A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Emergency Medical Technicians ; Erectile Dysfunction* ; Hemoptysis* ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate

No abstract available.
Neoplasm Metastasis*

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage ; Emergency Medical Technicians ; Erectile Dysfunction ; Hemoptysis ; Hemorrhage ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate

PURPOSE: Many different conditions result in pleural effusions (PEs) and making the differential diagnosis of PE is difficult. The purpose of the present study was to document the change of incidence and compare the etiologies of PEs with regards to age, the sidedness and characteristics of PE. METHODS: During the 10-year period from 1986 to 1995, thoracentesis was performed in 197 children with PEs at Seoul National University Children's Hospital. The hospital records of these children were reviewed, and radiologic findings and laboratory data of PE were analyzed. RESULTS: The distribution of the etiologies of PEs changed with the declining incidence of tuberculous PE. Infectious PE was the leading cause of PE in each age group. The most common etiology of infectious PE in children aged less than 3 years was bacterial PE, aged 3 to 6 years mycoplasma PE, and aged more than 6 years tuberculous PE. Malignant PE was the second most frequent cause of PE and the incidence of it was marked in children aged 3 to 6 years. Non-Hodgkin lymphoma was the most frequent cause of malignant PE and Burkitt lymphoma and leukemia were the next two leading causes of it. The sidedness of the PE was not helpful in differentiating various types of PEs. Measurements of the pleural fluid protein & glucose were not useful either. Bacterial PE presented the highest LDH activity. Infectious PE presented higher pleural fluid leukocyte count than any other type of PE, and bacterial PE was most prominent in this respect. The PE polymorphonuclear leukocyte % was marked in bacterial PE and the PE lymphocyte % in tuberculous PE. CONCLUSION: The distribution of the etiologies of PEs seems to have changed. Age, LDH, leukocyte count and differential cell count of PE were helpful in differentiating various types of PEs.
Burkitt Lymphoma ; Cell Count ; Child* ; Diagnosis, Differential ; Glucose ; Hospital Records ; Humans ; Incidence ; Leukemia ; Leukocyte Count ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Mycoplasma ; Neutrophils ; Pleural Effusion* ; Seoul

The purpose of this study was to collect the informations on the current status and the needs of the physically disabled elderlies in the rural community along with the prevalence rate of these population. One study group for the study of disability status evaluation was 139 physically disabled elderlies living in the main island of Kangwha, and the other group for the study on prevalence of disability was 542 elderlies living in Songhae myun. The prevalence of physical disability was 6.5% in Songhae myun. The neurologic disorder was the most frequent diagnosis among the physically disabled elderlies followed by the musculoskeletal disorder. The time for the medical service delivery was delayed; 45.3% of the subjects received medical service more than one month after the onset of disability. Only 18.0% of the disabled elderlies received the public disability service, and 15.8% of the subjects was waiting for further service. The most common need from the subjects was the medical service, followed by the service from the institution such as a nursing home and the financial support. Registration rate of the disabled was very low(7.7%). There were only three physical therapists for the rehabilitation services in studies areas. This study revealed that the public concepts for the disability and the rehabiltation service were inadequate. We hope that this basic data can be used for the planning of rehabilitation services in this community.
Aged ; Diagnosis ; Disabled Persons* ; Financial Support ; Hope ; Humans ; Nervous System Diseases ; Nursing Homes ; Physical Therapists ; Prevalence ; Rehabilitation ; Rural Population

The McGill Pain Questionnaire consists primarily of 3 major classes in word descriptorssensory, affective and evaluative-and is used in the studies of clinical and experimental pain. The purpose of the study is to analyz e characteristics of the central pain in patients with spinal cord injury and to compare with the musculosleletal pain using McGill Pain Questionnaire(MPQ) Korean version. The subjects of this study were ninety-nine patients with spinal cord injury who were admitted to Ajou University Hospital or registered with other social agencies, and thirty patients with musculoskeletal pain who were treated at the rehabilitation medicine out patient clinic of Ajou University Hospital. Central pain had significantly higher sensory, miscellaneous and total scores of MPQ Korean version than the musculoskeletal pain. There were no correlations between visual analogue scale and each dimension of MPQ Korean version except evaluative dimension in central pain. Central pain had significantly higher scores than musculoskeletal pain in subelasses such as spatial punctate, incisive, thermal and coldness. The most frequently chosen words were "radiating"(46%) in central pain and "throbbing"(32%) in musculoskeletal pain of all subjects. In conclusion, the central pain has no difference in pain intensity but shows bizzare and diverse character compared with the musculoskeletal pain. Authors suggest that MPQ Korean version can be an useful measuring tool for the evaluation and the follow up of the central pain of spinal origin.
Follow-Up Studies ; Humans ; Musculoskeletal Pain* ; Pain Measurement* ; Rehabilitation ; Spinal Cord Injuries* ; Spinal Cord*

