Over a period of recent 12 months, 41 patients who had localized pulmonary lesions, but were not diagnosedpathologically through bronchoscopy, transbronchial biopsy, sputum examination and cervical lymph node biopsy,underwent percutaneous needle aspiration and biopsy with a diagnostic accuracy of 83% concerning malignancy vs.benignity and 78% considering the specific cell types as well. Six patients developed small asymptomaticpneumothorax and the other three develped small amount of hemoptysis; One of them required treatement. There were21 malignancies and 14 benign lesions. Three cases were misinterpreted and five were inconclusive on cytology,maybe due to inadequate material. No material was aspirated in one case due to hardness of the mass, which, later,confirmed chondroarcoma on surgery. The method, problems and complications are discussed. Nowadays, thepercutaneous needle aspiration and biopsy appears to be the procedure of choice in pulmonary coin lesionsespecially when they are smaller, more peripheral, and whenever meastatic neoplasm in suspected.
Biopsy ; Bronchoscopy ; Hardness ; Hemoptysis ; Humans ; Lymph Nodes ; Methods ; Needles ; Numismatics ; Sputum

OBJECTIVES: This study was conducted to develop a Korean version of the Participatory Action Oriented Training (PAOT) program and training materials for improvement of agricultural working environments. METHODS: The PAOT manual and checklist were developed on the basis of the original English version of the training materials, a questionnaire survey of agricultural health and safety professionals, and a brainstorming conference. Good example pictures were collected through visits to agricultural workers' houses, and an easily understandable picture was drawn by an animation specialist. A PAOT action manual and five types of action checklists were developed for use in different agricultural environments. Each action checklist contained six categories and 38 items of agricultural health and safety principles; the six categories were material storage and handling, work stations and tools, machine safety, physical environment, working schedule and organization, and basic health and safety management. Incorporating these training materials, a one-day Korean PAOT program was developed. RESULTS: Among 307 candidate agricultural workers from four rural Korean villages, 94 workers (59 males, 35 females) participated in a PAOT from July 2007 to Oct 2008. The PAOT program was successful and the mean self-estimated satisfaction score of the participants was greater than 90%. CONCLUSIONS: A Korean PAOT program and training materials were successfully developed and applied to Korean agricultural workers. Although more studies are needed, it is expected that PAOT will greatly contribute to the improvement of agricultural working conditions and health and safety through the use of agricultural workers' self initiatives.
Appointments and Schedules ; Checklist ; Farmers ; Handling (Psychology) ; Humans ; Korea ; Male ; Safety Management ; Specialization ; Surveys and Questionnaires

Carbon monoxide poisoning is one of the most serios health problems in Korea, because we have been encountered with the highest incidence of CO poisoning in the world due to the unique heating system in home called "ondal". We opened Hyperbaric chamber unit in the Seoul National University Hospital last Jan, 1969. We have treated 848 patients as of Sept. 30., 1972, around 44 months period. We collected the informations on the environmental conditions of the place where CO intoxication actually occurred by filling up the questionaire from 505 patients. The following finding were obtained. 1. Age distribution showed that the highest incidence was found in the younger age group between age of 10 to age of 29 in both sex. 2. Sex ratio of the patients was 1:1.14. 3. The socio-economic level of the patient was relatively low. 4. Housewife & housemaid were the major victims of the intoxication in the female patients & in the case of the male patient, occupational backgrounds were diverse. 5. Many patients form the middle class experienced the intoxication bu sleeping at newly built room. 6. Many intoxication has been occurred in the structure of houses where communicating doors are existing between living room & kitchen. 7. All findings obtained taught us again that CO poisoning is the serious by-product of the national fuel policy which put emphasis on the use of coal & socio-economic status is very important parameter in this hazards.
Age Distribution ; Carbon Monoxide Poisoning ; Coal ; Female ; Heating ; Hot Temperature ; Humans ; Hyperbaric Oxygenation* ; Incidence ; Korea ; Male ; Poisoning ; Seoul ; Sex Ratio

