In order to study the exposure level of silica dust and the effects of silica dust on ventilatory function, respirable dust samples were collected by personal air samplers using NIOSH method 0500 from the selected foundry operations, and ventilatory function tests were performed on 209 male foundry workers and 239 male control subjects. Ventilatory indices such as forced vital capacity (FVC) , one-second forced expiratory volume (FEV1), ratio of FEV1 to FVC(FEV1 %), maximal mid-expiratory flow(MMF), peak expiratory flow rate (PEFR) and maximal expiratory flow at 25, 50 and 75 % of expired FVC (FEF25, FEF50, FEF75 were obtained by analyzing forced expiratory spirogram and maximal expiratory flow-volume curve which were simultaneously measured by Vitalography in standing position. The results were as follows : 1. The average quartz concentrations of respirable dust were the highest in melting operation (0.079 mg/m3) and followed by molding operation (0.051 mg/m3), finishing operation (0.041 mg/m3) and coremaking operation (0.023 mg/m3) in the descending order. 2. No significant differences for mean values of all ventilatory indices expressed as percent of predicted value were demonstrated between smokers and nonsmokers In foundry workers and control subjects. 3. Mean values of all ventilatory indices except FVC of foundry workers were significantly lower than those of control subjects. 4. Mean values of FEV1 %, MMF, FEF25, FEF50 and FEF75 expressed as percent of predicted value tended to decrease with increasing cumulative dust exposure. 5. In foundry workers, proportions of workers with low MMF, FEF50 and FEF75 were markedly higher than those with other indices, and were significantly increased with increasing cumulative dust exposure. 6. In foundry workers, 2 workers(1.0 %) were diagnosed as silicosis and the profusion of radiographic opacities were category 1/0 and q type. With the above considerations in mind, it suggested that increasing exposure of silica dust be associated with progressive deterioration in ventilatory function of an obstructive nature and that MMF, FEF50 and FEF75 be more sensitive indices in the detection of the early obstructive changes of air flow of workers exposed to silica dust.
Dust* ; Forced Expiratory Volume ; Freezing ; Fungi ; Humans ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Peak Expiratory Flow Rate ; Quartz ; Silicon Dioxide* ; Silicosis ; Vital Capacity

The increased survival of patients with breast cancer has given rise to other problems associated with the complications of chemotherapy. One major complication is premature ovarian failure, an especially harmful outcome for women of reproductive age. This study was performed to evaluate the efficacy of GnRH agonist (GnRHa) treatment on protecting ovarian function in young breast cancer patients (30.59+/-5.1 yr) receiving chemotherapy after surgery. Twenty-two women were enrolled and given subcutaneous injections of leuprolide acetate (3.75 mg) every 4 weeks during chemotherapy. Follow-up laboratory tests (luteinizing hormone [LH], follicle stimulating hormone [FSH], and estradiol) were performed 1, 3, and 6 months after chemotherapy. Menstruation patterns and clinical symptoms were followed up for a mean duration of 35.6+/-1.7 months. FSH and LH levels were normal in all patients 6 months after completing chemotherapy (8.0+/-5.3, 4.4+/-2.7 mIU/mL, respectively). During follow-up, none of the patients complained of menopausal symptoms and 81.8% experienced recovery of menstruation. This report is the first trial of GnRHa as a treatment modality to protect ovarian function during adjuvant chemotherapy in young Korean breast cancer patients.
Adult ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Agents, Hormonal/therapeutic use ; Breast Neoplasms/diagnosis/*drug therapy/surgery ; Combined Modality Therapy ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Follicle Stimulating Hormone/analysis ; Gonadotropin-Releasing Hormone/*agonists ; Humans ; Leuprolide/administration & dosage ; Luteinizing Hormone/analysis ; Menstruation ; Ovarian Function Tests ; Primary Ovarian Insufficiency/etiology/*prevention & control ; Republic of Korea ; Tamoxifen/therapeutic use ; Time Factors

Changes in contrast sensitivity have been demonstrated in patients with normal Snellen acuity. In an attempt to elucidate more sensitively the visual dysfunction before developement of either overt retinopathy or a reduction in Snellen acuity in patients with retinal disorders, contrast sensitivity test was performed in diabetic patients with normal Snellen acuity and control subjects matched for age and sex. The results were as follows. 1) Throughout all spatial frequencies(1.5 - 3.0 - 6.0 - 12.0 - 18.0 cpd), contrast sensitivity was significantly lower(P-value<0.01) in the diabetic eyes with retinopathy(30.7 - 49.3 - 52.5 - 16.1 - 7.8) than in the normal controls(42.5 - 84.3 - 103.0 - 60.5 - 25.1) or the diabetic eyes without retinopathy(43.1 - 92.2 - 95.8 - 43.4 - 16.4 ). 2) In high spatial frequencies(12.0 - 18.0 cpd) contrast sensitivity in the diabetic eyes without retinopathy group(43.4 - 16.4) was significantly decreased(P-value<0.01) in comparison with the normal controls(60.5 - 25.1). So, contrast sensitivity test is more sensitive test for central visual function than Snellen acuity.
Contrast Sensitivity* ; Diabetic Retinopathy* ; Humans ; Retinaldehyde

