The authors present 31 patient with acute epidural hematoma who had been admitted from January, 1987 to June. 1989 managed by consevative treatment. The results were as follows ; 1) The age of patients was distributed evenly, most patients were male (26 cases) and the most common mechanism of injury was traffic accidents(14 cases). 2) Sites of hematoma were mostly the temporal and parietal area and the maximum thickness of hematoma was not different from each site. 3) On admission, all patients presented GCS score above 13 except 2 cases. 4) All patients did not undergo delayed up, due to the enlargement of the hematoma or neurological deterioration. 5) The maximum thickness of hematoma was under 20 mm in all patients. 6) The hematoma was resolved within 30 days in all cases. This was confirmed with brain CT scan.
Brain ; Hematoma* ; Humans ; Male ; Rabeprazole ; Tomography, X-Ray Computed

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.
Aged ; Delivery of Health Care ; Female ; Health Services* ; Hospitalization ; Humans ; Inpatients* ; Korea ; Male ; Tertiary Care Centers ; Vascular Diseases

We recently noticed four cases of Vibrio(V.) vulnificus infection from July, 1985 to September, 1985. The V. vulnificus was isolated by culture from the necrotizirig skin bullae in three cases, blood culture in two cases, and cerebrospinal fluid(CSF) in one case. The clinical characteristics of V. vulnificus infection in our cases was as follows: 1)All patients were men with their age over forties and the outbreak of the disease was during the summer season. 2) It was suspected that all patients had the previous hepatic problems. 3) The skin lesions showing bullae in three patients and subcutaneous nodules in one patient were noticed. 4) Two patients were showed positive in blood culture and one of thern also showed positive in lesional skin, urine and CSF. Lesional skin culture showed positive in three patients. 5) The isolated v. ulnificus was sensitive to chloramphenicol, erythromycin, gentamycin, kanamycin and cefobid. 6) Two patients died due to sepsis within 48 hours after liospitalization and one patient died due to hepatic failure.
Cefoperazone ; Chloramphenicol ; Erythromycin ; Gentamicins ; Humans ; Kanamycin ; Liver Failure ; Male ; Seasons ; Sepsis ; Skin ; Vibrio vulnificus* ; Vibrio*

INTRODUCTION: The objective of the present study was to investigate the defense style of insomnia patients and to grasp the differences in defense style between primary insomnia patients and insomnia patients with history of major depressive disorder. METHODS: Forty three subjects with insomnia (11 subjects with primary insomnia and 32 subjects with major depressive disorder) and 138 control subjects participated in this study. To diagnose insomnia and major depressive disorder, interviews including structured clinical interview for DSM-IV (SCID-IV) were done. To assess the defense style, self-reported Korean version of Defense Style Questionnaire (K-DSQ) were completed by the participants. RESULTS: Compared to normal controls, subjects with insomnia used more acting out (t=3.25, p<0.01), consumption (t=2.66, p<0.01), fantasy (t=3.51, p<0.001), resignation (t=5.42, p<0.001), suppression (t=3.28, p<0.01), projection (t=3.92, p< 0.01), splitting (t=4.31, p<0.01), undoing (t=2.66, p<0.01), withdrawal (t=6.72, p<0.001) and isolation (t=3.80, p<0.001), and less omnipotence (t=4.08, p<0.001) and humor (t=3.20, p<0.01). Compared to normal controls, subjects with primary insomnia used more undoing and withdrawal. Compared to subjects with primary insomnia, subjects with insomnia with history of major depressive disorder used more resignation and withdrawal, and less humor. CONCLUSION: In the current study, there were differences in defenses between primary insomnia patients and insomnia patients with major depressive disorder history. To evaluate the pattern of defenses through the K-DSQ might provide important clues to differentiate these two conditions.
Acting Out ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Fantasy ; Hand Strength ; Humans ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

