Manganese is an essential element in the body. It is mainly diposited in the liver and to a lesser degree in the basal ganglia of the brain and eliminated through the bile duct. Rapid turnover of manganese in the body makes it difficult to evaluate the manganese exposure in worker, especially in those with irregular or intermittent exposure, like welder. Therefore, conventional biomarkers, including blood and urine manganese can provide only a limited information about the long-term or cumulative exposure to manganese. Introduction of magnetic resonance imaging (MRI) made a progress in the assessment of manganese exposure in the medical conditions related to manganese aculmulation, e. g., relaxation time on MRI due to its paramagnetic property, resulting in high signal intensity(HSI) on T1-weighted image(T1WI) of MRI. Manganese deposition int he brain, therefore, can be visualized as an HSI in the globus pallidus, the substantia nigra, the putamen and the pituitary. Clinical and epidemiologic studies regarding the MRI findings in the cases of occupational and non-occupational manganese exposure were reviewed. Relationships between HSI on T1WI of MRI and age, gender, occupational manganese exposure, and neurological dysfunction were analysed. Relationship between biological exposure indices and HSI on MRI were also reviewed. Literatures were reviewed to establish the relationships between HSI, manganese deposition in the brain, pathologic findings, and neurological dysfunction. HSI on T1WI of MRI reflects regional manganese deposition in the brain. This relationship enables an estimation of regional manganese deposition in the brain by analysing MR signal intensity. Manganese deposition in the brain can induce a neuronal loss in the basal ganglia but functional abnormality is supposed to be related to the cumulative exposure of manganese is relatively too short to reflect the long-term cumulative exposure of manganese in the brain, use of brain MRI for the assessment of exposure in a group of workers seems to be hardly rationalized, while it can be a useful adjunct for the evaluation of manganese exposure in the cases with suspected manganese-related health problems.
Basal Ganglia ; Bile Ducts ; Biomarkers ; Brain* ; Epidemiologic Studies ; Globus Pallidus ; Liver ; Magnetic Resonance Imaging* ; Manganese* ; Neurons ; Putamen ; Relaxation ; Substantia Nigra

PURPOSE: Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. MATERIALS AND METHODS: Seventeen patients (M:F=12:5, mean age: 50.4+/-17.5 years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: 197+/-81 days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. RESULTS: All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern was 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake. The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization (1.96+/-0.87 vs 1.17+/-0.08, p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization (8.44+/-5.45 vs 2.20+/-0.87, p<0.05). CONCLUSION: In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy.
Durapatite* ; Eye, Artificial ; Gamma Cameras ; Head ; Humans ; Orbit ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: This is a mixed method study to understand the experience regarding the job satisfaction of Physician Assistant (PA) male nurses. METHODS: First, factors influencing job satisfaction were analyzed using quantitative approach and job adaptation processes by qualitative research was done through interviews. Finally both of the collected data were comprehensively compared. RESULTS: The factors which had the greatest influence on job satisfaction in the regression analysis were job stress (β=-.49, p<.001) and job identity (β=.46, p<.001) and the explanatory power explaining these variables was 58% (Adj. R²=.58). The results of qualitative research were categorized using the same four variables with qualitative research variables. Five themes in job satisfaction, three themes in job identity, five themes in job stress and six themes in job value were identified by content analysis. CONCLUSION: This finding identified that the job stress and job identity were important variables related to job satisfaction. Therefore, the factors influencing job identity have to be strengthened, and a systematic management and interest to develop them are necessary.
Humans ; Job Satisfaction* ; Male* ; Methods ; Nurses, Male* ; Physician Assistants* ; Qualitative Research

No abstract available.
Vibration*

PURPOSE: This study investigated various factors relatied to wandering behavior of Korean elders with dementia (KED). METHODS: A sample of 160 ambulatory residents with dementia from 14 long term care facilities was used to examine demographic, individual, cognitive, physical health, and environmental characteristics by comparing wanderers (N=108) to nonwanders (N=52). Subjects were evaluated by Korean versions of the Mini-mental State Exam (K-MMSE), the Physical and Instrumental Activities of Daily Living (K-PIADL), and the Revised Algase Wandering Scale Nursing Home version (KRAWS-NH) along its six dimensions. Demographic and environmental data were also obtained. Independent sample ttests, Chi-square test, Fisher's Exact tests, and ANCOVAs were used to examine differences between wanderers and nonwanders. RESULTS: Wanderers were significantly (p<.05) older and had more limitations in K-PADL and K-IADL. The degree of overall wandering and certain features of wandering were significantly different (p<.05) by total number of residents in the facility, type of bedroom (i.e., "Ondol"), and color of bedroom and living-room walls (i.e., sky blue). CONCLUSIONS: Findings of this study may be useful in understanding wandering behavior of KEDs and thus developing more culturally specific management strategies.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Dementia/*psychology ; Demography ; Female ; Homes for the Aged ; Humans ; Korea ; Male ; Middle Aged ; Nursing Homes ; *Wandering Behavior

