This presentation is a case of osteomalacia, the cause of which was a nutritional deficiency. The patient was a 42-year-old female who had pseudofractures of ribs, ulnae, pelvic raml, the right second metacarpai bone and both femoral necks. Following treatment by medication combined with internal fixation of the femoral necks, the result was good.
Adult ; Female ; Femur Neck ; Humans ; Malnutrition ; Osteomalacia ; Ribs ; Ulna

This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead (PBB), Zinc-protoporphy (ZPP), hemoglobin (HB) and personal history, and completed 15 questionnaires related to symptoms of lead absorption; also measured lead concentration in air (PBA) in the workplace. The results obtained were as follow; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were 26.1+/-8.8 microgram/dl, 28.3+/-26.0 microgram/dl and 16.2+/-1.2g/dl; whereas those of nonexposed workers were 18.7+/-5.1 microgram/dl, 20.6+/-8.7 microgram/dl and 17.3+/-1.1g/dl. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed to different lead concentration in air were as follows; When it was below 25 microgram/m3 , the indices were 24.7+/-79, 26.1+/-26.8 microgram/dl and 16.4+/-1.1 g/dl respectively; These indices were 27.1+/-8.5, 23.9+/-10.92 /dl and 16.2+/-1.3 g/dl when the lead concentration in air was 25~50 microgram/m3; and they were 3.4+/-9.3, 42.3+/-31.3 microgram/dl and 15.5+/-1.2 g/dl when the concentration of lead was above 50 microgram/m3. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequently by complained symptom was "Generalized weakness and fatigue", and fewest symptom was "Intermittent pains in abdomen". 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were "Intermittent pains of abdomen" and "Joint pain or arthralgia" (p<0.05). No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms. 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.
Absorption ; Humans ; Male ; Prevalence ; Surveys and Questionnaires

A 19-year-old man had a good neurologic recovery from a severe hypothermia(19 degrees C) and a prolonged coma following active infernal rewarming. From inhaling hydrocarbons, he was left unconscious on the cold floor for 24 hours. As soon as the patient was brought into the emergency medical center, he was early evaluated arid treated aggressively. ECG showed Osborn(J) wave on all leads. The temperature o( patient was increased by 2-3 degrees C per hour through active external rewarming (by heating blankets and warm bag) and active infernal rewarming (by airway rewarming, warmed IV fluids, gastrointestinal tract irrigation, and bladder irrigation). The temperature reached 36 degrees C after 6 hours. Active infernal rewarming provides rapid core rewarming with the additional benefit of circulatory support during the period of cardiac instability.
Coma ; Electrocardiography ; Emergencies ; Gastrointestinal Tract ; Heating ; Hot Temperature ; Humans ; Hydrocarbons* ; Hypothermia* ; Inhalation ; Rewarming ; Unconsciousness* ; Urinary Bladder ; Young Adult

We report a case of malignant histiocytosis which began with intermittent fever and scaly skin lesions. A 3-year-old girl presented with erythematous scaly papules on the face and the trunk, and high fever for 3 months. The cutaneous lesions consisted of widespread coin-sized erythematous scaly papules with marginal brownish pigmentation. She was anemic and thrombocytopenic and had impairment of the liver function. Histopathologic study of the skin lesions showed non-specfic findings except for hyperkeratosis. However, bone marrow examination revealed an increased number of histiocytes, mostly immature with active phagocytosis of erythroid cells, myeloid cells, and platelets. She was diagnosed as having malignant histiocytosis and treated with cyclophosphamide and vincristine. She died the next day after the treatment had begun.
Bone Marrow Examination ; Child, Preschool ; Cyclophosphamide ; Erythroid Cells ; Female ; Fever* ; Histiocytes ; Histiocytic Sarcoma* ; Humans ; Liver ; Myeloid Cells ; Phagocytosis ; Pigmentation ; Skin* ; Vincristine

