Hematometra Due to Cervical Stenosis in a Postmenopausal Woman with Incidental Ovarian Steroid Cell Tumor: A Case Report

Vaginal bleeding is reported among 4%–11% of postmenopausal women. Hematometra is commonly associated with cervical stenosis due to senile atrophy, radiotherapy, or a uterine neoplastic lesion in women of postmenopausal age. Ovarian steroid cell tumor is a rare hormone-secreting tumor subtype accounting for approximately 0.1% of all ovarian tumors. Here we report a case of hematometra in a postmenopausal woman with high estrogen levels who was later diagnosed with a steroid cell tumor.

Characteristics and outcomes of public bath-related out-of-hospital cardiac arrests in South Korea

Objective@#To analyze the differences in characteristics and outcomes between public bath (PB)- related and non-PB-related out-of-hospital cardiac arrest (OHCA) patients in South Korea. @*Methods@#We performed a retrospective observational analysis of collected data from the Smart Advanced Cardiac Life Support (SALS) registry between September 2015 and December 2018. We included adult OHCA patients (aged >18 years) with presumed OHCA of non-traumatic etiology who were attended by dispatched emergency medical services. SALS is a field advanced life support with smartphone-based direct medical direction. The primary outcome was the survival to discharge rate measured at the time of discharge. @*Results@#Of 38,995 cardiac arrest patients enrolled in the SALS registry, 11,889 were included in the final analysis. In total, 263 OHCAs occurred in PBs. Male sex and bystander cardiopulmonary resuscitation proportions appeared to be higher among PB patients than among non-PB patients. Percentages for shockable rhythm, witnessed rate, and number of underlying disease were lower in the PB group than in the non-PB group. Prehospital return of spontaneous circulation (11.4% vs. 19.5%, P=0.001), survival to discharge (2.3% vs. 9.9%, P<0.001), and favorable neurologic outcome (1.9% vs. 5.8%, P=0.007) in PB patients were significantly poorer than those in non-PB patients. @*Conclusion@#Patient characteristics and emergency medical services factors differed between PB and non-PB patients. All outcomes of PB-related OHCA were poorer than those of non-PB-related OHCA. Further treatment strategies should be developed to improve the outcomes of PBrelated cardiac arrest.

Radiogenomics Based on PET Imaging / 대한핵의학회잡지

Radiogenomics or imaging genomics is a novel omics strategy of associating imaging data with genetic information, which has the potential to advance personalized medicine. Imaging features extracted from PET or PET/CT enable assessment of in vivo functional and physiological activity and provide comprehensive tumor information non-invasively. However, PET features are considered secondary to features on conventional imaging, and there has not yet been a review of the radiogenomic approach using PET features. This review article summarizes the current state of PET-based radiogenomic research for cancer, which discusses some of its limitations and directions for future study.

Development of Predictive Models in Patients with Epiphora Using Lacrimal Scintigraphy and Machine Learning / 대한핵의학회잡지

PURPOSE@#We developed predictive models using different programming languages and different computing platforms for machine learning (ML) and deep learning (DL) that classify clinical diagnoses in patients with epiphora. We evaluated the diagnostic performance of these models.@*METHODS@#Between January 2016 and September 2017, 250 patients with epiphora who underwent dacryocystography (DCG) and lacrimal scintigraphy (LS) were included in the study. We developed five different predictive models using ML tools, Python-based TensorFlow, R, and Microsoft Azure Machine Learning Studio (MAMLS). A total of 27 clinical characteristics and parameters including variables related to epiphora (VE) and variables related to dacryocystography (VDCG) were used as input data. Apart from this, we developed two predictive convolutional neural network (CNN) models for diagnosing LS images. We conducted this study using supervised learning.@*RESULTS@#Among 500 eyes of 250 patients, 59 eyes had anatomical obstruction, 338 eyes had functional obstruction, and the remaining 103 eyes were normal. For the data set that excluded VE and VDCG, the test accuracies in Python-based TensorFlow, R, multiclass logistic regression in MAMLS, multiclass neural network in MAMLS, and nuclear medicine physician were 81.70%, 80.60%, 81.70%, 73.10%, and 80.60%, respectively. The test accuracies of CNN models in three-class classification diagnosis and binary classification diagnosis were 72.00% and 77.42%, respectively.@*CONCLUSIONS@#ML-based predictive models using different programming languages and different computing platforms were useful for classifying clinical diagnoses in patients with epiphora and were similar to a clinician's diagnostic ability.

