A 36-year-old female was transferred to our emergency medical center with decreased mental status after a 6.0 g propafenone overdose because of domestic disturbance. She had no previous history of epilepsy, diabetes mellitus, hypertension or psychiatric illness. Before presenting to our center, gastrointestinal decontamination, charcoal administration, and endotracheal intubation due to bradycardia and generalized seizure had been performed. Soon after hospital arrival, at 5 h after ingestion, she collapsed into shock and fatal arrhythmia. We successfully resuscitated the patient with amiodarone, sodium bicarbonate, a large volume of normal saline, calcium, and ventilator care. At 23 h after ingestion, she was fully recovered and had no subjective signs or symptoms. To our knowledge, this is the first case report of intentional propafenone overdose in Korea, which we report with reviews of the previous literature.
Adult ; Amiodarone ; Arrhythmias, Cardiac ; Bradycardia ; Calcium ; Charcoal ; Decontamination ; Diabetes Mellitus ; Eating ; Emergencies ; Epilepsy ; Female ; Humans ; Hypertension ; Intubation, Intratracheal ; Korea ; Propafenone ; Seizures ; Shock ; Sodium Bicarbonate ; Ventilators, Mechanical

Objectives: Rational planning and efficient management of the oral health workforce is essential for the promotion of oral health. Therefore, this study aims to analyze the distribution characteristics of dentists, using public big data. The results of this study could contribute to the development of the oral healthcare policies proposal and desirable dental services. Methods: The data of dentists working in medical institutions were analyzed by type and region from 2010 to 2020 using the Korean Statistical Information Service. Python version 3.10 was employed for data analysis and visualization, and the matplotlib and seaborn libraries were used to create graphs. Results: The average age of dentists working in medical institutions was 47.4 years in 2020 ― an increase by 5.3 years compared to the 2010 data. When considering different regions, the average age of dentists in major cities, including Seoul (49.7 years), was higher than in their surroundings areas (47.2-49.5 years). Conclusions A continuous increase in the average age of dentists over the past 10 years and a difference in age distribution among different regions were observed. This is probably because new dental clinics are opening predominantly in smaller cities. Therefore, institutional support for new dental clinics in these areas is necessary to promote high-quality dental healthcare within regions.Additionally, oral healthcare services to vulnerable populations should be provided through a national oral healthcare policy utilizing these local dental clinics.

BACKGROUND: The purpose of this study was to survey the nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) among the patients admitted in a medical intensive care unit (MICU) and analyze risk factors associated with the colonization. METHODS: The study was carried out on patients admitted into the MICU in a 1,250-bed tertiary care university hospital from January through December 2006. Nasal surveillance cultures were obtained from patients within 24 hours of admission to the unit. Data were analyzed retrospectively by the review of medical records. RESULTS: A total of 312 patients were screened with active nasal cultures; 36 patients (11.6%) were positive for MRSA. Of these, 22 (7.1%) were positive in the nasal cultures only and 14 (4.5%) were positive in the cultures of other specimens (13, sputum; 1, joint fluid) in addition to the nasal swabs. Among the risk factors for MRSA nasal colonization were sex (man), route of admission (from other ICUs or wards), a history of ICU admission during the recent 12 months, and prolonged hospital days in ICU. CONCLUSION: MRSA nasal carrier rate was found higher in this study than in those reported in the literature. Most of the patients colonized with MRSA in the nostril were not colonized with the organism elsewhere in the body. Whether or not active surveillance for MRSA should be performed would depend on the nasal colonization rate of the patients at the time of admission to the ICU.
Colon* ; Humans ; Intensive Care Units* ; Critical Care* ; Joints ; Medical Records ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Retrospective Studies ; Risk Factors ; Sputum ; Tertiary Healthcare

PURPOSE: The Korean Triage and Acuity Scale (KTAS) is a triage tool for patients in the emergency department (ED). We aimed to investigate the association between the KTAS level and hospitalization of children with abdominal pain, a common chief complaint in the ED. METHODS: This study retrospectively reviewed medical records of children aged 3 to 14 years who visited the ED with abdominal pain as a chief complaint. KTAS level (1–3 vs. 4–5), age, gender, presence of associated symptoms (vomiting, diarrhea, hematochezia, and fever), and disposition (rapid discharge, discharge after intravenous hydration, and hospitalization) were collected and compared between the children with KTAS 1–3 and 4–5. RESULTS: Of 1,050 children enrolled, 618 (58.9%) were classified as KTAS 1–3, and 36 (3.4%) were hospitalized. Vomiting was the most common associated symptom in both groups (63.6%), and 41.5% underwent discharge after intravenous hydration. The children with KTAS 1–3 were more frequently hospitalized (5.0% vs. 1.2%, P < 0.001). CONCLUSION: The KTAS may be reliable to predict the hospitalization of children with abdominal pain in the ED with additional consideration of the associated symptoms.
Abdominal Pain* ; Child* ; Critical Illness ; Diarrhea ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Gastrointestinal Hemorrhage ; Hospitalization* ; Humans ; Medical Records ; Pediatrics ; Retrospective Studies ; Triage* ; Vomiting

