The authors analysed 261 cases of mycoplasmal pneumonia in children who were admitted to the pediatric department of Seoul Adventist Hospital between July 1986 and June 1991. The result obtained were as follows; 1) Yearly distribution of the cases showed high in 1987 and 1991, but no significant difference was noted in seasonally or monthly distribution. 2) The peak incidence of age was between 2 and 6 years of age, and the sex ratio of boy to girl was 1.1:1. 3) pulmonary manifestations were asthma in 21 cases (8.0%), atelectasis in 5 cases (1.9%), emphysema in 3 cases (1.2%), pleural effusion in 16 cases (6.1%), otitis media in 4 cases (1.2%) and sinusitis in 9 cases (3.4%). 4) Extrapulmonary complication were hepatitis in 53 cases (20.3%), skin rash in 9 cases (2.4%), proteinuria in 6 cases (2.3%), and hematuria in 4 cases (1.5%). 5) On the chest X-ray examination, the most common type of pneumonia was interstitial pneumonia (94 cases, 39.8%), and unilateral involvement was common (85.6%), and the most common involvement was right lower lobe (83 cases, 41.4%). 6) The relationship between the type of pneumonia and cold agglutinini titer, and between the type of pneumonia and Mycoplasma antibody titer were not found (P>0.05). 7) In the 16 cases of pleural effusion, The type of pneumonia was lobar, lobular (9 cases), bronchopneumonia (7 cases), and interstitial type was not present. The site of pneumonia was left (6 cases), right (9 cases), and 1 case showed bilatrality. The extent of pleural effusion was mild (10 cases), moderate (3 cases), and severe (3 cases). The result of pleural fluid exam in severe cases was all exudate. 8) The mean duration of admission was most common from 6 to 10 days. the mean duration of admission by the type of pneumonia was lobar, lobar (10.71+/-3.40), interstitial (8.78+/-2.14), and bronchopneumonia (8.83+/-2.47). 9) Both mycoplasma antibody test and cold agglutinin test were carried out in 185 cases and sensitivity of mycoplasma antibody test was 55.1%.
Asthma ; Bronchopneumonia ; Child* ; Emphysema ; Exanthema ; Exudates and Transudates ; Female ; Hematuria ; Hepatitis ; Humans ; Incidence ; Lung Diseases, Interstitial ; Male ; Mycoplasma* ; Otitis Media ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Proteinuria ; Pulmonary Atelectasis ; Seasons ; Seoul ; Sex Ratio ; Sinusitis ; Thorax

BACKGROUND AND OBJECTIVE: TDI is known to be the most prevalent cause of occupational asthma ( OA ) in Korea. However, the pathogenesis of TDI - induced occupational asthma still remains to be further clarified. So, we evaluated clinical significance of serum specific IgG and IgE antibodies to TDI - HSA conjugate in TDI - induced occupational asthma. Subjects and METHODS: Serum specific IgG and IgE antibodies to TDI - HSA conjugate were measured by enzyme linked immunosorbent assay. Serum was collected from 50 TDI- induced OA patients ( classified as group I ), and was compared with that from 13 asthmatic subjects with negative TDI - bronchoprovocation test ( BPT, group II ), allergic asthmatics ( group III ), and unexposed healthy controls ( group IV ). RESULTS: The prevalence of specific IgG was significantly higher in group I than in group II (p = 0.01) or group III (p <0.01). No significant difference was noted between group II and group III (p> 0.05). However, the prevalence of specific IgE was not different between group I and group II (p> 0.05 ) or group II and group III( p> 0.05 ). There was no significant difference in prevalence of specific IgG according to the asthmatic response during TDI bronchoprovocation test ( p> 0.05 ). No statistical significance was noted between specific IgG and IgE antibodies in group I subjects ( p> 0.05 ). CONCLUSION: These findings demonstrate that presence of specific IgG to TDI - HSA conjugate is closely related to TDI - BPT results and it may contribute to the development of TDI - induced asthma.
Antibodies* ; Asthma ; Asthma, Occupational* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunoglobulin E* ; Immunoglobulin G* ; Korea ; Prevalence ; Serum Albumin* ; Toluene 2,4-Diisocyanate* ; Toluene*