PURPOSE: Cortical dysplasia (CD) designates a diverse group of malformations resulting from one or more abnormalities in the development of the cerebral cortex. We investigated the findings of interictal SPECT and the diagnostic usefulness of interical and ictal SPECT according to pathological grading (PG) in comparison with MRI. MATERIALS AND METHODS: This study included 16 patients (M:F=9:7, age: 19.9+/-11.8 yrs) with pathologically proven CD. Tc-99m ECD SPECT was performed in all patients: interictal 11, interictal and ictal 3, ictal 2. MRI were obtained in all patients and image analysis was done blindly as to the result of SPECT. Pathologic findings of CD were classified into grade 1 (G1, dyslamination), grade 2 (G2, dysplastic neurons) and grade 3 (G3, balloon cells). We compared SPECT with MRI in lesions-to-lesions and analyzed the result according to PG. RESULTS: In SPECT and MRI, 38 and 27 lesions were visually recognized. In 14 interictal SPECT, variable findings in 35 lesions were demonstrated: 26 were hypoperfusion, 7 hyperperfusion, 2 heterotopic perfusion in the white matter. By comparison between two studies, missed lesions were founded: SPECT were 1 lesion, MRI 12. Review of missed 12 lesions of MRI were followed according to PG; G1 patients were 16.7% (4/19), G2 40.0% (6/15), and G3 50% (2/4). CONCLUSION: Interictal SPECT in CD showed variable findings such as hypoperfusion, hyperperfusion or heterotopic perfusion. However, for detection of missed CD on MRI, SPECT may help to detect a functional abnormality of the lesion with high PG.
Cerebral Cortex ; Humans ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: We evaluated plasma coagulation parameters sequentially and the influence of antithrombin III adjuvant treatment in children with acute lymphoblastic leukemia. METHODS: Twenty-nine cases with acute lymhoblastic leukemia who had been treated with L-asparaginase at Pusan National University Hospital were enrolled in this study. The coagulation parameters were checked before and on every week of L-asparaginase administration. The patients whose level of antithrombin III was below normal range were given antithrombin III done adjuvant treatment. RESULTS: In the twenty-nine cycles of chemotherapies, nine cycles were treated with antithrombin III adjuvant therapy and others were not treated with the therapy. The PT and aPTT levels showed no changes during L-asparaginase treatment. After one week of L-asparaginase treatment, the fibrinogen and antithrombin III levels were decreased markedly. Antithrombin III level in patients under antithrombin III adjuvant treatment had increased significantly. On the other hand, antithrombin III level in patients not on antithrombin III adjuvant treatment showed low levels until finishing L-asparaginase. We observed only one case of sudden cerebral thrombosis in the non-antithrombin III adjuvant treatment. CONCLUSION: Antithrombin III adjuvant treatment can correct hemostatic parameters partially and may prevent thromboembolic events in patients with L-asparaginase.
Antithrombin III* ; Busan ; Child* ; Drug Therapy ; Fibrinogen ; Hand ; Humans ; Intracranial Thrombosis ; Leukemia ; Plasma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Reference Values

PURPOSE: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. METHOD: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. RESULT: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. CONCLUSION: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost?effectiveness, and the patients' and staffs' satisfaction.
Critical Pathways* ; Diagnosis ; Diet ; Humans ; Length of Stay ; Medical Records ; Specialization ; Uterine Artery Embolization* ; Uterine Artery*

BACKGROUND: Recently malaria infection became one of the most important parasitic diseases in Korea. After the re-emergence of malaria in a young soldier in 1993 near the De-Militarized Zone (DMZ), three to four thousand people have been infected per year in the last few years and the cases of infection have been increasing threefold each year. Microscopic examination of a thick blood smear is a conventional and confirmatory method for diagnosis. However, it requires labor-intensive procedures and its interpretation is quite subjective. Faster and more reliable methods are needed for the diagnosis of malaria. METHODS: We evaluated 155 patients who were diagnosed as malaria. We performed point-of-care rapid diagnostic methods recently introduced: two antibody detection tests manufactured by Korean companies and one antigen (Plasmodium lactate dehydrogenase, pLDH) detection test. The results were compared with those of microscopic examinations of thick blood smears. RESULTS: Sensitivities of two antibody detection assays and one antigen detection assay in acute attacks of malaria were 64.7%, 72.5%, and 96.1%; and, specificities were 88.5%, 89.4%, and 95.1%, respectively. Overall accuracy for all samples were 80.6%, 83.9%, and 95.5%, respectively. CONCLUSIONS: Antibody detection tests for malaria have limitations in sensitivity and accuracy to replace microscopic examination of blood film. Antigen tests detecting pLDH could replace conventional microscopic examinations of blood film, especially in emergency situations in cases that require prompt medication.
Diagnosis* ; Emergencies ; Humans ; Korea* ; L-Lactate Dehydrogenase ; Malaria* ; Military Personnel ; Parasitic Diseases ; Plasmodium

No abstract available.
Asbestos*