We experienced a case of congenital choledochal cyst in a 6 months old korean female infant with complaints of abdominal distension, jaundice, loose stool and a large mass of the abdomenin the right upper quadrant since about 3 months prior to admission. The diagnosis was confirmed by clinical symptoms and signs, physical examination, radiological findings and surgical findings. She was operated with good result and discharged in well condition 28 days after. The review of the related literature was made briefly.
Choledochal Cyst* ; Diagnosis ; Female ; Humans ; Infant ; Jaundice ; Physical Examination

OBJECTIVE: To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients. METHODS: One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion. RESULTS: The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove. CONCLUSION: Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy.
Diabetes Mellitus ; Diabetic Neuropathies ; Elbow* ; Electrodiagnosis ; Forearm ; Humans ; Mononeuropathies ; Prevalence ; Ulnar Nerve ; Ulnar Neuropathies*

No abstract available.

Authors report a first Korean case of polyneuropathy in an acrylamide producing factory together with an environmental and epidemiologic survey for the ten workers of the same workplace and 46 workers in the production and manufacturing acrylamide in Ulsan, Korea. The case is 30 years old man who worked in the prcduction of the acrylamide for two years. In August, 1997, he had a weakness of the lower extremity with loss of body weight of 15 Kg which progressed to paresthesia of the limbs, the loss of vibration sense, difficulty in walking, speech disturbance, dysuria, constipation, difficulty in erection and swallowing difficulty. Neurologic examination showed a complete loss of vibration and position sense, and loss of deep tendon reflex in all the limbs. There was a contact dermatitis-like skin lesion on the feet. Electrodiagnostic test showed a generalized polyneuropathy of moderate degree involving motor and sensory component of peripheral and cranial nerves. After 8 months' cessation from exposure and supportive care, his symptoms were completely resolved, but abnormality in electrodiagnostic test and vibrotactile perception threshold still persisted, although much improved than before. There were 11 workers in the same workplace of the case, producing acrylamide by microorganism as a catalyst. Environmental monitoring of the workplace revealed air-borne concentration of the acrylamide to be from 0.05 to 0.23 mg/m(3) by personal sampling and from 7.65 to 11.65 mg/m(3) by area sampling during filter exchanging process, which far exceeds TLV-TWA of 0.03 mg/m(3). However acrylamide was not detected from the plasma of the workers. Symptom questionnaire showed a markedly higher complain of neurologic symptoms, compared to the workers of the other acrylamide producing companies. Electrodiagnostic test showed a several workers are in the lower normal range without definite abnormality. Vibrotactile perception threshold by Vibratron II showed a significantly increased threshold in the workers of the same workplace compared to the other acrylamide workers and significantly decreased test score of color vision compared to normal controls. After improvement of the production process and strict wearing of the protective device, most workers reported the improvement of clinical symptoms, but vibrotactile perception threshold was not improved. These result suggests the need for the effective environmental monitoring together with a periodic biological monitoring. Development of effective screening test is urgently needed to control and assess the skin absorption of acrylamide.
Acrylamide* ; Adult ; Body Weight ; Color Vision ; Constipation ; Cranial Nerves ; Deglutition ; Dysuria ; Environmental Monitoring ; Extremities ; Foot ; Humans ; Korea ; Lower Extremity ; Mass Screening ; Neurologic Examination ; Neurologic Manifestations ; Occupational Exposure* ; Paresthesia ; Plasma ; Polyneuropathies* ; Proprioception ; Protective Devices ; Questionnaires ; Reference Values ; Reflex, Stretch ; Skin ; Skin Absorption ; Threshold Limit Values ; Ulsan ; Vibration ; Walking

Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.
Abscess ; Aged ; Drainage ; Dyspnea ; Empyema ; Female ; Humans ; Immunocompromised Host ; Kidney Failure, Chronic ; Pleural Effusion ; Streptococcus ; Streptococcus constellatus ; Streptococcus milleri Group ; Thorax

