This paper presents a case of an early malignant transformation of untreated ulcers in a patient with diabetes. This case shows that Marjolin's ulcer can occur not only after chronic injury, but can also develop in the early stages after the onset. Hence, an early biopsy for diabetic foot ulcers that fail to heal with acute treatment can enable an earlier diagnosis and treatment without amputation, resulting in a better quality of life for the patient.
Amputation ; Biopsy ; Diabetic Foot* ; Diagnosis ; Humans ; Quality of Life ; Ulcer*

OBJECTIVE: We examined the difference in responses to donepezil between carriers and non-carriers of the A allele at the +4 position of the choline acetyltransferase (ChAT) gene in Koreans. METHODS: Patients who met the criteria for probable Alzheimer's disease (AD) (n=199) were recruited. Among these, 145 completed the 12-week follow-up evaluation and 135 completed the 26-week scheduled course. Differences and changes in the Korean version of the mini-mental state examination (MMSE-KC) score, Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery (CERAD-K[N]) wordlist subtest score (WSS), CERAD-K(N) total score (TS), and the Korean version of geriatric depression scale (GDS-K) score between baseline and 12 weeks or 26 weeks were assessed by the Student's t-test. RESULTS: At 12 weeks, the changes in the MMSE-KC score, CERAD-K(N) WSS, and CERAD-K(N) TS from baseline were not significant between ChAT A allele carriers and non-carriers; however, at 26 weeks, these changes were significantly larger in ChAT A allele carriers than in non-carriers (p=0.02 for MMSE-KC and p=0.03 for CERAD-K(N) WSS respectively). CONCLUSION: Our findings in this study suggested that presence of the A allele at the +4 position of ChAT might positively influence the treatment effect of donepezil in the early stages of AD in Koreans.
Alleles ; Alzheimer Disease* ; Choline O-Acetyltransferase* ; Choline* ; Depression ; Follow-Up Studies ; Genotype* ; Humans ; Polymorphism, Single Nucleotide

OBJECTIVES: We have investigated to manifest whether manganese-induced neurotoxicity is mediated by nitric oxide(NO) in the rat primary neuronal cultures and assess the effect of Mn2+ on the N-methyl-D aspartate(NMDA) receptors. METHODS: We have used 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay to examine the effect of cytotoxicity of MnCl2 in neuronal cells . NO production was determined by measuring nirites, a stable oxidation product of NO. The neurons in the rat that contains neuronal nitric oxide synthase(nNOS) were examined by immunofluorescence and confocal microscopy. The effects of Mn2+ on the NMDA receptors was assesed by the whole cell voltage clamp technique. RESULTS: We showed that the NO release and NOS expression were increased with 500uM MnCl2 treatment and an NOS inhibitors, NG-nitro-L-arginine , prevented neurotoxicity elicited by manganese. In the electrophysiological study, Mn2+ does not block or activate the NMDA receptors and not pass through the NMDA receptors in a neurons of basal ganglia. CONCLUSIONS: It is concluded that manganese neurotoxicity in basal ganglia was partially mediated by nitric oxide in the cell culture model.
Animals ; Basal Ganglia* ; Cell Culture Techniques ; Equidae ; Fluorescent Antibody Technique ; Manganese* ; Microscopy, Confocal ; Neurons* ; Nitric Oxide ; Nitroarginine ; Rats ; Receptors, N-Methyl-D-Aspartate

Chronic subdural hematoma usually occurs as a consequence of minor trauma. But, chronic subdural hematoma of occupational origin has not been reported yet in Korea. We experienced a case of chronic subdural hematoma induced by repeated trauma to the head. The patient was a 45-year-old male. He complained of repeated headache and nausea. By the computed tomogram, he diagnosed as chronic subdural hematoma and took the operation. He was not an alcoholism and had no intracranial disease nor coagulopathy. We studied all possibilities through working environment and personal environment survey. As a result, we decided the case as an example of cumulative trauma disorder to the head by occupational origin. We report a case of chronic subdural hematoma in the worker exposed repeated head trauma of occupational origin.
Alcoholism ; Craniocerebral Trauma ; Cumulative Trauma Disorders ; Head* ; Headache ; Hematoma, Subdural, Chronic* ; Humans ; Korea ; Male ; Middle Aged ; Nausea

