No abstract available.
Dinoprost* ; Female ; Pregnancy ; Pregnancy, Tubal*

BACKGROUND: This study was designed to describe the current tends of emergency tracheal intubation and predict difficult airway intubations in emergency department (ED) at a teaching hospital in Korea. METHODS: All patients who was taken endotracheal incubation in ED during a 1-year period (Mar 1997 through Feb 1998) were included in the study population. Medical records of the patients were retrospectively reviewed. Among them, 56 patients were prospectively evaluated parameters to predict difficult airway intubations. RESULTS: During the study period, a total of 413 patients(1.5%) required endotracheal intubation. Except far 2 cases, all patients intubated orotracheally, and 298(72%) patients were intubated by emergency medicine resident. Pharmacologic adjuncts were used in 200(48%) patients, the neuromuscular blocking agent(NMBA) was used in 16(3.8%) Commonly used drugs were thiopental and vecuronium. The difficult incubation was not associated with presence of denture, length and circumference of neck, and mental status. The visibility of vocal cord on laryngoscopy significantly correlated to the difficult airway. CONCLUSION: At this institution, the majority of ED incubation were performed by emergency physicians and NMBA was not routinely used. The visibility of vocal cord during the direct laryngoscopy could be a predictor of difficult incubation in ED.
Dentures ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital ; Hospitals, Teaching ; Humans ; Intubation* ; Intubation, Intratracheal ; Korea ; Laryngoscopy ; Medical Records ; Neck ; Neuromuscular Blockade ; Prospective Studies ; Retrospective Studies ; Thiopental ; Vecuronium Bromide ; Vocal Cords

No abstract available.
Pregnancy Rate* ; Pregnancy*

It is difficult to predict the recurrence of or the prognosis for breast cancer because of its tortuous postoperative course. There are many clinical factors and serologic markers which might be associated with the recurrence of the breast cancer, their relationship to recurrence has not been settled. For this reason, carried out a clinical study to determine the risk of recurrence according to the clinical factors, to evaluate the survival rate after recurrence, and to determine the usefulness of several serologic markers which might be associated with recurrence. To that end, medical records of 365 out of 415 patients (except stage IV patient and patients of underknown whereabouts) with breast cancer who underwent surgical therapy between January 1986 and June 1996 at the Department of General Surgery, Hanyang University Hospital, were retrospectively reviewed. By the time of follow up, recurrence had occurred in 58 of those 365 patients. The DNA ploidy pattern, the primary tumor size, and primary lymph-node metastasis were associated with recurrence. The last two were high risk factors for recurrence of breast cancer. The most common site of recurrence was the locoregional area, followed by the visceral organs and bones. There was a significant differece in survival according to the location of recurrence. The poorest prognosis was obtained for patients with multiple metastases, followed by visceral and bone metastases. Patients with a locoregional metastasis has a better prognosis than others. The serologic markers that significantly increased at recurrence were CEA, ESR, alkaline phosphatase and r-glutamyl transferase. They should be useful serologic markers for diagnosing the recurrence of breast cancer. However, CA15-3 failed to show any statistical difference because of its low concentration. Therefore, better statistical data are required for CA15-3.
Alkaline Phosphatase ; Breast Neoplasms* ; Breast* ; DNA ; Follow-Up Studies ; Humans ; Medical Records ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Survival Rate ; Transferases

No abstract available.
Blindness, Cortical* ; Diagnosis* ; Magnetic Resonance Imaging* ; Pregnancy*

