BACKGROUND: Intussuseception is one of the most common diseases requiring abdominal emergency care in early childhood. The delay in diagnosis increases morbidity and, in particular, reduces the success rate of the non-surgical method of reduction. In this report, the authors determined the clinical characteristics of pediatric patients with intussusception, and the factors involved in delayed diagnosis and the efficacy of doppler ultrasonography in diagnosis. METHODS: The authors performed a retrospective study of 44 cases in 42 patients with intussusception who had visited the emergency room of SamSung medical center from January 1st to December 31, 1996. RESULTS: The sex ratio was equal and 64.3% of the patients were under 1 year of age. The prevalent complaints were vomiting(36.4%) and abdominal pain(33.8%). Ultrasonography was used in 11 cases, 3 of them were performed because of obscure symptoms and the rest were due to diagnostic delay. The average time past from visit to diagnosis was 4 hours and 20 minutes, and there were 4 diagnostic delays. Air enema reductions were unsucessful in 11 cases(25%) and that was related to hospital-visit delays and long time past from symptom onset to diagnosis. There were no motalities. CONCLUSION: To reduce delays in diagnosis and unnecessary operations, the use of doppler ultrasonography is recommanded in suspicious cases. And to reduce the hospital-visit delays, related to the failure on non-surgical reduction, the education about this disease is necessary.
Delayed Diagnosis ; Diagnosis ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Enema ; Humans ; Intussusception* ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Ultrasonography, Doppler

OBJECTIVES: To evaluated the relation of familial history of alcoholism and plasma level of beta-endorphin, ethanol, beta-endorphin, cortisol and blood glucose were compared in 48 male alcoholics and 29 normal controls. METHODS: Subjects are divided into two groups by family history of alcoholism. Blood samples were obtained before and after 0.75mg/kg of ethanol consumption a 7th admission day. RESULTS: 1) The ratio of family history positive to negative of the patient group was 2 to 1. 2) The age at admission of positive family history group was younger than negative groups. 3) There was no significant difference in change of plasma ethanol level among three groups. 4) There was no significant difference in change of plasma beta-endorphin level among three group. 5) There was no significant difference in change of plasma cortisol level among three groups. 6) There was no significant difference in change of fasting blood sugar level between two patients groups.
Alcoholics ; Alcoholism* ; beta-Endorphin* ; Blood Glucose ; Ethanol ; Fasting ; Humans ; Hydrocortisone ; Male ; Plasma

OBJECTIVE: Asymmetries in evoked potential P300 topography of schizophrenia and bipolar disorder are still controversial. The purpose of this study was to examine the difference in P300 topography between schizophrenia and bipolar disorder. METHOD: P300 was recorded from 16 schizophrenic, 15 bipolar manic, and 16 control subjects. All were right-handed. Subjects silently counted target stimuli(2.0kHz) among trains of standard stimuli(1.0 kHz). Averages were constructed from brain responses to target stimuli. RESULTS: 1) Schizophrenics displayed significantly smaller peak amplitude of P300 over Cz, Pz, T3 than controls. 2) Schizophrenics displayed significantly smaller peak amplitude of P300 over T3 than bipolar manics. 3) Schizophrenics displayed significantly smaller peak amplitude of P300 over T3 than their T4. 4) Schizophrenics displayed significantly delayed latency of P300 over T3 than bipolar manics. 5) Schizophrenics displayed significantly delayed latency of P300 over T3 than their T4. CONCLUSION: Left-sided P300 abnormality, especially left superior temporal gyrus, in schizophrenics, relative to bipolar manics and controls suggests that psychophysiological cause of schizophrenia and bipolar disorder is different and P300 asymmetry is specific to the psychophysiological cause of schizophrenia.
Bipolar Disorder* ; Brain ; Evoked Potentials ; Schizophrenia*

PSTT has been established as a separate entity distinct from choriocarcinoma since 1983, because of its different morphological features, biologic behavior and response to chemotherapy. Most cases of PSTT have indolent clinical courses, but there have been several reports showing malignant behavior resulted in death of the patient. We report a case of PSTT showing vaginal metastatis. In biopsy specimen, it was difficult to make differential diagnosis from squamous cell carcinoma of uterine cervix due to uniform and mononuclear cytologic characteristics. Immunohistochemical stains for hPL and hCG were not typical for either PSTT or choriocarcinoma. We suggest that poorly differentiated PSTT may synthesize the lesser amount of hPL than typical PSTT and it may behave more aggressively.
Diagnosis, Differential ; Biopsy