To evaluate the prevalence of cumulative trauma disorders in relation to ergonomic evaluation of their work, 260 female directory assistance operators employed in three branch facilities of the nation-wide telecommunication company. Ergonomic evaluation of the work status was done by two industrial hygienists through inspection. Workers were surveyed with standardized self-administered questionnaire and examined by family physicians and an orthopaedician for cumulative trauma disorders. Laboratory examination of serum aspartate aminotransferase(AST), creatinine phosphokinase(CPK), aldolase and rheumatoid factor was done and X-ray of cervical spine and both shoulders was taken from all subjects and nerve conduction velocity test was done on 57 subjects with suspected nerve entrapment cases. Cumulative trauma disorders were categorized into 3 category according to work-relatedness of the disorders. On ergonomic evaluation of the working posture and work environment, improvement of work posture revealed inappropriate postures and devices. Mean age of the subjects were 39 years old and more than 80% graduated high school or above. Ninety-eight percent of the workers employed in the company for more than 15 years and 74.6% of the workers worked at the VDT job for more than 4 years. Mean daily work hours was 8.0 hours per day and mean break hours was 90.5 minutes per day with mean extra work hours of 10.7 hours per month. Mean daily calls were 1128.6 calls in maximum and 864.8 calls in minimum. On laboratory examination, 13 (5.0%) workers had abnormal AST, 53(20.4%) had abnormal CPK, and 1 (0.4%) had abnormal aldolase level. On x-ray examination of cervical spine, 111 (42.7%) had loss of or reversed normal cervical lordosis, 10(3.8%) had narrowing of intervertebral space. Nerve conduction velocity test was abnormal in 11 (19.2%) among 57 workers. Among disorders categorized as work-related, 131 (50.4%) were diagnosed to have fatigue myalgia of levator scapulae, 108 (41.5%) had cervical strain or sprain, 47 (18.1%) had fatigue arthralgia of phalangeal joints, and 47 (18.1%) had probable carpal tunnel syndrome, in 10 (3.8%) of those diagnosis was confirmed electrophysiologically. Age, seniority, work duration at present job, workload nor location of facilities were associated with the prevalence of symptoms nor specific diagnoses on simple statistical analysis and multiple logistic regression, which deems to be due to highly selected and homogeneous characteristics of the study subjects. Above results shows that cumulative trauma disorders are very prevalent among directory assistance operators and elaborate effort is needed to reduce the cumulative trauma disorders among the operators.
Adult ; Animals ; Arthralgia ; Aspartic Acid ; Carpal Tunnel Syndrome ; Creatinine ; Cumulative Trauma Disorders* ; Diagnosis ; Fatigue ; Female ; Fructose-Bisphosphate Aldolase ; Humans ; Joints ; Logistic Models ; Lordosis ; Myalgia ; Nerve Compression Syndromes ; Neural Conduction ; Physicians, Family ; Posture ; Prevalence ; Questionnaires ; Rheumatoid Factor ; Shoulder ; Spine ; Sprains and Strains ; Superficial Back Muscles ; Telecommunications ; Telephone*

BACKGROUND AND OBJECTIVES: Although increasing evidence has indicated that radial access is a beneficial technique, few studies have focused on Korean subjects. The aim of this study was to evaluate current practice of coronary angiography (CAG) and percutaneous coronary intervention (PCI) using radial access in South Korea. SUBJECTS AND METHODS: A total of 6338 subjects were analyzed from Korean Transradial Intervention prospective registry that was conducted at 20 centers in Korea. After evaluating the initial access, subjects intended for radial access were assessed for their baseline, procedure-related, and complication data. Subjects were categorized into three groups: group of overall subjects (n=5554); group of subjects who underwent PCI (n=1780); and group of subjects who underwent primary percutaneous coronary intervention (PPCI) (n=167). RESULTS: The rate of radial artery as an initial access and the rate of access site crossover was 87.6% and 4.4%, respectively, in overall subjects. Those rates were 82.4% and 8.1%, respectively, in subjects who underwent PCI, and 60.1% and 4.8%, respectively, in subjects who underwent PPCI. For subjects who underwent CAG, a 6-F introducer sheath and a 5-F angiographic catheter was the most commonly used. During PCI, a 6-F introducer sheath (90.6%) and a 6-F guiding catheter were standardly used. CONCLUSION: The large prospective registry allowed us to present the current practice of CAG and PCI using radial access. These data provides evidence to achieve consensus on radial access in CAG and PCI in the Korean population.
Catheters ; Consensus ; Coronary Angiography* ; Korea ; Percutaneous Coronary Intervention ; Prospective Studies* ; Radial Artery ; Registries

