PURPOSE: Violence in the Emergency Department is a common concern but it is an ill-defined and underreported problem because no organization or administrative guidelines exist to adequately address it. The aim of this effort was to gather demographic information on the persons responsible for the violence and on the causes of the violence, so we would have basic data for the prevention of such violence. METHODS: The answers of Emergency Department doctors and nurses working in tertiary, university hospitals in South Korea to questions on a prospective questionaires during the period from December 2002 through February 2003 were analyzed. The survey used 10 questions to elicit demographic information on the persons responsible for the violence, the degree of violence, the severity of the patient' s disease and the reason for the violence. RESULTS: Two hundred twenty-five (225) cases of violence in the emergency department were reported from 6 tertiary hospitals during the 2-month duration. Total respondents to the questionaires were 225 (6 staffs, 131 nurses, and 88 residents). Verbal insults and threats were the most common form of violence. Almost all of the violence was due to the male gender, and 74.5% of violence was done by patient's guardians. More than half of those responsible for the violence were in an alcohol-drunken state. The causes of violence were long waiting time and poor patient-practitioner relationship and were not related with the severity of disease. CONCLUSION: If violence in the emergency department is to be managed and/or prevented, more administrative and financial efforts, a regular format for documentation of incidents, regular preventive education, and further study, if possible, with the Korean Society of Emergency Medicine are necessary.
Surveys and Questionnaires ; Education ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Hospitals, University ; Humans ; Korea ; Male ; Prospective Studies ; Tertiary Care Centers ; Violence*

No abstract available.
Anti-Bacterial Agents* ; Arthroplasty* ; Knee* ; Replantation*

PURPOSE: Carcinomas of the male breast constitutes only 1% of all breast cancer and less than 1.5% of all malignant tumors in men. The low incidence of this disease prevents therapeutic questions from being addressed in prospective randomized trials. Our aim was to cover the characteristics of the etiology, presentation and treatment of male breast cancer; and therefore provide an overview of knowledge in this area. METHODS: We retrospectively analyzed 16 male breast cancer patients, who had been treated between 1983 and 1992 at the Department of Surgery, College of Medicine, The Catholic university of Korea. RESULTS: The peak age of incidence was in the 7th and 8th decades. The most common symptom was a palpable mass in the breast (75.1%), and the duration of symptom varied between 3 days and 10 years. According to the TNM staging system, there were 18.8%, 31.3%, 18.8%, 12.5%, 6.3%, at stages 0, I, II, III and IV, respectively, and 12.5% with an unknown stage. A modified radical mastectomy was performed in 11 patients (68.8%) and postoperative adjuvant therapy in 12 patients (75.1%). The mean duration of following up was 41.2 months, during which time 2 patients were lost. CONCLUSION: Sixteen male breast cancer patients were encountered and men with breast cancer were observed to be older, have a longer duration of symptom, and more likely to have a familial tendency. However, our review revealed that male breast cancer was not as far advanced and had more chance of cure than initially thought. Therefore, the early detection and aggressive treatment of breast cancer are important for improving the survival.
Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Humans ; Incidence ; Korea ; Male ; Male* ; Mastectomy, Modified Radical ; Neoplasm Staging ; Retrospective Studies

No abstract available.
Typhlitis*

As a part of plan to construct a multifunctional hospital information system, We planned to develop a chemotherapy order system. First, a software developing team was established which is composed of hematooncology staffs, special pharmacists and programmer who are responsible for OCS. We set up an outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.
Appointments and Schedules ; Drug Therapy* ; Education ; Hospital Information Systems ; Humans ; Pharmacists ; Prescriptions

Renal tubular dysfunctions have been observed in hydronephrosis, resulting in metabolic acidosis, hyperkalemia and excessive free water diuresis. These findings are occasionally found in infant and children. Batle et al. first reported distal tubular acidosis associated with low potassium excretion resulting from aldosterone resistance in adults with obstructive uropathy. We have experienced a case of transient hyperkalemia and hyperaldosteronism secondary to hydronephrosis in 63-year-old female patient. The causes of hyperkalemia were examined under the impression of secondary adrenal insufficiency due to corticosteroid abuse or hyporeninemic hypoaldosteronism due to diabetic nephropathy. But it proved to be resulted from hyperaldosteronism due to hydronephrosis. The hyperkalemia resulting from hyperaldosteronism is rare in adults. It may result from aldosterone resistance at distal nephron due to obstructive uropathy or the defect of distal nephron in hydrogen and potassium secretion in the distal nephron rather than from aldosterone deficiency. After she underwent percutaneous nephrostomy, serum potassium was maintained within normal range. She performed total cystectomy with ureterocutaneostomy in purpose for treatment of bladder cancer. So we report this case with a review of literature.
Acidosis ; Adrenal Insufficiency ; Adult ; Aldosterone ; Child ; Cystectomy ; Diabetic Nephropathies ; Diuresis ; Female ; Humans ; Hydrogen ; Hydronephrosis* ; Hyperaldosteronism* ; Hyperkalemia* ; Hypoaldosteronism ; Infant ; Middle Aged ; Nephrons ; Nephrostomy, Percutaneous ; Potassium ; Reference Values ; Urinary Bladder Neoplasms ; Water

