No abstract available.
Empyema* ; Fistula*

Dislocation of the temporomandibular joint(TMJ) is fairly frequent but backward dislocation of TMJ during induction of anesthesia is rarely reported. The causes include congenital weakness of the capsule or malformation of the condyles of both. The physical causes are as follows ; The joint may be strained or injured during general anesthesia, 1) possible straing or injureyto the joint, 2) yawning, 3) attempts by children to insert large objects into the mouth, 4) and positional pressures during sleep. Acase of backward dislocation of TMJ occureed during induction of anesthesia and treated with nanual reduction and subsequent intermaxillary fixation.
Anesthesia* ; Anesthesia, General ; Child ; Dislocations* ; Humans ; Joints ; Mouth ; Temporomandibular Joint* ; Yawning

No abstract available.
Cervix Uteri* ; Female ; Pregnancy*

No abstract available.
Lung Transplantation* ; Lung*

No abstract available.
Heart, Artificial*

PURPOSE: The purpose of this study is to determine for upper abdominal pain, the accuracy of emergency abdominal ultrasonography (EAU) performed by emergency physicians with limited training. METHODS: Two PGY-3 emergency physicians, who had received 2 hours of hands-on training, including the normal anatomy of a biliary system, liver, kindney, spleen, and pancreas, and who had studied the pathologic findings for another month were the subjects of this study. They used a Sonosite 180 R to perform EAU on patients with upper abdominal pain within 2 months after training. We determined the agreement between the radiologist 's abdominal ultrasonography(RAU) and EAU by using Kappa statistics. RESULTS: A total of 59 patients were enrolled. The agreement between the EAU and the RAU findings was 0.97, 0.88, 0.79, 0.73, 0.62, and 0.57 for gall bladder (GB) distension, cholelithiasis, GB wall thickening, duct dilatation, choledocholithiasis, and pericholecystic fluid, respectively (p<0.05). CONCLUSION: The results of EAU, performed by emergency physician with limited training on patients suffering from upper abdominal pain had a significant agreement with the RAU. However, more educations and cautions are warranted for diagnosing pericholecystic fluid and choledocholithiasis.
Abdominal Pain ; Biliary Tract ; Choledocholithiasis ; Cholelithiasis ; Dilatation ; Emergencies* ; Humans ; Liver ; Pancreas ; Spleen ; Ultrasonography* ; Urinary Bladder

PURPOSE: This study was designed to investigate the predictors of long-term admission in patients with acute diarrhea at an early stage of their emergency department (ED) visit. METHODS: We retrospectively analyzed clinical data of 125 patients who visited our ED with complaints of acute diarrhea and abdominal pain and underwent a stool test during one year (Jan. to Dec. 2001). We excluded patients who were transferred out or were self-discharged and those with another illness. We checked the numbers of cases of diarrhea, the presence of fever and abdominal pain, the stool cell counts, the blood cell counts, platelets, blood urea nitrogen, and creatinine on admission. We also counted the length of stay and defined a stay of over 4 days in the hospital as a long-term admission. We tried to find parameters that could predict long-term admission at an early stage. RESULTS: A total of 125 patients were enrolled (men : 56 ; women : 69), and their mean age was 44 +/- 0.25 years. The mean length of stay was 3.0 +/- 0.02 days. The length of stay had a statistically significant correlation with the stool WBC (p<0.01, R=0.361). Only the stool WBC a the discriminative variable for long-term admission (p<0.01). CONCLUSION: The stool WBC was a statistically significant predictive variable to determinate the long-term admission and the severity of acute diarrhea, and we think it could be used to make an early decision for the close medical attention.
Abdominal Pain ; Blood Cell Count ; Blood Platelets ; Cell Count ; Creatinine ; Diarrhea* ; Emergency Service, Hospital ; Female ; Fever ; Humans ; Length of Stay ; Nitrogen ; Retrospective Studies ; Urea

