Low back pain patients an controls of shipyard workers were surveyed between June 1995 and september 1995 to identify risk factors of industrial low back pain. The patients were 17 male workers who had got medical treatment for over 3 days because of industrial back pain controls were 51 male workers who had not have musculoskeletal disorder for one year before the survey. By univariate analysis, the workers who did overtime work 4 times or more for the last 2 weeks showed odds ratio of 3.67 on low back pain with the workers who did less overtime work. Carrying heavy materials was also associated with the low back pain and the odds ratio increased with the increase of carrying weight. work space and work posture were not associated with the low back pain significantly. The welder had higher odds ratio than the other workers on low back pain. The duration of employment and job satisfaction did not affect the risk of low back pain. Multiple logistic regression analysis showed that frequency of overtime work for the last 2 weeks and carrying heavy materials among the risk factors were associated significantly with the low back pain. We found that important risk factors of low back pain of shipyard workers are work intensity factors such as overtime work and carrying heavy weight.
Back Pain ; Employment ; Humans ; Job Satisfaction ; Logistic Models ; Low Back Pain* ; Male ; Odds Ratio ; Posture ; Risk Factors*

Background: The purpose of this study was to identify factors inhibiting access of people with disability to health check-ups as well as identify pertinent solutions for improvement. Methods: Twenty-three people with disability older than the age of 19 who took respective health check-ups within the last 3 years were selected as participants. For the data collection, the 1:1 intensive interview was used. The data were analyzed by the grounded theory by Corbin and Strauss. Results: The results comprised nine categories, 23 subcategories, and 179 concepts. The central phenomenon was ‘failure to obtain check-ups.’ Causal conditions were observed as a ‘lack of communication method,’ ‘physical difficulties,’ and ‘staff unfamiliar with people with disability,’ Interventional conditions comprised ‘physical accessibility,’ ‘staffs’ competency,’ and ‘assistant manpower.’ The active strategy was included ‘to investigate the professional medical institution,’ ‘to find the medical institution of convenient traffic accessibility,’ ‘to overcome communication difficulties through equipment,’ and ‘to overcome linguistic barriers through sufficient communication.’ Whereas, ‘utilization of ancillary equipment,’ ‘the education of staffs on people with disability,’ ‘universal design manual,’ and ‘customized check-ups’ were included in the passive strategy. Such processes arose in the contextual conditions of ‘lack of expectations for daily lives’ and ‘lack of government support.’ As a consequence, the subjects participated experienced the ‘disadvantages,’ ‘discrimination,’ and ‘reduced reliability of the health check-ups.’ Conclusion The subjects who participated in this study emphasized ‘staffs familiar with people with disability’ and ‘systems customized for people with disability’ are mandatory to secure complete health check-ups for people with disability.

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin

Human membranous nephropathy (MN) is morphologically characterized by subepithelial immune complex deposits and progressive thickening of glomerular basement membranes (GBM). Studies have suggested that the enhanced secretion of classical and novel type IV collagen chains in MN contributes to spike formation and the novel type IV collagen chain is particularly related to thickening of GBM. It is unclear whether the increased accumulation of extracellular matrix (ECM) proteins in GBM is due to the increased mRNA expression for type IV collagen in glomerular visceral epithelial cells (GECs). To answer this question, we analyzed seven renal biopsies of patients with idiopathic MN using in situ hybridization. In MN, the number of GECs expressing mRNA for alpha1(IV) collagen was 2.82+/-1.80/glomerular cross section (gcs), and the number expressing mRNA for alpha4(IV) collagen was 8.42+/-2.85/gcs. The number of GECs expressing mRNA for alpha4(IV) collagen was significantly larger than that of alpha1(IV) collagen mRNA. The expression of mRNA for these ECM proteins in normal controls was negligible. These results suggest that subepithelial immune complexes stimulate the gene expression of alpha1(IV) collagen and alpha4(IV) collagen in glomerular GECs which, in turn, increase the secretion of ECM proteins and contribute to the thickening of GBM in MN.
Antigen-Antibody Complex ; Biopsy ; Collagen ; Collagen Type IV* ; Extracellular Matrix ; Gene Expression ; Glomerular Basement Membrane ; Glomerulonephritis, Membranous* ; Humans* ; In Situ Hybridization ; Podocytes ; RNA, Messenger*

Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

Stomach of 34 year old man showed an early stage of the cancer with slight involvement of the superficial part of the inner muscle layer and accompanied with one metastatic lymph node. The cancer is that of medium differentiated adenocarcinoma. There is an heavy infiltration of lymphocytes mixed with histiocytic mononuclear cells and multinucleated giant cells. Some giant cells appear as Langhans' type suggesting phagocytic cells of their origin containing PAS positive materials in the cytoplasma. In other places, they appear as atrophic cancer nests suggesting that these tumor nests were arrested and undergone to regressive cellular process because of the over-whelming immunological pressure by the host.
Male ; Humans ; Neoplasm Metastasis ; Stomach Neoplasms

The term malignant mesenchymoma has been applied to those tumors of the soft tissue of mesenchymal origin which are composed of tumor cells differentiating into two or more unrelated malignant forms in addition to the fibrosarcomatous element. Recently authors experienced a case of malignant mesenchymoma in the right axillary area. Microscopically the sarcoma revealed multiple pattern of differentiation, including liposarcoma, malignant schwannoma, fibrosarcoma, malignant fibrous histiocytoma and rhabdomyoblastoma. The presence of rhabdomyblastic cells were proved by immunochemical study utilizing desmin. This patient was treated with surgical excision and radiation.

Laryngotracheoesophageal cleft is a rare congenital anomaly characterized by a midline defect of variable length between the posterior larynx and trachea and the anterior wall of the esophagus which was first reported by Richter in 1792. The male, birth weight 2780 gm, was born our hospital, After birth the infant breathed spontaneously, cried immediately but weak and did well initially but after minutes appeared moderate amount of mucus in the mouth, and sterile water was given but immediately vomited with chocking, cough and cyanosis. A nasogastric tube was inserted through the esophagus without resistance and kinking. Esophagogram was showed spillage of contrast media simultaneously into trachea and esophagus. In direct laryngoscopy, there appeared to be small laryngeal cleft posteriorly, to the level of vocal cord. But bronchoscopy could not be performed due to narrow tracheal orifice. So we confirmed the laryngeal cleft by means of CT and MRI of neck. CT and MRI scan of neck demonstrated a cleft in interarytenoid lesion and connection between esophagus and laryngeal lumen.
Birth Weight ; Bronchoscopy ; Contrast Media ; Cough ; Cyanosis ; Esophagus ; Gastrostomy ; Humans ; Infant ; Laryngoscopy ; Larynx ; Magnetic Resonance Imaging ; Male ; Mouth ; Mucus ; Neck ; Parturition ; Trachea ; Vocal Cords ; Water

No abstract available.
Neoplasm Metastasis* ; Vena Cava, Inferior*