To assess the pattern of psychiatric symptoms and to evaluate the relationship between exposure related variables(duration of work and urinary hippuric acid concenturation) and psychiatric symptoms in organic solvent exposed workers, case control study of forty-two solvent exposed workers and ninety-six non-exposed workers was conducted. The general health questionnaire 28(GHQ28) was administered to evaluate psychiatric symptoms and urinary hippuric acid concenturations was measured to estimate the present status of solvent exposure in exposed group and to estimate normal level in non-exposed group. The meand concenturation of urinary hippuric acid was significantly higher in exposed group (2.953g/creatinine g) than non-exposed group (0.395g/creatinine g) (P<0.01). The total positive rates of symptoms were significantly higher in exposed group(28.2%) than non-exposed group(17.5%) (P<0.05). The positive rates of symptoms for four sub-scales of GHQ 28 in exposed group were in the order of somatic symptoms, anxiety, social dysfunction, depression and in the order of social dysfunction, anxiety, depression, somatic symptoms in non-exposed group.The positive rates of symptoms for somatic symptoms and anxiety were significantly higher in exposed group than non-exposed group (P<0.05) and the proportion of workers with six or more positive symptoms(dysthymic states) in exposed group were significantly higher than non-exposed group (P<0.01). After the effect of age, sex, level of income, level of education, and duration of work were controlled, the total score of GHQ28 was still significantly different between exposed and non-exposed group(P<0.01). In multiple logistic regression analysis on the dysthymic state, the odds ratio of level of income was statistically significant in both group. The odds ratios of exposure related variables such as duration of work and hippuric acid concenturations were not statistically significant but there was a tendency that exposure related variables had an effect on dysthymic state in exposed group.In future, comtinuous evaluation of psychiatric symptoms on organic solvent exposed workers and studies to detect the factors that affect on psychiatric symptoms are required.
Anxiety ; Case-Control Studies ; Depression ; Education ; Logistic Models ; Odds Ratio ; Surveys and Questionnaires ; Solvents* ; Toluene

No abstract available.
Occupational Health*

This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at -20 C in polypropylene tubes further copper and zinc analysis. Mean of serum copper levels was 91.97+/-4.76 microgram/dl in control, 106.21+/-2.73 microgram/dl in cirrhosis and 127.05+/-0.77 microgram/dl in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were 110.82+/-7.24 microgram/dl in control, 68.10+/-5.43 microgram/dl in cirrhosis and 63.78+/-2.20 microgram/dl in HCC. The values of cirrhosis and HCC were statistically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistically significance on the cirrhosis and the HCC, but that of serum zinc was statistically significant as 0.951 and 0.952 (p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of "grouped" cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc may has an independently inhibitory effect on the liver disease and serum zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.
Bilirubin ; Biomarkers ; Carcinoma, Hepatocellular* ; Copper* ; Diagnosis ; Fasting ; Fibrosis ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver Function Tests ; Liver* ; Logistic Models ; Odds Ratio ; Polypropylenes ; Zinc*

Since the use of Charnley hip prosthesis, total hip arthroplasty has been used for the treatment of coxarthrosis. However, aseptic lossening of the acetabular cup component in total hip arthroplasty remains the most common cause of failure and most serious complication. Cementless acetabular cup fixation in total hip arthroplasty is increasingly popular because of the high failure rates of cemented components, particularly in younger and more active patients. We have experienced 62 cases of CLS expansion acetabular cup developed by L. Spontorno, from January 1992 to January 1994. We analysed 41 CLS expansion acetabular cup components in 38 patients performed at the Department of Orthopedic Surgery, Kang Nam General Hospital with minimum follow up lyear(average 17.3 months). The object of this study is to evaluate the radiographic change of the cup inclination, horizontal and vertical migration of the CLS expansion acetabular cup by methods of Engh et al, and Callagham et al. The results were as follows: 1. The initial adequate contact fit were 39 hips and inadequate fit in 2 hips. 2. The initial acetabular inclination between 35 degrees and 55 degrees were 38 hips. 3. Vertical and/or horizontal migration was not occurred, except 2 hips which were complicated by deep infection. 4. Change of acetabular cup inclination than 5 degrees were not occurred. 5. Radiolucent line wider than 2mm was not found. 6. In final follow up of out 41 hips optimal stability was obtained in 39 hips, suboptimal stability was obtained in 2 hips, and definite instability was not found.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Hip Prosthesis ; Hospitals, General ; Humans ; Orthopedics ; Osteoarthritis, Hip

No Abstract Available.
Arthroplasty* ; Knee*

Here we report a single-stage operation we performed on a patient with a large schwannoma that extended from the lower clivus to the cervico-thoracic junction caudally. A number of authors have previously performed multilevel laminectomy to remove giant schwannomas that extend for considerable length. This technique has caused cervical instability such as kyphosis or gooseneck deformity on several occasions. We removed the tumor with a left lateral suboccipital craniectomy with laminectomy only at C1 and without any subsequent surgery-related neurologic deficits. However, this technique requires meticulous preoperative evaluation on existence of Cerebrospinal fluid (CSF) cleft between the tumor and spinal cord on magnetic resonance imaging, of tumor origin located at the upper cervical root, and of detachment of tumor from the origin site.
Cerebrospinal Fluid ; Congenital Abnormalities ; Cranial Fossa, Posterior ; Humans ; Kyphosis ; Laminectomy* ; Laminoplasty ; Magnetic Resonance Imaging ; Neurilemmoma* ; Neurologic Manifestations ; Spinal Cord ; Spinal Cord Neoplasms

