BACKGROUND: Trauma is a major cause of death for individuals under the age of 45 years and the third leading cause of death for all ages. So, it has been recognized as an important socioeconomic problem. The purpose of this study was to evaluate the outcome of surgical care of traumatized parients. METHODS: We retrospectively analyzed data of patients who had undergone surgical operation on head, abdomen, or chest trauma from January 1, 1995 to December 31, 1995. TRISS method and W- and Z- statistics were used to evaluate the trauma outcome and the quality assurance of surgical treatment. RESULTS: Two hundred and sixty eight patients were enrolled in this study. Traffic accident in injury mechanisms was the most common(n=185, 69.2%), and severely injured patients with over ISS 16 were 205 of total 268 patients(76.5%). Crude mortality rate was 11.6% (non-survivors/number of patients : 31/268). By TRISS method, predicted mortality rate was 10.1%, excess mortality rate was 14.2%, and W value was - 1.43 indicating less actual survivors than predicted, but absolute Z score was 0.91 and it was statistically not significant. CONCLUSION: These data show that trauma outcome and quality of surgical care in our hospital is adequate. We also suggest that it will provide a valuable data for further studies.
Abdomen ; Accidents, Traffic ; Cause of Death ; Head ; Humans ; Injury Severity Score* ; Mortality ; Retrospective Studies ; Survivors ; Thorax

No abstract available.
Animals ; Bacteria* ; Carcinoma, Lewis Lung* ; Lactic Acid* ; Mice* ; Sarcoma 180* ; Sarcoma*

Basta(R) is one of the Phospho-amino acid group herbicide. It consist of glufosinate ammonium (18.5%), alkylether sulfate as surfactant (30%) and some solvents. Although it's WHO classification is Bade III, the intoxicated patient appears an serious clinical findings and have a 20% mortality rate. Nowadays, in Korea the ingestion of herbicidal agents for suicidal attempts is Sequent. The literature for intoxication of bipyridilium (Gramoxon(R)) as herbicide is varied, but the information for Basta(R) is poor even though the use of it tends to increase. Recently, We experienced six cases of Basta(R) intoxication and found that the patient expressed a gradually progressed depression of mentation, recent memory disturbances, convulsions, hypotension, or bradycardia because of CNS or cardiovascular effects of Basta(R) We report these cases with literature review.
Ammonium Compounds* ; Bradycardia ; Classification ; Depression ; Eating ; Humans ; Hypotension ; Korea ; Memory ; Mortality ; Seizures ; Solvents

BACKGROUND: The current recommendation of rescue breathing techniques in the infant is to blow both the nose and mouth of infants by caregiver's mouth but recent studies suggest some caregivers may have trouble sealing a infant's mouth and nose. The purpose of this study is to estimate the ability of mothers to create a seal to their infants for the provision of rescue breathing according to current recommendation. METHODS: Infants up to 1 year of age(n=98) and their mothers were enrolled from emergency department of Chonbuk National University Hospital. We measured the facial lengths of the infants and the width of mouth in their mothers and compared mouth widths of mothers with their infant's nose-to-mouth lengths. RESULTS: In infants between 0 to 6 months, Mother transverse lengths were significantly larger than mouth, nose and nose-to-mouth lengths of the infants. In infants between 7 to 12 months, Mother transverse lengths were significantly larger than mouth and nose lengths of the infants but there was no statistically significant difference between mother transverse lengths and nose-to-mouth lengths of infants. CONCLUSION: The finding indicate that the present recommendation to cover mouth and nose is partly not possible. We recommend that the mouth-to-nose ventilation of rescue breathing techniques for the infants who have respiratory arrest be taught to mothers.
Caregivers ; Emergency Service, Hospital ; Humans ; Infant* ; Jeollabuk-do ; Mothers ; Mouth ; Nose ; Respiration* ; Ventilation

