To evaluate the health risk of the workplace environment of a general hospital toward the hospital workers, a questionnaire survey on the perception of risk at the workplace environment and environmental measurements at 27 locations with 240 workers in the hospital were made from October 25th, 1993 to October 30th, 1994. The results were as follows; 1. By the environmental measurements, 86 workers(36%) were found to be exposed to poor or harmful degree of general illumination, 193 workers(80%) were exposed to poor or harmful local illumination, 34 workers(14%) were exposed to poor or harmful degree of thermal condition and l80 workers(75%) were exposed to poor or harmful noise level, but nobody was exposed to poor or harmful dust and toluene concentration. Also nobody was exposed to poor or harmful level of radiation or anticancer/antibiotic agents. 2. The subjective perceptions on the environmental conditions felt by the workers were different from the objective findings by the environmental measurements. The workers underscored the poor illumination state and overscored the dust concentrations. Also workers oversensitized about the thermal condition, the noise level, the radiation level, the toluene concentration and anticancer/antibiotic agents. 3. The sources of noise were the dialogue(179 workers) and the office instruments(131workers). The sources of dust came from the clothes(108 workers) and the building materials(79 workers). 4. The questionnaire survey showed that the 28 workers were exposed to poor or harmful level of the antibiotics, 10 workers to alkali or acid and 6 workers to drug dust in the pharmacy but the above findings could not be proved by the environmental measurements.
Alkalies ; Anti-Bacterial Agents ; Dust ; Hospitals, General* ; Lighting ; Noise ; Pharmacy ; Surveys and Questionnaires ; Toluene

Adrenal gland is a rare location for an oncocytic neoplasm. In English literature less than 10 cases of adrenocortical oncocytoma have been reported. We have experienced a case of adrenocortical oncocytoma in a 35-year-old man which was detected incidentally during the ultra-sonographic evaluation of the abdomen for a routine physical examination. This case did not demonstrate any clinical evidence of adrenocortical abnomalities, such as virilization or hypertension. Grossly, the tumor was light to dark tan on cut surface. Light-microscopic examination revealed tumor cells with abundant lipid- sparse eosinophilic cytoplasm and occasional pleomorphic nuclei. Mitotic figures were less than 5/50 HPFs. Tumor cells were positive for vimentin but negative for pancytokeratin, CAM 5.2, chromogranin and synaptophysin. Ultrastructural examination demonstrated abundant mitochondria containing occasional intramitochondrial dense bodies or inclusions.
Abdomen ; Adenoma, Oxyphilic* ; Adrenal Glands ; Adult ; Cytoplasm ; Eosinophils ; Humans ; Hypertension ; Mitochondria ; Physical Examination ; Synaptophysin ; Triacetoneamine-N-Oxyl ; Vimentin ; Virilism

Primary pulmonary tuberculosis is one of the common pulmonary disease affecting children in Korea. Simple chest film is essential in diagnosis of primary pulmonary tuberculosis, but it is difficult to interpret the findings in some cases. Authors reviewed chest films of 162 cases of clinically confirmed primary pulmonary tuberculosis from April 1978 to June 1981 at Seoul National University Hospital. The results are as follows; 1. Lymph node enlargement, either hilar or mediastinal, was found in 82.7% and pulmonary parenchymal infiltration in74%. 2. Incidence of unilateral and bilateral hilar lymph node enlargement is about 50% (81cases) and 30% (49cases) respectively. Incidence of unilateral and bilateral mediastinal lymph node enlargement is about 21% (34cases) and 4.3% (7 cases), more common in right side. 3. Pulmonary parenchymal lesion is demonstrated in 74% (120cases). The pattern of primary focus is as follows in order; patchy infiltration 47% (76 cases) linear-streaky infiltration 15% (25 cases), lobar or segmental homogenous infiltration 9% (14 cases), nodular infiltration 4% (7cases). The primary focus of right lung is two times as common as that of left. 4. Calcification in primary focusis noted in about 27% in pulmonary parenchyma and 49% in hilum. 5. Plerual effusion is identified in 10%, but pleural effusion without pulmonary parenchymal lesion or lymph node enlargement is noted in only 2% (3 cases).
Child ; Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Diseases ; Lymph Nodes ; Pleural Effusion ; Seoul ; Thorax ; Tuberculosis, Pulmonary

