Generally working environment and worker's health status of small scale industries(SSI) which employ less than 50 workers are known to be poorer than those of large scale industries(LSI) which employ more than 500 workers. However, according to the analysis of occupational injuries in Korea, prevalence rate of occupational injuries of SSI was 3.1 times as high as LSI. But there was no difference in prevalence rate of occupational disease and workers with suspected occupational disease(D1) between SSI and LSI. To confirm these two different facts, we surveyed working environment and worker's health status of SSI and LSI in Kyeungin industrial complex. Workers in SSI were 10,878 and workers in LSI were 8,291 and number of hazardous agents in SSI were 3,554 and those of LSI were 1,916. We found following results. First, proportion of male workers and workers who were less than 30 years old and more than 50 years old was higher in SSI compared to LSI. Second, worker in SSI had more liver disease, viral hepatitis, and pneumoconiosis than in LSI, and there were more worker with suspected occupational disease, general disease, and worker needed close observation in SSI. But these effects had not statistical significance under the condition controlled by age and sex with logistic regression. Third, the numbers measured for specific chemicals, organic solvents, and heavy metals in SSI was more than in LSI. However there was on difference in the excess rate of each hazardous agent between SSI and LSI. As the above results workers' health status in SSI was poorer than in LSI, but these results were mainly due to the population structure difference. Although there were some limitation of this study and problems of sensitivity and validity for periodic health examination and working environment evaluation method, the concept that working environment and worker's health status in SSI should be reviewed. In future the study that will reveal the real weak point of SSI should be performed.
Adult ; Hepatitis ; Humans ; Korea ; Liver Diseases ; Logistic Models ; Male ; Metals, Heavy ; Middle Aged ; Occupational Diseases ; Occupational Injuries ; Organic Chemicals ; Pneumoconiosis ; Prevalence ; Solvents

Industrial Accident Compensation Insurance (IACI) has a history of about 50 yr, and is the oldest social insurance system in Korea. After more than 20 times of revision improvements in benefits, its contents and claim systems have been upgraded. It became the protector of injured workers and their families, and at the same time became the system which could cope with both financial burden of employers and their responsibilities. However, there are some issues to be reformed to upgrade the IACI: 1) the problems in the approval system of occupational diseases, 2) quality improvement of workers' compensation medical care, 3) vocational rehabilitation and return to work, 4) workers' compensation premiums and out-of-pocket money of injured workers, 5) issues in application of IACI. Growth of IACI cannot be achieved by an effort of an individual. Efforts by workers, owners, and government, in addition to physicians and welfare professionals toward the same goal are required for the next level improvement of IACI.
Humans ; Industry/economics ; Insurance, Accident/*economics ; Occupational Diseases/economics ; Rehabilitation, Vocational/economics ; Workers' Compensation/*economics

PURPOSE: Lacunar stroke, in the context of small vessel disease, is a type of cerebral infarction caused by occlusion of a penetrating artery. Pulsatility index (PI) is an easily measurable parameter in Transcranial Doppler ultrasound (TCD) study. PI reflects distal cerebral vascular resistance and has been interpreted as a surrogate marker of small vessel disease. We hypothesized that an increased PI, a marker of small vessel disease, might be associated with a larger infarct volume in acute lacunar stroke. MATERIALS AND METHODS: This study included 64 patients with acute lacunar stroke who underwent TCD and brain MRI. We evaluated the association between the mean PI value of bilateral middle cerebral arteries and infarct volume on diffusion-weighted MRI using univariate and multivariate linear regression. RESULTS: The mean infarct volume and PI were 482.18±406.40 mm3 and 0.86±0.18, respectively. On univariate linear regression, there was a significant positive association between PI and infarct volume (p=0.001). In the multivariate model, a single standard deviation increase of PI (per 0.18) was associated with an increase of 139.05 mm3 in infarct volume (95% confidence interval, 21.25 to 256.85; p=0.022). CONCLUSION: We demonstrated that PI was an independent determinant of infarct volume in acute lacunar stroke. The PI value measured in acute stroke may be a surrogate marker of the extent of ischemic injury.
Aged ; Cerebral Infarction/*diagnostic imaging/*physiopathology ; *Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Middle Cerebral Artery ; Pulsatile Flow/physiology ; Retrospective Studies ; Stroke, Lacunar/*diagnostic imaging/*physiopathology ; *Ultrasonography, Doppler, Transcranial ; Vascular Resistance/physiology

PURPOSE: The effect of delays in surgical treatment on survival outcomes in patients with breast cancer remains uncertain, but it is an issue of importance to both patients and clinicians. The purpose of this study was to determine the impact of delayed surgical treatment on survival and tumor progression such as changes in tumor size and lymph node metastasis. METHODS: Among 1,219 patients who underwent breast cancer surgery at Asan Medical Center between January 2008 and December 2008, 1,074 patients were finally included in the study following the application of inclusion and exclusion criteria. Patients were divided into two groups based on the interval between diagnosis and surgery: ≤30 days (group 1) and >30 days (group 2). We retrospectively analyzed clinical characteristics, changes in tumor size and axillary lymph-node status, and overall survival (OS) and disease-free survival (DFS) rates. RESULTS: Between group 1 and group 2, there were no differences in clinical characteristics or in changes in tumor size between findings based on ultrasonography (USG) with biopsy at diagnosis and pathologic results (p=0.134). Furthermore, changes in tumor size and lymph-node status between USG results at Asan Medical Center and pathologic results also showed no differences (p=0.249 and p=0.233, respectively). There were also no significant differences in DFS (p=0.395) or OS (p=0.813). CONCLUSION: Our study showed that short-term delays of ≤2 months between diagnosis and surgery for breast cancer do not negatively affect cancer progression or survival rates.

Intracranial developmental venous anomalies (DVAs) are the most common cerebral vascular malformation and are usually asymptomatic. Movement disorders are rarely associated with DVAs within basal ganglia regions. We report a case of markedly asymmetric parkinsonism due to unilateral DVA in the basal ganglia, which occurred together with symmetrical nigrostriatal dopaminergic deficits. A 57-year-old woman presented with resting tremor in the right hand lasting for 6 months. She also experienced problems with gait and started falling while walking one month ago. The neurological examination found a resting tremor in the right hand and moderate rigidity and bradykinesia in the right extremities. She reported light headedness on standing up. The patient displayed minimal response to treatment with 300 mg levodopa. The FP-CIT PET scan revealed symmetrical decrease of radiotracer uptake in bilateral basal ganglia. Brain MRI and cerebral angiography identified a large DVA draining the basal ganglia, thalamus, and surrounding deep white matter in the left side. Conclusion: A DVA may contribute to the prominent asymmetrical manifestation in our patient, in combination with symmetrical dopaminergic loss from neurodegenerative Parkinsonian syndrome. A marked asymmetry in patients with signs of atypical Parkinsonism can be a clue for further imaging investigation to exclude superimposed structural lesions such as DVAs.