Development of Predictive Models in Patients with Epiphora Using Lacrimal Scintigraphy and Machine Learning / 대한핵의학회잡지

PURPOSE: We developed predictive models using different programming languages and different computing platforms for machine learning (ML) and deep learning (DL) that classify clinical diagnoses in patients with epiphora. We evaluated the diagnostic performance of these models.METHODS: Between January 2016 and September 2017, 250 patients with epiphora who underwent dacryocystography (DCG) and lacrimal scintigraphy (LS) were included in the study. We developed five different predictive models using ML tools, Python-based TensorFlow, R, and Microsoft Azure Machine Learning Studio (MAMLS). A total of 27 clinical characteristics and parameters including variables related to epiphora (VE) and variables related to dacryocystography (VDCG) were used as input data. Apart from this, we developed two predictive convolutional neural network (CNN) models for diagnosing LS images. We conducted this study using supervised learning.RESULTS: Among 500 eyes of 250 patients, 59 eyes had anatomical obstruction, 338 eyes had functional obstruction, and the remaining 103 eyes were normal. For the data set that excluded VE and VDCG, the test accuracies in Python-based TensorFlow, R, multiclass logistic regression in MAMLS, multiclass neural network in MAMLS, and nuclear medicine physician were 81.70%, 80.60%, 81.70%, 73.10%, and 80.60%, respectively. The test accuracies of CNN models in three-class classification diagnosis and binary classification diagnosis were 72.00% and 77.42%, respectively.CONCLUSIONS: ML-based predictive models using different programming languages and different computing platforms were useful for classifying clinical diagnoses in patients with epiphora and were similar to a clinician's diagnostic ability.

The Utility of Non-Invasive Nasal Positive Pressure Ventilation for Acute Respiratory Distress Syndrome in Near Drowning Patients

PURPOSE@#Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV).@*METHODS@#This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows.@*RESULTS@#NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05).@*CONCLUSIONS@#NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.

Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy for Treatment of Calcium Channel Blockers, Angiotensin II Receptor Blockers, and Metformin Overdose

An overdose of antihypertensive agents, such calcium channel blockers (CCBs) and angiotensin II receptor blocker (ARBs), and the antihyperglycemic agent, metformin, leads to hypotension and lactic acidosis, respectively. A 40-year-old hypertensive and diabetic man with hyperlipidemia and a weight of 110 kg presented to the emergency room with vomiting, dizziness, and hypotension following an attempted drug overdose suicide with combined CCBs, ARBs, 3-hydroxy-3-methylglutaryl-coemzyme A reductase inhibitors, and metformins. A conventional medical treatment initially administered proved ineffective. The treatment was then changed to simultaneous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT), which was effective. This shows that simultaneous ECMO and CRRT can be an effective treatment protocol in cases of ineffective conventional medical therapy for hypotension and lactic acidosis due to an overdose of antihypertensive agents and metformin, respectively.

Ethanol changes atpB gene expression and proton permeability in Streptococcus mutans / 대한구강보건학회지

OBJECTIVES: As a first step to study the anticaries effect of ethanol alone, we investigated the effects of ethanol on the expression levels of the atpB gene and proton permeability of Streptococcus mutans in suspension cultures. METHODS: S. mutans UA159 was grown in brain heart infusion medium at either pH 4.8 or 6.8. The total extracted RNA was reverse-transcribed into cDNA using a Superscript™ First-Strand Synthesis System. The resulting cDNA and negative controls were amplified by ABI PRISM 7700 real-time PCR system with SYBR Green PCR Master Mix. For proton flux assay, bacterial suspensions were titrated to pH 4.6 with 0.5 M HCl, and then additional 0.5 M HCl was added to decrease the pH values by approximately 0.4 units. The subsequent increase in pH was monitored using a glass electrode. Ten percent (v/v) butanol was added to the suspensions at 80 min to disrupt the cell membrane. RESULTS: In a concentration-dependent manner, ethanol alone not only decreased the growth rate of S. mutans and the expression of the atpB gene but also increased the proton permeability at both pH 4.8 and 6.8. CONCLUSIONS: These findings suggest that ethanol has the potential for an anticaries ingredient. We believe that ethanol may be used together with fluoride and/or other cariostatic agents in order to develop better anticaries toothpastes and/or mouthrinses.

