BACKGROUND: It goes without saying for the importance of pre-hospital care in EMS system. At present 119 rescuers take charge of the majority for the pre-hospital care in Korea. But the present activity and job satisfaction of 119 rescuers is not studied. METHOD: The authors analyzed the questionnaire from the 98 rescuers had taken the lessons on emergency medical technician training program at the Central Fire Fighting School, Cheonan city. We used a Likert's five stage barometer for the analysis of job satisfaction. RESULTS: On regional distribution of rescuers 29.6% was in metropolitan city and 70.4% was from each province. On sexual distribution male was 93%, average age was about 30 years old. The academic background was commonly below the high school graduation. Sixty-one of 98 rescuers (62.2%) was married. The monthly mean income is 1.07 million Won. There was a statistical difference of the monthly mean income between the age, sex, and the period of work (p<0.05). The average duration of job was 27 months. In most cases. the patients or relatives decided the evacuation hospital (89.8%). 67.0% of rescuers answered the necessity of emergency communication system during transport. The serious problems during transport were the lack of manpower, the knowledge of emergency care, the deficit of emergency equipment and telecommunication system. The priority of decision for evacuation hospital is the presence of special medical team, the severity of patients, the presence of modern hospital. The emergency equipment of ambulance was satisfactory in general. Almost all the rescuers (99.0%) want continuous education and 92.7% of them want at the emergency center or general hospital twice a year. The degree of job satisfaction was the job of special knowledge and skills, the professional work and self-assurance in order. CONCLUSION: 119 rescuers were gratified generally at the job satisfaction. But it was poor at work condition. The authors think that a government office and the korean society of Emergency Medicine must hard work for the improvement of work condition and the administration of continuous education.
Adult ; Ambulances ; Chungcheongnam-do ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Medicine ; Fires ; Hospitals, General ; Humans ; Job Satisfaction* ; Korea ; Male ; Surveys and Questionnaires ; Telecommunications

No abstract available.
Angiomyoma*

It is generally recognized that several chemical mediators are involved in tbe pathogenesis of sunbum; however, the exact mechanism is still to he resolved. Recently, prostaglandin has been found to be one of the inflammatory mediators in sunbum, particularly in the delayed erythema response and several investigators have shown that the nonsteroidal antiinflammatory drugs inhibit the in vivo synthesis of prostaglandin. On the assumption that the nonsteroidal antiinflammatory drugs might exert a beneficial effect on the sunbum through the antiprostaglandin effect, several authors have reported the effect of indomethacin on sunbum. This study was undertaken to evaluate the effect of topical indomethacin on the delayed erythema response induced by artificial sunlamp and sunlight by clinical and histopathological examination. Indomethacin(2. 5% ointment, 2. 5% solution, 5% solution) was applied immediately after 3 MED irradiation of artificial sunlamp to the shaved back skin of 6 healthy albino guinea pigs weighing 550-850gm and 9 human volunteers and the delayed erythema response was observed at 2, 4, 6, 12, 24 and 48 hours after irradiation respectively. Punch biopsies of the skin were performed on 6 guinea pigs at 6, 12, 24 a.nd 48 hours after irradiation and the histologic changes were observed. Four human volunters were exposed t,o 3 MED of sunlight and indomethacin preparations were applied immediately after irradiation. The delayed erythema response was observed at 2, 4, 6, 12, 24 and 48 hours postirradiation and in one volunteer, the skin was biopsied at 24 hour for histologi.c evaluation. The results were as follows: 1. Topical indomethacin in ointment or solution forms delayed and decreased the appearance and degree of erythema induced by sunlight and artificial sunlamp in both human and animal subjects. 2. Histologically, the number of sunbum cells at 24 hour in the epidermis of one human volunteer was decreased on indomethacin applied sites. The dermis showe6 no difference in histologic changes between control and indomethacin sitea. In animal study, however, no detectable difference in epidermal or dermal changes was observed between control and indomethacin applied sites. The autors confirmed that topical indometha,cin was effective in delaying and blanching of the delayed erythema of sunbum in guinea pigs as well as in human volunteers, though there was no difference in histologic changes between indomethacin and control sites in guinea pigs. The mechanism involvel on this aspect is remained to be resolved.
Animals ; Biopsy ; Dermis ; Epidermis ; Erythema ; Guinea Pigs ; Healthy Volunteers ; Humans ; Indomethacin* ; Research Personnel ; Skin ; Sunburn* ; Sunlight ; Volunteers

