PURPOSE: The advent of laparoscopic abdominal surgery made it possible to perform a laparoscopic adrenalectomy (LA). We have successfully performed 10 such operations since November 21, 1995. We retrospectively compared the effectiveness and the safety of a laparoscopic adrenalectomy with the effectiveness and the safety of an open adrenalectomy (OA). METHODS: The 45 patients with adrenal diseases who underwent an adrenalectomy from March 1990 to January 1998 were included in this study. Ten (10) laparoscopic cases comprised the study group, and 17 of the 32 open adrenalectomy cases, performed by anterior approach, comprised the control group. RESULTS: No one died from an adrenalectomy. Nine cases (45%) from the OA group needed transfusions (average: 661 ml), but one patient from the LA group, who had required a conversion to a celiotomy, required a transfusion (400 ml). The operating times were, on average, 191 minutes in the OA group and 230 minutes in the LA group (p=0.0384). The average size of the masses was 6.5 cm. The first days of walking after the operation was 3.4 days for the OA group and 1.3 days for the LA group (p=0.0002). The patients' former regular diets were started on days 6.9 and 3.2 for the OA and LA groups, respectively (p=0.0001). Postoperative in-hospital days were 17.5 for the OA group and 7.9 for the LA group (p=0.0001). CONCLUSION: In comparison with an open adrenalectomy, a laparoscopic adrenalectomy showed better convalescent features: that is, less chance of transfusion, earlier recovery, faster resumption of the former diet, shorter postoperative hospital stays, and cosmesis. We think and suggest that a laparoscopic adrenalectomy is a safe and effective procedure, and hopefully it will become the standard choice of operation for various adrenal diseases.
Adrenalectomy* ; Diet ; Humans ; Laparoscopy ; Length of Stay ; Retrospective Studies ; Walking

PURPOSE: The advent of laparoscopic abdominal surgery made it possible to perform a laparoscopic adrenalectomy (LA). We have successfully performed 10 such operations since November 21, 1995. We retrospectively compared the effectiveness and the safety of a laparoscopic adrenalectomy with the effectiveness and the safety of an open adrenalectomy (OA). METHODS: The 45 patients with adrenal diseases who underwent an adrenalectomy from March 1990 to January 1998 were included in this study. Ten (10) laparoscopic cases comprised the study group, and 17 of the 32 open adrenalectomy cases, performed by anterior approach, comprised the control group. RESULTS: No one died from an adrenalectomy. Nine cases (45%) from the OA group needed transfusions (average: 661 ml), but one patient from the LA group, who had required a conversion to a celiotomy, required a transfusion (400 ml). The operating times were, on average, 191 minutes in the OA group and 230 minutes in the LA group (p=0.0384). The average size of the masses was 6.5 cm. The first days of walking after the operation was 3.4 days for the OA group and 1.3 days for the LA group (p=0.0002). The patients' former regular diets were started on days 6.9 and 3.2 for the OA and LA groups, respectively (p=0.0001). Postoperative in-hospital days were 17.5 for the OA group and 7.9 for the LA group (p=0.0001). CONCLUSION: In comparison with an open adrenalectomy, a laparoscopic adrenalectomy showed better convalescent features: that is, less chance of transfusion, earlier recovery, faster resumption of the former diet, shorter postoperative hospital stays, and cosmesis. We think and suggest that a laparoscopic adrenalectomy is a safe and effective procedure, and hopefully it will become the standard choice of operation for various adrenal diseases.