Carbon monoxide poisoning is one of the most serios health problems in Korea, because we have been encountered with the highest incidence of CO poisoning in the world due to the unique heating system in home called "ondal". We opened Hyperbaric chamber unit in the Seoul National University Hospital last Jan, 1969. We have treated 848 patients as of Sept. 30., 1972, around 44 months period. We collected the informations on the environmental conditions of the place where CO intoxication actually occurred by filling up the questionaire from 505 patients. The following finding were obtained. 1. Age distribution showed that the highest incidence was found in the younger age group between age of 10 to age of 29 in both sex. 2. Sex ratio of the patients was 1:1.14. 3. The socio-economic level of the patient was relatively low. 4. Housewife & housemaid were the major victims of the intoxication in the female patients & in the case of the male patient, occupational backgrounds were diverse. 5. Many patients form the middle class experienced the intoxication bu sleeping at newly built room. 6. Many intoxication has been occurred in the structure of houses where communicating doors are existing between living room & kitchen. 7. All findings obtained taught us again that CO poisoning is the serious by-product of the national fuel policy which put emphasis on the use of coal & socio-economic status is very important parameter in this hazards.
Age Distribution ; Carbon Monoxide Poisoning ; Coal ; Female ; Heating ; Hot Temperature ; Humans ; Hyperbaric Oxygenation* ; Incidence ; Korea ; Male ; Poisoning ; Seoul ; Sex Ratio

INTRODUCTIONPosterior segment involvement has been described to be associated with central nervous system involvement in sarcoidosis as a result of direct sarcoid tissue infiltration or mass effect of a cerebral lesion. However, isolated intermediate uveitis occurring concurrently with central nervous system involvement prior to extensive systemic disease is rare.

CLINICAL PICTUREWe describe a patient with neuro-ophthalmic manifestations of intermediate uveitis and an enhancing basal ganglia lesion at initial presentation, in the absence of extensive systemic disease.

TREATMENTHe was treated with high-dose systemic steroids which was progressively tailed down over 6 months.

OUTCOMEThere was prompt resolution of vitritis with good preservation of visual acuity.

CONCLUSIONThe difficulties of the initial diagnosis of sarcoidosis and the indications for initiation of steroid therapy are illustrated. We use this case to emphasise the need for a high clinical suspicion of sarcoidosis in the presence of similar unusual and seemingly unrelated combinations of neurological manifestations so as to facilitate the prompt institution of appropriate treatment when indicated.

Adult ; Angiography ; Basal Ganglia ; diagnostic imaging ; physiopathology ; Brain Ischemia ; complications ; diagnosis ; Comorbidity ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Sarcoidosis ; complications ; diagnosis ; Time Factors ; Tomography, X-Ray Computed ; Uveitis ; complications ; diagnosis

Antioxidants oppose the toxic actions of lipid peroxides and oxygen radicals, and they limit the amount of lipid peroxides formed. Women with normal pregnancies have an increase in oxidative stress and lipid peroxidation when compared with nonpregnant women. The antioxidants also increase progressively with advancing gestation, and the antioxidants in the fetus also increase with advancing gestation, especially during late gestation. The purpose of this study is to investigate the diefference of antioxidant status in maternal and neonatal plasma according to the delivery type. So, we investigated the status of antioxidant in the maternal and neonatal plasma when compared normal vaginal delivery with Cesarian section without labor. This study was done under the hypothesis that labor pain is originated from the hypoxic state of myometrium during uterine contraction. The number of women who were studied was total 56, 24 women were delivered by normal vaginal delivery and 32 women were done by Cesarean section without labor. The blood was sampled during active labor and postpartum 24 hour in the case of normal vaginal delivery, the women who were done Cesarean section being sampled before operation and 24 hours after operation. The neonatal blood was sampled from cord, birth 1 day and 3 day. The antioxidant levels were measured by Total Antioxidant Status (Randox Laboratory Ltd., UK) kit. The results were as follows. 1. The mean maternal plasma antioxidant status was not significantly different according to delivery types and not significantly different when compared antepartum with postpartum (vaginal delivery; antepartum: 1.54+/-0.31 mM/L, postpartum: 1.58+/-0.32 mM/L, Cesarean section; antepartum: 1.55+/-0.29 mM/L, postpartum: 1.56+/-0.33 mM/L). 2. The neonatal antioxidant status was not significantly different between the neonates who were born by vaginal delivery and the neonates who were born by Cesarean section. The neonatal plasma antioxidant status was increased progressively after birth (cord: birth 1 day: birth 3 day=1.46+/-0.25 mM/L: 1.59+/-0.25 mM/L: 1.79+/-0.37 mM/L). Therefore, labor pain was not seems to be significantly affect the maternal and neonatal plasma antioxidant status. And the neonatal antioxidant status was increased for adaptation to the external environment after birth.
Animals ; Antioxidants ; Cesarean Section ; Female ; Fetus ; Humans ; Infant, Newborn ; Labor Pain ; Lipid Peroxidation ; Lipid Peroxides ; Mice ; Myometrium ; Oxidative Stress ; Parturition ; Plasma* ; Postpartum Period ; Pregnancy ; Reactive Oxygen Species ; Toxic Actions ; Uterine Contraction