A 24-year-old woman was seen for evaluation of an skin lesion on thiright nipple. Examination revealed a solitary 1.5 x 1cm-sized, erythematous, oozing, eroded andruted, verrucous nodule on the right nipple. A small amount of serous discharge was found but there was no pain or tenderness. Histopathologic findings showed cystic invaginations extending down vard from the epidermis and papillary projections extending into the lumina of the invagination. Pupiae were lined by two rows of cells. In stroma, there were marked inflammatory infiltrates containing any plasma cells. The overlying dermis showed an adenomatous growth pattern with a prolifertion of round, oval or irregular shaped ducts and fibrotic stroma.
Adenoma* ; Cytochrome P-450 CYP1A1 ; Dermis ; Epidermis ; Female ; Humans ; Nipples* ; Plasma Cells ; Skin ; Young Adult

PURPOSE: This study was aimed to compare the effect between wet gauze with cold normal saline and wet gauze with cold water on thirst, oral cavity condition, and saliva pH among postoperative patients. METHODS: This study was a quasi-experimental study with 56 participants. The experimental group received wet gauze with cold normal saline, and control group received wet gauze with cold water for three times at 15 minute intervals. Data were collected using visual analog scale for thirst, oral assessment guide for oral cavity condition and acidity tape for saliva pH. Measurement were made before applying the gauze and at 15min, 30min, and 45min after applying gauze. Data were analyzed using repeated measured ANOVA. RESULTS: Thirst, oral cavity condition, and saliva pH improved in both groups with increasing number of gauze application. Thirst for the experimental group improved more than for the control group (F=4.29, p=.009), oral cavity condition except saliva, and saliva pH were not significantly different between the groups. CONCLUSION: This study results indicated that nurses can apply wet gauze with cold normal saline to reduce thirst and saliva acidity, and to improve the oral cavity condition for postoperative patients.
Humans ; Hydrogen-Ion Concentration* ; Mouth* ; Saliva* ; Sodium Chloride ; Thirst* ; Visual Analog Scale ; Water* ; Xerostomia

OBJECTIVE: To evaluate the effect of neuromuscular electrical stimulation (NMES) therapy on swallowing dysfunction in patients with chronic (more than 6 months) dysphagia caused by stroke. METHOD: A total of 16 patients with stroke-caused swallowing disorders based on a videofluoroscopic swallowing study (VFSS) were treated with NMES for two weeks. NMES was applied to the skin over the anterior neck muscles for one hour a day. Swallowing function was evaluated by the functional dysphagia scale using the VFSS, clinical dysphagia scale and the American Speech-Language Hearing Association National Outcomes Measurements System Swallowing Scale (ASHA NOMS scale) before and after electrical stimulation. Follow up VFSS was performed one month after intervention. RESULTS: After completing ten treatment sessions, aspiration, reflex coughing and the total score in the clinical dysphagia scale were significantly decreased (p<0.05). There was also a significant improvement in the ASHA NOMS scale (p<0.05). Regarding the functional dysphagia scale, the residue in the valleculae and piriformis sinus, and total scores were significantly decreased (p<0.05). Specifically, the scores of the pharyngeal phase were mainly decreased as compared to that of the oral phase. In addition, these effects were maintained one month after the intervention as measured with functional dysphagia scale. CONCLUSION: After ten sessions of NMES, we found improvement in dysphagia parameters in chronic dysphagia patients. Specifically, residue in the valleculae and piriformis sinus, and a parameter of the pharyngeal phase were significantly improved.
Cough ; Deglutition ; Deglutition Disorders* ; Electric Stimulation Therapy* ; Electric Stimulation* ; Follow-Up Studies ; Hearing ; Humans ; Neck Muscles ; Reflex ; Skin ; Stroke*

