BACKGROUND: The pediatric CPR is rather uncommon practice than adult CPR in emergency room. Therefore, few interest and studies were focused in pediatric CPR. The object of this study is to make an analysis about pediatric CPR performed within hospital setting. METHOD: From January 1. 1990 to December 31. 1996, a total of 59 patients, less than 15-year-old, who received cardiopulmonary resuscitation were subject of this study. The study was done retrospective chart analysis for sex, age, weight, the place of cardiac arrest, initial EKG rhythms, endotracheal tube size, the causes of arrest, CPR time, ROSC, the amount and types of CPR drugs used during resuscitation. Wilcoxon rank sum test and chi2 test were used to compare the dose of drugs during CPR in each group. RESULTS: There were no statistical difference between ROSC and non-ROSC group in place of arrest, initial EKG rhythms, CPR time, dosage of CPR drugs. CONCLUSION: The uniform reporting guideline of pediatric advanced life support should be used for future pediatric CPR study, such as Utstein style guideline in pediatric CPR.
Adolescent ; Adult ; Cardiopulmonary Resuscitation* ; Electrocardiography ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Resuscitation ; Retrospective Studies

In evaluating the early state of shock patients and their response to treatment, generally vital signs or additional hemodynamic values were used. Vital signs are easily obtained and repetitious values or continous monitoring is possible, whereas it cannot evaluate the patient's status properly nor is it a good prognostic factor. Meanwhile, additional hemodynamic values are obtained from pulmonary artery catheterization. But this procedure is difficult to proceed in the emergency room. Since central venous oxygen saturation has the advantage of being easily obtained and acts as a good prognostic factor for shock patients, we intended to prove its efficacy. From 1997 May to October, 50 patients admitted to Yonsei University Young Dong Severance Hospital in shock state, with systolic blood pressure below 90mmHg, were evaluated. Central venous catheter was inserted to obtain central venous oxygen saturation, serum lactate, base excess value, and its' initial value compared with the prognosis. The central venous oxygen saturation and base excess were low, while serum lactate value was high in the nonsurvival group. And in ROC(relative operating characteristic) curve, the AUC(area under curve) of central venous oxygen saturation was larger than the others. In comparing the MOF(multi-organ failure) group with the non-MOF group, the MOF group had a lower central venous oxygen saturation and base excess, and a higher serum lactate level, whereas in ROC curve, the AUC of base excess was larger than the others. Therefore, in estimating the prognosis of shock patients, the early central venous oxygen saturation proved to be a good prognostic factor.
Area Under Curve ; Blood Pressure ; Catheterization, Swan-Ganz ; Central Venous Catheters ; Emergency Service, Hospital ; Hemodynamics ; Humans ; Lactic Acid ; Oxygen* ; Prognosis ; ROC Curve ; Shock* ; Vital Signs

BACKGROUND: We designed this study to determine whether trauma history and initial assessment anticipate the injury severity of the free-fall patient. METHODS: Two hundred patients who admitted emergency department of Severance hospital because of the fall from a height were enrolled in this study. The height of fall, the body orientation, and the characteristics of impacted material, and the Injury Severity Score(ISS) were evaluated by retrospective chart reviews. And regression equations were determined for predicting ISS on the basis of clinical parameters using multiple regression analysis. RESULTS: According to the characteristics of impacted material, the ISS was higher in the hard surface(13.7+/-9.5) than the sort surface(10.5+/-8.8)(p<0.05). There were correlations between height of fall and ISS(p<0.01, r=0.5). To the body orientation, the ISS was higher in the head-to-feet orientation(18.211.7) than the feet-to-head(10.9+/- 7.0) or other position(8.5+/-5.8)(p<0.01). The regression equations were as follows, ISS=2 +0.082xage(year)-1.54x(Glasgow Coma Scale)-3x(feet-to-head orientation)+0.65x height of fall(m)+2.7 x (hand surface)(p<0.01, R2=0.53). CONCLUSION: This study suggest that the injury severity of patient with free fall are significancy related to the height of fall, the characteristics of impacted material and the body orientation.
Coma ; Emergency Service, Hospital ; Humans ; Retrospective Studies

