No abstract available.
Pulmonary Artery*

This study was conducted to evaluate the health hazards and to develop diagnostic methods of glass fiber workers. We examined 40 male glass fiber workers (exposure group) and 57 male non-glass fiber workers (reference group) with a questionnaire, physical examination, chest x-ray and pathological examination in Mar, 1997. Also we examined 65 male glass fiber workers (exposure group) and 42 male non-glass fiber workers (reference group) with the same methods also we did some energy-dispersive x-ray analyses with a scanning electron microscopic examination in Sep. 1997. Most of the clinical symptoms were significantly more frequent among the exposure group than the reference group. Coughing (32.5%), itching of the nose (30.0%), irritation of eyes (27.5%), irritation of the nose (25.0%) and sputum (22.5%) were the major symptoms among the exposure group in Mar. 1997. Only itching of the nose was significantly more frequent in Sep. 1997. No cases of pneumoconiosis were observed among the groups and there were no differences in chest abnormalities between the exposure group with the reference group on both examinations. The prevalence of dermatosis among the exposure group was 20.0% (8 cases) and the cumulative prevalence was 72.5% (29 cases) in Mar. 1997. The prevalence of dermatosis among the exposure group was 23.1% (15 cases) and the cumulative prevalence was 58.5% (38 cases) in Sep. 1997. Onset of dermatosis among the exposure group was most frequent within one month after handling. The frequent sites of skin lesions were the hands and arms on both examinations. Glass fiber induced skin lesions can be diagnosed by the scotch tape method or KOH mount and then can be examined under the light, polarizing and phase-contrast microcopies. Glass fibers can be identified by some energy-dispersive x-ray analyses with a scanning electron microscopic examination.
Arm ; Cough ; Glass* ; Hand ; Humans ; Male ; Nose ; Physical Examination ; Pneumoconiosis ; Prevalence ; Pruritus ; Questionnaires ; Skin ; Skin Diseases ; Sputum ; Thorax

OBJECTIVES: The aim of this study is to find out the effect of ApoE genotype on correlation between head circumference and cognition of the elderly in the community. METHODS: A total of 1,152 subjects (380 men and 772 women) aged 60-91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history and K-MMSE (Korean version-Mini Mental State Examination). We also measured the head circumference and examined ApoE genotype. RESULTS: On regression analysis, as head circumference becomes smaller, K-MMSE scores decreased adjusted by age, sex, educational level, ApoE epsilon4 allele, current smoking and alcohol drinking status (beta=0.15, p=0.04). Only in the lowest quartile group, presence of ApoE epsilon4 allele reduced K-MMSE scores adjusted by age, sex, educational level, height, current alcohol drinking and smoking status (beta=-1.39, p=0.008). CONCLUSION: These results suggest that head circumference may have an influence on K-MMSE scores, and presence of ApoE epsilon4 allele may be a medicating factor.
Aged* ; Alcohol Drinking ; Alleles ; Apolipoproteins E* ; Cognition* ; Cognitive Reserve ; Dementia ; Genotype* ; Head* ; Humans ; Male ; Surveys and Questionnaires ; Smoke ; Smoking

PURPOSE: To compare functional MR imaging of the motor cortex during active and passive movement. MATERIALS AND METHODS: Seven healthy, right-handed volunteers (M:F=6:1; age:25-30 years) were included in this study. A 1.5-T whole body scanner and the multislice EPI BOLD method were used. The motor paradigm was flexion-extension of a thumb against rest. In the active motion task, the thumb was flexed voluntarily once a second, while in the passive task, it was tied with a thread and pulled to flex and extend passively at the same interval and with the same intensity as in the active task. For image postprocessing, an SPM 96 program was used. The sites, numbers, and signal intensity of the activated pixels were determined, and the threshold for significance was set at p<0.001 to p<0.01. RESULTS: In the active motion task, strong activation at the contralateral side of the primary sensorimotor cortex and supplementary motor cortex occurred in all 14 examples in all seven volunteers. Additionally, the ipsilateral primary sensorimotor cortex and supplementary motor area were activated in 12/14 and 11/14 such tasks, respectively. During passive motion tasks, on the other hand, weak activation occurred at the contralateral side of the primary sensorimotor cortex in all cases, but in the contralateral supplementary motor cortex in only three. In the ipsilateral primary sensorimotor cortex and supplementary motor area, there was no activation. CONCLUSION: Compared with the active motion task, activation occurring in the contralateral primary sensorimotor cortex and supplementary cortex was weaker and less frequent during the passive task, and during this latter, the ipsilateral motor cortex remained inactive. These results may be useful for the clinical application of functional MR imaging in unconscious patients or in animal studies.
Animals ; Hand ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex* ; Thumb ; Volunteers

