OBJECTIVES: The purpose of this study was to determine the current status of presenteeism and absenteeism among railroad workers as well as to investigate whether or not job stress level and psychosocial well-being status are associated with presenteeism and absenteeism. METHODS: As the cross-sectional design, a self-reported questionnaire using the Korean Occupational Stress Scale(KOSS), Psychosocial Well-being Index(PWI), and Work Productivity and Impairment-General Health(WPAI-GH) was administered to railroad workers. Univariate and multivariate logistic regressions were used to analyze the association between job stress, psychosocial well-being status and presenteeism, absenteeism in 1,099 subjects. RESULTS: Among the study subjects, 52.0% and 22.0% experiened presenteeism and absenteeism, respectively. Job stress level in railroad workers was higher than that in general workers. Multivariate logistic regression with presenteeism as the dependent variable showed an elevated odds ratio of 3.56(95% CI 1.48-8.54) in the highest job stress group, and an odds ratio of 3.20(95% CI 1.94-5.26) in the high-risk psychosocial stress group. There was no significant association between job stress level and absenteeism, whereas weak association between psychosocial stress and absenteeism was found. CONCLUSIONS: Since railroad workers have a high level of job stress and elevated experience of presenteeism, a management strategy is required to control presenteeism and absenteeism in order to promote railroad workers' health and safety.
Absenteeism ; Efficiency ; Logistic Models ; Odds Ratio ; Questionnaires ; Railroads ; Sick Leave

PURPOSE: To determine the time of magnetic resonance(MR) signal intensity changes in denervated skeletal muscle and to compare MR imaging with electromyography(EMG) in the evaluation of peripheral nerve injury. MATERIALS AND METHODS: We evaluated MR imagings of denervated muscles after experimental transection of the sciatic nerve in five rabbits using 1.0T MR unit. MR imaging and EMG were performed 3 days and 1, 2 and 3 weeks after denervation. T1-weighted images(T1-WI), T2-WI and Short Tau Inversion Recovery(STIR) images were obtained. The signal intensity (SI) of muscles in the denervated and normal sides were visually and quantitatively compared. After measuring the SI of the normal and abnormal areas, the time of SI change was determined when there was significant difference (P<0.05) of SI between the normal and denervated sides. RESULTS: On STIR images, two of the five rabbits showed significant SI changes at the third day(P<0.05) and all showed significant changes(P<0.05)at the first week. On T2-WI, one rabbit showed significant SI changes at the third day, and all showed significant SI changes at the first week. On T1-WI, significant SI changes were seen in one rabbit at the second week and in one at the third. One week after denervation, all showed denervation potential on EMG. CONCLUSION: This study suggests that MR imaging using STIR images is a useful method in the evaluation of denervated muscle, and that MR signal changes of denervated muscle may precede EMG changes after denervation. To localize and to determine the severity of the peripheral nerve injury, future analysis of the distribution of abnormal MR SI in denervated muscles would be helpful.
Denervation ; Magnetic Resonance Imaging* ; Muscle, Skeletal* ; Muscles ; Peripheral Nerve Injuries ; Rabbits* ; Sciatic Nerve

OBJECTIVE: To evaluate the relationship between results of 50-g one-hour glucose screening test (50 GTT) and gestational diabetes and to find cut-off result value of 50 g GTT which can diagnosis the gestational diabetes without other confirmative tests. METHODS: Retrospective study were performed from 1353 pregnant women between 24-28 weeks of gestation, whose results of 50 gGTT were the same or above 140 mg/dl. The diagnosis of gestational diabetes was determined by 100-g 3-hour oral glucose tolerance test (100 gGTT) result. RESULTS: From 1998 to 2002, One hundred twenty-six pregnant women were diagnosed as gestational diabetes among 1353 pregnant women performed 100 gGTT. We couldn't decide any diagnostic cutoff value to gestational diabetes. There was a correlation between the results of 50 gGTT and the incidence of gestational diabetes (p<0.0001). Twenty-one (63.64%) patients among 33 patients whose 50-g screening test result Diabetes, Gestational* ; Diagnosis ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Incidence ; Mass Screening* ; Pregnancy ; Pregnant Women ; Retrospective Studies

