Clinical and Epidemiological Characteristics of Severe Poisoning Patients and Analysis of Prognostic Factors

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.

A Study on Epidemiological Factors of Burn Patients in Emergency Rooms

Purpose@#It is important to consider both clinical factors and epidemiological factors in treating burn patients in emergency rooms. However, many emergency medical staffs happen to miss their chances of treating burns based on these considerations. This study is designed to find a better treatment for burn patients in emergency rooms along this approach. @*Methods@#This study was conducted based on the data of the burn patients visiting the emergency room of a single general hospital from January 2015 to December 2019. The epidemiological and clinical factors were extracted out of the data, then the relationship between the prognosis and these factors were analyzed. @*Results@#Most of burn accidents occurred at home, and were caused by hot water, soup, drinks, oil, etc. Especially, flame burns showed high hospitalization rate, surgical rate and mortality. In addition, their prognosis was poor when the affected area included facial, limb and perineal areas etc., or any inhalation burn co-existed. Also, the hospitalization rate and period increased when the treatment time was delayed or the pre-treatment was taken. There was a strong relationship between prognosis and the period of follow-up when patients were admitted during the period. @*Conclusion@#It is difficult for medical staffs to evaluate prognosis of burns in emergency rooms due to progressive damages.Precise treatment and disposition are essential for patients’ good prognosis. Therefore, medical staffs should establish treatment plans by identifying the patient’s epidemiological and clinical factors, rather than giving prescriptions based on fragmentary and superficial symptoms.

Clinical and Epidemiological Characteristics of Severe Poisoning Patients and Analysis of Prognostic Factors

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.

A Preliminary Application of an Emergency Department-based Indepth Injury Surveillance System

PURPOSE: We tried to apply an Emergency-Departmentbased In-depth Injury Surveillance System designed on the basis of the International Classification of External Causes of Injuries (ICECI). METHODS: We registered prospectively all victims presenting with an injury from August 2004 to February 2005 at a local emergency center with 530 inpatient beds and 24 emergency beds. We evaluated the distribution and the proportion by injury-related factors and compared the severity by using the New Injury Severity Score (NISS), the Revised Trauma Score (RTS), the International Classification of Disease-10-based Injury Severity Score (ICISS). RESULTS: The total number of cases was 2,994 and 58.4% of those involved male. Accidental injuries were much greater in number (88.2%) than intentional injuries (10.7%). By mechanism, falls, motor vehicle accidents, piercing/cutting/biting, burns, poisoning/chemical, and other blunt injuries accounted for 28.3%, 14.0%, 13.8%, 3.9%, 2.8%, and 21.5%, respectively, of all injuries. The most common activity was unpaid work (27.3%) and the most common place was a home/residence or institute (44.1%). By severity based on the NISS, mild (below 8 points), moderate (9 to 24 points), and severe (above 25 points) injuries accounted for 89.6%, 9.6%, and 0.8%, respectively, of all injuries. The ICISS and the NISS showed a strongly negative correlation (correlation coefficient= -0.656, p<0.001), and the ICISS and the RTS showed a strongly positive correlation (correlation coefficient = 0.518, p<0.001). CONCLUSION: The In-depth EDISS based on the ICECI was a useful tool for the surveillance of injury-related factors and was a feasible method for measuring and comparing injury severity.

Familial Trichophyton mentagrophytes Infection Transmitted from Guinea Pig / 대한의진균학회지

Recently, small mammals have become a papular pet in Korea, there has been an increase in reports of dermatophytosis in human as a result of frequent contact with small mammals. We report a case of Trichophyton(T.) mentagraphytes infection which developed in whole family members, transmitted from Guinea Pig. Each family member has erythematous scaly pruritic patch on the face or elbow. Cultures from skin lesions of the patients on Mycogel agar showed T. mentagraphtes. The lesions were cured by the administration of itraconazol.

A Case of Seborrheic Dermatitis Caused by Overgrowth of Malassezia globosa / 대한의진균학회지

Seborrheic dermatitis is a very common, subacute or chronic disease, characterized by red scaly lesions on the sebum-rich areas of the scalp, face and upper trunk. The causal factor of the disease is still unknown, but is thought that seborrheic dermatitis may be associated with the direct or indirect effect caused by the distribution of the sebaceous glands. It is also thought that the Malassezia yeast, altered pattern of the epithelial proliferation, or damaged neurotransmitters may act as a factor. There are many studies indicating that Malassezia yeast can be associated with seborrheic dermatitis. We present one case of seborrheic dermatitis, which has been resistant to the continuous therapy over one year and showed the excess proliferation of Malassezia globosa. We believe this case to be indicating the relationship between the Malassezia yeast and seborrheic dermatitis.

A Statistical Review of 3738 Cases of Skin Tumors Referred from Primary Physicians / 대한피부과학회지

BACKGROUND: Many stu iies focused on the distribution of skin tumors, but none of them included the data refered from primat y physicians in Korea. OBJECTIVE: This study was to investigate the incidence and distribution of skin tumors among Korean people. METHODS: A Total of 3738 cases of skin tumor biopsy specimens referred from primary physicians nationwide to Ewon Reference Laboratory(EWON) from July 1989 to June 1992 were reviewed with a microscope, and classified. The result was compared with the data of skin tumor cases biopsied during the same period at the department of dermatology of Asan Medical Center (AMC). RESULTS: 1. Of all skin turnors reviewed, malignant tumors were 3.9% at EWON and 11.0% at Asan Medical Center. 2. The most common primary malignant tumors of the skin were in the order of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma in both centers. 3. The most common benign tumors were in the order of epidermal cyst, lipoma, pilomatricoma, hemangioma, and dermatofibroma at EWON, and epidermal cyst, seborrheic keratosis, syringoma, pyogenic granuloma, derr iatofibroma and lipoma at AMC. 4. While the prevalence of benign skin tumors were highest in the fourth & fifth decades, that of malignant skin tumorware highest in the sixth & seventh decades. CONCLUSION: Our study shows that the data obtained from tertiary hospitals can be quite different from those of primaiy physicians and the incidence of malignant skin tumors can be overestirnated when only data from large university hospitals were included.