Mass casualty disasters have complex communication requirement. The involvement of many different communication systems and agencies and the difficulty of exchanging information between them is a perplexing problem. This may be compounded by telecommunication systems overload or failure, and electric service disruptions in the disaster area. In addition, emergencies are characterized by a sudden need for an increased information flow, an explosion in the topographical complexity of the information network, and a feeling of intense psychological pressure among the participants. The rescue, treatment, evacuation of a lot of patients from a natural disaster or mass casualties must be performed in accordance to several national agencies. Without an effective communication system, morbidity and mortality will needlessly rise. The stabilization and evacuation off lot of patients in a disaster is a serious and complex medical problem that must be resolved expeditiously. The potential far maximizing care depends on an well-organized rescue. However, without adequate communications, the patient may experience needless delays into the health care system an6 thus compromise prognosis. Established communication systems in most communities consist of private services, provincial and national agencies, and military and amateur radio operator. A disaster situation can severely disrupt routine telephone and radio communication. Customary frequencies may be incompatible with military and emergency civilian frequencies or become overloaded and useless because of intense activity. In a disaster, local telephone communication resources may be destroyed: qualified staffing of communications networks may be inadequate or unavailable to cope with the demands of the emergency. So, we recommend, that Amateur Radio should be provide as a effective emergency communication in a disaster.
Delivery of Health Care ; Disasters* ; Emergencies* ; Explosions ; Humans ; Information Services ; Mass Casualty Incidents ; Military Personnel ; Mortality ; Prognosis ; Telecommunications ; Telephone

Congenital hypopituitarism is a rare disorder with absence or reduction of hormones produced by the pituitary gland. The clinical manifestations are hypoglycemia, prolonged jaundice, hyponatremia, micropenis, underdeveloped clitoris, lethargy, convulsion, pallor, cyanosis, apnea, hypotension, temperature instability etc. in neonates and growth failure, delayed or absent puberty in older infants and children. We experienced a case of congenital hypopituitarism who was a 20-year-old male patient with short stature and delayed puberty. Combined pituitary function test revealed panhypopituitarism and magnetic resonance imaging of brain showed anterior pituitary aplasia and ectopic posterior pituitary gland.
Adolescent ; Apnea ; Brain ; Child ; Clitoris ; Cyanosis ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Infant ; Infant, Newborn ; Jaundice ; Lethargy ; Magnetic Resonance Imaging ; Male ; Pallor ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Gland, Posterior* ; Puberty ; Puberty, Delayed ; Seizures ; Young Adult

Congenital hypopituitarism is a rare disorder with absence or reduction of hormones produced by the pituitary gland. The clinical manifestations are hypoglycemia, prolonged jaundice, hyponatremia, micropenis, underdeveloped clitoris, lethargy, convulsion, pallor, cyanosis, apnea, hypotension, temperature instability etc. in neonates and growth failure, delayed or absent puberty in older infants and children. We experienced a case of congenital hypopituitarism who was a 20-year-old male patient with short stature and delayed puberty. Combined pituitary function test revealed panhypopituitarism and magnetic resonance imaging of brain showed anterior pituitary aplasia and ectopic posterior pituitary gland.
Adolescent ; Apnea ; Brain ; Child ; Clitoris ; Cyanosis ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Infant ; Infant, Newborn ; Jaundice ; Lethargy ; Magnetic Resonance Imaging ; Male ; Pallor ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Gland, Posterior* ; Puberty ; Puberty, Delayed ; Seizures ; Young Adult

The usefulness of two-dimensional echocardiography to measure the right ventricular volume was assessed in 58 normal children (mean age 5 years and 3 months). From the apical 4-chamber view (A4CV), the subcostal RV sagittal view (SCRVSV), the subcostal right anterior oblique view (SCRAOV), and the subcostal RV coronal view (SCRVCV), the dimensions and areas of the right ventricle were measured. The right ventricular volumes and ejection fractions were calculated from these data by pyramid model and single plane area/length method. We could obtain subcostal right ventricular sagittal view in 98%, apical 4-chamber view in 90%, subcostal right anterior oblique view in 79%, and subcostal right ventricular coronal view in 71% of our children. The areas and dimensions correlated with all growth indices, such as age, height, weight, and body surface area. In general the areas showed higher correlation with body surface area, and dimensions with height. correlations of parameters obtained from the subcostal right anterior oblique view and subcostal right ventricular sagittal view with the growth indices were better than those of the subcostal right ventricular coronal view. The calculated right ventricular volume and ejection fraction showed a great varibility depending on the model used. The right ventricular volume calculated by pyramid model correlated better with the growth indices than that by single plane area/length method. the right ventricular volume calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model is the model which showed the best correlation with growth indices. Right ventricular ejection fraction did not change with any growth indices. Among the right ventricular volumes and ejection fractions by single plane area/length method, the volume(59.9+/-29.9 ml/m(2)) and ejection fracton (58.7+/-10.9%) from the subcostal right anterior oblique view were similar to those (51.0+/-17.3ml/m(2), 51.3+/-10.2%) calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model. The subcostal right anterior oblique view reflects three parts of the right ventricle. Its area and dimension are well correlated with growth indices. Also the right ventricular volume and ejection fraction obtained by single plane area/length method using the subcostal right anterior oblique view correlate with the growth indices. Therefore the subcostal right anterior oblique view is the most valuable single view representing the right ventricle.
Body Surface Area ; Child* ; Echocardiography* ; Heart Ventricles ; Humans ; Stroke Volume

