Journal of Yeungnam Medical Science

Volume 16(2); December 1999

Reviews

Management of Preterm Labor.: Woon Ki Park; Yeungnam Univ J Med. 1999;16(2):141-154. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.141

1,400 View
4 Download

Abstract PDF: Premature birth is the single largest cause of perinatal mortality and morbidity in nonanomalous infants in developing countries. Advances in neonatal care have lead to increased survival and reduced short and long term morbidity for preterm infants. but the rate of preterm birth has actually increased. This review provides recent multifactorial approaches to treatment and prevention of preterm birth.

Recent Advances in the Drug Therapy of Osteoporosis.: Hyoung Woo Lee; Yeungnam Univ J Med. 1999;16(2):155-168. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.155

1,419 View
1 Download

Abstract PDF: Osteoporosis is one of the most important public health problems facing the aging population. Drug therapy for osteoporosis can be divided operationally into two main categories: drugs that inhibit bone resorption, and thus reduce bone turnover, and those that stimulate bone formation, exerting an anabolic effect. Antiresorptive agents such as estrogens, calcitonin, and bisphosphonates are most effective in the prevention of osteoporosis. Formation-stimulating agents such as sodium fluoride or monofluorophosphate, parathyroid hormone fragments, and anabolic steroids are of potential value in the treatment of established osteoporosis, where bone mass s already low and benefit from antiresorptive drug is likelyto be small. Recently, raloxifene, a selective estrogen receptor modulator, has become available in various countries for clinical use in the treatment of involutional osteoporsis . This paper will review the use of these drugs in postmenopausal woman.

Original Articles

Cervicography as a Screening Test for Cervical Cancer.: Doo Jin Lee, Sung Ho Lee; Yeungnam Univ J Med. 1999;16(2):169-180. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.169

1,852 View
5 Download
1 Crossref

Abstract PDF

BACKGROUND
Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screeningg test of cervical cancer. MATERIALS AND METHODS: Cervicography was taken from 482 women at department of obstetrics and gymecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999, of the 482 women, 172women were excluded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology(Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. RESULTS: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chromic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05) The sensitivity of cytology and cervicography were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13.3%)(p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%)(p<0.05). CONCLUSION: It seems inappropriate to use cervicography as a single scerrning test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

Citations

Citations to this article as recorded by

Physico-Chemical Characterization of Bioactive Mixed Ligand Complexes of Antimony with 3,5-Diarylsubstituted Pyrazolinates and O,O’-Alkylene Dithiophosphates
Kanchan Lata Singh, Afshan Siddiqui, Kajal Singh, U.N. Tripathi
Chemistry & Chemical Technology.2019; 13(4): 407. CrossRef

The Effects of Nitric Oxide Inhibitor on Hyperdynamic Circulation in Portal Hypertensive Rats.: Pill Young Kim, Byeong Ik Jang, Tae Nyeun Kim, Moon Kwan Chung; Yeungnam Univ J Med. 1999;16(2):181-192. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.181

1,417 View
1 Download

Abstract PDF: BACKGROUND
Nitric oxide, a vasodilator synthesized from L-arginine by vascular endothelial cells. accounts for the biological activity of endothelium derived relaxing factor. Previous studies demonstrated that nitric oxide inhibitor. N'-Nitro-L-Arginine(NNA)diminished the hyperdynamic splanchnic and systemic circulation in portal hypertensive rats. The present study was done to determine the role of nitric oxide in the development of hyperdynamic circulations in the prehepatic portal hypertensive rat model produced by partial portal vein ligation. METHODS: The portal hypertensive rats were divided into water ingestion group and NNA ingestion group. After partial portal vein ligation. NNA ingestion group and water ingestion group received NNA, 1mg/kg/day and plain water through the mouth for 14 days, respectively. Cardiac output, mean arterial pressure, organ blood flow and porto-systemic shunting were measured by radioisotope microsphere methods. Vascular resistances were calculated by standard equation. RESULTS: There were significant decreases in mean arterial pressure, increases in cardiac output and cardiac index, and decreases in total systemic and splanchnic vascular resistance in portal hypertensive rats compared to normal control froup(p<0.01). Compared to the water ingestion group, significantly increased mean arterial pressure wit decreased cardiac output and cardiac index were dexeloped in the NNA ingestion group. Total systemic and splanchnic vascular resistance were significantly increased in the NNA ingestion group compared to water ingestion group(p<0.05). But, there was no significant difference in portal pressure between the two groups. CONCLUSION: The hemodynamic results of this study indicate that hyperdynamic circulation in prehepatic portal hypertensive rat model was attenuated by ingestion of NNA. Nitric oxide may play an important role in the development of hyperdynamic circulation with splanchnic vaodilation in chronic portal hypertension.

