No abstract available.
Emergencies* ; Emergency Service, Hospital*

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Violence*

Pityriasis rotunda is characterized by perfectly circular to oval brownish scaly patch on the trunk and extremities. This disease is considered to be a form of acquired ichtkyosis of unknown etiology and develops usually in association with certain systemic diseases, such as tuberculosis, malignant neoplasrn, leprosy, ovarian cyst and uterine myoma etc, We experienced 2 cases of pityriasis rotunda on the abdomen, chest and back associated with liver cirrhosis in 66 year old man 43 year old woman and clinical presentation was made with review of related literatures.
Abdomen ; Adult ; Aged ; Extremities ; Female ; Humans ; Leiomyoma ; Leprosy ; Liver Cirrhosis* ; Liver* ; Ovarian Cysts ; Pityriasis* ; Thorax ; Tuberculosis

BACKGROUND: Ketamine use in emergency room has been increased. It has rapid onset of action and appropriate duration of action. It does not need endotracheal intubation and produces potent analgesia, sedation, and amnesia. The object of this study is to determine the safety and the degree of physician's satisfaction in relation to ketamine use. MATERIALS AND METHODS: This is a prospective study using protocol. Pediatric trauma patients who need sedation were given IM ketamine(4mg/kg) and atropine(0.01mg/kg) in a same syringe. Monitoring of patients was done by EM residents and complications of ketamine use were recorded. Physician's satisfaction was also recorded after the procedure. RESULTS: Intramuscular ketamine was administered 54 times, mainly for laceration repair. Physicians completed protocol for 51 of treated children. The median time for onset of sedation was 6.5+/-2.4 min, and duration of action was 32.4+/-10.8 min. Hypersalivation occurred in 9.8%(n=5); random movement 3.9%(n=2), emesis during procedure(n=1), emesis at home(n=1), and transient oxygen desaturation(n=1). All were quickly identified and treated without specific airway management and sequelae. Of 84% of physicians was satisfied with ketamine use for pediatric sedation. CONCLUSION: Intramuscular ketamine can be administered safely and satisfactorily in emergency room to facilitate pediatric procedures in conjunction with a defined protocol and appropriate monitoring.
Airway Management ; Amnesia ; Analgesia ; Child ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intubation, Intratracheal ; Ketamine* ; Lacerations ; Oxygen ; Prospective Studies ; Sialorrhea ; Syringes ; Vomiting

BACKGROUND: Hemorrhage itself has been shown to produce abnormalities in immunity, particularly depression of the lymphocyte function. In order to better examine the amount of hemorrhage required to suppress the lymphocyte function, we determined the effect of graded fixed-volume hemorrhage on splenocyte proliferation and the lymphocyte subpopulation. METHODS: Male Sprague-Dawley rats(weight, 350~400g) were anesthetized, subjected to hemorrhages of 7.5ml/kg, 15ml/kg, and 22.5ml/kg by percutaneous cardiac puncture with 26G needles. After 1, 2, 4, and 7 days, animals were killed to obtain the blood and spleen. The splenocyte proliferative capacity was measured by using the tritiated thymidine incorporation technique, and the peripheral lymphocyte subpopulation was determined using flow cytometry with the following monoclonal antibodies: T cell(CD3+), T helper cell(CD4+), T cytotoxic cell(CD8+), and B cell(CD45RA+). RESULTS: Hemorrhage of 7.5ml/kg did not induce depression of splenocyte proliferation. However, for hemorrhage greater than 15ml/kg, the splenocyte proliferative capacity was significantly depressed at 2 days after hemorrhage and recovered at 4 days. Hemorrhage induced no changes in the relative percentage of lymphocyte subpopulations and in the number of each cell in peripheral blood. CONCLUSION: This study suggests that cellular immunity is depressed at 48 hrs after a hemorrhage greater than 15ml/kg without any change in the peripheral lymphocyte subpopulation.
Animals ; Antibodies, Monoclonal ; Depression ; Flow Cytometry ; Hemorrhage* ; Humans ; Immunity, Cellular ; Lymphocyte Subsets ; Lymphocytes* ; Male ; Needles ; Punctures ; Rats* ; Rats, Sprague-Dawley ; Spleen ; Thymidine

