PURPOSE: The purpose of this study was to analyze the expierience of the Wonju Disaster Medical Assistant Team (DMAT)'s activities during the Chun-cheon landslide (AM 00:08 on July 7th, 2011) and to present damages caused by the landslide. The scale of the domestic DMAT in the landslide disaster was also assessed. METHODS: In a retrograde study, victims were analyzed video camera recordings and medical records at the landslide disaster. Follow-up surveys of patients taken to the hospital after the Chun-cheon landslide were also analyzed. In addition, pertinence of the Wonju DMAT's activities during the rescue activity, designated by National Emergency Management, were evaluated. RESULTS: Rescue efforts continued until 13:00 on July 7th, 2011. The number of casualties was forty one, consisted of three immediate patients, six delayed patients, nineteen minimal patients, and thirteen expectant patients. The Wonju DMAT arrived at the scene of the landslide disaster at AM 02:30 on July 7th, 2011. After installing a medical office, they categorized patients by ID-ME classification and provided medical treatment to twenty-two patients, including local residents and rescue workers. CONCLUSION: The cause of death in the landslide disaster was suffocation. A small-scale DMAT rescue, composed on five to six people, is more proper for disaster response in a landslide disaster.
Asphyxia ; Cause of Death ; Classification ; Disasters* ; Emergencies ; Follow-Up Studies ; Humans ; Landslides* ; Medical Assistance ; Medical Records ; Rescue Work

PURPOSE: The purpose of this study was to analyze the expierience of the Wonju Disaster Medical Assistant Team (DMAT)'s activities during the Chun-cheon landslide (AM 00:08 on July 7th, 2011) and to present damages caused by the landslide. The scale of the domestic DMAT in the landslide disaster was also assessed. METHODS: In a retrograde study, victims were analyzed video camera recordings and medical records at the landslide disaster. Follow-up surveys of patients taken to the hospital after the Chun-cheon landslide were also analyzed. In addition, pertinence of the Wonju DMAT's activities during the rescue activity, designated by National Emergency Management, were evaluated. RESULTS: Rescue efforts continued until 13:00 on July 7th, 2011. The number of casualties was forty one, consisted of three immediate patients, six delayed patients, nineteen minimal patients, and thirteen expectant patients. The Wonju DMAT arrived at the scene of the landslide disaster at AM 02:30 on July 7th, 2011. After installing a medical office, they categorized patients by ID-ME classification and provided medical treatment to twenty-two patients, including local residents and rescue workers. CONCLUSION: The cause of death in the landslide disaster was suffocation. A small-scale DMAT rescue, composed on five to six people, is more proper for disaster response in a landslide disaster.
Asphyxia ; Cause of Death ; Classification ; Disasters* ; Emergencies ; Follow-Up Studies ; Humans ; Landslides* ; Medical Assistance ; Medical Records ; Rescue Work

INTRODUCTION: This study examined the genetic influence of mandibular prognathism epidemiologically in Korean families. MATERIALS AND METHODS: Over a 5-year period from 2005 to 2009, a questionnaire with a pedigree chart was given to 100 (male 51, female 49) probands with skeletal Class III mandibular prognathism, who had undergone orthognathic surgery in Samsung Medical Center. RESULTS: The average age of the probands was 22.1. The average SNA, SNB and ANB angles of the probands were 81.2degrees, 84.1degreesand -2.9degrees, respectively. A total of 2729 (male 1,354, female 1,375) family members were examined, and the affected ratio of the families was 3.5% with no significant difference between genders. 45% of families had at least one member with a Class III malocclusion other than the proband. The affected ratio of the first-degree relatives (10.9%) was significantly higher than those of the second-degree (3.3%) and third-degree (1.9%) relatives. The affected ratio of the total relatives from the male probands (4.2%) was significantly higher than that of the female probands (2.8%). Heritability (h2, Falconer'method) was estimated to be 29.8% (0.298+/-0.059) in first-degree relatives. CONCLUSION: These results showed the significant influence of mandibular prognathism with relatively low heritability in first-degree relatives in Korean families of probands, who had undergone orthognathic surgery to correct a skeletal Class III malocclusion.
Female ; Humans ; Male ; Malocclusion ; Orthognathic Surgery ; Pedigree ; Prognathism ; Surveys and Questionnaires

