PURPOSE: This study is to identify the factors that affect middle-aged workers' health promoting behaviors. METHODS: 214 middle-aged workers participated in surveys, and the data were collected from August to September 2012 and analyzed by using descriptive statistics, Pearson's correlation coefficient, and multiple regression analysis with PASW 18.0 program. RESULTS: It was found that among the factors, the degree of job stress (t=7.69, p<.001) and depression (t=6.23, p<.001) were significantly high for type D individuals, while non type D showed meaningful degree of self-related health status (t=-3.66, p<.001) and health promoting behaviors (t=-4.71, p<.001). The notable variable that affected the health promoting behaviors of the middle-aged workers was depression for both type D (beta=-.357, p= .029) and non type D (beta=-.325, p<.001) individuals, and this variable accounted for 24.1% and 18.2% respectively. CONCLUSION: The study revealed that the middle-aged workers showed high degree of job stress and depression that influenced on their health promoting behaviors. Thus, they are recommended to receive health management programs that offer treatment through consulting considering their individual personalities.
Depression ; Health Behavior

Although severe hemolytic diseases of the newborn triggered by anti-M are very rare, anti-M alloantibodies have been known to be associated with a cause of multipie intrauterine death. Serological and hematological investigations have been reported on a woman who experienced four multiple intrauterine deaths due to anti-M. The mothers blood type was of group A, NN and the husbands cells were of group B, MN. In the serological examination at 9th week's gestation of the fifth pregnancy, anti-M antibodies were identified in her serum. The antibodies comprised IgM saline agglutinin at a titer of 16 at 4 degrees C and IgG agglutinin reacted in an indirect antiglobulin technique at a titer of 4 at 37 degrees C. She underwent high-dose immunoglobulin infusion therapy on a monthly program from 3rd month gestation and a total of 6 times of intravenous immunoglobulin was given. The anti-M titer did not rise during the pregnancy. She delivered a live girl by cesarean section at the 37th week because of a failure of induction. The childs blood type was of group O, MN. The child was discharged and developed normally.
Antibodies ; Cesarean Section ; Child ; Female ; Humans ; Immunization, Passive* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins* ; Infant, Newborn ; Isoantibodies ; Mothers ; Pregnancy* ; Spouses

The aim of this study was to evaluate the efficacy of intravenous immunoglobulin treatment for recurrent spontaneous abortion. Immunologic causes in either alloimmune or autoimmune type have been suggested for more than 80% of these patients. Various immunotherapy including paternal leukocyte transfusion has been used, but there is controversy on its efficacy and side-effects. The proposed immunomodulatory mechanism of intravenous immunoglobulin includes passive transfer of blocking or anti-idiotype antibody, blockade of Fc receptors, enhancement of supressor T-cell function, down regulation of B cell function. In this study, we used intravenous immunoglobulin for the prevention of spontaneous abortion. Five patients with a history of two or more spontaneous abortions were enrolled in this study. Other etiologic factors such as anatomical, chromosomal, hormonal factors were excluded. Three of them were positive for anti-cardiolipin antibody (ACA). When the pregnancy was diagnosed at about five weeks of gestation, 30 g intravenous immunoglobulin was administered and continued up to 28 weeks with three weeks. Ongoing pregnancy beyond 20 weeks was considered successful. Four among five patients (80%) was successful in maintaining pregnancy now ongoing 20, 31, 33, 39 weeks. One patient with ACA positive had abartion due to anembryonic pregnancy. No adverse reaction was observed during the treatment. From these preliminary data, it is suggested that intravenous immunoglobulin treatment may be effective in maintaining pregnancy in patients with unexplained recurrent spontaneous abortion, Further studies are needed to clarify the its immunomodulatory mechanism and establish a more simplified protocol limiting the use at certain critical period of time.
Abortion, Spontaneous* ; Critical Period (Psychology) ; Down-Regulation ; Female ; Humans ; Immunoglobulins* ; Immunotherapy ; Leukocyte Transfusion ; Pregnancy ; Receptors, Fc ; T-Lymphocytes