As regard to the treatment modality and its prognosis following the treatment, there are some differences between the thoracolumbar compression fracture and bursting fracture. If bursting fracture is accompanied by nerve injury, especially if the fracture fragment is compressing the spinal cord, it is reported that decompression with early surgical intervention would achieve a much better prognosis. Therefore, the authors tried to suggest an overall statistics on the patient's age, mechanism of injury and injured site and to compare the sensitivity of tools used in diagnosing bursting fracture radiologically, as well as the sensitivity of posterior vertebral body angle, which is used in diagnosing subtle bursting fracture. Three hundred forty three patients admitted to emergency center of Yongdong Severance Hospital with a thoracolumbar fracture from 1992. Jan. to 1994. Dec. Of the 343 patients, minor fracture and those with insufficient X-ray films and clinical notes were excluded from the study. The study was done with 199 patients in retrospective method. All the 199 patients had plain X-ray and computed tomography taken. the results were as follows 1. The male to female ratio was 114 to 85 with average age being 47.1 years old(14-93 years old). 2. The mechanisms of injury were falling down, traffic accident, slipped down, sprain and confusional injury in the order written. 3. There were 67 cases of compression fracture and 132 cases of bursting fracture. 157 cases had I level injury in the order of Ll, T12, and L2, 33 cases had 2 level injury, and 8 cases were injured in 3 level of the spine. 4. Of the factors determining the radiological diagnosis of bursting fracture, the disruption of posterior cortical line had the highest sensitivity. 5. Of the 45 cases of 1 level injured subtle bursting fracture, those with posterior vertebral body angle of more than 100 degree radiographically had a sensitivity of 82%. Of the thoracolumbar fractured patient admitted to the emergency room, searching for disruption of posterior cortical line in plain film helped in diagnosing bursting fracture, and calculating the posterior vertebral body angle helped in determining whether further computed topography was needed in subtle bursting fracture.
Accidents, Traffic ; Decompression ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Female ; Fractures, Compression ; Humans ; Male ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine ; Sprains and Strains ; X-Ray Film

In Korea, there are about 8 million motor vehicles and one-fourth of it is motorcycle. Last year Korean government report on the motor vehicle accidents claimed 12,781 cases of motorcycle accidents and it account for 5.1% of all of motor vehicle accidents occurred in Korea. But this is too broad analysis and lack of statical values. In general, most of people think motorcycle rider will suffer or die from head injuries sustained with motorcycle accident. Even though mandatory law on wearing helmet during motorcycle ride, but we see too many motorcycle riders not wearing helmet, especially in teenagers. The loss of young person by accident is great loss for family, society and economy of nation. No one will doubt the effectiveness of helmet on reduced incidence of head injuries. And multiple studies from United States of America have clearly demonstrated the benefit of helmets in motorcycle accidents. The following study was undertaken to determine the relationship between head injuries and helmet use in motorcycle accident, as well as analysis of general motorcycle accident.
Adolescent ; Americas ; Craniocerebral Trauma ; Head Protective Devices ; Humans ; Incidence ; Jurisprudence ; Korea ; Motor Vehicles ; Motorcycles* ; United States

No abstract available.
Emergencies* ; Emergency Service, Hospital*

BACKGROUND: In animal models of cerebral ischemic-reperfusion has been shown to have a beneficial effect. The object of this study is to compare the effect of pathologic findings between normotheimic and moderate hypothermic group. METHODS: We investigated the effect of moderate hypothermia induced 1 hour after transient(10 min) both carotid artery occlusion on the extent of ischemic-reperfusion cell damage in Mongolian Gerbil model. The terminal deoxyribonucleotidyl transferase (TdT) -mediated biotin-16-dUTP nick-end labelling(TUNEL staning) are used to detect apoptosis. RESULTS: 1. We suggest that Core body temperature is down to moderate hypothermia(30-32degrees C) beyond 10 minite by selective bain cooling method in Mongolian Gerbil model. 2. By light microscopy, ischemic-reperfusion damage were detected in the hippocampal CA1 pyramidal layer on the 3 day after transient ischemic insult, which showed chrosomal condensation and cytoplasmic eosinophilia. Ischemic-reperfusion cells were increased in the CA1 region on the 5 day. Apoptotic cells of the CA1 neurons seen by TUNEL staining than ischemic neurons seen by Hematoxylin-eosin staining were investigate 3 and 5 days after ischemic-reperfusion insult. CONCLUSION: We suggest that is not neuroprotective effects of Intraischemic(1 hour) moderate hypothermia in Gerbil brain global ischemic-reperfusion model.
Apoptosis ; Body Temperature ; Brain* ; Carotid Arteries ; Cytoplasm ; DNA Nucleotidylexotransferase ; Eosinophilia ; Gerbillinae* ; Hypothermia* ; In Situ Nick-End Labeling ; Microscopy ; Models, Animal ; Neurons ; Neuroprotective Agents*

The outcomes of treatment of 31 patients who were managed by single visual internal urethrotomy were compared with those of 25 patients managed by perineal urethroplasty to asses whether the replacement of almost urethroplasty by the simpler urethrotomy was justified. The overall successful results were achieved in 51.6% of visual internal urethrotomy and 76%, of urethroplasty. Patients with anterior urethral strictures more than 1 cm long or completely obliterated strictures had higher failure rates in the visual internal urethrotomy than urethroplasty (p<0.05). The morbidity rates were 9.6% in the visual internal urethrotomy and 24% in the urethroplasty. We recommend that visual internal urethrotomy be reserved for patients with urethral strictures 1 cm or less in length and posterior urethral stricture which is supposed to have a high recurrence rate since the procedure is simple and it does not compromise asecondary urethroplasty.
Constriction, Pathologic ; Equidae ; Humans ; Recurrence ; Urethral Stricture*