BACKGROUND: The purpose of this study was to identify risk factors for low back pain in order to provide basic information for intervention programs to prevent low back pain in civil airline flight attendants. METHODS: Cross sectional observation was used by using systematic randomized sampling method. Among 1,764 study population, 398 people were selected. For statistical analysis, 210 completed questionnaires were used. Data was analyzed using SPSS 11.0 for t-test, chi square and regression. RESULTS: 1. Positive low back pain rate was 58.7% in the whole study group. In the highest positive group age ranged between 25 to 29 years, and career duration between 37 to 60 months. 2. According to job position, the risk of low back pain was the highest in economy class senior, cabin sales charge, and economy class junior group. On the contrary, cabin manager was the lowest risk group. 3. According to the average score of job stress, low job control and low supervisory support were each associated with higher positive rate of low back pain. 4. Wide degree of bending, more frequent waist movement and heavy lifting showed high positive rate of low back pain. CONCLUSION: Low back pain prevention program should be developed on the basis of the confirmed risk factors. These data will be helpful to provide prevention strategy and to promote intervention program for low back pain in airline flight attendants.
Commerce ; Lifting ; Low Back Pain* ; Risk Factors* ; Surveys and Questionnaires

Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythemia(ET). Physicians often use hydroxyurea which reduces the platelet count for the initial treatment of ET. A 74-year-old man with ET was presented with headache, dysarthria, and right hemiparesis 10 months after discontinuation of hydroxyurea. Initial platelet count was 450x103/microliter and we gave him heparin. However, his platelet count rised upto 1,019x103/microliter within 4 days. He was on hydroxyurea 1.5 g/day and his symptoms improved with decrease of platelet count. We report a case of left MCA(middle cerebral artery) multifocal infarction in ET after discontinuation of hydroxyurea.
Aged ; Cerebral Infarction* ; Dysarthria ; Headache ; Heparin ; Humans ; Hydroxyurea* ; Infarction ; Paresis ; Platelet Count ; Thrombocythemia, Essential*

BACKGROUND: Trisomy 16 in mice is considered to be an animal model for Down's syndrome in human. We studied the morphologic characteristics of the heart and the edema, and their significance to the teratogenesis in this animal model. METHODS: A total of 30 dams were sacrificed to bear 125 (61.9%) normal fetuses 35 (17.3%) abnormal fetuses and 42 (20.8%) resorptions. Cytogenetic study and morphological examination were performed using microdissection agar-mount sectioning histologic examination and scanning electron microscope. RESULTS: The crown-rump length was significantly shorter in abnormal (trisomic fetuses) than the normal (eusomic) fetuses. Trisomic fetuses showed massive edema at the back from the vertex to the lumbar area. Four-chamber view section of the agar-mount and histologic section showed a common atrioventricular valve bridging the left and the right atrioventricular junction. Scanning electron microscopic examination on atrioventricular valves showed three types of atrioventricular valves:five cases with common atrioventricular orifice, three cases with partitioned atrioventricular orifice and two cases with atresia of the right atrioventricular orifice. CONCLUSION: This study confirmed the presence of massive edema and cardiac anomalies in the mouse with trisomy 16. But there was morphologic diversity of cardiac anomaly in this model.
Animals ; Crown-Rump Length ; Cytogenetics ; Down Syndrome ; Edema* ; Endocardial Cushion Defects ; Fetus* ; Heart ; Humans ; Hydrops Fetalis ; Mice ; Microdissection ; Models, Animal ; Pathology* ; Teratogenesis ; Trisomy*

No abstract available.
Emergencies*

Neurofibromatosis type 1 (NF1; also known as von Recklinghausen's neurofibromatosis) is inherited in an autosomal dominant fashion, although it can also arise due to spontaneous mutation. Gastrointestinal involvement of NF1 is seen in 10% to 25% and causes symptoms in fewer than 5%. Histologically, the gastro intestinal (GI) manifestation of NF1 occurs in three forms: hyperplasia of the gut neural tissue, stromal tumors, and duodenal or periampullary endocrine tumors. A 31-year-old female, diagnosed with NF1, presented with poor oral intake and vomiting for 10 days prior to admission. Preoperative gastrofiberscopic finding was gastric outlet obstructing polypoid duodenal bulb lesion. The patient underwent hemigastrectomy with antecolic gastrojejunostomy due to gastric outlet obstruction. The final pathologic report was submucosal neurofibromatous proliferation with Brunner's gland hyperplasia located at the duodenal bulb in the NF1 patient. We report this case with a review of literatures.
Adult ; Female ; Gastric Bypass ; Gastric Outlet Obstruction ; Humans ; Hyperplasia ; Neurofibromatoses ; Neurofibromatosis 1 ; Vomiting

Tethered cord syndrome is a type of spinal dysraphism with a low-lying conus, which is frequently associated with an intraspinal lipoma, diastematomyelia, or fibrous band. The clinical manifestations include spine abnormalities such as the spina bifida or various neurological symptoms involving lower extremities and sphincters. However, the spinal roots are often injured during the detethering procedures which clinically results in a neurological deficit. The continuity of spinal roots should be monitored during detethering surgery for the tethered spinal cord because neural elements are embedded in lipoma or anomalous tissues. Evoked muscle action potentials indicate only motor function, therefore, it is more appropriate to record somatosensory evoked potentials across the operative field at the same time. We used a combined technique of tibial nerve somatosensory evoked potential and compound muscle action potentials stimulated in the spinal roots directly for an intraoperative monitoring during the untethering procedure. We reported good results from three patients with tethered cord syndrome who had taken the intraoperative monitoring during the untethering surgery. We suggest that intraoperative monitoring can prevent the unwanted injury to the neural tissue in the level of the tethering during the detethering surgery.
Action Potentials ; Conus Snail ; Evoked Potentials, Motor* ; Evoked Potentials, Somatosensory* ; Humans ; Lipoma ; Lower Extremity ; Monitoring, Intraoperative* ; Neural Tube Defects* ; Spinal Cord ; Spinal Dysraphism ; Spinal Nerve Roots ; Spine ; Tibial Nerve

