No abstract available.
Diagnosis*

No abstract available.
Diagnosis*

PURPOSE: This descriptive correlational study investigated the effects of violent experience and resilience on burnout in emergency medical technicians (EMTs). METHODS: The participants were 160 EMTs working in fire stations (safety center and local center) located in U, B, and D city. The collected data were analyzed by descriptive statistics, independent t-test, ANOVA, Scheffé test post-hoc analysis, Pearson correlation coefficients, and multiple regression analysis using IBM SPSS Statistics 20.0. RESULTS: The number of EMTs getting into ambulances was significantly associated with violent experience, resilience, and burnout. Position of EMTs was significantly associated with both resilience and burnout. In the multiple regression analysis, the subscales of durability and optimism in resilience were significantly associated with burnout after controlling for confounding variables. CONCLUSION: This study indicated that improving durability and optimism in resilience was important to cope with experience of violence and to prevent burnout in EMTs.
Ambulances ; Confounding Factors (Epidemiology) ; Emergencies* ; Emergency Medical Technicians* ; Fires ; Humans ; Optimism ; Violence

No abstract available.
Gastrin-Secreting Cells* ; Gastrins* ; Gastrointestinal Tract*

From March 1985 to June 1997, 451 patients of spontaneous pneumothorax treated at Kangbuk Samsung Hospital were reviewed retrospectively. Most of the patients were male (male to female ratio, 8.2:1). The mean age of the primary spontaneous pneumothorax (PSP) was 26.8 years, and that of secondary spontaneous pneumothorax (SSP) was 53.1 years. 330 out of 451 patients (73%) were PSP. The causes of the SSP were mostly pulmonary tuberculosis and COPD: 87 patients (72%), and 24 patients (19.2%), respectively. All the patient were treated by one of the following modalities: 1)rest and oxygen therapy in 42 patients, 2) closed thoracostomy in 208 patients, 3) thoracotomy in 156 patients, 4) VATS bullectomy in 45 patients. The mean duration of postoperative chest tube drainage was as following: thoracotomy 8.3 days, VATS bullectomy 4.7 days. For recent 3 consecutive years, VATS bullectomy has become the more frequently applied operative procedure than thoracotomy in the treatment of surgically indicated PSP, from 33% in 1994 to 78% in 1996. With the minimally invasive thoracoscopic surgery being more prevalent, VATS bullectomy will be able to be the 1st choice of treatment not only for the recurrent pneumothoracies but also for the some selected cases of the 1st episode pneumothoracies. To verify this approach as clinically acceptable one in terms of cost-effectiveness, recurrence rate, etc, a large scale of multi-institutional clinical study will be needed in a sooner time.
Chest Tubes ; Drainage ; Female ; Humans ; Male ; Oxygen ; Pneumothorax* ; Pulmonary Disease, Chronic Obstructive ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracostomy ; Thoracotomy ; Tuberculosis, Pulmonary

BACKGROUND: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. MATERIAL AND METHOD: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. RESULT: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186+/-40cc, control group:409+/-69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317+/-53cc, control group: 671+/-133cc, P=0.024). CONCLUSION: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.
Adult* ; Aprotinin* ; Cardiopulmonary Bypass ; Creatinine ; Hemorrhage ; Humans ; Retrospective Studies ; Thoracic Surgery

OBJECTIVE: To survey the prevalence of Cumulative trauma disorders (CTDs) and to analyze the ergonomic factors among the bank workers and post officers. METHOD: Seventy seven subjects were collected from bank workers (50) and post officers (27) from the multiple areas of country who had been exposed to risky working environment regarding CTDs. The subjects were first screened by occupational medicine specialists and confirmed by rehabilitation medicine specialist. The serologic test, radiologic imaging, electrodiagnostic study were performed in all the subjects. Ergonomists analyzed the job element to identify the risk factors by baseline checklist of CTDs. RESULTS: Among bank workers, 30 (60%) of 50 were confirmed as having CTDs. MPS was present in 30 patients (60%), latenl epicondylitis in 5 (10%), medial epicondylitis in 3 (6.0%), tendinitis 3 (6.0%), and other disease in 3 (6.0%). Among post officers, 14 (51.9%) of 27 were confirmed as having CTDs. MPS present in 10 (37.0%), cervical disc disease in 4 (14.8%), others in 4 (14.8%). The ergonomic risk score was highest 1.87 in the 'package deviding' job, and 1.82 in 'bagging to cart', 1.62 in 'initial devision'. CONCLUSION: The result would be helpful for the prevention and management of CTDs in the bank workers and post officers.
Checklist ; Cumulative Trauma Disorders* ; Human Engineering ; Humans ; Occupational Medicine ; Prevalence* ; Rehabilitation ; Risk Factors ; Serologic Tests ; Specialization ; Tendinopathy