Development of Multichannel On-line Thermometry System.: Sei One Shin, Hyun Jin Shin, Myung Se Kim, Sung Kyu Kim; Yeungnam Univ J Med. 1999;16(2):193-199. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.193

1,329 View
4 Download

Abstract PDF: BACKGROUND
Measurement of body temperature is an important parameter inpatient management in many clinical condition. Failure to reach minimal acceptable and has necessitated the application of additional therapy. The authors developed a new, simple, accurate thermometry system, which could be used to undertake precise temperature measurement for various clinical conditions. MATERIALS AND METHODS: A new thermometry system using a specially designed temperature detecting and display system was developed. This system contains a temperature detecting sensor(LM 35CZ), which enables multiple serual checking of heat, data collection and processing computer, and 3-dimensional display system. It provides realtime volumetric visualization of temperature of a defined volume and stores and prints the data. RESULTS: With this system, temperature can be measured at multiple interesting sites simultaneously , demonstrated as a 3-dimensional temperature distribution and stored. In well-controlled, systematic experiments a significant correlation has been observed between standard temperature using this system at carious measuring points. CONCLUSION: This thermonetry system is a real-time measurement system, which can demonstrate 3-dimensional heat distribution in experimental phantom and human body and can be used for diagnosing abnormal conditions. In addition, this system reduces the nursing staff work load, providing them more time for long term care to patients.

The Relationship Between Chewing Ability and Health Status in the Long-lived Elderly of Kyungpook Area.: Hee Kyung Lee, Young Kwon Lee; Yeungnam Univ J Med. 1999;16(2):200-207. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.200

1,695 View
2 Download
6 Crossref

Abstract PDF

BACKGROUND
The objective of this study is to evaluate the effect of the dental and general health in relation to the state of dentition and chewing ability by survering oral condition and anthropometric measure in order to provide primary statistics for the development of a program which may lead to an improvement in the long-lived elderly health status in a rural community. MATERIALS AND METHODS: The subjects of this study were 97 rural long-lived elderly(27 males and 70 females) who were over 85 years-old (average age of subjects are 88.14+/-3.20 year old) in Sungju-Gun. Kyungpook Province. Data were collected by using questionnaires and direct measurement of anthropometrics, and oral examination from all 97 subjects on July, 1999. RESULTS: The following results were obtained: 1. 53.6% of all subjects believe that they are healthy. The average values of height, weight, BMI, body fat, lean body fat and total water were 148.8+/-11.2cm, 46.9+/-10.5kg, 21.2+/-3.5kg/m2, 26.7+/-6.9%, 73.0+/-7.1%, and 53.4+/-5.2%, respectively. 2. The average number of teeth remaining in the subjects were 3.50+/-571: the number of maxillary teeth remaining were 1.08+/-2.88; and the number of mandibular teeth remaining were 2.41+/-3.76. The maximum number of teeth remaining among subjects were 22 teeth, and the fully edentulous(no natural teeth) people were 76.3%. The oral conditions of the subjects were 52.6% using denture, 23.7% using natural teeth and 23.7% masticating edentulous ridge without denture. 3. In terms of oral condition in self-assessment of health, digestive ability, and chewing ability : On self-assessment of health, 47.1% of those wearing denture group responded as feeling food, 56.5% of those of edentulous without denture, and 65.2% in group of matural teeth only. On self-assessment of digestive ability, 82.4% of those in group of denture responded as feeling food, 65.2% of those in group of no teeth and no denture, and 73.9% of those in group of natural teeth only. On self-assessment of chewing ability, 90.2% of those in the group wearing a denture, 60.9% of those in the group of no teeth and no denture, and 65.2% of those in the group of natural teeth only. 4. In terms of oral condition in anthropometric measurements; The height. weight, body fat, lean body mass, and total water according to oral conditions were 150.0+/-10.7cm, 49.0+/-10.9kg, 26.9+/-6.6%, 72,7+/-7.0%, 53.2+/-5.1%, respectively, in group wearing a denture, 142.7+/-6.0cm, 43.2+/-5.5kg, 29.5+/-7.2%, 70.8+/-6.9%, 51.8+/-5.0%, respectively, in the group of no teeth and no denture, and 152.3+/-14.1cm, 45.9+/-12.6kg, 23.4+/-6.0%, 75.9+/-6.9%, 55.6+/-5.1%, respectively, in the group of natural teeth only. CONCLUSION: The subjective measurements of good health were higher denture user, and natural teeth.

