Five hundred and thirty five cases of patients who were transferred to the Department of Emergency Medicine in Pusan University Hospital from Aug 1, 1997 to Aug 31, 1997 and from Oct 1, 1997 to Oct 31, 1997 were studied prospectively. The results were as follows: 1. Total 535 patients were transferred to the emergency department of PNUH(Pusan National University Hospital) for 2 months(average 8.2 a day). Male to female ratio was 1.58:1 and peak age group was 6th decade(17.0% of total). 2. In distribution about arrival time of transferred patients, 40.7% was from 08:00 to 16:00, 39.3% was from 16:00 to 24:00 and 20.0% was from 0:00 to 8:00. 3. Cases that were communicated with the emergency department of PNUH were 7.7%, cases that were communicated with other departments of PNUH were 10.1%, and 82.2% of total cases were transferred without any communication. 4. A 40.7% of patients was transferred by a hospital ambulance, 33.1% of patients used non-emergency vehicles such as taxis or buses, 25.3% of patients was transferred by an 119 or 129 rescue ambulance, and 0.9% was transferred by on foot or others. 5. Transferring hospital was divided into 3 groups: primary hospital, secondary hospital, and university hospital. The majority was secondary hospital(83.6%). 6. The cases that patients wanted to be treated in PNUH were the greatest in number as 55.5%, the cases transferred due to emergency surgery were 9.3%, the cases transferred without specialized department concerned were 28.6%, the cases transferred because of bed deficit were 1.7% and the cases transferred due to other cause were 4.9%. 7. Traumatic patients were 32.5%, and among them 9.9% was due to motor vehicle accident, among these 78.5% was mild patients. Non-traumatic patients were 67.5% and among them 74.2% was mild patients. 8. Among all transferred patients, 75.7% was admitted for general care, emergency operation, and ICU care. The percentage of discharge was 19.1%, the percentage of death was 2.4%, and the percentage of transfer to other hospital was 2.8%. Generally, because of bed deficit and of availability of operation room, patients were transferred to other hospital. 9. Among specialized departments, the proportion of the department of internal medicine, neurosurgery and pediatrics was 29.3%, 17.2% and 11.4% respectively. In conclusion, it is considered that proper patient transfer and effective medical service can be achieved through the well-organized EMSS, and cooperative interhospital communication.
Ambulances ; Busan* ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Foot ; Humans ; Internal Medicine ; Male ; Motor Vehicles ; Neurosurgery ; Patient Transfer ; Pediatrics ; Prospective Studies

No abstract available.
Animals ; Rats*

BACKGROUND: The prehospital care system in the Pusan area is primitive in organization, and the emergency medical system of every hospital needs to be developed. A analysis of patients who were treated in emergency rooms and who died is necessary in order to establish an emergency medical service system which is appropriate for the community. METHOD: The authors reviewed the records of 117 patients who died in the emergency room of Pusan National University Hospital from January 1998 to December 1998. RESULTS: 1) Among the 117 patients, 68 patients were male (58.1%) and 49 patients were female (41.9%). The incidence of patients over the age of 70 was very high (33 cases, 28.2%). 2) Among the 117 patients, 99 patients died due to disease (84.6%), 16 due to trauma, and 2 due to intoxication. The most prevalent disease was cardiovascular disease. 3) Among the 117 patients, 63 patients arrived voluntarily (53.8%); the remainder were transferred from other hospitals. Forty-eight patients were transported by 119 ambulance (41.0%), and 41 patients were transported by hospital ambulance. 4) As for consciousness level, 52 patients (44.4%) were alert upon arrival at the emergency room, but 42 patients (35.9%) were unresponsive. 5) In 53 patients, the intervals between arrival at the emergency room and the onset of cardiac arrest were from 2 to 24 hours (45.3%). 6) Cardiac arrest was most frequent between 10:00 pm and 8:00 am. 7) Cardiopulmonary resuscitation was done in 74 patients (63.2%), and the mean duration was from 30 minutes to 1 hour. 8) Sixty-six patients were patients of internal medicine, and their mean stay time was 17 hours 27 minutes. CONCLUSION: These results suggest that systematic education in advanced cardiopulmonary resuscitation, expansion of emergency physicians, an increase in the number of intensive care units are required.
Ambulances ; Busan ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Consciousness ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Female ; Heart Arrest ; Humans ; Incidence ; Intensive Care Units ; Internal Medicine ; Male

