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PURPOSE: Disaster is defined as hazards that impact on human lives, causing adverse physical, social, economic or even political effects that exceed abilitiesto rapidly and effectively respond. The purpose of this study, conducted in 2003 and in 2005, was to improve regional disaster plans through a disaster-recognition survey conducted among medical personnel and rescuers in Daegu, Korea. METHODS: This study was carried out using a questionnaire to gauge disaster awareness among medical personnel and 119 rescuers in the Daegu area. We compared responses obtained from medical personnel with those obtained from 119 rescuers. One way ANOVA was used for comparisons. Statistical significance attributed to a pvalue less than 0.05. RESULTS: Many medical personnel and 119 rescuers showed a poor understanding of the disaster response system with regard to activities and triage systems at disaster sites, communication between facilities emergency response exercises in mock disasters, and laws and regulations related to regional governments and facilities. This lack of understanding was especially evident among medical personnel. CONCLUSION: This study revealed that medical personnel and rescuers in Daegu had little understanding of and ability to cope with actual disaster conditions. In view of the close cooperation required in disaster situations between regional medical facilities, rescue workers and government agencies, disaster training and education are imperative. If these groups can work together well, any disaster can be dealt with rapidly and effectively.
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Humanos , Desastres , Educação , Emergências , Exercício Físico , Órgãos Governamentais , Jurisprudência , Coreia (Geográfico) , Inquéritos e Questionários , Ferrovias , Trabalho de Resgate , Controle Social Formal , TriagemRESUMO
PURPOSE: Though their clinical effectiveness of intra-arterial thrombolytic treatment has been proven, there is still some controversy in the choice of baseline imaging study for selecting particular hyper acute stroke patients who would benefit from thrombolysis from among patients with hyper acute stroke. In spite of their excellent resolution MR images has limitations for use in a baseline study because of their cost. The purpose of this study was to assess which baseline study, CT image or diffusion-weighted image, was more beneficial in evaluating hyper acute stroke patients who might particularly benefit from intra-arterial thrombolysis of the middle cerebral artery occlusion. METHODS: We divided the patients into two groups: those for whom CT was used for the initial imaging modality and those for whom MRI was used. We compared in-hospital time delay and the disadvantage of time consumed in evaluating of patients between the two groups. Baseline and 24-hour follow-up CT or MR scans of patients treated with intra-arterial thrombolysis were retrospectively scored by using the Alberta Stroke Program Early CT Score (ASPECTS). RESULTS: The analysis included 64 patients with angiographically confirmed middle cerebral artery occlusion. Although there was significant time delay in obtaining a MR diffusion weighted image (130.20+/-71.63 min) compared to a CT scan (73.64+/-28.99 min) (p<0.001), there were no significant clinical loss scored by using National Institutes of Health Stroke Scale (NIHSS) (p=0.676) and no significant difference in the prognosis estimated by using the modified Rankin scale (p= 0.162). Diffusion weighted images showed significantly higher ASPECT score (p=0.028) in the good prognosis group, and the ROC curve revealed the diffusion weighted images to be better indication for intra-arterial thrombolysis. CONCLUSION: According to our results, MR diffusion weighted images were more useful than CT scans for predicting the outcome of intra-arterial thrombolytic treatment. Our results suggest MR diffusion weighted images can replace CT scans for baseline imaging studies for hyperacute stroke patients.
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Humanos , Alberta , Difusão , Seguimentos , Infarto da Artéria Cerebral Média , Imageamento por Ressonância Magnética , Artéria Cerebral Média , Prognóstico , Estudos Retrospectivos , Curva ROC , Acidente Vascular Cerebral , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Rapid ascent from low to high altitude (above 2500 m) often causes acute mountain sickness (AMS), a symptom-complex characterized by headache and other systemic symptoms (gastrointestinal upset, weakness, dizziness, and difficulty sleeping). In this study, we observed the vital signs and AMS symptoms. 13 participants in a mountain climb in order to determine correlation between AMS and risk factors such as obesity, smoking, and a previous history of AMS. METHODS: We studied 13 participants who climbed Mt.Cholatse (6440 m), and measured their vital signs and symptoms during the trekking. Standard Lake Louise questionnaires were filled out at five times during the trek: at the sea level, 2700 m, 3440 m, 4040 m, and 4700 m. With AMS scores and severity grades, we evaluate the severity of symptoms and the physical status. RESULTS: The overall AMS score was 3.7+/-.5, and headache was the most frequent symptom. As the altitude increased, oxygen saturation decreased whereas other vital signs (blood pressure, respiratory rate, and pulse rate) increased. The average AMS scores and severity grades increased more rapidly for obese men than for non-obese men (p<0.001). Smoking and previous history of AMS were also associated with the development of AMS (p<0.001). CONCLUSION: Persons who are obese or have a history of a smoking or AMS, are more likely to develop AMS symptoms. Further understanding of the natural and evolution of AMS and of the risk factors associated with AMS will educate the general population and physicians and help in its prevention and treatment.
