As most medical facilities in Korea have been concentrated in large cities, the need to improve emergency medical services in islands and mountainous areas has emerged. Consequently, the Ministry of Health and Welfare and local governments have introduced emergency medical helicopters (known as helicopter ambulances or air ambulances) with doctors in medically vulnerable areas. Having been introduced in two regions in 2011, air ambulances are operational in seven regions as of the end of 2019. The flight time is from sunrise to sunset, except in Gyeonggi province, which is open all day. Although the criteria for transport vary depending on whether an ambulance is available for operation, it is basically intended for emergency critical diseases, such as severe trauma, stroke, and acute myocardial infarction. From September 23, 2011 to December 31, 2018, a total of 10,367 transfer requests were received, which included 534 (5.2%) interruptions, 2,657 (25.6%) rejects, and 7,176 (69.2%) transfers. A total of 7,209 patients were transferred during this period, which included 1,693 (23.5%) patients of severe trauma, 1,149 (15.9%) patients of stroke, 802 (11.1%) patients of acute myocardial infarction, and 3,565 (49.5%) patients suffering from other emergency diseases. Some economic research on air ambulances in Korea has been reported to be cost-effective, but additional research should be performed. In the future, it is necessary to widen the area of operation of air ambulances and find alternative means of transporting patients during unfavorable conditions such as night or bad weather.

BACKGROUND: Superoxide disrnutase(SOD) provides a protective defease mechanism against potential cytotoxicity of superoxide radical in the aerobic organism. Although human skin is constantly at risk for developing acute and chronic changes by ultraviolet radiation and phototoxic reactions with exogenous and endogenously procluced photosensitizing molecules, studies in SOD in the human skin are rare. OBJECTIVE: We measured the level of SOD activities in the scar tissues and the normal human skin specimens. This study was to investigate changes of SOD activity by age, sex, and regional differences of SOD activities in the scar issues and the normal skin. METHODS: Aut,hors assayed the level of SOD activit,ies in 32 scar tissues(male 8, female 24) and 11 normal human skin specimens(male 8, female 3), which were obtaine 3 from face/neck(17 and 3 specimens), forearm(only 4 scar tissues), trunk(10 and 8 specimens), and lower extremity(only 1 scar tissue). RESULTS: First, activities of total SOD, Cu, Zn-SOD, and Mn-SOL ere 18.93+5.49, 16.97+55.31, and 1.96+0.90 units/mg proteiii respectively in the scar tissues. Second activities of total SOD, Cu, Zn-SOD, and Mn-SOD were 17.27+7.09, 13.82+6.44, and 3.45+1.07 units/mg protein respectively in the normal skin. Third, the changes of total SOD, Cu, Zn-SOD, and Mn-SOD activities by age and sex were similar each other and three were no significant, differneces between age groups in total, Cu, Zn- SOD, and Mn-SOD activities. Fourth, in sun exposed area and unexposed area there were no significant differences in the scar tissues in SOD activities. But, SOD activite.(total, Cu, Zn, and Mn-SOD) in face/neck were higher than those in trunk and lower extremity in tae normal skin(P<0.05). CONCLUSION: These findings suggest that there are no differences in the intrinsic SOD activities by age and sex in the mature scar tissues and the normal skin. Differences between exposed and unexposed area in the normal skin are due to the induction of exogenous SOD activity by sun-light generation of superoxide radicals. In wound, increased production of leukocyte derived superoxide radicals is the main factor of increased level of SOD activity.
Cicatrix* ; Female ; Humans ; Leukocytes ; Lower Extremity ; Skin ; Solar System ; Superoxide Dismutase* ; Superoxides* ; Wounds and Injuries

INTRODUCTION: The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively. METHODS: A total of 181 participants (73 males and 108 females ; mean age 41.59+/-8.92) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R). RESULTS: There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08). CONCLUSION: In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.
Axis, Cervical Vertebra ; Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Male ; Surveys and Questionnaires ; Republic of Korea ; Sleep Initiation and Maintenance Disorders

INTRODUCTION: The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively. METHODS: A total of 181 participants (73 males and 108 females ; mean age 41.59+/-8.92) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R). RESULTS: There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08). CONCLUSION: In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.
Axis, Cervical Vertebra ; Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Male ; Surveys and Questionnaires ; Republic of Korea ; Sleep Initiation and Maintenance Disorders

BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.
Activities of Daily Living ; Aged* ; Alcohol Drinking ; Anemia ; Dementia ; Depression ; Female ; Gait ; Humans ; Hypertension ; Mental Health ; Osteoarthritis ; Prevalence ; Seoul ; Smoke ; Smoking ; Urinary Incontinence

No abstract available.
Erythropoietin* ; Humans* ; Renal Dialysis*

A case with a true posterior communicating artery aneurysm is reported, who had been managed by early surgical neck clipping and post-operative intensive cares for numerous complications. The small saccular aneurysm was located at the proximal posterior communicating artery and directed superiorly. A lacunar infarct developed at right anterior thalamus post-operatively, which had resulted probably from the occlusion of a fine posterior communicating arterial perforator. Aneurysms of the posterior communicating artery itself are saccular or fusiform. Great cares should be taken in surgical aneurysmal neck clipping to avoid any injury of the perforators and the oculomotor nerve;trapping of the posterior communicating artery to treat fusiform or wide-necked aneurysms will result in unpredictable outcomes.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Neck ; Stroke, Lacunar ; Thalamus