PURPOSE: The sentinel lymph node is defined as the first draining node from a primary tumor and reflects the histologic feature of the remainder of the lymphatic basin status. The aim of this study was to evaluate the usefulness of lymphoscintigraphy and intraoperative radioguided gamma probe for identification and removal of sentinel lymph node in breast cancer. MATERIALS AND METHODS: Lymphoscintigraphy was performed preoperatively in 15 patients with biopsy proven primary breast cancer. Tc-99m antimony sulfide colloid was injected intradermally at four points around the tumor. Imaging acquisition included dynamic imaging, followed by early and late static images at 2 hours. The sentinel lymph node criteria on lymphoscintigraphy is the first node of the highest uptake in early and late static images. We tagged the node emitting the highest activity both in vivo and ex vivo. Histologic study for sentinel and axillary lymph node investigation was done by Hematoxylin-Eosin staining. RESULTS: On lymphoscintigraphy, three of 15 patients had clear lymphatic vessels in dynamic images, and 11 of 15 patients showed sentinel lymph node in early static image and three in late static 2 hours image. Mean detection time of sentinel lymph node on lymphoscintigraphy was 33.5+/-48.4 minutes. The sentinel lymph node localization and removal by lymphoscintigraphy and intraoperative gamma probe were successful in 14 of 15 patients (detection rate: 93.3%). On lymphoscintigraphy, 14 of 15 patients showed 2.47+/-2.00 sentinel lymph nodes. On intraoperative gamma probe, 2.36+/-1.96 sentinel lymph nodes were detected. In 7 patients with positive results of sentinel lymph node metastasis, 5 patients showed positive results of axillary lymph node (sensitivity: 72%) but two did not. In 7 patients with negative results of sentinel lymph node metastasis, all axillary nodes were free of disease (specificity: 100%). CONCLUSION: Sentinel lymph node biopsy with lymphoscintigraphy and intraoperative gamma probe is a reliable method to predict axillary lymph node metastasis in breast cancer, and unnecessary axillary lymph node dissection can be avoided.
Antimony ; Biopsy ; Breast Neoplasms* ; Breast* ; Colloids ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Vessels ; Lymphoscintigraphy* ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy*

No abstract available.
Breast Diseases* ; Breast* ; Estrogens* ; Progesterone* ; Receptors, Estrogen* ; Receptors, Progesterone*

Due to the great deal of effort that has gone into the study of osteoclastic differentiation and activation over the last few decades, the mechanisms of these two events have been discovered gradually. Nitric oxide(NO-), which is produced from arginine by a nitric oxide synthase, opened up a new area of biological research. Recently, it has been reported that NO- is produced by osteoblasts stimulated by lipopolysaccharide and several other cytokines. In this study, the effect of sodium nitroprusside(SNP), a donor of nitric oxide(NO-), on osteoclast-like cell formation and on mature osteoclast function was examined. To determine the mechanism of the inhibitory effects of SNP decreased not only the basal 45Ca release but also thee bone resorption induced by PTH and l,25-dihydroxyvitamin D3 (I ,25[OH]2D3). The inhibitory effect of SNP on bone resorption induced by PTH appeared 2 days after treatment, whereas SNP effect on inhibiting bone resorption induced by l,25[OH]2D3 appeared at the third days. When chicken and rat osteoclasts were cultured on dentin slices, treatment of 300micronM SNP resulted in a significant decrease in dentin resorption by osteoclasts in terms of total resorption area and average individual area. We also examined the effect of SNP on formation of osteoclast-like cells that is TRAP-positive multinucleated cells from chicken and rat bone marrow cells in the presence or absence of 10(-8)M l,25[OH]2D3. The addition of 300 micronM SNP inhibited the formation of TRAP-positive multinucleated cells. The present data suggest that SNP, possibly as a NO- donor, inhibits the osteoclastic differentiation and osteoclastic activity.
Animals ; Arginine ; Bone Marrow Cells ; Bone Resorption ; Chickens ; Cytokines ; Dentin ; Humans ; Nitric Oxide Synthase ; Nitroprusside* ; Osteoblasts ; Osteoclasts* ; Rats ; Sodium* ; Tissue Donors