No abstract available.
Bone Marrow Examination* ; Bone Marrow*

No abstract available.
Bacteria* ; Ulsan*

BACKGROUND: Nowadays, acute drug intoxication is a important section of emergency medicine. The purpose of this study was to determine what is the best-way to manage acutely intoxicated patients with drug in emergency department setting. METHODS: Clinical assessment were made on 135 cases of drug intoxication visited to emergency center of Hospital during one year from June 1997 to May 1998. RESULTS: 1. The total number of cases of acute drug intoxication was 135 which is 0.5% of total patients presented to emergency center. 2. There was no sexual difference in incidence, but the highest incidence of age group was in 3rd decade(23.7%) and the next was 7th decade(20.0%). 3. High frequency of acute intoxication was observed in autumn. October had the largest portion in monthly distribution. The largest portion of presumed time of poisoning was noon - 4 p.m. and of the time on arrival to emergency center was 8 p.m. -midnight. 4. Suicidal attempt was the most common motive of intoxication (72.6%). 5. The most common drug of intoxication was insecticides (35.7%) and the others were centrally active agents, herbicides in orders. 6. Mental change was observed in 20.7% of patients and the abnormal vital signs were hypertension, tachycardia, and hypotension in order on arrival to emergency center. 7. Mean duration of treatment was 36.1 hours. Mortality rate of the cases was 7.4%. CONCLUSION: The mortality rate was high in patients who ingested relatively fatal drugs (i.e. herbicides, antimicrovials, insecticides), showed mental change on arrival or received mechanical ventilatory care(p<0.05).
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Herbicides ; Humans ; Hypertension ; Hypotension ; Incidence ; Insecticides ; Mortality ; Poisoning ; Tachycardia ; Vital Signs

BACKGROUND: Clonidine, which is known to have analgesic and sedative properties, has recently been shown to be an effective preanesthetic medication in humans. The drug may cause side effects, including bradycardia and hypotension. This study was conducted to evaluate the ability of intravenous atropine to increase the heart rate (HR) in awake adults receiving clonidine preanesthetic medication. METHODS: We studied HR responses to intravenous atropine in 45 patients assigned randomly to either a control group, who received no medication (group 1, n=15), or clonidine groups, who received oral clonidine of 2~2.5 mcg/kg (group 2, n=15), or 4.5~5 mcg/kg (group 3, n=15) 90 min before scheduled induction of anesthesia. When HR and blood pressure had been confirmed to be stable in operating room, all patients received incremental doses of atropine, 2.5, 2.5 and 5 mcg/kg at 2-min intervals. The HR and mean arterial pressure were recorded at 1-min intervals. RESULTS: Before atropine injection, the HR decreased significantly (P<0.05) in group 3. The increases in HR in response to a cumulative dose of atropine 10 mcg/kg were 21+/-8, 17+/-7 and 7+/-5 beats/min (mean+/-SD) in group 1, 2 and 3, respectively (P<0.05). The positive chronotropic response to intravenous atropine was attenuated significantly only in group 3 (P<0.01). CONCLUSIONS: It was concluded that oral clonidine of 4.5~5 mcg/kg decreased HR significantly, and blunted the increase in HR after intravenous atropine in awake adults although oral clonidine of 2~2.5 mcg/kg did not.
Adult* ; Anesthesia ; Arterial Pressure ; Atropine* ; Blood Pressure ; Bradycardia ; Clonidine* ; Heart Rate* ; Heart* ; Humans ; Hypotension ; Operating Rooms ; Preanesthetic Medication

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

Regionalization of high-risk perinatal care has been advocated because intensive care for small and ill newborn infants lowers mortality and morbidity. This report is based on analysis of admissions to the Neonatal Intensive Care unit (NICU) at the Wonju christian Hospital during the 4-year period from January, 1988 to December, 1991. There were 786 inborn infants and 1155 outborn infants admitted to the NICU. The results of our study follow; 1) Mean gestational ages were 36.8 weeks in inborn infants and 39.0 weeks in outborn infants. Mean birth weight was 2.5kg in inborn and 3.0kg in outborn infants. 2) The high-risk maternal factors, such as cesarian section delivery, eclampsia, preeclampsia, multiple pregnancy and placental anomaly were significantly more frequent in inborn infants than in outborn infants. 3) Perinatal sphyxia, HMD and transient tachypnea of newborn (TTN) were more common in inborn than in outborn infants, but pneumonia, meconium aspiration syndrome, and seizure were more common in outborn infants. 4) The positivity of bacterial cultures in blood and urine was higher in outborn infants than in inborn infants. The most frequently isolated microorganism was staphylococcus species in both inborn and outborn infants. 5) Hospital days, duration of TPN, duration of mechanical ventilation, frequency of seizure, and frequency of transfusion were longer or more frequent in inborn than in outborn infants. 6) Mortality rate was higher in inborn infants than in outborn infants. 7) In outborn infants, mortality rate was higher in infants whose transporting time was longer than 2 hours than for infants within 2 hour distances. However, this difference was not statistically significant. 8) These findings suggest that many lower birth weight and severly ill infants were not transported to the NICU of Wonju Christian Hospital perhaps due to poor transport systems, distance or socio-economic status. In conclusion, the improvement of transporting systems and socio-economic conditions will be required within this region.
Birth Weight ; Eclampsia ; Female ; Gangwon-do ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Critical Care ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Mortality ; Perinatal Care ; Pneumonia ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Respiration, Artificial ; Seizures ; Staphylococcus ; Transient Tachypnea of the Newborn