PURPOSE: This study aims to assess the effects of psychosocial work environment and self-efficacy on stress, depression, and burn-out among office workers. METHODS: Survey data were collected from 331 office workers who worked in one workplace from April 10 to 30, 2012. The impact of psychosocial work environment and self-efficacy on stress, depression, and burn-out was analyzed with hierarchical multiple regression using SAS version 9.3. RESULTS: Work-family conflicts and emotional demands were identified as main factors influencing mental health. Other work environment factors influencing mental health were role clarity for stress, possibilities for development, meaning-of work, social support-from supervisors and job insecurity for depression, and social community at work for burn-out. Self-efficacy was correlated with most psychosocial work environment and factor with independent influence on stress and depression. The final models including general characteristics, psychosocial work environment, and self-efficacy accounted for 34%, 44%, and 36% for stress, depression, and burn-out respectively. CONCLUSION: To promote mental health in office workers, there is a need to decrease work-family conflicts and emotional demands and to improve work organization and job contents, social support, and self-efficacy.
Depression ; Mental Health ; Social Work

Polyethylene wear is one of the major problems following total knee arthroplasty. Many factors affect the degree and the pattern of polyethylene wear. We experienced three cases of early catastrophic poly- ethylene wears. All cases showed flexion contracture with severe genu varum deformity and total knee arthroplasty was performed with Advantim total knee prostheses in all cases. Postoperatively, bony align- ment and ligament balancing were good in all cases. However, in 12 to 22 months later, lateral subluxa- tion and valgus instability were developed with early catastrophic polyethylene wear especially in the medial compartments. Flat surface geornetry of polyethylene might be responsible for the development of lateral subluxation and early catastrophic wears. From these experience, we concluded that the mediolat- eral as well as anteroposterior dishing is essential for the stability of the artificial joint and prevention of early rapid wear of polyethylene articular inserts following total knee arthroplasty.
Arthroplasty ; Congenital Abnormalities ; Contracture ; Genu Varum ; Joints ; Knee ; Knee Prosthesis ; Ligaments ; Polyethylene*

Raynaud's phenomenon manifests as triphasic color change episodes of blanching, cyanosis, and reddening of the digits, induced by exposure to low temperature or emotional stress. It is a relatively common disorder, estimated to affect 5-10% of the general population and 20-30% of otherwise healthy women. Most cases of primary Raynaud's phenomenon also called Raynaud's disease, are mild and self-limited. Secondary Raynaud's phenomenon presents as a secondary manifestation of an underlying disease and are complicated by ulcerations and tissue necrosis. From March 1996 to August 1998, we experienced 4 patients with Raynaud's phenomenon. Two patients were diagnosed Raynaud's disease and the other two were secondary. Raynaud's disease responded to drug therapy and sympatetic ganglion block. Secondary Raynaud's syndrome was treated with vein graft and free tissue transfer. During postoperative follow-up of 33-49 months, both severity and symptomatic intervals were improved.
Cyanosis ; Drug Therapy ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Necrosis ; Raynaud Disease ; Stress, Psychological ; Transplants ; Ulcer ; Veins

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage

Explosive burns following inhalation of butane gas rarely occurred in the past, but recently it has brought about a social problem among groups of teenagers. This constitutes 1.6% of admissions due to flame burn in the burn unit of Hallym Medical Center. A retrospective review during a five-year period identified 48 patients. The male to female ratio was 3:1. The mean age was 16 years and 8 months. The place of accidents were commonly bedrooms or motel rooms. There were nine group settings of 27 patients at the time of the accident. The pneumothorax(n=3) and respiratory difficulty(n=12) were noted on admission. The average burn area was 28.5% of the total body surface area. All patients sustained burn injury on the face, arms and hands, and 24 patients among them had extended burn areas on the trunk and/or lower extremity. Twenty-two patients(mean hospital stay; 51.6%) required skin grafting, and 12 patients (mean hospital stay; 22.3 days) were treated with conservative management. The mortality rate was 10.4 percent. Explosive burns following inhalation of butane gas can result in mortality as well as major burn injuries.
Adolescent ; Arm ; Body Surface Area ; Burn Units ; Burns* ; Female ; Hand ; Humans ; Inhalation* ; Length of Stay ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Skin Transplantation ; Social Problems