BACKGROUND: The clinical presentation of microscopic colitis (MC) consists of chronic non-bloody watery diarrhea for weeks or months at a time, abdominal pain, and changes in bowel habits with a normal mucosal appearance upon performing colonoscopy. MC includes two relatively well established histopathologic entities: collagenous colitis (CC) and lymphocytic colitis (LC) as well as atypical forms. The recognition of the microscopic findings of this heterogeneous entity is very important for making the correct diagnosis and providing proper treatment. METHODS: We studied the colonoscopic biopsy specimens that were obtained from 26 patients who had clinical findings that were suggestive of MC. RESULTS: Fifteen patients (M:F=9:6) and 9 patients (M:F=5:4) showed the microscopic features of LC and MC, not otherwise specified, respectively. CONCLUSIONS: The clinicopathologic findings (the incidence of the subtypes, the patients' ages and the male/female ratio) of the 24 cases of MC in this study showed differences from the previously reported findings from other countries. Further studies with a sufficient number of patients from multi-centers would be necessary to confirm the regional or ethnic influence.
Abdominal Pain ; Biopsy ; Colitis, Collagenous ; Colitis, Lymphocytic ; Colitis, Microscopic ; Colonoscopy ; Diarrhea ; Humans ; Incidence ; Lymphocyte Count

Background: Prompt insertion and placement of supraglottic airway (SGA) devices in the correct position are required to secure the airway. This meta-analysis was performed to validate the usefulness of the 90° rotation technique as compared with the standard digit-based technique for the insertion of SGA devices in anesthetized patients in terms of insertion success rate, insertion time, and postoperative complications. Methods: A literature search of PubMed, EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science was conducted. Randomized controlled trials, without limitations on publication period, language, journal, or region, until July 2021, that compared the 90° rotation and the standard digit-based techniques for insertion of SGA devices in anesthetized patients were included. Results: The first-attempt (risk ratio [RR]: 1.16, 95% CI [1.09, 1.25], P < 0.001) and overall success rates (RR: 1.06, 95% CI [1.03, 1.09], P < 0.001) were significantly higher in the 90° rotation group. The insertion time was shorter in the 90° rotation group (mean difference: −4.42 s, 95% CI [−6.70, −2.15 s], P < 0.001). The incidences of postoperative sore throat (RR: 0.63, 95% CI [0.49, 0.83], P < 0.001) and blood staining (RR: 0.28, 95% CI [0.20, 0.39], P < 0.001) were lower in the 90° rotation group. Conclusions The use of the 90° rotation technique increases the success rate of SGA device insertion and decreases postoperative complications as compared with that of the standard digit-based technique in anesthetized patients.

OBJECTIVE: To provide a systematic overview of the effects of various parameters on contrast enhancement within the same population, an animal experiment as well as a computer-aided simulation study was performed. MATERIALS AND METHODS: In an animal experiment, single-level dynamic CT through the liver was performed at 5-second intervals just after the injection of contrast medium for 3 minutes. Combinations of three different amounts (1, 2, 3 mL/kg), concentrations (150, 200, 300 mgI/mL), and injection rates (0.5, 1, 2 mL/sec) were used. The CT number of the aorta (A), portal vein (P) and liver (L) was measured in each image, and time-attenuation curves for A, P and L were thus obtained. The degree of maximum enhancement (Imax) and time to reach peak enhancement (Tmax) of A, P and L were determined, and times to equilibrium (Teq) were analyzed. In the computed-aided simulation model, a program based on the amount, flow, and diffusion coefficient of body fluid in various compartments of the human body was designed. The input variables were the concen-trations, volumes and injection rates of the contrast media used. The program generated the time-attenuation curves of A, P and L, as well as liver-to-hepatocel-lular carcinoma (HCC) contrast curves. On each curve, we calculated and plotted the optimal temporal window (time period above the lower threshold, which in this experiment was 10 Hounsfield units), the total area under the curve above the lower threshold, and the area within the optimal range. RESULTS: A. Animal Experiment: At a given concentration and injection rate, an increased volume of contrast medium led to increases in Imax A, P and L. In addition, Tmax A, P, L and Teq were prolonged in parallel with increases in injection time The time-attenuation curve shifted upward and to the right. For a given volume and injection rate, an increased concentration of contrast medium increased the degree of aortic, portal and hepatic enhancement, though Tmax A, P and L remained the same. The time-attenuation curve shifted upward. For a given volume and concentration of contrast medium, changes in the injection rate had a prominent effect on aortic enhancement, and that of the portal vein and hepatic parenchyma also showed some increase, though the effect was less prominent. A increased in the rate of contrast injection led to shifting of the time enhancement curve to the left and upward. B. Computer Simulation: At a faster injection rate, there was minimal change in the degree of hepatic attenuation, though the duration of the optimal temporal window decreased. The area between 10 and 30 HU was greatest when contrast media was delivered at a rate of 2 -3 mL/sec. Although the total area under the curve increased in proportion to the injection rate, most of this increase was above the upper threshould and thus the temporal window was narrow and the optimal area decreased. CONCLUSION: Increases in volume, concentration and injection rate all resulted in improved arterial enhancement. If cost was disregarded, increasing the injection volume was the most reliable way of obtaining good quality enhancement. The optimal way of delivering a given amount of contrast medium can be calculated using a computer-based mathematical model.
Animal ; Computer Simulation ; Contrast Media/*administration & dosage ; Dogs ; Human ; Liver/*radiography ; Support, Non-U.S. Gov't ; *Tomography, X-Ray Computed

