PURPOSE: Despite significant concern on elevating the rate of return of spontaneous circulation (ROSC) of prehospital cardiac arrest patients, the rate in Korea is still low compared to other advanced countries. The purpose of this study is to investigate prehospital factors that can influence the use of an automated external defibrillator (AED). METHODS: We retrospectively analyzed 94 non-cardiogenic prehospital cardiac arrest patients who arrived at one hospital from June 20, 2010 to August 10, 2012. RESULTS: AED was attached to 37(39.4%) patients. Age (p=0.024), witnessed arrest (p=0.023), rate of AED attachment (p<0.001), and time interval call to emergency medical service (EMS) arrival at a scene (p=0.004) influenced the detection of ventricular tachycardia (VT) or ventricular fibrillation (VF). Bystander cardiopulmonary resuscitation (CPR) was performed in 6.4% of total patients. We assumed that assessment of patients' status, including age and underlying disease, might influence the decision of AED attachment. CONCLUSION: In cardiac arrest patients, early CPR and rapid defibrillation should be performed. Results of our study showed a low bystander CPR rate and low AED attachment rate. Further investigations should be conducted in order to find determine the factors that affect decisions of EMS personnel regarding attachment of AED.
Cardiopulmonary Resuscitation ; Defibrillators* ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Tachycardia, Ventricular ; Ventricular Fibrillation

PURPOSE: Despite significant concern on elevating the rate of return of spontaneous circulation (ROSC) of prehospital cardiac arrest patients, the rate in Korea is still low compared to other advanced countries. The purpose of this study is to investigate prehospital factors that can influence the use of an automated external defibrillator (AED). METHODS: We retrospectively analyzed 94 non-cardiogenic prehospital cardiac arrest patients who arrived at one hospital from June 20, 2010 to August 10, 2012. RESULTS: AED was attached to 37(39.4%) patients. Age (p=0.024), witnessed arrest (p=0.023), rate of AED attachment (p<0.001), and time interval call to emergency medical service (EMS) arrival at a scene (p=0.004) influenced the detection of ventricular tachycardia (VT) or ventricular fibrillation (VF). Bystander cardiopulmonary resuscitation (CPR) was performed in 6.4% of total patients. We assumed that assessment of patients' status, including age and underlying disease, might influence the decision of AED attachment. CONCLUSION: In cardiac arrest patients, early CPR and rapid defibrillation should be performed. Results of our study showed a low bystander CPR rate and low AED attachment rate. Further investigations should be conducted in order to find determine the factors that affect decisions of EMS personnel regarding attachment of AED.
Cardiopulmonary Resuscitation ; Defibrillators* ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Tachycardia, Ventricular ; Ventricular Fibrillation

The conventional radiologic method for liver segmentation is based on the position of the hepatic and portal veins. However, during surgery, liver segments are resected based on the distribution of hepatic portal blood flow. This discrepancy can lead to a number of problems, such as miscommunication among clinicians, missing the location of the segment with the hepatic mass, and the risk of extended hepatic resection. We suggest a novel method to determine hepatic segments based on portal blood flow, as in the surgical approach, but by using high and low mechanical indexes in contrast-enhanced ultrasonography with Sonazoid. This approach is helpful for preoperatively determining hepatic segments and reducing the risk of missing the location of a hepatic tumor or extended hepatic resection.

