No abstract available.
Humans

Muscles from three patients were obtained during continuous ischemic periods and were investigated ultrastructural changes to know the reversible tourniquet time. Tourniquet was applied for periods lasting between 60 minutes and 90 minutes in the human and muscle biopsies were taken from 10 minutes to 90 minutes ischemic period and at the same periods after release of the tourniquet. All specimens were investigated with electron microscopy and the results were as follows: In 10 minutes tourniquet period, loss of cristae in few mitochondria were observed. In 30 minutes tourniquet period, partial swelling, loss of cristae and myelin figure in many mitochondrias and vacuolar dilatation in T-tubule and sarcoplasmic reticulumn were observed. In 60 minutes tourniquet period, above change were observed in nearly all mitochondrias and total number of mitochondrias were decreased. In 90 minutes tourniquet period, above changes were more distinct. 20 minutes after release of 90 minutes tourniquet period, small sized new mitochondria were appeared and abundant electron dense granule in their matrix and sarcoplasmic reticulumn were visible. 60 minutes after release of 90 minutes tourniquet period, the majority of damaged mitochondrias were replaced by small sized new mitochondrias and electron dense granule were abundant in sarcoplasmic reticulumn. In human, the changes on the ultrastructure were reversible for at least a succeeding 90 minutes ischemic periods.
Biopsy ; Dilatation ; Humans ; Microscopy, Electron ; Mitochondria ; Muscle, Skeletal ; Muscles ; Myelin Sheath ; Tourniquets

Fractures of the upper end of the humerus are common and account for 4% to 5% of all fractures. They occur more frequently in older patients. In older patient the fracture often results from a minor fall and can be extremely disabling and their management often demands experienced surgical skill and judgement. Fortunately, in 80% of upper humeral fractures none of the four major segment is significantly displaced. These lesions are amenable to simple treatment by early function exercises. In 15% to 20% of upper humeral fractures one or more of the major segment is displaced. They are often unstable, may not be reduced by closed method. Many different methods of open reduction and internal fixation has been used and are still employed. These include wire loops, screw, staples, plates, intramedullary nail, but adequate internal fixation was not easily achieved due to the osteoporosis, displacement and shape of fragment. We treated 8 cases of surgical neck fractures by Rush pin and tension band wiring method. We consider this method as effective, simple and rigid fixation technique to attempt early exercise and to restore normal range of motion.
Exercise ; Humans ; Humeral Fractures ; Humerus ; Methods ; Neck ; Osteoporosis ; Reference Values

Purpose: Early diagnosis and treatment are essential features to save the kidney in patients with an acute renal infarction. To reduce the delay in diagnosis, the clinical features and treatments of an acute renal infarction were evaluated. Materials and Methods: The medical records of 19 patients (14 men and 5 women) diagnosed with an acute renal infarction were retrospectively analyzed. Symptoms, findings of a cardiologic evaluation, laboratory findings, presumptive diagnosis and treatments were evaluated. Results: All patients complained of flank or abdominal pain. Fifty-three percent of the patients had a history of cardiovascular disease and 37% had no history of specific illnesses. The level of serum LDH was markedly elevated in all patients that performed the test. Initially, only 4 patients were diagnosed as acute renal infarction. In the others, the presumptive diagnoses were urinary stone, acute abdomen, aortic dissection and so forth. Seven patients were managed with conservative care due to the delay in diagnosis or poor general condition. Nine patients were managed with systemic anticoagulation and 3 with intra-arterial thrombolytic therapy. Conclusions: An acute renal infarction must be considered as one of the presumptive diagnoses in patients presenting with flank or abdominal pain and a history of cardiovascular diseases. Prompt CT scanning and testing of the serum LDH level will help in the accurate and immediate diagnosis of an acute renal infarction.
Abdomen, Acute ; Abdominal Pain ; Cardiovascular Diseases ; Diagnosis ; Early Diagnosis ; Humans ; Infarction* ; Kidney ; Male ; Medical Records ; Retrospective Studies ; Thrombolytic Therapy ; Tomography, X-Ray Computed ; Urinary Calculi

