No abstract available.
Peripheral Blood Stem Cell Transplantation*

No abstract available.
Knee*

No abstract available.
Osteoma, Osteoid* ; Spine*

It would be naive to assume that any operative procedure is the solution to the problem of sacral pressure sore in the field of the orthopaedic surgery. The procedures outlined here involve the creation of compound myocutaneous flaps of the gluteus maximus muscle, skin, and the subcutaneous tissue. The myocutaneous flap us- ing the gluteus maximus muscle is a vascular flap instead of a random flap, with better blood supply for healing and advantage of an increased amount of cushion effect. We present an alternative method which will provide satisfactory and substantial soft tissue coverage in sscral pressure sores.
Methods ; Myocutaneous Flap ; Pressure Ulcer ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Operative

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

Blunt trauma to the chest may result in various cardiac injuries. But traumatic myocardial infarction with coronary artery fistula as a complication of chest trauma has been reported in very few cases. The etiology of myocardial infarction is not entirely clear. A 40 years old male was admitted after a traffic accident. He complained of acute retrosternal pain of about one hours duration. There was an area of contusion over the right sternal border. The ECQ showed deep Q wave and elevated ST segments in leads 2, 3 and aVF. There was a considerable increase in creatine kinase(CK) peak level and a CK-MB fraction. Coronary angiography revealed a total proximal occlusion of the right coronary that communicated directly with the right atrium. The left ventridulogram showed hypokinesia of the inferior wall. He was managed with conservative treatments and has remained well sebsequently. We reported a middle aged man who developed an acute transmural inferior wall myocardial infarction associated with coronary artery fistula secondary to blunt cheat trauma in an automobile accident.
Accidents, Traffic ; Adult ; Automobiles ; Contusions ; Coronary Angiography ; Coronary Vessels* ; Creatine ; Fistula* ; Heart Atria ; Humans ; Hypokinesia ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Thorax*

Paraphilia is a psychiatric disease that has been difficult to cure. However, recently developed therapeutic methods hold promise. The patient was a 20-yr-old male with chief complaints of continuous masturbation, genital exposure, and aggressive behavior that started 2 yr ago. We administered leuprorelin 3.6 mg intramuscular injection per month, a depot gonadotrophin-releasing hormone analogue, to this patient who a severe mentally retardation with paraphilia. The clinical global impression (CGI)-severity, CGI-improvement and aberrant behavior checklist were performed. After one month, we observed significant improvement in symptoms, such as decreases of abnormal sexual behavior and sexual desire. The GnRH analogues are suggested to be used as an alternative or supplementary therapeutic method for sexual offenders after clinical studies.
Humans ; Leuprolide/pharmacology/*therapeutic use ; Male ; Mental Disorders/complications/diagnosis/*drug therapy ; Paraphilias/complications/diagnosis/*drug therapy ; Sex Offenses/prevention & control ; Sexual Behavior/drug effects ; Young Adult

A 82-year old man was presented with a 0.7 by 0.5 cm sized, atrophic, mild erythematous macule on the left temple for 4 months. There was no history of verruca on the lesion or taking arsenic. Histopathologically, there were suprabasal acantholysis, lacunaes, vesicles with a few corps ronds and grains in the suprabasal layer and granular layer. Atypical cells and dyskeratotic cells were, in groups, seen in the entire epidermis and its appendages. But, glandular structures were not found. We report a rare case of actinic keratosis showing Darier-like features.
Acantholysis ; Actins* ; Aged, 80 and over ; Arsenic ; Edible Grain ; Epidermis ; Humans ; Keratosis, Actinic* ; Warts