This study developed, and applied, a portable emergency medical information system, enabling patient-related information to be efficiently shared with the hospital information system, via a PDA, while an emergency patient was being taken to the emergency room. The system consisted of an emergency patient`s server for monitoring the condition of the emergency patients registered in an emergency room, in real time, and a PDA terminal that delivers patient and emergency ac tivity information to a se rver through a wireless connection. Within the emergency room of G hospital a DB server was in charge of the stored information to de liver information the patients' conditions, emergency treatments, and activities, with 119 emergency medical system personnel being responsible for the information storage space, via a PDA. In addition, the member of personnel in charge of an emergency room can check the registrations of the 119 EMS personnel through a user's application, that enablings real-time checks of the fir st-aid patients being registerted in the information storage space. In conclusion, the development and experimental application of the emergency patient information delivery system demonstrated that a PDA can be used in an emergency medical environment. Modification to the interface, for a convenient input into a PDA, and an increase in its usability, through the training and continuous studies of the users, will help to make qualitative improvements to this emergency medical service.
Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital ; Emergency Treatment ; Hospital Information Systems ; Humans ; Information Storage and Retrieval ; Information Systems ; Liver

OBJECTIVE: To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation. METHODS: Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO₂ (ETCO₂) and pulse oxyhemoglobin saturation (SpO₂) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days. RESULTS: A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive. CONCLUSION: NIV may promote successful weaning in neuromuscular patients with experience of reintubation.
Humans ; Neuromuscular Diseases* ; Noninvasive Ventilation* ; Oxyhemoglobins ; Rehabilitation ; Respiration, Artificial ; Retrospective Studies ; Tracheotomy ; Weaning*

No abstract available.
Duane Retraction Syndrome* ; Facial Paralysis ; Mobius Syndrome*

PURPOSE: To report a case of epithelioid hemangioendothelioma of the lacrimal sac. METHODS: A 51-year-old woman was admitted to our hospital because of tearing on the left eye. Nasolacrimal duct stenosis was found on dacryocystogram. After observation of 2 months, the tearing became worse and a palpable mass at the medial canthal area was noted. Orbital computed tomography showed the tumor of the left lacrimal sac and complete excision of the tumor and sac was performed. RESULTS: Pathologic diagnosis of the excised mass was epithelioid-hemagioendothelioma. There was no evidence of recurrence until last follow-up at postoperative 4 months.
Constriction, Pathologic ; Diagnosis ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Middle Aged ; Nasolacrimal Duct ; Orbit ; Recurrence ; Tears

No abstract available.
Aged ; Anesthesia, General ; Heart Arrest ; Humans ; Myocardial Ischemia

PURPOSE: Allergic inflammation of the lower respiratory tract is a characteristic clinical feature in asthma patients, in which eosinophils play an important role. The activity of eosinophil may be determined by measuring the level of eosinophil cationic protein(ECP) in sputum or serum as a potential marker of the inflammatory severity. METHODS: We measured the serum concentrations of ECP produced by eosinophils in 29 children with M. pneumoniae as the infected group, 26 children with M. pneumoniae as the non-infected group. RESULTS: Number of infected group was 29(male 18, female 11, mean age 5.5 years old), and that of non-infected group was 26(male 17, female 9, mean age 5.2 years old). There were no sex and age differences between the two groups. The mean concentrations of serum ECP in infected group and non-infected group were 14.37+/-9.00microgram/L and 9.15+/-7.75microgram/L, respectively. It showed significant change statistically(P<.05). Total eosinophil count in infected group(221.10+/-232.84/mm3) was higher than that of non-infected group(171.8+/-262.46/mm3). There was no significant difference between the two groups. But there was an increment of serum ECP and eosinophilia and no increment of total IgE and specific IgE in either group(P<.001). CONCLUSION: The results suggest that ECP may as a factor cause damage to the respiratory system similar to asthma in children with M. pneumonia.
Asthma ; Child ; Eosinophilia ; Eosinophils ; Female ; Humans ; Immunoglobulin E ; Inflammation ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory System ; Sputum

PURPOSE: This study evaluated whether the axial length of the fellow eye measured by A-scan biometry can be utilized for selecting the proper size of the orbital implant. METHODS: Thirty four eyes of 34 adult patients who had undergone eviscerations between March 2000 and May 2002 were included. We measured the axial length of the fellow eyes by A-scan preoperatively. Postoperatively, the central thickness and volume of ocular prosthesis were measured to determine the ideal size of prosthesis. RESULTS: Average diameter of the fellow eyes was 22.6mm. Average difference in diameter between the fellow eyes and orbital implants was 1.8mm among eyes with 20-22 mm in adults, and 3.8mm among eyes with 22-24mm. Average central thickness of the ocular prosthesis was 6.47 mm, and average volume was 2.2 ml. Complications occurred in 4 cases, and 2 of those cases were corrected by operations. CONCLUSIONS: Preoperative measurement of the diameter of the fellow eye using A-scan ultrasonography can be useful in selecting the size of the orbital implant before evisceration in adult patients. It also helped the selection of the proper sized ocular prosthesis and the prevention of many postoperative complications.
Adult ; Biometry ; Eye, Artificial ; Humans ; Orbit* ; Orbital Implants* ; Postoperative Complications ; Prostheses and Implants* ; Ultrasonography