Compliance of epileptic patients is one of the most important factors for adequate therapy. Recently, it had been shown that the variability of three serial measurement of the serum levels of antiepileptic drug(AED) may be used as an indication of the degree of compliance. Coefficient variation(CV) of serum drug levels calculated by only one AED had been used to determine the compliance in epileptic patients who took multiple AEDs. We attempted to evaluate the CV of AEDs and then find the objective clue of compliance and the compatible therapeutic planing according to CV. Ninety seven epileptic patients of outpatients department of the Gyengsang National University Hospital were entered to this study. All patients were taking medication at least for 6 months without any changes of drug regimen. Patient's information was acquired by reviewing the chart and interview with questionnaire. With these informations, we determined the compliance of the patients. Antiepileptic serum levels were measured three times at intervals of at least two to four weeks apart, and their CV was calculated. We compared the CV between the compliant and non-compliant group in each AED(phenytoin, carbamazepine , valproic acid) and three drugs in the compliant group. The mean CVs of phenytoin, carbamazepine and valproic acid in the compliant group were 18.3+/-13.0, 15.2+/-10.2 and 23.8+/-8.9, respectively(mean+/-SD). The mean of CV in the compliant and the non-compliant group were 17.9+/-10.9 and 38.8+/-27.2, respectively. The CVs of the compliant group were significantly lower than those of the non-compliant group(p<0.05). However, CVs had no significant difference between three antiepileptic drugs. This study showed that CVs of AEDs were not different between each AEDs, even though they possess different pharmacokinetic properties. Therefore, the CV of one AED can be used in determining the compliance of the epileptics who are taking multiple AEDs.
Anticonvulsants ; Carbamazepine* ; Compliance ; Humans ; Outpatients ; Phenytoin* ; Surveys and Questionnaires ; Valproic Acid*

OBJECTIVE: The object of this study was to assess the accuracy of dipyridamole stress intravenous (IV) myocardial contrast echocardiography (MCE) using pulse inversion harmonic imaging and PESDA in the detection of perfusion defect in the patients with coronary artery disease in comparison with dipyridamole stress Tc-99m sestamibi SPECT. METHODS: Total 46 patients (29 males, mean age 64 years old) were consecutively enrolled. Patients with prior myocardial infarction were excluded. MCE and Tc-99m sestamibi SPECT were performed at the same day during rest and after 0.56 or 0.84mg/Kg dipyridamole infusion. Continuous IV infusion of PESDA (2-5 mL/min) was administered while obtaining triggered (1:1) end-systolic apical 2, 4 chamber and long axis views. Tc-99m sestamibi was injected 3 minutes after dipyridamole. Tc-99m sestamibi SPECT images were obtained one hour later. Coronary angiography was followed within two days in all patients. Tc-99m sestamibi SPECT images were matched to the sixteen segments of left ventricle according to American Society of Echocardiography for segmental comparison. Both images were analyzed visually. Results Using coronary angiography as the standard, MCE showed overall sensitivity of 70.7%, specificity of 95.8%, positive predictive value (PPV) of 87.8% and negative predictive value (NPV) of 88.5% in the detection of coronary atherosclerosis (70% stenosis). Tc-99m sestamibi SPECT showed sensitivity of 75.6%, specificity of 98.9%, PPV of 96.8% and NPV of 90.6%. The overall concordance rate between MCE and Tc-99m sestamibi SPECT for the detection of perfusion defects was 86.9% (Cohen's kappa value 0.63) according to the coronary territory and 86.8% (Cohen's kappa value 0.55) according to segmental analysis. CONCLUSION: Dipyridamole stress IV MCE using pulse inversion harmonic imaging and PESDA is feasible and comparable to Tc-99m sestamibi SPECT in identifying significant coronary stenosis and inducible myocardial perfusion defects in the patients with coronary artery disease. MCE using pulse inversion harmonic imaging seems to be a promising modality for assessing myocardial perfusion in the patients with suspected coronary artery disease.
Axis, Cervical Vertebra ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Dipyridamole ; Echocardiography* ; Heart Ventricles ; Humans* ; Male ; Myocardial Infarction ; Perfusion* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

