One hundred and seven cases of coronary heart disease were clinically studied at Seoul National University Hospital from September 1967 to August 1971 and following results were obtained. 1. The total cases were composed with 70 cases of myocardial infarction (46 cases of acute type and 24 cases of old type), 26 cases of angina pectoris and 11 cases of coronary insufficiency. 2. The ratio of male to female was 3.5:1, and over two-thirds of patients were sixth and seventh decade in ages. 3. As the underlying diseases, hypertension was found in 38.3% of the cases, and diabetes mellitus in 10.3%. 4. Among the various symptoms, precordial pain was a most common and characteristic, which was noted in 81.1% of the cases. Pain was radiated to the left arm and/or left shoulder in 45.2% of the cases. 5. In 57.2% of the cases, serum cholesterol was more than 200mg%. 6. The ratio between anterior and posterior wall infarction on electrocardiogram was about 3.5:1. 7. Left ventricular hypertrophy was the most frequently noted finding, and sinus tachycardia, low voltage, ventricular premature beat, myocardial ischemia, and others were also observed in some cases. 8. Mortality rate was 8.4%, and the major causes of death were cardiogenic shock and ventricular fibrillation.
Angina Pectoris ; Arm ; Cardiac Complexes, Premature ; Cause of Death ; Cholesterol ; Coronary Disease* ; Diabetes Mellitus ; Electrocardiography ; Female ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Infarction ; Male ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Seoul ; Shock, Cardiogenic ; Shoulder ; Tachycardia, Sinus ; Ventricular Fibrillation

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

BACKGROUND: We studied the incidence of trauma caused by alcohol related accidents, and the effects that has on the occurrence, the extent, and the outcome to the patient. METHODS: In our study we studied trauma patients excluding pediatric patients(15 years old and under) who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of january 1996 to 30th of June 1996, looked into their medical records, and studied the records in a retrospective manner. The trauma patients were divided into two groups, a) alcohol-related and b) alcohol-non-related. The two groups were then subdivided according to their sex, age, the time they came in, the anatomical part of the trauma, the mechanism of their injury, the extent of the injury, the length of their hospital stay, the length of their ED stay and were seperately compared and analysed. Statistically, ANOVA and logistic regression analysis using SAS were used in the study and then was assessed in Chi-square analysis methods. RESULTS: The total of the trauma patients, added up to 832 people, 577: male and 255: female. Among this sum, 16 trauma patients were alcohol related(male:127 & female 36). 115 people were in the age group of 21-40. Compared to the non-alcohol related trauma group, the alcohol-related group had more facial & scalp injuries and tended to come in the hours between 0-6 AM. The cause of the injuries were mossy by fast-fighting and suicide, compared to mostly accidental-slipping injuries in the non alcohol-related group. There were no difference in the degree of the injury(ISS) and the length of hospital stay between the two groups, whereas the length of the stay at the ED was longer alcohol-related trauma patients. CONCLUSION: Alcohol related trauma patients were mostly in their 20s and 30s, came to the hospital at a late time it the reason for their visit were mossy because of fist fighting. In the Emergency department, because prompt and correct diagnosis is quite difficult to make in this group, their ED stay tended to be longer. We can conclude that measuring the blood alcohol level of these patients, continuing the psychological therapy and educating people is needed.
Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Korea ; Length of Stay ; Logistic Models ; Male ; Medical Records ; Retrospective Studies ; Scalp ; Schools, Medical ; Suicide

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

No abstract available.

