PURPOSE: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. MATERIALS AND METHODS: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MRI, and US at 1 day, 3 day, and 1 week after operation. RESULTS: US was superior to MRI or spiral CT in diagnosis of diaphragmatic rupture(P<0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitively of MRI and spiral CT increased as the size of laceration were larger, but no statistical significant was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase. US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spinal CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05) In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). CONCLUSION: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.
Animals ; Delayed Diagnosis ; Diagnosis* ; Diaphragm ; Hemothorax ; Hernia ; Humans ; Lacerations ; Magnetic Resonance Imaging ; Models, Animal ; Mortality ; Pleural Effusion ; Rabbits ; Rupture* ; Sensitivity and Specificity ; Tomography, Spiral Computed* ; Ultrasonography* ; Viscera

OBJECTIVE: This study was designed to evaluate how much depression and pain symptoms could be shown, what kind of factors affect them, and whether the correlation between them could be or not in patients with cancer. METHODS: The subjects were composed of 25 patients with cancer who admitted at the department of oncology (male: 10, female: 15). We reviewed the medical record and interviewed patients and their family. A psychiatric diagnosis was made according to the criteria of the DSM-IV, and depressive symptoms were evaluated by Hamilton Rating Scale for Depression (HRSD). The intensity of pain (maximal, minimal, mean, present), disability due to pain, the effects of analgesics were measured by Brief Pain Inventory (BPI). RESULTS: 32% of patients had major depressive disorders, 16% of patients had depressive disorders, NOS and 16% of the patients had adjustment disorders. The score of HRSD was significantly correlated with the maximal intensity, mean intensity and present intensity of pain and disability due to pain, but not with minimal intensity and the effects of analgesics. Depression and pain were not correlated with duration of illness. Scores of depression and pain did not differ in sex, religion, metastasis, and the knowledge of illness. The widowed or unmarried patients showed significantly higher scores than patients living with the spouse in HRSD, minimal intensity and mean intensity of pain. CONCLUSION: In patients with cancer, depression and pain were highly prevalant. The relationship between depression and pain was shown in patients with cancer. These results suggest that more active evaluation and intervention of depression and pain should be carried out in patients with cancer.
Adjustment Disorders ; Analgesics ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Medical Records ; Mental Disorders ; Neoplasm Metastasis ; Single Person ; Spouses ; Widowhood

PURPOSE: The purpose of the study is to find whether there is any effect on shortening the length of stay of long term patients due to issuing of hospitalization sheets by emergency department. METHODS: For the investigation, 27,948 patients who resided in hospitals over 6 hours from 2006 to 2007 were chosen as the subjects. The main materials for the investigation were various time variables according to the medical records. For the verification of each factor, Student's t-test and Pearson' correlation coefficient were used. RESULTS: There was statistically significant difference in regard to length of stay (p<0.01). The departments related to internal medicine showed that they required longer times in every aspect compared to those of non-internal medicine. There were statistically significant differences (p<0.01) in regard to the time of patients' length of stay and the time of issuing sheets for hospitalization according to the numbers of related department. However, there was no meaningful difference in regard to the waiting time for hospitalization. CONCLUSION: In conclusion, in the cases of long term patients who stayed over 6 hours in 2007 when the random sheets for hospitalization were issued by emergency department, the length of stay was significantly reduced. It was found that the time was more increased in the departments of internal medicine than the departments of noninternal medicine and when the related sub departments increased.
Emergencies ; Emergency Medicine ; Hospitalization ; Humans ; Internal Medicine ; Length of Stay ; Medical Records