We present 15 patients with progressive neurological deterioration while on medical treatment for massive cerebral or cerebellar edema due to large cerebral or cerebellar infarction. Clinical signs of uncal herniation were present in 10 of these patients. Remaining five patients showed progressive neurological deterioration accompanied with impending herniation. Brain CT confirmed mass effect from cerebral or cerebellar edema in all cases. All 15 patients were treated with decompressive craniectomy, duroplasty and/or ventriculostomy. Nine patients showed good results and six patients had poor results. As compared with poor result group, good result group had high score of Glass Gow Coma Scale(GCS) on admission(12.8 vs. 8.3 on average) and time from worsening to operation is shorter(8.8 vs. 21.3hrs on average). Infarction was all on right side and hearniation sign just before operation appeared infrequently in good result group. These results suggest that decompressive surgery can be effective life saving procedure for massive cerebral edema after large brain infarction, especially in cases with right side lesion, high GCS score on admission, and pertinent timing of operation(before occurrance of irreversible brain stem damage due to herniation).
Brain Edema ; Brain Infarction* ; Brain Stem ; Brain* ; Coma ; Decompression, Surgical* ; Decompressive Craniectomy ; Edema ; Glass ; Humans ; Infarction ; Ventriculostomy

PURPOSE: Children with acute colonic diverticulitis(ACD), can be misdiagnosed with acute appendicitis. METHODS: We reviewed 15 cases of ACD during five years, from January 1998 to June 2002 retro spectively. RESULTS: Most patients(80%) with ACD in children presented with right lower quadrant pain. The primary diagnosis on admission was mostly acute appendicitis(87%), and all ACD in children occurred in the right colon. Fourteen patients were managed by conservative treatment including antibiotics. A follow-up study was performed in 15 patients. There were symptomatic recurrences in two patients, but no significant complication was noted. The frequency of ACD was 11.7 per 1000 acute appendicitis. CONCLUSION: ACD in children can mostly be cured by conservative treatment. It is prudent to choose the management through the diagnostic work up, including abdominal sonography and computed tomography, because there was no significant difference of clinical findings between ACD and acute appendicitis.
Anti-Bacterial Agents ; Appendicitis ; Child* ; Colon* ; Diagnosis ; Diverticulitis ; Diverticulitis, Colonic* ; Follow-Up Studies ; Humans ; Recurrence

A 45-year-old woman was admitted due to severe headache and neck stiffness. She had visited a local clinic for back pain and received a lumbar nerve root steroid injection 10 days before admission. Computed tomography and magnetic resonance imaging showed psoas abscess, pneumocephalus, and subdural hygroma. She was diagnosed with psoas abscess and meningitis. The abscess and external ventricle were drained, and antibiotics were administered. Unfortunately, the patient died on hospital day 19 due to diffuse leptomeningitis. Lumbar nerve root steroid injections are commonly used to control back pain. Vigilance to "red flag signs" and a rapid diagnosis can prevent lethal outcomes produced by rare and unexpected complications related to infection. Here, we report a case of fatal meningitis after infection of the cerebrospinal fluid following a lumbar nerve root steroid injection.
Abscess ; Anti-Bacterial Agents ; Back Pain ; Cerebrospinal Fluid* ; Diagnosis ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Middle Aged ; Neck ; Pneumocephalus ; Psoas Abscess ; Subdural Effusion

