No abstract available.
Myxoma* ; Perineum*

Brachial plexus block is a suitable, technique for surgery of the forearm, because it provides good intraoperative anesthesia and prolonged postoperative analgesia when long-acting local anesthetics are used. An eighty-year-old male patient was admitted to our hospital for right radioulnar fracture. He had active pulmonary tuberculosis, severe valvular heart disease, hypertension, mild subarachnoid hemorrhage and a difficult airway. So, we performed an infraclavicular block to treat the fracture site and used a nerve stimulator when median nerve dital response and musculocutaneous nerve response were sought, and combined spinal-epidural block for the iliac bone graft at the same time. Regional anesthesia many advantages compared to general anesthesia in extremity operation. Peripheral nerve block and neuraxial block, when used properly in combination, should be able to replace general anesthesia in the majority of cases.
Analgesia ; Anesthesia* ; Anesthesia, Conduction ; Anesthesia, General ; Anesthetics, Local ; Brachial Plexus* ; Extremities ; Forearm ; Heart Valve Diseases ; Humans ; Hypertension ; Male ; Median Nerve ; Musculocutaneous Nerve ; Peripheral Nerves ; Subarachnoid Hemorrhage ; Transplants* ; Tuberculosis, Pulmonary

OBJECTIVE: We undertook this study to find out clinical characteristics and prognostic factors of neonatal survival in nonimmune hydrops fetalis (NIHF). METHODS: From Oct. 1988 to Feb. 2001, 54 cases of nonimmune hydrops fetalis diagnosed at Seoul National University Hospital (SNUH) were included in our study. The incidence and perinatal mortality were investigated. The diagnostic work-up for associated conditions (or etiology) included detailed ultrasonography, karyotyping, fetal echocardiography, infection work-up (TORCH, parvovirus), and autopsy (if fetus was dead). Among 54 cases, 20 cases of liveborns were divided into two groups. Group I survived beyond neonatal period (survived>28 days) and group II did not (expired3 (OR=21, CI 1.77, 248.1; p<0.05), and 5-min AS>3 (p<0.01). CONCLUSION: Over 3 of 1-min and 5-min AS were meaningful factors for neonatal survival in NIHF.
Apgar Score ; Autopsy ; Echocardiography ; Female ; Fetofetal Transfusion ; Fetus ; Gestational Age ; Hydrops Fetalis* ; Incidence ; Karyotyping ; Parturition ; Perinatal Mortality ; Pleural Effusion ; Polyhydramnios ; Pregnancy ; Seoul ; Ultrasonography

OBJECTIVES: One of the antidiabetic drugs, metformin, have shown that it prevented oxidative stress-induced death in several cell types through a mechanism involving the opening of the permeability transition pore and cytochrome c release. Thus, it is possible that the antioxidative effect of metformin can also serve as protection against gentamicin-induced cytotoxicity related to reactive oxygen species (ROS). The aim of this study was to examine the protective effect of metformin on gentamicin-induced vestibulotoxicity in primary cell culture derived from rat utricle. METHODS: For vestibular primary cell culture, rat utricles were dissected and incubated. Gentamicin-induced cytotoxicity was measured in both the auditory and vestibular cells. To examine the effects of metformin on gentamicin-induced cytotoxicity in the primary cell culture, the cells were pretreated with metformin at a concentration of 1 mM for 24 hours, and then exposed to 2.5 mM gentamicin for 48 hours. The intracellular ROS level was measured using a fluorescent dye, and also measured using a FACScan flow cytometer. Intracellular calcium levels in the vestibular cells were measured with calcium imaging using Fura-2 AM. RESULTS: Vestibular cells were more sensitive to gentamicin-induced cytotoxicity than auditory hair cells. Metformin protects against gentamicin-induced cytotoxicity in vestibular cells. Metformin significantly reduced a gentamicin-induced increase in ROS, and also reduced an increase in intracellular calcium concentrations in gentamicin-induced cytotoxicity. CONCLUSION: Metformin significantly reduced a gentamicin-induced increase in ROS, stabilized the intracellular calcium concentration, and inhibited gentamicin-induced apoptosis. Thus, Metformin showed protective effect on gentamicin-induced cytotoxicity in vestibular primary cell culture.
Animals ; Apoptosis ; Calcium ; Cytochromes c ; Fura-2 ; Gentamicins ; Hair Cells, Auditory ; Hypoglycemic Agents ; Metformin* ; Permeability ; Primary Cell Culture* ; Rats* ; Reactive Oxygen Species ; Saccule and Utricle ; Vestibule, Labyrinth

