No abstract available.
Dinoprost* ; Female ; Laparoscopes* ; Pregnancy ; Pregnancy, Tubal*

This study was carried out to investigate pathogenesis of E. coli-induced cystitis by light and electron microscopy with immunocytochemistry. A group of ICR mice was intravesically given 0.3ml of E. coli DIE 174 lysate( 1000000000/ml). Another group was given E. coli lysate after acid solution(pH 4.5) washing for 30 minutes. The urinary bladders were observed at 2 hours and 24 hours after E.coli lysate irrigation. On light microscopy, submucosal edema, congestion, and perivascular neutrophilic infiltration occurred 2 hours after E. coli lysate irrigation. The congestion and acute inflammation were more pronounced 24 hours after. In cases of acid washing and E. coli lysate irrigation, mucosal acute inflammatory infiltration with edema and congestion was marked at early stage. Necrosis of transitional cells developed with time. On immunostain for E. coli, surface of transitional cells was stained 2 hours after E. coli lysate irrigation. At 24 hours after irrigation, intercellular spaces of transitional cells were stained. In cases of acid washing and E. coli lysate irrigation, entire mucosa was stained at early stage. Electron microscopically, transitional cells revealed increase of cytoplasmic processes, enlargement of cytoplasmic vesicles, and widening of intercellular spaces. There were large amounts of various shapes of lysosomes in neutrophils and monocytes infiltrated in the mucosa in acid washing groups. According to the above results, it is concluded that E. coli lysate may easily penetrate into the bladder mucosa and that the mucosal mucopolysaccharide plays as a barrier against bacterial invasion.
Animals ; Cystitis ; Cytoplasm ; Cytoplasmic Vesicles ; Edema ; Estrogens, Conjugated (USP) ; Extracellular Space ; Immunohistochemistry ; Inflammation ; Lysosomes ; Mice ; Mice, Inbred ICR ; Microscopy ; Microscopy, Electron ; Monocytes ; Mucous Membrane* ; Necrosis ; Neutrophils ; Urinary Bladder*

BACKGROUND: Advanced age alone should not be a serious deterrent to surgery. Preoperative evaluation of concomitant illness, operation time, accurate and minimal, but adequate surgery will serve to minimize morbidity and mortality in elderly patients. METHODS: The total number of surgical patients admitted to Kwang Hye Hospital, Pusan, from March 1994 to August 1996 was 3211, and the number of surgical geriatric patients admitted during the same period was 214. Operations were performed on 139 patients. We recorded information about age, sex, anesthesia type, operation time, non malignancy vs malignancy, emergency vs elective "Surgery", coexisting disease, and APACHE II score, and we examined the patients for results affecting postoperative morbidity and mortality. RESULTS: Postoperative complications occured in 55 cases (39.6%), and the operative mortality was 2.2%. The significant factors affecting postoperative morbidity were emergency operation, malignancy and APACHE II score. The operation time and coexisting diseases were not significant. Age had little effect on the postoperative prognosis CONCLUSIONS: Performance of elective surgery and preoperative evaluation of the APACHE II score are important factors.
Aged ; Anesthesia ; APACHE ; Busan ; Emergencies ; Humans ; Mortality ; Postoperative Complications ; Prognosis

Traditionally, the gingko nut is used for enhancing liver function, skin immunity, pulmonary function, and antitussive action in chronic asthma. However, when overused, it can induce central nervous system dysfunction, and the following symptoms can manifest themselves: vomiting, dizziness, convulsion, insomnia, and confusion. We experienced a case of suspected cyanide intoxication that was manifested by convulsion and metabolic dysfunction after consuming a large number of ginko nuts. We report that case, together with a review of the literature.
Asthma ; Central Nervous System ; Cyanides ; Dizziness ; Ginkgo biloba* ; Liver ; Nuts* ; Poisoning* ; Seizures ; Skin ; Sleep Initiation and Maintenance Disorders ; Vomiting

PURPOSE: A general analysis of patients in the Emergency Department (ED) and the Intensive Care Unit (ICU) was performed to evaluate the effectiveness of a noninvasive ventilator (NIV) for the effective treatment of patients in respiratory distress without using endotracheal intubation. METHODS: The 38 patients who were treated with a NIV from December 1, 2001, to September 31, 2002, were studied. The ER doctors investigated prospectively sex, age, the causes of disease, the main symptoms, the duration of treatment, the mode of ventilation, the vital signs and the arterial blood gas analysis at the time of admission and after 30 minutes of NIV use, adaptation of patients, complications, and the success or failure of the treatment. RESULTS: 1) General features: Out of 38 cases, 25 males and 13 females, the average age was 60.61 years old. In group X (treatment success), the average age was significantly lower than it was in group Y (treatment failures). 2) The causes of disease and symptoms: The causes of disease were as follows: asthma and chronic obstructive pulmonary disease, 13 patients; drug intoxication, 8 patients; pulmonary edema, 8 patients; respiratory failure, 2 patients; lung contusion, 3 patients; pneumonia, 2 patients. 3) Adaptation and complications: 11 patients adapted well, 18 patients adapted normally, and 11 patients failed. Complications were minimal and included gastric distension in 2 patients and xerophthalmia in another 2. 4)Vital signs and arterial blood gas analysis results: The arterial blood gas analysis performed after 30 minutes in treatment showed improved results, but only the pH had any effect on success or failure. CONCLUSION: NIV had a success rate of 72%. The factors influencing success were surveyed according age, pH level before treatment, pH P a C O2 S a O2 30 minutes after treatment, and adaptation.
Asthma ; Blood Gas Analysis ; Contusions ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Intubation, Intratracheal ; Lung ; Male ; Pneumonia ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema ; Respiratory Insufficiency ; Ventilation ; Ventilators, Mechanical* ; Vital Signs ; Xerophthalmia

