No abstract available.
Humans ; Ulsan*

BACKGROUND: The fire victims are affected not only by bum and trauma but also carbon monoxide(CO) and hypoxia. It may be useful to triage mass casualties of fire field that preestimate the victim's injury sevrrities by experiments of measuring the concentration of CO and oxygen according to time progression. METHOD: We prepared one house of apartment as like usual residental environment. The mesuring of concentrations of CO and oxygen was started from firing. RESULT: 3.8 Min. after firing: CO concentration(0.007%) was reached to the level that can give rise to spontaneous headache. 5 Min.: The concentration of CO was incerased. At this level(0.012%), the victims of fire may be suffered severe headache inspite of mild movement. 5.5 Min.: At this time,0.02% of CO concentration that the victims can't escape by themselves was checked. 6 Min.; 0.08% was measured, almost patients may be unconscious and the symptoms will be more severe at this CO concentration because of hypoxia.6.4 Min.: It was absolutly impossible to be survival at this time due to incresing of CO concentration(0.195%) and decreasing of O2 concentration(5%). CONCLUSION: It is within 5.5 Min. that the patient can escape by themselves, and impossible to be survival more than 6.5 Min. in fire field. Rescuers and EMTs must consider time factor as well as sysmtoms of patients.
Anoxia ; Carbon* ; Fires* ; Headache ; Humans ; Mass Casualty Incidents ; Oxygen ; Time Factors ; Triage ; United Nations

The humanitarian motivation of medical support from the three Scandinavian countries during the Korean War cannot be doubted, but the countries also had to be politically sensitive during this period. The fact that these countries only dispatched medical support, and that the team was not only for military purpose but also intended to help the civilians is a different point from the U.S. military medical support, which distinguished military medical support that is the U.S. Eighth Army, from the civilian treatment and relief, which is the UNCACK. In addition, medical support activities from the Scandinavian countries were bound to be flexible depending on the rapidly changing trend of war, active regions, and their support methods. At a time when the battle was fierce and the number of wounded soldiers increased, they had no choice but to concentrate on treating wounded soldiers, whether in Busan or Incheon. However, even while treating these wounded soldiers, they tried to treat and rescue civilians around the base area whenever they had chance. It is easily imaginable that in the urgent situation of war, the nature of medical support cannot be clearly divided into military or civilian if there is only one team that is operating. It is clear, however, that the common humanitarian purpose of rescuing and treating civilians affected the establishment of the National Medical Center in Seoul after the war. The Scandinavians had indeed remained even after the end of the war in to provide full support of establishing modern medical system in Korea. This suggests that modern Korean medical or public health system did not start to be developed in the 1960s like some researchers argue, but started a few years earlier during the time of the war with the support from the countries world-wide.

OBJECTIVE: We could measure diameters of lacrimal sac and surrounding bone thickness of normal Korean with accurate data by using orbital CT. METHODS: We measured the lacrimal sac, surrounding bone thickness, and frequency of Haller cell with thin-section computed tomography examinations in 115 normal Korean orbits with no signs of pathology related to the lacrimal drainage system for 1999 to 2001. RESULTS: The mean length of lacrimal sac was 10.45+/-1.96 mm, A-P width was 5.96+/-1.26 mm, L-R width was 3.72+/-0.92 mm. The surrounding bone thickness of upper portion of lacrimal sac was 6.46+/-1.40 mm, middle portion was 3.24+/-1.11 mm, lower portion was 0.78+/-0.23 mm. The frequency of Haller cell was 13.9%. The diameters of lacrimal sac and surrounding bone thickness were larger in males than females, and increasing tendency with aging. CONCLUSION: In this study, Korean lacrimal sac size was slightly smaller than the caucasian and Korean male's surrounding bone thickness was thicker than female. These data will be very helpful in making appropriate osteotomy by using the drill during dacryocystorhinostomy and avoiding unnecessary manipulation.
Aging ; Dacryocystorhinostomy ; Drainage ; Female ; Humans ; Male ; Orbit ; Osteotomy ; Pathology

