BACKGROUND: The Stroop color word test is useful to examines the frontal lobe function of selective attention and inhibition. The Korean Color Word Stroop Test(K-CWST) was widely used in Korea. But, it was difficult in elderly individual with low educational level and visual problem and in patients with more progressed dementia. So we developed the Korean Stroop Test(KST). METHODS: The KST consist of word reading(WR), color naming(CN), interference word reading(IWR) and interference color naming (ICN). The interference tasks are naming the ink color of color words which were mismatched with word meaning. We measured reaction time and number of error. This study used the K-CWST to assess and compare the KST in eighteen probable alcohol related dementia patients and nineteen normal control. All subjects received the Korean version of Mini-Mental State Examination (K-MMSE) and the K-CWST and the KST. We tested reliability and validity of the KST. Also we enrolled normal adult from 41 to 80 year old for evaluating the change of the KST test with age. RESULTS: The KST tasks were correlated with K-MMSE -0.33(p<0.05) to -0.63(p<0.001) and K-CWST correlated with K-MMSE 0.37 (p<0.05) to 0.55(p<0.01). The interference color naming of KST was correlated the most to K-MMSE -0.78(p<0.001). The interference color naming of KST and interference color naming of K-CWST was correlated by 0.81(p<0.001). The internal consistency were 0.78 (Cronbach's alpha). The KST score was statistically different between alcohol related dementia patients and normal subjects in CN, ICN and ICN error. The KST was not differ in old age group except some tasks. CONCLUSION: The KST has a excellent reliability and validity. It takes less time and easy than the K-CWST. So the KST is a good test for evaluating frontal lobe function in elderly with low educational level of older people.
Adult ; Aged ; Aged, 80 and over ; Dementia ; Frontal Lobe ; Humans ; Ink ; Korea ; Reaction Time ; Reproducibility of Results ; Stroop Test*

Microphallus species occur primarily as intestinal parasites of birds and mammals, and metacercariae of a new species belonging to this genus have been discovered from the crab, Macrophthalmus dilatatus, in the Republic of Korea. The metacercaria of this fluke was round with 2 thick walls, and the excysted one had mature genital organs. The adult flukes recovered from experimentally infected chicks had numerous intrauterine eggs, well-developed pars prostatica, widely bifurcating ceca, and prominent uterine bulge. After observing internal structures, it was concluded that this species is different from any other known Microphallus spp. Based on the morphology of metacercariae and adult flukes, we describe this specimen as a new species, Microphallus koreana n. sp.
Animals ; Brachyura/*parasitology ; Chickens ; Rats ; Trematoda/*anatomy & histology/*classification/isolation & purification ; Trematode Infections/parasitology/transmission

PURPOSE: This study was conducted in order to evaluate the possibility of improving the comprehension and satisfaction of patients discharged after receiving discharge instructions using a tablet personal computer (tablet PC), compared with conventional discharge instructions. METHODS: A randomized, prospective, consecutive, exploratory study was conducted on patients with ureteral stones in an emergency department (ED). The patients' objective comprehension, satisfaction, and subjective comprehension regarding their discharge instructions were compared with regard to discharge instruction (traditional verbal method, N=53 versus tablet PC method, N=53). RESULTS: No statistically significant differences in age, gender, or level of education were observed between the two groups. The mean number of correct answers regarding ureteral stones on the questionnaire was 2.35+/-1.02 in the conventional group (CG) and 3.37+/-0.9 in the tablet PC group (TG) (p<0.05). The score for satisfaction was 7.75 in the CG and 8.03 in the TG (p>0.05). The subjective comprehension score was 7.42 in the CG and 7.8 in the TG (p>0.05). CONCLUSION: Objective comprehension of ureteral stones showed improvement in the group with discharge instructions provided by the tablet PC. However, satisfaction and subjective comprehension did not show improvement.
Comprehension ; Computer-Assisted Instruction ; Computers, Handheld ; Emergencies ; Humans ; Microcomputers ; Patient Discharge ; Prospective Studies ; Surveys and Questionnaires ; Ureter ; Urolithiasis