Subchondral Bone Restoration of Supra-acetabular Brown Tumor Secondary to Parathyroid Carcinoma: A Case Report / 대한고관절학회지

The causes of osteolytic lesions found in radiological examinations are not quite certain. Therefore, to determine the appropriate treatment method, various approaches and analyzes are required to find the real cause. Hyperparathyroidism is one of the diseases which forms osteolytic bone lesions so-called brown tumor. A 55-year-old woman who had painful osteolytic bone lesions in both hip joint areas was diagnosed as parathyroid carcinoma after serial work-up. She underwent parathyroidectomy and follow-up imaging showed a decrease in brown tumor size and bone consolidation in the subchondral bone destruction area. Proper evaluation of osteolytic bone lesions helps to avoid unnecessary operative treatments and the first choice for the treatment of osteolytic bone lesions caused by parathyroid carcinoma is parathyroidectomy.

Inverse Prognostic Relationships of ¹⁸F-FDG PET/CT Metabolic Parameters in Patients with Distal Bile Duct Cancer Undergoing Curative Surgery / 대한핵의학회잡지

PURPOSE@#As there were few previous studies with a small number of subjects, the purpose of this was to evaluate the prognostic significance of ¹⁸F-FDG PET/CT in patients with distal bile duct cancer undergoing curative surgery.@*METHODS@#The study included 40 patients (M/F = 24:16; age 68.0 ± 8.0 years) who underwent preoperative ¹⁸F-FDG PET/CT followed by curative surgical resection. The participant's age, sex, Eastern Cooperative Oncology Group performance-status score, baseline serum CA 19-9 level, stage, pathologic T and N stages, tumor size, tumor grade, tumor growth pattern, R0 resection, and adjuvant therapy were included as clinicopathological variables for predicting overall survival. The PET variables were maximum standardized uptake value (SUV(max)), average SUV (SUV(avg)), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the tumor. The Kaplan-Meyer method and Cox proportional hazards model were used for the survival analysis.@*RESULTS@#A total of 15 of 40 patients (37.5%) died during the follow-up period. In univariate analysis, low SUVmax (≤ 2.7, p = 0.0005) and low SUV(avg) (≤ 2.6, p = 0.0034) were significant predictors of poor overall survival. In multivariate analyses, only low SUV(max) (HR = 6.7016, 95% CI 1.9961–22.4993, p = 0.0047) was an independent prognostic factor associated with poor overall survival.@*CONCLUSION@#The SUVmax of the primary tumor measured by ¹⁸F-FDG PET/CT was an independent significant prognostic factor for overall survival in patients with distal bile duct cancer. However, different results from a previous study warrant further large sample-sized study.

Inverse Prognostic Relationships of ¹⁸F-FDG PET/CT Metabolic Parameters in Patients with Distal Bile Duct Cancer Undergoing Curative Surgery / 대한핵의학회잡지

PURPOSE: As there were few previous studies with a small number of subjects, the purpose of this was to evaluate the prognostic significance of ¹⁸F-FDG PET/CT in patients with distal bile duct cancer undergoing curative surgery.METHODS: The study included 40 patients (M/F = 24:16; age 68.0 ± 8.0 years) who underwent preoperative ¹⁸F-FDG PET/CT followed by curative surgical resection. The participant's age, sex, Eastern Cooperative Oncology Group performance-status score, baseline serum CA 19-9 level, stage, pathologic T and N stages, tumor size, tumor grade, tumor growth pattern, R0 resection, and adjuvant therapy were included as clinicopathological variables for predicting overall survival. The PET variables were maximum standardized uptake value (SUV(max)), average SUV (SUV(avg)), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the tumor. The Kaplan-Meyer method and Cox proportional hazards model were used for the survival analysis.RESULTS: A total of 15 of 40 patients (37.5%) died during the follow-up period. In univariate analysis, low SUVmax (≤ 2.7, p = 0.0005) and low SUV(avg) (≤ 2.6, p = 0.0034) were significant predictors of poor overall survival. In multivariate analyses, only low SUV(max) (HR = 6.7016, 95% CI 1.9961–22.4993, p = 0.0047) was an independent prognostic factor associated with poor overall survival.CONCLUSION: The SUVmax of the primary tumor measured by ¹⁸F-FDG PET/CT was an independent significant prognostic factor for overall survival in patients with distal bile duct cancer. However, different results from a previous study warrant further large sample-sized study.