BACKGROUND: The findings of head impulse tests (HIT) are usually normal in cerebellar lesions. CASE REPORT: A 46-year-old male presented with progressive dizziness and imbalance of 3 weeks duration. The patient exhibited catch-up saccades during bedside horizontal HIT to either side, which was more evident during the rightward HIT. However, results of bithermal caloric tests and rotatory chair test were normal. MRI revealed a lesion in the inferior cerebellum near the flocculus. CONCLUSIONS: This case provides additional evidence that damage to the flocculus or its connections may impair the vestibulo-ocular reflex only during high-speed stimuli, especially when the stimuli are applied to the contralesional side. By observing accompanying cerebellar signs, the abnormal HIT findings caused by a cerebellar disorder can be distinguished from those produced by peripheral vestibular disorders.
Caloric Tests ; Cerebellar Diseases ; Cerebellum ; Dizziness ; Head Impulse Test* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Reflex, Vestibulo-Ocular ; Saccades ; Vertigo

PURPOSE: The aim of this study was to determine the relationship between buccal bone thickness and gingival thickness by means of a noninvasive and relatively accurate digital registration method. METHODS: In 20 periodontally healthy subjects, cone-beam computed tomographic images and intraoral scanned files were obtained. Measurements of buccal bone thickness and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0–5 mm from the alveolar crest on the superimposed images. The Friedman test was used to compare buccal bone and gingival thickness for each depth between the 3 tooth types. Spearman's correlation coefficient was calculated to assess the correlation between buccal bone thickness and gingival thickness. RESULTS: Of the central incisors, 77% of all sites had a buccal thickness of 0.5–1.0 mm, and 23% had a thickness of 1.0–1.5 mm. Of the lateral incisors, 71% of sites demonstrated a buccal bone thickness <1.0 mm, as did 63% of the canine sites. For gingival thickness, the proportion of sites <1.0 mm was 88%, 82%, and 91% for the central incisors, lateral incisors, and canines, respectively. Significant differences were observed in gingival thickness at the alveolar crest level (G0) between the central incisors and canines (P=0.032) and between the central incisors and lateral incisors (P=0.013). At 1 mm inferior to the alveolar crest, a difference was found between the central incisors and canines (P=0.025). The lateral incisors and canines showed a significant difference for buccal bone thickness 5 mm under the alveolar crest (P=0.025). CONCLUSIONS: The gingiva and buccal bone of the anterior maxillary teeth were found to be relatively thin (<1 mm) overall. A tendency was found for gingival thickness to increase and bone thickness to decrease toward the root apex. Differences were found between teeth at some positions, although the correlation between buccal bone thickness and soft tissue thickness was generally not significant.
Cone-Beam Computed Tomography ; Gingiva ; Healthy Volunteers ; Incisor ; Maxilla ; Methods* ; Radiographic Image Interpretation, Computer-Assisted ; Tooth

No abstract available.
Gingival Crevicular Fluid* ; Humans ; Matrix Metalloproteinase 1* ; Matrix Metalloproteinases* ; Periodontitis*

Pupil-involving oculomotor nerve palsy (ONP) is frequently associated with compressive lesion such as intracranial aneurysm originating from the posterior communicating arteries. Vascular variant of posterior intracranial circulation is regarded as an uncommon cause and association between these vascular variants and intracranial hypertension has not been reported. We present an 18-year-old girl with pupil-involving ONP combined with idiopathic intracranial hypertension who revealed compression of oculomotor nerve by a vascular variant of superior cerebellar artery (SCA). This is a rare case of an ONP attributed to compressive effect from an aberrant SCA affected by intracranial hypertension.
Adolescent ; Arteries ; Female ; Humans ; Intracranial Aneurysm ; Intracranial Hypertension ; Oculomotor Nerve Diseases ; Oculomotor Nerve ; Pseudotumor Cerebri