PURPOSE: Recently, the emergency medical information center has evolved into a new alternative institution providing emergency medical dispatching in Korea. The objective of this study is to analyze the recognition level of the emergency medical information center, the compliance of the emergency medical dispatch, and the accuracy of dispatching questions for appropriate triage. METHOD: A telephone survey of Gwangju citizens and a retrospective analysis of audio recordings of dispatcher-caller conversations collected by the Gwangju Emergency Medical Information Center for one year were conducted. RESULT: Of 105 respondents, only 21 (21.9%) were aware of the existence of the emergency medical information center and it's telephone number '1339' while 92 (87.6%) respondents were aware of 119, another emergency call number for ambulance service. Distributions of calls are as follows: The most frequent age was 0~9 (43.1%) years and the busiest hour was between 18:00 and 23:59. Also, most callers asked about abdominal pain (19.7%), high fever (10.9%), and injury (10.5%). The compliance of callers to dispatcher's recommendation, 'reassurance or self-care,' 'visit a physician's office,' 'use emergency room service,' 'immediately visit emergency medical center,' was 66.7%, 70.1%, 64.0%, and 92.6%, respectively. Overall, caller's compliance and satisfaction rate were 75.95% and 68.4%, respectively. Logistic regression models showed no significant association between the cardinal dispatcher questions and appropriate triage of trauma patients. CONCLUSION: The recognition level of the emergency medical information center was very low. This result indicates that some new strategies are needed to increase community knowledge and usage of the emergency medical information center. The utilization pattern of emergency medical information center was similar to that of emergency room. It is expected that non-urgent patients could be diverted from overcrowded emergency medical centers to other medical resources by improving the emergency medical information center. Lastly, if prehospital care is to be improved further, the dispatch protocol should be refined and revised with a comprehensive emergency medical system considered.
Abdominal Pain ; Ambulances ; Compliance* ; Surveys and Questionnaires ; Emergencies* ; Emergency Medical Service Communication Systems ; Emergency Medical Services ; Emergency Service, Hospital ; Fever ; Gwangju ; Humans ; Information Centers* ; Korea ; Logistic Models ; Retrospective Studies ; Telecommunications ; Telephone ; Triage

PURPOSE: The efficacy of intranasal corticosteroids for the treatment of allergic rhinitis has been reported. But the efficacy of intranasal corticosteroids has not been compared between perennial nonallergic rhinitis (PNAR) and perennial allergic rhinitis (PAR). METHODS: Twenty-three patients with PNAR and 19 patients with PAR were enrolled in this study. Every patient received fluticasone propionate (FP) 200 g (100 g, bid) daily for 4weeks. Control group (n=16) was received only anti-histamine (hydroxyzine 0.6 mg/kg/dose) intermittently. Efficacy of FP was evaluated by the mean change in nasal congestion, rhinorrhea, nasal itching, sneezing and total nasal symptom score (a sum of patient ratings of nasal congestion, rhinorrhea, nasal itching, and sneezing). RESULTS: Both groups (PNAR and PAR) showed similar improvement of nasal symptom with FP 200 g compared with control. (P< 0.05) In the total population, both groups showed significant improvements from baseline in TNSS compared with control during each week of treatment. (P< 0.05) In PNAR and PAR, nasal congestion was significantly improved more than in control. (P< 0.01, P< 0.01) Rhinorrhea and itching in PAR were improved more than in control. (P=0.02, P=0.03) In sneezing, all three groups showed no differences. (P=1.00, P=0.31, P= 0.29) CONCLUSION: Intranasal FP is an effective treatment for perennial nonallergic rhinitis as same as perennial allergic rhinitis.
Adrenal Cortex Hormones ; Diethylpropion ; Estrogens, Conjugated (USP) ; Humans ; Pruritus ; Rhinitis* ; Sneezing ; Fluticasone

Medical students and doctors should study the appearance of normal anatomical structures in the magnetic resonance images (MRIs). For this purpose, horizontal, coronal, sagittal MRIs of a healthy entire body and corresponding segmented images were prepared. However, it is inconvenient to select interesting MRIs and segmented images; and it is difficult to understand how stereoscopic anatomical structures appear in the MRIs. Therefore, in this research, a software, on which interesting MRIs can be conveniently displayed among the horizontal, coronal, sagittal MRIs and corresponding segmented images can be displayed together, was composed. And after stacking the segmented images, three-dimensional (3D) image of each anatomical structure was manually reconstructed by surface rendering. Then another software, on which interesting 3D images of anatomical structures can be displayed and rotated, was composed too. These softwares are expected to help medical students and doctors understand normal anatomical structures in the MRIs and read pathological findings in the MRIs of patients.
Humans ; Imaging, Three-Dimensional* ; Magnetic Resonance Imaging* ; Students, Medical