BACKGROUND AND OBJECTIVES: To evaluate the effect of eggshell membrane (ESM) patching for tympanic membrane (TM) perforation, and to investigate correlations between healing time and age, gender, patching time, perforation size, and perforation location. SUBJECTS AND METHODS: One hundred and seventy-five patients diagnosed with traumatic TM perforation at the Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, between January 2008 and October 2013. Patients were divided into two groups, according to perforation edge approximation or ESM patching treatment. Healing time was compared between the group that received perforation edge approximation and the group that received ESM patching. Perforation grade, age, onset, and location were also compared between the two groups. RESULTS: ESM patching significantly improved healing time compared to spontaneous healing, especially in patients with moderate or large traumatic TM perforations (≥grade II). However, patient age, gender, perforation location, and especially timing of procedure, did not significantly affect healing time. CONCLUSIONS: ESM patching can be a good treatment choice to promote tympanic membrane healing in large traumatic TM perforations.
Gyeonggi-do ; Humans ; Korea ; Membranes* ; Neck ; Tympanic Membrane Perforation* ; Tympanic Membrane*

OBJECTIVES: The association of workplace cumulative noise exposure and blood pressure was investigated in this study using cross-sectional design. METHODS: The study population comprised 852 manufacturing male workers of whom occupational health examination data, questionnaire and personnel records were available. Workplace ambient noise monitoring data was used for calculating individual cumulative noise exposure level. Mean of each systolic and diastolic blood pressure of occupational health examination data was used for individual systolic and diastolic blood pressure level. Possible confounding variables including family history of hypertension, smoking habit, alcohol drinking habit were collected by questionnaire. On the basis of job location and duration of work at the location, a cumulative time-weighted average noise level was calculated for each workers. According to this cumulative noise exposure level, each study subject was categorized as low noise exposure group, moderate noise exposure group, high noise exposure group, very high noise exposure group. Among noise exposure groups, mean of systolic and diastolic blood pressure was compared after adjusting possible confounding variables such as age, body mass index, serum cholesterol level, family history of hypertension, smoking history, alcohol drinking habit. RESULTS: After adjusting possible confounding variables, noise exposure group was significant explanatory variables for both systolic and diastolic blood pressure, and mean of both systolic and diastolic blood pressure of very high exposure group was higher than that of low exposure group. CONCLUSIONS: These findings suggested that the high cumulative noise exposure might elevate the blood pressure.
Alcohol Drinking ; Blood Pressure* ; Body Mass Index ; Cholesterol ; Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Humans ; Hypertension ; Male ; Noise* ; Occupational Health ; Questionnaires ; Smoke ; Smoking

OBJECTIVES: This study was conducted to develop a worksite-based, post-examination, health care management system for continuous and systematic management of workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT detected by periodic health examination and to assess the effectiveness such a system as an intervention study. METHODS: Study subjects were selected from workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT according to the selection criteria. The intervention group, but not the control group, received medical treatment of disease, follow up examination, and health education which consisted of information about the disease and the importance of life-style modification through periodic interview using the resources of occupational health service center in the worksite. To assess the effectiveness of this system, we compared follow up examination data from the intervention group with periodic examination data from the worksite control group. RESULTS: In the intervention group a significant reduction trend was recorded for systolic and diastolic blood pressure, fasting blood sugar, postprandial 2 hour glucose, total cholesterol, triglyceride, LDL-cholesterol, AST, ALT, and gamma-GTP, and a rising trend for HDL-cholesterol. Significant group differences ware recorded for fasting blood sugar, postprandial 2 hour glucose, total cholesterol, AST, and ALT. CONCLUSIONS: The worksite-based, post-examination, health care management system was effective for the continuous and systematic management of workers who had abnormal findings detected by periodic health examination.
Blood Glucose ; Blood Pressure ; Cholesterol ; Delivery of Health Care* ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Glucose ; Health Education ; Hyperlipidemias ; Hypertension ; Intervention Studies ; Occupational Health Services ; Patient Selection ; Triglycerides ; Workplace