BACKGROUND: Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. But we do not know the true effectiveness of resuscitation. Studies originated from different settings and have different patient population. These differences prevent valid interhospital and international comparisons. There are no guidelines for reviewing, reporting, conducting research on resuscitation in Korea. To develop these guidelines, we research on resuscitation in emergency department. METHODS: Seventy eight patients were retrospectively reviewed, who confirmed cardiac arrest in Emergency Department of Korea University Hospital from May, 1997 to February, 1999. Of 78 patients, 8 were excluded due to declare "DNR(do not resuscitation)". Parameters analyzed were age, sex, place arrested, collapse to start of CPR, collapse to first dose epinephrine, collapse to first defibrillation shock, collapse to advanced airway, collapse to stop of CPR interval, cause of arrest, arrest witnessed, initial rhythm, ROSC(return of spontaneous circulation), and discharged alive. We used reporting form based on "Utstein Style ". RESULT: Of 78 patients, the mean age was 58 years old. Thirty four patients were arrested out of hospital. The mean age was 48.74 +/-21.3 years old, mean CPR time 33.00 +/-17.8min. Percent successfully resuscitated was 41.2%(14/34), percent survival from the arrest to at least 24hours 8.8%(3/34), percent survival from arrest to discharge 2.9%. Number of cardiac etiology was 12(35.2%), witnessed arrest 28(82.3%), ventricular fibrillation or tachycardia 1(2.9%) and its percent successfully resuscitated 25%, 42.8%, 0%, respectively. Forty four patients were arrested in emergency department, 8 were excluded due to declare "DNR(do not resuscitation )". The mean age was 61.72 +/-12.9 years. Percent successfully resuscitated was 58.3%(21/36), percent survival from the arrest to at least 24hours 27.8%(10/36), percent survival from arrest to discharge 25.0%(9/36). The mean CPR time in patients of ROSC was 19.81 +/-22.3 minute, and shorter than non-ROSC( p>0.05). Patients discharged alive had shorter interval of each event(collapse to start of CPR, 1.78 +/- 1.5min, to first defibrillation, 2.29 +/-1.3min, to first dose epinephrine 2.67 +/-3.8, to stop of CPR, 11.56 +/- 17.6min) than patients died in hospital(p<0.05). Number of cardiac etiology was 18(50.0%), monitored arrest 30(83.3%), ventricular fibrillation or tachycardia 12(33.9%) and its percent successfully resuscitated 61.1%, 53.3%, 83.3%, and its percent survival from arrest to discharge 33.3%, 23.3%, 58.3% respectively. CONCLUSION: Initial rhythm of patients discharged alive was mainly ventricular defibrillation and tachycardia(89%). Early patient access and defibrillation are essential to resuscitation. Develope EMS is needed to improve outcome of resuscitation and standard guideline for resuscitation is needed for medical control.
Cardiopulmonary Resuscitation ; Emergencies* ; Emergency Service, Hospital* ; Epinephrine ; Heart Arrest* ; Humans ; Korea ; Middle Aged ; Resuscitation ; Retrospective Studies ; Shock ; Tachycardia ; Ventricular Fibrillation

No abstract available.

To verify the accuracy and reproducibility of corneal thickness measurements obtained with Orbscan (Orbtek, Inc., Salt Lake City, USA), the measurements were compared with those taken with an ultrasound pachymeter (Omega Compuscan, Storz). Central corneal thickness was measured by each method in 100 eyes of 50healthy subjects. The averages by the two methods were compared. One examiner took the measurements twice by each method in 20 eyes of 10 subjects, and intraexaminer reproducibility was evaluated. Two examiners measured the thickness in 20 eyes of 10 subjects and interexaminer reproducibility was assessed. The average corneal thickness was 550.27+/-3.56 micrometer in the Orbscan measurements and 526.62+/-3.70 micrometer in the ultrasound pachymetry: There was a statistically significant difference between the two methods. Significant difference was noticed but this showed a constant corresponding correlation with the Orbscan showing a 4.4%lower average. The intraexaminer and interexaminer reproducibility showed high reliability(Guttman split-half point<0.99). The Orbscan pachymetry is a highly reliable method and may be widely used in clinical practice.
Corneal Pachymetry* ; Lakes ; Ultrasonics* ; Ultrasonography

BACKGROUND: Although surgical angioplasty for isolated coronary ostial stenosis is assumend as an alternative approach to CABG, the clinical features of isolated coronary ostial stenosis, postoperative complications and follow-up angiographic results would have not been well studied. METHODS: We retrospectively studied 24 patients (female : male = 20 : 4, mean age 50.0 +/- 12.3 yr) who underwent surgical angioplasty for isolated coronary ostial stenosis using patch ( 22 fresh autologous pericardium, 2 saphenous vein) during the period of March 1990 through February 1998. Repeat coronary angiography (16 patients) and echocardiography (24 patients) were performed. Aortic regurgitation was evaluated semiquantitatively (Grade I - Grade IV). RESULTS: There were 3 deaths after surgical angioplasty. One death was due to acute coronary dissection perioperatively, the second due to low cardiac output syndrome 2 weeks post-surgery, and the third due to traumatic panperitonitis 10 months post-procedure. Angina recurred in 4 patients and the remaning 18 patients were symptom-free. Repeat angiography (19.3 +/- 20.7 Mo) showed widely patent ostium with excellent run-off except 2 patients (1 distal patch stenosis, 1 ostial restenosis in Takayasu's arteritis). The third symptomatic patient was proven to have coronary spasm by ergonovine test. AR increased in the fourth patient (Grade II -> III) with patent ostium. CONCLUSION: Surgical angioplasty may be feasible and alternative operative method to CABG for isolated coronary ostial stenosis. It should however be noted that postop AR can develop and/or increase. Further investigation is needed to evaluate the clinical significance of the AR.
Angiography ; Angioplasty* ; Aortic Valve Insufficiency ; Cardiac Output, Low ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Ergonovine ; Follow-Up Studies ; Humans ; Male ; Pericardium ; Postoperative Complications ; Retrospective Studies ; Spasm