OBJECTIVE: This study was aimed to compare lipid peroxide level, total peroxyl radical-trapping antioxidative parameter (TRAP) value, and antioxidant vitamin level in the maternal venous plasma between normal pregnancy and preeclampsia. METHODS: Samples of venous plasma were obtained from 38 normal and 24 preeclamptic women. Lipid peroxides levels were measured by thiobarbituric acid reaction. The TRAP values were measured by Wayner's method, although some reaction conditions were modified. Ascorbic acid, retinol, alpah-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. RESULTS: There was no significant correlation between the lipid peroxides level in the maternal venous plasma and gestational age in normal pregnancy (n=38, r=0.04, p=NS). The lipid peroxide level in the maternal venous plasma of preeclampsia (n=24) was significantly higher than that of gestational age-matched normal pregnancy (n=26), (4.39 +/- 0.38 vs. 3.23 +/- 0.15 nmol/mg protein, p<0.01). There was no significant correlation between the TRAP value in the maternal venous plasma and gestational age in normal pregnancy (n=38, r=0.02, p=NS). The TRAP value in the maternal venous plasma of preeclampsia (n=24) was significantly lower than that of gestational age-matched normal pregnancy (n=26), (0.33 +/- 0.02 vs. 0.38 +/- 0.02 mM, p<0.05). Ascorbic acid level in the maternal venous plasma of preeclampsia was significantly lower than that of normal pregnancy (377.8 +/- 23.6 vs. 552.2 +/- 52.1 nmol/mL, p<0.05). However, there was no significant difference in maternal venous plasma retinol, alpah-tocopherol, and gamma-tocopherol levels between normal pregnancy and preeclampsia. CONCLUSION: The above results suggest that the imbalance of increased lipid peroxidation and decreased antioxidant activity were in the maternal blood of preeclampsia, and an antioxidant vitamin, ascorbic acid, may be decreased result from counteracting free radical-mediated cell disturbance.
Antioxidants ; Ascorbic Acid ; Chromatography, Liquid ; Female ; gamma-Tocopherol ; Gestational Age ; Humans ; Lipid Peroxidation ; Lipid Peroxides ; Oxidative Stress ; Plasma* ; Pre-Eclampsia* ; Pregnancy ; Vitamin A ; Vitamins*

Thioredoxin-1 (Trx-1) is one of important anti-oxidative molecules to overcome the oxidative stress. The aim of the present study is to investigate the clinical relationship between serum concentration of Trx-1 on the pre-percutaneous coronary intervention (prePCI) and myocardial damage amount in the patients with acute myocardial infarction with the culprit lesion in only the left anterior descending artery on coronary angiography (n = 100). Initial value of creatine kinase (CK) was 368.3 +/- 531.4 U/L, and MB isoenzyme of CK (CK-MB) level was 22.92 +/- 33.8 ng/mL, and cardiac specific troponin T (cTnT) level was 0.61 +/- 1.6 ng/mL. Positive correlations were observed between prePCI Trx-1 level and initial CK (P = 0.005, r = 0.281), and cTnT (P < 0.001, r = 0.453), peak CK (P = 0.001, r = 0.316) in all patients, but the statistical relation was observed only in ST segment elevation myocardial infarction (STEMI) patients (P = 0.008, r = 0.329 for initial CK, P = 0.001, r = 0.498 for initial cTnT, P = 0.005, r = 0.349 for peak CK), not in Non-STEMI patients. Conclusively, we consider prePCI serum Trx-1 as a predictor for myocardial damage amount in patients with STEMI.
Acute Disease ; Adult ; Aged ; Biological Markers/blood ; Coronary Angiography ; Creatine Kinase/blood ; Creatine Kinase, MB Form/blood ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*blood/pathology ; Myocardium/*pathology ; Percutaneous Coronary Intervention ; Thioredoxins/*blood ; Troponin T/blood

BACKGROUND AND OBJECTIVES: It is necessary to establish the most efficient diagnostic and therapeutic method for benign paroxysmal positional vertigo (BPPV), which is appropriate for Korean healthcare system. We aimed to evaluate current state of Korean clinician's diagnostic and therapeutic approaches for BPPV. MATERIALS AND METHODS: A 16-item survey was emailed to the members of dizziness department of Otology Research Interest Group in the Korean Otologic Society (n=68). 43 were returned and analyzed. RESULTS: All respondents (100%) used Dix-Hallpike test as a diagnostic tool for vertical canal-BPPV. Supine roll test was used for diagnosing lateral canal BPPV in nearly all the respondents (97.7%). Epley maneuver was chosen as otolith repositioning maneuver (ORM) for posterior canal BPPV in all respondents and barbecue rotation (BBQ) was used for treating lateral canal BPPV with geotropic nystagmus in 95.3% of respondents. Extreme variation was noted for therapeutic approach of lateral canal BPPV with ageotropic nystagmus BBQ, with 4 kinds of ORM and adjunctive measures to liberate otolith from cupula, while BBQ was again the most commonly used ORM (76.7%). CONCLUSION: The development of practical and efficient ORM for lateral canal BPPV with ageotropic nystagmus is necessary.
Surveys and Questionnaires ; Delivery of Health Care ; Dizziness ; Electronic Mail ; Korea ; Otolaryngology ; Otolithic Membrane ; Public Opinion ; Vertigo