OBJECTIVE: To investigate the long-term outcomes of cardiac rehabilitation (CR) on exercise capacity in diabetic (DM) and non-diabetic (non-DM) patients with myocardial infarction (MI). METHODS: Of the MI patients who received hospital-based CR from February 2012 to January 2014, we retrospectively reviewed the medical records of the patients who continued follow-up through the outpatient clinic and community-based self-exercise after CR. A total of 37 patients (12 with DM and 25 without DM) were included in this study. Exercise capacity was measured by symptom-limited exercise tests before and after hospital-based CR and 1 year after the onset of MI. RESULTS: Before the CR, the DM group had significantly lower exercise capacity in exercise times, peak oxygen consumption (VO2peak), and metabolic equivalent tasks (METs) than did the non-DM group. After the CR, both groups showed significantly improved exercise capacity, but the DM group had significantly lower exercise capacity in exercise times, submaximal rate pressure products (RPPsubmax), VO2peak, and METs. One year after the onset of the MI, the DM group had significantly lower exercise capacity in exercise times, RPPsubmax, and VO2peak than did the non-DM group, and neither group showed a significant difference in exercise capacity between before and after the CR. CONCLUSION: As a result of continued follow-up through an outpatient clinic and community-based self-exercise after hospital-based CR in patients with MI, the DM group still had lower exercise capacity than did the non-DM group 1 year after the onset of MI, but both groups maintained their improved exercise capacity following hospital-based CR.
Ambulatory Care Facilities ; Diabetes Mellitus ; Exercise Test ; Follow-Up Studies ; Humans ; Medical Records ; Metabolic Equivalent ; Myocardial Infarction* ; Oxygen Consumption ; Rehabilitation* ; Retrospective Studies

Methemoglobinemia is an uncommon but potentially fatal disorder. Most cases have no adverse clinical consequence and require no treatment, but methemoglobinemia is often overlooked as a cause of low oxygen saturation, and often mistaken for the more common causes of hypoxia by anesthesiologists despite simple bedside tests that indicate the presence of this treatable abnormality. We present a 68-year-old female patient who underwent gastrectomy for advanced gastric cancer with bleeding. In the preoperative period, the patient showed cyanosis and oxygen saturation was 85% by pulse oximeter, but oxygen saturation by arterial blood gas analysis was 100%. After tracheal intubation, the methemoglobin level was 18.3%. Ascorbic acid and methylene blue were administered. During preanesthetic evaluation, the patient had not informed the anesthesiologist that she had been taking dapsone.
Aged ; Anesthesia, General ; Anoxia ; Ascorbic Acid ; Blood Gas Analysis ; Cyanosis ; Dapsone ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Intubation ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Oximetry ; Oxygen ; Preoperative Period ; Stomach Neoplasms

This study sought to describe and to evaluate the characteristics of the Health Screening Records Database (HSRD) of the Korea Association of Health Promotion as a data source for epidemiologic studies. The HSRD was compared to a National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) database for 2015. Common variables between the databases were selected, and sex-based analyses were conducted. The HSRD showed statistical concordance when NHIS-HEALS estimates fell within the HSRD estimate's 95% confidence interval. The HSRD and NHIS-HEALS included 946461 and 111690 participants in health screening programs, respectively. Compared to the NHIS-HEALS, the HSRD had more female (55.2% vs. 42.6%) but fewer older adult participants (34.4% vs. 51.2%). Virtually all variables had clinical concordance, with some having statistical concordance as well, among both general and life-transition program participants. The HSRD comprised more clinical information over a wider age range in contrast to the NHIS-HEALS, while showing clinical concordance. Providing more comprehensive clinical data, the HSRD may serve as an alternative resource for epidemiologic studies.
Adult ; Cohort Studies ; Epidemiologic Studies ; Female ; Health Promotion ; Humans ; Information Storage and Retrieval ; Korea ; Mass Screening ; National Health Programs ; Observational Study ; Physical Examination

Anatomic variation of palmar digital nerve pathways were reported in several cases. Selective exploration of palmar digital nerves with a nerve conduction study has been challenging, because of technical issues. We report a patient who received bilateral carpal tunnel release operation, complaining of a tingling sensation, and hypoesthesia on the middle and ring fingers. An electrodiagnostic study revealed a sensory neuropathy of palmar digital nerve of the left median nerve, supplying the ulnar side of the middle finger, and radial side of the ring finger. She underwent re-operation of open left carpal tunnel release, and a branching site of common digital nerves of the median nerve was identified not at the palm, but at a far proximal site around the distal wrist crease. Usefulness of an orthodromic sensory conduction study was clarified to eliminate volume conducted response or co-activation of nearby nerves in the patient with selective involvement of palmar digital nerve.
Anatomic Variation ; Carpal Tunnel Syndrome ; Electrodiagnosis ; Fingers ; Humans ; Hypesthesia ; Median Nerve ; Median Neuropathy ; Neural Conduction ; Sensation ; Wrist