Liver cirrhosis is one of the major complications of hepatitis C virus (HCV) infection, but the mechanisms underlying HCV-related fibrogenesis are still not clear. Although the roles of HCV core protein remain poorly understood, it is supposed to play an important role in the regulation of cellular growth and hepatocarcinogenesis. The aim of this study was to examine the role of HCV core protein on the hepatic fibrogenesis. We established an in vitro co-culture system with primary hepatic stellate cell (HSC) isolated from rats, and a stable HepG2-HCV core cell line which had been transfected with HCV core gene. The expressions of fibrosis-related molecules transforming growth factor beta1 (TGF-beta1), transforming growth factor b receptor II (TGF beta RII), alpha-smooth muscle actin (alpha-SMA) and connective tissue growth factor (CTGF) were analyzed via histological or molecular methods. In addition, the expression levels of matrix metaloprotinase-2 (MMP-2) and collagen type I (Col I) from the co-cultured media were measured by zymogram and ELISA, respectively. The expressions of alpha-SMA, TGF-beta1, Col I, TGF beta RII and MMP-2 were significantly increased in the co-culture of stable HepG2-HCV core with HSC. Moreover, the significant increases of CTGF and TGF-beta1 in the HCV core-expressing cells were observed by either Northern or Western blot analysis. These results suggest that HCV core protein may contribute to the hepatic fibrogenesis via up-regulation of CTGF and TGF-beta1.
Actins/metabolism ; Animals ; Cell Line, Tumor ; Cells, Cultured ; Coculture Techniques ; Collagen Type I/metabolism ; Gelatinase A/metabolism ; Immediate-Early Proteins/*biosynthesis ; Intercellular Signaling Peptides and Proteins/*biosynthesis ; Liver/metabolism/*pathology ; Liver Cirrhosis/*metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Transforming Growth Factor beta/metabolism ; Research Support, Non-U.S. Gov't ; Transforming Growth Factor beta/*metabolism ; Up-Regulation ; Viral Core Proteins/genetics/*metabolism

PURPOSE: To investigate the effects of anthocyanins extracted from black soybean, which have antioxidant activity, on apoptosis in vitro (in hormone refractory prostate cancer cells) and on tumor growth in vivo (in athymic nude mouse xenograft model). MATERIALS AND METHODS: The growth and viability of DU-145 cells treated with anthocyanins were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and apoptosis was assessed by DNA laddering. Immunoblotting was conducted to evaluate differences in the expressions of p53, Bax, Bcl, androgen receptor (AR), and prostate specific antigen (PSA). To study the inhibitory effects of anthocyanins on tumor growth in vivo, DU-145 tumor xenografts were established in athymic nude mice. The anthocyanin group was treated with daily oral anthocyanin (8 mg/kg) for 14 weeks. After 2 weeks of treatment, DU-145 cells (2x106) were inoculated subcutaneously into the right flank to establish tumor xenografts. Tumor dimensions were measured twice a week using calipers and volumes were calculated. RESULTS: Anthocyanin treatment of DU-145 cells resulted in 1) significant increase in apoptosis in a dose-dependent manner, 2) significant decrease in p53 and Bcl-2 expressions (with increased Bax expression), and 3) significant decrease in PSA and AR expressions. In the xenograft model, anthocyanin treatment significantly inhibit tumor growth. CONCLUSION: This study suggests that anthocyanins from black soybean inhibit the progression of prostate cancer in vitro and in a xenograft model.
Animals ; Anthocyanins/*pharmacology ; Apoptosis/*drug effects ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Cell Survival/drug effects ; Gene Expression Regulation, Neoplastic/drug effects ; Humans ; Male ; Mice, Inbred C57BL ; Mice, Nude ; NAD/metabolism ; Prostate-Specific Antigen/metabolism ; Prostatic Neoplasms/genetics/*pathology ; Receptors, Androgen/metabolism ; Tumor Suppressor Protein p53/metabolism ; *Xenograft Model Antitumor Assays ; bcl-2-Associated X Protein/genetics/metabolism

OBJECTIVE: To evaluate the impact of preoperative transarterial chemoembolization (TACE) for the treatment of patients undergoing curative liver resection for hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Preoperative TACE was performed in 164 of 339 HCC patients that had a curative resection and follow-up. Retrospective clinico-pathological analysis was performed with regard to the safety and response to treatment, early and late incidence and the pattern of recurrence as well as survival. RESULTS: For 159 patients in the TACE group (96.9%), TACE was performed preoperatively only once. The mean waiting time from TACE to resection was 19.5 days. There was no difference in the operative time, postoperative mortality and duration of hospital stay after resection between the two groups (patients that underwent TACE and patients that did not undertake the procedure). Ed-highlight-you did not define the two groups-is the above description in parentheses accurate? Microvascular invasion was significantly decreased in the TACE group (p < 0.01) and complete necrosis of the tumor was induced in 21 patients (12.8%) of the TACE group. Early and late recurrence patterns were not different between patients in the two groups. Overall survival and disease-free survival rate was not different between patients in both groups. However, the 3 year disease-free survival rate was significantly improved in the TACE group (p = 0.04) and the 3 year disease-free survival rate was also improved (p = 0.06), especially for patients with AJCC stage I or II. Multivariate analysis showed microvascular invasion, large tumor size, the presence of daughter nodules, gross portal invasion, Child classification and histological stage of cirrhosis to be risk factors for HCC recurrence and poor survival. CONCLUSION: Preoperative TACE is a safe procedure and can improve early postoperative recurrence and survival, especially in stage I or II HCC patients.
Carcinoma, Hepatocellular* ; Child ; Classification ; Disease-Free Survival ; Fibrosis ; Follow-Up Studies ; Humans ; Incidence ; Length of Stay ; Liver ; Mortality ; Multivariate Analysis ; Necrosis ; Nuclear Family ; Operative Time ; Recurrence ; Retrospective Studies ; Risk Factors