PURPOSE: Recently, all-terrain vehicle (ATV)-related injuries have increased. The purpose of this study was to evaluate and analyze the ATV injuries in Korea. METHODS: We analyzed the patients who visited Chuncheon Sacred Heart Hospital emergency center with ATVrelated injuries, from 2004 January to 2008 December. The injury severity was evaluated according to the injury severity score (ISS), the revised trauma score (RTS), and the yrauma score and the injury severity score (TRISS). RESULTS: From 2004 to 2008, a total of 78 cases, 28 male and 50 female, of ATV-related injuries were reviewed. The annual incidence had increased 22.5-fold from 2004(2 cases) to 2008(45 cases). The age ranged from 8 to 68 years (median, 24 years). The most frequently injured site was the lower extremity(48.7%). The primary mechanism of injury was roll-over(35.9%), the next was falling down (33.3%). Eighty-two percent(82%) of accidents occurred on paved roads when ATVs are legislated for off-road use only. The average ISS was 6.8. In cases including both the driver and the passenger, the ISS of passengers was higher than that of drivers(7.4 vs. 4.7). Fifty percent (50%) of patients required an operation. The rate of admission was 62.8%. The average length of hospital stay was 25 days. Eighty-one percent (81%) of patients had no previous experience of operating an ATV. Sixty-seven percent (67%) of patients did not receive any formal training before operating an ATVs. CONCLUSION: Both the incidence and severity of ATV-related injuries are increasing in Korea. There is a lack of regulation enforcement and public awareness of the dangers of ATV use. The wearing of appropriate safety equipment and sufficient education about driving skills can reduce the ATVrelated injuries.
Emergencies ; Female ; Heart ; Hospitals, General ; Humans ; Incidence ; Injury Severity Score ; Korea ; Length of Stay ; Male ; Off-Road Motor Vehicles

PURPOSE: Hypertension may be involved an alteration of intrinsic basal tone in vascular smooth muscle. The purpose of this study was to investigate the vasorelaxant effect of atrial natriuretic peptide (ANP) on isolated non-contracted aorta from two-kidney, one clip (2K1C) renovascular hypertensive rats. METHODS: 2K1C hypertension was induced by clipping the left renal artery and were used 6 weeks later. Age-matched rats receiving a sham treatment, which served as controls. The thoracic aortae were mounted in tissue baths to measure the isometric tension. RESULTS: ANP diminished basal tone in previously unstimulated thoracic aortic rings from 2K1C hypertensive rats, while it had no effect in the control rats. Endothelial destruction potentiated the vasorelaxant effect of ANP on basal tone in 2K1C rats. A similar potentiation of the ANP response was observed by pre-treatment with N omega-nitro-L-arginine methyl ester (L-NAME) or methylene blue in aortic rings with endothelium. Treatment with calcium-free Krebs decreased basal tone and abolished ANPresponse. These effects were observed only in aortic rings from 2K1C rats. Similarly, staurosporine and calphostin C, inhibitors of protein kinase C (PKC), lowered basal tone and abolished ANP-response in hypertensive rats. CONCLUSION: These results demonstrate that ANP has a vasorelaxant effect on basal tone in 2K1C renovascular hypertension. Inhibition of ANP effects on basal tone by calcium-free Krebs and PKC antagonists suggests that altered Ca2+ -active tone is involved in hypertension, that modifies the response of vascular smooth muscle to the ANP.
Animals ; Aorta ; Aorta, Thoracic ; Atrial Natriuretic Factor ; Baths ; Endothelium ; Hypertension ; Hypertension, Renovascular ; Methylene Blue ; Muscle, Smooth, Vascular ; Naphthalenes ; NG-Nitroarginine Methyl Ester ; Placebos ; Protein Kinase C ; Rats ; Renal Artery ; Salicylamides ; Staurosporine