PURPOSE: Antivenin is a standard therapy in snakebite victims. While the required antivenin dose can be easily estimated, based on the initial symptoms, this strategy may be unsuccessful if the initial symptoms progressively worsen. The purpose of this study was to identify the progression rate of the initial symptoms following snakebite and its associated factors. METHODS: The medical records of 44 patients treated for snakebite from give the actual dates of the study period were retrospectively examined. Thirty-two of these patients were enrolled. Demographic data, local wound grade and local effect score at initial presentation (G-0 and LES-0, respectively) and 12 hours after admission (G-12 and LES-12, respectively) were reviewed, along with laboratory data. RESULTS: The 32 patients had an average age of 54.0+/-14.5 years and were predominantly male (n=26) and presented mainly during summer. Compared to G-0 and LES-0, re-evaluated G-12 and LES-12 were significantly increased despite initial administration of proper antivenin dosage (p=0.001 and p=0.000, respectively). Total amounts of antivenin correlated with LES-12 (correlation co-efficiency 0.558, p<0.05). However, factors associated with symptom progression were not revealed. CONCLUSION: Initial snakebite symptoms might progressively worsen within hours despite acceptable initial antivenin therapy. Therefore, re-evaluation within several hours must be considered if when the initial snakebite symptoms are minimal or mild.
Antivenins ; Chronology as Topic ; Disease Progression ; Humans ; Male ; Medical Records ; Retrospective Studies ; Snake Bites

Neonatal lupus erythematosus (NLE) is a rare disease characterized by typical clinical features and the transplacental passage of maternal autoantibodies, particularly anti-SSA/Ro. The major clinical manifestations are cutaneous lupus lesions, congenital heart block, hematological disorders, and hepatobiliary diseases. We report a case of NLE presenting with multiple round and oval target-like erythematous skin lesions and abnormal liver function, born to a clinically asymptomatic mother whose diagnosis was made retrospectively only after her newborn's diagnosis. Both the infant and the mother were positive for the anti-SSA/Ro and anti-SSB/La antibodies.
Antibodies ; Autoantibodies ; Heart Block ; Humans ; Infant ; Liver ; Lupus Erythematosus, Systemic ; Mothers ; Rare Diseases ; Retrospective Studies ; Skin

Thrombosis of venous channels in the brain is not a common cause of cerebral infarction relative to arterial disease but is an important consideration because of its variable clinical features and potential morbidity. It is very often unrecognized at initial presentation. The diagnostic modality is brain imaging with magnetic resonance venography. An empty-delta sign appears on a contrast CT scan as enhancement of the collateral vein in the superior sagittal sinus wall surrounding a nonenhanced thrombus in the sinus. However, the sign is frequently absent. Heparin should be considered in the management of cerebral venous sinus thrombosis (CVST). We report a case of CVST in a 59-year-old woman that presented initially as a headache and was diagnosed after several visits to clinics.
Brain ; Cerebral Infarction ; Female ; Headache ; Heparin ; Humans ; Middle Aged ; Neuroimaging ; Phlebography ; Sinus Thrombosis, Intracranial* ; Superior Sagittal Sinus ; Thrombosis ; Tomography, X-Ray Computed ; Veins

In vitro ethylene-diamine-tetra-acetic acid (EDTA) dependent satellitism and phagocytosis of platelets by neutrophils have been considered to be rare phenomena. It is associated with pseudothrombocytopenia, abnormal histogram of platelets and pseudoleukocytosis on complete blood cell count (CBC) by automated blood cell counter, but these findings are not found in heparinized or sodium citrated blood. It has no clinical significance such as bleeding tendency or abnormal platelet function. EDTA dependent platelet satellitosis and phagocytosis must be differentiated from true thrombocytopenia. We report a case of EDTA dependent platelet phagocytosis by neutrophils in a 68 year-old male patient who was diagnosed as mycosis fungoides. His EDTA blood smear showed frequent phagocytosis of platelets by neutrophils and occasional platelet satellitism. The bood cell counts were within normal limits without pseudothrombocytopenia. Phagocytized platelets were confirmed by immunohistochemistry using GpIIb/IIIa antibody and transmission electron micrographs.
Aged ; Blood Cell Count ; Blood Platelets* ; Cell Count ; Edetic Acid* ; Hemorrhage ; Heparin ; Humans ; Immunohistochemistry ; Male ; Mycosis Fungoides* ; Neutrophils* ; Phagocytosis* ; Sodium ; Thrombocytopenia

PURPOSE: The aim of this study was to identify usefulness of simple oral and gastric pH measurement using pH paper on detection of symptomatic gastroesophageal reflux in neonates. METHODS: This prospective study included a total of 66 neonates born at Konyang University Hospital from June 2004 to June 2005. Each neonate's oral and gastric pH levels measured with pH paper at 6 hourly intervals. Suspected gastroesophageal refluex neonates were studied 24-hr lower esophageal pH monitoring or upper GI series and confirmed. We compared oral and gastric pH between symptomatic gastroesophageal reflux (GER) group and asymptomatic (control) group. RESULTS: GER group consist of 12 neonates and control group consist of 54 neonates. Oral and gastric pH were 5.4+/-0.6, 2.9+/-0.5 in GER group, 6.0+/-0.3, 3.9+/-0.9 in control group, the differences between two groups were significant (P<0.05). All neonates of GER group were corfirmed gastroesophageal reflux by 24-hr lower esophageal pH monitoring or upper GI series studies. Our data indicate as a predictor for significantly symptomatic gastroesophageal reflux, at oral pH 5.75, has a sensitivity 92%, specificity 89%, positive predictive value of 65%, and negative predictive value of 98%. The difference between oral and gastric pH (oral pH-gastric pH) was not significant in each group. CONCLUSION: In neonates with symptomatic gastroesophageal reflux oral and gastric pH were significantly lower than asymptomatic neonates. Oral and gastric pH were related with clinically significant symptoms of gastroesophageal reflux. We suggest that pH measurement could be a possible simple screening test of symptomatic gastroesophageal reflux.
Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mass Screening ; Prospective Studies ; Sensitivity and Specificity

No abstract available.
Aminophylline* ; Humans* ; Neutrophils* ; Pneumonia* ; Sepsis* ; Superoxides*