No abstract available.
Estradiol* ; Female ; Humans ; Plasma* ; Progesterone*

PURPOSE: Poisoning is a major health problem for the elderly, and poisoning can cause fatal side effects. However, the characteristics and clinical features of elderly patients with acute poisoning have not been well studied in the previous domestic research. So, we tried to analyze the clinical characteristics and toxic substances of the patients who were 65 years old or older and who were admitted to the regional emergency medical center due to acute poisoning. METHODS: We retrospectively reviewed the medical records and poisoning protocols of the patients who were 65 years of age or older and who had with acute poisoning and who visited the ED in our emergency center from January 2005 to December 2009. We collected the demographic information, the gender, the underlying diseases, the causes and toxic substances, the initial presentation, the treatment and the outcomes. RESULTS: A total of 2179 poisoned patients visited the hospital during 5 years, and among them 244 were 65 years of age or older (11.2%). The mean age was 75.6+/-6.9 years and the male:female ratio was 1:1.7. The most common cause of poisoning was suicide (73.4%) and the most common source of poisonous substances was their own drugs. Of the substances used for poisoning, benzodiazepine was the most common drug (25.8%), followed by sedatives other than benzodiazepine (25.4%), insecticide (12.7%), chemical agents (12.3%) and herbicides (8.2%). The most common initial presentation was mental change (64.8%). CONCLUSION: In this Korean study, unlike the foreign studies, the most common cause of poisoning in elderly patients was intentional poisoning. The admission rate was 68.8% and mortality rate was 10.2%.
Aged ; Benzodiazepines ; Emergencies ; Herbicides ; Humans ; Hypnotics and Sedatives ; Medical Records ; Retrospective Studies ; Suicide

PURPOSE: Accidental out-of-hospital deliveries are generally associated with high rates of perinatal morbidity and mortality. To determine the status of accidental out-of-hospital deliveries transferred by emergency medical services (EMS), we analyzed the records of EMS runsheets in two South Korean provinces, Gyeonggi and Gangwon. METHODS: The EMS runsheets of patients who were more than 20 weeks pregnant and had delivery-related symptoms between January 2012 and December 2013 in Gyeonggi and Gangwon province were reviewed retrospectively. We analyzed the characteristics of accidental out-of-hospital deliveries by comparing these with those non out-of-hospital deliveries. RESULTS: There were 1,426 urgent dispatches during the study period. In 137 (9.6%) out-of-hospital deliveries, which took place prior to arriving at the hospital, and 48 of these were attended by EMS providers. The accidental out-of-hospital deliveries were more frequent during night time and more common among multiparous and younger age women; however, these observation was without any significance with respect to premature birth. The rate of the accidental out-of-hospital deliveries was not significantly different between rural and urban areas. Twenty cases of complication, including 10 arrests of neonates and EMS providers managed them by the following intervention: reduction of nuchal cord, umbilical cord clamping and cut, warming-up of and stimulating the neonates warms, using oropharyngeal suction, O₂ supplication, and neonatal cardiopulmonary resuscitation. CONCLUSION: As the rate of accidental out-of-hospital deliveries in patients who were transferred by EMS is higher than the rate of out-of-hospital deliveries in general, EMS providers should be fully trained. Moreover, there is the need for more completive records and continuous education.
Cardiopulmonary Resuscitation ; Constriction ; Education ; Emergencies* ; Emergency Medical Services* ; Female ; Gangwon-do ; Gyeonggi-do ; Humans ; Infant, Newborn ; Mortality ; Nuchal Cord ; Obstetric Labor Complications ; Pregnancy ; Premature Birth ; Retrospective Studies ; Suction ; Umbilical Cord

PURPOSE: To investigate the factors associated with discharge of children from the emergency department (ED) after interfacility transfer. METHODS: We reviewed consecutive children who visited the ED via interfacility transfer from January 2014 to December 2015. The children were divided into two groups according to whether they were discharged from the ED or not (the discharge and admission groups), and their characteristics were compared. Multivariable logistic regression analysis was performed to identify the factors associated with discharge of children from the ED after interfacility transfer. RESULTS: Of the 999 transferred children, 426 (42.6%) were discharged. Compared to the admission group, these children showed older age, more frequent transfers from clinics and arrivals between 16 h and 20 h, shorter stay in the ED, and less frequent surgical abdomen. We found that age (3 to 6 years; adjusted odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3–2.6, compared with 0 to 2 years), diagnosis (trauma; OR, 2.4; 95% CI, 1.5–4.0, compared with gastrointestinal diseases), and referring hospital (primary clinic; OR, 5.4; 95% CI, 3.1–9.4, compared with tertiary hospitals) were the factors. CONCLUSIONS: The children who aged 3 to 6 years, had trauma or underwent transfers from primary clinics were more likely to be discharged at the ED. Considering these factors, we should reduce unnecessary transfers.
Abdomen ; Child* ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Logistic Models ; Odds Ratio ; Patient Discharge ; Patient Transfer ; Pediatrics