OBJECTIVE: The aims of this study are to determine the effects of multiple courses of antenatal corticosteroid therapy on the perinatal outcomes, especially the respiratory outcomes of the preterm neonates and to compare them with the single course of antenatal corticosteroid therapy. METHODS: We performed a retrospective analysis of 282 mothers who admitted between 24 and 34 weeks' gestation with high risk of preterm delivery and delivered before 34 weeks' gestation. They were categorized into three groups; (1) no antenatal corticosteroid user (non-user group), (2) single course of corticosteroid user (single-course group), (3) multiple courses of corticosteroid user (multiple-course group). Then we compared the pregnancy results and the perinatal outcomes, especially the respiratory outcomes of neonates in each groups. RESULTS: One hundred twenty-four patients were included in steroid non-user group, 111 patients in single- course group and 47 patients in multiple-course group respectively. There were no statistical differences of pregnancy results including the occurrence of clinical and histological chorioamnionitis, gestational age at delivery, birth weight, neonatal intensive care unit admission rate and hospital stay, ventilator treatment rate and neonatal death among the three groups. But the duration of ventilator treatment was significantly shorter in multiple-course group. The incidence of neonatal respiratory distress syndrome was significantly lower in multiple-course group, and the incidence tends to decrease as the number of corticosteroid use increases. Multiple logistic regression analysis and Spearman's partial correlation test revealed that multiple courses of antenatal corticosteroid treatment were significantly associated with lower incidence of neonatal respiratory distress syndrome and shorter duration of ventilator treatment respectively, even after the adjustment of other independent variables. There were no significant differences of other neonatal morbidities among the three groups. CONCLUSION: Multiple doses of antenatal corticosteroid administered to patients with risk of preterm delivery is associated with shorter duration of ventilator therapy and lower incidence of respiratory distress syndrome of the premature neonates without complicating any other perinatal outcomes.
Birth Weight ; Chorioamnionitis ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Newborn* ; Intensive Care, Neonatal ; Length of Stay ; Logistic Models ; Mothers ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies ; Ventilators, Mechanical

PURPOSE: To evaluate percutaneous nephrostomy and ureteral stent placement in patients with postoperative ureteral injury. MATERIALS AND METHODS: Percutaneous nephrostomy and antegrade ureteral stent placement we reattempted in 12 patients with postoperative ureteral injuries. The previous operations which caused ureteral injuries included ureteroscopic extraction of ureteral stones(7), total abdominal hysterectomy due to uterinemyoma(2), ureteroscopic biopsy in a patient with ureteral tuberculosis(1), open ureteroplasty due to retroperitoneal fibrosis(1), and ureterocystostomy during renal transplantation(1). After percutaneousnephrostomy, a 7.0 F ureteral stent was inserted in each patient. The stent was removed under cystoscopic guidancefour to six weeks after this procedure. Urinalysis was performed to evaluate the presence of urinary tractinfection after ureteral stent placement. Ultrasonography and/or intravenous urography were performed three weeksafter stent placement, and every six months after the stent removal. RESULTS: Percutaneous nephrostomy andplacement of an antegrade ureteral stent were successfully performed in all 12 patients. In three patients, the diagnosis of ureteral injuries was made immediately and in nine was delayed for between two and nineteen days. Theureteral stents remained in position for 25-95 days (average, 51) ; no evidence of urine leakage or ureteralstricture was seen on the follow-up examinations carried out from six months to several years after removal of thestent and no case required reintervention. CONCLUSION: Percutaneous nephrostomy and antegrade ureteral stentingare easy to perform, provide for the drainage of urine, cause no significant complication and show a successful therapeutic effect, and are this effective non-operative interventional techniques for patients with postoperative ureteral injury.
Biopsy ; Drainage ; Follow-Up Studies ; Humans ; Hysterectomy ; Nephrostomy, Percutaneous* ; Stents* ; Ultrasonography ; Ureter* ; Urinalysis ; Urography

