The purpose of this study is to provide a fundamental basis for defining measures to prevent suicide by specifically examining the relationship between suicide and alcohol consumption, which is thought to be a key factor in suicide. This study reviewed 426 suicide autopsies diagnosed by the department of forensic medicine, National Forensic Service (2007-2009) and analyzed the preliminary data on variables such as gender, age, and cause of death, with particular focus on the relationship between these variables and blood alcohol concentration. The relationship between each variable and alcohol consumption was as follows. First, alcohol was present in 48.4% of suicides. Second, blood alcohol concentration wrere twice as high in women as in men. Third, the relationship between suicide and alcohol consumption was greater in people in their 30s and 40s. The correlation between suicide and alcohol intake was evident this age group. These results are more specific and practical than the results of previous studies on the correlation between suicide and alcohol intake. The results of this study will help define measures to facilitate suicide prevention as an important reference and may eventually help lower the suicide rate in Korea.
Alcohol Drinking ; Autopsy ; Cause of Death ; Drinking ; Female ; Forensic Medicine ; Humans ; Korea ; Male ; Suicide

A Clinical observation was made on five patients with ruptured aortic sinus of Valsalva who visited Seoul National university hospital during the period of May, 1975~Jan., 1980. 1. Age distribution was from 19 to 32 years and four patients were male and the rest one case was female. 2. Chief complaints on admission were dyspnea in 3 cases and chest pain in 2 cases. Onset of symptoms was abrupt in 4 cases. 3. Continuous murmur was heard at third and fourth intercostal space along left sternal border with thrill in all cases. 4. Cardiac catheterization and aortography showed regurgitant flow from aorta to right ventricle in all cases. 5. Operation was done successfully in 3 cases, of which aortic insufficiency was persistent in one case.
Age Distribution ; Aorta ; Aortography ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dyspnea ; Female ; Heart Ventricles ; Humans ; Male ; Seoul ; Sinus of Valsalva*

Pentoxifylline (Trental(R)) is a drug which blocks pathophysiologic process of cerebrovascular disease by inhibiting platelet aggregation, improving cerebral microcirculation preventing development of cerebral edema. In an attempt to evaluate the effect of pentoxifylline for the treatment of 25 patients (male 17 cases, female 8 cases) with cerebrovasculaar disease, we administered pentoxifylline 600mg daily in devided dosage for 1 to 7 months. Most of them were patients with cerebral thrombosis (52%), cerebral embolism (24%), cerebral hemorrhage (12%) and transient ischemic attack (12%). Clinical effects were evaluated at least 1 month later by the criteria using scoring method of serverity of symptoms. In summary, definite effect was found in 15 cases (60%), mild effect in 6 cases (24%) and no efect or aggravation in 4 cases (16%), especially in patients with cerebral hemorrhage. During treatment there was no significant side effect except mild elevation of serum creatinine in one case who was associated with chronic renal failure.
Brain Edema ; Cerebral Hemorrhage ; Creatinine ; Female ; Humans ; Intracranial Embolism ; Intracranial Thrombosis ; Ischemic Attack, Transient ; Kidney Failure, Chronic ; Microcirculation ; Pentoxifylline* ; Platelet Aggregation ; Research Design

OBJECTIVES: In most DEHP exposure assessment studies, single spot urine sample was used. It could not compare the exposure level among studies. Therefore, we are going to represent the necessity of selection of proper sampling time of spot urine for assessing the environmental DEHP exposure, and the association urinary DEHP metabolites with steroid hormones. METHODS: We collected urine and plasma from 25 men. The urine sampling times were at the end of the shift (post-shift) and the next morning before the beginning of the shift (pre-shift). Three metabolites of DEHP {mono(2-ethylhexyl) phthalate [MEHP], mono-(2-ethyl-5-hydroxyhexyl)phthalate [MEHHP], and mono(2-ethyl-5-oxohexyl)phthalate [MEOHP]} in urine were analyzed by HPLC/MS/MS. Plasma luteinzing hormone, follicle stimulating hormone, testosterone, and 17beta-estradiol were measured at pre-shift using a ELISA kit. A log-transformed creatinine-adjusted urinary MEHP, MEHHP, and MEOHP concentration were compared between the post- and pre-shift. The Pearson's correlation was calculated to assess the relationships between log-transformed urinary MEHP concentrations in pre-shift urine and hormone levels. RESULTS: The three urinary metabolite concentrations at post-shift were significantly higher than the concentrations in the pre-shift (p<0.0001). The plasma hormones were not significantly correlated with log-transformed creatinine - adjusted DEHP metabolites. CONCLUSIONS: To assess the environmental DEHP exposure, it is necessary to select the urine sampling time according to the study object. There were no correlation between the concentration of urinary DEHP metabolites and serum hormone levels.
Adult ; Diethylhexyl Phthalate/analogs & derivatives/pharmacokinetics/*urine ; Estradiol/blood ; Follicle Stimulating Hormone/blood ; Humans ; *Laboratories, Dental ; Luteinizing Hormone/blood ; Male ; Middle Aged ; Occupational Exposure/*analysis ; Phthalic Acids/urine ; Specimen Handling/*methods ; Testosterone/blood ; Time Factors