Fourteen total cystectomy specimens with primary carcinoma of urinary bladder were investigated to illustrate the overall prevalence and nature of mucosal changes adjacent to the overt carcinoma and to clarify the distribution pattern and extent of carcinoma in situ in regard with multiplicity, histological type and depth of invasion of the macroscopically visible tumor mass. Of 14 cases subjected to this study were 12 cases of transitional cell carcinoma of varying degree of differentiation and invasion, one adenocarcinoma, and the another one with no grossly detectable tumor but history of previous cystoscopic removal of papillary transitional cell carcinoma. Each specimen was processed by a histotopographic technique developed by authors, an easy access to reconstruct the mucosal changes using reconstruction paper. For the histological grading and staging of the overt carcinomas, Ash's and Collins' classifications were applied, respectively. Carcinoma in situ (CIS) was found in 10 out of 11 cases with overt urothelial carcinoma of urinary bladder and one case with no grossly visible neoplasm, in which cystoscopic removal of papillary carcinoma was carried out previously. Distribution pattern of CIS was mostly circular (group I) or arborizing (group II) , located around the overt carcinoma within 0.5 to 2.0cm., but not beyond 3.0cm. from its margin. Correlation between multiplicity of overt carcinomas and presence of CIS was evident together with irregularity of its distribution, but no significance was found with gross appearance, histological grading or with staging.
Adenocarcinoma ; Carcinoma in Situ* ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Classification ; Cystectomy ; Mucous Membrane* ; Prevalence ; Urinary Bladder*

Ranunculus tachiorei is a member of the buttercup family (Ranunculaceae) which contains unsaturated lactone and protoanemonine. Protoanemonine is formed by the breakdown of the glycoside Ranunculin after injury to the plant and causes severe vesiculation and linear streaks after contact with field buttercups(Ranunculus spp.) The amount of protoanemonine in buttercups varies widely with the species of plant and its stage of growth, the highest content being at the time of flowering. We report a case of primary irritant dermatitis due to contact with Ranunculus Tachiorei which was applied for the folk treatment of Bell palsy.
Bell Palsy ; Dermatitis, Irritant* ; Flowers ; Humans ; Plants ; Ranunculus*

Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixtture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequentlly in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb (T3N0M0). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.
Bronchi ; Carcinosarcoma* ; Humans ; Laparotomy ; Male ; Middle Aged ; Neoplasm Metastasis ; Pneumonectomy* ; Pulmonary Atelectasis ; Smoke ; Smoking

The mandibular contour determines the shape of the lower part of face and thus influences the appearance of head and neck. A prominent mandibular angle produce characteristic quadriangular, coarse and muscular appearance. To correct this facial contour to oval shape, the prominent angle can be contoured. the cutaneous approach has been used, but it leaves noticeble scar and has risk of facial nerve injury. Thus the intraoral approach has been used commonly. But because of restricition of operation field, the intraoral approach disadvantages of long operation time, high risk of complications. So, we have performed mandibular contouring procedure by new approach which uses reciprocating saw through stab incision under the mandibular body to correct the 9 patients of mandibular angle protrusion who visited our clinics recently. And we found that mandibular angle contouring by this new approach is easy, and makes the operation and recovery time shorter. There were no complications and cosmetic results were quite satisfactory.
Cicatrix ; Facial Nerve Injuries ; Head ; Humans ; Neck

Fourtyone patients fo gallbladder and bile duct diseases were studied clinically and sonographically.Tweentynine (Seventyone percent) patients were distributed between age fourty to fiftynine and male to femaleratio was 1:1.4. The order of frequency of biliary tract disease was cholelithiasis, acalculous cholecystitis, CBDstone and CBD cancer. Sonographic findings of cholelithiasis were strong echo with posterior shadowing, faintinternal echoes without shadowing, gallbladder wall thickneing and anechoicity of the gallbladder wall. Instead ofsmall proportion of gallbladder distension and wall anechoicity, faint internal echoes without shadowing were seenin ten of nineteen cases of cholelithiasis. On choledocholithiasis, meniscus sign at the junction of the stone andgallbladder wall was identified in most cases and was helpful to differentiation stone from malignancy. The degreeof CBD dilatation was more severe in malignancy than in CBD stones and ascaris in CBD. Sonographic examination wasuseful in detection of gallbladder and bilicary tree pathology and the cause of biliary tract obstruction could beidentified.
Acalculous Cholecystitis ; Ascaris ; Bile Duct Diseases ; Biliary Tract Diseases ; Biliary Tract ; Choledocholithiasis ; Cholelithiasis ; Dilatation ; Gallbladder ; Humans ; Male ; Pathology ; Shadowing (Histology) ; Trees ; Ultrasonography

Purpose: This study was aimed to investigate the changes in pediatric injury-related visits at an emergency department (ED) during coronavirus disease 2019 pandemic. Methods: We retrospectively compared injury-related visits to an ED in Korea by children aged 15 years or younger during February 2020-December 2021 (pandemic period), and the visits during February 2018-December 2019. Clinical characteristics, injury mechanisms, diagnostic codes, and ED outcomes were noted. We performed 2 sub-analyses of the pandemic period: biannual changes in the visits, and monthly trends of proportions of concussion and superficial injury as diagnostic codes using linear regression. Results: Despite a 51.2% reduction in injury-related visits during the pandemic, the proportion of the visits increased (25.2% vs. 40.0%; P < 0.001). Overall, increases were noted in proportions of use of emergency medical services and high acuity (P < 0.001). Among the diagnostic codes, brain injuries, fracture and dislocation, and laceration increased while superficial injuries, burn, intoxication, and foreign body ingestion decreased (P < 0.001). As the pandemic prolonged, injury-to-ED time shortened and ED length of stay lengthened while the abovementioned trends remained unchanged. Linear regression showed that the proportions of concussion and superficial injury respectively increased and decreased by 0.01% per month (P < 0.001). Conclusion The changes in pediatric injury-related visits at the ED during the coronavirus disease 2019 pandemic may serve as a basis for distributing emergency medicine resources in future infectious disease outbreaks.