An experiment was planned to observe the histopathological alteration with administration of the Rheomacrodex and blood pressure changes in induced cerebral infarct after occlusion. Eighty well developed cats, weighing 2.3 to 3.5kg, were used in this experiment. The right MCA was exposed through temporal approach and the proximal part of the MCA was occluded with a silver clip. The animals were divided into 4 groups: The control group was comprised of 20 cats with occlusion of the right MCA alone, Rheomacrodex-treated group was comprised of 20 cats after occlusion of right MCA, induced hypotension and hypertension groups consisted in each 20 cats following occlusion of the MCA. The animals were sacrificed at intervals of 3 hours, 6 hours, 24 hours, 1 week and 2 weeks respectively after occlusion of the MCA. The animals were studied for clinical deficits and histopathological changes of the cerebral infarct according to the time courses. The results obtained were as follows: 1) In the control group, severe contralateral hemiplegia was developed in the early stage following the MCA occlusion, however the neurological deficits were progressively improved to the state of abnormal walking in 24 hours to 2 weeks. The hemorrhagic infarct was involving the basal ganglia, internal capsule and extending to the cortex with mild brain edema in the early stage and the area of the infarct was gradually enlarged from 6 hours to 24 hours following the MCA occlusion. Although the brain edema of surrounding area of the lesion was remained unchanged, the size and distribution of the infarct were decreased in one week to 2 weeks. Extensive ischemic neuronal damage was observed in the control group. 2) In the Rheomacrodex-treated group, mild to moderate neurological deficit was developed in the early stage after MCA occlusion and the deficit was less severe than control group. The clinical deficit was improving in the time course and one case had shown completely normal activity in 2 weeks. The distribution of the infarct was well defined and it was smaller than control group. The infarct mainly involved the basal ganglia and internal capsule. The area of the infarct was gradually enlarged from 6 hours to one week after MCA occlusion, then the extent of the infarct was decreased in 2 weeks. The ischemic neuronal change in this group was less severe than control group. 3) In the induced hypotension group, the early neurological deficit was worse than that of the control group and severe hemiplegia was developed in one week. There was minimal improvement of the neurological deficit in 2 weeks. The area of the infarct was ill-defined and hemorrhagic extending a large portion of the brain with severe brain edema. The infart was involving the basal ganglia, internal capsule, claustrum and the cortex from 3 hours to 24 hours after the occlusion and the area of the infarct was not changed during the observation. Severe ischemic nerve cell change or resolution of the cells was oserved in this group. 4) In the induced hypertension group, the neurological deficit was mild and it was better than that of the control group. The distribution of the infarct was well localized and minimum in extent. The extent of the infarct was not changed during the observation. There was no observable gross brain edema and the ischemic nerve cell changes were not severe.
Animals ; Basal Ganglia ; Blood Pressure* ; Brain ; Brain Edema ; Cats ; Dextrans* ; Hemiplegia ; Hypertension ; Hypotension ; Internal Capsule ; Middle Cerebral Artery* ; Neurons ; Silver ; Walking

We experienced a case of primary sternal tuberculosis with destroyed midsternum and bony defect. An 22-year-old female was admitted to our hospital two times for severe sternal pain and spontaneous fracture without history of trauma. On hospital admission, chest X-ray and chest CT showed destruction of midsternum and soft tissue swelling. Fine needle aspiration cytology revealed tuberculous osteomyelitis with cold abscess. And the patient was treated with usual anti-tubeculosis medication for preoperative preparation. At operation, we confirmed midsternal destruction with cold abscess and multiple sinus tracts. After removal of diseased sternal segment and cold abscess, we performed sternal reconstruction with autologus iliac bone graft. The pathologic report was compatible with tuberculous osteomyelitis and caseous necrosis.
Abscess ; Biopsy, Fine-Needle ; Female ; Fractures, Spontaneous* ; Humans ; Necrosis ; Osteomyelitis ; Sternum ; Thorax ; Tomography, X-Ray Computed ; Transplants ; Tuberculosis* ; Young Adult

Malignant mesenchymoma is a very rare tumor presented during the embryonic and infant period and malignant mesenchymoma in the adult is extremely rare. Tumor is composed of two or more unrelated mesenchymal derivatives apart from fibrous tissue. These tumors are thought to be originated from embryonic mesenchyme capable of differentiating into any type of connective tissue. A 61 years old man with complaints of cough and copious sputum of onset of two months was admitted after initial examinations, showing a very huge mass over the right upper lobe. Right pneumonectomy with partial rib resection of 3rd, 4th, and 5th ribs was performed due to the initial diagnostic impression of squamous cell carcinoma by the fine needle aspiration biopsy. The operative field presented a mass locating across the interlobal fissure with severe adhesions to the chest wall. Postoperatively, the patient received 5,000 rads of radiotherapy and presently, 6 months later, has shown no signs of recurrence.
Adult* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Connective Tissue ; Cough ; Humans ; Infant ; Lung Neoplasms ; Lung* ; Mesenchymoma* ; Mesoderm ; Middle Aged ; Pneumonectomy ; Radiotherapy ; Recurrence ; Ribs ; Sputum ; Thoracic Wall