Background: Laboratory tests in blood banks vary with respect to methods,equipment, and quality control according to the hospital’s environment. Methods: We surveyed institutions that regularly participated in the Koreanassociation of external quality assessment using a web-based questionnairecomprising 79 questions regarding transfusion laboratory work. Results: A total of 84 institutions were surveyed including 17 senior generalhospitals, 43 general hospitals, 19 hospitals, four clinics, and one commerciallaboratory. ABO cell typing was performed by slide (63, 75.0%), tube (42,50.0%), automated column (19, 22.6%), and automated microplate (7, 8.3%)methods. ABO serum typing was performed by tube (75, 89.3%), automatedcolumn (19, 22.6%), automated microplate (7, 8.3%), and slide (7, 8.3%)methods. Irregular antibody screening test and identification test wasperformed by 58 (69.0%) and 36 (42.9%) institutions, respectively. Irregularantibody screening test and identification test was performed by the columnagglutination method in 34 (40.5%) and 26 (31.0%) institutions, respectively.Room temperature saline, albumin, and anti-globulin reagent crossmatchingtest (three-step method) was the most popular method (48, 57.1%). Theuse of anti-globulin reagent in the crossmatching test did not significantlyvary according to the size of the hospital. A daily quality control programfor ABO, Rh typing, and the crossmatching test was conducted in 58 (69.0%)institutions. Conclusions There were differences in transfusion-related laboratory testsamong the institutions. Although this survey included a limited number ofinstitutions, it can be helpful to evaluate the routine laboratory tests andtransfusion-related blood bank work in each institution.

Objective: Many trauma centers use their own criteria for major trauma patients, and these criteria are organized according to physiological causes and their related mechanisms. Mechanism related criteria have high sensitivity but low specificity. We confirmed 20 feet as a single factor for trauma team activation criteria. Methods: This study was retrospectively conducted in the Pusan National University Hospital trauma center, which is a level 1 trauma center in Busan. Patients were grouped as group 1, a fall from less than 20 feet; and group 2, a fall from more than 20 feet. We compare the two groups of prognostic factors using logistic regression analysis. Results: The relationship between the height of the fall and the patient’s prognosis showed a positive relationship on the logistic regression analysis. Yet the cut-off value of a 20 foot height showed poor predictive power for the patient’s prognosis. Conclusion In conclusion, as trauma team activation criteria, a 20 foot height seems to be a reasonable aspect of patients’ clinical prognosis between above 20 feet and below 20 feet. Yet it seems to be controversial as a cut-off value. Thus, more studies will be needed to identify a specific height for trauma team activation.

PURPOSE: A tension pneumothorax is a fatal condition that requires immediate intervention. Although a definitive treatment for a tension pneumothorax is a tube thoracostomy, needle decompression can provide temporary relief, that is lifesaving. The traditional procedure for needle decompression involves inserting a needle or catheter at the second intercostal space, the midclavicular line. Recent evidence suggests that the commonly used catheters do not have sufficiently penetrate the chest wall. There are also claims that a lateral approach to needle decompression is easier and safer than the traditional anterior approach. The purpose of this study is to evaluate the optimal approach for needle decompression for the Korean population by measuring chest wall thicknesses at the points used for both the anterior and the lateral approaches. METHODS: The chest wall thickness (CWT) of trauma victims who visited the Emergency Center of Pusan National University Hospital was measured by computed tomography (CT) images. The CWT was measured at the points used for the anterior and the lateral methods and was compared with the length of commonly used catheters, which is 45 mm. RESULTS: The mean CWT at the second intercostal space, the midclavicular line, was shorter than the CWT at the 5th intercostal space, the anterior axillary line. However, the percentage of patients whose CWT was greater than 45 mm was larger when measured anteriorly (8.2%) that when measure laterally (5.7%). Female patients and those older than 60 were more likely to have an anterior CWT greater than 45 mm (28.2% for females and 15.5% for those older than 60). CONCLUSION: The percentage of trauma victims in Korea whose CWT is greater than 45 mm is lower than the values previously reported by other countries. However, females and older patients tend to have thicker chest walls, so the lateral approach would be suggested when performing needle decompression for such patients with suspected tension pneumothoraces.
Catheters ; Decompression ; Emergencies ; Female ; Humans ; Korea ; Needles ; Pneumothorax ; Thoracic Injuries ; Thoracic Wall ; Thoracostomy ; Thorax