BACKGROUND/AIMS: Periostin is an extracellular matrix protein and is known to be related to the metastatic potential and prognosis of cancer. However, few studies have investigated the expression level of periostin and its association with prognoses in hepatocellular carcinoma. Therefore, we analyzed periostin overexpression in hepatocellular carcinoma and its implication for prognoses. METHODS: We evaluated 149 patients who underwent surgical resection between 2006 and 2010. Tissue microarrays were constructed from hepatocellular carcinoma tissue and adjacent nontumor tissue, and immunohistochemistry was performed. RESULTS: A high periostin level was observed more frequently in cases of multiple tumors (odds ratio [OR], 2.826; 95% confidence interval [CI], 1.224 to 6.527; p=0.013), positive microvascular invasion (OR, 2.974; 95% CI, 1.431 to 6.181; p=0.003), and advanced stage disease (OR, 3.032; 95% CI, 1.424 to 6.452; p=0.003). Patients with high periostin expression had significantly (p=0.002) lower overall survival rates than those with low periostin expression (90.3%, 66.1%, and 56.2% vs 97.7%, 85.1%, and 77.5% at 1, 3, and 5 years). CONCLUSIONS: We found that a combination of periostin overexpression and microvascular invasion in hepatocellular carcinoma was correlated with a poor prognosis and can be a good prognostic marker for hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Extracellular Matrix ; Humans ; Immunohistochemistry ; Prognosis* ; Survival Rate ; Tissue Array Analysis

BACKGROUND/AIMS: Periostin is an extracellular matrix protein and is known to be related to the metastatic potential and prognosis of cancer. However, few studies have investigated the expression level of periostin and its association with prognoses in hepatocellular carcinoma. Therefore, we analyzed periostin overexpression in hepatocellular carcinoma and its implication for prognoses. METHODS: We evaluated 149 patients who underwent surgical resection between 2006 and 2010. Tissue microarrays were constructed from hepatocellular carcinoma tissue and adjacent nontumor tissue, and immunohistochemistry was performed. RESULTS: A high periostin level was observed more frequently in cases of multiple tumors (odds ratio [OR], 2.826; 95% confidence interval [CI], 1.224 to 6.527; p=0.013), positive microvascular invasion (OR, 2.974; 95% CI, 1.431 to 6.181; p=0.003), and advanced stage disease (OR, 3.032; 95% CI, 1.424 to 6.452; p=0.003). Patients with high periostin expression had significantly (p=0.002) lower overall survival rates than those with low periostin expression (90.3%, 66.1%, and 56.2% vs 97.7%, 85.1%, and 77.5% at 1, 3, and 5 years). CONCLUSIONS: We found that a combination of periostin overexpression and microvascular invasion in hepatocellular carcinoma was correlated with a poor prognosis and can be a good prognostic marker for hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Extracellular Matrix ; Humans ; Immunohistochemistry ; Prognosis* ; Survival Rate ; Tissue Array Analysis

BACKGROUND: Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The PINI (prognostic inflammatory nutritional index) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill patients. The aim of this study was designed to investigate the relationship between nutritional status after the palliative chemotherapy and prognosis in advanced metastatic cancer. METHODS: This study included 130 patients with ECOG PS (Eastern Cooperative Oncology Group performance status) 1~3 in advanced metastatic cancer following the palliative chemotherapy. ECOG PS, body mass index, alpha 1-acid glycoprotein, C-reactive protein, albumin, prealbumin, transferrin, protein, lactate dehydrogenase, PINI ratio, and survival time were evaluated. RESULTS: In 130 patients, the median age was 57 years. The ECOG PS was 1 68 patients, 2 43, 3 19. The mean value of PINI was PS 1 16.0+/-47.8, PS 2 55.6+/-106.9, PS 3 106.3+/-141.6. The mean survival was PS 1 144.0+/-71.8, PS 2 68.9+/-41.2, PS 3 32.0+/-6.9 days. In the PS 3 group, the mean values of alpha 1-acid glycoprotein, C-reactive protein, and lactate dehydrogenase were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of albumin, prealbumin, and transferrin were significantly lower than in the PS 1 group. The survival time was correlated with the ECOG PS (r=-0.602, p<0.001,), PINI (r=-0.318, p<0.001,), alpha 1-acid glycoprotein (r=-0.265, p=0.002), C-reactive protein (r=-0.345, p<0.001), albumin (r=0.324, p<0.001), prealbumin (r=0.260, p=0.003) and transferrin (r=0.277, p=0.001). CONCLUSIONS: The PINI may be a useful scoring system for the assessment of nutritional status and prognosis in advanced metastatic cancer following palliative chemotherapy, but the ECOG PS is most strong correlation with the survival time.
Body Mass Index ; C-Reactive Protein ; Critical Illness ; Drug Therapy ; Humans ; L-Lactate Dehydrogenase ; Nutrition Assessment ; Nutritional Status* ; Orosomucoid ; Prealbumin ; Prognosis* ; Transferrin ; Weight Loss