Fetal hydrops is often serious and associated with a high perinatal motality rate. Cardiac causes of fetal hydrops include congenital heart diseases and rhythm disturbances. An irregular fetal heart rate may indicate atrial fibrillation and atrial flutter with variable AV conduction. Fetal atrial flutter is characterized by the pressence of flutter waves which are regular sawtooth undulations in the baseline that are larger than p waves. Authors experienced a case of fetal atrial flutter with hydrops fetalis at 30 week's gestation which was confirmed by fetal M-mode echocardiogram and electrocardiography. A new born infant had shown to have atrial flutter in utero and after delivery was successfully converted to normal sinus rhythm with digoxin and quinidene.
Atrial Fibrillation ; Atrial Flutter* ; Digoxin ; Edema* ; Electrocardiography ; Female ; Heart Diseases ; Heart Rate, Fetal ; Humans ; Hydrops Fetalis* ; Infant ; Pregnancy

PURPOSE: We measured pulmonary epithelial permeability by Tc-DTPA radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate Tc-DTPA radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. MATERIALS AND METHODS: We performed ' Tc-DTPA radioaerosol scan in 10 normal subjects, 10 asym-ptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). Tc-DTPA clearance half-time (T1/2) was calculated, then compared with the result of chest radiography and pulmonary function test. RESULTS: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with micraangiopathy were significantly older (p<0.05). The T1/2of normal subjects and asyrnptomatic smokers were significantly different (65.2+23.7min vs 39.6+9.8min, p<0.05). For diabetic patients with microangiopathy, the T, was 90 5+46.5min and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the T1/2of diabetic patients without microangiopathy, 70.0+12.7 min, was not significantly different from those of normals or asyrnptomatic smokers (p>0.05). No significant correlation was found between the T1/2and spirometric parameters including DLcc>, FVC, FEV>, FEV(/FVC (%) and FEF)5-75g in all subjects, and between the T1/2 and duration of diabetes in diabetic patients. CONCLUSION: Eventhough the influence of age cant be excluded, delayed Tc-DTPA clearance half-time (T1/2)in diabetic patients with microangiopathy indicates decreased pulmonary cspillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.
Diabetes Mellitus ; Diagnostic Tests, Routine ; Humans ; Permeability ; Radiography ; Respiratory Function Tests ; Smoke ; Smoking ; Technetium Tc 99m Pentetate ; Thorax

BACKGROUND: The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. METHODS: From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. RESULTS: Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. CONCLUSIONS: The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
Anticoagulants ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Hemostasis, Surgical ; Heparin ; Humans ; International Normalized Ratio ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Retrospective Studies ; Tracheostomy*

Single coronary artery is a rare congenital anomaly occurring in approximately 0.04% of the population. This entity can be diagnosed during life only by coronary angiography. Typical angina does not occur with single coronary artery in the absence of coexisting coronary artery disease or aortic stenosis. Among 874 patients who underwent diagnostic coronary angiography at Asan Medical Center. we have experienced a case of single coronary artery with significant atherosclerotic coronary artery disease which has been managed succesfully coronary angioplasty. We report this case of single coronary artery with a review of literature.
Angioplasty ; Aortic Valve Stenosis ; Chungcheongnam-do ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Humans

No abstract available.
Humans

This study was to find out whether the rendering screen difference affect to measuring distance in a CAD program according to three types of CAD programs. Materials and methods: The model presented in ISO 12836 for dental scanner evaluation was reduced by 70%. This model was repeatedly scanned 15times using Trios II (3Shape, Denmark). Using the output STL file, 3Shape CAD, inLab 15, and ExoCAD programs were used to measure the horizontal distance (H) and vertical distance (V) between adjacent point angle, and for each experiment, three groups were set according to the CAD program type. Statistical analysis was performed using One-way ANOVA test and post hoc was performed using Dunnett T3 test. Results: In the horizontal and vertical distance measurement, there was no difference in the average of the measured values between the three groups according to the CAD program (P>.05). Conclusion: There were no effect of the difference in the rendering screen in the horizontal and vertical linear distance measurements of the inlay model on the dental CAD program.