Leiomyomas are the most common benign tumors found in the esophagus. They are mostly solitary and multiple diffuse lesions are rare, occurring in only 2.4% of cases (1). We describe the case of a 13-year-old boy with a history of Alport syndrome who complained of progressive dysphagia and postprandial vomiting, and in whom diffuse leiomyomatosis of the esophagus was diagnosed. Chest PA showed mediastinal widening, and a barium study revealed diffuse esophageal wall thickening with dilatation, and obstruction at the level of the distal esophagus. Manometry showed increased pressure in the lower esophagus, and CT demonstrated diffuse thickening of the entire esophageal wall and an intraluminal mass in the distal esophagus. Follow-up CT three years later showed further esophageal wall thickening, as well as luminal narrowing. By means of distal esophagectomy, diffuse leiomyomatosis involving the entire esophageal wall and intraluminal mass was diagnosed.
Adolescent ; Barium ; Deglutition Disorders ; Dilatation ; Esophagectomy ; Esophagus ; Follow-Up Studies ; Humans ; Leiomyoma ; Leiomyomatosis* ; Male ; Manometry ; Nephritis, Hereditary ; Phenobarbital ; Thorax ; Vomiting

Multiple extradural arachnoid cysts of the spine are extremely uncommon in children with only a few cases reported. The authors report a case of multiple extradural spinal arachnoid cysts in children with a review of the relevant literature.
Arachnoid ; Arachnoid Cysts ; Child ; Humans ; Spine

BACKGROUND: Although pulmonary tuberculosis is effectively controlled with 6 months or 9 months short course standard regimens, comparable numbers of treatment failures ensued because of inadequate treatment mainly due to patient's poor compliance. Indequate treatment with standard regimens during initial treatment may cause emergence of drug resistance and prolong the duration of chemotherapy. Also it may make the patient lesser compliant and finally increase the morbidity and the mortality. METHODS: A clinical study was done to evaluate clinical and bacteriological characteristics of 94 patients who were retreated for pulmonary tuberculosis. RESULTS: 1) 62 of the 94 patients were male and 32 patients were female. Mean age is 51 years old in male and 45 years old in female. 2) The extent of the disease on the chest radiograph was minimal in 10(11.1%) patients, moderate in 31(33.3%) patients, and far advanced in 52(55.6%) patients. 3) On sputum bacteriologic examination, 73(77.7%) patients were positive in sputum AFB smear and/or culture for Mycobacterium tuberculosis. 4) Results of drug sensitivity test performed in 42 patients showed that the resistance to one drug is in 9(20.5%) patients, two drugs in 18(40.8%) patients, and more than three drugs in 14(31.8%) patients. 5) Poor patient's compliance was the leading cause of the retreatment of pulmonary tuberculosis (43.6%) 6) Only 24(25.5%) patients of the 94 retreatment patients were successfully treated and 39 (41.6%) patients were dropped out during follow-up. CONCLUSION: We concluded that poor patient's compliance was the most important cause of treatment failure not only in primary treatment patients but also in retreatment patients. Primary treatment of pulmonary tuberculosis should be completed under strict monitoring of the patient because significant number of retreatment patients had multiple drug resistance and poor outcome.
Compliance ; Drug Resistance ; Drug Resistance, Multiple ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Mortality ; Mycobacterium tuberculosis ; Radiography, Thoracic ; Retreatment ; Sputum ; Treatment Failure ; Tuberculosis* ; Tuberculosis, Pulmonary

Kimura's Disease is a very rare, chronic inflammatory disorder with an unknown etiology, and this illness is primarily seen in young Asian males. The typical clinical features consist of painless subcutaneous masses in the head or neck region, and especially in the salivary gland and submandibular region. It is often accompanied with a regional lymphadenopathy, peripheral blood eosinophilia and elevated serum IgE levels. Histologically, it is characterized by prominent germinal centers in the involved lymph nodes, together with eosinophilic infiltration in these lymph nodes. The treatment modalities for this disease are steroid therapy, radiation therapy and surgical excision. Its clinical course is of a benign nature. We report here on a case of a 28 year old man who had a soft tissue mass in his left arm. We excised this mass and the microscopy confirmed that he suffered from Kimura's disease on microscopic examination in his left distal arm.
Arm ; Asian Continental Ancestry Group ; Eosinophilia ; Eosinophils ; Germinal Center ; Head ; Humans ; Immunoglobulin E ; Lymph Nodes ; Lymphatic Diseases ; Male ; Microscopy ; Neck ; Salivary Glands