PURPOSE: This study was undertaken to determine the adequate cutoff value of the neonatal screening test to decrease recall and false-positive rates. METHODS: During the period of January 1999 through December in Asan Medical Center, newborn screening tests for phenylketonuria, congenital hypothyroidism, congenital adrenal hyperplasia, and galactosemia were performed in 3,775, 3,707, 3,783, and 3,806 newborns respectively using commercial ELISA kits. We reviewed and analyzed the recall rate at currently used cutoff values. RESULTS: 1)In neonatal screening test for congenital hypothyroidism, using a current cutoff value, 17 microIU/mL, the recall rate was 0.9% and using a 99.7% cutoff value, 21.3 microIU/mL, the predictive recall rate was 0.4%. There were no significant differences in the other reports that suggest adequate recall rate. 2)In neonatal screening test for phenylketonuria, using a current cutoff value, 3.6 mg/dL, the recall rate was 1.5% which was no significant difference compared with expected presumptive positive rate, 1.44%. 3)In neonatal screening test for congenital adrenal hyperplasia and galactosemia, the recall rate was high when using current cutoff value. But all results were within normal limits in reevaluation. CONCLUSION: The cutoff values of screening test which are currently recommended by manufacturers of commercial kits for congenital hypothyroidism, congenital adrenal hyperplasia and galactosemia, are needed to be reset to decrease the recall rate by false-positive results on the basis of data from an individual newborn screening laboratory.
Adrenal Hyperplasia, Congenital ; Chungcheongnam-do ; Congenital Hypothyroidism ; Enzyme-Linked Immunosorbent Assay ; Galactosemias ; Humans ; Infant, Newborn ; Mass Screening ; Neonatal Screening* ; Phenylketonurias

PURPOSE: To assess whether pretreatment IGF-I SDS and pretreatmental bone age are useful indicators in the response of rhGH therapy in children with GH deficiency (GHD), the relationship between pretreatment IGF-I SDS, delay in bone age and the growth response during the first year of rhGH treatment was analyzed. METHODS: This study included 12 children with GHD. We measured IGF-I levels by RIA after acid-ethanol extraction at pretreatment and then calculated IGF-I SDS as follow: SDS = (IGF-I- mean IGF-I for normal subjects of the same age and sex)/SD of IGF-I for normal subjects of the same age and sex. GH levels were measured by immunoradiometric assay. All patients were treated with rhGH, 0.1IU/kg daily, 6 times a week for 1 year. RESULTS: Twelve patients (6 males and 6 females), age distribution from 4 to 16 years, were studed. The data is reported as the mean +/- SD. Height SDS for chronologic age of the group as a whole as -3.6 +/- 1.0 and bone age was 8.2 +/- 3.4 years. Pretreatment height velocity (HV) was 4.0 +/- 1.7cm/yr and the HV during each 3 months of therapy were 10.1 +/- 4.5cm/yr, 9.6 +/- 4.5cm/yr, 8.5 +/- 4.3cm/yr and 7.8 +/- 1.3cm/yr, respectively and therefore the HV during the first year of rhGH therapy increased to 9.3 +/- 2.9cm/yr (P=0.002). Pretreatmental IGF-I SDS was -2.2 +/- 0.9 (-0.4~-3.6). A significant negative correlation between pretreatmental IGF-I SDS and incremental height gain was obtained (r=-0.40, P<0.05). The height velocity of the group whose pretreatmental IGF-I SDS was below -2 (n= 8) as a whole increased significantly from 3.5 +/- 1.8cm/yr to 10.3 +/- 2.9cm/yr (P=0.001). Pretreatmental bone age delay was 3.1 +/- 1.9 (0.5-7.8) years. The height velocity of the group whose pretreatmental bone age delay above 2 years (n=9) increased significantly from 4.1 +/- 1.1cm/yr to 9.7 +/- 2.9cm/yr (P=0.001). CONCLUSION: The height velocity of GH deficient children whose pretreatmental IGF-I SDS below -2 or pretreatmental bone age delay above 2 years increased significantly after rhGH therapy. It suggests that the pretreatmental IGF-I SDS and pretreatmental bone age may be significant indicatiors in the response of GH therapy in children with GHD.
Age Distribution ; Child* ; Growth Hormone* ; Human Growth Hormone* ; Humans* ; Immunoradiometric Assay ; Insulin-Like Growth Factor I* ; Male

