samples, and array CGH analyses were performed. Four corresponding genes with obvious genomic changes were analyzed using real-time PCR in order to assess the level of genomic imbalance identified by array CGH. RESULTS: Genomic gains were most frequently detected at 8q24.3 (56%), followed by regions 7q35, 11q12.2, and 15q25.2 (50%). Genomic losses were most frequently observed at 4q35.2 (56%). Real-time PCR confirmed the results of the array CGH studies of the COL6A2, DGCR14, PCSK6, and SDHA genes. CONCLUSION: This is the first study to identify candidate regions by array CGH in patients with ADs. The identification of genes that may predispose an individual to AD may lead to a better understanding of the mechanism of AD formation. Further multicenter studies comparing cohorts of patients of different ethnicities are warranted.
Aorta ; Cohort Studies ; Comparative Genomic Hybridization ; DNA ; Humans ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction

BACKGROUND: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. MATERIAL AND METHOD: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with pre- existing dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5 cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. RESULT: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis- dependent CRF patient. The mean time between the operation and the initiation of CRRT was 25.8+/-5.8 hours and the mean duration of CRRT was 62.1+/-41.2 hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. CONCLUSION: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.
Acute Kidney Injury* ; Coronary Artery Bypass ; Creatinine ; Hemodynamics ; Hospital Mortality ; Humans ; Incidence ; Kidney Failure, Chronic ; Length of Stay ; Mortality ; Renal Replacement Therapy* ; Survivors ; Transplants

PURPOSE: There have been no studies on the termination of resuscitation (TOR) in Korea. We retrospectively applied TOR rules to OHCA patient data in order to validate the BLS and ALS TOR rules for Korea. METHODS: We collected OHCA (out-of-hospital cardiac arrest) data from 3 hospitals for the period January 1 to December 31, 2009. We then retrospectively applied BLS and ALS TOR rules to this data. We measured both the specificity and positive predictive value for each BLS and ALS TOR rule. RESULTS: The overall rate of survival until hospital discharge was 14.5%. Out of 102 patients who met BLS criteria TOR rules, 8 patients survived until hospital discharge. Out of 52 patients who met ALS criteria TOR rules, 4 patients survived until hospital discharge. The BLS rule had a specificity of 0.57 and a positive predictive value of 0.92. The ALS rule had a specificity of 0.78 and a positive predictive value of 0.92. CONCLUSION: In this study, the BLS and ALS TOR rules had relatively low positive predictive value and were not applicable to patients with low survival probability in Korea.
Cardiopulmonary Resuscitation ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Resuscitation ; Retrospective Studies ; Sensitivity and Specificity