BACKGROUND: While aspirin sensitivity has been known to be common among patients with severe asthma, its frequency among asthmatics with mild to moderate severity remains to be learned. OBJECTIVES: To elucidate the frequency of aspirin sensitivity and its clinical characteristics among asthma patients with mild to moderate severity. MATERIAL AND METHODS: A total of 96 asthmatics with mild to moderate severity were enrolled. They underwent lysine-aspirin and methacholine bronchial provocation tests, and gave their induced sputum after the lysine-aspirin challenge. RESULTS: FEV1 declined greater than 20% compared with baseline FEV1 in 11 of 96 patients on the lysine-aspirin challenge. The frequency of aspirin sensitivity was higher among patients with enhanced bronchial hyperresponsiveness to methacholine (PC20 < 1 mg/ml) than among those without it (27.3% vs. 6.8%). The frequency was also higher in those with induced sputum eosinophil count higher than 3% than among those without it (38.9% vs. 0%). However, it was not associated with other risk factors such as age, sex, atopy, nasal polyps, and rhinosinusitis. CONCLUSION: More than 10% of mild to moderate asthmatics have aspirin sensitivity even though they have experienced no history of aspirin sensitivity which may be related with bronchial hyperresponsiveness to methacholine and eosinophil activation.
Aspirin* ; Asthma ; Asthma, Aspirin-Induced ; Bronchial Provocation Tests ; Eosinophils ; Humans ; Methacholine Chloride ; Nasal Polyps ; Prevalence* ; Risk Factors ; Sputum

PURPOSE: Inappropriate cuff inflations cause many complications. A conventional pilot balloon palpation technique is insufficient to detect high cuff pressures, but is still preferred. Hence, we conducted this study to identify effectiveness, preference and ease of use of a new estimation technique named "passive release technique" for endotracheal tube cuff inflation. METHODS: Twenty-nine nurses inflated cuffs by a pilot balloon palpation technique in manikins inserted with a 7.5 mm endotracheal tube. Then, being educated about passive release techniques, they inflated cuffs using such a passive release technique. Intracuff pressures and air volumes were measured by manometers and syringes. Preference and ease of use between the two methods were scored using a 10-point Likert scale. RESULTS: For the pilot balloon palpation technique, only 4 nurses (13.8%) inflated cuffs within the normal range of pressures (normal: 15 to 30 mb) with an average of 39.3+/-34.0 cmH2O. For the passive release technique, 19 nurses (65.5%) inflated cuffs within the normal range of pressures with an average of 24.2+/-9.3 cmH2O (McNemar's test, p<0.01). In the pilot balloon palpation technique, inflated air volumes of 7.8+/-2.0 ml were not significantly different from inflated air volumes 8.5+/-1.2 ml (p=0.07) for the passive release technique. But the difference was found to be statistically significant in a variance ratio test (F-test) (p<0.01). In view of preference and ease of use between the two methods, mean values were not statistically different, 7.3+/-2.0 vs. 7.0+/-2.0 and 7.0+/-2.3 vs. 7.3+/-2.4, respectively. CONCLUSION: When direct intracuff measurement is not available, a passive release technique using a syringe is an effective and easy method to achieve cuff inflation.
Inflation, Economic ; Intubation ; Manikins ; Palpation ; Reference Values ; Statistics as Topic ; Syringes

BACKGROUND: Because of the ubiquity of Legionella species in aquatic environments, molecular epidemiological analysis of Legionella isolates is important in investigation for source of infection and subsequent control of nosocomial legionellosis. In association with an unusual cluster of nosocomial pneumonia with Legionella in a tertiary-care hospital, we performed an environmental surveillance with molecular epidemiological study of Legionella isolates. METHODS: We randomly collected 20 samples of environmental and portable water from the hospital where three cases of Legionella pneumonia occurred consecutively during the period of 5 months. We detected Legionella from the samples by using both culture and polymerase chain reaction(PCR), and analyzed Legionella isolates from patients and environmental samples together with 12 reference strains by ribotyping using HpaI and EcoRI. RESULTS: Legionella was isolated from 3 out of 20(15%) samples by culture, and detected in 9 of 20(45%) by PCR. Ribotyping analysis showed that 2 patients' and 2 environmental isolates from a faucet of the patient's room and an air handling unit shared the same pattern which was also identical to that of Legionella pneumophila serogroup 6, a reference strain. CONCLUSION: The study showed that the hospital environments were contaminated with at least 2 Legionella species including L. pneumophila serogroup 6, and indicated that an unusual cluster of Legionella pneumonia occurred in the hospital was possibly linked to the contamination of a faucet with L. pneumophila serogroup 6.
Environmental Monitoring ; Epidemiologic Studies* ; Humans ; Legionella pneumophila ; Legionella* ; Legionellosis ; Pneumonia* ; Polymerase Chain Reaction ; Ribotyping ; Water