We report two cases of proliferating trichilemmal cyst in a 61-ear-old woman and a 44-year-old woman who had a solitary tumor, on the left temporal area of the scalp and right flank, respectively. Histologically, the tumors were localized in the dermis and corisised of multilobulated cysts. The cyst walls were composed of liquamous epithelium showing trichilemmhl keratinization. Some of the cells had clear cytoplasm and were positive on PAS staining. Individiial cell keratinization, mild nuclear atypia were also found in the cyst walls. For the treatment, surgical excision was performed with sufficiert margin.
Adult ; Cytoplasm ; Dermis ; Epithelium ; Female ; Humans ; Scalp

BACKGROUND: The efficiency of lipid extraction by different kinds of solvents from stratum corneum may vary. OBJECTIVE: To assess the efficiency of lipid extraction by several solvents from the stratum corneum, the total lipids weights were measured by an electronic microbalance, and lipids compositions of a stratum corneum were analyzed by thin layer chromatography(TLC) after pretreatment of several solvents, respectively. METHODS: Stratum corneums separated fro circumcised prepuce were pretreated with acetone, petroleum ether, or distillecl water for 10 minutes. Lipids of stratum corneum were extracted with methanol chlorofonn-H,O mixture(4: 2: 1.6, v/v, Bligh Dyer solvent). Lipids weights were weighed, and the ratio of lipid weight and wet weight of stratum corneum were measured. TLC was performed and lipids compositions were quantitated by photodensitometer. Lipids extraction in viva was performed on both forearms. After two times stripping with sellotape, lipids were extrected with the solvents using cup method. These were dried and lipids weights were weighed. RESULTS: The efficiency of lipid extraction from the stratum corneum of circumcised prepuce were acetone, petroleum e1 her, and distilled water in decreasing order. All groups were similar in the compositions of the stratum corneum lipids except for those of cholesterol esters and sphingolipids. The efficiency of lipid extraction from in vivo skin were ranked in order from petroleurn ether, acetone, down to distilled water. The efficiency of lipid extraction of petroleum ether and acetone were higher than that of distilled water. CONCLUSION: The efficiency of lipid extraction is influenced by the kinds of solvents as well as the materials and the methods of extraction.
Acetone ; Cholesterol Esters ; Ether ; Forearm ; Methanol ; Petroleum ; Skin ; Solvents* ; Sphingolipids ; Water ; Weights and Measures

Meralgia paresthetica is a syndrome consisting of numbness, pain, tingling, burning and/or a variety of other paresthesias on the distribution of the lateral femoral cutaneous nerve (LFCN) of the thigh. We report a case of meralgia paresthetica in a 41-year-old woman who complained of the symptoms of pain, burning sensation, and dysesthesia which occurred whilst standing up without any other constitutional symptoms. The authors suspect that frequent. and persistent squatting may play a role in the development of the present symptoms.
Adult ; Burns ; Female ; Humans ; Hypesthesia ; Paresthesia ; Sensation ; Thigh