Adrenalectomy* ; Diet ; Humans ; Laparoscopy ; Length of Stay ; Retrospective Studies ; Walking

OBJECTIVES: The purpose of this study was to evaluate the factors which affect pulmonary function in shipyard workers in order to build a body of basic information that can be used to prevent and manage pulmonary disorders in the future. METHODS: We studied the respiratory symptoms, smoking history, chest radiographies, and pulmonary functions of 793 workers associated with two shipyards from April 2009 to July 2009. The workers were subdivided into 3 groups by job type: welders, grinders, and machinist-managers. The data was analyzed according to job type and other possible impact factors. RESULTS: Significant differences among job type were seen with dyspnea and coughing during working hours and in the morning. In pulmonary functions, there were significant differences in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF) (except FEV1/FVC%) among job types. Grinders especially showed significantly lower figures in the indices of FEV1, FVC, and MMEF. CONCLUSIONS: Pulmonary function was significantly lower in grinders. Grinders seem to be affected by exposure to a combination of dust particles (silica, lead, and manganese) and irritant gases in the workplace. These results suggested that workers and health officials should work together to adopt technical preventive measures, such as having well- ventilated work areas and appropriate respiratory protective devices.
Cough ; Dust ; Dyspnea ; Forced Expiratory Volume ; Gases ; Respiratory Function Tests ; Respiratory Protective Devices ; Smoke ; Smoking ; Thorax ; Vital Capacity ; Welding

BACKGROUND AND OBJECTIVES: Increased QT dispersion (QTD) in patients with acute myocardial infarction (AMI) may be related with such adverse events as sudden cardiac death and ischemic heart failure. SUBJECTS AND METHODS: Two hundred eight patients (age : 62+/-10.4 years, 158 males), underwent diagnostic coronary angiography under the diagnosis of AMI between January and December 2001 at the Heart Center of Chonnam National University Hospital, and these patients were enrolled to evaluate the relationship between the QTD and myocardial injury and the complex coronary arterial lesion. RESULTS: A QTD of over 80 ms was observed in 89 patients (42.7%). There were in 61 patients with ST elevation myocardial infarction (STEMI, 68.5%) and 28 patients with non-ST elevation myocardial infarction (NSTEMI, 31.5%). There was no correlation between the QTD and such risk factors as hypertension, diabetes, gender, smoking, hyperlipidemia and family history. The level of CK-MB on admission was correlated with the QTD (112.5+/-98.1 U/L in the group with a QTD over 80 ms and 72.6+/-73.4 U/L in the group with a QTD under 80 ms, p<0.05). The ejection fraction measured by two dimensional echocardiography on admission showed correlation with the QTD (50.9+/-11.4% in the group with a QTD over 80 ms and 54.7+/-11.2% U/L in the group with a QTD under 80 ms, p<0.05). For the coronary angiographic findings, the lesion type, according to American College of Cardiology/American Heart Association classification, correlated with the QT dispersion (type B2 or C : 64.1% in the group with a QTD over 80 ms, 49.6% in the group with a QTD under 80 ms, p<0.05) CONCLUSION: There was significant correlation between the prolonged QTD and the severity of myocardial injury at admission, and the complex coronary arterial lesion in patients with AMI.
Classification ; Coronary Angiography ; Coronary Vessels* ; Death, Sudden, Cardiac ; Diagnosis ; Echocardiography ; Electrocardiography ; Heart ; Heart Failure ; Humans ; Hyperlipidemias ; Hypertension ; Jeollanam-do ; Myocardial Infarction* ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Cardiogenic shock (CS) after acute myocardial infarction (AMI) develops in 5~10% of patients and it is associated with high mortality. The aim of this study is to assess the predictive factors of mortality for patients with AMI and CS. METHODS: Two hundred fifty five AMI patients with CS (the mean age was 66.0 +/- 11.0 years, M: F=156: 99) out of 1, 268 AMI patients who admitted at Chonnam National University Hospital between July 2000 and June 2002 were analyzed according to the clinical characteristics, coronary angiographic findings and MACE during admission and for the 1-year clinical follow-up. RESULTS: Among the enrolled patients, 129 patients survived without MACE (Group I, mean age 64.2 +/- 10.6 years, M: F=76: 53), and 126 patients had MACE (Group II, mean age 68.1 +/- 10.0 years, M: F=80: 46) during admission or during the 1-year follow-up period. There were significant differences in age between the Groups I and II (64.2 +/- 10.6 vs. 68.1 +/- 11.0 years, respectively, p=0.004) and the previous MI history (0 vs. 17.4%, respectively, p< 0.001). The left ventricular ejection fraction (EF) was lower in Group II (Group I vs. II: 49.1 +/- 13.0 vs. 39.1 +/- 12.9%, p< 0.001). The levels of troponin (Tn) I and C-reactive protein (CRP) were higher in Group II (Group I vs. II: 29.2 +/- 7.72 vs. 50.8 +/- 5.17 ng/dL, p=0.017, 3.8 +/- 0.48 vs. 9.9 +/- 1.21 mg/dL, p< 0.001 respectively). Left main stem lesion (LMSL) was more common in Group II than in Group I (0.7% vs. 22.0%, respectively, p=0.004). In-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization. CONCLUSION: Old age, a previous MI history, high Tn and CRP, low EF and LMSL are associated with higher MACE for patients with AMI and CS. Coronary revascularization with TIMI 3 flow lowers the in-hospital mortality.
