• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.467-471
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• 2023

The torsion of the uterus is a rare gynecological emergency. It occurs mainly in the gravid uterus and extremely rarely in the non-gravid uterus. In this article, we report a case of a torsion of non-gravid uterus accompanied by a huge intramural leiomyoma with focus on CT and MR imaging findings.

• The Korean Journal of Emergency Medical Services
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• v.11 no.1
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• pp.53-64
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• 2007

Purpose: Ths study aims to examine characteristics of patients using emergency room after execution of five-day workweek system by government and provide basic materials for operation of efficient emergency room. Methods: Data were collected tbrough medical records of patients visiting emergency room from July of 2004 to October of 2006 and they were analyzed with SPSSlPC 10.0. Conclusion : 1. The number of patients visiting emergency room was average 16.7 persons a day in 2004, 17.5 in 2005 and 18.6 in 2006 and it was found that it was increasing every year since the execution of five-day workweek system 2. Gender distribution of subjects using emergency room was higher in male than in female every year. 3. Means of transport to emergency room were mostly private car and others(public transport or on foot), but use of ambulance was increasing. 4. Residential areas of subjects were mostly 'Myeon area' in 2004~2005, but it was changed to residents at 'Eup area' in 2006. 5. Distribution of patients by medical departments was highest in internal medicine and surgery in 2004~2006 and rate of visiting pediatrics was increasing every year. 6. Time to stay at emergency room was most at 'below 30 min'. in 2004~2006, but cases of stay for 'more than 2 hours' were increasing every year. 7. On presence or absence of trauma in patients visiting emergency room, rate of visit to emergency room with 'no trauma' was higher and this result was increasing every year. 8. As a result of classifying severity of patients visiting emergency room, use rate of emergency room by 'non-emergency' patients was over 90% in 2004~2006 and such a phenomenon was deepened in 2006 compared to that in 2004. 9. Measures after emergency care of patients were most in case of 'discharge' in 2004~2006, but cases of admission to hospital after emergency care were increased every year. 10. According to use of emergency room by a day of the week, use on Sunday was most frequent in 2004~2006, but use on Friday the day before holiday was increasing. 11. According to distribution by age, use by those between '40~49' was most in 2004~2005, but use by those 'below 10' was most in 2006. 12. According to time to visit emergency room, using emergency room at "15:31~23:30 was most in 2004~2006, cases of visiting emergency room at day working hour were decreased every year and those at evening and night working hours were increased. Conclusion: In sum, it was found that characteristics of patients visiting emergency room and their actual status were changed after the execution of five-day workweek system and efforts to rearrange emergency medical system are required.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.208-211
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• 2021

Gallbladder injuries are rare in cases of blunt abdominal trauma and are usually associated with damage to other internal organs. If the physician does not suspect gallbladder injury and check imaging studies carefully, it may be difficult to distinguish a gallbladder injury from gallbladder stone, hematoma, or bleeding. Therefore, in order not to miss the diagnosis, the clinical findings and correlation should be confirmed. In the present case, a 60-year-old male presented to a local trauma center complaining of pain in the upper right quadrant and chest wall following a motor vehicle collision. Abdominal computed tomography (CT) showed a hepatic laceration and hematoma in the parenchyma in segments 4, 5, and 6 and active bleeding in the lumen of the gallbladder. Traumatic gallbladder injuries generally require surgery, but in this case, non-operative management was possible with cautious follow-up consisting of abdominal CT and angiography with repeated physical examinations and hemodynamic monitoring in the intensive care unit.

• Archives of Plastic Surgery
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• v.48 no.4
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• pp.373-377
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• 2021

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The aim of this paper is to report the first case of BIA-ALCL diagnosed in a pregnant patient. It is well known that BIA-ALCL appears as an indolent lymphoma with a good prognosis when diag-nosed at early stages and clinical guidelines for its management have been clearly published. Nevertheless, they lack a standardized approach for BIA-ALCL during pregnancy. With limited experience in our case, treatment has been safely postponed after term without affecting patient's overall prognosis and without fetal complication. The fact that the disease was diagnosed at an early stage (stage I) undoubtedly influenced the course of treatment. A multidisciplinary approach weighing the risks and benefits of treatment is of paramount importance in order to ensure the best possible outcome for both the mother and her child and clinical update guidelines should be issued.

• Transactions of the Korean Society of Automotive Engineers
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• v.16 no.3
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• pp.52-59
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• 2008

Most accident reconstruction or analysis depend on the coefficient of friction to estimate the vehicle speeds. Skid mark and coefficient of friction are usually utilized to calculate the velocity and behavior of vehicles. For a critical case such as traffic accident reconstruction, however, the initial velocity of the car should be calculated precisely. In this paper, emergency brake tests on ABS and Non-ABS brake system are conducted on the dry pavement asphalt road on speed 40, 60, 80 and 100 km/h respectively. The SWIFT sensor was established in the front wheel and rear wheel at driver side to measure the forces, moments and speeds of revolution of the tires. These tests results can be available to brake tests and accident reconstruction.