PURPOSE: To determine correlation between stress fracture of the posterior tibia and flexor digitorum longusmuscle injury caused by athletic or sporting activity during adolescence. MATERIALS AND METHODS: Eleven casesdiagnosed as stress fracture after X-ray and MR imaging of the lower leg were reviewed. With regard to eachfracture, the following features were noted: age, sex, and athletic or sporting activity of the patient, and site.Using MR imaging techniques, axial and sagittal T1 and T2 weighted images were obtained in all cases and T1-GdDTPA images in seven. RESULTS: The activities undertaken were running (n=3), football (n=2), ballet (n=2),taekwando (n=1), badminton (n=1), field hockey (n=1), and basketball (n=1). MR images revealed localized corticalthickness (n=11), linear intramedullary callus showing a low signal on T1 and T2 weighted images (n=9), marrowhyperemia (n=7), and flexor digitorum longus muscle injury showing a high signal on T1-Gd DTPA and T2 weightedimage (n=7). CONCLUSION: Stress fracture of the posterior tibia might be induced by flexor digitorum longusmuscle activity induced by athletic or sporting activities during adoleseence.
Adolescent ; Basketball ; Bony Callus ; Football ; Fractures, Stress* ; Hockey ; Humans ; Leg ; Magnetic Resonance Imaging ; Pentetic Acid ; Racquet Sports ; Running ; Sports ; Tibia*

Amyloidosis is a rare disease defined by extracellular deposits of amorphous fibrillar proteins, derived from aggregations of misfolded proteins. Localization of amyloidosis in the gallbladder is uncommon; only eight cases have been reported. We describe a case of amyloidosis diagnosed by cholecystectomy, which possibly also affected the liver and kidney. The patient was misdiagnosed with polymyalgia rheumatica, but after a cholecystectomy to treat chronic cholecystitis, we ultimately diagnosed him with amyloidosis. We review amyloidosis with gallbladder involvement in the literature.
Amyloidosis* ; Cholecystectomy ; Cholecystitis* ; Gallbladder ; Humans ; Kidney ; Liver ; Polymyalgia Rheumatica* ; Rare Diseases

BACKGROUND: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. METHODS: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 +/- 2.2 kg/m2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. RESULTS: The percent VF reduction was -23.4 +/- 17.2% in the LCD group and -9.8 +/- 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). CONCLUSION: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.
Caloric Restriction ; Diabetes Mellitus, Type 2 ; Glucose ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Muscles ; Plasma ; Weight Loss

BACKGROUND: Combination fitness regimens (including aerobic and resistance exercises) are effective for improving cardio-respiratory fitness, reducing visceral fat and increasing insulin sensitivity in diabetic patients. The combination exercise intensity that a patient is capable of is limited by his or her aerobic capacity and one repetition maximum (1RM). We investigated the relationships between 1RM, aerobic exercise capacity and body mass index in patients with type 2 diabetes. METHODS: A total of 177 (men: 85, women: 92) diabetic subjects with HbA1c < or = 10% were enrolled. Muscle strength and 1RM were assessed bychest press (upper body) and leg press (lower body). We assessed aerobic capacity by VO2max and muscle mass by bioimpedance analysis. RESULTS: There was no correlation between 1RM and VO2max in type 2 diabetic patients (upper: P = 0.122, lower: P = 0.138 for men, and upper: P = 0.952, lower: P = 0.570 for women). However, 1RM was significantly correlated with muscle mass both in men and women (upper: r = 0.493, P < 0.001, r = 0.315, P = 0.002 lower: r = 0.437 P < 0.001, r = 0.307, P =0.003, respectively). There was also a significant correlation between 1RM and BMI. In obese male subjects with BMI > or = 25 kg/m2, we observed a significant correlation between muscle mass and BMI (r = 0.374, P = 0.032), but this correlation was not observed in women. CONCLUSION: Clinicians treating Korean type 2 diabetic subjects should recommend resistance exercise to their patients. In particular, obese women with diabetes may receive greater benefits by increasing muscle mass through resistance exercises.
Body Mass Index ; Diabetes Mellitus ; Exercise ; Female ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Leg ; Male ; Muscle Strength ; Muscles ; Resistance Training