PURPOSE: The aim of this study was to evaluate the prevalence of Benign Vocal Fold Lesion (polyp, cysts, nodules) and Leukoplakia in Korea. MATERIALS AND METHODS: The data from the 2008 to 2011 Korea National Health and Nutrition Examination Surveys, which were cross-sectional survey of the civilian noninstitutionalized population of South Korea. A survey team that included an otolaryngology residents, nurses, and interviewers moved with a mobile examination unit and performed laryngologic interviews and examinations of vocal folds using rigid telescopic laryngoscopy on survey participants over 19 years old (n=19636). RESULTS: Laryngoscopic examination revealed normal results in 19251 (98.04%) of those included in the survey. Abnormal laryngoscopic findings were observed in 1.96% of the population examined, and vocal cord nodules were the most common abnormal finding. The prevalence of vocal cord nodules was 0.99-1.72%, the prevalence of vocal cord polyps was 0.31-0.55%, the prevalence of vocal cysts was 0.04-0.17%, and the prevalence of vocal cord leukoplakia was 0.07-0.21%. There was no significant correlation of linear trend of prevalence by year, and there were no significant differences in prevalence between males and females. CONCLUSION: This is the first nationwide epidemiologic study to assess the prevalence of Benign Vocal Fold Lesion (polyp, cysts, nodules) and Leukoplakia by both the Korean Otolaryngologic Society and the Ministry of Health and Welfare. The results of this large epidemiologic study provide valuable information regarding the prevalence of voice disorders and the management of laryngologic diseases.
Cross-Sectional Studies ; Epidemiologic Studies ; Epidemiology ; Female ; Humans ; Korea* ; Laryngeal Diseases* ; Laryngoscopy ; Leukoplakia ; Male ; Methods ; Nutrition Surveys* ; Otolaryngology ; Polyps ; Prevalence* ; Republic of Korea* ; Vocal Cords ; Voice Disorders

BACKGROUND: This study was designed to review the cases of patients who had undergone diffusionweighted magnetic resonance imaging(DWI) in the emergency department(ED), and to investigate its clinical usefulness and current indications. METHODS: We analyzed the cases of 152 consecutive patients who underwent DWI in the ED from Jan to Mar 2001. DWI was obtained with the use of a multislice, single-shot, spin-echo plana imaging technique(GE Signa(R)). Imaging time was less than one minute. The medical records, the DWI films and the computed tomography results were reviewed. We investigated the chief complaint, initial findings of physical examination, final diagnosis, decision-making department, interval from admission to imaging, and DWI findings. RESULTS: DWI showed positive findings of high signal intensity in 84 patients(55.3%). Among the 68 patients who yielded a negative result, false negative occurred with 12 patients(17.6%): 10 lacunar infarctions, a pons infarction, and a brainstem infarction. Eleven patients were determined as having a cerebral hemorrhage, all of whom showed the abnormal finding of a mixed signal in DWI. The sensitivity and the specificity of DWI to rule out stroke were 85.5% and 98%, respectively. Current indications for DWI in our ED are age older than 60, alert mental status, and one of the symptoms or signs among lateralyzing sign, language disturbance, and dizziness/vertigo. CONCLUSION: DWI was highly specific to rule out stroke, so emergency care professionals should be familiar with this new technology. Further prospective study is required to determine the proper indications and clinical usefulness of DWI in the ED.
Brain Stem Infarctions ; Cerebral Hemorrhage ; Diagnosis ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Medical Records ; Physical Examination ; Pons ; Sensitivity and Specificity ; Stroke ; Stroke, Lacunar

BACKGROUNDS: The mortality of geriatric trauma patients is higher than that of other age groups. However, little research has been done the methods or criteria of triage for geriatric trauma patients. This study evaluated a clinical significance of the triage-revised trauma score(t-RTS) for triage of geriatric trauma patients. METHODS: We retrospectively analyzed clinical data on 528 trauma patients over 65 years of age who were treated from Jan 1999 to Dec 2000. The t-RTS was calculated utilizing the RR(respiratory rate), SBP(systolic BP), and GCS scores and the ISS was abstracted from the final diagnosis. The obtained t-RTS and ISS were evaluated using the measures of sensitivity, specificity, accuracy, and AUC curve. RESULTS: The overall mortality rate was 9%, and there was no significant differences between the survival group and the mortality group according to age and sex. The mean scores of SBP, RR and GCS of the survival group were significantly higher than those of mortality group(p=0.001). The mean of t-RTS and RTS of the survival group were also significantly higher(p=0.001), but the ISS was significantly higher in the mortality group(p=0.001). The t-RTS, RTS, and ISS showed good prediction rates on the ROC curve(p=0.001), and the AUC value was higher in the ISS than in the t-RTS and the RTS. The sensitivity and the accuracy were high in the t-RTS and the RTS, and the specificity was high in the ISS. The t-RTS is less than 10 for a survival probability of 50% or less CONCLUSONS: Implementation of the t-RTS in the triage of geriatric trauma patients in the field and in emergency room would be very useful. The probability of death in geriatric trauma patients is high when the t-RTS is less than 10.
Area Under Curve ; Diagnosis ; Emergency Service, Hospital ; Humans ; Mortality ; Retrospective Studies ; Sensitivity and Specificity ; Triage*