Vocal cord paralysis is a comlex disorder which may result from numerous causes. It is often associated with trauma, disease in adjacent tissue, or a generalized neuroligical disorder. Laryngeal EMG is a useful technique for vocal cord paralysis. However it has not been used due to the uncertainties of normal human vocal cord physiology and the technical difficulties in performing these studies. We investigated the pathophysiology of vocal cord paralysis with laryngeal electromyography(LEMG). We studied 20 patients with idiopathic vocal cord paralysis. 6 patients were denervated in the cricothyroid(CT) and 6 patients in the thyroarytenoid(TA), and 3 patients in both CT and TA muscles. These indicated superior laryngeal neuropathy, recurrent laryngeal neuropathy, and proximal laryngeal or vagus neuropathy, respectively. LEMG proved to be a safe and effective procedure in the diagnosis of laryngeal neuropathy, and make it possible to use electromyography as a routine procedure in diagnosis laryngeal paralysis.
Diagnosis ; Electromyography* ; Humans ; Muscles ; Physiology ; Vagus Nerve Diseases ; Vocal Cord Paralysis* ; Vocal Cords*

Clinical criteria have been established for idiopathic hypereosinophilic syndrome (HES): persistent eosinophilia of 1500 eosinophils/mm3 for at least 6 months or death even within 6 months with signs and symptoms of HES; no evidence for parasitic, allergic, or other recognized causes of eosinophilia despite careful evaluation; and signs and symptoms of organ system involvement or dysfunction, such as congestive heart failure, hepatosplenomegaly, central nerveous system disease. Because cerebral hemorrhage in HES has not been reported yet in Korea, we report a case of hypereosinophilic syndrome with peripheral blood eosinophilia, with biopsies of skin and duodenum showing diffuse eosinophilic infiltration, and multiple organ dysfunction in a 49 year old man died of cerebral hemorrhage three months after the occurrence of the disease.
Biopsy ; Cerebral Hemorrhage ; Duodenum ; Eosinophilia ; Eosinophils ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Intracranial Hemorrhages* ; Korea ; Middle Aged ; Polyradiculoneuropathy* ; Skin

Glacial acetic acid, a caustic substance of strong acidity, can easily be found in our daily lives; sometimes, it is drunk for the purpose of suicide, or it can be misjudged as a beverage. Glacial acetic acid is corrosive and toxic, therefore, even a tiny amount may cause fatal damage, such as gastrointestinal injury and systemic complication. A 66-year-old male patient, based on the wrong information, that glacial acetic acid is a healthy beverage, ingested 250 mL of 99% glacial acetic acid. Complications included gastric perforation, hemolysis, disseminated intravascular coagulation, acute renal failure, and liver dysfunction. We achieved successful treatment through performance of emergency surgery and hemodialysis on the patient, who had ingested a more than fatal dose of glacial acetic acid; herein, we would like to report on the case along with a review of the literature.
Acetic Acid ; Acute Kidney Injury ; Aged ; Beverages ; Disseminated Intravascular Coagulation ; Eating ; Emergencies ; Hemolysis ; Humans ; Liver Diseases ; Male ; Renal Dialysis ; Suicide

Nitrogen is an inert gas that is harmless to humans under normal conditions. While it is not inherently toxic, nitrogen gas becomes dangerous when it displaces oxygen, resulting in suffocation. Herein, we report a case of a 34-year-old man who attempted suicide by nitrogen asphyxiation who presenting with decreased mental function and agitation. Lactic acidosis and hyperammonemia were observed on presentation at the emergency department, but these improved after a few hours. After 2 days, the patient regained full consciousness, and was discharged without any complications. Survival after asphyxiation due to nitrogen gas is very rare, and these patients are more likely to have poorer outcomes. There is a potential for the increasing use of nitrogen gas as a method of committing suicide because of the ease of access to this gas.
Acidosis, Lactic ; Adult ; Asphyxia ; Consciousness ; Dihydroergotamine ; Emergency Service, Hospital ; Gas Poisoning ; Humans ; Hyperammonemia ; Methods ; Nitrogen* ; Oxygen ; Suicide ; Suicide, Attempted*