In Korea the system of medical management has been bifurcated into two parts since the restoration of nation from Japanese after World War II. One is 'Western Medicine' and the other is 'Oriental Medicine' like Chinese but not like Japanese. The authors attempted to study on the unification of both medicines to prevent the confusion of medicare for people. The major part of medical care is accomplished by Western medicine among people in Korea and China. However, Oriental medicine is still present as well as college of Oriental medicine in small number. There have been long struggles between two parts of medicine because of each assertions for the theories. The ancient medicine has been likely to have its characteristics either in Western or Oriental medicine although in many countries were succeeded by Western medicine except a few Asian countries such as Korea and China. In Japan since the license of Oriental(herb) medicine was ceased about one hundred years ago, the Western medicine has been authorized by law until today and the herb is the secondary medicine as a kind of folk treatment as well as continuous and enormous study for scientification. In only China and Korea this herb medicine has been kept to use as a part of medicine by law though China has developed combined medicine to use both Western and Oriental medicine by one physician since previous prime minister Chou En-Lai around the year 1950 who made a recommendation to the two medical societies, Western and Oriental. This fact has a big sense to establish the unification of two medicines in near future in Korea as well as China. For this accomplishment of medical unification both parts of medicine require sincere and enormous efforts to study the theory and practice of herb medicine even from now on. This unification of two medicines will provide the best medicare in most convenient way to the people in the world creating new world medicine like the third medicine including alternative medicine. The acupuncture is changing to a new method in Western medicine especially applying into anesthesia and pain clinic in even USA and Western countries at this time. In conclusion the unification of the Western and Oriental medicine will provide the most reasonable and practical medicare including alternative medicine to people in the world. Because the Oriental medicine will be used at least separately to supplement the Western medicine by one physician
Asia ; China ; English Abstract ; History of Medicine, 20th Cent. ; Korea ; *Medicine ; Medicine, Oriental Traditional/*history ; Philosophy, Medical/*history ; Western World

Panax ginseng (PG) has been used as an important analeptic in traditional medicine. This study was purposed to investigate the effect of PG on immune responses induced by glucocorticoid in mice. PG solution was injected into CV6 and BL23, which are the classical acupuncture points, for 7 days after injection with glucocorticoid. And then B and T cell proliferation and cytolytic activity of natural killer (NK) cells were measured. B cell proliferation by 'H-thymidine incorporation was decreased by about 25% in control group as compared with normal group. However, B cell proliferation was significantly increased 1.8-fold in CV6 group and 2.5-fold in BL23 group as compared with normal group. T cell proliferation by H- thymidine incorporation was decreased by about 15% in control group as compared with normal group. On the other hand, T cell proliferation was significantly increased 1.9-fold in CV6 group and 2.3-fold in BL23 group as cornpared with normal group. Furthermore in purified T cell, the proliferation was furtherly increased rather than in non-purified T cell. The activity of NK cell was remarkably decreased in control group as compared with normal group. However, the activities of NK cells in CV6 and BL23 groups were recovered to the above levels of normal group. On the other hand, the activity of NK cell in the blank locus group was slightly increased compared with control group. However this increasement was not reached the levels of CV6 and BL23 groups. And in the case of purified NK cell, the cytolytic activity of NK cell was respectively increased 1.6-fold in normal group, 1.4-fold in control group, 2.0-fold in blank locus group and 2.0-fold in CV6 group and 1.4-fold in BL23 group as compared to the non-purifed NK cell. These results suggest that PG aqua-acupuncture at CV6 and BL23 may proliferate B and T cells that is suppressed by glucocorticoid, and activate NK cell activity.
Acupuncture Points ; Acupuncture* ; Animals ; Cell Proliferation ; Hand ; Killer Cells, Natural ; Lymphocytes* ; Medicine, Traditional ; Mice* ; Panax* ; T-Lymphocytes ; Thymidine

To evaluate the effect of manganese on the respiratory system, we investigated the respiratory symptoms of 63 male workers exposed to fume containing manganese (Mn), iron (Fe), and silica (Si), and compared them with those of 66 male workers not exposed to the fume in a manganese alloy smelting factory. The prevalence ratios of the seven respiratory symptoms were not different between two groups. The presence of any respiratory symptom was not related with the age, duration of employment, smoking status of workers, and exposure to fume. In furnace workers, it was not related with the airborne Mn, Fe, and Si concentration in the total or respirable fume. Airborne Mn concentrations of all 4 furnaces in the respirable fume were below 1 mg/m(3). There were two suspicious cases of pneumoconiosis among furnace workers and one definite case(1/2) among casting workers who were not exposed to fume. The above results suggest that the exposure to the low airborne Mn concentration is not related with respiratory symptoms and pneumoconiosis. However, it is necessary to study the respiratory effects of Mn using the symptom questionnaire with consideration of the severity and persistence of symptoms and the time interval from exposure.
Alloys ; Employment ; Humans ; Iron ; Male ; Manganese* ; Osmeriformes ; Pneumoconiosis ; Prevalence ; Surveys and Questionnaires ; Respiratory System ; Silicon Dioxide ; Smoke ; Smoking

