OBJECTIVES: This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island. METHODS: The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases. RESULTS: The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries. CONCLUSIONS: We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.
Ambulances ; Cause of Death ; Education ; Emergencies* ; Emergency Medical Services* ; Humans ; Labor Unions ; Medical Records ; Shock ; Thoracic Injuries ; Transportation

We have investigated the clinical response of 12 patients with erythrodermic psoriasis to therapy with etretinate. Initial dosage of etretinate was 20-60mg/day. The time for complete disappearance of scales averaged 19.9 days. In 10 of 12 patients(83.3%) satisfactory results were obtained after 2 to 11 months of treatment. Cheilitis was the most common side effect. Three patients had mild elevation of blood lipids, which was corrected by dose reduction. Remission period, of ten patients who showed good result, averaged 4.2 months.
Acitretin* ; Cheilitis ; Etretinate* ; Humans ; Psoriasis* ; Weights and Measures

Etretinate, an effective retinoid in the treatment of pustular, erythrodermic and chronic plaque type psoriasis, has the disadvantage of a long terminal elimination half-life. On the other hand, acitretin, the active metabolite of etretinate, has much shorter terminal elimination half-life and is being reported as an agent with good antipsoriatic activity by several authors. To evaluate the clinical efficacy of acitret.in in comparison with etretinate, we treated 10 patients wit,h acitretin at a dose of 30mg per day and 11 patients with etretinate at a same dose for 12 weeks. The PASI score at 12 week was significantly reduced in each group as compared with baseline PASI score. In the acitretin treated group the initial PASI score of 14.5 reduced to 3.9, while the etretinate group PASI score reduced from 12.0 to 3.1. The PASI score differ ences between the acitretin and etretinate groups at each time during therapy and the end of therapy were not statistically significant. The severity of adverse reactions with acitretin was similar to those with etretinate but their incidence was higher. The change in laboratory parameters in the acitretin group was simlar to that of the etretinate group. In view of these results and the known pharmacokinetic advantage of acitretin, that is the short terminal elimination half-life, it is conceivable that acitretin may be a useful alternative to etretinate in the treatment of psoriasis.
Acitretin* ; Etretinate* ; Half-Life ; Hand ; Humans ; Incidence ; Psoriasis*

No abstract available.
Child* ; Hemagglutination* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

Clinical trials were done to obtain ifnormation on the clinical efficacy, tolerance and side effects of a new antihistarnine, Mecloprodine(Tavegyl), in various skin disordetrs. A total of 48 patients suffered from various skin disorders as urticaria, eczema etc. v ere treated with 2mg. daily for 3 days to 15 days according to state of disorders. The results are as follows. 1. Improvement was noticed in 79.2% of total patients(38/48). 2. Tavegyl was efiective in all 8 cases of acute urticaria and most cases(7/8) of urticaria factitia. 3. Among 19 cases of chronic urticaria, improvement was noticed in 13 cases(68. 49). Improvement was alsa noticed in all 6 cases of eczema. 5. Drowsiness and weakness cccurred in 6.2% of cases(3/48).
Clemastine* ; Eczema ; Humans ; Skin ; Sleep Stages ; Urticaria

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

Fifteen cases of corrective operation for the ascending aortic aneurysm performed under general anesthesia from 1979 to 1985 in Severance Hospital were studied retrospectively. There were ten male patients and 5 female and their average age were 36.6 years(range 25~50 years). Most of the patients showed aortic regurgitation. Thus the anesthetic management involved consideration for patients with aortic dissection combined with aortic incompetence(annuloaortic ectasia). Patients were premedicated with atropine or glycopyrrolate in 14 cases and a combination of triflupromazine, hydroxyzine, diazepam and pethidine in 13 cases or a combination of hydroxyzine and morphine in 2 cases. Anesthesia was induced with thiopental sodium and/or diazepam and/or midazolam and/or morphine IV. Morphine and a mixture of 50% nitrous oxide and oxygen was administered for maintenance of anesthesia. Supplementary volatile anesthetics were inhaled as needed. Vasodilating therapy and avoidance of bradycardia during anesthesia are the most importance considerations for the reduction of left ventricular wall tension and to maximize the myocardial oxygen supply while maintaining cardiac output. Operative complications were reoperation due to bleeding in four cases, myocardial infarction in two cases, pericardial tamponade and urethral track infection in one case each. One patient died of sepsis. Fourteen patients improved in their heart size and function.
Anesthesia ; Anesthesia, General ; Anesthetics ; Aortic Aneurysm* ; Aortic Valve Insufficiency ; Atropine ; Bradycardia ; Cardiac Output ; Cardiac Tamponade ; Diazepam ; Female ; Glycopyrrolate ; Heart ; Hemorrhage ; Humans ; Hydroxyzine ; Male ; Meperidine ; Midazolam ; Morphine ; Myocardial Infarction ; Nitrous Oxide ; Oxygen ; Reoperation ; Retrospective Studies ; Sepsis ; Thiopental ; Triflupromazine

