Ticlopidine is a powerful inhibitor of platelet aggregation which is induced by adenosine diphosphate. Ticlopidine has been shown to be effective in reducing combined stroke, myocardial infarction, reocclusion of coronary stent. The principal side effects of ticlopidine are severe neutropenia, rash and gastrointestinal upset. Recently, we experienced two cases of severe neutropenia associated with ticlopidine. One was administered ticlopidine to prevent subacute thrombosis after intracoronary stent implantation in unstable angina pectoris. Thirty days of therapy, her absolute neutrophil count (ANC) had dropped to 14/mm3 . The other patient was presented with recurrent episodes of cerebral infarction, for which he had undergone right carotid angiogram. The carotid angiogram demonstrated tight stenosis of right internal carotid artery. Carotid artery stenting was performed at right internal carotid artery without any complications. Twenty seven days of ticlopidine therapy, his ANC had dropped to 111/mm3. The ticlopidine was stopped, and they were given granulocyte-colony stim-ulating factor 250 microgram/day subcutaneous injection until their ANC was up to 1000/mm3. They were discharged with normal neutrophil count and no other complications.
Adenosine Diphosphate ; Angina, Unstable ; Carotid Arteries ; Carotid Artery, Internal ; Cerebral Infarction ; Constriction, Pathologic ; Exanthema ; Granulocyte Colony-Stimulating Factor ; Humans ; Injections, Subcutaneous ; Myocardial Infarction ; Neutropenia* ; Neutrophils ; Platelet Aggregation ; Stents ; Stroke ; Thrombosis ; Ticlopidine*

No abstract available.
Surgery, Oral* ; Transplants* ; Veins*

This study was conducted to evaluate the effect of VDT work on eyes and vision among workers in a TV manufacturing plant. The study subjects consisted of 264 screen workers and 74 non-screen workers who were less than 40 years old male and had no history of opthalmic diseases such as corneal opacities, trauma, keratitis, etc and whose visual acuity on pre-employment health examination by Han's test chart was 1.0 or above. The screen workers were divided into two groups by actual time for screen work in a day; Group 1, 60 workers, lesser than 4 hours a day and group 11, 204 workers, more than 4 hours a day. From July to October 1992 a questionnaire was administered to all the study subjects for the general charateristics and subjective eye symptoms after which the opthalmologic tests such as visual acuity, spherical equivalent, lacrimal function, ocular pressure, slit lamp test, fundoscopy were conducted by one opthalmologist. The proportion of workers whose present visual acuity was decreased more than 0. 15 in comparison with that on the pre-employment health examination by Han's test chart was 20.6% in Group Ii, 15.0% in Group I and 14.9% in non-screen workers. However, the differences in proportion were not statistically significant. The proportion of workers with decreased visual acuity was not associated with the age, working duration, use of magnifying glass and type of shift work (independent variables) in all of the three groups. However, screen workers working under poor illumination had a higher proportion of persons with decreased visual acuity than those working under adequate illumination (P<0.05). The proportion of workers whose near vision was decreased was 27.5% in Group II, 18.3% in Group I, and 28.4% in non-screen workers and these differences in proportion were not statistically significant. Changes of near vision were not associated with 4 independent variables in all of the three groups. Six out of sever-subjective eye symptoms except tearing were more common in Group I than in non-screen workers and more common in Group II than in Group I (P<0.01). Mean of the total scores for seven subjective symptoms of each worker (2 points for always, 1 point for sometimes, 0 point for never) was not significantly different between workers with decreased visual acuity and workers with no vision change. However, mean of the total scores for Group II was higher than those for the Group I and non-screen workers (P < 0. 01). Total eye symptom scores were significantly correlated with the grade of screen work, use of magnifying glass, and type of shift work. There was no independent variable which was correlated with the difference in visual acuity between the pre-employment health examination and the present state, the difference between far and near visions, lacrimal function, ocular pressure, and spherical equivalent. Multiple linear regression analysis for the subjective eye symptom scores revealed a positive linear relationship with actual time for screen work and shift work(P<0.01). In this study it was not observed that the VDT work decreased visual acuity but it induces subjective eye symptoms such as eye fatigue, blurred vision, ocular discomfort, etc. Maintenance of adequate illumination in the, work place and control of excessive VDT work are recommended to prevent such eye symptoms.
Adult ; Asthenopia ; Corneal Opacity ; Glass ; Humans ; Keratitis ; Lighting ; Linear Models ; Male ; Plants* ; Surveys and Questionnaires ; Tears ; Vision, Ocular ; Visual Acuity ; Workplace