To validate the prevalence rate of symptoms of asthma produced by the phase I ISAAC (International Study of Asthma and Allergies in Childhood) study, hypertonic saline challenge test was carried out during the phase II study at a year after the phase I study. For the phase II study, six middle schools from three cities in the phase I study were selected. Finally, 499 children who responded to both studies were analyzed. All subjects were asked to complete the written questionnaire (WQ) first, followed by a video questionnaire (AVQ 3.0) during the phase I study. Of the 499 children, only 19 (3.8%) were positive to the hypertonic saline bronchial challenge test. The degree of agreement between responses to the two corresponding questions "wheezing at rest" and "nocturnal wheeze" in the AVQ 3.0 and WQ were moderate and weak with a Kappa indices of 0.45 and 0.23, respectively. The question on "severe wheeze" in the AVQ 3.0 had the highest Youden's index among the five questions related to asthma symptoms in the previous 12 months, but its specificity was low whereas it 's sensitivity was 1.0. There was no consistency of priority between the two questionnaires in predicting bronchial hyperreactivity in a group of Korean schoolchildren. Therefore we need to develop more appropriate WQ or AVQ to compare the prevalences of asthma to other countries.
Adolescent ; Asthma/diagnosis* ; Asthma/epidemiology ; Asthma/etiology ; Bronchial Hyperreactivity/complications ; Bronchial Hyperreactivity/diagnosis* ; Bronchial Hyperreactivity/epidemiology ; Bronchial Provocation Tests ; Comparative Study ; Female ; Human ; Korea/epidemiology ; Language ; Male ; Prevalence ; Questionnaires* ; Random Allocation ; Respiratory Sounds ; Saline Solution, Hypertonic/diagnostic use ; Sampling Studies ; Videotape Recording ; Writing

BACKGROUND: The margin of safety is the length of the mainstem bronchi, over which double-lumen endotracheal tubes (DLTs) can be moved and still be correctly positioned. A negative value of margin of safety means that DLTs may not be safe. We measured the length of the left and right mainstem bronchi and margin of safety in Korean adults. METHODS: One hundred and fifty-six ASA I or II adult patients undergoing an elective surgery were examined. After nduction of general anesthesia, we measured the lengths from the upper incisor to the tracheal carina, to the proximal margin of the left and right upper lobe bronchial opening using a fiberoptic bronchoscope. We calculated the lengths of the left and right mainstem bronchi and margin of safety using the measured lengths. RESULTS: In Korean adults, the average margin of safety of left-sided DLTs of males and females was 2.4 +/- 1.0 cm and 1.9 0.7 cm and right-sided DLTs of males and females was 1.0 +/- 0.9 cm and 0.8 +/- 0.3 cm, respectively. The percentage of a negative value of the margin of safety in positioning right-sided DLTs was 10.4% in males and 8.6% in females. However, all values of the margin of safety in left-sided DLTs were positive. CONCLUSIONS: Using left-sided DLTs, regardless of the operative side, is better than right-sided DLTs because left-sided DLTs have a greater margin of safety in positioning. If we use right-sided DLTs, we should confirm the proper position of tubes using a fiberoptic bronchoscope.
Adult* ; Anesthesia, General ; Bronchi ; Bronchoscopes* ; Female ; Humans ; Incisor ; Male ; One-Lung Ventilation

Quantifying and rating the impairments due to mental and behavior disorders are difficult for their own characteristics. Korean Academy of Medical Sciences (KAMS) is developing guidelines of rating impairment in mental and behavioral disorders based on Korean Neuropsychiatric Association (KNPA)'s new guidelines. We compared the new KNPA's guidelines and the American Medical Association (AMA)'s 6th Guides in assessing impairment due to mental and behavioral disorders to develop new guidelines of KAMS. Two guidelines are different in diagnosing system, applicable disorders, qualification of assessors, application of scales, contents of assessment and rate of impairment of the whole person. Both AMA's and the proposed guidelines have individual merits and characteristics. There is a limitation in using the 6th AMA's Guides in Korean situation. However to improve objectivity in Korean assessment of psychiatric impairment, the new AMA's Guides can serve as a good reference.
Academies and Institutes ; Behavioral Symptoms/classification/*diagnosis/physiopathology ; Brief Psychiatric Rating Scale/standards ; *Disability Evaluation ; Humans ; Korea ; Mental Disorders/classification/*diagnosis/physiopathology ; *Practice Guidelines as Topic ; Program Development

PURPOSE: The purpose of this study was to analyze and assess the current situation of Korea's school health education program and to establish measures to efficiently carry out school health education in Korea. METHOD: The survey was conducted through the internet with the health educators of elementary, middle, and high schools nationwide to assess the current condition of school health education programs, and 2,459 samples were collected which accounted for 23.4% of the total respondents. RESULTS: According to school health educators on the enforcement of health education, the higher the education became, the less the health education was enforced. The enforcement rate was 96.9% in elementary schools, 76.7% in middle schools, and 67.3% in high schools. The major reasons were found as difficulty in securing class time (54.5%) and other excessive workloads (20.9%). As a result of the health education awareness survey, over 99% answered that health education is needed, over 80% answered that the education requires independent health textbooks, and over 95% answered that health educators are suitable for the person in charge of the education. CONCLUSION: This study will be a useful in establishing a detailed policy on enhancing school health education in the future.
Adolescent ; Adult ; Aged ; Child ; Health Education/organization & administration/*trends ; Humans ; Korea ; Male ; Middle Aged ; Questionnaires ; School Health Services/*trends