In order to investigate the level of lead exposure of workers in litharge making industry and to evaluate how lead exposure, personal habit such as smoking and drinking affect the prevalence of lead related symptoms and other study variables, we investigate 114 workers(24 office workers and 90 lead exposed workers) in a litharge making industry. Study variables chosen were blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), Hemoglobin(Hb), hematocrit (Hct), SGOT and SGPT. symptom questionnaires which had 15 lead exposure related symptoms were provided to all workers and filled up by themselves and reconfirmed by physician. The results obtained were as follows; 1. The mean value of PbB, ZPP and SGOT in lead exposed group were higher than those of non-exposed group, and there were no differences of means in other study variables. 2. The smoking and drinking rate of study subjects were 65.8% and 71.0% as a whole. Smoking rates were lower in non-exposed group than exposed group, but drinking rate were not. 3. There were no differences of mean values of study variables between smoker and non-smoker in non-exposed and exposed group, but there was a difference of mean value of SGOT between drinker and non-drinker in lead exposed group. 4. while the symptom prevalence of lead exposed group were higher in neuromuscular category than non-exposed group, those of non-exposed group were higher or same with exposed group in gastrointestinal and general symptom category. 5. The symptom prevalence of smoker were higher than non-smoker regardless of exposure. 6. The symptom prevalence of drinker were only higher in gastrointestinal symptom category than non-drinker. 7. In multiple stepwise regression analysis of lead related symptoms as dependent variable and blood lead, smoking habit, drinking habit and work duration as independent variables, drinking habit contributed to the gastrointestinal symptom category, whereas blood lead and smoking contributed to the neuromuscular symptom category. For the total symptoms work duration and smoking habit contributed significantly.
Alanine Transaminase ; Aspartate Aminotransferases ; Drinking ; Hematocrit ; Humans ; Prevalence ; Surveys and Questionnaires ; Smoke ; Smoking ; Zinc

The managements of fractures of femoral shaft in children differ in many ways from those in adults. Fourty eight cases of fractures of femoral shaft in children who were treated at Masan Korea General Hospital from March 1981 to February 1984 were analyzed both clinically and radiologically and the following results were obtained. l. Among 48 cases, the ratio of male and female was about 2.7:1 and the highest incidence was between the age of 3 and 8 years(52.1%). 2. The main cause of fracture was traffic accident(66.7%) and the other was falling or slip down injury. 3. Middle 1/3 of femoral shaft was most commonly injured(45.8%) and transverse type was common (41.7 %). 4. The common associated injuries were head injuries, fracture of the lower extremities and fracture of pelvis. 5. 43 cases were treated with traction method and 5 with open reduction and internal fixation. 6. In general, angulation at fracture site was under 10 degrees and no clinical deformity was resulted in. 7. Among 48 cases, overring of fractured fragment was occured in 28 cases and the average length of overring was 7.5mm.
Accidental Falls ; Adult ; Child ; Congenital Abnormalities ; Craniocerebral Trauma ; Female ; Hospitals, General ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Methods ; Pelvis ; Traction

As is well known, myxoma of the heart is very rare(incidence 0.03%), constituting nearly 50% of all primary cardiac tumors. It is important because it can be abolished by surgical removal but usually fatal if unrecognized or untreated. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We have experienced a case of bilateral atrial myxoma which simulated mitral valvular disease clinically and had typical three cardinal manifestations such as obstructive, embolic and constitutional symptoms. The patients was 39 years old woman. The left atrial myxoma was diagnosed preoperatively by echocardiography and cardiac angiography and the remainder during open heart surgery under the E.C.C. Both of them were removed successfuly and confirmed as typical myxoma microscopically. This is the first case report of bilateral atrial myxoma in Korea to our knowledge.
Adult ; Angiography ; Echocardiography ; Female ; Heart ; Heart Neoplasms ; Humans ; Korea ; Mass Screening ; Myxoma* ; Thoracic Surgery

Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
Pregnancy ; Female ; Humans

We report a case of secretory carcinoma with axillary lymph node metastasis in a 21-year old woman. She was aware of a mass in her breast for 10 years and noticed a rapid growth of the preexisting mass during the last years. Histologically, the tumor was composed of micropapillary and microcystic or cribriform glandular structures which contained eosinophilic, mucinous, intraluminal secretions. The center had a dense hyalinized strama with a solid infiltrative growth of tumor cells with intracytoplasmic secretory vacuoles at the periphery. In addition, marked intraductal papillary epithelial proliferations were present at the superficial portions of the tumor near the nipple. Prognostic factors and their relationship to juvenile papillomatosis are discussed with a review of the literature.
Female ; Humans ; Neoplasm Metastasis ; Breast Neoplasms