The primary hyperparathyroidism is a complex endocrine disease caused by neoplasm or diffuse hyperplasia of parathyroid gland in which excessive paratyroid hormon is secreted. This results in chemical abnormalities of serum, and exerts major influences on the bone, kidney and gastrointestinal tract. The authors report 2 cases of primary hyperparathyroidism with review of the literature.
Adenoma ; Endocrine System Diseases ; Gastrointestinal Tract ; Hyperparathyroidism, Primary ; Hyperplasia ; Kidney ; Parathyroid Glands

No abstract available.
Extremities* ; Osteogenesis, Distraction*

Bone scan measuring bone metastasis were analysed in fifty five patients diagnosed as malignant tumor, seven were primary bone tumor and forty eight were metastatic tumor, who treated in Kyung Hee Hospital from March 1981 to January 1982. The results were as follows: l. In 55 patients, positive bone scan were found in 76.4% of the patients and positive X-ray were found in 56.4%. 2. 7 patients with primary bone tumor showed all positive bone scan, 45 patients with metastatic tumor showed positive bone in 72.9%. 3. Among the patients with metastatic tumor who no clinical symptoms, positive bone scan were found in 59.3% and positive X-ray in 26%. 4. Most common metastatic site was femur in primary bone tumor and vertebra in metastatic tumor. 5. In 48 patients of metastatic tumor, positive bone scan within negative X-ray were found in 56%, negative bone scan within positve X-ray were found in 5%. 6 The lesions showed clod area on bone scan were considered of positive finding as compared with clinical symptom and X-ray finding.
Diagnosis ; Femur ; Humans ; Neoplasm Metastasis ; Spine

The normal vascularization of peripheral nervesand the vascular factor in peripheral nerve les ons have regained increasing interest among surgeons. So, several attempts have been made to assess the relative importance of the vasa nervorum and intrinsic longitudinal vascular plexuses of nerve in maintaining the blood supply.of a segment of nerve trunk. The purpose of our experiment was to determine in laboratory animals the maximum extent to which a nerve can be mobilized without impairing its vascular supply so much that nerve function is jeopardized. All our studies were carried out on both sides of the sciatic-tibial nerve of thirty-two rabbit which were anesthetized intraperitoneally with urethane. The experimental procedure differed in three groups, Group I in which the sciatic nerve was mobilized 3 cm in length, Group II was mob lized 7 cm length and Group III was mobilized 10cm long. The tibialis post. muscles of each group were analyzed at intervals ot 1,2,4,6 and 8 weeks after neurolysis. Each muscles were examined grossly and histologically after hematoxylin and eosin staining. Experimental studies showed that a peripheral nerve is a well vascularized structure with a considerable reserve capacity in its microirculation. The intrinsic collateral system is well developeed and experimental deta supported the view that peripheral nerves may be mobilized over a cons derable length with or the only minium interference with their microvascular flow. The results were as follows: 1. The first evidence of histologic change in the muscle fibers was in the sarcolemmal neclei. 2. Localized atrophy of muscle fibers were observed at the six weeks after neurolysis. 3. With increasing length of neurolysis, abnormal finding were developed in early stage. 4. Massive atrophy of muscle fibers were noted in the muscle fibers which neurolysed more 7cm.
Animals, Laboratory ; Atrophy ; DEET ; Eosine Yellowish-(YS) ; Hematoxylin ; Muscles ; Peripheral Nerves ; Sciatic Nerve ; Surgeons ; Urethane ; Vasa Nervorum