No abstract available.

No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

No abstract available.

No abstract available.

PURPOSE: This study was performed to improve cardiopulmonary resuscitation(CPR) training strategies for occupational groups, through the analysis of first responders' characteristics, knowledge and attitudes concerning CPR. METHODS: The occupational groups expected to have some training on rescue and emergency care in Korea were regarded as the first responders. In particular, this study focused on nurse-teachers, traffic policemen, and industrial safety supervisors, taxi drivers and restaurant workers as potential first responders, clerical workers comprised the control group. The subjects were given a questionnaire to answer over the internet. RESULTS: First responders' knowledge on CPR was significantly higher than that of the control group. First responders' attitude on CPR was more affirmative compared with the control group. In first responder group, nurse-teachers, traffic policemen and industrial safety supervisors had a higher fund of knowledge and more positive attitudes when compared to taxi drivers and restaurant workers. CONCLUSION: More training for first responders in CPR and emergency care is required given the likelihood of medical emergencies arising while on duty. Taxi drivers and restaurant workers' knowledge on CPR were found to be inadequate based on our survey questionnaire. Thus, it is necessary to strengthen CPR training for these individuals and groups.
Cardiopulmonary Resuscitation* ; Emergencies ; Emergency Medical Services ; Financial Management ; Humans ; Internet ; Korea ; Occupational Groups ; Surveys and Questionnaires ; Restaurants

BACKGROUND: The purpose of this study was to evaluate whether physicians' practice was adequate for the diagnosis and treatment of osteoporosis in patients with proximal humeral fracture over the age of 50 years, which is one of major osteoporotic fractures. METHODS: A retrospective nation-wide cohort study was performed using data collected in 2010 by the Korean Health Insurance Review Agency. The incidences of fractures around the hip, spine, and proximal humerus in patients more than 50 years of age, the frequencies of diagnostic bone density scan for osteoporosis, and the prescription for the osteoporosis medication were analyzed and compared. RESULTS: A search of database identified 48,351 hip fractures, 141,208 spine fractures, and 11,609 proximal humeral fractures in patients more than 50 years of age in 2010. Among these patients, 12,097 (25.0%) of hip fractures, 41,962 (29.7%) of spine fractures, and 1,458 (12.6%) of proximal humeral fractures underwent diagnostic bone density scan (p < 0.001); 4,773 (9.9%) of hip fractures, 27,261 (19.3%) of spine fractures, and 639 (5.5%) of proximal humeral fractures were managed with at least one medication approved for the treatment of osteoporosis (p < 0.001). Furthermore, 1,217 (2.5%) of hip fractures, 7,271 (5.2%) of spine fractures, and 188 (1.6%) of proximal humeral fractures received diagnostic bone density scans as well as osteoporosis medications (p < 0.001). Younger patients (50–69 years of age) were less likely to be evaluated and managed for osteoporosis relative to older patients (≥ 70 years of age) (p < 0.001); and men were less likely to be evaluated and managed for osteoporosis relative to women (p < 0.001). CONCLUSIONS: Current physicians' practice pattern may be inadequate for the diagnosis and treatment of osteoporosis in patients of proximal humeral fractures over the age of 50 years. Additional study and educational programs are necessary to improve this care gap, beginning with physicians who are responsible for the fracture treatment and shoulder diseases.
Aged ; Bone Density ; Bone Density Conservation Agents/therapeutic use ; Female ; Humans ; Male ; Middle Aged ; *Osteoporosis/complications/diagnosis/drug therapy/epidemiology ; Retrospective Studies ; Shoulder Fractures/*complications/*epidemiology

Severe acute respiratory distress syndrome (ARDS) is a life-threatening disease with a high mortality rate. Although many therapeutic trials have been performed for improving the mortality of severe ARDS, limited strategies have demonstrated better outcomes. Recently, advanced rescue therapies such as extracorporeal membrane oxygenation (ECMO) made it possible to consider lung transplantation (LTPL) in patients with ARDS, but data is insufficient. We report a 62-year-old man who underwent LTPL due to ARDS with no underlying lung disease. He was admitted to the hospital due to influenza A pneumonia-induced ARDS. Although he was supported by ECMO, he progressively deteriorated. We judged that his lungs were irreversibly damaged and decided he needed to undergo LTPL. Finally, bilateral sequential double-lung transplantation was successfully performed. He has since been alive for three years. Conclusively, we demonstrate that LTPL can be a therapeutic option in patients with severe ARDS refractory to conventional therapies.
Extracorporeal Membrane Oxygenation ; Humans ; Influenza, Human* ; Lung Diseases ; Lung Transplantation* ; Lung* ; Middle Aged ; Mortality ; Pneumonia* ; Respiratory Distress Syndrome, Adult*

