No abstract available.
Gyeonggi-do* ; Mental Health*

No abstract available.

No abstract available.
Animals ; Hyperbaric Oxygenation* ; Osteomyelitis* ; Rats*

No abstract available.
Animals ; Osteomyelitis* ; Rats*

Mass casualty disasters have complex communication requirement. The involvement of many different communication systems and agencies and the difficulty of exchanging information between them is a perplexing problem. This may be compounded by telecommunication systems overload or failure, and electric service disruptions in the disaster area. In addition, emergencies are characterized by a sudden need for an increased information flow, an explosion in the topographical complexity of the information network, and a feeling of intense psychological pressure among the participants. The rescue, treatment, evacuation of a lot of patients from a natural disaster or mass casualties must be performed in accordance to several national agencies. Without an effective communication system, morbidity and mortality will needlessly rise. The stabilization and evacuation off lot of patients in a disaster is a serious and complex medical problem that must be resolved expeditiously. The potential far maximizing care depends on an well-organized rescue. However, without adequate communications, the patient may experience needless delays into the health care system an6 thus compromise prognosis. Established communication systems in most communities consist of private services, provincial and national agencies, and military and amateur radio operator. A disaster situation can severely disrupt routine telephone and radio communication. Customary frequencies may be incompatible with military and emergency civilian frequencies or become overloaded and useless because of intense activity. In a disaster, local telephone communication resources may be destroyed: qualified staffing of communications networks may be inadequate or unavailable to cope with the demands of the emergency. So, we recommend, that Amateur Radio should be provide as a effective emergency communication in a disaster.
Delivery of Health Care ; Disasters* ; Emergencies* ; Explosions ; Humans ; Information Services ; Mass Casualty Incidents ; Military Personnel ; Mortality ; Prognosis ; Telecommunications ; Telephone

While Joint Commission on Accreditation of Healthcare Organizations(JCAHO) and American College of Surgeon(ACS) have identified certain audit filters in trauma care, there are few studies to substantiate the value of these audit filters. Some researchers found that audit filters qualifiers were significantly associated with adverse outcomes, however, others were unable to reproduce such association. It is also necessary to test their validity and applicability in Korea. The purpose of this present study was to validate two trauma audit filters proposed by the JCAHO and the ACS, through the analysis of the relationship between timeliness of operation and risk-adjusted mortality. Among trauma audit filters, timeliness of operation in epidural or subdural hematoma(EDH/SDH) and intraabdominal injury were selected. By stratified random cluster sampling, 19 emergency medical centers (EMCs) were selected from 30 EMCs and all patients who received craniotomy or laparotomy in 1996 were evaluated in each hospital. Six medical records administrators reviewed medical records of 463 patients with EDH/SDH and of 508 patients with intraabdominal injury retrospectively. In other to adjust risk of mortality, timeliness of operation, age, Revised Trauma Score(RTS), ICD-9CM based ICISS, and experiences of transfer were included in logistic regression model. In the logistic regression models of all EDH/SDH or intraabdominal injury patients, timeliness of operation was not significant predictor of mortality. However, if patients who have been operated later than 12 hours were excluded from the statistical model, timeliness of operation showed significant or marginally significant relationship with mortality in the following situations; craniotomy > 4 hours in EDH(OR=30.46, p=0.032), craniotomy > 8 hours in SDH(OR=6.50, p=0.020), laparotomy > 2 hours in shock patients(OR=9.26, p=0.055). In addition to timeliness of operation, RTS and ICISS were significant variables in every logistic regression model, and experience of transfer and types of EMC were significant or marginally significant only in EDH. Timeliness of operation as audit filters for trauma care could not be applied to all cases. Early operations seem to improve clinical outcome only in the patients for whom emergent craniotomy or laparotomy were indicated. It could be interpreted as a phenomenon of 'confounding by indication'. Additional studies to establish more objective eligibility criteria for these audit filiters are needed.
Accreditation ; Administrative Personnel ; Craniotomy ; Delivery of Health Care ; Emergencies ; Humans ; Joint Commission on Accreditation of Healthcare Organizations ; Joints ; Korea ; Laparotomy ; Logistic Models ; Medical Records ; Models, Statistical ; Mortality ; Retrospective Studies ; Shock