Aged ; Female ; Hospital Mortality ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Myocardial Infarction/complications/*mortality ; Prognosis ; Shock, Cardiogenic/etiology/*mortality

OBJECTIVES: This research aimed to know the actual condition and problems of medical information protection at a workplace with the target of industrial health care managers of small and medium-sized enterprises. METHODS: A self-administered questionnaire was given to industrial health-care managers of 216 enterprises from March 15 to May 17, 2010. The questionnaire was produced by referring to the Act on Personal Information Protection of Public Institutions, etc. This research evaluated agreement of cognition and practice according to 10 items of medical information protection using kappa and cross-analysis of significant factors between cognition and practice of medical information protection and general characteristics. RESULTS: Cognition about medical information protection appeared to be 85.4-97.1% and its practice appeared to be 44.1-95.3%, so practice was lower than cognition. In addition, the agreement of cognition and practice appeared significantly low (kappa 0.082-0.387). The practice of medical information protection tended to be lower when the managers were older and held a higher job title. Health examination results were being delivered only to workers except for an employer (94.2%), but there were many industrial health-care managers who felt discomfort about their work in group occupational health-care systems (58.1%). CONCLUSIONS: The practice of protecting medical information by industrial health-care managers was clearly lower than the cognition. Therefore, introduction of educational programs about personal information protection and provision of an independent place for group occupational health care service is urgent. In addition, in order to use the health examination results conveniently in group occupational health services, an institutional complement is necessary.
Cognition ; Complement System Proteins ; Computer Security ; Delivery of Health Care ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Occupational Health ; Occupational Health Services ; Ophthalmoplegia ; Questionnaires

OBJECTIVES: Exposure to second-hand smoke varied by smoking rate in the workplace and no-smoking policies. The purpose of this study was to estimate the status of second-hand smoke exposure by occupation through urine cotinine analysis in Busan, Ulsan, and Kyeongnam provinces. METHODS: Data was obtained from the National Institute of Environmental Research of Korea as 'The 2008 Korea National Survey for Environmental Pollutants in Human Body'. We selected 629 non-smokers who lived in Busan, Ulsan and Gyeongnam provinces. General and occupational characteristics were gathered using a structured questionnaire. Urine cotinine concentrations were analyzed by a gas chromatograph-mass selective detector. Statistical analysis was carried out using the Chi-square test, Student t-test and ANOVA. RESULTS: The geometric mean (geometric standard deviation) of urine cotinine concentration was 17.11 (2.74) ng/ml. The urine cotinine concentration of the middle school graduate group (18.47 (2.86) ng/ml) was higher than the college graduate group (15.64 (2.60) ng/ml, p=0.212). Also, the cotinine concentration of current drinkers (18.98 (2.47) ng/ml) was higher than non-drinkers (16.15 (2.88) ng/ml, p=0.054). The proportion who smelled smoke was higher in workers (38.5%) than in non-workers (29.7%, p=0.02). Therefore, urine cotinine concentration was higher in workers (17.29 (2.66) ng/ml) than