Iron deficient state occurs commonly in the athlets, and the cause may be inadequate iron intake, loss of iron from sweat, blood loss of gastrointestinal tract, and hematuria. The age of the athletes ranged from 11 to 17 years old. I messured red blood cell count, hemoglobin, hematocrit, and related hematologic factors in the 32 adolescent female athletes and 21 female controls. a hematologic comparison was perfomed between the athletes and controls. The results obtained were as follows: 1) A value of hemoglobin were 11.6+/-1.4g/dl in the athletes and 12:4+/-0.8g/dl in controls (p<0.05). 2) Hematocrits were 34.1+/-3.4% in the athletes and 37.4+/-2.3% in controls (p<0.05). 3)A value of red bolld cell distribution width values were 13.9+/-2.1% in the athletes and 12.2+/-1.1% in controls (p<0.05). 4) Serum iron was 87.7+/-30.3ug/dl in the athletes and 121.8+/-39.0ug/dl in controls (p<0.001). 5) Total iron binding capacity was 445:6+/-31.8ug/dl in the athletes and 384:6+/-54.2ug/dl in controls (p<0.001). 6) Mean transferrin saturation values were 19.7+/-6.9% in the athletes and 32.5+/-10.8% in control (p<0.001). 7) Ferritin was 14.5+/-10.0ng/ml in the athletes and 33.9+/-13.9ng/ml in controls (p<0.001). 8) The duration of exercise was 4.8+/-2.5 years in the stage III iron deficiency, whil 3.0+/-2.0 years in normal group in iron deficient state (p<0.05).
Adolescent* ; Athletes* ; Erythrocyte Count ; Female* ; Ferritins ; Gastrointestinal Tract ; Hematocrit ; Hematuria ; Humans ; Iron* ; Sweat ; Transferrin

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

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*

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: 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

BACKGROUND: Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid regurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. MATERIAL AND METHOD: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. RESULT: There were 43 cases of tricuspid annuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 10 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regurgitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p>0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. CONCLUSION: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent significant tricuspid regurgitation that may develop later.
Follow-Up Studies ; Heart Failure ; Heart Valve Diseases* ; Humans ; Medical Records ; Prognosis* ; Pulmonary Artery ; Stroke Volume ; Tricuspid Valve Insufficiency*

A 68-yr-old man complaining of sudden, postprandial chest pain visited the emergency room. His symptom had been aggravated during the preceding two days. Upper gastrointestinal contrast study with gastrographin showed leakage of dye from the epiphrenic diverticulum in the lower third of the esophagus. The primary repair was urgently carried out. Upper gastrointestinal contrast study 14 days after operation revealed an esophageal leakage which was small and confined. The patient was managed with conservative treatments such as intravenous hyperali-mentation and broad-spectrum antibiotics. Forty-two days after the operation, a gastrographin swallow study showed the absence of leaks. This is the first report-ed case of a perforated epiphrenic esophageal diverticulum repaired by delayed primary repair in Korea.
Aged ; Diverticulum, Esophageal/complications/*diagnosis/*surgery ; Esophageal Perforation/*diagnosis/etiology/*surgery ; Esophagectomy/*methods ; Humans ; Male ; Research Support, Non-U.S. Gov't ; Time Factors ; Treatment Outcome