No abstract available.
Ultrasonography, Prenatal*

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

Neutrophils are important effector cells against protozoan extracellular parasite Entamoeba histolytica, which causes amoebic colitis and liver abscess in human beings. Apoptotic cell death of neutrophils is an important event in the resolution of inflammation and parasite's survival in vivo. This study was undertaken to investigate the ultrastructural aspects of apoptotic cells during neutrophil death triggered by Entamoeba histolytica. Isolated human neutrophils from the peripheral blood were incubated with or without live trophozoites of E. histolytica and examined by transmission electron microscopy (TEM). Neutrophils incubated with E. histolytica were observed to show apoptotic characteristics, such as compaction of the nuclear chromatin and swelling of the nuclear envelop. In contrast, neutrophils incubated in the absence of the amoeba had many protrusions of irregular cell surfaces and heterogenous nuclear chromatin. Therefore, it is suggested that Entamoeba-induced neutrophil apoptosis contribute to prevent unwanted tissue inflammation and damage in the amoeba-invaded lesions in vivo.
Animals ; Apoptosis/*physiology ; Entamoeba histolytica/*physiology ; Host-Parasite Relations/physiology ; Humans ; In Vitro ; Neutrophils/physiology/*ultrastructure ; Research Support, Non-U.S. Gov't

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*

PURPOSE: In spite of preventive measures and excellent prognosis with immediate treatments, drowning and drowning- related injuries remain as one of the leading causes of accidental death in Korea. However, abundant statistical data for drowning has yet to be collected. Thus, this study aimed to describe the epidemiologic characteristics of drowning in terms of demographic characteristics, geopolitical factors and socio-economic status. METHODS: This study was conducted with drowning patients who either visited hospitals or died between January 2001 and December 2003. Of these patients, we enrolled individuals registered for such coverages as automobile insurance, national health service and work injury insurance and we reviewed death records reported to the Korea National Statistical office. NISS (New Injury Severity Scale) and EMR-ISS (the Excessive Mortality Ratio -adjusted Injury Severity Score) values were calculated for each patients and the results were classified 4-into four different severity groups. After analysis, we drew conclusions in terms of year, gender, age, region, insurance type, daily rate of incidences and severity. RESULTS: The incidences of drowning-related injury were 2,486 in 2001, 2,364 in 2002, and 2,595 in 2003 (average of 2,482). The average annual death were 1,954. Victims were more likely to be male and especially high incidence rates were found for two groups: (1) Children aged 5-9 years, (2) Adults aged 40 and older. Seoul and Gyeonggi had the largest total numbers of injury cases, while JeJu had the highest per capita incidence rate (106 per 1,000,000 population). The seasonal distribution of incidence rates showed that predictably, incidents were most frequent between the beginning of July and September. CONCLUSION: The average number of incidents was 55.73 per 1,000,000 population, which constitutes approximately 0.02% of all injuries. Based on this data, we recommand continuing studies and further evaluations in order to develop specific measures to combat drowning.
Adult ; Aged ; Automobiles ; Child ; Death Certificates ; Drowning ; Humans ; Incidence ; Insurance ; Korea ; Male ; National Health Programs ; Prognosis ; Seasons

PURPOSE: To assess binocular visual outcomes in patients who were implanted with a monofocal IOL (intraocular lens) in one eye and a multifocal IOL in the contralateral eye or with a bilateral multifocal IOL. METHODS: This study enrolled 15 patients (30 eyes) implanted with a monofocal IOL in one eye and a multifocal IOL in the contralateral eye (5 patients, group 1) or with a bilateral multifocal IOL (10 patients, group 2). Binocular visual acuity (uncorrected/best distance corrected near, intermediate, and distance vision), binocular uncorrected reading speed, and contrast sensitivity were assessed at 6 months following the last implantation. Patient's quality of life (overall satisfaction, halos and glare presence, and spectacle dependence) was also assessed using a questionnaire at 6 months postoperatively. RESULTS: There was significant difference in the uncorrected and corrected near visual acuity between the 2 groups in the mesopic condition. There was no significant difference in visual acuity, reading speed and contrast sensitivity in other conditions between the 2 groups. Spectacle dependence rate was 60% in group 1 and 20% in group 2. The glare symptom was present in 60% of patients in both groups and the halo symptom was present in 3 out of 10 patients in group 2. Overall satisfaction score was not significantly different between the groups. CONCLUSIONS: The combined implantation of a monofocal and a multifocal lens revealed similar visual outcomes compared to bilateral multifocal IOL implantation except for near vision. In addition, the results showed similar patient satisfaction in both groups.
Cataract ; Contrast Sensitivity ; Eye ; Glare ; Humans ; Lenses, Intraocular ; Patient Satisfaction ; Quality of Life ; Surveys and Questionnaires ; Telescopes ; Vision, Ocular ; Visual Acuity