INTRODUCTIONDeveloping effective exercise programmes for the paediatric population is a strategy for decreasing obesity and is expected to help in eventually limiting obesity-associated long-term health and societal impact. In this study, the effects of a 12-week twice weekly additional exercise training, which comprised a combination of circuit-based resistance training and aerobic exercises, in additional to typical physical education sessions, on aerobic fitness, body composition and serum C-reactive protein (CRP) and lipids were analysed in 13- to 14-year-old obese boys contrasted with a control group.

MATERIALS AND METHODSBoth the exercise group (EG, n = 12) and control group (CG, n = 12) participated in the typical 2 sessions of 40-minute physical education (PE) per week in schools, but only EG participated in additional 2 sessions per week of 45 to 60 minutes per session of exercise training, which comprised a combination of circuit-based resistance training and aerobic exercises maintained at 65% to 85% maximum heart rate (HRmax = 220 - age). Body composition was measured using dual energy X-ray absorptiometry (DEXA). Fasting serum CRP and blood lipids were analysed pre- and postexercise programme. Aerobic fitness was measured by an objective laboratory submaximal exercise test, PWC170 (Predicted Work Capacity at HR 170 bpm).

RESULTSExercise training significantly improved lean muscle mass, body mass index, fitness, resting HR, systolic blood pressure and triglycerides in EG. Serum CRP concentrations were elevated at baseline in both groups, but training did not result in a change in CRP levels. In the CG, body weight increased significantly at the end of the 12-week period.

CONCLUSIONThis study supports the value of an additional exercise training programme, beyond the typical twice weekly physical education classes, to produce physiological benefits in the management of obesity in adolescents, including prevention of weight gain.

Adolescent ; C-Reactive Protein ; analysis ; metabolism ; Exercise Therapy ; Humans ; Lipids ; analysis ; blood ; Male ; Obesity ; physiopathology ; therapy ; Physical Fitness ; physiology

Previous clinical studies have demonstrated that gabapentin, a drug that binds to the voltage-gated calcium channel alpha2delta1 subunit proteins, is effective in the management of neuropathic pain, but there is limited evidence that addresses the participation of glial cells in the anti-allodynic effects of this drug. The present study investigated the participation of glial cells in the anti-nociceptive effects of gabapentin in rats with trigeminal neuropathic pain produced by mal-positioned dental implants. Under anesthesia, the left mandibular second molar was extracted and replaced by a miniature dental implant to induce injury to the inferior alveolar nerve. Mal-positioned dental implants significantly decreased the air-puff thresholds both ipsilateral and contralateral to the injury site. Gabapentin was administered intracisternally beginning on postoperative day (POD) 1 or on POD 7 for three days. Early or late treatment with 0.3, 3, or 30 microg of gabapentin produced significant anti-allodynic effect in the rats with mal-positioned dental implants. On POD 9, in the mal-positioned dental implants group, OX-42, a microglia marker, and GFAP, an astrocyte marker, were found to be up-regulated in the medullary dorsal horn, compared with the naive group. However, the intracisternal administration of gabapentin (30 microg) failed to reduce the number of activated microglia or astrocytes in the medullary dorsal horn. These findings suggest that gabapentin produces significant anti-nociceptive effects, which are not mediated by the inhibition of glial cell function in the medullary dorsal horn, in a rat model of trigeminal neuropathic pain.
Amines ; Anesthesia ; Animals ; Astrocytes ; Calcium Channels ; Cyclohexanecarboxylic Acids ; Dental Implants ; gamma-Aminobutyric Acid ; Horns ; Mandibular Nerve ; Microglia ; Molar ; Neuralgia ; Neuroglia ; Proteins ; Rats