BACKGROUND: Diabetes is a major health problem in Korea. However, interest in the quality of life in patients with diabetes is low. We examined the effects of diabetes on health-related quality of life (HRQoL) and compared it with HRQoL in the general Korean population using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009). METHODS: Using KNHANES IV data, we compared EuroQol (EQ)-5D and EQ-visual analogue scale (VAS) scores after adjusting for sociodemographic and psychosocial factors as well as for comorbidities (hypertension, heart disease, stroke, arthritis, and chronic renal disease). Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group. RESULTS: The mean age of the 14,441 enrolled subjects (6,129 men and 8,312 women) was 52.5+/-14.5 years. The mean EQ-5D and EQ-VAS scores were significantly lower in the diabetes group (EQ-5D. 0.87; EQ-VAS, 71.94) than in the non-diabetes group (EQ-5D, 0.94; EQ-VAS, 77.40) (P<0.001). Self-reported depressive symptom had a significant effect on lowering the EQ-VAS (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1 to 2.6) in the diabetes group. Stress level had a significant effect in lowering both the EQ-5D (OR, 2.0; 95% CI, 1.3 to 2.9) and the EQ-VAS (OR, 1.9; 95% CI, 1.3 to 2.9). HbA1c, diabetes duration, and treatment modalities had no significant effect on lowering HRQoL. CONCLUSION: Diabetes was clearly associated with impaired HRQoL compared with the non-diabetic population regardless of comorbidities. Therapeutic approaches should focus much more on the subjective perception of health in patients with diabetes.
Arthritis ; Comorbidity ; Depression ; Diabetes Mellitus ; Heart Diseases ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Quality of Life ; Stroke ; Weights and Measures

Primary hyperparathyroidism is one of the most common endocrine diseases and is defined as the inappropriate overproduction of parathyroid hormone, resulting in hypercalcemia. It occurs mostly as a result of parathyroid adenoma or hyperplasia. The incidence of primary hyperparathyroidism increases with advancing age. The standard treatment of symptomatic primary hyperparathyroidism is parathyroidectomy; however, in older patients with multiple comorbidities, the risks associated with surgical treatment involving general anesthesia are high. Compared with surgery, radiofrequency abalation (RFA) is a minimally invasive procedure, in which the mass is removed. We here present a case of an elderly patient with primary hyperparathyroidism associated with parathyroid adenoma who was successfully treated with ultrasonography-guided RFA. RFA is an alternative therapeutic option for treatment of primary hyperparathyroidism for high-risk elderly patients, and further evaluation of its clinical value is warranted.
Aged ; Anesthesia, General ; Catheter Ablation* ; Comorbidity ; Endocrine System Diseases ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Incidence ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy

To study the effect of extracranial-intracranial(EC/IC) bypass on symptomatic patients with hemodynamic cerebral ischemia, we prospectively reviewed 14 patients who underwent EC/IC bypass surgery. A series of 14 patients treated in a 2 years period met the following criteria, 1) symptomatic internal carotid artery(ICA) or middle cerebral aetery(MCA) obstruction or stenosis over 80M, 2) decrease in basal cerebral blood flow(CBF) over 10%, 3) hyporeactivity to acetazolimide of CBF Amomg these, the type of ischemic episode was transient ischemic attack(TIA) or reversible ischemic neurological deficit(RIND) in 4, minor stroke in 8, and major stroke in 2. Of these, 10 patients had multiple episode of ischemic attack. CT or MRI were showed infarction of the MCA territory in 3, border zone infarction in 5, basal ganglia infarction in 2 and multiple lacunar infarction in 4. Based on our criteria, superficial temporal artery(STA)-MCA anastomosis was performed in 13 cases and EC-IC bypass grafting using radial artery in one. Average follow up period was 24 months. Postoperative course was uneventful in 12 patients. One patient suffered a postoperative stroke with complete recovery and another suffered operative wound infection. Of the 14 patients 12(85.7 % ) have had an excellent to good outcome with complete resolution or significant improvement of preoperative neurologic symptom, remaining two show no improvement of preoperative neurologic deficit. Bypass patency was confirmed by postoperative angiography in all cases except for one. Postoperative follow up studies of the basal CBF and response to the acetazolamide of the CBF showed significant increased CBF activity to acetazolamide in 12 cases(85. 7%) while the basal CBF was essentially unchanged in all cases except for two. In view of these finding, the authors suggest that EC-IC bypass surgery to be considered as an appropritate therapy for improvement of the cerebrovascular reserve capacity in patients with hemodynamic cerebral ischemia, defined using the strict selection criteria employed in this study.
Acetazolamide ; Angiography ; Basal Ganglia ; Brain Ischemia* ; Constriction, Pathologic ; Follow-Up Studies ; Hemodynamics* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Patient Selection ; Prospective Studies ; Radial Artery ; Stroke ; Stroke, Lacunar ; Transplants ; Wound Infection