PURPOSE: This study were designed to supply the opportunity to make a base of emergency syndromic surveillance warning system to detect the bioterrors through the construction of predictive models which were made by reported patients in 'Emergency Syndromic Surveillance System' who were diagnosed as waterborne contagious diseases. METHODS: On this study, we used the neural network analysis methods among the data mining to analyze the reliable variables which was extracted from the reported data bases in the Emergency Syndrome Surveillance System. RESULTS : In this study, we were using the patients data pools from 13th May 2002 to 13th May 2003 in Emergency Syndrome Surveillance System. So we could get the reliable variables - clinical symptoms, severity of patient, humidity and temperature - to predict the waterborne infections. This study shows the successful predictation rate of 96% in error rate of 0.4 with sensible variables through Chisquare analysis and the construction of one hidden layer which is near linearity. CONCLUSION: Early emergency syndromic surveillance warning models made by the neural network in Emergency Syndrome Surveillance System could make the early detection of waterborne infections, could also stop the transmission of waterborne infections in early stage, and furthermore could be used as the preventive and detective methods of bioterror attacks.
Bioterrorism ; Data Mining ; Emergencies* ; Humans ; Humidity

PURPOSE: This study was conducted to examine various clinical factors for their ablity to predict mortality in geriatric patients following trauma. METHODS: In this retrospective study, medical records from Chun Cheon Sacred Heart hospital were reviewed for patients 65 years and older who sustained trauma. The following variables were extracted and examined, independently and in combination, for their ablity to predict death: age, gender, mechanism of injury, blood pressure, and respiration, pulse rate, as well as Glasgow Coma Score, Revised Trauma Score, and Injury Severity Score. These patients had entered the hospital following trauma during a 2-year period (1999-2000). RESULTS: the Injury Severity Score (more than 28), the Glasgow Coma Score (less than 9), and the Revised Trauma Score (less than 8) were variables that correlated with mortality. Mortality rates were higher for men than for women. Admission variables associated with the highest risks of death included hypotension (mean blood pressure < 78 mmHg); pedestrian and motorcycle traffic accident; skull fracture, subdural hemorrhage, and diffuse axonal injury; and hemothorax and lung contusion. CONCLUSION: Admission variables in geriatric trauma patients can be used to predict the outcome and may also be useful in making decisions about triage, and treatment of the patient.
Accidents, Traffic ; Blood Pressure ; Coma ; Contusions ; Diffuse Axonal Injury ; Female ; Gangwon-do ; Heart ; Heart Rate ; Hematoma, Subdural ; Hemothorax ; Humans ; Hypotension ; Injury Severity Score ; Lung ; Male ; Medical Records ; Mortality ; Motorcycles ; Respiration ; Retrospective Studies ; Skull Fractures ; Triage

Neck trauma can result in a spectrum of injuries and complications ranging from incidental to life threatening, including hemorrhagic shock, acute neurologic injury, and airway obstruction. A prevertebral hematoma associated with a cervical vertebra fracture is not a common condition, moreover, in such cases, airway obstruction is rare. If this condition occur, it may very fatal that can producing hypoxia, cyanosis, acidemia, hypoxic brain damage, and then death. For this reason, the attending physitian must careful observation and protect the airway until the hematoma is reduced and other complications relieved. Recently, we experienced a case of airway obstruction induced by cervical vertebra teardrop fracture (C5). The hematoma progressed slowly and then progressively; Finally it compressed the airway. So we present this case with a reviews of the literature.
Airway Obstruction* ; Anoxia ; Cyanosis ; Hematoma* ; Hypoxia, Brain ; Neck ; Shock, Hemorrhagic ; Spine*