PURPOSE: To analyze the causes and clinical outcomes associated with re-revision total knee arthroplasty. MATERIALS AND METHODS: Eighteen cases of re-revision total knee arthroplasty (TKA) were performed between June 1996 and September 2006. The average patient age was 69.8 years, and the average follow-up period was 3.4 years. We evaluated the time interval between revision and re-revision arthroplasty and the causes of re-revision. Clinical outcomes were assessed using the Hospital for Special Surgery (HSS) knee rating score and determining the range of motion in the knee. RESULTS: The mean interval between revision and re-revision arthroplasty was 9 years 1 month. Causes of re-revision included 9 cases of polyethylene wear, 6 cases of aseptic loosening, 1 case of infection, and 2 cases of other causes. The average HSS score was 89.1, and the average range of motion was 111.1 degrees. For 5 cases of revision undertaken secondary to infected TKA, the interval between revision and re-revision arthroplasty was 9 years 3 months, and the cause of re-revision surgery was aseptic loosening in all cases. CONCLUSION: The main causes of re-revision surgery were polyethylene wear and aseptic loosening. Reasonable restoration of function was achieved in re-revision arthroplasty using appropriately selected implants, metal augmentation, structural allografts, and stems. When revising an infected TKA, it is important to achieve structural stability in the implant because of the possibility of late aseptic loosening.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Polyethylene ; Range of Motion, Articular ; Transplantation, Homologous

We present a case of adult onset Still's disease (AOSD) that was misdiagnosed as septic arthritis of the shoulder and knee. A forty-nine-year-old woman was admitted for pain in the left knee. The patient's medical history showed that she had undergone arthroscopic irrigation twice and an open debridement under the diagnosis of septic shoulder at another hospital. The laboratory and joint fluid analysis findings led us to suspect septic knee. Arthroscopic irrigation and antibiotics treatment were performed. At five weeks after discharge, she presented with pain in the same joint, fever, and rash. The symptoms were consistent with Yamaguchi's criteria for AOSD. We started corticosteroid therapy, and clinical remission was achieved. In conclusion, we suggest that AOSD should be considered as a diagnosis of exclusion to avoid misdiagnosis with septic arthritis.
Adult ; Anti-Bacterial Agents ; Arthritis, Infectious ; Debridement ; Diagnostic Errors ; Exanthema ; Female ; Fever ; Humans ; Joints ; Knee ; Shoulder ; Still's Disease, Adult-Onset

PURPOSE: To investigate the result of total knee arthroplasty (TKA) using an intra-articular correction in patients with extra-articular deformity of the femur. MATERIALS AND METHODS: We performed 23 TKAs in 23 patients with extra-articular deformity of the femur. The mean age was 58.0 years and the follow-up period averaged 54.7 months. The American Knee Society's knee and function score were evaluated, and the mechanical axis (MA) was measured. Sixteen knees with a deformity in the distal third of the femur were assigned to group I and 7 knees with a deformity in the proximal or middle third were assigned to group II. Between groups differences in results were analyzed. RESULTS: The average knee score was 47.8 preoperatively and 91.6 at the last follow-up. The average function score was 46.9 preoperatively and 89.1 at the last follow-up. The MA averaged varus was 7.7degrees preoperatively and 1.0degrees postoperatively. The average knee score at the last follow-up was 90.1 in group I and 95.0 in group II. The average function score at the last follow-up was 87.8 in group I and 92.1 in group II. The MA averaged varus was 2.0degrees in group I and 1.3degrees in group II (p=0.042). CONCLUSION: TKA in conjunction with intra-articular correction produced satisfactory results for patients with an extra-articular deformity of femur. The possibility of incomplete correction of limb alignment should be carefully considered, especially in cases with a severe deformity at the distal third of the femur.
Arthroplasty ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Extremities ; Femur ; Follow-Up Studies ; Humans ; Knee