PURPOSE: Apoptosis is a process of active cell death which has been suggested to be part of hippocampal cell loss caused by kainic acid (KA). Immature rats showed higher susceptibility and mortality to KA but did not develop recurrent seizure, long term behavioral or neuropathologic changes. We investigated whether this was due to age-dependent resistance, and elucidated the molecular mechanics which mediate P53-induced apoptosis, identifying bax and bcl-2 as P53 protein expressions that serve as a paradigm on how the balance of bcl-2 to bax is differentially altered by apoptotic stimuli. METHODS: Sprague-Dawley rats were classified into postnatal age (P) 10, 15, 20 and 30 days and given specific doses of i.p. KA (P10; 3mg/kg, P15; 4mg/kg, P20; 8mg/kg, P30; 10mg/kg). Only rats that achieved continuous clonic seizure were selected and decapitated at 24, 48, and 72h (n=15 each age). We analysed P53, bax and bcl-2 protein expressions by immunohistochemistry as well as apoptosis by TUNEL in each group. RESULTS: KA-induced hippocampal cell death first appeared in P20. Remarkable expressions of apoptosis, P53 and bax, while bcl-2 proteins were suppressed were observed at 48 hours following KA in P20 and the most prominently affected areas were hippocampal CA1 and CA3 neurons. Similar results were obtained in P30. CONCLUSOIN: A Induction of P53, a growth regulatory gene which has been implicated in apoptosis and the changes in bcl-2 to bax ratio may be important to KA mediated excitotoxicity of specific regions during the critical period of developing rat brain.
Animals ; Apoptosis* ; Brain ; Cell Death ; Critical Period (Psychology) ; Genes, Regulator ; Hippocampus* ; Immunohistochemistry ; In Situ Nick-End Labeling ; Kainic Acid ; Mechanics ; Mortality ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Seizures*

BACKGROUND: The penetraton in vivo of topically applied substances can be assessed by physiological or pharmacalogical signs or analysed by chemical or histological techniques. In vitro absorption can be commonly quantitated by measuring the passage of a radioisotope-labelled substance across skin that has been mounted in a diffusion chamber. OBJECTIVE: Fluorescence polarization immunoassay technique has made the possible rapid growth of therapeutic drug nonitoring. We applied this methodology in measuring percutaneous absorption in a diffusion chamber. METHODS: We utilized sheets of whole epidermis prepared from the circumcised prepuce. Some epidermal sheets were treated with 2 ml of acetone for 2 minutes, and others not. The epidermal sheet was mounted in a diffusion chamber between the donor compartment for the penetrant and the receptor compartment containing saline. Lidocaine HC1(10 microgram/cm2) in vehicle(propylene glycol:ethanol; 7:3, vol/vol) was applied to the donor compartment for the penetrant. With flow rate of about 3 ml/h all of the receptor phase collected during 2 hours interval were quantitated for 10 hours by the fluorescence polarization immunoassay. RESULTS: Total absorption of lidocaine HC1 in the acetone-untreated group was 2.14+/-0.74% of the applied dose. Total absorption in the acetone-treated group showed no substantial difference (2.09+/-1.25%) compared to those of acetone-untreated group. The amount of lipid extracted from a epiderrnal sheet with acetone was 19+/-2.97%. CONCLUSION: Fluorescence polarization immunoassay may be a useful method in measuring percutaneous absorption in vitro.
Absorption ; Acetone ; Diffusion* ; Epidermis ; Fluorescence Polarization Immunoassay* ; Fluorescence Polarization* ; Fluorescence* ; Histological Techniques ; Humans ; Lidocaine ; Skin ; Skin Absorption* ; Tissue Donors