PURPOSE: In Korea, 119 rescue plays the largest role in treating emergency patients on the scene and in transferring them to the emergency department. We wanted to find out the perception of and the satisfaction with 119 rescue, as well as its future, in the view of medical service-consumers, that is, patients and their guardians. METHODS: The subjects were patients and their guardians who came to Chosun University Hospital by means of 119 rescue between July 1 and September 31, 2002. Responders were asked their age, sex, academic background and relation to the patient. RESULTS: Perception and satisfaction - They recognized treatment on the scene (66.6%) rather then transport to the hospital (17.2%) as the most important duty of 119 rescue. Seventy percent answered that 119 rescue came to mind right away in an emergency situation, which reflects a high perception of 119 rescue. As to the time to arrive at the scene after a report, many people showed satisfaction (55%), answering that it was fast. Responsibility and rights - As to the question of whether they should hold 119 rescue responsible if the patient's condition is aggravated after treatment by 119, 48.9% answered that they shouldn't because 119 was acting with a good intention. Direction of future development - If the 119 services if to be improved, regular intensive training and testing (39.5%) intensive hospital experience (33.3%) and hiring 1st degree EMTs (27.2%) are believed to be necessary. CONCLUSION: 119 rescue was recognized as a comfortable and reliable means of emergency service. In general, most people were satisfied with the service provided by 119 rescue, but demanded experience with patient care.
Emergencies ; Emergency Service, Hospital ; Human Rights ; Humans ; Intention ; Korea ; Patient Care

OBJECTIVES: The goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea. METHODS: The National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database. RESULTS: Of the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%). CONCLUSIONS: The reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.
Angiography ; Angioplasty ; Coronary Vessels ; Diagnosis ; Emergency Service, Hospital ; Hospitalization* ; Humans ; International Classification of Diseases ; Korea ; Myocardial Infarction* ; National Health Programs* ; Vascular Surgical Procedures

OBJECTIVE: The objective of this study is to evaluate the safety and the clinical efficacy of the laparoscopic myomectomy through analyzing several operation factors. METHODS: There were 185 cases of laparoscopic myomectomy between January 2004 and December 2008 at the department of obstetrics and gynecology in Hanyang University Guri Hospital. Retrospectively many factors of the operation were analyzed. The factors include the size, number and type of the myoma, BMI (body mass index), operation method, operation time, and complication and the prognosis of the operation. RESULTS: For the type of myomas, 115 (62.2%) cases were intramural myomas, 38 (20.5%) cases were subserosal types and 32 (17.3%) cases were mixed types. The average diameter of the biggest myoma was 6.67+/-0.16 cm (range, 2.5~15 cm) and the average number of the myoma was 2.07+/-0.15 (range, 1~15). Previous operation history and pelvic adhesion did not show correlation with the operation time. The size, type and number of myoma and the operation methods showed correlation with the operation time. According to myoma size and number, we divided the cases into two groups, low risk group (122 cases) and high risk group (63 cases). The analysis showed that post-operation hemoglobin drop (2.89+/-0.10 g/dL vs. 4.03+/-0.23 g/dL) and blood transfusion amount (2.89+/-0.10 pints vs. 4.03+/-0.23 pints) as well as the operation time (137.58+/-4.37 min vs. 193.73+/-9.88 min) showed noticeable increase in the high risk group. CONCLUSION: This statistics show that laparoscopic myomectomy is now being applied to patients with larger and more myomas. Factors affecting operation time were the weight of myomas, number of myomas, type of myomas, number of trocars and methods of resected myomas removal. Also, operation time and post-operative hemoglobin drop increased in the high risk group.
Blood Transfusion ; Gynecology ; Hemoglobins ; Humans ; Laparoscopy ; Myoma ; Obstetrics ; Prognosis ; Retrospective Studies ; Surgical Instruments

BACKGROUND: This study aimed to explore the effects of norepinephrine on the potassium currents of rat medial vestibular nuclear neurons by using the whole-cell patch clamp technique. METHODS: Sprague-Dawley rats aged 14 to 16 days were anesthetized with ether and decapitated. After enzymatic digestion, the portion of the medial vestibular nucleus neurons were obtained by micropunching. The dissociated neurons were transferred into a recording chamber mounted on an inverted microscope and potassium currents were recorded by standard patch-clamp techniques under voltage-clamp modes. RESULTS: Norepinephrine inhibited the whole potassium currents of the medial vestibular nuclear neurons. Outward potassium currents were more suppressed in 4 mM 4-aminopyridine and norepinephrine added solutions than 4 mM 4-aminopyridine only, but were not suppressed in 10 mM tetraethylammonium and norepinephrine added solutions compared to 10 mM tetraethylammonium only. CONCLUSIONS: These results suggest that norepinephrine blocks the delayed rectifier potassium channels in medial vestibular nuclear neurons.
4-Aminopyridine ; Animals ; Delayed Rectifier Potassium Channels ; Digestion ; Ether ; Neurons* ; Norepinephrine* ; Patch-Clamp Techniques ; Potassium* ; Rats* ; Rats, Sprague-Dawley ; Tetraethylammonium ; Vestibular Nuclei

The incisional hernia through trocar site is an uncommon complication of gynecologic laparoscopy. Its incidence is less than 1% and most of them are occurring through 10 mm trocar site. Small bowel herniation through 5 mm trocar site is very rare. Furthermore, 5 mm trocar site bowel herniation with drain tube in situ has not yet been reported. We present a case of small bowel herniation through 5 mm trocar site with drain tube in situ and its reduction by laparoscopy with a brief review of literature.
Drainage ; Hernia ; Incidence ; Laparoscopy ; Surgical Instruments