A 11-year-old, female Russian Blue cat was presented with anorexia, vomiting, and diarrhea lasting for 3 days. Abdominal ultrasonography revealed a hypoechoic, non-circumferential, and eccentrically formed intestinal loop with altered wall layering and thickening of the tunica muscularis. After surgical resection, histopathologic examination confirmed an infiltrative, round-cell neoplasm composed of sheets and cords of neoplastic mast cells within a fibrotic, edematous stroma. The cat was alive and healthy 6 months after surgery. To the best of our knowledge, this is the first reported case of an intestinal mast cell tumor in a Russian Blue cat in South Korea.
Animals ; Anorexia ; Cats* ; Child ; Diarrhea ; Female ; Humans ; Korea ; Mast Cells* ; Ultrasonography ; Vomiting

Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate(Ca++ : 3.5 mEq/L). Furthermore, the high calcium concentration in standard dialysate may have a suppressive effect on parathyroid hormone(iPTH) level, contributing to the high prevalence of low-urnover bone disease. We studied the effect of low calcium dialysate(Ca++ : 2.5 mEq/L) for those patients with high risk of low- turnover bone disease. Among 386 patients(1996. 1.- 1999. 12.) who had been stable on CAPD for at least 3 months, 46 patients were included in this study. The patients were divided into 3 groups on the basis of the iPTH levels(<150 pg/mL) and/or corrected serum calcium levels(>10 mg/dL) before the conversion to low calcium dialysate. Group 1(n=29), iPTH <150 pg/mL and Ca++>10 mg/dL; Group 2 (n=14), iPTH <150 pg/mL and Ca++<10 mg/dL; Group 3(n=3), iPTH >150 pg/mL and Ca++ >10 mg/ dL. During a 2-month run-in period, those patients were treated with standard dialysate. After that, a 12-month therapy with low calcium dialysate was followed. Biochemical data including calcium, phosphorus, iPTH and alkaline phosphatase were measured regularly and daily phosphate binder and calcitriol intake(pill counting) were assessed during the run-in and therapy period. We obtained the following result: the prevalence of hypercalcemia(Ca++>10.5 mg/dL) was 5.7%(22/ 386 patients). Serum calcium levels decreased during the therapy period(12 months)(10.5+/-1.4 vs 9.4+/-1.3 mg/dL, p<0.05). Serum phosphorus levels remained unchanged. Mean serum alkaline phosphatase level increased(203.0+/-92.9 vs 257.2+/-103.4 U/L, p<0.05). Serum iPTH levels increased (92.7+/-128.8 vs 225.3+/-237.3 pg/mL,p<0.05). The mean intake of oral phosphate binders was not significantly different between run-in period and therapy period. But calcitriol doses increased 0.038+/-0.087 at run-in period to 0.158+/-0.288 tablets/person/day at therapy period(p<0.05). In the six patients, low calcium dialysate was converted to standard dialysate due to high iPTH level (n=3), symptomatic hypo calcemia(n=2), and uncontrolled edema(n=1). In conclusion, in the study of 46 patients over 12 month period, the usage of 2.5 mEq/L calcium dialysate resulted in a significant decrement in calcium levels and increased iPTH levels. Therefore, we propose that dialysis with a low calcium dialysate is an acceptable form of therapy for the patients with high risk of low-turnover bone disease showing hypercalcemia and low iPTH level. However, further study will be needed for evaluating the effect of low calcium dialysate in low-turnover bone disease.
Alkaline Phosphatase ; Bone Diseases* ; Calcitriol ; Calcium* ; Dialysis ; Humans ; Hypercalcemia ; Peritoneal Dialysis, Continuous Ambulatory* ; Phosphorus ; Prevalence

PURPOSE: Synuclein has been identified as an important neuroprotein for developing pathologic deposits in Alzheimer's and Parkinson's disease patients. gamma-synuclein is also known as a breast cancer-specific gene 1 thats's not found in normal breast tissues but it has been reported to be overexpressed in breast cancer, ovarian cancer and other tumors. To evaluate the availability of gamma-synuclein expression as a prognostic factor for infiltrative breast cancer, we analyzed its correlation with the clinical parameters and the HER-2/neu gene expression. METHODS: Two hundred fiffty samples of breast cancer tissues embedded in paraffin and that were obtained from the infiltrative breast cancer patients who were operated in our institution from January 1995 to December 2000 were analyzed with employing the tissue microarray technique. The expression of gamma-synuclein was studied with immunohistochemistry and with using gamma-synulcein antibodies. One hundred thirty one cases that showed favorable staining were selected and studied retrospectively. RESULTS: Fiffty five% (71/131) of the patients showed gamma-synuclein overexpression. The histopathological findings that significantly correlated with gamma-synuclein overexpression were the number of metastatic lymph nodes (p<0.01) and the cancer stage (p<0.01). Using the same tissue mircoarray, the HER-2/neu gene expression and gamma-synuclein expression also showed statistically significant correlation (p=0.04). CONCLUSION: gamma-synuclein overexpression showed significant correaltion with lymph node metastasis and cancer stage. It also showed significant relevance with the HER-2/neu gene expression, and that is already known to be a prognostic factor for breast cancer. Therefore gamma-synuclein may be a useful prognostic factor for infiltrative breast cancer and further studies on the its correlation with survival, local recurrence, and distant metastasis should be conducted
Antibodies ; Breast Neoplasms* ; Breast* ; gamma-Synuclein* ; Gene Expression ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Ovarian Neoplasms ; Paraffin ; Parkinson Disease ; Recurrence ; Retrospective Studies ; Synucleins