BACKGROUND: Atopic dermatitis and urticaria are relatively common dermatologic diseases and several reports on skin prick test reactivity have been presented in Korea. However, there has not been any report on the skin prick test reactivity of Chuncheon and the Northern Kangwon Province. OBJECTIVE: This study was done for the evaluation of correlation of the skin prick test reactivities, peripheral blood eosinophils, and total serum IgE levels in 143 patients with urticaria and 107 patients with atopic dermatitis in Chuncheon and the Northern Kangwon Province. METHODS: We performed the skin prick test with 85 allergens and the evaluations of peripheral blood eosinophils and total serum IgE levels in 250 patients at the department of dermatology in Chuncheon Sacred Heart Hospital, Hallym University during a 4-Year-Period from Aug. 1995 to Aug. 1999. RESULTS: 1.In the patients with urticaria, the sex ratio of male to female of 143 patients was 1:1.6, and third and sixth decades occupied 39% in male patients, and forth and fifth decades occupied 44% in female patients. In the patients with atopic dermatitis, the sex ratio of male to female of 107 patients was 1:1.1, and third decade occupied 47% in male patients and 42% in female patients. 2.Monthly peak incidence was July in the patients with urticaria(P<0.05) and August in the patients with atopic dermatitis(P>0.05), and seasonal analysis was statistically insignificant(P>0.05). 3.The positive reactivities to allergens in the patients with urticaria and atopic dermatitis were 60.8% and 69.2%, respectively. 4.In the patients with urticaria, the skin prick test reactivities to allergens were D. farinae(28.7%), D. pteronissnus(25.9%), cultivated maize pollen(18.2%), hay dust(13.3%), threshings(9.1%) in decreasing order, whereas in the patients with atopic dematitis; D. pteronissnus(43.9%), D. farinae(41.9%), ugwort pollen(15.9%), cultivated maize pollen(13.1%), cat fur(12.1%). When our study results were compared with previous reports from other regions in Korea, cultivated maize pollen revealed relatively high positive reactivity in the skin prick test. 5. In the patients with urticaria and atopic dermatitis, increase of peripheral blood eosinophil were encountered in 16.8% and 38.7%, respectively, but statistically significant difference of peripheral blood eosinophil between the prick test-positive group and prick test-negative group was not observed in both patients with urticaria and those with atopic dermatitis. 6. In the patients with urticaria and atopic dermatitis, increase of total serum IgE levels were encountered in 64.2% and 70%, respectively. Statistically significant difference of total serum IgE levels between the prick test-positive group and the prick test-negative group was observed in the patients with urticaria. CONCLUSION: The results of our study were similar to those of reports from other regions in Korea, except for higher reactivity of skin prick test to cultivated maize pollen. The difference of reactivity of skin prick test to cultivated maize pollen between our study and others is thought to be due to the regional characteristic of Chuncheon and the Northern Kangwon Province. But the difference of results between patients with atopic dermatitis and normal persons in Chuncheon and the Northern Kangwon Province is not statistically significant.
Allergens ; Animals ; Cats ; Dermatitis, Atopic* ; Dermatology ; Eosinophils* ; Female ; Gangwon-do* ; Heart ; Humans ; Immunoglobulin E* ; Incidence ; Korea ; Male ; Pollen ; Seasons ; Sex Ratio ; Skin ; Urticaria* ; Zea mays

PURPOSE: To identify the necessity of more reasonable diagnostic criteria and the possibility of early prediction of coronary involvement in the higher risk group, we investigated and compared clinical and laboratory findings in the acute phase and coronary involvements in those younger (n=17) and older(n=53) than one year of age in Kawasaki disease(KD). METHODS: Retrospective chart reviews were performed on 70 patients with KD who were admitted to the Chung-Ang University Hospital from April 1997 to May 2001. RESULTS: Male were significantly higher in the younger age group(M : F ratio 3.3 : 1 vs. 1.0 : 1, P=0.004). Fever durations before intravenous immunoglobulin(IVIG) and echocardiography were significantly shorter in the younger group(4.6+/-1.3 vs. 6.2+/-2.5, P=0.004 vs. 0.01, respectively). Cases meeting typical diagnostic criteria were significantly less in the younger group(P=0.006). In the laboratory findings, serum albumin, BUN and K+ levels in the acute febrile phase were significantly higher in the younger group(P=0.002, 0.006, <0.001, respectively) and incidences of coronary artery dilatation in the acute phase were significantly higher in the younger group(P=0.01). CONCLUSION: Although less met the typical diagnostic criteria of KD, infants younger than one year of age are more susceptible to coronary artery change in the acute febrile phase. Therefore, KD should be entertained as a diagnostic possibility in young infants with prolonged fever without distinct fever focus, and echocardiography should be considered as part of the evaluation of these patients, and then early diagnosis and prompt IVIG should be conducted.
Coronary Vessels ; Dilatation ; Early Diagnosis ; Echocardiography ; Fever ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies ; Serum Albumin