Present study aimed to investigate the immunological activities of cell wall associated protein antigen solubilized with Triton X-100 (TSP) from Mycobacterium tuberculosis H37Rv and conducted on 43 patients with pulmonary tuberculosis (newly diagnosed, medicated within 12 months and chronic refractory patients) and 17 normal healthy controls. These immunological responses were compared with those induced by the PPD or 30 kDa antigen from M, tuberculosis H37Rv culture filtrates, identified as biologically important secreted proteins. Proliferative responses to mycobacterial antigens were compared in peripheral blood mononuclear cells (PBMC) of healthy subjects and pulmonary tuberculosis patients. Signiticant blastogenic responses to the TSP were observed in healthy tuberculin reactors, newly diagnosed and some of antituberculosis drug-medicated patients by H-thymidine incorporation assay. IL-12 p40 and IFN-r mRNA expressions to the TSP were markedly increased, whereas IL-10 and TNF-a mRNA expressions were decreased at a 5 day-stimulation by PBMC in healthy tuberculin reactors, newly diagnosed and medicated patients. However, patients with chronic refractory tuberculosis exhibited more depressed IL-12 p40 and IFN-r mRNA expressions to all of the antigens than another groups. Interestingly, very low IL-10 and TNF-a mRNA expressions cultured with the TSP were also shown. These data suggest that the TSP may be involved in the macrophage activation by induction of Th1 stimulatory signals, such as IL-12, and suppression of Th1 inhibitory cytokine, IL-10.
Tumor Necrosis Factor-alpha

BACKGROUND: It has been a standard practice in many institutions to combine light general anesthesia with epidural block for abdominal and pelvic surgery. We attempted to prove the effectiveness of prehydration and to find an suitable epidural local anesthetic dose in terms of hemodynamic stability for upper abdominal surgery. METHODS: For preliminary studies, 11 patients scheduled for elective upper abdominal surgery had received general anesthesia immediately after epidural anesthesia. After epidural injection of 10~16 mL of 2% plain lidocaine into the T9~10 intervertebral space, the changes in blood pressure were observed. Thirty-two patients scheduled for elective upper abdominal surgery were divided into two groups. In group A (study group), after prehydration with Hartmann solution (10 mL/kg), 5~7 mL of 2% plain lidocaine was injected into T8~9 or T9~10 intervertebral space and general anesthesia was then induced. Group B (control group) received general anesthesia only. RESULTS: There were no significant differences in hemodynamics between the epidural with general anesthesia and the control group except SVR (systemic vascular resistance). SVR in group A increased in contrast to the group B in which it remained unchanged. CONCLUSIONS: The combined epidural and general anesthesia, using prehydration and 0.5~1 mL/segment of 2% plain lidocaine at the T8~9 or T9~10 intervertebral space was safe without significant hemodynamic changes.
Anesthesia, Epidural ; Anesthesia, General* ; Blood Pressure ; Hemodynamics* ; Humans ; Injections, Epidural ; Lidocaine

No abstract available.

Plasma cholinesterase was assayed during the period immediately following IV bolus injection of succinylcholine 1mg/kg to test the effect of succinylcholine on pseudocholinesterase activity. Twenty healthy adult patients scheduled for elective surgery were studied. The resutls were as follows: The mean value of pre-injection pseudocholinesterase activity was 1124.15 IU/L, and the activity following succinylcholin injection was 1159.55IU/L during fasciculation, 982.70 at 1 min, 936.60 at 3 min, 891.25 at 5 min, 926.80 at 7 min, 1015.45 at 10 min, and 1007.70 at 15 min. It was concluded that the tendency to increase pseuducholinesterase activity during fasciculation seems to be due to choline, the metabolite of succinylcholine, however the cause of the significant decrease in pseudocholinesterase activity after fasciculation is uncertain. The only suggested mechanism is due to the inhibition of pseudocholinesterase by succinylcholine and its metabolites.
Adult ; Choline ; Cholinesterases ; Fasciculation ; Humans ; Plasma ; Pseudocholinesterase ; Succinylcholine*

No abstract available.
Myocardial Infarction*