PURPOSE: To evaluate the hemostatic effect of N-butyl 2-cyanoacrylate(NBCA) injection and RF electrocauterization of the tract after fine needle biopsy of the liver, and the histopathologic changes of the liver. MATERIALS AND METHODS: Three lobes of rabbit liver were selected and separately punctured four times with 21 gauge biopsy needles. According to the hemostatic procedure on fine needle biopsy, three groups (1, 2, 3) were formed : group 1, in which there was no maneuver for bleeding control, was the control group ; group 2, in which NBCA was injected into the puncture tract while slowly removing the needle ; group 3, in which RF electrocauterization of the tract was carried out. After completely removing the needle, each group was evaluated for amount of bleeding and histologic change. RESULTS: The amount of bleeding was 0.407gm+/-0.245 in group 1,0.028gm+/-0.036 in group 2 and 0.035gm+/-0.028 in group 3. As compared with the control group(group 1), injecting NBCA into the biopsy tract(P=0.0002) and RF electrocauterization of the tract(P=0.0003) significantly reduced the amount of bleeding after liver biopsy. The amount of bleeding was not statistically different between group 2 and 3, however (P=0.58). In Group 1, the tract was fully filled with blood. Group 2 showed NBCA embolized in the biopsy tract, adhering to hepatocytes and mixed with blood; small vessels adjacent to the puncture tract were filled with NBCA. Group 3 showed tissue degeneration, including necrosis of hepatocytes, vacuolation and neutrophil infiltration. CONCLUSION: Injection of NBCA and RF electrocauterization of the tract after puncture of the liver for biopsy efficiently controlled bleeding. In particular, the efficiency of NBCA injection was due to its effect of plugging the tract and causing the embolization of adjacent small vessels. With regard to procedural handling, RF electrocauterization of the tract is superior to injection of NBCA.
Animals ; Biopsy* ; Biopsy, Fine-Needle ; Hemorrhage* ; Hepatocytes ; Liver* ; Necrosis ; Needles ; Neutrophil Infiltration ; Punctures

No abstract available.
Epidemiology

OBJECTIVE: With the increasing popularity of pedicle screw fixation devices for several indications, the safety and reliability of screw insertion in the small pedicle has become a major issue. Many studies have investigated the accuracy of screw placement after pedicle screw fixation using various method. The reported displacement rates have been very different. The purpose of the study is to investigate the proper placement of pedicle screw insertion in the lumbar spine on 26 consecutive patients. METHODS: Between September and December 2003, 26 consecutive patients (16women and 10men) were analyzed after transpedicular screw fixation of the lumbar and lumbosacral spine. After pedicle screw fixation in this study, 2-mm slices of CT scan were performed in all patients to detect caudal and cranial deviation of screw and medial and lateral deviation. Pedcile screw placement related complication was evaluted clinically. RESULTS: A total of 144 inserted pedicle were analyzed in 26patients, and 58pedicle screws (40.3%) were detected to be improper placement. There were 14level (9.0%) of caudal or cranial deviation and 44level (30.6%) of medial or lateral deviation to the pedicle. Extra-pedicle placement was found on 4levels (2.7%) with only 1case of neurologic injury. CONCLUSION: Proper screw placement, though complication rate is low, is important not only for clinical symptom but also for biomechanics. Further study for screw placement related biomechanical changes is needed.
Humans ; Spine ; Tomography, X-Ray Computed

A total of 106 Penicillium species were tested to examine their ability of degrading cellobiose, pectin and xylan. The activity of beta-glucosidase was generally strong in all the Penicillium species tested. P. citrinum, P. charlesii, P. manginii and P. aurantiacum showed the higher ability of producing beta-glucosidase than other tested species. Pectinase activity was detected in 24 Penicillium species. P. paracanescens, P. sizovae, P. sartoryi, P. chrysogenum, and P. claviforme showed strong pectinase activity. In xylanase assay, 84 Penicillium species showed activity. Strong xylanase activity was detected from P. megasporum, P. sartoryi, P. chrysogenum, P. glandicola, P. discolor, and P. coprophilum. Overall, most of the Penicillium species tested showed strong beta-glucosidase activity. The degree of pectinase and xylanase activity varied depending on Penicillium species.
beta-Glucosidase ; Cellobiose ; Penicillium* ; Polygalacturonase