in non-workers (16.97 (2.81) ng/ml) but not at a statistically significant amount (p=0.826). In addition, cotinine concentration between the group who smelled smoke (20.45 (2.42) ng/ml) and the group who did not smelled smoke (15.53 (2.78) ng/ml) was significantly different (p=0.016) in workers but not in non-workers (17.08 (2.42) ng/ml vs 16.92 (2.98) ng/ml, p=0.942). According to the National Center for Health Statistics occupational categories in the US and the Korea Standard Classification of Occupations, the urine cotinine concentration of white collar workers such as technical workers and administrators, professional specialists, and managers was higher (18.01 (2.55) ng/ml) than that of blue collar workers such as plant and machine operators and assemblers, elementary occupations, and craft and related trades workers (15.36 (3.48) ng/ml). CONCLUSIONS: The workplace is an important contributor to second-hand smoke exposure in Busan, Ulsan and Kyeongnam provinces. Unlike in advanced countries, where anti-smoking policies have been implemented, urine cotinine concentration in people in Busan, Ulsan and Kyeongnam provinces was higher in the white collar group than in the blue collar group. This result might be due to a higher indoor second-hand smoking rate of workplaces in these areas. Further studies are needed to evaluate the correlation between regional characteristics of industries, anti-smoking policies in the workplace, smoking rates and urine cotinine concentrations of workers.
Administrative Personnel ; Cotinine ; Environmental Pollutants ; Humans ; Korea ; National Center for Health Statistics (U.S.) ; Occupations ; Plants ; Questionnaires ; Smell ; Smoke ; Smoking ; Specialization

BACKGROUND: Cardiogenic shock (CS) after acute myocardial infarction (AMI) is developed in 5~10% of patients and associated with high mortality. The aim of this study is to assess the predictive factors of major adverse cardiac events (MACE) in patients with AMI and CS. METHODS: Two hundred fifty five AMI patients with CS (66.0 +/- 11.0 years, M:F=156:99) out of 1,268 AMI patients, who admitted at Chonnam National University Hospital between July 2000 and June 2002, were analyzed according to clinical characteristics, coronary angiographic findings and MACE during admission and 1-year clinical follow-up. RESULTS: Among the enrolled patients, 129 patients survived without MACE (Group I, 64.2 +/- 10.6 years, M:F=76:53) and 126 patients had MACE (Group II, 68.1 +/- 10.0 years, M:F=80:46) during admission and 1-year follow-up period. There were significant differences in age (64.2 +/- 10.6 vs. 68.1 +/- 11.0 years, p=0.004) and previous MI history (0 vs. 17.4%, p<0.001). Left ventricular ejection fraction (EF) was lower in Group II (Group I vs. II: 49.1 +/- 13.0 vs. 39.1 +/- 12.9%, p<0.001). The levels of troponin (Tn) I and C-reactive protein (CRP) were higher in Group II (Group I vs. II: 29.2 +/- 7.72 vs. 50.8 +/- 5.17 ng/dL, p=0.017, 3.8 +/- 0.48 vs. 9.9 +/- 1.21 mg/dL, p<0.001 respectively). Left main stem lesion (LMSL) was more common in Group II than in Group I (0.7% vs. 22.0%, p=0.004). In-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization. CONCLUSION: Old age, previous MI history, high Tn and CRP, low EF and LMSL are associated with higher MACE in patients with AMI and CS. Coronary revascularization with TIMI 3 flow lowers in-hospital mortality.
C-Reactive Protein ; Coronary Disease ; Follow-Up Studies ; Hospital Mortality ; Humans ; Jeollanam-do ; Mortality ; Myocardial Infarction* ; Prognosis ; Shock ; Shock, Cardiogenic* ; Stroke Volume ; Troponin