In order to decide on appropriate treatment strategy against gastric cancer, an accurate preoperative evaluation of the depth of cancer invasion is essential. We studied 165 cases(19%) of early gastric cancer among 706 cases of gastric cancer. resected over a 6 year period. A retrospective study of early gastric cancer was done to evaluate the endoscopic accuracy and lymph node metastasis status, the following results were obtained: 1) The proportion of EGC according to macroscopic type was 68.5% of depressed type(II, III, IIa+III, IIc+III, III+IIc, IIb+IIc), 26% of elevated type(I, IIa, IIa+ IIb, IIa+IIc), 5.5% of flat type(IIb). 2) In the view of accuracy of endoscopic diagnosis, the rate of accurate diagnosis suitable for postoperative macroscopic type was 37.5%, the rate of unsuitable typed EGC was 33.3%, overestimation(diagnosed to AGC) was 20.6% and underestimation(diagnosed to benign diseases)was 8.6%. Overall accuracy of endoscopic diagnosis was 70.8%. 3) The cases confined to the mucosa were 40.6% and others were submucosal cancers(59.4%). 4) Positive lymph node metastasis was found in 1.5% of M-cancer and 18.4% of SM-cancer(overall 11.5%). 5) Node positive rate of differentiated cancer was 10.5%, undifferentiated carcinoma was 15.4%. There was no signficant difference in frequency of nodal metastasis according tumor size and macroscopic type. 6) Tumors which satisfy the following criteria may not metastasize to lymph nodes:(1) confined to the mucosa; (2) less than 2.0cm in diameter; (3) macroscopically elevated or flat; (4) histologically well or moderately differentiated.
Carcinoma ; Diagnosis ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms*

OBJECTIVES: To evaluate the patient satisfaction and its influencing factors after medical care for workrelated injuries. METHODS: A self-reported questionnaire was mailed to 921 workers who had experienced workers' compensation medical care. The data from 335 respondents (response rate was 36.4%) were merged and analysed with the data from the Korea Labor Welfare Corporation (KLWC) which contain other general information of the respondents. RESULTS: Dissatisfaction with their medical care was reported by 17.3% of the respondents. Overall patient satisfaction (OPS) was highly correlated with the medical treatment process such as hospital facility, medical therapy, surgical therapy, doctor's explanation and physical therapy. However, OPS was negatively influenced by three factors: 1) unsatisfactory hospital care during waiting period before the approval of workers' compensation, 2) forced end of the hospital care by the workers' compensation, and 3) end of the hospital care with no further improvement. CONCLUSIONS: To improve the satisfaction of patients with work-related injuries, both the practice of medical treatment and also the administrative process of workers' compensation must be reformed. These reforms are needed to improve the quality of workers' compensation medical care and prevent abnormal illness behavior such as inappropriate treatment seeking.
Data Collection ; Humans ; Illness Behavior ; Korea ; Patient Satisfaction* ; Postal Service ; Questionnaires ; Workers' Compensation*

OBJECTIVES: This research was conducted to investigate workers'return to work rate after work-related injury or illness and to determine which factors could predict return to work and job retention. METHODS: From the documents held by the six local branches of the Korea Labor Welfare Corporation(KLWP), 2,464 cases of work-related injury or illness which had telephone numbers were identified from September to December, 2003. Data about the employment status was gained from 921 occupationally injured workers through telephone questionnaire and was merged with the electronic data obtained from KLWP with included information of the workers whose worker's compensation period was ended from 2002 to 2004. Finally the data for 516 workers was analysed by logistic regression using SAS 9.0. RESULTS: The return to work rate was 50.3% and the job retention rate was 28.3%. Decreased return to work rate was associated with old age, shorter employment duration, longer treatment duration, higher disability grade, lower average wage and manual worker. Decreased job retention rate was associated with a smaller number of employees, shorter employment duration and work in the construction industry. CONCLUSIONS: This research highlighted the numerous occupationally injured workers who couldn't return to work and the multiple factors that were associated with the return to work or job retention. Based on this and related research, rehabilitation programs which consider the issues of return to work and job retention have to be implemented.
Construction Industry ; Employment ; Korea ; Logistic Models ; Occupations ; Questionnaires ; Rehabilitation ; Return to Work* ; Salaries and Fringe Benefits ; Telephone ; Workers' Compensation