No abstract available.
alpha-Fetoproteins* ; Humans ; Infant* ; Infant, Newborn*

Using the 15 strains of Vibrio eulnificus isolated from the blood and tissue fluid of the patients with primary septicemia, cultural characteristics were studied on various media. The media to be used in culturing Vibrio vulnificus should contain sodium chloride, because it could not survive on the media without NaCl. The organism grew poorly or not at all on the media with eosin-y, methylene blue, crystal violet, or azide, because these substances suppress its growth. Vibrio vulnificus grew well in the enrichment media such as brain heart infusion, tryptic soy broth, and nutrient broth with 0. 5% NaCl.
Brain ; Cultural Characteristics* ; Gentian Violet ; Heart ; Humans ; Methylene Blue ; Sepsis ; Sodium Chloride ; Vibrio vulnificus* ; Vibrio*

Ischemia causes tissue necrosis in a wide variety of pathologic conditions. Permanent deprivation of blood flow is lethal to any tissue and the prudent therapy for ischemia unquestionably is reperfusion. While reperfusion is necessary to reverse the progression towards ischemic death, reperfusion is also thought to be accompanied by its own component of injury. Oxygen free radicals, formed during ischemia/reperfusion, have been proposed as one of the main causes of reperfusion injury. Free radical attacks on biological membrane, such as mitochondria and endoplasmic reticulum, and can lead to the oxidative destruction of the polyunsaturated fatty acids of the membranes through lipid peroxidation. However, direct association between microsomal lipid peroxidation in vivo after ischemia/reperfusion and changes in secretory function and drug metabolism on the liver have not been established. Therefore, present study was performed to evaluate the hepatic secretory function and the hepatic microsomal drug metabolizing enzyme activity after ischemia/reperfusion preparation in rat liver. Further, the effect of oxygen free radical scavengers was investigated. The animals were divided into sham operation group and ischemia/reperfusion group. The ischemia/reperfusion group was subdivided into non-treated control and treated (with superoxide dismutase, allopurinol, alpha-tocopherol, deferoxamine) groups. Hepatic ischemia was produced by clamping the left branches of portal vein and hepatic artery, resulting in complete ischemia to the median and left lobes while the right lobes remained per Fused to prevent intestinal congestion. Reperfusion was permitted by declamping after 1 hour. After 1 or 5 hours of reperfusion, bile was collected, blood was obtained from abdominal aorta, and liver microsomes were isolated. The results are as follows. Serum aminotransferase was increased 15~20 times by ischemia/reperfusion. However, this increase was attenuated by free radical scavengers, especially 5 hours of reperfusion. The wet weight-to-dry weight ratio of the liver was significantly increased by ischemia/reperfusion. alpha-tocopherol pretreatment minimized the increase of ratio. Malondialdehyde level in the liver microsomal fraction was significantly increased after ischemia/reperfusion, but this increase was attenuated by scavenger pretreatment, especially alpha-tocopherol. Bile flow and cholate output but not the bilirubin output, were decreased after ischemia/reperfusion. The free radical scavenger pretreahnent restored the secretion significantly. Cytochrome P-450 content was significantly decreased after ischemia/reperfusion and ameliorated by free radical scavenger pretreatment. NADPH cytochrome P-450 reductase activity and aminopyrine N-demethylase activity were also decreased and improved by free radical scavengers pretreatment. These results indicate that ischemia/reperfusion deteriorates the hepatic secretory function as well as hepatic microsomal drug metabolizing enzyme activity, and the oxygen free radical scavengers attenuate the functional changes of the liver induced by ischemia/reperfusion.
Allopurinol ; alpha-Tocopherol ; Aminopyrine N-Demethylase ; Animals ; Aorta, Abdominal ; Bile ; Bilirubin ; Cholates ; Constriction ; Cytochrome P-450 Enzyme System ; Endoplasmic Reticulum ; Estrogens, Conjugated (USP) ; Fatty Acids, Unsaturated ; Free Radical Scavengers ; Free Radicals ; Hepatic Artery ; Ischemia ; Lipid Peroxidation ; Liver ; Malondialdehyde ; Membranes ; Metabolism* ; Microsomes, Liver ; Mitochondria ; NADPH-Ferrihemoprotein Reductase ; Necrosis ; Oxygen ; Portal Vein ; Rats* ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase

No abstract available.
Clubfoot*

Epidermolysis bullosa dystrophica is rare, chronic non-inflammtory mechanobullous disease of hereditary trait, which easily produces bullae by minor trauma or sponta neosly. A 1-day old male neonate presented wide spread vesicobullous minor, eruptions since birth. On examination, tense bullse were noted on the dorsa of the feet and right knei: area Which is usually serous but may be hemarrhagic tendeney. This was healed by the dropping of oxoline and wet betadine auze application along with the administration of vitamin E and phenytoin. We present a case of epidermolysis bullosa dystrophica that seems be a dominant type considering the presence of family history with histopathologic and electron microscopic findings.
Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa* ; Foot ; Humans ; Infant, Newborn ; Male ; Parturition ; Phenytoin ; Povidone-Iodine ; Transcutaneous Electric Nerve Stimulation ; Vitamin E ; Vitamins

No abstract available.
Splints* ; Sterilization, Tubal*