Measurements of local shoulder muscle function during shoulder abduction are of a great interest in biomechanics research and in ergonomic applications. There have been so many opinions that the supraspinatus muscle acts in synergy with the deltoid muscle as a single unit throughout the shoulder abduction. However the specific actions of deltoid and supraspinatus muscles have been subjects of controversy. Electromyography is an established evaluation method of biomechanical study. It reflects the electrical activity at the muscle membrane level and indirectly the mechanical output of the muscle. The purpose of this study was to evaluate the role of deltoid and supraspinatus muscles during shoulder abduction by the comparison of motor unit action potentials using a quantitative electromyographic analysis method, to provide a good insight into the biomechanics of shoulder abduction. Motor unit action potentials of deltoid muscle were seen earlier than those of supraspinatus muscle at the time of initiation of shoulder abduction. The Root Mean Square (RMS) voltage of deltoid muscle was increased gradually from 0o to 90o of shoulder abduction, and then decreased gradually above 90o to 180o of shoulder abduction. The RMS voltages of deltoid muscle were significantly higher than those of supraspinatus muscle at each degree of shoulder abduction wholly. There was no differences in the RMS voltages of deltoid muscle, during shoulder abduction between the loading of 1 kg and without loading. However, the RMS voltages of supraspinatus muscle were significantly higher in the loading state than without loading. The Mean Rectified Voltages (MRV) were similar to the RMS voltages of deltoid and supraspinatus muscles during shoulder abduction. Based on these results, we concluded that the deltoid muscle was not only an initiator but also a major contributor in shoulder abduction, where as the supraspinatus muscle acts as a secondary muscle for the initiation of shoulder abduction and a supporting muscle when there is a resistance against shoulder abduction.
Action Potentials ; Deltoid Muscle ; Electromyography ; Membranes ; Muscles* ; Shoulder*

The prevalence of obesity in Korea has steadily increased over the past decade, reaching 38.4% in 2021. Notably, the rate of class II– III obesity, defined as a body mass index (BMI) of 30 kg/m2 or higher, exceeded 7% in the same year. Since January 2019, the National Health Insurance Service (NHIS) has provided coverage for bariatric surgery (BS) for eligible patients. Coverage is available for individuals with a BMI of 35 kg/m2 or higher, or those with a BMI of 30 kg/m2 or higher who also have obesity-related comorbidities. Additionally, partial reimbursement is offered for BS in patients with type 2 diabetes mellitus who have BMI values between 27.5 and 30 kg/m2. From 2019 to 2022, the NHIS recorded 9,080 BS procedures, with sleeve gastrectomy being the most commonly performed. The average percentage of weight loss 198±99.7 days post-surgery was 17.9%, with 80.0% of patients losing more than 10% of their body weight. This article presents the trends in obesity and BS in Korea.

PURPOSE: There is no specific treatment guidelines for Henoch-Schonlein (HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine METHODS: Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenously 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following I month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. RESULTS: Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean 7.4+/-7.4 weeks. Clinical remission were seen in 4 cases out of 5 (80%). Mean time period with disappearance of proteinuria and microscopic hematuria were 5+/-2.4 month and 13.3+/-2.9 month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up kidney biopsies after 2 years treatment. CONCLUSION: As there no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.
Azathioprine ; Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Mucoepidermoid* ; Child ; Clinical Protocols ; Follow-Up Studies ; Hematuria ; Humans ; Kidney ; Korea ; Nephritis ; Proteinuria ; Salivary Glands*

With recent advances in molecular diagnostic methods and targeted cancer therapies, several molecular tests have been recommended for gastric cancer (GC) and colorectal cancer (CRC). Microsatellite instability analysis of gastrointestinal cancers is performed to screen for Lynch syndrome, predict favorable prognosis, and screen patients for immunotherapy. The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor has been approved in metastatic CRCs with wildtype RAS (KRAS and NRAS exon 2–4). A BRAF mutation is required for predicting poor prognosis. Additionally, amplification of human epidermal growth factor receptor 2 (HER2) and MET is also associated with resistance to EGFR inhibitor in metastatic CRC patients. The BRAF V600E mutation is found in sporadic microsatellite unstable CRCs, and thus is helpful for ruling out Lynch syndrome. In addition, the KRAS mutation is a prognostic biomarker and the PIK3CA mutation is a molecular biomarker predicting response to phosphoinositide 3-kinase/AKT/mammalian target of rapamycin inhibitors and response to aspirin therapy in CRC patients. Additionally, HER2 testing should be performed in all recurrent or metastatic GCs. If the results of HER2 immunohistochemistry are equivocal, HER2 silver or fluorescence in situ hybridization testing are essential for confirmative determination of HER2 status. Epstein-Barr virus–positive GCs have distinct characteristics, including heavy lymphoid stroma, hypermethylation phenotype, and high expression of immune modulators. Recent advances in next-generation sequencing technologies enable us to examine various genetic alterations using a single test. Pathologists play a crucial role in ensuring reliable molecular testing and they should also take an integral role between molecular laboratories and clinicians.