PURPOSE: To evaluate and compare effectiveness of single acquisition CT and conventional angiography (CA) in grading stenosis in an artery of the lower extremity . MATERIALS AND METHODS: CA and CTA were performed in 12 patients with acclusive arterial disease of the lower extremity. CA extended from the bifurcation site of the abdominal aorta to the popliteal artery, 25-30 seconds after the injection of 120-150ml contrast media by a power injector at the rate of 2.5-3ml/sec via the antecubital vein. Using SSD and MIP methods, the data was reconstructed three-dimensionally. The artery was divided into five segments and the degree of lesion was definedas normal or mild (1-49%), moderate (50-74%), or severe stenosis (75-99%), or occlusion (100%). We retrospectively evaluated and compared the effectiveness of CTA and CA in the detection of each vessel and the grading ofstenosis. RESULTS: Although 11 segments were graded by CA as occluded, only five of these were similarly graded by CTA, and the remaining six were undergraded. The ratio of consistency for grading was 88.5% (46/52) in less thanmild stenosis, and 63.6% (7/11) in moderate or severe stenosis ; if the 11 segments detected only by CTA wereexcluded, the ratio of consistency for occlusion was 100%. Overall diagnostic accuracy was 84.2% (85/101) and whenthe 11 segments were excluded, this was 88.9% (80/90). Because of the capacity of CTA to distinguish vessles with greater than 50% stenosis from those with less than mild stenosis, sensitivity of 86.0%, specificity of 93.2% and accuracy of 89.1% were recorded. If the 11 vessels detected only by CTA were excluded, sensitivity and accuracy would be 91.3% and 92.2%, respectively. CONCLUSION: For detecting and grading stenosis in an artery of the lowerextremity, single acquisition CTA is more accurate than its conventional counter part, and we believe that CTA is a useful modality in the planning and follow-up of treatment.
Angiography* ; Aorta, Abdominal ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Contrast Media ; Follow-Up Studies ; Humans ; Lower Extremity* ; Popliteal Artery ; Retrospective Studies ; Sensitivity and Specificity ; Silver Sulfadiazine ; Tomography, Spiral Computed* ; Veins

OBJECT: This study was performed to increase the sensitivity and specificity for screening the examinee of second hearing test. METHODS: Study subjects were 219 workers who exposed more than average 80dB. They were taken the hearing test two times, before noise exposure and at 1 hour to 4 hours after worksite noise exposure. To investigate the ambient noise workers who were taken the hearing test in the test room which ambient noise was less than 45dB were classified Group I and the others were classified Group E. To calculate the sensitivity and specificity we made it gold standard whether worker had noise induced hearing loss. RESULTS: Difference of hearing loss between before and after noise exposure for left and right ear was 11. 4 dB and 11. 7 dB respectively at 500 Hz, 8. 7 dB and 9. 6 dB at 1, 000 Hz, 6. 3 dB and 6. 9 dB at 2, 000 Hz and 6. 9 dB and 7. 4 dB at 4, 000 Hz in Group I. That for left ear and right ear was 5.8 dB and 4.9 dB at 500 Hz respectively, 5.4 dB and 6.4 dB at 1,000 Hz, 6.3 dB and 5.3 dB at 2,000 Hz, and 5.5 dB and 5.8 dB at 4,000 Hz in Group E. The sensitivity was 100 in both Groups and the specificity was increased to 58. 3 and 71. 8 in Group I and Group 3 respectively until 10 dB was deducted from hearing level at 1, 000 Hz and 4, 000 Hz. CONCLUSION: When the screening hearing test was performed at worksite, we might deduct 10 dB from measured hearing level to increase the specificity without reduction of sensitivity.
Ear ; Hearing ; Hearing Loss ; Hearing Tests ; Mass Screening* ; Noise* ; Sensitivity and Specificity* ; Workplace