Supine exercise test was done with bicycle ergometer and echocardiography in 28 patients with chronic aortic regurgitation. Ejection fraction was measured before and immediately after exercise from echocardiography, wall stress and radius/thickness ratio was calculated from echocardiography and systolic blood pressure. 1. There was no difference in left ventricular end systolic and diastolic dimension, ejection fraction at rest, radius/thickness ratio, wall stress between NYHA functional class I, II, III. But work capacity was greater in NYHA class I than in class II, III(39712+/-10778 watt-sec, 23766+/-14280 watt-sec, 11968+/-6052 watt-sec respectively). Ejection fraction after exercise was significantly increased in class I(66.3+/-8.9% at rast vs 71.3+/-10.7% after exercise). 2. Ejection fraction was increased more than 5% in 12 patients(group I) and increased less than 5% or decreased in 16 patients(group II). There was no difference in basal E.F., Ded, Des and postexercise heart rate-blod pressure product between group I and II. But between group I and II, there was significant difference in diastolic redius/thickness ratio(2.55+/-0.30 vs 3.00+/-0.51), mean radius/thickness ratio(1.86+/-0.23 vs 2.18+/-0.30), systolic wall stress(192.3+/-38.6mmHg vs 240.2+/-57.7mmHg), mean wall stress(265.8mmHg vs 334.8+/-68.7mmHg) and work capacity(33848+/-12682 watt-sec vs 19210+/-12342 watt-sce). 3. Work capacity was more than 23800 watt-sec in 16 patients(group A), and less than 23800 watt-sec in 12 patients(group B). There was no difference in ejection fraction at rest, radius/thickness ratio, wall stress, and left ventricular dimension. But ejection fraction after exercise was significantly different between group A and B(68.6+/-14.6% vs 55.8+/-14.2%). 4. In nine patients with end systolic dimension greater than 50 mm ejection fraction was decreased or increased less than 5% in 7 patients. So mean ejection fraction was significantly decreased after exercise(56.8+/-7.5% at rest, 51.0+/-16.3% after exercise).
Aortic Valve Insufficiency* ; Blood Pressure ; Echocardiography* ; Exercise Test ; Heart ; Humans

BACKGROUND: Generally, in order to decrease the fetal exposure time from anesthetic drugs, anesthetic induction is conducted after the completion of surgical preparation in general anesthesia for cesarean section. However, this method, in decreasing the fetal exposure time from anesthetic drugs, has been regarded as also aggravating the feeling of anxiety and fear of the patients. The purpose of this research is to compare the result of anesthetic induction conducted before and after surgical preparation in relation to the well-being of the newborn. METHODS: Fifty healthy women scheduled for elective cesarean section, not in labor, with no signs of fetal distress were randomly divided into 2 groups. Group A (n = 25) started anesthetic induction after surgical preparation and group B (n = 25) started before surgical preparation. Induction to delivery (I-D) interval and uterine incision to delivery (U-D) interval were measured and for the evaluation of the neonatal outcome, blood gas analysis at umbilical vein and artery, 1 and 5 min Apgar scores, and neurobehavioral test at 15 min, 2 hr and 24 hr of age, respectively, were performed. RESULTS: There was a significant difference in the I-D interval (P < 0.05) but no significant difference in the U-D interval between the two groups. Blood gas analysis, acid-base status, Apgar score and neurologic and adaptive capacity score (NACS) all did not differ significantly between the two groups. CONCLUSIONS: From our results, the induction before surgical preparation did not seem to affect neonatal well-being significantly. Therefore, when patients without fetal distress are very anxious, anesthetic induction before surgical preparation would reduce the patient's anxiety and fear without neonatal depression in general anesthesia for cesarean section.
Anesthesia, General* ; Anesthetics ; Anxiety ; Apgar Score ; Arteries ; Blood Gas Analysis ; Cesarean Section* ; Depression ; Female ; Fetal Distress ; Humans ; Infant, Newborn ; Pregnancy ; Umbilical Veins