Citations

Citations to this article as recorded by

Difference in food and nutrient intakes in Korean elderly people according to chewing difficulty: using data from the Korea National Health and Nutrition Examination Survey 2013 (6th)
Song Hee Kwon, Hae Ryun Park, Young Mi Lee, Soo Youn Kwon, Ok Sun Kim, Hee Young Kim, Young Suk Lim
Nutrition Research and Practice.2017; 11(2): 139. CrossRef
Correlation with subjective oral health status and food preference in elderly people
Chung-Soon Park, In-Ja Kim, So-Young Park
Journal of Korean society of Dental Hygiene.2015; 15(6): 973. CrossRef
Demand for Elderly Food Development: Relation to Oral and Overall Health -Focused on the Elderly Who Are Using Senior Welfare Centers in Seoul-
Geum-Yong Lee, Jung-Ah Han
Journal of the Korean Society of Food Science and Nutrition.2015; 44(3): 370. CrossRef
A study of chewing ability According to malocclusion and orthodontic treatment
Hong-Sik Kim, Soo-Chul Park, Nam-Joong Kim
Journal of Korean Acedemy of Dental Technology.2013; 35(1): 67. CrossRef
Characteristics of the dietary intake of Korean elderly by chewing ability using data from the Korea National Health and Nutrition Examination Survey 2007-2010
Ji Eun Park, Hee Jung An, Sung Ug Jung, Yoonna Lee, Cho-il Kim, Young Ai Jang
Journal of Nutrition and Health.2013; 46(3): 285. CrossRef
The effects of dental prostheses to the quality of life among the elderly
Ik-Gang Hur, Tae-Yong Lee, Jin-Keun Dong, Song-Hee Hong
The Journal of Korean Academy of Prosthodontics.2010; 48(2): 101. CrossRef

A Clinical study on the Hypercalcemia in Primary Bronchogenic Carcinoma.: Hye Jung Park, Kyeong Cheol Shin, Young Chul Moon, Jin Hong Chung, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):208-218. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.208

1,364 View
1 Download

Abstract PDF: BACKGROUND
Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic desorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advenced atage with obvious bulky tumor and carry a poor prognosis. MATERIALS AND METHODS: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level> or =10.5 mg/dL, and symptons which could possibly be attributed to hypercalcemia. In this retrospective study, we evalluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics RESULTS: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance statusm and bone ore frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. CONCLUSION: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of drath and should be treated aggressively to prevent sudden deterioration or death.

The Clinical Effects of Cefpirome for the Treatment of Acute Lower Respiratory Infection.: Kyeong Cheol Shin, Young Hoon Hong, Eun Young Lee, Ki Do Park, Sung Dong Kim, Jin Hong Chung, Choong Ki Lee, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):219-227. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.219

1,708 View
6 Download

Abstract PDF: BACKGROUND
In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).

Clinical Aspects in Patients with Thyrotoxic Periodic Hypokalemic Paralysis.: Sang Yob Nam, Jae Hong Kim, Jung Hyn Oh, Jin Chul Park, Hyun Dae Yoon, Kyu Chang Won, Ihn Ho Cho, Hyoung Woo Lee, Cha Kyung Sung; Yeungnam Univ J Med. 1999;16(2):228-236. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.228