• Journal of Medicine and Life Science
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• v.21 no.2
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• pp.31-39
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• 2024

This study was conducted to determine whether level-1 emergency medical technicians (EMTs) can adequately recognize ST-segment elevation myocardial infarction (STEMI) in the emergency department (ED) and whether their ability to do so differs from that of emergency medicine physicians (EMP). From December 2022 to November 2023, patients aged 20 years or older visiting the ED with chief complaints suggesting acute coronary syndrome (ACS) were enrolled. As soon as the patient arrived at the ED, a level-1 EMT conducted a 12-lead electrocardiogram (ECG) to assess STEMI; an EMP subsequently assessed whether to activate the percutaneous coronary intervention team. Demographic characteristics, test results, and final diagnoses were collected from the medical records. Among the 723 patients with case report forms, 720 were included in the analysis. These were categorized as follows: 117 (16.3%) with STEMI, 159 (22.1%) with non-ST-segment elevation ACS, and 444 (61.7%) with other conditions. STEMI was correctly recognized in 100 patients (91.7%) by level-1 EMTs and in 104 patients (95.4%) by EMPs (kappa=0.646). EMTs with less than 1 year of ED work experience correctly recognized 60 out of 67 STEMI patients (89.6%), which was comparable with the EMPs who recognized 65 out of 67 STEMI patients (97.0%, kappa=0.614). EMTs with more than 1 year of ED work correctly recognized 40 out of 42 STEMI patients (95.2%), and therefore performed better than EMPs, who recognized 39 out of 42 STEMI patients (92.9%, kappa=0.727). The level-1 EMTs adequately recognized STEMI using a 12-lead ECG and were in substantial agreement with the evaluations of the EMPs.

• Journal of Yeungnam Medical Science
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• v.37 no.1
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• pp.59-62
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• 2020

Hemoptysis is a major reason for emergency department (ED) visits. Catamenial hemoptysis (CH), a rare condition of thoracic endometriosis, can cause recurrent hemoptysis but is difficult to diagnose in the ED due to the scarcity of cases and nonspecific clinical findings. We report a case of a 26-year-old woman who presented to the ED with recurrent hemoptysis since 2 years without a definite cause. Her vital signs and blood test findings were unremarkable. Chest computed tomography (CT) did not show any specific lesions other than a non-specific ground-glass opacity pattern in her right lung. She was on day 4 of her menstrual cycle and her hemoptysis frequently occurred during menstruation. Although there was no histological confirmation, based on her history of hemoptysis during menstruation and no other cause of the hemoptysis, the patient was tentatively diagnosed with CH and was administered gonadotropin-releasing hormone. She had no recurrence of hemoptysis for 3 months. While CH is difficult to diagnose in the ED, the patient's recurrent hemoptysis related to menstruation was a clue to the presence of CH. Therefore, physicians should determine the relationship between hemoptysis and menstruation for women of childbearing age presenting with repeated hemoptysis without a definite cause.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.94-101
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• 2020

Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.

• Journal of Digestive Cancer Research
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• v.9 no.2
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• pp.43-49
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• 2021

Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.44-47
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• 2006

Symptoms of aspirin overdose may vary from acid-base disturbance, electrolyte abnormality, non-cardiogenic pulmonary edema, chemical hepatitis, seizure to cardiac toxicity. Cardiac adverse effects from aspirin are uncommon but there are reports of arrhythmia, cardiopulmonary arrest, and myocardial infarction. We report 2 cases of young women with aspirin overdose who exhibited ischemic changes on their ECGs a few hours after the ingestion with spontaneous recovery in a few days. First case, a 29 year old woman, presented to the emergency department 6 hours after ingesting 250 tablets of aspirin (325 mg/T). On examination, the temperature was $36.3^{\circ}C$: blood pressure, 105/72mmHg; Pulse, 111/min and respiratory rate, 24/min. Second case, a 27 year old woman, an hour after ingesting 60 tablets (325mg/T). On examination, the temperature was $36.0^{\circ}C$: blood pressure, 102/72 mmHg; pulse, 89/min and respiratory rate, 25/min. In both cases, ECG after 6 hours of ingestion had sinus tachycardia and developed T wave inversion on the anterior leads in the following ECGs. Their initial serum salicylate levels after 6 hours of ingestion were 71.2 mg/dL and 28.4 mg/dL respectively. These salicylate levels were resolving when these ECGs were observed. The ECG changes resolved in the following days and they were discharged without any further symptoms. Further studies are needed, but for the time being, when dealing with salicylate overdose, transient cardiac depression should be kept in mind to avoid adverse ischemic cardiac events.