Juvenile dermatomyositis is an uncommon autoimmune disease with classic heliotrope discoloration of eyelids, erythematous skin rash of joints and proximal muscle weakness. Quite different from adults, malignancy is rarely accompanied in juvenile dermatomyositis. However vasculitis, muscle atrophy, calcification and gastrointestinal involvement are often observed in juvenile dermatomyositis. A six year old boy was admitted with chief complaints of general weakness and skin rash. Muscle biopsy was performed which was consistent with dermatomyositis. The patient was treated with intravenous immunoglobulin, steroid, methotrexate and physiotherapy. We report a case of juvenile dermatomyositis.
Adult ; Autoimmune Diseases ; Biopsy ; Dermatomyositis* ; Exanthema ; Eyelids ; Humans ; Immunoglobulins ; Joints ; Male ; Methotrexate ; Muscle Weakness ; Muscular Atrophy ; Vasculitis

Maxillary anterior teeth were intruded and lingually root torqued with two maxillary anterior microimplants between the lateral incisors and canines. Overerupted maxillary canines were intruded with two other microimplants between the maxillary canines and first premolars. Maxillary posterior teeth and canines were distalized, then the maxillary incisors were retracted with two maxillary posterior microimplants between the first and second molars. The mandibular anterior teeth were intruded and the mandibular posterior teeth were extruded with conventional method such as anterior bite plane, intrusion arch and Class II elastics. The mandible moved slightly forward after the correction of deep bite and retroclination of the upper incisors. Consequently, microimplant anchorage (MIA) provided absolute anchorage for simultaneous correction of Class II canine and molar relationships and deep overbite.
Adult* ; Bicuspid ; Humans ; Incisor ; Mandible ; Molar ; Overbite ; Tooth

The present study was carried out to evaluate the correlation of metastasis and prognostic factors in squamous cell carcinoma of head and neck. Examination was performed on a series of thirty-seven patients who were confirmed to squamous cell carcinoma and its lymphatic metastasis by pathologist. Correlations of metastasis and other factors such as angiogenesis, histologic grading, and p53 expression and ras oncogene were studied. The depth of tumors was around 1 to 27mm. Twenty cases were more than 10mm deep, of which seventeen cases were shown lymphatic metastasis. Total score of histologic grading including keratinization, nuclear atypia, growth pattern and intensity of inflammation was ranged from 5 to 10 points. Of these factors, nuclear atypia with intensity of inflammation, and nuclear atypia with growth pattern was correlated with nuclear atypia each. For angiogenesis, number of new-formed vessels were counted 13 to 58 each. Twenty-eight cases were shown to lymphatic metastasis. No correlation with histologic grading and lymphatic metastasis was found. The results of immunohistochemical staining for p53 and ras oncogene revealed that positive cases were 16 and 22, negative for 21 and 15 each. However, both were not correlated with histologic grading and lymphatic metastasis. These results were revealed that angiogenesis was not correlated with lymphatic metastasis of squamous cell carcinoma arising in head and neck. Nuclear atypia with intensity of inflammation and dysplasia with growth pattern were correlated with histologic grading, which suggested that more careful and adequate advice is needed for effective treatment.
Carcinoma, Squamous Cell* ; Genes, ras ; Head* ; Humans ; Inflammation ; Lymphatic Metastasis ; Neck* ; Neoplasm Metastasis*

PURPOSE: The purpose of this study was to evaluate the risks of undergoing intramedullary nailing with minimum surgical optimization (fast-track) for geriatric trochanter fracture due to fall from a standing height. MATERIALS AND METHODS: From May 2006 to August 2013, 48 fractures were enrolled in fast-track, and were an average age of patients was 77.6 years (range, 62-97 years). They underwent primary testing for anesthesia, including basic body fluid test, arterial blood, electrocardiography, and chest radiographs. The time from visit to surgery was 28.9 hours (range, 1-96 hours). RESULTS: During hospitalization, there was one case of stress-induced cardiac arrest; however, other complications, infection, and 30-day mortality did not occur. According to preoperative classic test, the average albumin was 3.45 g/dl, blood sugar, 169 mg/dl, blood urea nitrogen, 20.5 mg/dl, Cr, 1.5 mg/dl, Na, 135.3 mEq/L, and K, 4.21 mEq/L. The average PaCO2 of arterial blood was 37.6 mmHg. CONCLUSION: We found that the fast-track for trochanteric fracture due to slip-down was relatively safe, and could be considered as a therapeutic approach.
Aged* ; Anesthesia ; Blood Glucose ; Blood Urea Nitrogen ; Body Fluids ; Electrocardiography ; Femur* ; Fracture Fixation, Intramedullary ; Heart Arrest ; Hospitalization ; Humans ; Mortality ; Osteoporotic Fractures ; Prospective Studies* ; Radiography, Thoracic