BACKGROUND: There are very few cohort studies on the hypertension in family practice. In order to investigate epidemiological characteristics of hypertensive patients and assess the safety and tolerability of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out. METHODS: A total of 1,181 patients were observed from July 1997 to August 1999. At 2, 4, 8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment is continued and development of any adverse reactions. RESULTS: Calcium channel blockers(CCBs) were the most commonly prescribed initial drug class (44.2%) in family practice, followed by angiotensin converting enzyme inhibitors(ACEI)(21.0%), angiotensin II receptor antagonists(ARA)(11.8%), beta blockers(9.6%), alpa blockers(3.9%), and diuretics(3.6%). During the first 12 weeks, the percentage of subjects continuing their initial ACEIs(40.7%) was substantially lower than the percentages that of subjects continuing ARAs(66.2%), alpa blockers(63.0%), CCBs(61.3%), beta blockers(55.8%), and diuretics(53.5%), respectively(P<0.01). The following adverse reactions were detected: cough(7.5%), headache(6.1%), dizziness(3.9%), flushing(3.7%) and impotence(2.4%). The incidence of cough associated with ACEI(27.9%) was higher than those of other classes(P<0.01). CONCLUSION: CCBs were the most commonly prescribed initial drug class in family practice, followed by ACEIs, ARAs, beta blockers, alpa blockers, and diuretics. The tolerability of antihypertensive medication was the highest in Korean patients treated with ARAs, followed by CCBs, beta blockers, diuretics, alpa blockers, and ACEIs.
Calcium Channels ; Cohort Studies ; Cough ; Diuretics ; Family Practice* ; Humans ; Hypertension ; Incidence ; Peptidyl-Dipeptidase A ; Prospective Studies* ; Receptors, Angiotensin

BACKGROUND: Combined therapy with alendronate and calcitriol may have additive effects on bone density. An observational study was performed to evaluate the efficacy and safety of Maxmarvil, a combinative agent of alendronate (5 mg) and calcitriol (0.5 microg), and to identify factors associated with efficacy. METHODS: A total of 568 postmenopausal women with osteoporosis were enrolled by family physicians in 12 hospitals. The study subjects took Maxmarvil daily for 12 months. Questionnaires about baseline characteristics, socioeconomic status, and daily calcium intake were completed at the first visit. Adverse events were recorded every 3 months and bone mineral density (BMD) in the lumbar spine was measured using dual-energy X-ray absorptiometry at baseline and after 12 months. We evaluated the efficacy and safety of Maxmarvil, and the factors related to BMD improvement. RESULTS: A total of 370 patients were included in final analysis. The median BMD was 0.81 +/- 0.12 g/cm2 at pre-treatment and 0.84 +/- 0.13 g/cm2 after one year. The average BMD improvement was 3.4% +/- 6.4% (P < 0.05), and 167 (45.1%) patients showed improvement. Factors associated with improved BMD were continuation of treatment (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.15 to 5.07) and good compliance (OR, 2.54; 95% CI, 1.29 to 5.00). Adverse events were reported by 35 of the 568 patients, with the most common being abdominal pain and dyspepsia. CONCLUSION: Maxmarvil was found to be safe, well tolerated and effective in osteoporosis treatment. Continuation of treatment and good compliance were the factors associated with efficacy.
Abdominal Pain ; Absorptiometry, Photon ; Alendronate ; Bone Density ; Calcitriol ; Calcium ; Compliance ; Drug Combinations ; Female ; Humans ; Osteoporosis ; Osteoporosis, Postmenopausal ; Physicians, Family ; Social Class ; Spine ; Surveys and Questionnaires

OBJECTIVES: We evaluated the health effects of exposure to BTEX (Benzene, Toluene, Ethylbenzene, m,p-Xylene, o-Xylene) in the Taean area after the Hebei Spirit oil spill. METHODS: We used a questionnaire survey to look for health effects among 80 pregnant women 2 to 3 months following the Hebei Spirit oil spill. Their BTEX exposures were estimated using the CALPUFF method. We then used a multiple logistic regression analysis to evaluate the effects of BTEX exposure on the women's health effets. RESULTS: Pregnant women who lived near the accident site reported more symptoms of eye irritation and headache than those who lived farther from the site. There was a trend of decreasing symptoms with an increase in distance from the spill site. Pregnant women exposed to higher ambient cumulative levels of Xylene were significantly more likely to report symptoms of the skin (OR 8.01 95% CI=1.74-36.76) in the first day after the accident and significantly more likely to report abdominal pain (OR 3.86 95% CI=1.02-14.59 for Ethylbenzene, OR 6.70 95% CI=1.82-24.62 for Xylene) during the 1st through 4th days following the accident. CONCLUSIONS: This study suggests that exposure to BTEX from an oil spill is correlated with an increased risk of health effects among pregnant women. This implies the need to take proper measures, including the development of a national policy for environmental health emergencies and a plan for studying the short- and long-term chronic health effects associated with such spills.
Adult ; Benzene/*adverse effects/analysis ; Benzene Derivatives/*adverse effects/analysis ; *Disasters ; *Environmental Exposure ; Environmental Pollutants/*adverse effects/analysis ; Eye Diseases/chemically induced/epidemiology ; Female ; Health Surveys ; Humans ; *Petroleum ; Pregnancy ; Questionnaires ; Respiratory Tract Diseases/chemically induced/epidemiology ; Risk Factors ; Skin Diseases/chemically induced/epidemiology ; Time Factors ; Toluene/analysis ; *Women's Health ; Xylenes/analysis