BACKGROUND: Vibrio vulnificus sepsis, a highly fatal and relatively common disease in Korea, requires rapid bacteriological diagnosis for optimal management of the patient. The Vitek GNI+ card(bioMerieux Vitek. Inc., MO., USA) has been introduced to accomplish more accurate and more rapid reporting for gram-negative bacilli identification. The present study evaluated the ability of the Vitek GNI+ card to identify the species of V. vulnificus. METHODS: A total 103 strains of V. vulnificus isolated from clinical specimens in Chonnam University Hospital during 1986-1999, were tested. Identification of GNI+ card was carried out in accordance with the instructions of the manufacturer, except the suspension medium of 0.85% NaCl rather than the original concentration of 0.45%. Additional tests for growth on TCBS, salt tolerance, and the antimicrobial susceptibility to colistin were also performed. RESULTS: At the completion of the appropriate incubation period, the GNI+ system correctly identified 96.1%(99 strains) of the total isolates. The misidentification rate for the GNI+ system was 3.9%(4 strains) of the total isolates. The misidentified organisms were confirmed to V. vulnificus by the additional tests. The average time to identify the organisms by GNI+ System was 6.8 +/- 1.4 hour. Total 103 isolates could be separated into 24 different bionumber types in Vitek system. CONCLUSION: This results indicate that Vitek GNI+ card is adequate for the identification of clinical isolates of V. vulnificus within several hours, but additional tests should be performed for a few isolates misidentified by the Vitek GNI+ card.
Colistin ; Diagnosis ; Humans ; Jeollanam-do ; Korea ; Salt-Tolerance ; Sepsis ; Vibrio vulnificus* ; Vibrio*

A 32-year-old female patient and her sister show high levels of high density lipoprotein (HDL) cholesterol in regular health checkups, since female patient was 11 years old. The patient's serum total cholesterol was 285 mg/dL and HDL cholesterol was 113 mg/dL. Her sister's total cholesterol was 240 mg/dL and the HDL cholesterol measured to be 90 mg/dL. Lipoprotein pattern and cholesteryl ester transfer activity gene analysis were examined in these patients. We found c.1321+1G>A (IVS14+1G/A) hetero mutation in cholesteryl ester transfer protein (CETP) genes. Generally, CETP mediates transfer and exchange of triglycerides and cholesteryl ester between plasma lipoproteins. Also we investigated a key role of HDL-CE and Apo A-1 metabolism. Patients with low levels of CETP have increased serum HDL levels. We hereby report two Korean cases of CETP deficiency in a family. Brief literature review ensues with the cases.
Adult ; Apolipoprotein A-I ; Cholesterol ; Cholesterol Ester Transfer Proteins ; Cholesterol, HDL ; Female ; Humans ; Hypercholesterolemia ; Lipid Metabolism, Inborn Errors ; Lipoproteins ; Plasma ; Protein Deficiency ; Siblings ; Triglycerides

Haemophilus paraphrophilus is a normal inhabitant of the naso- and oropharynx and has been rarely reported as a cause of endocarditis. H. paraphrophilus is a slow-growing and fastidious gram-negative bacterium and belongs to the HACEK group. We experienced a case of infective endocarditis due to H. paraphrophilus. The organism was repeatedly isolated from the blood cultures of a 60 year -old patient presenting with high fever, chills, cardiac murmur, and change of mental state. The patient had a history of mitral and tricuspid valve replacements and had been followed up for complications of cirrhosis of liver such as esophageal varix and oral bleeding. The isolate was identified as H. paraphrophilus by the characteristics, including factor V requirement, negative indole, urea and ornithine decarboxylase and acid production from glucose and lactose. Antimicrobial susceptibility testing by the disk diffusion method showed that the organism was susceptible to ampicillin, chloramphenicol, tetracycline, trimethoprim/sulfamethoxazole, cefotaxime, ceftazidime, aztreonam, imipenem, and ciprofloxacin. The patient expired on hospital day 8, probably due to complications of cirrhosis of liver To our knowledge, this is the first case of infective endocarditis caused by H. paraphrophilus in Korea.
Ampicillin ; Aztreonam ; Cefotaxime ; Ceftazidime ; Chills ; Chloramphenicol ; Ciprofloxacin ; Diffusion ; Endocarditis* ; Esophageal and Gastric Varices ; Factor V ; Fever ; Fibrosis ; Glucose ; Haemophilus paraphrophilus* ; Haemophilus* ; Heart Murmurs ; Hemorrhage ; Humans ; Imipenem ; Korea ; Lactose ; Liver ; Ornithine Decarboxylase ; Oropharynx ; Tetracycline ; Tricuspid Valve ; Urea