OBJECTIVE: This study was to investigate the factors that influence the propensity of Koreans in choosing care settings of dementia patients. METHODS: This study analyzed the data from the '2014 Nationwide Survey on Dementia Awareness of Koreans' that was conducted by the National Institute of Dementia. Korean's perception of care burden for dementia was measured with grading on its types. Also its influences on preference for care between facilities and homes were evaluated using multivariate analysis with socio-demographic characteristics. RESULTS: In terms of preferred care settings, respondents preferred facilities over homes in case of themselves and their family, respectively 77.5% and 68.2%. The preference for facilities was significantly influenced by the respondents' age for both themselves and their family. Additionally, the perception of relatively higher emotional and physical burden compared to economic burden significantly influenced preference for facilities for their family. CONCLUSION: Improving public awareness and setting-up a practical social supporting system are needed to reduce emotional and physical burden as well as economic burden of dementia. Furthermore, building up an appropriate and safer communities for dementia patients and their caregivers is much demanded for reducing their burdens.
Caregivers ; Surveys and Questionnaires ; Dementia* ; Humans ; Multivariate Analysis

BACKGROUND: Aging population correspond with an increase in the numbers of dementia patients. Dementia decreases the quality of life of patients and care-givers. However, current pharmacological treatment is limited by modest efficacy and adverse effect. Nonpharmacological treatment for dementia has been considered to be a substitute treatment. Recently we developed a special planned program for dementia with depression. The aim of this study was to evaluate therapeutic effect of this program. METHODS: We included patients aged 65 and older who diagnosed dementia with depression in a geriatric institution from April to June, 2006. We surveyed their sex, age, education period, and histories of hypertension, smoking, and alcohol intake. Patients in experimental group carried out our program, including cooking, painting, recreation, and activity, 9 times for 60 minutes a session. All included patients were checked Korean Mini-Mental State Examination (K-MMSE) and Korean Form of Geriatric Depression Scale (KGDS) before starting program and after 3 months when programs finished. RESULTS: There was no difference in demographic factors between two groups. K-MMSE was significantly improved in experimental group compared with control group (P = 0.01). And, the KGDS was significantly improved in experimental group compared with control group (P = 0.00). CONCLUSION: Multidivisional program for social skill improvement was effective on treatment for patients of dementia with depression. Nonpharmacological treatment for dementia with depression would be developed and studied to enhance the qualities of life of patients and care of dementia.
Aged ; Aging ; Alzheimer Disease ; Cooking ; Dementia ; Demography ; Depression ; Humans ; Hypertension ; Paint ; Paintings ; Quality of Life ; Recreation ; Smoke ; Smoking

OBJECTIVE: This is a retrospective review of 13 unstable Hangman's fractures who underwent posterior C2-3 fixation to describe clinical outcomes with a literature review. METHODS: Thirteen patients for unstable Hangman's fracture were enrolled between July 2007 and June 2010 were included in this study. The medical records of all patients were reviewed. Concurrently, clinical outcomes were evaluated using Neck Disability Index (NDI) scores and Visual Analogue Scale (VAS) scores during preoperative and postoperative follow up period. Plain radiographs were obtained on postoperative 1day, 1week, and then at 1, 2, 6, and 12 months. CT was done at postoperative 12 months in all patients for evaluation of bone fusion. The mean period of clinical follow-up was 17 months. RESULTS: Mean age were 43 years old. Bone fusion was recognized in all cases at the final follow-up. The average preoperative VAS score for neck pain was 8.3+/-1.1, while the final follow-up VAS score was 2.07+/-0.8 (p<0.001). The average immediate postoperative NDI was 84% points and final NDI was 22% points (p<0.001). There were one case of infection and 1 case of screw loosening. CONCLUSION: In the treatment of the patients with unstable Hangman's fracture, posterior C2-C3 fusions is effective and curative treatments to achieve cervical spinal stability.
Follow-Up Studies ; Humans ; Medical Records ; Neck ; Neck Pain ; Retrospective Studies