Interview survey and dermatological examination have been performed to investigate the health problems of workers continuously exposed to coal-tar pitch. The phototoxicity of coal-tar pitch was confirmed by the photopatch tests for six healthy adults. The main results are followings; 1. There was no special history of allergic diseases in both the exposed and non-exposed group. 2. The frequency of the phototoxic dermatosis and the coal-tar acne in the exposed group was significantly greater(p<0.05) than that of the control group. In the exposed group, the phototoxic dermatosis and the coal-tar acne were observed in nine workers(90%) and seven workers(70%), respectively. However, those disease were not observed in the control group. 3. Five results(83%) were positive to the photopatch test for coal-tar pitch 48 hours after UVA irradiation. But the lesion was subsiding 72 hours after UVA irradiation. 4. Malignant cancers were not reported among workers ever exposed to coal-tar pitch. In conclusion, it appears that workers exposed to coal-tar pitch have high risks of phototoxic dermatosis and coal-tar acne. A health policy should be provided to prevent phototoxic dermatosis among coal-tar pitch workers. More studies are required to determine malignancy.
Acne Vulgaris ; Adult ; Dermatitis, Phototoxic ; Health Policy ; Humans ; Skin Diseases*

Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-workers(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.
Animals ; Arthroscopy ; Female ; Foot ; Horns ; Humans ; Joints ; Knee ; Magnetic Resonance Imaging ; Menisci, Tibial ; Middle Aged

A study for seroprevalence of Hepatitis B virus markers (HBsAg, Anti-HBs, HBeAg and Anti-HBe) by EIA method and the Liver Function Test(SGOT and SGPT) using kinetic method was carried :out from January; to October 1995 :among male workers of a .major iron and steel manufacturing company, located,,in Pohang. The results were as follows; 1. The distribution of hepatitis B virus markers showed that the proportions of HBsAg(+)/Anti-HBs (-), HBsAg(-)/Anti-HBs (+) 'and HBsAg(+)/Anti-HBs (+) were 8.1%, 60.5% and 0.1%, respectively. The positive rate of HBsAg in all subjects was 8.2% whereas that of anti-HBs was 60.6%. 2. The proportions of HBsAg(+)/Anti-HBs (-) and HBsAg(-)/Anti-HBs (+) increased significantly with age. While the distribution of hepatitis B virus markers exhibited no significant differences among the groups classified by educational background or work type. 3. The proportion of drinkers in HBsAg (+)/Anti-HBs (-) (73; 9%) was significantly lower than those of HBsAg (-)/Anti-HBs (-) and HBsAg (-)/Anti-HBs (+) (84.6% and 85.7% respectively). The proportions of smoking for the three groups of HBsAg (-)/Anti-HBs(+),-HBsAg (+)/Anti-HBs (-) and HBsAg (-)/Anti-HBs (-) were 54.3%, 53.7% and 53.0%, respectively (p<0.01). The proportion of the subjects with abnormal liver function test in HBsAg (+)/Anti-HBs (-) was 40.1%, whereas those in HBsAg (-)/Anti-HBs (-) and HBsAg(-)/Anti-HBs (+) were 21.9% and 18.4%, respectively. 4. The distribution of e Ag markers among HBsAg (+) subjects showed that the proportions of HBeAg(+)/Anti-HBe(-), HBeAg(-)/Anti-HBe(+) and HBeAg(+)/Anti-HBe(+) were 31.3%, 55.0% and 1.6%, respectively. The proportion of HBeAg(+)/Anti-HBe(-) decreased significantly with age and those of HBeAg(-)/Anti-HBe(-) and HBeAg(-)/Anti-HBe(+) increased with age. The positive rate of HBeAg among HBsAg (+) subjects was 32.9%. In conclusion, as a screening method, EIA is. recommended to test hepatitis B virus markers, especially when examining Anti-HBs more sensitively. For the workers of the iron and steel manufacturing company studied, liver diseases caused by other than hepatitis B should be given a special care including an education avoiding alcohol drinking.
Alcohol Drinking ; Education ; Epidemiology ; Gyeongsangbuk-do ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Iron ; Liver ; Liver Diseases ; Liver Function Tests ; Male ; Mass Screening ; Seroepidemiologic Studies ; Smoke ; Smoking ; Steel*