No abstract available.
Humans

No abstract available.
Humans

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation

Prediction of individual outcome after cardiopulmonary resuscitation is of major medical, ethical, and socioeconomic interest but uncertain. We experienced the case thats the patient got complete neurologic recovery after the 123th day firm cardiac arrest, who had been suspected to go with poor prognosis because she got the findings of Glasgow Coma Scale 4, severe diffuse encephalopathy on encephalogram and generalized tonic-clonic seizure at the 4th day. Recently, a 29 year-old women who sustained from respiratory arrest induced presumably by sedative and anticonvulsant therapy for control of seizure that happened during local lidocaine anesthesia far mamoplasty was transfered to our emergency medical center from local private plastic office. Arrest time was about 20 minutes. On hospital arrival, she had a pulseless bradyasystole and no respiration, but spontaneous circulation was restored at 10 minutes artier CPR started. We started cerebral oriented resuscitation including mild hypothermia(34degrees C), hemodilution, calcium channel blocker infusion. On hospital day 4, patient's glasgow coma scale(GCS) was 4. On hospital clay 7, Brain Magnetic Resonance Imaging(MRI) showed high signal intensity on T2WI, involving the bilateral basal ganglia. After contrast administraton, marked enhancement can be seen at the lesion site. Patient's glasgow coma scale(GCS) increased step by step to 5 on 8th day, 7 on 14th day, 10 on 15th day, 13 on 17th day, 15 on 20th day. 40 days later the patient was discharged with minor neurologic abnormality including hand tremor, dysphonia, amenorrhea and Mini Mental State Examination(MMSE) score(26). Long-term Follow up revealed that all neurologic functional abnormality inducting hand tremor, dysphonia, amenorrhea and MMSE score(26) is completely recovered on 123th day after episode of cardiopulmonary arrest.
Adult ; Amenorrhea ; Anesthesia ; Basal Ganglia ; Brain ; Calcium Channels ; Cardiopulmonary Resuscitation ; Coma ; Dysphonia ; Emergencies ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Hand ; Heart Arrest* ; Hemodilution ; Humans ; Hypoxia-Ischemia, Brain* ; Lidocaine ; Plastics ; Prognosis ; Respiration ; Resuscitation ; Seizures ; Tremor

The SGO-T and SGP-T values were studied among 19 non-biliary surgical patients for control and 21 biliary tract surgical patients from Feb. to August 1969 in Chung Nam Medical Centor. The results obtained are as follows: 1. The SGO-T and SGP-T evels in the non-biliary surgical patients was in the normal range during pre-operative and postoperative days. 2. In patients with biliary disease SGO-T and SGP-T level were high beyond normal range on the pre-operative day. On the 1st postoperative day, these values were more elevated about 20 % and 11 %, respectively, but decreased gradually on the second and third postoperative days. 3 In biliary patients, the values were lower than pre-operative level on the 3rd postoperative day. On the other hand, values had not dropped to pre-operative level on the 3rd postoperative day in non-biliary patients.
Alanine Transaminase* ; Biliary Tract ; Hand ; Humans ; Reference Values

No abstract available.
Enterotoxigenic Escherichia coli* ; Enterotoxins*

Retinal detachment is a rare and unusual complication of preeclampsia. In 6,194 consecutive deliveries from January 1987 to July 1990 at the Soonchunhuang University Hospital, pregnancy induced hypertension was diagnosed in 223 patients(3.6%), and in 11 cases serous retinal detachment occured. We studied retrospectively the incidence, clinical characteristics and pathophysiology of the retinal detachment in the pregnany induced hypertension. The results were as follows: 1. Retinal detachment was serous type and mostly bilateral(90.9%). 2. Retinal detchment occured principally in primigravid(63.64%). 3. Serotts retinal detachment occured in 11 cases in 6,194 consecutive diliveries(0.18%) with 9 cases in 211 preeclampsia(4.27%) and 2 cases in 12 eclampsia(17.67%). 4. Reattachment of the retina occured at an interval of 7 to 29 days with an average interval of 14 days after delivery. 5. The fluorescein angiographic findings provide clinical evidence that retinal detachment in pregnancy induced hypertension is secondary to choroidal damage.
Choroid ; Female ; Fluorescein ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Pre-Eclampsia ; Pregnancy* ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies

Retinal detachment is a rare and unusual complication of preeclampsia. In 6,194 consecutive deliveries from January 1987 to July 1990 at the Soonchunhuang University Hospital, pregnancy induced hypertension was diagnosed in 223 patients(3.6%), and in 11 cases serous retinal detachment occured. We studied retrospectively the incidence, clinical characteristics and pathophysiology of the retinal detachment in the pregnany induced hypertension. The results were as follows: 1. Retinal detachment was serous type and mostly bilateral(90.9%). 2. Retinal detchment occured principally in primigravid(63.64%). 3. Serotts retinal detachment occured in 11 cases in 6,194 consecutive diliveries(0.18%) with 9 cases in 211 preeclampsia(4.27%) and 2 cases in 12 eclampsia(17.67%). 4. Reattachment of the retina occured at an interval of 7 to 29 days with an average interval of 14 days after delivery. 5. The fluorescein angiographic findings provide clinical evidence that retinal detachment in pregnancy induced hypertension is secondary to choroidal damage.
Choroid ; Female ; Fluorescein ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Pre-Eclampsia ; Pregnancy* ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies

OBJECTIVE: To analyze the interrelationship between homocysteine and methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: Homocysteine and MTHFR mutation were tested by fluorescent polarizing immunoassay and PCR-RFLP method, respectively. RESULTS: In patients with homocysteine level less than 5 mmol/L, there was no case of normal group but there were four cases of heterozygosity and one case of homozygosity. In patients with homocysteine level 5~10 mmol/L, the number of normal, heterozygosity and homozygosity group were eleven, eighteen and eight, respectively. In patients with homocysteine level 10~15 mmol/L, the number of normal, heterozygosity and homozygosity group were four, one and one, respectively. In patients with homocysteine level more than 15 mmol/L, there was no case of normal and heterozygosity group but there were two cases of homozygosity. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. And there was a significant relationship between homocysteine and MTHFR mutation.
Abortion, Spontaneous* ; Female ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

OBJECTIVE: To evaluate luteinizing hormone(LH) in patients with infertility and recurrent spontaneous abortion. MATERIAL AND METHOD: LH was tested by solid phase immunoradiometric assay based on monoclonal and polyclonal anti-LH antibodies. RESULTS: Of 100 infertile patients, the number of less than 5 mIU/ml, 5~10 mIU/ml, greater than 10 mIU/ml in LH level was 67(67%), 22(22%), 11(11%), respectively. Of 100 patients with recurrent spontaneous abortion, the number of less than 5 mIU/ml, 5~10 mIU/ml, greater than 10 mIU/ml in LH level was 79(79%), 18(18%), 3(3%), respectively. There was a significant difference between patients with infertility and recurrent spontaneous abortion only in the group with LH level greater than 10 mIU/ml(p=0.325). CONCLUSIONS: High LH in the follicular phase is known to decrease pregnancy rate and increase abortion rate. But in this study the incidence of high LH in patients with recurrent spontaneous abortion was low. On the contrary, there was a significant increase of LH in infertile patients. So recurrent spontaneous abortion does not seem to be related to high LH level.
Abortion, Induced ; Abortion, Spontaneous* ; Antibodies ; Female ; Follicular Phase ; Humans ; Immunoradiometric Assay ; Incidence ; Infertility* ; Lutein* ; Luteinizing Hormone* ; Pregnancy ; Pregnancy Rate