PURPOSE: We wanted to evaluate the actual work patterns of residents and nurses and the effects of controlling visits by relatives on the mortality of patients and their length of stay and on the workload of the residents and nurses. METHODS: We investigated the actual workload of the residents who worked 12 hours shifts and nurses who worked 8 hours shifts in an emergency center for two weeks. We compared the mortality of the patients, the length of their stay and the work patterns between before we controlled visits by relatives and after we controlled visits by relatives. RESULTS: On the average, residents spent 407.01 minutes (56.5%) taking care of patients for a shift (720 min.) and nurses spent 305.29 minutes (63.6%) taking care of patients for a shift (480 min.). Although we controlled visits by relatives, we're unable to reduce the patient mortality and the length of their stay. Yet we were able to reduce the unnecessary repeated explanation-time, the resting time and the nurses and residents were able to better concentrate to explain to patients or their relatives. We were also able to increase the treatment time and description time, and especially for residents. Nurses spent 71.86 minutes (15.0%) to take a rest a shift, and residents spent 166.40 minutes (23.1%) resting a shift (p=0.01). CONCLUSION: To reduce unnecessary repeated explanation-time and the resting time and to allow nurses and residents to better concentrate when explaining to patients or their relatives, and also to increase the treatment and description time, controlling relatives in an emergency center is necessary.
Emergencies ; Humans ; Length of Stay

There is no therapy currently available that influences the natural history of disease progression in patients with chronic obstructive pulmonary disease (COPD). Although stem cell therapy is considered a potential therapeutic option in COPD, there are no clinical trials proving definitive therapeutic effects in patients with COPD. Recently, it was reported that pioglitazone might potentiate the therapeutic effects of stem cells in patients with heart or liver disease. To test the capacity of pioglitazone pretreatment of stem cells for emphysema repair, we evaluated the therapeutic effects of pioglitazone-pretreated human adipose-derived mesenchymal stem cells (ASCs) on elastase-induced or cigarette smoke-induced emphysema in mice. We also investigated the mechanisms of action of pioglitazone-pretreated ASCs. Pioglitazone-pretreated ASCs had a more potent therapeutic effect than non-pretreated ASCs in the repair of both elastase-induced and smoke-induced emphysema models (mean linear intercept, 78.1±2.5 μm vs 83.2±2.6 μm in elastase models and 75.6±1.4 μm vs 80.5±3.2 μm in smoke models, P<0.05). Furthermore, we showed that pioglitazone-pretreated ASCs increased vascular endothelial growth factor (VEGF) production both in vitro and in mouse lungs in the smoke-induced emphysema model. Pioglitazone-pretreated ASCs may have more potent therapeutic effects than non-pretreated ASCs in emphysema mouse models.
Animals ; Disease Progression ; Emphysema* ; Heart ; Humans ; In Vitro Techniques ; Liver Diseases ; Lung ; Mesenchymal Stromal Cells ; Mice* ; Natural History ; Pancreatic Elastase ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Stem Cells* ; Therapeutic Uses* ; Tobacco Products ; Vascular Endothelial Growth Factor A

Pulmonary barotrauma during ascent is a common complication in SCUBA diving. One of the most severe forms of pulmonary barotrauma is a cerebral arterial gas embolism(CAGE). It is reported to account for about 30% of diving related deaths. The early recognition of CAGE is very important for the emergency physician because prompt hyperbaric recompression therapy can improve the clinical course. Thus, the emergency physician should know the clinical manifestation of CAGE to apply several treatment modalities early. We report a case of cerebral arterial gas embolism presented with hemiparesis and blurred vision immediately after SCUBA diving at 13 meters.
Barotrauma ; Diving* ; Embolism, Air* ; Emergencies ; Paresis

Organophosphate (OP) pesticides are the most common source of human toxicity globally, causing high mortality and morbidity despite the availability of atropine as a specific antidote and oximes to reactivate acetylcholinesterase. The primary toxicity mechanism is inhibition of acetylcholinesterase (AchE), resulting in accumulation of the neurotransmitter, acetylcholine, and abnormal stimulation of acetylcholine receptors. Thus, the symptoms (muscarinic, nicotinic, and central nervous system) result from cholinergic overactivity because of AchE inhibition. OP can also cause rhabdomyolysis, pancreatitis, parotitis, and hepatitis. OP therapy includes decontamination, supportive therapy, and the use of specific antidotes such as atropine and oximes. However, there has been a paucity of controlled trials in humans. Here we evaluated the literature for advances in therapeutic strategies for acute OP poisoning over the last 10 years.
Acetylcholine ; Acetylcholinesterase ; Antidotes ; Atropine ; Decontamination ; Hepatitis ; Humans ; Neurotransmitter Agents ; Oximes ; Pancreatitis ; Parotitis ; Pesticides ; Receptors, Cholinergic ; Rhabdomyolysis

Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis, and angina pectoris. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed. This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by urination and angina pectoris as an initial manifestation. This case study suggests that thunderclap headache and angina pectoris occurring concurrently with sudden blood pressure elevation during or immediately after urination are important diagnostic clues of bladder pheochromocytoma.
Angina Pectoris* ; Blood Pressure ; Diagnosis ; Female ; Headache ; Headache Disorders, Primary* ; Humans ; Hypertension ; Neuroendocrine Tumors ; Pheochromocytoma* ; Strikes, Employee ; Tachycardia ; Urinary Bladder* ; Urination*

BACKGROUND/AIMS: Pyloric exclusion has been recommended in patients with severe injury to the pancreas and duodenum. METHODS: A retrospective case review of 8 patients treated with pyloric exclusion following pancreaticoduodenal injury from March 1994 to May 2002 in Department of Surgery, the Catholic University of Korea, Daejeon St. Mary's Hospital. RESULTS: The age range of the patients was from 8 to 31 years. Most of the etiolgy (n=7) was the blunt abdominal trauma and one case due to the iatrogenic injury from the therapeutic endoscopic retrograde cholangiopancretography. The time interval between the injury and the operation varied from 3 to 48 hours. The most common postoperative complication was wound infection (n=8). We found the other complications such as intraabdominal abscess (n=3), pneumonia (n=3), but the complications were treated successfully with conservative measures. There was no mortality cases in these patients. The duration of admission was delayed in the cases of concomitant injury (64 vs 46 days). All patients above 16 years old (n=7) were supported with parenteral nutritional fluid via central intravenous route (mean 32 days). We could not find the spontaneous opening of the pyloric closure at least 4 patients in postoperative 3 months but there was no major complication according to the sustained gastrojejunostomy. CONCLUSION: Pyloric exclusion appears to offer a satisfactory option for the treatment of the severe pancreaticoduodenal injury with minor complication. Do you have any comments about the spontaneous opening of the pyloric closure?
Abscess ; Adolescent ; Duodenum ; Gastric Bypass ; Humans ; Korea ; Mortality ; Pancreas ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Wound Infection

PURPOSE: Blunt trauma can cause a wide range of ocular injuries. This study was performed to describe the prevalence of severe intraocular injuries (SIOI) and their correlation with the severity of blunt orbital trauma. METHODS: We retrospectively analyzed 117 eyes of 107 patients with orbital wall fractures who visited the emergency room at Konyang University Hospital from July 2006 to June 2008. Clinical features such as age, sex, causes of injury, revised trauma score (RTS), type of orbital wall fractures were recorded. The patients were divided into two groups: blowout fracture with severe intraocular injuries (SIOI) and blowout fracture without SIOI. We compared the clinical and the injury-related characteristics between two groups and analyzed the SIOS-related factors. RESULTS: Among the 107 patients (117 eyes) with blowout fractures, 29 (27.1%) patients with 32 eyes (25.6%) had complicated severe intraocular injuries. Retrobulbar hemorrhage (14.5%), hyphema (13.7%), traumatic optic nerve injury (4.3%), and sustained loss of visual acuity (4.3%) were the most common SIOI disorders. A logistic regression analysis revealed that loss of visual acuity (odds ratio = 4.75) and eyeball motility disorder (odds ratio=7.61) were significantly associated with SIOS. CONCLUSION: We suggest that blowout fracture patients with loss of visual acuity or eyeball motility disorder are mostly likely to have severe intraocular injuries, so they need an ophthalmologic evaluation immediately.
Emergencies ; Eye ; Eye Injuries ; Humans ; Hyphema ; Logistic Models ; Optic Nerve Injuries ; Orbit ; Orbital Fractures ; Prevalence ; Retrobulbar Hemorrhage ; Retrospective Studies ; Visual Acuity

No abstract available.
Angiotensin II ; Angiotensin Receptor Antagonists ; Angiotensins ; Hyperkalemia ; Receptors, Angiotensin