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

PURPOSE: To evaluate the clinical and radiological results and to analyze the survivorship after closing wedge proximal tibial osteotomy(PTO) using miniplate staple. MATERIALS AND METHODS: From November 1993 to August 2003, sixty closing wedge PTO using miniplate staple were performed in forty patients. The average follow-up period was 7.2 years(range, 2.8~12.5 years). According to the post- operative femorotibial angle(FTA), group I was defined as the cases whose FTA was less than 7 degrees of valgus(25 cases) and group II was defined as the cases whose FTA was more than 7 degrees of valgus(35 cases). The HSS score, FTA and survivorship were compared between group I and II. RESULTS: Average HSS score at the last follow up were 75.3 in group I and 85.9 in group II(p=0.006). Average FTA at the last follow up were 0.8 degrees in group I and 7.7 degrees in group II(p=0.006). The overall 7-year survivorship was 92.6% and 12-year survivorship was 75.5%. The 7-year survivorship and 12-year survivorship of group I were 86.7% and 54.2%, respectively. Group II have no failure at last follow up(p=0.0489). CONCLUSION: Our results suggest that the desirable postoperative FTA was more than 7 degrees of valgus, considering the long term satisfactory result and survivorship of the closing wedge PTO using miniplate staple for the osteoarthritic knees.
Follow-Up Studies ; Humans ; Knee ; Osteotomy* ; Survival Rate*

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

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

PURPOSE: To compare the measurements using a navigation system and radiographic measurement in an open wedge high tibial osteotomy under navigation control. MATERIALS AND METHODS: From July, 2005 to January, 2007, 32 open wedge high tibial osteotomies were performed using a navigation system for osteoarthritis of the knee. The postoperative mechanical axis % (MA%), which is planned on the navigation system, were 62%. The mechanical axis (MA) and MA% were measured on the navigation system. The preoperative and postoperative MA and MA% were measured on the radiographs. The angles measured with the navigation system and radiographs were compared. RESULTS: On the navigation system, the mean MA before osteotomy was varus 8.8degrees. The mean MA and MA% after fixation were valgus 2.9degrees and 57.7%. On the radiographs, the mean MA was varus 9.7degrees preoperatively and valgus 4.0degrees postoperatively. The mean MA% was 10.2% preoperatively and valgus 64.4% postoperatively. There were positive correlations between the values measured with the navigation system and the radiographs (r>0.5, p<0.001). CONCLUSION: There were significant correlations between the values measured with the navigation system and radiographs in an open wedge high tibial osteotomy using a navigation system. The correction angle from the navigation system is reliable, predictable and controllable during surgery.
Axis, Cervical Vertebra ; Knee ; Osteoarthritis ; Osteotomy ; Surgery, Computer-Assisted

PURPOSE: To evaluate midterm results after microfracture in osteoarthritic knees. MATERIALS AND METHODS: Between October 1997 and April 2006, 67 osteoarthritic knees, with minimum 4-year follow-up, underwent microfracture. Baumgaertner scores were evaluated to determine clinical results. Radiological results were assessed based on joint space widening and improvement of mechanical axis deviation. Joint space widening was calculated by comparing the preoperative joint space with the final follow-up joint space. Varus deformity was evaluated on orthoroentgenogram and recorded as a percentile of the point at which the mechanical axis intersected a line extending from the center of the knee to medial border of the medial tibial condyle. The figure was expressed as MA%. RESULTS: The average Baumgaertner score at final follow-up was 7.0. The average joint space changed from 2.74 mm to 4.22 mm on AP radiographs and from 1.91 mm to 3.85 mm on lateral radiographs. Average MA% was 57.5% preoperatively and 45.8% at final follow-up. Clinical and radiological improvements were maintained in most cases followed for more than 4 years. Four patients had total knee arthroplasty after an average of 4.1 years. CONCLUSION: We noted pain relief, joint space widening, and improvement of mechanical axis after microfracture for degenerative arthritis of the knee. Maintenance of clinical and radiological improvement was observed at midterm follow-up.
Arthroplasty ; Arthroscopy ; Axis, Cervical Vertebra ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Knee ; Osteoarthritis