BACKGROUND: One of the problem in emergency room(ER) of university hospital is over-crowdedness that causes exhaustion of medical resources (personnel, device, space) and disturbes optimal treatment. METHODS: This is an evaluative research for the purpose of promoting efficient operation system in ER of university hospital. RESULTS: 1) In 387 visitors, mean age was 47.5 years, and male to female ratio 1.21:1. As the specialty in charge, 28.9%f them were internal medicine, 26.6%mergency medicine, 9.9%eurology, and 8.5%eurosurgery. 24%f visitors have come by ambulances. The patients stayed for average 16.1 hours. The admission rate of ER visitors was 33.4 %60.3 %returned home after some management. 2) The visitors had various causes without correlation between the severity of conditions and the choice of high level hospital ER. They perceived their situations emergent in 78.4% but after triage only 25.6%were classified emergent. 48.6%of the visitors were the patients of out-patient department of this hospital due to chronic diseases. 3) The patients were assessed within 9.5 minutes after arrival at ER by nurse and within 34 minutes by doctor. If they were in need of consultation to second/third department, they waited for 141.5/460 minutes respectively to see the doctor. They waited for 59.9/52.7 minutes to get routine laboratory sampling/radiologic examination respectively. 4) Every 2.3 new patients visited this ER per hour. Average 63.2 patients were taken over to next shirt of nurse duty, and 60%of them had chronic degenerative diseases. CONCLUSION: The causes of overcrowding in ER of the university hospital were (1) huge number of patients at out-patient department of the hospital, (2) shortage of beds compared to the number of patients waiting admission, (3) too many kinds of procedures performed in ER, (4) cooperation failure among doctors of different specialty, and (5) no definite criteria of admission/discharge into/from ER. To solve these problems, conversion of ER management policy from complete examination and treatment to more simple and rapid one is necessary.
Ambulances ; Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals ; Humans ; Internal Medicine ; Male ; Outpatients ; Triage

Aspiration and resultant chemical pneumonitis remain a serious hazard associated with the administration of anesthesia. Anticholinergic drugs are commonly used to reduce the volume and acidity of gastric secretion. We studied the effectiveness of atropine, glycopyrrolate and cimetidine in increasing gastric pH, free acidity and total acidity in the pre-and the 1hr post-anesthesia. Fifty patients scheduled for elective surgery in Dept. of Ansthesiology in EWUH, were randomly allocated into five groups with ten patients in each group. Patients in the control group were given neither anticholinergics nor cimetidine; patients in group I received 0.5 mg of atropine intramuscularly 1 hr. before induction of anesthesia, patients in group II received 0.2 mg of glycopyrrolate intramuscularly 1 hr. before induction of anesthesia, patients in group III received 200 mg of cimetidine intravenously and atropine as in group I, patients in group IV received 200 mg of cimentidine intravenously and glycopyrrolate as in group II. The results were as follows; 1) There were not any significant changes in the gastric pH, free acidity or total acidity in any of the patient groups in pre-and post-anesthesia. 2) In the control group, the mean gastric pH was 1.86+/-0.07, free acidity was 33.48+/-8.73 and total acidity was 49.31+/-9.10. 3) In the group I, the mean gastric pH was 2.62+/-0.24, free acidity was 5.65+/-1.89 and total acidity was 19. 76+/-3.27. Compared with the control group, the gastric pH in group I increased but free acidity and total acidity both decreased significantly(p<0.05). 4) In the group II, the mean gastric pH was 3.46+/-0.52, free acidity was 4.18+/-l.75 and total acidity was 19.76+/-3.27. 5) In the group III, the mean gastric pH was 6.17+/-0.66, free acidity was 10.96+/-4.42. Compared with the control group, the mean gastric pH in group III increased but free acidity and total acidity both decreased significantly(p<0.001).6) In the group IV, the mean gastric pH was 2.70+/-0.39, free acidity 11.01+/-4.73 and total acidity was 33.41+/-5.81. Compared with the control group, the gastric pH in group IV increased but free acidity and total acidity both decreased significantly(p<0.05). So, compared with the control group, the mean gastric pH above 2.5 increased significantly in the all groups. In conclusion, it would seem that the incidence of severe aspiration pneumonitis can be decreased by anticholinergic drugs and cimetidine pretreatment in surgical patients.
Anesthesia ; Atropine ; Cholinergic Antagonists* ; Cimetidine ; Glycopyrrolate ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Pneumonia