BACKGROUND: Tei index is a Doppler-derived index of combined systolic and diastolic myocardial performance proposed to be a promising noninvasive measurement of overall cardiac function, calculated as the sum of isovolumic contraction (ICT) and isovolumic relaxation times (IRT) divided by ejection time (ET). This study aimed to investigate the effect of changes in preload on Tei index. SUBJECTS AND METHOD: The study population was 10 patients with chronic renal failure who are on regular hemodialysis (HD). They were 3 men and 7 women with a mean age of 45.3+/-12.4 years old. The complete 2-dimensional and Doppler echocardiography including recordings of mitral inflow and left ventricular outflow were performed using HP SONOS 1500 equipment before and after HD. Body weight was measured using electric scale before and after HD. Blood pressure and pulse rate were measured by an automated cuff measurement every 1 hour throughout HD. Hematocrit was monitored noninvasively and continuously using the Crit-Line instrument (In-Line Diagnostics, Riverdale, UT, USA) during HD. RESULTS: There were no significant changes in systolic and diastolic blood pressure, RR interval, left ventricular end-diastolic and end-systolic dimension, left atrial dimension, and left ventricular ejection fraction during HD. The mean body weight loss during HD was 2.1+/-0.65 kg. The percentage of reduction of body weight was 4.1+/-1.56%. Changes in total blood volume at the end of HD were compared with that of baseline -11.79+/-5.51%. The percent change in total blood volume during the HD correlated significantly with the amount of change in body weight (r=0.678, p<0.05) and percent change in body weight (r=0.835, p<0.01), respectively. ICT before HD and at the end of HD were 39+/-13.0, 42+/-24.1 msec (p=NS). IRT before HD and at the end of HD were 76+/-29.1, 95+/-28.5 msec (p<0.01) and , ET before HD and at the end of HD were 317+/-18.1, 289+/-9.0 msec (p<0.01), respectively. Tei index before HD was 0.36+/-0.10, and the index at the end of HD were 0.47+/-0.13 (p<0.001). CONCLUSION: When there is a change in preload during a short period, it seems that the effect of change in preload should be considered when using Tei index to assess ventricular function.
Blood Pressure ; Blood Volume ; Body Weight ; Echocardiography, Doppler ; Female ; Heart Rate ; Hematocrit ; Humans ; Kidney Failure, Chronic ; Male ; Relaxation ; Renal Dialysis ; Stroke Volume ; Ventricular Function

BACKGROUND AND OBJECTIVES: This study was designed to investigate the relationship between myocardial perfusion defect in single photon emission tomography(SPECT) and the difference in left ventricular functional parameters obtained after stress and at rest. MATERIALS AND METHODS: Eighty five patients known to have coronary artery disease (CAD) or suspected to have CAD underwent gated Tc-99m sestamibi SPECT using one or separate day rest/stress protocol. We compared post-stress left ventricular ejection fraction (LVEF-s) with that at rest (LVEF-r) in gated myocardial SPECT. We considered myocardial stunning was developed when LVEF was >5% lower than that at rest. METHODS: Forty one (48%) patients demonstrated reversible or irreversible perfusion defects in gated perfusion SPECT (group 1). Forty four (52%) patients demonstrated normal perfusion status (group 2). In group 1, LVEF-s was significantly lower than that at rest([mean+/-SD] 46+/-15.5 vs 48+/-16.0 respectively, p<0.05). In group 2, There was no significant difference among LVEF-s and LVEF-r(60+/-7.6 vs 61+/-7.9, p=NS). In group 1, no difference was observed between LVEF-s and LVEF-r by stress modes. In 13 (32%) of 41 patients with perfusion defects, LVEF-s was >5% lower than LVEF-r. CONCLUSION: The LVEF obtained after stress with gated SPECT may not reflect true resting values. We recommend gated myocardial perfusion SPECT should be performed also at rest especially in patients with myocardial perfusion defects.
Adenosine* ; Coronary Artery Disease ; Humans ; Myocardial Stunning ; Perfusion* ; Stroke Volume ; Tomography, Emission-Computed, Single-Photon* ; Ventricular Function, Left*