1,372 View
2 Download

Abstract PDF: BACKGROUND
Thyrotoxic periodic paralysis is an uncommon illness characterized by intermittent flaccid paralysis of skeletal muscle, usually accompanied by hypokalemia, in patient with hyperthyroidism. However. the pathophysiology of thyrotoxic periodic paralysis remains largely unexplained and controversial. This report describes the clnical and biochemical findings in 19 patients with thyrotoxic periodic paralysis who were examined at the Yeungnam University Medical Center (YUMC) during the past decade. METHODS: The medical records of 997 YUMC patients, seen between 1986 and 1996, with dignosis of hyperthyroidism were reviewed. Nineteen patients out of 997 hyperthyrodism patients were diagnosed, and examined by history, physical examination, serum electrolyte value, and thyroid function test during paralysis. On the basis of these results, compasons were made on age. sex, precipitating factors, timing, affected limbs, prognosis, serum potassium and serum phosphate and thyroid hormone levels. RESULTS: the prevalence of periodic paralysis in hyperthyroidism was 1.9 percent and the male to female prevalence ratio was 30:1 and in all patients, the development of perodic paralysis was correlated with hyperfuntional state of the throid gland. Eleven cases of periodic paralysis were associated with hypokalemia and their throid hormon levels were significantly more increased than those of the patients without hypokalemia. interestingly, our study shows the recurrence of paralysis after treatment. CONCLUSION: Although the precise pathophysiology of the disease is as yet undefined and controversial, it occurs primarily in Asians with an overwhelming male preponderance and prevalence of 2 percent in hyperthyrodism. The interactive roles of thyroid hormon. Na-K pump. and genetically inherited defect in the celluar membrance potential of the skeletal muscle can be speculated. Further investigation will be neede to firmly establish the mechanism of thyrotoxic periodic paraysis.

Optimization of Correction Factor for Linearization with Tc-99m HM PAO and Tc-99m ECD Brain SPECT.: Ihn Ho Cho, Kohei Hayashida, Kyu Chang Won, Hyoung Woo Lee, Hiroshi Watabe, Norihiko Kume, Chikao Uyama; Yeungnam Univ J Med. 1999;16(2):237-243. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.237

1,384 View
3 Download

Abstract PDF: No abstract available.

An Investingation of Psychological Factors in Patients with Functional Dyspepsia.: Jin Sung Kim, Dai Seog Bai, Kwang Heun Lee, Jeong Ill Suh; Yeungnam Univ J Med. 1999;16(2):244-254. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.244

1,575 View
2 Download
1 Crossref

Abstract PDF

OBJECTIVES
This subjects investigated the psychological characteristics of patients with functional dyspepsia. METHODS: The subjects included ninety patients with functional dyspepsia and sixty four psychiatric out-patients. We administered Minnesota Multiphasic Personality Inventory (MMPI) and Illness Behavior Questionnaire(IBQ). RESULTS: There were no significant differences between the patients with functional dyspepsia and the psychiatric out-patients by MMPI. Two groups both showed a higher distribution in hypochondriasis, depression, hysteria subscales than in any other subscales. The patients with functional dyspepsia showed lower scores in disease conviction and affective disturbance subscales in IBQ subscales were similar between the patients with functional dyspepsia and the psychiatric out-patients. The patients with functional dyspepsia were divided into three groups for the Multivariate cluster analysis: normal(group 1), similar to psychiatric out-patient(group 2), and severe neurotic(group 3). The severe neurotic group showed higher scores in hypochondriasis, depression, hysteria, psychathenia, and schizophrenia subscales in MMPI and showed significant different scores in affective disturbance, disease conviction, psychological and somatic concerns, affective disturbance, denial, and irritability subscales in IBQ. CONCLUSION: If patients with functional dyspepsia show severe neurotic behavior, such as those in(group 3), they would need appropriate psychiatric intervention.

Citations

Citations to this article as recorded by

The Relationship Between Children's Temperament and Character to Functional Gastrointestinal Disorders
Eun Ju Lee, Hyung Joong Kim, Sun Haeng Lee, Gyu Tae Chang
The Journal of Korean Oriental Pediatrics.2015; 29(1): 60. CrossRef

The Psychiatric Consideration on the Mind in the Treatise of Awakening Mahayana Faith.: Jin sung Kim; Yeungnam Univ J Med. 1999;16(2):255-269. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.255

1,282 View
4 Download

Abstract PDF: BACKGROUND
The author investigated the structural theory of the mind. the origin of psychopathology. the resolving stage of the psychopathology. and nature of the true mind in the human mind. METHODS: the author reviewed the "Awakening of Faith in the Mahayana"by Mamyung and "The Commentary on the Treatise of Awakening Mahayana Faith" and "Expository Notes on the Treatise of Awakening Mahayana Faith" by Wonhyo. RESULTS: The author of the Treatise insistod on bellieving the true mind in the human being. Also in the treatise, Alayavijnana explained the harmonized mind of the true mind and the ignorant mind. The ignorant mind as the source of fundamental ignorance. which results in peripheral ignorance arising from the ego in relation with the extenal world. Also, he explains the origin of ignorance and encourages to abandon the deep attachment to ignorance. The developing and resolving stages of ignorance are similar to the developing and resolving stage of psychopathology. CONCLUSION: The author insists on the psychiatric application of the mind theory in the "Awakening of Faith in the Mahayana", "The Commentary on the Treatise of Awakening Mahayana Faith". and "Expository Notes on the Treatise of Awakening Mahayana Faith". Also. the author encourages deep faith of the true human mind.