No abstract available.
Congenital Hypothyroidism* ; Diagnosis* ; Prognosis*

The objective of this study was to compare early child care center teachers' attitudes for meal and snack guidance between Sweden and Korea. Participants were 251 early child care center teachers (Sweden: 134, Korea: 117) working in Goetebory, Sweden, and Seoul, Korea. The survey was conducted from December in 2003 to February in 2004. SPSS programme was used for statistical analysis. Sixty five point eight percent of the Korean early child care center teachers provided a certain amount of foods for children. But 20.9% of Swedish provided a certain amount of foods for children, 79.1% of them provided the amount a child wanted. Sixty one point seven percent of Korean teachers allowed a child leave foods on the plate, but 95.5% of Swedish teachers asked a child eat all food on the plate. When a child didn't want to eat, 61.1% of the Korean teachers fed him/her, but 11.0% of the Swedish teachers did. Only 42.4% of the Swedish teachers allowed a children eat sweets, but 92.9% of Korean did. The Swedish teachers' perception for food guidance were eating by child himself/herself > washing hands before eating > having appropriate table manner > eating as talking with friends > not playing during the meal time, while the Korean teachers' was taking various food > having appropriate table manner > eating by child himself/herself, not playing during the meal time > washing hands before eating. The Swedish teachers thought 'eating as talking with friends' and 'eating by child himself/herself' is important, where as the Korean's did 'eating without making noise', 'not playing during the mealtime' in the eating behavior. For 'brushing teeth after meal' the Swedish teachers' score (1.5) was lower than the Korean (4.2). The results is necessary to improve meal and snack guidance for Korean early child care center teachers' education.
Child ; Child Care* ; Child* ; Eating ; Education ; Feeding Behavior ; Friends ; Hand ; Humans ; Korea* ; Meals* ; Seoul ; Snacks* ; Sweden* ; Tooth

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

The authora have had contact with 951 cases of surgery of the lower extremities receiving various kinds of anesthtic methods and these cases were analyzed at the department of Anesthesiology, Ewha Womans University Hospital during the 7 year period from January 1970 to December 1982. The result are as follows: 1) There is a trend towards increasing numbers of operations annually. 2) The most common age group was 3rd decade(24%) 3) Ratio of males to females was 2:1. 4) Class I of physical status(ASA) was most common(61.2%) 5) For premedication, meperidine and atropine sulfate were commonly used(32.9%). 6) In the section of surgery, Orthopedic surgery is most common(90.4%) 7) General anesthesia was the most commonly used technique(69.8%) 8) Most cases ended within 2 hours(60.1%)
Anesthesia* ; Anesthesia, General ; Anesthesiology ; Atropine ; Female ; Humans ; Lower Extremity* ; Male ; Meperidine ; Orthopedics ; Premedication

The authors analyzed statistically, 2,290 cases of anesthesia for emergency Cesarean section perfomed at Ewha Womans University Hospital from January 1978 to December 1982. The results are as follows: 1) The incidence of emergency Ceaarean section was 73.8% of total Cesarean sections. 2) The most common indication was CPD(41.4%). 3) The most common gestational age group was 38-42 weeks(85.2%). 4) In NPO time, general anesthesia was twice in more than 6 hours, but spinal anesthesia was twice in less than 6 hours. 5) General anesthesia was increaaed but spinal anesthesia was decreased during the five year period. 6) In estimated blood loss, less than 1,000 ml was 80.0%. 7) Neonates with poor Apgar score (0-3 point) were 5.9% which related to prolonged induction-delivery time and general anesthesia. 8) A drop in blood pressure developed within 5 minutes in 58.3% after spinal anesthesia.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Apgar Score ; Blood Pressure ; Cesarean Section* ; Emergencies* ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Pregnancy

Ovarian tumors are rare in children. Their incidence is estimated to be about 2.6 cases per 100,000 girls per year. About 1/3 of all childhood ovarian tumors are reported to be malignant. Germ cell tumors are more frequent than epithelial and sex cord stromal tumors in children and teratoma is the most common germ cell tumor occurring in children. In most cases, the presenting symptoms in childhood included abdominal pain, an abdominal mass, abdominal distention and so on. These non-specific symptoms and low incidence lead to suspicions of more common diseases, so the diagnosis of ovarian masses in childhood is difficult. We experienced a rare case of mature cystic teratoma in a 5-year-old girl with urinary frequency without abdominal discomfort despite the large size. The pre-operative magnetic resonance imaging finding showed unusual characteristics, rising suspicion of malignancy. So, we present this case with a brief review of literature.
Abdominal Pain ; Child ; Humans ; Incidence ; Magnetic Resonance Imaging ; Neoplasms, Germ Cell and Embryonal ; Preschool Child ; Sex Cord-Gonadal Stromal Tumors ; Teratoma

PURPOSE: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. METHOD: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as "metabolic syndrome", "intervention", "lifestyle modification", or "community-based" were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program-Adult Treatment Panel(NCEP-ATP III). RESULTS: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. CONCLUSION: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.
Humans ; Life Style ; Metabolic Syndrome X/*nursing ; *Nursing Methodology Research ; Randomized Controlled Trials as Topic ; Statistics, Nonparametric

Angioleiomyoma is a benign mesenchymal neoplasm composed of smooth muscle cells and thick-walled vessels. It usually originates in the extremities or the head. Thus angioleiomyoma of the uterus is a very rare so that there were only 10 cases in the available English literature. Angioleiomyoma cause no serious problems with regard to diagnosis and are simply recognized as benign leiomyomas. These tumors happen to be found only after the surgery through histologic findings. It is therefore extremely difficult to diagnose angioleiomyoma by its shape through preoperative sonography test. We experienced a case of angioleiomyoma with massive vaginal bleeding causing severe anemia which seemed as a benign leiomyoma before the surgery. Hence, we report this case with a brief review of literature.
Anemia ; Angiomyoma ; Extremities ; Head ; Leiomyoma ; Myocytes, Smooth Muscle ; Uterine Hemorrhage ; Uterus