Supracondylar fracture of the humerus is the most common fracture of the elbow in children and it can also be one of the most difficult fractures to be treated. A number of methods to manage supracondylar fracture of the humerus in children, have been being practiced and the ideal one is generally agreed with prompt, accurate and anatomical. reduction performed with the least possible trauma, and, it will prevent most complications. It is essential to minimize additional trauma to the already traumatized joint and pericapsular tissues including blood vessles and nerves. 105 patients with supracondylar fracture of the humerus managed at the Department of Orthopedic Surgery, Busan National University from January, 1971 to June, 1976 were reviewed and the following results were obtained. 1. The age of the patients ranged from 2 years to 14 years; the average age was 7. 0 year. 70 patients were boys. 2. The left side was involved in 62 patients; The distal fragment was displaced posterioly in 102 patients and anteriorly in 3 patients The medial displacement in the posteriorly displaced distal fragment was 60 patients. 3. 20 fractures were treated by open reduction and internal fixation. The indications for open reduction were failure to obtain accurate reduction after a few attempts of closed reduction in 15, an open fracture in 2, acute vascular embarrassment in 2, and redisplacement after open reduction in 1. 4. 15 of the 20 fractures treated by open reduction were re-examine 1 to 5 years; The results were normal elbow motion in 10, loss of extension (average 24 degree) in 5, loss of flexion in 2 and neuro-vascular complication in 2.
Busan ; Child ; Elbow ; Fractures, Open ; Humans ; Humerus ; Joints ; Orthopedics

We performed this study to investigate the distribution of axes of astigmatism, the occurrence and amount of astigma- tism among pediatric population aged from 1 to 15 years who have visited our clinic from January to December 1997. After routine ophthalmologic examination to rule out any organic abnormality, the cycloplegic refraction was performed with 0.5-1.0% atropine on 529 eyes. Out of 529 eyes, astigmatism was found in 356 eyes (67.3%) with the highest incidence in 15-year-old group being 87.0%. Among 356 eyes with astigma- tism, with-the-rule astigmatism was found in 322 eyes (90.4%); against-the-rule, 30 eyes (8.5%); oblique, 4 eyes (1.1%). With-the-rule astigmatism occurred far more frequently found than against-the-rule in all age groups. As to the type of astigmatism classified by the state of refractive errors,hyperopic astigmatism was found in 144 eyes (40.4%); myopic,136 eyes (38.3%); mixed, 76 eyes (21.3%). Of the total of 356 eyes with astigmatism, astigmatism of 1.0 diopter or less was found in 181 eyes (50.8%).
Adolescent ; Astigmatism* ; Atropine ; Axis, Cervical Vertebra* ; Child* ; Humans ; Incidence

Malignant mixed mullerian tumor (MMMT) is an unusual tumor composed of malignant epithelial and nonepithelial components in the same lesion and is subdivided into homologous and heterologous types. Epidemiologically, these tumors are associated with prior pelvic irradiation, functioning ovarian lesions, exogenous estrogen therapy and rarely endometriosis. We experienced a case of uterine MMMT which arose from adenomyosis in a 47-year-old woman who had no specific past medical history. The posterior uterine corpus showed a 3.5x3.0x2.0 cm sized, relatively well defined tumor mass within the background of the adenomyosis. The tumor was composed of well differentiated endometrial adenocarcinoma and sarcomatous stroma with foci of rhabdomyosarcomatous differentiation confirmed by immunohistochemical and electron microscopic studies. Through the immunohistochemical study, both the epithelial and nonepithelial components were positive for cytokeratin and it suggested that the sarcomatous area originated from metaplasia of the adenocarcinoma component. From the overall findings, it is regarded as an uterine heterologous MMMT which arose from adenomyosis.
Adenocarcinoma ; Adenomyosis* ; Endometriosis ; Estrogens ; Female ; Humans ; Keratins ; Metaplasia ; Middle Aged ; Rhabdomyosarcoma ; Uterus*

No abstract available.
9,10-Dimethyl-1,2-benzanthracene* ; Carcinogenesis* ; Hyperbaric Oxygenation* ; Submandibular Gland*