BACKGROUND: The multifactorial hypothesis is proposed as a working hypothesis which encompass both the genetic and environmental factors known to participate in the etiology of congenital heart anomalies. So, at the moment, it is believed that avoidance of suspected environmental factors in early pregenancy is most certain preventive measure of congenital heart anomalies. This study has been undertaken in order to find the possible environmental risk factors for congenital heart anomalies in Korea. METHOD: A total of 320 mothers of infants with congenital heart anomalies diagnosed at Seoul National University Hospital were included in this study as case group. And 413 mothers of healthy infants, who visited well baby clinic at the hospital during the same period of 2 years from 1987, comprised the control group. Data related to environmental risk factors including drug use during the first trimester of pregnancy, any other confounders were collected by direct interview using questionmaires. RESULT: There were positive associations for lower educational level of mother, indoor smoking habit of father, number of pregnancy, and of experience of previous abortion of mother, and multiple(or twin) birth. Relative risk estimates for the first trimester exposure to anti-emetics and herb medicine were 2.1(p<0.006) and 1.4(p<0.044), respectively. Data showed a positive association between anti-inflammatory drug exposure and congenital anomalies of pulmonary valve(OR=22.7, p<0.01), and between anti-histamine exposure and coarctation of aorata(OR=12.7, p<0.017). CONCLUSION: Environmental factors such as smoking habit of father, certain drugs used in early pregnancy, plays a role in the etiology of congenital heart anomlaies. Further studies, designed to focus on specific drug and to differentiate the effect of the suspected drug and to differentiate the effect of the suspected drug form that of the underlying conditions prompting its use, should be called upon.
Abortion, Induced ; Antiemetics ; Case-Control Studies* ; Fathers ; Female ; Heart* ; Humans ; Infant ; Korea* ; Mothers ; Parturition ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors ; Seoul ; Smoke ; Smoking

Kimura's disease is a granulomatous disease which develops in the skin, subcutaneous tissues and lymph nodes and is characterized histologically by the presence of lymphoid follicles, vascular proli- feration and infiltration with eosinophils. The disease shows geographical predilection to Japan, China and South East Asia. The exact etiology and pathogenesis remain uncertain. Some patients had proteinuria or nephrotic syndrome. We have recently experienced the superimposed oliguric acute renal failure associated with Kimura's disease in a male patient with chronic renal failure who had been managed conservatively. Inguinal lymph node biopsy revealed Kimura's disease. He recovered from acute renal failure after being treated with hemodialysis and prednisolone. Lymphadeno- pathy and fever subsided with steroid treatment. We report a case of Kimura's disease which was complicated by acute renal failure in the patient with chronic renal failure.
Acute Kidney Injury* ; Biopsy ; China ; Eosinophils ; Far East ; Fever ; Humans ; Japan ; Kidney Failure, Chronic* ; Lymph Nodes ; Male ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Renal Dialysis ; Skin ; Subcutaneous Tissue

BACKGROUND: Hepatitis B is a worldwidely distributed disease. The hepatitis B prevalence of South East nations is reported to be higher than that of America or Europe. Korea is known to be one of high prevalent nation among Asia-Pacific nations. But hepatitis B prevalence in North Korea, separate from South Korea due to politics and ideology, is not reported. This study was performed using the data of North Korean defectors to estimate the prevalence of hepatitis B in North Korea. METHODS: We analyzed the data of 107 persons (98, mals, 9 females) who defected from North Korea and underwent screening exammination in a general hospital from July 1987 to March 1996. Twenty nine persons(25 males, 4 femals) were excluded because of incomplete data. The HBsAg test was carried out by reversed passive hemagglutination(RPHA) and the anti-HBs test was carried out by passive hemagglutination(PHA). The liver function tests were carried out by biochemical quantitative analysis method of Dimension. RESULTS: The study group were 73 males(93.6) and 5 females(6.4%). Mean age was 33.0+/-8.4 years and third decade was the largest as 35 persons(44.9%). The overall HBsAg positive rate was 15.4% and anti-HBs positive rate was 83.9%. Those who need vaccination was 51.4%. The only item amorg liver function tests which was statistically different by the hepatitis B viral marker groups was alkaline phosphatase. Mean total cholesterol was 176.4+/-38.0mg /dL. But no other item of liver function tests was statistically different in abnormal value by the hepatitis B viral marker groups. CONCLUSIONS: The overall HBsAg positive rate of North Korean defectors was much higher than that of South Korean and anti-HBs positive rate was much lower. So HBsAg positive rate of North Korean seems to be higher than that of South Korean. We think that a large study of hepatitis B for North Korean should be performed at every opportunity and take a measure to meet the situations.
Alkaline Phosphatase ; Americas ; Biomarkers ; Cholesterol ; Democratic People's Republic of Korea ; Europe ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hospitals, General ; Humans ; Korea ; Liver Function Tests ; Male ; Mass Screening ; Politics ; Prevalence* ; Vaccination

