A 71-yr-old male patient with three vessel coronary artery disease underwent a coronary artery bypass graft. The patient was found to have a large pericardial defect at the apex of the heart that measured approximately 18 cm in circumference. The edge of the pericardial defect impinged on the epicardial coronary arteries. The left phrenic nerve descended via the dorsal boundary of the pericardial defect. Following coronary artery bypass grafting, the pericardial defect was repaired with a polytetrafluorethylene patch. The patient had an uncomplicated postoperative course.
Aged ; Coronary Angiography ; *Coronary Artery Bypass ; Coronary Artery Disease/radiography/*surgery ; Humans ; Male ; Pericardium/*abnormalities ; Phrenic Nerve ; Polytetrafluoroethylene/therapeutic use

Background: The purpose of this study is to investigate the tooth whitening effect of Listerine Healthy White and provide effective management of extrinsic discoloration by comparing the whitening effects of existing whitening products. Methods: The included study four groups: those using whitening gel, whitening toothpaste, and Listerine Healthy White and a control using artificial saliva. Each group received 40 bovine tooth specimens, which were stained with commonly consumed tooth-coloring-inducing foods; black tea, black coffee, and instant noodles for 72 hours. The specimens were treated with tooth whitening materials for 5 weeks, after which the lightness (L*) was measured weekly using a spectrophotometer. Results: There was a significant difference in lightness among the groups between the 1st and 5th week of treatment for all tooth-coloring-inducing foods (p＜0.05). When comparing the changes in lightness values from before whitening to the 5th week of whitening for all tooth-coloring-inducing foods, the order of change was as follows: whitening gel, whitening toothpaste, Listerine Healthy White, and artificial saliva. Listerine Healthy White showed a significant whitening effect for all toothcoloring-inducing foods (p＜0.05). Particularly, changes in lightness values for specimens stained by black tea after 5 weeks of whitening were in the following order: whitening gel (21.72), whitening toothpaste (14.89), Listerine Healthy White (12.91), and artificial saliva (3.85). For specimens stained by black coffee, the changes in lightness values were in the following order: whitening gel (12.99), whitening toothpaste (9.66), Listerine Healthy White (7.91), and artificial saliva (3.12). Lastly, changes in lightness values for specimens stained by instant noodles were as follows: whitening gel (10.84), whitening toothpaste (9.85), Listerine Healthy White (7.71), and artificial saliva (2.61). Conclusion Listerine Healthy White exhibits continuous whitening effects over time, and for consumers seeking convenient ways to achieve tooth whitening effects at home, consistent use of Listerine Healthy White is recommended.

PURPOSE: This paper examined the relationship between knowledge differences of maternal oral health and of relevant demographic variables. METHODS: Participants included 239 pregnant women who were recruited from Women's Hospital located in B city who agreed to participate in this study. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation analysis using the SPSS 21.0 program. RESULTS: Maternal knowledge of oral health was moderate level (10.22±2.36). Scores of maternal knowledge of oral health were different according to age, education, occupation, parity, and dental care experience in pregnancy. Level of oral healthcare knowledge was weakly related to age and education. CONCLUSION: Consequently, it is necessary to encourage pregnant women to take part in oral health education program during antenatal care.
Delivery of Health Care ; Dental Care ; Education ; Female ; Humans ; Occupations ; Oral Health* ; Parity ; Pregnancy ; Pregnant Women*

Renal infarction usually occurs in patients with atrial fibrillation, valvular heart disease, trauma, renal artery stenosis, atherosclerosis, vasculitis, and hypercoagulable state. Protein C or S deficiency is an uncommon condition among hypercoagulable states and manifests deep vein thrombosis, pulmonary thromboembolism, cerebrovascular accident. In this report, we present a case of renal infarction occurred in 36-year-old male without underlying diseases except a family history of thromboembolism. He was admitted to our hospital due to an abrupt and continuous left flank pain. He had no previous history of an arterial or venous thrombosis. Tomography and renal angiography showed a left renal artery occlusion. He was treated with heparin and warfarin therapy. In laboratory tests, Protein C antigen level and protein S activity was 51.80% (72-160%) and 48% (65-140%). Thus, we concluded that renal infarction was secondary to combined type 1 protein C deficiency and type 2 protein S deficiency.
Adult ; Angiography ; Atherosclerosis ; Atrial Fibrillation ; Flank Pain ; Heart Valve Diseases ; Heparin ; Humans ; Infarction* ; Male ; Protein C Deficiency ; Protein C* ; Protein S ; Protein S Deficiency ; Pulmonary Embolism ; Renal Artery ; Renal Artery Obstruction ; Stroke ; Thromboembolism ; Vasculitis ; Venous Thrombosis ; Warfarin