Most skin damage caused by ultraviolet B (UVB) radiation is owing to the generation of reactive oxygen species. Phytochemicals can act as antioxidants against UVB-induced oxidative stress. This study investigated the protective effects of the flavone galangin against UVB-induced oxidative damage in human keratinocytes. Galangin efficiently scavenged free radicals and reduced UVB-induced damage to cellular macromolecules, such as DNA, lipids, and proteins. Furthermore, galangin rescued cells undergoing apoptosis induced by UVB radiation via recovering mitochondrial polarization and down-regulating apoptotic proteins. These results showed that galangin protects human keratinocytes against UVB radiation-induced cellular damage and apoptosis via its antioxidant effects.
Antioxidants ; Apoptosis ; DNA ; Free Radicals ; Humans ; Keratinocytes* ; Oxidative Stress* ; Phytochemicals ; Reactive Oxygen Species ; Skin

We, herein, present a patient with no history of trauma who developed shoulder pain after undergoing low-voltage electric shock. According to the computed tomography, there was a multi-segmental fracture that extended into the glenoid cavity of the left scapula. A good outcome was obtained after open reduction and internal fixation. Emergency physicians should be aware of the possibility of scapular fracture extending into the glenoid cavity, especially in patients with shoulder pain after electrical injury.
Electric Injuries ; Emergencies ; Glenoid Cavity* ; Humans ; Scapula ; Shock* ; Shoulder Pain

BACKGROUND/AIMS: The purpose of this study was to assess the value of acoustic radiation force impulse (ARFI) for predicting the extent of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) by correlating the elasticity of HCC and peritumoral parenchyma (as measured by ARFI) with the extent of ablation determined by computed tomography (CT). METHODS: From September 2009 to June 2011, 158 patients underwent RFA ablation for HCC (single, < or =3 cm). We evaluated the data of a total of 38 prospectively enrolled patients who underwent both ARFI imaging and contrast-enhanced CT after one session of 12 minutes of RFA without a change in needle position. The ARFI imaging indices, including the mean shear wave velocity (SWV) of HCC, mean SWV of the peritumoral parenchyma and tumor size, were evaluated to determine the statistical correlation with RFA extent after one session of 12 minutes of RFA. RESULTS: A stiffer liver parenchyma in patients with cirrhosis results in a smaller ablation zone. CONCLUSIONS: SWV of ARFI in liver parenchyma was well correlated with RFA extent. After evaluating the correlation between ARFI and RFA extent, we suggest that the SWV in liver parenchyma might be a non-invasive supplementary tool for predicting the extent of RFA.
Acoustics ; Carcinoma, Hepatocellular ; Elasticity ; Elasticity Imaging Techniques ; Fibrosis ; Humans ; Liver ; Needles ; Prospective Studies

The aim of this study was to determine whether single nucleotide polymorphisms (SNPs) of matrix metallopeptidase 2 (MMP2) are associated with obesity. MMP2 is an enzyme with proteolytic activity against matrix and nonmatrix proteins, particularly basement membrane constituents. To identify the relationship between polymorphisms of MMP2 and overweight/obese, we genotyped 5 SNPs (rs17242319, rs1053605, rs243849, rs2287074, and rs10775332) of the coding region of MMP2 using the Golden Gate assay on an Illumina BeadStation 500 GX. One hundred and forty two overweight/ obese (BMI > or =23) and 145 normal (BMI 18 to <23) subjects were analyzed. SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were used for the analysis of genetic data. A linkage disequilibrium (LD) block was discovered among the 5 SNPs selected, including rs17242319, rs1053605, rs243849, and rs2287074. Of the 5 polymorphisms, 2 synonymous SNPs [rs17242319 (Gly226Gly) and rs10775332 (Phe602Phe)] were found significant associations with overweight/obese. Recently, rs1132896 replaced rs17242319 as a new number (SNP database, BUILD 129). In haplotype analysis using Haploview, a haplotype (haplotype: CCCA) containing a meaningful polymorphism (rs17242319) was found to be significantly different. The results suggest that MMP2 may be associated with overweight/obese in Korean population.
Basement Membrane ; Body Mass Index ; Clinical Coding ; Haplotypes ; Lidocaine ; Linkage Disequilibrium ; Obesity ; Polymorphism, Single Nucleotide ; Proteins