PURPOSE: To assess visual acuity, spherical aberration and contrast sensitivity in patients who were implanted with spheric, aspheric ReSTOR(R) or Crystalens HD(R) lenses. METHODS: The present study enrolled 16 patients (32 eyes) implanted with biliateral spheric ReSTOR(R) (four patients, spheric ReSTOR group), bilateral aspheric ReSTOR(R) (seven patients, aspheric ReSTOR group) or bilateral Crystalens HD(R) (five patients, Crystalens HD group) lenses. At three months postoperatively, visual acuity, spherical aberration, and contrast sensitivity were evaluated. RESULTS: Three months after surgery, there were no significant differences in uncorrected distant or intermediate visual acuity among the three groups. Uncorrected near visual acuity in the spheric and aspheric ReSTOR groups was superior to that in the Crystalens HD group, and the aspheric ReSTOR group had less spherical aberration. Mesopic contrast sensitivity in the Crystalens HD group was significantly higher at three cycles per degree compared to those in the spheric and aspheric ReSTOR groups. CONCLUSIONS: Uncorrected near visual acuity in the Crystalens HD group was inferior to those in the spheric and aspheric ReSTOR groups, but the mesopic contrast sensitivity of the Crystalens HD group at three cycles per degree was superior to those in the spheric and aspheric ReSTOR groups.
Contrast Sensitivity ; Humans ; Visual Acuity

A survey was made to find the extent of intestinal parasite infection in Kampongcham, Cambodia in February 2002. A total of 251 fecal specimens were collected from Tonlebat primary school children and examined by formalin-ether sedimentation technique. The overall infection rate of intestinal parasite was 54.2% (males, 57.3%; females, 50.8%). The infection rate of intestinal helminths by the species were as follows: Ascaris lumbricoides 26.3%, Echinostoma sp. 15.6%, hookworm 6.4%, Opisthorchis sp. 4.0%, Rhabditis sp. 2.4%, and Trichuris trichiura 0.4%. The infection rate of intestinal protozoa were as follows: E. coli 7.6%, G. lamblia 3.2%, I. butschlii 3.2%, and E. histolytica 0.8%. More than two different kinds of parasites were found in 16.7% of the stool samples. All the children infected were treated with albendazole, praziquantel and metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in this area.
Age Factors ; Animals ; Antiparasitic Agents/therapeutic use ; Cambodia/epidemiology ; Child ; Feces/parasitology ; Female ; Human ; Intestinal Diseases, Parasitic/drug therapy/*epidemiology/parasitology ; Intestines/parasitology ; Male ; Parasites/isolation & purification ; Prevalence ; Schools/*statistics & numerical data

Specific serum IgE levels of Clonorchis sinensis in infected humans were measured by avidin-biotin ELISA, and allergens from C. sinensis were identified by immunoblot and autoradiography. Then, allergens fractionated by Sephadex G-200 gel filtration were analyzed, and cross-reactive allergenic components of C. sinensis reacted with paragonimiasis sera were revealed. Fourteen out of 15 C. sinensis egg-positives were found to be serum IgE positive (absorbance > 0.27). Of 14 IgE-reacting allergen bands visualized, major allergens of 66, 61.5, 45, 37, 28.5, 23.5 and 15.5 KD were recognized by more than 50% of the sera of infected humans. The considerable individual variations of IgE immune responses to C. sinensis allergenic components were also noticed. C. sinensis extract was separated into 5 fractions by Sephadex G-200 gel filtration. Seventy-four KD allergen was recognized in the first fraction, 50, 45, 37, 29.5 and 28.5 KD in the third, and 15.5 KD in the fourth. Cross-reactive allergens with sera of paragonimiasis cases were identified as 66, 45, 28.5, 13 and 7.5 KD.
Allergens/*immunology ; Animal ; Antibodies, Helminth/*blood ; Antigens, Helminth/*immunology ; Clonorchiasis/*immunology ; Clonorchis sinensis/*immunology ; Cross Reactions ; Human ; Immunoglobulin E/*blood ; Support, Non-U.S. Gov't

The treatment of fingertip amputation is difficult and controversial. Although the microsurgery has been accepted as a procedure of choice, in distal location, however, both reattachment of amputated portion as a composite graft and microvascular anastomosis are prone to failure. The fact that microscopic reconstruction of vessels is safer means of replacing amputated digits, makes considerably smaller the need to use the technique of composite graft nowadays. Nevertheless, there still remains a group of distal digital amputations which cannot be replaced by microsurgical procedure and the composite grafting is the only way of achieving a full length digit with a normal nail complex. Nowadays, it is generally accepted that replacement should be made as early as possible for the prevention of bacterial and proteolytic activity. However, if the replacement is made so quickly that bleeding doesn't stop, there is a layer of clot blocking adhesion between the two surfaces, and the union will not be achieved. We report a new strategy: the tie-over dressing ensures not only fixation, but also hemostasis, and the drainage application is used to drain retained blood, so composite graft doesn't need to be delayed until the bleeding stops. We achieved good results by using this new technique.
Amputation* ; Bandages* ; Drainage ; Hemorrhage ; Hemostasis ; Microsurgery ; Transplants*