No abstract available.
Child* ; Humans ; Tuberculosis, Meningeal*

No abstract available.
Erythema* ; Leukemia, Myelomonocytic, Juvenile*

The relationship between lead related subject symptoms and lead exposure indices was studied in 435 male lead workers in thirteen lead using industries. 212 male office workers who were not exposed to lead occupationally were also studied as a control group. Fourteen lead related symptoms were selected. They were further subdivided into 4 sub-symptom groups such as 1) gastrointestinal, 2) neuromuscular and joint 3) constitutional, and 4) psychological symptoms. Symptom questionnaires were provided to the workers and filled up by themselves and reconfirmed by interviewer(doctor). The test used for the evaluation of lead exposure were blood lead (PbB), zinc protoporphyrin in whole blood(ZPP), hemoglobin(Hb), hematocrit(Hct), delta-aminolevulinic acid in urine(DALA). The results obtained were as follows; 1. The higher prevalence rate in the sub-group of neuromuscular and joint symptoms was observed in occupationally lead exposed subjects than non-exposed subjects. Among the sub-groups, the most frequent symptom was "numbness of finger, hands of feet", and the prevalence of the symptom of "arthralgia", "weakness of fingers, hands or feet" and "myalgia" were higher in order. 2. While the symptom which showed the biggest difference of prevalence rate among the 14 symptoms between exposed and non-exposed subjects was "numbness of fingers, hands or feet" , the symptom which showed the highest prevalence rate was "feeling tired generally" in exposed and non-exposed subjects, but no statistical difference of symptom prevalence were observed. 3. In total study population, PbB and ZPP had dose-response relationship with 4 symptoms of neuromuscular and joint symptoms ("numbness of finger, hands or feet", "arthralgia", "weakness of fingers, hands or feet" and "myalgia") and one symptom of gastrointestinal group("intermittent pains in lower abdomen"). 4. In lead exposed workers, only neuromuscular and joint symptoms group showed dose-response relationship with PbB and ZPP. 5. In lead exposed workers, the prevalence rate of overall symptoms of lead workers with age below 39 years was higher than that of lead workers with age above 40. While neuromuscular and joint symptoms group had a dose-response relationship with PbB in former group, it had a dose-response relationship with ZPP in latter group. 6. Age adjusted odds ratios of symptoms of non-exposed with exposed and odds ratios of low exposed with high exposed workers showed the dose-response relationship of lead exposure with neuromuscular and joint symptoms group("numbness of fingers, hands or feet", "arthralgia", "weakness of fingers, hands or feet" and "myalgia") and gastrointestinal symptoms group("intermittent pains in lower abdoman").
Aminolevulinic Acid ; Fingers ; Hand ; Humans ; Joints ; Male ; Occupations ; Odds Ratio ; Prevalence* ; Surveys and Questionnaires ; Zinc

No abstract available.
Humans* ; Interleukin-10*

For evaluating the boosting (anamnestic) effects of the most recent commercially produced plasma derived heat-inactivated hepatitis B vaccine (A. Co.), 117 adults with naturally acquired antibody to hepatitis B surface antigen (anti-HBs) were selected at random. In addition, out of case immunized at zero and 1 month, and boosted at 6 months (primary booting) by conventional vaccine (B.Co), inactivated by pepsin digestion and formalin treatment, 11 cases who showed elevated titer after primary boosting were also submitted to the study. The results were as follows: 1) Out of the 117 subjects with naturally acquired anti-HBs, 6(5.1%) showed isolated anti-HBs and the titers were below 10 ratio units (RU). Negative seroconversion was seen in 4 (3.4%) of the 117 cases at 12 months after the screening and, of these cases, 3 showed isolated anti-HBs below 10 RU (increased GMT, 28.04) at one month after primary booster injection with 3 microgram dose of A. Co. Vaccine at all, but 90% of the other subjects responded. 3) The anti-HBs titers of all the 11 cases who showed a rise of more than 10 RU (increased GMT, 28.04) at one month after primary booster injection by 20 microgram dose of B. Co. vaccine decreased at 19 months after the primary booster. And 3 subjects (27.3%) of the 11 reached negative seroconversion. All of the 11 cases, who had secondary booster injection with 3 microgram dose of A. Co. vaccine at 19 months after primary boosting, showed increased anti-HBs titer at least 20 RU or more (increased GMT, 57.72) at one month after the boosting. According to the above results in the anti-HBs screening survey for the purpose of immunization with hepatitis B vaccine, subjects with isolated anti-HBs below 10 RU should be regarded as being in an unimmunized state. In cases who are in risk circumstances, immunized primarily with a 20 microgram dose of B. Co. vaccine, a secondary booster injection should be given within 2 years after initiation of primary immunization and a 3 microgram booster dose of A. Co. vaccine can be reliably used.
Adult ; Digestion ; Formaldehyde ; Hepatitis B Surface Antigens* ; Hepatitis B Vaccines ; Humans ; Immunization* ; Mass Screening ; Pepsin A ; Plasma

The influence of lead exposure on renal function was studied. Eighty nine lead exposed workers who worked in 2 storage battery factories, and seventy one control workers were chosen for this study. Blood lead(pbB) and zinc protoporphyrin in whole blood(ZPP) were selected as indicators of lead exposure. As indicators of renal function, urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(S-Cr), total protein in urine(U-Tp),and serum uric acid(S-Ua) were selected. The results obtained were as follows: 1. while the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. 2. BUN, logarithmic U-TP, logarithmic NAG and S-Cr showed statistically significant correlation with pbB. 3. The proportion of workers whose values of renal function indicators were over the normal limits(NAG7.5 U/g cr; U-TP 10.9mg/dl; BuN20 mg/dl; S-Cr1.2 mg/dl; S-Ua7.0 mg/dl) by the level of lead absorption in terms of pbB and ZPP were calculated. The proportion of workers with over the normal limits of U-TP among total workers showed the dose-response relationship. when age is adjusted, U-TP showed significantly strong dose-response relationship with the level of pbB and ZPP.
Absorption ; Blood Urea Nitrogen ; Humans ; Male* ; Urea ; Zinc