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Humanos , Masculino , Altitude , Doença da Altitude , Tontura , Medicina Ambiental , Cefaleia , Lagos , Montanhismo , Obesidade , Oxigênio , Inquéritos e Questionários , Taxa Respiratória , Fatores de Risco , Fumaça , Fumar , Sinais VitaisRESUMO
PURPOSE: To determine the rate of successful biopsy and frequency of post-biopsy pneumothorax and hemorrhage using an 18-gauge cutting needle in CT-guided automated needle biopsies according to lesion size, and the distance between lesion and pleura. MATERIALS AND METHODS: Ninety-four patients with focal lung lesion who had undergone CT-guided automated needle biopsies using an 18-gauge cutting needle were retrospectively reviewed. We evaluated the relationship between successful biopsy rate and pneumothorax and hemorrhage according to lesion size and distance between lesion and pleura. For the purposes of this study, size and distance were grouped as follows : 3cm . RESULTS: Biopsy was successful in 78 of 94 patients(83%). When lesions were larger than 2cm in size the diagnostic rate increased (P=0.002), but the distance between lung lesion and pleura was not statistically related to successful biopsy (P>0.005). Where there were post-biopsy complications, the pneumothorax rate was higher in lesions less than 2 cm in size (P=0.041) and in those separated by more than 2 cm from the pleura (P= 0.006). Where separation was of this order, the hemorrhage rate was higher (P=0.021), but statistically, this was not affected by lesion size (P>0.05). CONCLUSION: When 18-gauge cutting needle is used in CT-guided automated needle biopsies of pulmonary lesions, the rate of successful biopsy is affected by lesion size ; the pneumothorax rate is also affected by lesion size, as well as by the distance between lesion and pleura; the hemorrhage rate is influenced only by the distance between lesion and pleura.
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Humanos , Biópsia , Biópsia por Agulha , Hemorragia , Pulmão , Agulhas , Pleura , Pneumotórax , Estudos RetrospectivosRESUMO
PURPOSE: To determine the rate of successful biopsy and frequency of post-biopsy pneumothorax and hemorrhage using an 18-gauge cutting needle in CT-guided automated needle biopsies according to lesion size, and the distance between lesion and pleura. MATERIALS AND METHODS: Ninety-four patients with focal lung lesion who had undergone CT-guided automated needle biopsies using an 18-gauge cutting needle were retrospectively reviewed. We evaluated the relationship between successful biopsy rate and pneumothorax and hemorrhage according to lesion size and distance between lesion and pleura. For the purposes of this study, size and distance were grouped as follows : 3cm . RESULTS: Biopsy was successful in 78 of 94 patients(83%). When lesions were larger than 2cm in size the diagnostic rate increased (P=0.002), but the distance between lung lesion and pleura was not statistically related to successful biopsy (P>0.005). Where there were post-biopsy complications, the pneumothorax rate was higher in lesions less than 2 cm in size (P=0.041) and in those separated by more than 2 cm from the pleura (P= 0.006). Where separation was of this order, the hemorrhage rate was higher (P=0.021), but statistically, this was not affected by lesion size (P>0.05). CONCLUSION: When 18-gauge cutting needle is used in CT-guided automated needle biopsies of pulmonary lesions, the rate of successful biopsy is affected by lesion size ; the pneumothorax rate is also affected by lesion size, as well as by the distance between lesion and pleura; the hemorrhage rate is influenced only by the distance between lesion and pleura.