BACKGROUND: The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. MATERIALS AND METHODS: An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. RESULTS: The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. CONCLUSION: Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.
Back Injuries ; Diet ; Epidemiologic Studies* ; Female ; Hospital Departments ; Hospitals, General* ; Humans ; Lifting ; Low Back Pain* ; Surveys and Questionnaires ; Risk Factors

OBJECTIVE: This study was conducted to investigate the presence and pattern of Hyrtl anastomosis, and to examine the effect that each type has on obstetrical outcome. METHODS: This study was carried out from January of 2001 to May of 2003 on 904 randomly selected patients who had given birth by Cesarean section or vaginal delivery at Catholic University Holy Family Hospital. Immediately proceeding delivery, barium sulfate was infused into the umbilical artery. This was followed by umbilical artery dissection to grossly confirm Hyrtl anastomosis. In order to evaluate the effect that each type of anastomosis has on obstetrical outcome, we retrospectively examined chart for birth weight, Apgar score, results of cord blood gas analysis, obstetrical complications, etc. RESULTS: Out of the 904 cases studied, 99.7% possessed Hyrt's anastomosis with frequency according to type as follows: 50.8% oblique, 48.0% transverse, 1.8% of anastomosis between one umbilical artery and the branch of the other, 1.6% of fusion of branches of each umbilical artery, 0.6% of anastomosis represented by two separate vessels between umbilical arteries, 0.1% of anastomosis between branches of each umbilical artery, 0.1% lacking anastomosis, and 0.2% of a single umbilical artery. In terms of obstetrical outcome, there was no significant difference for term and preterm infants in the frequency of type of Hyrtl's anastomosis according to birth weight, maternal age, Apgar score, obstetrical complications, etc. CONCLUSION: In an attempt to verify the presence and type of Hyrtl anastomosis, 8 types of Hyrtl's anastomosis were found, of which the oblique and transverse variety were the most common. There was no significant difference in the types of Hyrtl's anastomosis in relation to obstetrical outcome. Frequency was also similar with oblique and transverse types being the most common. Further studies detailing anatomical features of and blood flow/volume through the anastomosis are required in order to better understand the effects of Hyrtl's anastomosis on obstetrical outcome.
Apgar Score ; Barium Sulfate ; Birth Weight ; Cesarean Section ; Female ; Fetal Blood ; Humans ; Infant, Newborn ; Infant, Premature ; Maternal Age ; Parturition ; Pregnancy ; Retrospective Studies ; Single Umbilical Artery ; Umbilical Arteries

OBJECTIVE: It is controversial whether routine or selective iron supplementation during gestation is needed. The aim of this study is to evaluate whether screening with serum ferritin during the first trimester of pregnancy could be identify women who need prophylactic iron supplementation. METHODS: According to the serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy and the presence of iron supplementation during gestation, the subject was divided into 4 group that were as follows: serum ferritin level of 30 microgram/L and iron- supplemented group (n=40), serum ferritin level of >30 microgram/L and non iron-supplemented group (n=15). Maternal serum ferritin, TIBC, iron, hemoglobin, hematocrit, red cell indices (MCV, MCH, MCHC, RDW) were measured before 14 weeks of gestation and after 34 weeks of gestation. RESULTS: All hematologic and biochemical markers indicated more severe anemic status in the late pregnancy than during the first trimester of pregnancy. The effect of iron supplementation was profounder on the pregnant woman whose ferritin levels were below 30 microgram/L during the first trimester of pregnancy. Regardless of iron supplementation, the group (ferritin >30 microgram/L during the first trimester of pregnancy) showed relatively higher ferritin level in late pregnancy. CONCLUSION: The screening with serum ferritin level of cut-off point of 30 microgram/L during the first trimester of pregnancy may be useful to identify women who need prophylactic iron supplementation.
Biomarkers ; Erythrocyte Indices ; Female ; Ferritins ; Hematocrit ; Humans ; Iron* ; Mass Screening ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women