BACKGROUND: Backache is a common complication following anesthesia and surgery. Previous studies indicated that the use of a lumbosacral wedge was effective in reducing the incidence of postoperative backache. We investigated the effective inflation pressure of an inflatable wedge in preventing postoperative backache following spinal anesthesia and surgery in the lithotomy position. METHODS: A pilot study established a mean comfortable pressure for the wedge when used to support the lumbar curvature. In males and females, the mean pressure values were 23.6 +/- 3.1 mmHg and 18.9 +/- 3.7 mmHg, respectively. The design of the main study was a randomized, controlled trial involving the use of a wedge intra-operatively in patients undergoing spinal anesthesia and urological surgery in the lithotomy position. Fifty male and 50 female patients were included in the main study and randomly allocated to the control or study group. In the study group, the wedge was inserted immediately after the induction of anesthesia and maintained during surgery. On the first day after surgery, all patients were asked whether they had backache. If there was backache, the degree of pain was noted using the numeric rating scale (NRS). RESULTS: In the study and control groups of male patients, the incidence of backache was 16% and 24%, respectively. There was no significant difference between the two groups. In the study and control groups of female patients, the incidence of backache was 20% and 52%, respectively (P < 0.05). Where backache occurred, there was no significant difference in its severity between the study and control groups. CONCLUSIONS: The effective pressure value of an inflatable wedge in preventing postoperative backache following spinal anesthesia and surgical operation in lithotomy position was 19 mmHg in female patients.
Anesthesia ; Anesthesia, Spinal ; Back Pain* ; Female ; Humans ; Incidence ; Inflation, Economic ; Male ; Pilot Projects

We report a case of successful endovascular treatment of a pseudoaneurysm and the obstruction of an aorto-aortic bypass graft, which had been performed to treat Takayasu's arteritis fifteen years prior, at the thoracic aorta. Along with the immediate relief of proximal hypertension that had caused severe heart failure, the successful exclusion of the pseudoaneurysm and the patency of the stem graft were maintained three years after the procedure.
Aneurysm, False ; Aorta, Thoracic ; Aortic Aneurysm ; Heart Failure ; Humans ; Hypertension ; Stents ; Takayasu Arteritis* ; Transplants* ; Vascular Diseases

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

Rab40 proteins are an atypical subgroup of Rab GTPases containing a unique suppressor of the cytokine signaling (SOCS) domain that is recruited to assemble the CRL5 E3 ligase complex for proteolytic regulation in various biological processes. A nonsense mutation deleting the C-terminal SOCS box in the RAB40B gene was identified in a family with axonal peripheral neuropathy (Charcot-Marie-Tooth disease type 2), and pathogenicity of the mutation was assessed in model organisms of zebrafish and Drosophila. Compared to control fish, zebrafish larvae transformed by the human mutant hRAB40B-Y83X showed a defective swimming pattern of stalling with restricted localization and slower motility. We were consistently able to observe reduced labeling of synaptic markers along neuromuscular junctions of the transformed larvae. In addition to the neurodevelopmental phenotypes, compared to normal hRAB40B expression, we further examined ectopic expression of hRAB40B-Y83X in Drosophila to show a progressive decline of locomotion ability. Decreased ability of locomotion by ubiquitous expression of the human mutation was reproduced not with GAL4 drivers for neuron-specific expression but only when a pan-glial GAL4 driver was applied. Using the ectopic expression model of Drosophila, we identified a genetic interaction in which Cul5 down regulation exacerbated the defective motor performance, showing a consistent loss of SOCS box of the pathogenic RAB40B. Taken together, we could assess the possible gain-of-function of the human RAB40B mutation by comparing behavioral phenotypes in animal models; our results suggest that the mutant phenotypes may be associated with CRL5-mediated proteolytic regulation.

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