PURPOSE: This study describes the CT and MR findings of mucoceles occurred in the post-operative maxillary sinuses. MATERIALS AND METHODS: CT and/or MR of 19 maxillary mucoceles in 16 patients who had been operated by CaldwelI-Luc procedure were reviewed. CT scans were performed after contrast enhancement in axial and coronal planes with 5mm thickness. Three cases were studied with a 2.0 T or 0.5 T MRI, which demonstrated multi-compartment lesions. RESULTS: The lesions were bilateral in 3 cases. Compartmentalization of the antral cavity was seen in 7 out of 19 involved sinuses. Surgical bone defect of the anterior wall was the most frequent route of extension (11 cases) and extension into the infratemporal fossa with erosion of posterolateral wall was seen in 7 lesions. In 6 cases, the lesions involved orbit. The expansile and erosive bone changes were localized in every case. In one case with multi-compartment lesion, both T1- and T2-weighted MR images showed different signal intensities in each compartment which represented different protein concentration. CONCLUSION: Post-operative maxillary mucocele showed CT findings of localized erosion and bulging most frequently at the anterior wall in which the bone windows were made during the previous surgery. Post-operative compartmentalization of maxillary antrum may cause eccentric expansion of mucocete and each compartment may show different signal intensities on MR.
Humans ; Magnetic Resonance Imaging ; Maxillary Sinus* ; Mucocele* ; Orbit ; Tomography, X-Ray Computed

BACKGROUND: HLA-B40 is the most frequently identified HLA-B type in Koreans. Also HLA-B60 and B61 are the serologic split antigens of HLA-B40. But because of the lack of mono-specific alloantisera, cross reactivity of sera used as typing reagents, and poor antigenicity of some specific cells such as cord blood lymphocytes, discrimination between HLA-B60 and B61 has been often problematic in laboratories. In this study, authors evaluated whether the PCR-SSP method can be useful for accurate assignments of HLA-B60 and B61 or not. METHODS: Twenty-nine lymphocytes samples which were suspected as heterozygotes or homozygotes of HLA-B60 or B61 and three samples typed as HLA-B40 are selected from stored cord blood and organ transplantation donors. HLA types of these samples were defined by serologic method using a commercial typing kit. PCR that amplified exons 2 and 3 of the HLA-B gene using sequence specific primer pairs exactly matched to HLA-B60 or B61 allele making up a serological specificity was done. RESULTS: A clear discrimination between B60 and B61 was possible in all samples including 9 serologically ambiguous samples. Discrepancy between serologic typing and molecular typing was seen in three cases identified serologically as B40 positive but inable to define a split. Among three samples, two were identified as HLA-B61 and one was identified as HLA-B60. CONCLUSIONS: Molecular typing was useful in discriminating between HLA-B60 and B61. The PCR-SSP method for HLA-B60 and B61 including other cross-reactive HLA types will be helpful as a supplemental method of the serologic typing.
Alleles ; Discrimination (Psychology)* ; Exons ; Fetal Blood ; Heterozygote ; HLA-B Antigens ; HLA-B40 Antigen ; Homozygote ; Humans ; Indicators and Reagents ; Lymphocytes ; Molecular Typing ; Organ Transplantation ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Tissue Donors ; Transplants

Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
Pregnancy ; Female ; Humans

PURPOSE: To evaluate and compare the diagnostic findings and usefulness of MRI and MR arthrogram in recurrent anterior dislocation of the shoulder. MATERIALS AND METHODS: MRI and MR arthrogram of thirty-two cases of thirty patients with recurrent anterior dislocation of the shoulder were retrospectively analyzed to evaluate glenohumeral ligaments, pattern of labral injury, bony Bankart lesion, capsular stripping, Hill-Sachs lesion, and loose body. RESULTS: Labral abnormalities was detected on MRI in 23 cases(72%) and MR arthrogram in 22 cases(69%) as labral tear, detachment, and deficiency. All cases involved anteroinferior labrum. On MR arthrogram, labral abnormalities was confined to anteroinferior portion in 4 cases(18%), extended into midglenoid level in 13 cases(59%), and that into anterosuperior portion in 5 cases(23%). Capsular stripping was noted on MRI in 6 cases(19%) and MR arthrogram in 12 cases(38%). Loose body was detected only on MR arthrogram in 5 cases (16%). Bony Bankart lesion and Hill-Sachs lesion was detected equally on MRI and MR arthrogram in 2 cases (6%) and 21 cases(66%) respectively. We obtained identical findings on both MR arthrogram and operation field in 6 patients. CONCLUSION: MRI with its excellent soft tissue contrast resolution and multiplanar imaging capafility helps detection of labral injury in recurrent anterior dislocation of the shoulder. MR arthrogram is slightly invasive, but shows good artatomic details of labral-ligamentous-capsular relationship and thus provides accurate detec- tion of pattern of labral injury, capsular stripping, and loose body.
Dislocations* ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Retrospective Studies ; Shoulder*