No abstract available.
Ultrasonography, Prenatal*

Pheochromocytomas are rare tumors that originate in chromaffin tissue and produce distant variant effects, such as EKG abnormality, myocarditis, cardiomyopathy, and acute coronary syndrome, by secretion of catecholamines. Such variant effects of pheochromocytoma tend to lead the emergency physician to a wrong diagnosis. We describe the case of a 29-year-old female with pheochromocytoma who was diagnosed at the ER as having myocarditis with acute renal failure. The diagnosis of pheochromocytoma was made later. To avoid misdiagnosis, we should include pheochromocytoma in the differential diagnosis. We should also use additional imaging tests, such as bed-side abdominal ultrasonography or abdominal CT, at the ER on relatively young patients presenting with hypertensive crisis, acute renal failure, and features, such as ischemic EKG changes, which are suggestive of acute coronary syndrome or myocarditis.
Acute Coronary Syndrome ; Acute Kidney Injury ; Adult ; Cardiomyopathies ; Catecholamines ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Electrocardiography ; Emergencies ; Female ; Humans ; Myocarditis* ; Pheochromocytoma* ; Tomography, X-Ray Computed ; Ultrasonography

Posterior reversible encephalopathy syndrome (PRES) is typically characterized by headache, altered mental functioning, seizure, and visual loss associated with imaging findings of bilateral subcortical and cortical edema with a predominantly posterior distribution. The usual causes of PRES are hypertensive encephalopathy, preeclampsia, eclampsia, cyclosporine A neurotoxicity and uremic encephalopathy. Early recognition of PRES is important because the treatment of PRES can be relatively contraindicated in some conditions, such as cerebral ischemia. We describe a 28-year-old woman who presented with a seizure 11 days after delivery. The diagnosis of PRES was made later. To make an early diagnosis of PRES, the emergency physician should include PRES in the differential diagnosis and consider an MRI with diffusion-weighted imaging in patients presenting with seizure, altered mental status, headache, and visual loss, especially patients with a hypertensive crisis, an organ transplantation, or a history of recent delivery.
Adult ; Brain Ischemia ; Cyclosporine ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Eclampsia ; Edema ; Emergencies ; Female ; Headache ; Humans ; Hypertensive Encephalopathy ; Magnetic Resonance Imaging ; Organ Transplantation ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Pregnancy ; Seizures* ; Transplants

Colchicine poisoning is relatively uncommon, but potentially life-threatening, situation confronting the emergency physician. Although the toxic dose of colchicine is reported to be more than 0.5 mg/kg, it is extremely variable. Therefore, the emergency physician should always consider colchicine poisoning to be serious, even when the dose is small. We present a case of death after intentional ingestion of 12 mg (0.17 mg/kg) of colchicine by a 30-year-old male.
Adult ; Colchicine* ; Eating ; Emergencies ; Humans ; Male ; Poisoning*

With the exception of Meckel's diverticulum, a small bowel diverticulum is an acquired disease due to high pressure in the small bowel lumen. The causes of the increase in the pressure of the lumen are usually a motility disorder of the small bowel, a luminal obstruction due to a tumor mass, or adhesion of the bowel loop. The prevalence of small bowel diverticulum increases with age, but the clinical manifestations are asymptomatic or nonspecific, such as vague abdominal pain, nausea, vomiting, indigestion, constipation, and diarrhea. Therefore, the disease is relatively difficult to diagnose until complications, such as perforation, obstruction, intussusception, or hemorrhage, develop. Because of its rarity, Physicians usually neglect to rule out small bowel diverticulitis. As the proportion of the elderly increases, the rate of small bowel diverticulitis will increase. If complications from small bowel diverticulitis develop in the elderly, mortality and morbidity may increase. To detect small bowel diverticulitis before complications develop, emergency physicians need to be aware of small bowel diverticulitis in elderly patients with abdominal pain of uncertain cause and need to evaluate it with multiple diagnostic tools. We report a case of perforation of a small bowel diverticulum due to intestinal obstruction caused by primary Non-Hodgkin's lymphoma of the terminal ileum.
Abdominal Pain ; Aged ; Constipation ; Diarrhea ; Diverticulitis ; Diverticulum* ; Dyspepsia ; Emergencies ; Hemorrhage ; Humans ; Ileum* ; Intestinal Obstruction ; Intestine, Small ; Intussusception ; Lymphoma, Non-Hodgkin* ; Meckel Diverticulum ; Mortality ; Nausea ; Phenobarbital ; Prevalence ; Vomiting