A Case of a Herbicide Poisoning Induced Methemoglobinemia Patient Treated with High-dose Vitamin C

Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.

Acute Thrombosis of an Abdominal Aortic Aneurysm Followed by Direct Abdominal Trauma: A Case Report

An abdominal aortic aneurysm (AAA) is a regional dilatation diameter of greater than 3 cm of the abdominal aorta. Clinical manifestations include abdominal pain with a pulsatile mass, back and/or leg pain; however, AAA is typically asymptomatic. A ruptured AAA can result in severe abdominal pain, back pain, and hypovolemic shock, and may result in eventual death. Cases of ruptured AAAs have been reported frequently and are typically encountered in emergency departments. However, acute occlusion of AAA is an uncommon vascular emergency with a high mortality rate. We encountered a patient with sudden-onset abdominal and back pain, coldness, paresthesia, and loss of motor function in both lower extremities after experiencing sustained abdominal compression for 3 minutes. Despite rapid diagnosis and treatment, the patient died 2 days post-operation due to reperfusion injury. This report discusses the rare occurrence of an acute occlusion of AAA due to thrombosis; our aim is to increase awareness of this diagnosis in emergency departments.

Blood Lipid Profile as a Prognostic Factor in Patients with Organophosphate Poisoning

PURPOSE: The purpose of this study is to compare clinical outcomes with blood lipids level and lipid solubility of organophosphate-poisoned patients. METHODS: Data from 88 patients who visited the emergency room from January 2008 to July 2014 were analyzed. This study was conducted retrospectively using blood test results and progress notes. The contents of data included the type of organophosphate herbicide, ingesting dose, vital signs on emergency room, blood lipids level, electrocardiographic finding, and hospital course. For lipid solubility, octanol/water coefficient was used. RESULTS: Among a total of 88 patients with organophosphate herbicide intoxication, 48 patients ingested high lipophilic organophosphate. There were statistically significant between cholesterol and duration of ventilator care. And there was a trend toward significance between cholesterol and intensive care unit, total admission stay, between triglyceride and total admission stay. As cholesterol and triglyceride level of patient was higher, the prognosis was worse. CONCLUSION: In this study, blood cholesterol and triglyceride levels in high lipophilic organophosphate herbicide intoxicated patients are useful predictable factors for prognosis.

A Case of Ascites without Liver Failure in Patient with Valproic Acid Intoxication

Valproic acid (VA) has been used for treatment of various convulsive disorders. As its use has increased, many complications of VA have been reported. Complications include significantly dangerous organ failures such as liver failure, brain edema, respiratory arrest, and pancreatitis, and so on. Some clinicians have reported rare cases of ascites with liver failure and necrotizing pancreatitis in patients with VA overdose. However, no case of ascites without organ problems has been reported. A 19 year-old man who was intoxicated with VA was transferred to our hospital. He had abdominal distension with a moderate amount of ascites despite having no organ dysfunction. We will describe this rare case.

Effect of Tranexamic Acid on Blood Loss and Blood Transfusion Reduction after Total Knee Arthroplasty

PURPOSE: Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. MATERIALS AND METHODS: A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups. RESULTS: The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group than in the control group at 24 hours postoperatively. The mean units of transfusion were smaller in the tranexamic acid group (0.76 units) than in the control group (1.28 units). CONCLUSIONS: Our data suggest that intravenous injection of tranexamic acid decreases the total blood loss and transfusion after TKA.

