Journal of Korean medical science
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This study was conducted to examine the nation-wide emergency department (ED) utilization pattern by children in Korea. Most referral hospital EDs provide their essential ED information to the National Emergency Medical Center through the National Emergency Department Information System (NEDIS). We analyzed the NEDIS data on pediatric visits (< 19 yr old) during three years, from June 1, 2008 to May 31, 2010. ⋯ Most patients were discharged (81.2%), and 15.3% were admitted. In conclusion, the most common age group who are brought to EDs in Korea is 1 to 4 yr-old young children, and common chief complaints of the visiting children are age-dependent, such as fever in younger children and abdominal pain and headache in older children. We need more improved and organized emergency medicine service system for children in Korea.
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J. Korean Med. Sci. · Oct 2012
Case ReportsUnintended cannulation of the subclavian artery in a 65-year-old-female for temporary hemodialysis vascular access: management and prevention.
Ultrasound-guided cannulation of a large-bore catheter into the internal jugular vein was performed to provide temporary hemodialysis vascular access for uremia in a 65-yr-old woman with acute renal failure and sepsis superimposed on chronic renal failure. Despite the absence of any clinical evidence such as bleeding or hematoma during the procedure, a chest x-ray and computed tomographic angiogram of the neck showed that the catheter had inadvertently been inserted into the subclavian artery. Without immediately removing the catheter and applying manual external compression, the arterial misplacement of the hemodialysis catheter was successfully managed by open surgical repair. The present case suggests that attention needs to be paid to preventing iatrogenic arterial cannulation during central vein catheterization with a large-bore catheter and to the management of its potentially devastating complications, since central vein catheterization is frequently performed by nephrologists as a common clinical procedure to provide temporary hemodialysis vascular access.
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J. Korean Med. Sci. · Oct 2012
Change in body compositions of Asian recipients after kidney transplantation.
Kidney transplantation and accompanying medical conditions may result in changes in body composition. Such changes have been evaluated in Caucasian recipients, but not in Asian recipients. Herein, we conducted a study on Asian recipients because Asians have a different body composition from Caucasians. ⋯ The proportion of muscle mass significantly decreased (P(trend) = 0.001) and the proportion of fat mass significantly increased over time (P(trend) = 0.002). The multivariate results revealed that male recipients, deceased donor type, and low protein intake were associated with an increase in fat mass and a decrease in muscle mass. The results from this study may help to investigate differences in body composition changes between races, as well as the factors related to these changes.
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J. Korean Med. Sci. · Oct 2012
Case ReportsAn intrathecally located broken catheter used for an intrathecal drug delivery system.
The intrathecal drug delivery system (ITDDS), an effective treatment tool for intractable spasticity and pain, is associated with various complications but breakage of the catheter is rare. We report the case of a 50-yr-old man with ITDDS, in whom an intrathecal catheter was severed, resulting in a 28.6-cm-long intrathecal fragment. The catheter completely retracted into the intrathecal space from the anchor site. ⋯ Although the outcome of ITDDS was associated with the length or diameter of the broken catheter, no neurologic complications occurred in our patient. Thus, we inserted another catheter instead of removing the old one. Thereafter, the patient has been regularly followed up, and no neurologic complications have developed during the 28 months.
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J. Korean Med. Sci. · Oct 2012
Dendritic eIF4E-binding protein 1 (eIF4E-BP1) mRNA is upregulated by neuronal activation.
Long-term synaptic plasticity requires addition of new proteins at the synaptic site. The local protein synthesis at subsynaptic sites confers advantageous mechanisms that would regulate the protein composition in local domains on a moment-by-moment basis. However, our information on the identities of 'dendritic' mRNAs is very limited. ⋯ The FISH signals formed clusters along dendrites that colocalized with ICC signals for Staufen, a marker for RNA granules. The neuronal activation by KCl (60 mM, 10 min) significantly increased the density of 4EBP1 FISH signals in the nucleus after 2 hr, and both in the nucleus and dendrites after 6 hr. Our results indicate that 4EBP1 and its mRNA are present in dendrites, and the mRNA is upregulated and transported to dendritic domains in RNA granules upon neuronal activation.