BACKGROUND AND OBJECTIVES: A number of reports have suggested that Epstein-Barr virus (EBV) is associated with different forms of head and neck cancers (HNC) such as nasopharyngeal carcinoma, NK/T cell lymphoma and Burkitt's lymphoma. We evaluated the association of EBV with HNC as a causative factor in an endemic area of the virus. SUBJECTS AND METHOD: Fresh specimens of HNC were obtained from 72 new patients between August 2003 and January 2005. In situ hybridization for EBER was performed with immunohistochemical staining of p53, Bcl-2 and LMP-1 and serologic tests on anti-viral capsid antigen(VCA) and anti-early antigen (EA)-D. The results of EBV positivity were analyzed according to tumor TNM stages, sites, pathology and smoking status. A correlation between EBV positivity and p53, Bcl-2, LMP-1 positive staining was investigated. RESULTS: Nine (12%) of the total 72 patients showed EBV positivity of tumor, depending mainly on pathology and sites, but not tumor staging, age, sex or smoking status : NPC (3), NK/T cell lymphoma (5), lymphoephithelial carcinoma of the parotid gland (1). All patients had sero-positivity of anti-VCA IgG but not anti-VCA IgM and anti-EA-D. There was a relationship between the presence of EBV, its oncoprotein (LMP-1) and oncogene (Bcl-2). CONCLUSION: Overall, the incidence of EBV positivity of HNC in an endemic area is not significantly different from the prior reports about non-endemic area. The association between EBV and LMP-1 or Bcl-2 may be helpful for understanding the role of viral oncogenes in the HNC.
Burkitt Lymphoma ; Capsid ; Head and Neck Neoplasms* ; Head* ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; In Situ Hybridization ; Incidence ; Lymphoma ; Neck ; Neoplasm Staging ; Oncogenes ; Parotid Gland ; Pathology ; Serologic Tests ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: This study aims to identify whether the sequential bilateral cochlear implantation in children with a long inter-implant interval provides functional benefits in everyday situation. SUBJECTS AND METHOD: Seventeen children with sequential bilateral cochlear implants (BiCIs) (mean age at first implantation, 2.6 years; mean age at second implantation, 8.5 years; mean inter-implant interval, 6.0 years) and 17 children with unilateral cochlear implants (UniCIs) were included in this study. The questionnaire SSQ (The Speech, Spatial, and Qualities of hearing scale for parents of children with impaired hearing, Galvin, 2007) was used to evaluate the performance of two groups by individually interviewing the parents of the subjects. For the BiCIs, anecdotal reports of the performance in everyday listening situation and device use were also collected in interviews. RESULTS: The BiCI group showed significantly better performance in all three areas (speech perception, spatial hearing, and other qualities of hearing) of the SSQ than did the UniCI group. The differences between the two groups were significantly larger in performance on 'spatial hearing' and 'other qualities of hearing' than on 'speech perception'. All subjects with bilateral cochlear implants had a positive attitude on bilateral hearing. Anecdotal reports indicated that bilateral hearing has positive effects such as reduced repeated questions, increased participation in conversation, facilitated language and learning acquisition, and improved concentration. CONCLUSION: Children who received sequential bilateral cochlear implantation with a long inter-implant interval could obtain functional benefits in daily life. Also it turned out that these benefits have positive effects on children's communication, language, learning, and socio-emotional areas.
Child* ; Cochlear Implantation* ; Cochlear Implants* ; Hearing ; Humans ; Learning ; Parents

Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.
Aged ; Alzheimer Disease ; Anemia, Iron-Deficiency ; Biopsy ; Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Diagnosis ; Foreign Bodies ; Hemoptysis ; Humans ; Inflammation* ; Iron ; Korea ; Necrosis ; Nervous System Diseases ; Parkinsonian Disorders ; Reflex ; Respiratory Aspiration ; Stroke ; Tablets