Neurofibromatosis is a complex hereditary disease involving many organs and systems. The incidence in pregnancy is less frequent and has been reported as 1/5000 to 1/18500 deliveries. Therefore, little is known about the interactions between neurofibromatosis and pregnancy. A survey of relevant literature suggests that patients with NF have an increased risk of perinatal complications (pregnancy induced hypertension, IUGR, preterm labor, abortion, stillbirth, high cesarean section rate) and maternal disease aggravation (rupture of an aneurysm, sarcomatous degeneration of neurofibroma, activation of pheochromocytoma). Refined ultrasound, flow studies and fetal monitoring allow us to provide improved pregnancy care for neurofibromatosis. However, It should be remembered that even now, neurofibromatosis places pregnant women and their fetuses in a high risk group with the potential to develop life threatening complications. We report a case of vertebral artery aneurysm and preeclampsia complicating a pregnancy with neurofibromatosis."
Aneurysm* ; Cesarean Section ; Female ; Fetal Growth Retardation ; Fetal Monitoring ; Fetus ; Genetic Diseases, Inborn ; Humans ; Hypertension ; Incidence ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Obstetric Labor, Premature ; Pre-Eclampsia* ; Pregnancy* ; Pregnant Women ; Stillbirth ; Ultrasonography ; Vertebral Artery*

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

Diffuse interstitial lung disease(DILD) is a large group of heterogeneous diseases that diffusely involve the pulmonary connective tissues, principally subpleural, interlobular and alveolar wall portions. Terminology and classification of these diseases are not uniform, and the cause and the pathogenesis are unknown in many entities. It is generally accepted that the response to therapy is related to the relative degree of cellularity and fibrosis present, therefore a histologic evaluation of the relative extent and severity of these changes is required. We reviewed 52 cases of DILD from January 1990 to May 1995 diagnosed by open lung biopsy to reappraise classification and quantitative assessment of the histopathologic features. Differential histopathologic features between usual interstitial pneumonia(UIP) and nonspecific interstitial pneumonia(NIP) were examined with a correlation of HRCT findings and clinical findings. Among 52 cases of DILD, 18 cases(34.6%) were UIP, 6 cases(11.5%) were hypersensitivity pneumonia was NIP was 5 cases(9.6%), interstitial lung diseases associated with the connective tissue diseases were 5 cases(9.6%), inorganic dusts were 4 cases(7.7%), infections were 4 cases(7.7%), durgs were 2 cases(3.8%), acute interstitial pneumonia was 1 case(1.9%), sarcoidosis was 1 case(1.9%) in order of frequency plus 6 other cases(11.5%). UIP was the most frequent DILD in this study which seemed to be a criteria bias of patient selection on open lung biopsy. Quantitative assessment of histopathologic features was useful in the differential diagnosis of DILD and differentiation of UIP from NIP was possible based on histopathologic features and supported by HRCT. UIP disclosed a significantly high score of fibrotic changes, especially in the interstitial fibrosis, smooth muscle proliferation and honeycombing, otherwise NIP appeared relatively high score in inflammatory changes. Correlation between histopathologic scores and the clinical outcome after steroid therapy or no therapy in UIP was not evident.
Diagnosis, Differential ; Biopsy

PURPOSE: To evaluate and compare the difference of predictive post-operative refraction preoperatively and real post-operative refraction among five types of intraocular lens. METHODS: We reviewed retrospectively 567 cataractous eyes that had undergone phacoemulsification or ECCE with posterior chamber intraocular lens (IOL) implantation by the same surgeon. Applied IOLs were AMO(R) Phacoflex(R) II SI40NB, Acrysof(R) MA60BM, Sensar(TM) AR40e, CeeOn(TM) 811B and CeeOn(TM) 720A. Prediction of post-operative refraction (predictive refraction) was calculated by the SRK/T formula with manufactured A constant. Post-operative manifest refraction (real refraction) was done at least 2 months postoperatively. We compared the difference between the predictive refraction and the real refraction by paired t-test. RESULTS: Total studied eyes were 390 eyes. In all groups, more myopic shift were observed than predicted. In AMO(R) Phacoflex(R) II SI40NB group, statistically significant difference was seen in postoperative manifest refraction over the predictive refraction as much as mean 0.46 diopter myopically (p<0.05, paired t-test), but others were not. In the AR40e implanted group, the error of predictive refraction was the smallest among groups. CONCLUSIONS: Prediction of postoperative refractive state was influenced by various clinical factors. Using a revised A constant, predictive error would be decreased. We recommend that every cataract surgeon had better have one's original A constant over each IOL and A constant may be revised when major surgical or biomedical measurement settings were changed.
Cataract ; Lenses, Intraocular* ; Phacoemulsification ; Refractive Errors ; Retrospective Studies

We designed a new electrophoresis apparatus. This was consisted of the body into which agarose could be poured directly and the cover from which the platinium electrodes were suspended. After running the nucleic acid in this electrophoresis, we observed the band of nucleic acid on the ultraviolet transilluminator without touching the agarose gel, keeping the cover with the electrodes and discarding the gel in body. We compared the variuos types of the electrophoresis apparatus. In the electrophoresis apparatus which body was consisted of the flat bottom, the migration of dyes was the fastest among studied types. The high migration velocity of dyes was due to high electric current.
Coloring Agents ; Electrodes ; Electrophoresis* ; Running ; Sepharose