BACKGROUND: Early death is an important problem associated with the management of community-acquired pneumonia. However, there is little information on the risk factors associated with it. The aim of this study was to identify the factors associated with early death in community-acquired pneumonia patients. METHODS: From January 1999 to July 2004, 1,487 adult patients with community-acquired pneumonia who were admitted to the pulmonary department via emergency center were examined. Early death was defined as those who died within 2 days of hospitalization. The clinical and laboratory aspects of the patients who died early (n=30) were compared with those of an age and gender matched control population (n=60) . RESULTS: In the early death group, respiratory rate, heart rate, and blood urea nitrogen (BUN) were significant higher (p<0.05 for all), while the arterial pH, systolic pressure, and PaO2 were significant lower (p<0.05 for all) than the control. The independent factor significantly associated with early death was tachypnea (OR, 7.049). CONCLUSION: The importance of an early clinical assessment in emergency center with community-acquired pneumonia needs to be emphasized in order to recognize patients at risk of early death.
Adult ; Blood Pressure ; Blood Urea Nitrogen ; Emergencies ; Heart Rate ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Pneumonia* ; Respiratory Rate ; Risk Factors ; Tachypnea

OBJECTIVE: To evaluate the perinatal outcome of vaginal delivery in twin pregnancy according to the presentation of the fetus. METHODS: A total of 274 cases suitable to this objective were selected from the 301 cases of twin pregnancy delivered between March 2000 and February 2005. They were categorized into 3 groups according to the presentation of the fetus; vertex/vertex as the group A (133 cases), vertex/nonvertex as the group B (80 cases), nonvertex in the first twin as the group C (61 cases). And then each group also was divided into 2 subgroups according to the mode of delivery; vaginal delivery and cesarean delivery. The difference between the subgroups in each group as to perinatal outcome was retrospectively compared and analyzed for statistical significance. RESULTS: The incidence of vaginal delivery in group A (46/133, 34.6%) was significantly higher than in group B (5/80, 6.3%) and C (5/61, 8.2%). A total of 218 (79.6%) cases were underwent the cesarean delivery and the most common indication of cesarean delivery was elective twin cesarean delivery in all 3 groups (65.4%, 93.8%, 91.8% respectively). The incidence of neonatal admission to the neonatal intensive care unit was, however, higher in vaginal delivery (40.2%) than in cesarean delivery (32.8%) in group A. The most common cause for neonatal intensive care unit admission was low birth weight for simple observation, and average admission dates of vaginal delivery was 17.0 days and cesarean delivery was 16.8 days. CONCLUSION: Vaginal delivery of twins depends on the presentation of the fetus, but no significant difference in perinatal outcome of group A were observed between the mode of delivery. Therefore attempt to decrease the incidence of elective twin cesarean delivery in group A is demanded.
Fetus ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Pregnancy, Twin* ; Retrospective Studies

During civil engineering construction near Sejong-ro, Jongro-ku, Seoul, cultural sites were found that are thought to have been built in the 15th century. This area was home to many different people as well as the leaders of the Yi dynasty. To gain further insight into the life styles of the inhabitants of the old capital, soil samples were collected from various areas such as toilets, water foundations, and drainage ways. Parasite eggs were examined by microscopy after 5 g soil samples were rehydrated in 0.5% trisodium phosphate solution. A total of 662 parasite eggs from 7 species were found. Species with the highest number of eggs found were Ascaris lumbricoides (n=483), followed by Trichuris trichiura (138), Trichuris vulpis (21), Fasciola hepatica (8), Clonorchis sinensis (6), Paragonimus westermani (4), and Metagonimus yokogawai (2). These findings indirectly indicate the food habits of the people in Yi dynasty.
Ascaris lumbricoides ; Clonorchis sinensis ; Drainage ; Eggs* ; Fasciola hepatica ; Food Habits ; Foundations ; Heterophyidae ; Korea* ; Life Style ; Microscopy ; Ovum* ; Paragonimus westermani ; Parasites* ; Seoul* ; Soil ; Trichuris ; Water

BACKGROUND: The aim of this study is to determine the clinical outcomes of early vancomycin administration before identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients with nosocomial pneumonia on a ventilator. METHODS: We retrospectively reviewed patients with nosocomial pneumonia in a 20-bed medical ICU during a period of 2 years and 2 months. This study included 52 inpatients, who were admitted for more than 72 hr and had a new or progressive lung infiltrate plus at least two of the following three criteria for pneumonia: abnormal body temperature (>38oC or <35oC), abnormal leukocyte count (>10,000/mm3 or <3,000/mm3), and purulent bronchial secretions. All of the MRSA were identified in tracheal aspirates during mechanical ventilation. RESULTS: A total of 23 patients who received vancomycin prior to identification of MRSA exhibited a 28-day mortality rate of 60%, while 29 patients who received vancomycin after identification of MRSA showed a 28-day mortality rate of 40% (p=0.17). There was no statistically significant difference in severity index and routine laboratory findings between the two groups. CONCLUSIONS: Early vancomycin administration before identification of MRSA does not appear to affect the mortality rate for patients with nosocomial pneumonia.
Body Temperature ; Humans ; Inpatients ; Leukocyte Count ; Lung ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Mortality ; Pneumonia* ; Respiration, Artificial ; Retrospective Studies ; Vancomycin* ; Ventilators, Mechanical