PURPOSE: For the measurement of testicular volume, we tried to evaluate the differences between the 1) ultrasonographic and intraoperative ruler measurements, 2) the performances by a radiologist and urologic residents and also 3) the difference among the various formulas for volume calculation. MATERIALS AND METHODS: The sizes of 108 testes of 96 children (mean age: 4) were measured preoperatively for the length (L) and width (W) with using ultrasonography by a radiologist. These testes were also measured intraoperatively for the L, W and thickness (T) with using a ruler. Of the 108 testes, 57 testes were also scanned with using ultrasonography by urologic residents to measure the L, W and T. The testicular volumes were calculated with three different formulas: LxW2x0.52 (F1), LxWxTx0.52 (F2) and LxWxTx0.71 (F3). RESULTS: The mean volumes of the 108 testes measured with ultrasonography by the radiologist and with a ruler were 0.27+/-0.2ml vs. 0.87+/-0.56ml, respectively (p<0.001). The mean difference between the volumes measured with ultrasonography and a ruler was 0.61+/-0.47ml. The mean volume of 57 testes measured with ultrasonography by the urologic residents was not significantly different from that measured by a radiologist (p=0.235), and it was also smaller than the volume measured with an intraoperative ruler (p<0.001). CONCLUSIONS: The testicular volume in children was much underestimated by ultrasonography with statistical significance. Therefore, the possibility of underestimation must be considered in clinical settings. The testicular volumes measured with ultrasonography by the radiologist and by the urologic residents had no significant difference.
Child* ; Humans ; Testis ; Ultrasonography

Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is 100 ng/dl which is supposed to match the level of 40 ng/dl of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level(100 ng/dl) of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over 40 ng/dl. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin(Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were 79.5+/-46.7 ng/dl, 38.7+/-15.1 ng/dl, and 14.8+/-1.2 g/dl, respectively. There were significant differences in blood ZPP, PbB and Hb by industry(P<0.01). 2. The percents of lead workers whose blood ZPP were above 100 ng/dl in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above 40 ng/dl in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below 40 ng/dl, 40-59 ng/dl and above 60 ng/dl were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below 100 ng/dl, 100-149 ng/dl and above 150 ng/dl were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant(P<0.05) and as PbB was 40 ng/dl, blood ZPP was 82.1 ng/dl. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB over 40 ng/dl were observed in the cut-off level of 50 ng/dl and 100 ng/dl of blood ZPP, respectively, the highest validity(sensitivity+specificity) of blood ZPP to detect lead workers with PbB over 40 ng/dl was observed in the cut-off level of around 70 ng/dl of blood ZPP. But even with optimal cut-off level of around 70 ng/dl of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from 100 ng/dl to somewhat lower level such as around 70 ng/dl and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.
Absorption ; Humans ; Korea ; Linear Models ; Male ; Mass Screening ; Sensitivity and Specificity ; Zinc*

OBJECTIVES: This study was carried out to assess psychosocial distress of lead workers and to examine the relationship between lead exposure indices and psychosocial distress. METHODS: The study design was cross-sectional and research subjects were 234 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), -aminolevulinic acid in urine(ALAU) were selected as indicators of lead exposure. RESULTS: There was significant difference in PWI according to lead exposure level and job characteristics. The results of correlation analysis showed that PWI was significantly correlated with PbB(r=0.203, P=0.002). CONCLUSIONS: Our results supported the association between lead exposure and psychosocial distress. The inclusion of psychosocial distress measurement as a special health examination for lead workers was highly recommended for the effective health management.
Humans ; Osmeriformes ; Questionnaires ; Research Subjects ; Zinc