BACKGROUND: The fast EMS helicopter was introduced to Korea in 1996 and from Dec. 1. 1997, it was used far transporting emergent patients. Authors, here upon, report the transporting experiences. METHODS: From Dec. 1, 1996 to Dec. 31,1997, Samsung Medical Centers EMS helicopter was used for air evacuation of critically ill patients. The patients data prospectively analyzed. RESULT: A total of 65 patients were transported. Male to female ratio was 1.95 : 1. The mean transport time was 64.1min(10-160 min). Majority of the evacuated patients was surgical patients (General Surgery'16, Orthopedic surgery : 10, Neurosurgery : 6, Infernal medicine 13, Pediatrics : 3, and others : 3). Twenty-one of the 65 patients transported were admitted to ICU and 31 did not require ICU care. During the air evacuation, one physician and one nurse trained for air evacuation amended The patients. No medical problems or deaths developed during the air evacuation period. CONCLUSION: The first EMS helicopter was introduced to Korea in 1996. From Dec. 1, 1996 to Dec. 31, 1997, Samsung Medical Center's EMS helicopter was used for air evacuation of critically ill patients. The patients data reported.
Aircraft* ; Critical Illness ; Emergencies* ; Female ; Humans ; Korea ; Male ; Neurosurgery ; Orthopedics ; Pediatrics ; Prospective Studies

Heat stroke, a medical emergency, occurs when the body's thermal regulation is upset and unable to dissipate adequate amounts of heat with a rise in body temperature. It is characterized by hyperyrexia, with a core temperature of 40degrees C or more, hot dry skin, and central nervous system disturbance and usually results in rhabdomyolysis and multiorgan failure. Our case, a 43-year-old healthy male, was caused by a marathon, half course, on a sunny day in late summer. He suddenly fell down on the road and was delivered to a nearby hospital, where a seizure developed. He was transfered to our hospital and then displayed Central Nervous System disturbance, hot dry skin, acute liver failure, rhabdomyolysis, anuric acute renal failure, and disseminated intravasculular coagulopathy. He was treated with general supportive care and hemofiltration. Despite the aggressive management, he died of shock on the fifth day after admission.
Acute Kidney Injury ; Adult ; Body Temperature ; Central Nervous System ; Emergencies ; Heat Stroke* ; Hemofiltration ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Rhabdomyolysis ; Seizures ; Shock ; Skin

No abstract available.
Bowen's Disease ; Foot

BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

BACKGROUND: Experimental data indicate that low-flow reperfusion following prolonged cardiocirculatory arrest may aggravate early cerebral microcirculatory repefusion disorders. We investigated the influence of cerebral repefusion flow change to the ischemic histopathologic damage of brain tissue after incomplete forebrain ischemia in rats. MATERIALS AND METHOD: Anesthetized Sprague-Dawley rats were undergone ligation of both infernal carotid artery by microvascular clamp for 10 minutes. After release of the clamp, reperfusion was started with several different flow levels (0, 10, 20, 30, 50, and 100%) of infernal carotid artery comparing to pre-clamping phase using flowmeter. After 15minutes of reperfusion, rat brains were prepared by perfusion-fixation with 3% formaldehyde. Under light microscopic examination of Hematoxylin-Eosin stained tissue slide, histopathologic damage was examined at cortex, putamen, and hippocampus regions. Categorical hisotopathologic damage scores were derived in each regions by manual counts of ischemic neurons. RESULT: The histopathologic damage scores were 0, 10. 2+/-0.5, 7.6+/-1.5, 5.9+/-1.4, 5.0+/- 2.8, 3.5+/-0.7, and 1.0+/-0.0 in control, 0, 10, 20, 30, 50, and 100% reperfusion groups, respectively(p<0.05). CONCLUSION: Our insults showed significant increment of brain histopathologic damage scores along with decreasing amount of cerebral reperfusion know after incomplete forebrain ischemia. We believe restoration of repefusion flow to pre-ischemic level would be a critical component in attenuation of brain ischemic damage.
Animals ; Brain ; Carotid Arteries ; Flowmeters ; Formaldehyde ; Hippocampus ; Ischemia* ; Ligation ; Models, Animal* ; Neurons ; Prosencephalon* ; Putamen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion*

OBJECTS: Sanjoin, the seeds of Zizyphus vulgaris var. spinosus has been used as the most important hypnotic agent in chinese medicine to treat insomnia. This research was performed in order to examine the effect of betulinic acid and sanjoinine-A which are components of Sanjoin. METHOD: Sleeping time, sleep recordings of EEG, serum serotonin level, and locomotor activity were measured in rats which received betulinic acid and sanjoinine-A as sleep induction material extracted from Sanjoin. RESULTS: 1) Groups received betulinic acid, sanjoinine-A, and lorazepam showed increased sleep time than control group with saline. 2) Groups with betulinic acid, sanjoinine-A, lorazepam and saline recorded beta-wave in sleep recording of EEG. In there was no significant difference among all groups. 3) No significant difference in serum serotonin level among all groups was found. 4) In autonomic activity testing, groups of betulinic acid, sanjoinine-A, and lorazepam showed significantly more decreased in activity than saline group. In comparison of groups of betulinic acid and sanjoinine-A with a group of lorazepam, there was no significant difference. CONCLUSION: These results suggests that betulinic acid and sanjoinine-A have the sedative effect like lorazepam rather than sleep effect.
Animals ; Asian Continental Ancestry Group ; Brain* ; Electroencephalography* ; Humans ; Hypnotics and Sedatives ; Lorazepam ; Motor Activity ; Rats* ; Serotonin* ; Sleep Initiation and Maintenance Disorders ; Ziziphus