BACKGROUND: The purpose of this study was to identify the factors that influence mortality in organophosphate intoxication and the differences between the elderly (> or =65 years) and younger adults (18-64 years) looking at vital sign, length of admission, cholinesterase activity, complications, and prognosis. METHODS: All patients visiting one Emergency Department (ED) with organophophate intoxication between January 2000 and December 2011 were reviewed retrospectively. We divided the patients into two groups, geriatric adults (> or = 65 years) and nongeriatric adults (18-64 years). RESULTS: During the study period, 155 patients (45 patients, > or =65 years; 110 patients, 18-64 years) presented to the ED with organophosphate intoxication. Thirty-six elderly patients (80.0%) vs. 63 younger adult patients (57.3%) were intubated endotracheally, with the analysis showing a clear distinction between the two groups (p=0.026). Twenty-two elderly patients (48.9%) vs. 23 younger adult patients (20.9%) went into shock, displaying a significant gap (p=0.008). Thirtyfive elderly patients (81.4%) vs. 62 younger adult patients (59.0%) developed respiratory complications and 20 elderly patients (46.5%) vs. 19 younger adult patients (18.1%) developed central nervous system complications, with obvious differences seen in each of the comparison at (p=0.031) and (p=0.005), respectively. Comparing plasma cholinesterase levels at 1st, 3rd, 5th, 10th, 15th, and 20th days, the rate of increase was faster in the younger adults (p=0.022). CONCLUSION: With organophosphate intoxication, elderly patients tended to be intubated endotracheally, went into shock, developed central nervous system complications, were more severe, and showed a slower increase in cholinesterase level.
Adult ; Aged ; Central Nervous System ; Cholinesterases ; Emergencies ; Humans ; Mortality ; Organophosphate Poisoning ; Plasma ; Prognosis* ; Retrospective Studies ; Shock ; Vital Signs

Tolosa-Hunt syndrome is a rare self-limiting disease characterized by a painful, unilateral ophthalmoplegia caused by an idiopathic granulomatous inflammation in cavernous sinus, the superior orbital fissure or the orbital apex. We report a case of a 51-year-old man who presented at the emergency department with periocular pain and diplopia. Physical examination, and radiological and laboratory testing performed at that time were diagnostically inconclusive. After hospitalization, the patient was diagnosed with Tolosa-Hunt syndrome. Treatment with high dose steroid was started; by 2 days later, the periocular pain was relieved and other symptoms had improved. The rarity of Tolosa-Hunt syndrome calls for knowledge of the disease and attention by an emergency physician. The case report includes as summary of the syndrome, its' diagnosis and treatment.
Cavernous Sinus ; Diplopia ; Emergencies ; Hospitalization ; Humans ; Inflammation ; Male ; Middle Aged ; Ophthalmoplegia ; Orbit ; Physical Examination ; Tolosa-Hunt Syndrome

Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.
Cheek ; Compressed Air ; Emergencies ; Firearms ; Fires ; Head ; Humans ; Korea ; Nails ; Neck ; Neck Injuries ; Spine ; Suicide ; Trachea ; Wood

Commotio cordis is induction of sudden cardiac arrest and ventricular fibrillation (VF) by chest blunt trauma and nonpenetrating injury without damage to the rib, sternum, and heart in a person without underlying cardiovascular disease. Commotio cordis has been rarely reported worldwide, and it is particularly rare in the case of traffic accident (TA). We experienced a case of commotio cordis in a healthy 20-year-old man who was involved in a TA. The patient had no other signs of trauma except blunt chest trauma, and the initial electrocardiography (ECG) rhythm checked by the emergency medical technician (EMT) team was VF. They performed defibrillation and cardiopulmonary resuscitation (CPR) during transfer. CPR including defibrillation was performed because VF continued upon arrival at the emergency department, and therapeutic hypothermia (THT) was performed because glasgow coma scale (GCS) score was 3 after return of spontaneous circulation (ROSC). The patient's mental status became alert after performance of THT and cerebral performance category (CPC) score was 1 without neurological symptoms at the time of discharge. In trauma patients who may be have blunt chest trauma, including TA, emergency medical service providers must perform continuous monitoring with commotio cordis in mind, and perform defibrillation and CPR immediately if VF arises. With training in basic CPR and a supply of automated external defibrillators (AED) for application to trauma patients, the survival rate of commotio cordis patients can be increased.
Accidents, Traffic* ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Commotio Cordis* ; Death, Sudden, Cardiac ; Defibrillators ; Electrocardiography ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital* ; Glasgow Coma Scale ; Heart ; Humans ; Hypothermia ; Ribs ; Sternum ; Survival Rate ; Thoracic Injuries ; Thorax ; Ventricular Fibrillation ; Wounds, Nonpenetrating ; Young Adult