PURPOSE: The purpose of this study was to assess the usefulness of CT angiography(CTA) with spiral CT in evaluation of intracranial vascular lesions. MATERIALS AND METHODS: CTA and conventional angiography(CA) were performed in 22 patients with suspected intracranial vascular lesion. Nine patients had 10 aneurysms and 2 patients had arteriovenous malformation(AVM)s, while the remaining 11 patients had no vascular lesion. Twenty seconds after beginning injection of contrast media(100 mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second continuous exposure and 60-mm length) was performed with a table speed of 2mm/sec and a section thickness of 2mm. The starting point was selected at the floor of the sella turcica. The resulting data were reformatted by MIP and SSD after reconstruction of 1 mm interval. For aneurysm, its size, shape, direction, neck and the relationship to adjacent vessels were compared to CA. RESULTS: The aneurysm diameter was ranged between 3mm and 20mm and all aneurysms were clearly visualized with CTA. CTA findings of the size, shape, direction, and neck of aneurysms and the relationship between aneurysm and adjacent vessels were well correlated with CA. In one case of aneurysm, calcification of the aneurysm wall was demonstrated on CTA. In one case of AVM, the nidus and its arterial supply and venous drainage were well visualized. In the other case of AVM, however, the feeding artery of AVM was not demonstrated on CTA(it was also unclear on CA). CONCLUSION: CTA with spiral CT may be useful in the evaluation of intracranial vascular lesion and valuable as a screening test for intracranial aneurysm.
Aneurysm ; Angiography* ; Arteries ; Drainage ; Humans ; Intracranial Aneurysm ; Mass Screening ; Neck ; Sella Turcica ; Silver Sulfadiazine ; Tomography, Spiral Computed*

PURPOSE: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. METHODS: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. RESULTS: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under- developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imipramin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. CONCLUSIONS: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.
Child ; Cognition ; Deamino Arginine Vasopressin ; Enuresis ; Fertilization ; Humans ; Nocturnal Enuresis ; Physicians, Primary Care ; Primary Health Care ; Surveys and Questionnaires ; Urinary Bladder

BACKGROUND: Thoracoscopic sympathicotomy is an effective treatment in essential hyperhidrosis. However,many patients suffer from compensatory hyperhidrosis. Compensatory hyperhidrosis is avery uncomfortable problem,but the mechanisms underlying compensatory hyperhidrosis are not completely understood. MATERIAL AND METHOD: From May 1999 to June 2001,25 cases of thoracoscopic sympathicotomy at the 2nd rib for facial hyperhidrosis and 116 cases of thoracoscopic sympathicotomy at the 3rd rib for palmar hyperhidrosis were performed in 141 patients.All of the patients were divided into noncompensatory sweating(NCS)and compensatory sweating(CS)group.Each group was investigated according to age,sex,body surface area(BSA), level of sympathicotomy and occupation. RESULT: The global rate of compensatory hyperhidorsis were 64.5%(91/141).There was no difference between the two groups for BSA,level of sympathicotomy and occupation.Mean age showed 23.2 years old in NCS group and 26.4 years old in CS group(p=0.09).In CS group,46 cases were male(50.5%)and 45 cases were female(49.5%)and in NCS group,19 cases were male(38.0%)and 31 cases were female(62.0%) (p=0.16). CONCLUSION: There were no available statistical data,but there was the fact that old age and male patients had the tendency for compensatory hyperhidrosis.If we have more patient group and consider the patient's family history or psychiatric pr obl ems ,we will have mor evaluable data for compensatory hyperhidrosis.
Humans ; Hyperhidrosis* ; Male ; Occupations ; Ribs