Detection Rate of Extended-Spectrum beta-Lactamase Producers in Klebsiella pneumoniae and Escherichia coli Isolated at Yeungnam University Medical Center.: Chae Hoon Lee, Ho Chan Lee, Kyung Dong Kim, Tae Su Lee; Yeungnam Univ J Med. 1999;16(2):270-276. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.270

1,555 View
1 Download

Abstract PDF: BACKGROUND
Extended-spectrum beta-lactamases(ESBL) are enzymes that confer resistance to oxyimino-beta-lactams as well as to penicillins and cephalosporins. Strains of Klebsiella pneumoniae and Escherichia coli that produce ESBL have been increasingly prevalent in many countries. The purpose of this study was to investigate the ESBL production rate of K. pneumoniae and E. coli at the in Yeungnam University Medical Center. MATERIALS AND METHODS: Thirty-one isolates of K. pneumoniae and twenty-five isolates of E. coli were examined for ESBL by double disk synergy test, using 20/10microgram ticarcillin/clavulanic acid and 30microgram oxymino-beta-lactam(ceftazidime, ceftriaxone and aztreonam) disks. RESULTS: Fifty-two percent of K. pneumoniae and sixteen percent of E. coli isolates revealed double disk synersism. Majority of ESBL-producing strains(fifty-five percent) were isolated from patients in the intensive care unit. CONCLUSION: ESBL production of K. pneumoniae and E. coli were also common at the Yeungnam Univercity Medical Center and pose a serious problem for antimicrobial therapy.

Analysis of Arrival Information and Status of the Patients in Emergency Department.: Sam Beom Lee, Byung Soo Do; Yeungnam Univ J Med. 1999;16(2):277-282. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.277

1,458 View
5 Download

Abstract PDF: BACKGROUND
For effective and systematic management of patients in the emergency department (ED), the data on patient arrival and status in DE of Yeungnam University Hospital were evaluated, MATERIALS AND METHODS: During the seven days form Apr. 1 to. 7 , 1998, the general patient information such as onset time and place, factors associated with transportation. causes of admission, cared department and patient disposition were recorded. RESULTS: Total of 464 patients visited the ED during the seven days, and the mean number of patients per day was 66.3 Male to female ratio was 1:0.71. Daily staying patients were 17.3 and 83.6 patients were cared totally each day. The methods of transportation and distribution of patients according to region and event were as follows: visit by walk (57.3%), transportation by car(58.0%),place of event in residence(85.3%), regional distribution in Taegu(81.5%), and direct visit(97.4%). Cause of admission due to diseases was 74.6%. The percentages of department which cared the patients were internal medicine 26.6%, pediatrics 16.8%, orthopedics 8.6%, neurology 8.2%, neurosurgery 7.8% and other department including emergency medicine 8.2%, respectively. Patient dispositions were admission 38.4%, discharge 61.0% and death on arrival(DOA) 0.6%, but referred-patient-to -another-hospital was zero. CONCLUSION: Improvements in several aspects of ED's caring system such as "fast tracking" system and reinforcement of disease and trauma caring system, would be helpful for effective management of emergency patients.

Clinical Presentation of th patients with Non-traumatic Chest Pain in Emergency Department.: Jun Young Chung, Sam Beom Lee, Byung Soo Do, Jong Seon Park, Dong Gu Shin, Young Jo Kim; Yeungnam Univ J Med. 1999;16(2):283-295. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.283

1,582 View
7 Download

Abstract PDF: BACKGROUND
Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were 1.1+/-0.9 in non-cardiac diseases, 1.4+/-1.1 in cardiac diseases and 1.7+/-1.1 in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. CONCLUSION: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

First
Prev
Page of 2
Next
Last

Previous issues