BACKGROUND: The recurrence rate of rosacea was not known very well, but has been reported as 60% in 6 months after withdrawal of the drug. It is not known which treatment can reduce relapses of rosacea effectively. OBJECTIVE: The objective was to identify whether 595 nm-pulsed dye laser (PDL) treatment reduced recurrence rate among rosacea patients who were treated with oral minocycline. METHODS: One hundred and seven Korean patients with rosacea who started treatment with oral minocycline (100 mg/d) with or without PDL (2∼4 sessions) were evaluated retrospectively. The recurrence rate was estimated using the Kaplan-Meier method, and difference was evaluated using the log-rank test. Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals (CIs) of risk factors for the recurrence of rosacea. RESULTS: The recurrence-free survival analysis revealed that the group with oral minocycline plus PDL was significantly different compared with the group with oral minocycline alone (p=0.011). Cox proportional hazards model showed that the combined use of PDL with oral minocycline appeared to be a significant protective factor for the hazard of recurrence of rosacea (hazard ratio, 0.492; 95% CI, 0.257∼0.941; p=0.032). CONCLUSION: PDL can be used added to oral minocycline to reduce relapses among rosacea patients who are undergoing oral minocycline treatment.
Humans ; Lasers, Dye* ; Methods ; Minocycline* ; Proportional Hazards Models ; Protective Factors ; Recurrence* ; Retrospective Studies ; Risk Factors ; Rosacea*

Objective: In oblique lateral interbody fusion (OLIF) surgery at the L5-S1 level (OLIF51), anatomical complexity and the possibility of vascular injury during retraction of the common iliac vein (CIV) make the surgery challenging. We radiologically evaluated patients who underwent OLIF surgery to determine approaches that can make OLIF51 surgery easier during multilevel OLIF. Methods: We retrospectively analyzed 275 consecutive patients who underwent OLIF surgery between September 2014 and December 2019. The distance between the left and right CIVs (dCIV) was measured using an axial image at the L5 lower endplate level, and the height of the iliocaval junction (hCIV) was measured from the L5 lower endplate to the iliocaval junction in the sagittal image. The sum of anterior disc height of each level (sADH) was calculated. Results: Eighty-two patients (33 males and 49 females) were enrolled. The number of three- (L2-3-4-5), two- (L3-4-5), and one-level (L4-5) fusions was 13, 21, and 48, respectively. Changes between the pre- and postoperative sADH, dCIV, and hCIV values were 17.1±4.7, 7.7±3.5, and 13.1±4.7 mm in three-level fusion; 10.6±4.1, 5.6±3.7, and 7.0±3.1 in two-level fusion; and 4.3±2.5, 3.3±2.7, and 3.0±2.0 mm in one-level fusion, respectively. As the number of surgical levels increased, the changes in sADH, dCIV, and hCIV significantly increased. Conclusions The dCIV and hCIV values increased when the upper segment underwent surgery before OLIF51 during multilevel OLIF.

Bovine viral diarrhea virus (BVDV) is an RNA virus belonging to Pestivirus in the family Flaviviridae. BVDV has economic significance for the livestock industry because of its association with acute disease, fetal loss, and birth of persistently infected (PI) animals. This study aimed to investigate the BVDV infection rates in Korean native cattle farms in Jeju for further planning of a BVDV control program in the Jeju Province. BVDV antibodies and antigens were tested in 15,842 sera collected from 302 Korean native cattle herds between January 2014 and June 2017 using enzyme-linked immunosorbent assay (ELISA). Viral antigen was detected by reverse transcription-polymerase chain reaction from 60 sera that were antigen ELISA-positive. BVDV antibodies were found in 90.7% (274/302) herds and 61.1% (9,678/15,842) cows. BVDV antigens were found in 13.2% (40/302) herds and 0.4% (61/15,842) cows. The oldest animal group (> 8 years) exhibited the highest sero-positive rates (91%), while the youngest animal group (< 1 years) had the highest antigen positivity rates (0.52%). Of the 60 antigen-positive sera, BVDV types 1 and 2 were found in 36 and 12 sera, respectively. Additionally, six animals were considered to be PI as BVDV was continually detected in annual examination.