Effect of Retinoic Acid in a Mouse Model of Allergic Rhinitis

PURPOSE: All-trans retinoic acid (ATRA) modulates immune responses by affecting T cells. Several studies have revealed that allergic inflammation of the lower airways is negatively associated with the vitamin A concentration. However, the role of ATRA in allergic inflammation of the upper airways is unclear. We investigated the effects of ATRA in an allergic rhinitis mouse model. METHODS: BALB/c mice except control groups (CON group) were sensitized with and challenged intra-nasally with Dermatophagoides farina (AR group). The ATRA groups were administered ATRA intraperitoneally. The steroid groups were administered steroid intranasally (ST group). Allergic symptoms and the average eosinophil number were counted. Cytokines and transcription factors were measured by Real-Time PCR and Western blotting. Der f-specific immunoglobulin E (IgE) was measured. Flow cytometry results of CD4+CD25+Foxp3+ T cells were analyzed. RESULTS: The symptom scores were lower in the ATRA group than in the AR group and higher than in the CON group. The levels of IgE were lower in the ATRA group than in the AR group and higher than in the CON and ST groups. The levels of Foxp3, TGF-beta, and IL-10 mRNA, as well as the percentage of CD4+CD25+Foxp3+ T cells, were higher in the ATRA group than in theAR group. In the ATRA group the levels of IFN-gamma mRNA were higher, and the levels of GATA-3 and IL-4 mRNA, and ROR-gammat were lower. In Western blotting analyses, the expression patterns of all factors, except Foxp3, showed similar to those of mRNA expression. CONCLUSIONS: ATRA has anti-allergic effects in an allergic rhinitis model, and its underlying mechanisms mainly include the induction of regulatory T cells and the inhibition of Th2 responses.

Practice Patterns in Endoscopic Sinus Surgery: Survey of the Korean Rhinologic Society

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea. MATERIALS AND METHOD: A series of eight surveys were sent to the board members of the Korean Rhinologic Society via e-mail between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously. RESULTS: The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was preferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS. CONCLUSION: The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.

The correlation between allergy sensitization rate in pediatric and aerobiological study for airborne pollen in Busan for 15 years

PURPOSE: Airborne pollen is the most common causative agents of allergic disease. Since 2000, there isn't no more report about airborne pollen in Busan. This study is that pollen in one area of Busan was collected to investigate species, particle counts, seasonal distribution, and of its correlation with reactivity to skin prick test in children during 1998-2012. METHODS: Rotorod sampler was installed on the rooftop of St. Mary Hospital in Busan. A 24-hour sampling of airborne allergens over a fifteen-year period was conducted 6 days/wk from January 1, 1998 to December 31, 2012. After staining they were identified, counted and recorded with the weather in Busan. RESULTS: Major pollens collected were Pine, Alder, Oak, Juniperus, Humulus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen, from April to September in case of grass pollen and from August to October in case of weed pollen. Total annual pollen count ranged from 36,412 grains/m3 (2002) to 1,342 grains/m3 (2006). The peak pollen season was seen for spring and autumn, especially in May and September during 1998-2012. In skin prick tests, birch was the highest sensitization rate (15.1%), followed by alder (14.7%), hazel (14.1%) in the tree for 15 years. And in weed, mugwort and ragweed were the highest sensitization rate (10.6%, 10.3%), followed by humulus (5.5%) for 15 years, but since 2008, was increased. CONCLUSION: Analysis of pollens sampled in the atmosphere of Busan, Korea, for a 15-year period identified 24 species of pollens with seasonal variation of some clinically important pollen load. Analysis of data, it showed that alder and birch are main allergen in spring for 15 years, and in 1998-2008, ragweed and artemisia was main allergen in fall, since 2009, followed by humulus.

Experience of a Medical Assistance for Disaster Caused by a Typhoon of Haiyan in the Philippines

PURPOSE: On November 8, 2013, Typhoon Haiyan attacked the Philippines, causing damage to many houses and trees as well as loss of many lives. A medical team from our hospital and university was sent to Philippines in order to provide medical assistance. We wish to describe our experiences of disaster medicine and discuss problems and improvement points. METHODS: We analyzed the characteristics of patients who received medical treatment administered by us at Tagobon city in the Philippines for five days. RESULTS: We provided medical services to 951 patients for five days. Most patients visited us for medical treatment not trauma. Almost all chief complaints were associated with respiratory, gastrointestinal, dermatologic, and ophthalmologic symptoms. We mainly treated the patients with medications. CONCLUSION: During the subacute period after the disaster, most patients complained of medical and dermatologic problems due to lack of sanitation rather than traumatic complications. Medical assistance for disaster should be administered appropriately according to the types of diseases that occurduring each period after disaster.