The Extended Rapid Response System: 1-Year Experience in a University Hospital

The rapid response system (RRS) is an innovative system designed for in-hospital, at-risk patients but underutilization of the RRS generally results in unexpected cardiopulmonary arrests. We implemented an extended RRS (E-RRS) that was triggered by actively screening at-risk patients prior to calls from primary medical attendants. These patients were identified from laboratory data, emergency consults, and step-down units. A four-member rapid response team was assembled that included an ICU staff, and the team visited the patients more than twice per day for evaluation, triage, and treatment of the patients with evidence of acute physiological decline. The goal was to provide this treatment before the team received a call from the patient's primary physician. We sought to describe the effectiveness of the E-RRS at preventing sudden and unexpected arrests and in-hospital mortality. Over the 1-yr intervention period, 2,722 patients were screened by the E-RRS program from 28,661 admissions. There were a total of 1,996 E-RRS activations of simple consultations for invasive procedures. After E-RRS implementation, the mean hospital code rate decreased by 31.1% and the mean in-hospital mortality rate was reduced by 15.3%. In conclusion, the implementation of E-RRS is associated with a reduction in the in-hospital code and mortality rates.

Two cases of primary renal sarcoma / 대한비뇨기과학회지

Primary renal sarcoma is a rare malignant mesenchymal tumor with a variety of histologic type. The clinical differential diagnosis with renal cell carcinoma may be impossible. The prognosis of primary renal sarcoma is extremely poor and majority of patients die within 2 years. We experienced two cases or primary renal sarcoma, which was diagnosed by immunohistochemical stains.

A Case of Rhabdomyosarcoma of the Bladder Developed in a Child / 대한비뇨기과학회지

Embryonic rhabdomyosarcoma is an extremely malignant tumor of the lower genitourinary tract which arises from striated muscle. It characteristically presents as a lobular grape-like mass. Rhabdomyosarcoma was subclassified by Stout, Horn and Enterline, into 3 basic type; embryonal, alveolar and pleomorphic The onset of irritative, painful and obstructed symptoms predominants in this type of tumor. Combined therapy is the key to proper treatment of this disease utilizing chemotherapy, surgery and radiotherapy, so the survival rate has continued to rise. We report a case of embryonal rhabdomyosarcoma of the bladder developed in a 6 year old boy and the relevant literature has been reviewed.

A Clinical Observation in Renal Angiography / 대한비뇨기과학회지

There are many radiodiagnostic methods it renal diseases; intravenous pyelogram, retrograde pyelogram, antegrade pyelogram, nephrotomogram and renal angiogram. In recent years, ultrasonogram and computed axial tomogram were developed. They help for early detection and accurate diagnosis of renal disease Abdominal aortogram was described by dos Santos, a Portugese doctor in 1923. It was greatly advanced by Seldinger through his development of percutaneous method of transfemoral catheterization in 1956. Rentl arteriogram is a highly valuable diagnostic procedure. It appears clearly that selective angiography is a safe and excellent procedure for an early detection and accurate diagnosis of benign and maligtant disease In the past, selective renal angiography has been used mainly in diagnosis of surgical disease rather than those medical disease. But now, many information are available regarding the vascular disease, pyelonephritis, glomerulonephritis and renal tuberculosis, particularly with regard to changes in the small renal arteries And it supplied various information for anatomic vascular feature of donor kidney in renal transplantation. The intent of this report is to emphasize usefulness of this procedure in the diagnosis of certain lesion of kidney which was not clearly defined by conventional methods. Radiologic findings associated with conditions and presenting symptoms or signs were analyzed in 97 cases of renal angiogram, during the period of May 1972 to August 1978.