BACKGROUND: This study was performed to examine the status of diabetes mellitus (DM) in the community and effects of related factors on heart rate variability (HRV). METHODS: The author conducted HRV testing, a questionnaire survey, and blood chemistry analysis for fasting blood sugar (FBS) and HbA1c levels in 855 patients in a community over a period of 10 days, from August 14 to 25, 2006. The subjects were divided into a DM group and normal group by our study criteria. RESULTS: The proportion of DM was 12.6% and increased with old age. The mean measures of HRV (SDNN, Tp, Vlf, Lf, Hf, Lf/Hf) in the DM group were 22.7 (1.6) msec, 364.9 (2.7) msec2, 174.1 (3.0) msec2, 88.1 (3.2) msec2, 55.3 (3.2) msec2, and 1.6 (2.6), respectively, while those in the normal group were 32.2 (1.6) msec, 676.6 (2.8) msec2, 295.7 (3.1) msec2, 169.2 (3.4) msec2, 117.2 (3.2) msec2, and 1.4 (2.6), respectively. All parameters except for Lf/Hf were significantly lower in the DM group than in the normal group (P < 0.01). The Spearman's correlation coefficients between HRV and FBS or HbA1c were SDNN -0.222/-0.244 (P < 0.01), Tp -0.211/-0.212 (P < 0.01), Vlf -0.149/-0.132 (P < 0.01), Lf -0.188/-0.235 (P < 0.01), Hf -0.207/-0.204 (P < 0.01), and Lf/Hf (P > 0.05), respectively. CONCLUSION: This study shows that the DM group had a reduced HRV and increased pulse rate in comparison with the normal group. According to our results, the HRV test may be used accessorily for the early detection of cardiovascular autonomic neuropathy (CAN) and its related factors, as well as to prevent CAN.
Blood Glucose ; Diabetes Mellitus ; Diabetic Neuropathies ; Fasting ; Heart ; Heart Rate ; Humans ; Risk Factors ; Surveys and Questionnaires

Hydrofluoric acid is one of the strongest irritating, corrosive and poisonous inorganic chemicals. The most significant chronic consequence of excessive fluoride exposure is the disorder of skeletal system and connective tissue. The first stage of osteofluorosis consists of an increase in the density of flatbone such as pelvic bone and vertebral bones, with coarseness and blurring of bone trabecular. Therefore we wanted to observe the change of the bone density among workers exposed to hydrofluoric acid. Questionnaires and radiological investigations were performed for 39 hydrofluoric acid manufacturing factory worker sexposed to hydrofluoric acid. And then authors checked urinary fluoride level by fluoride ion method. the radiographs were doubly read by two radiologists for reliability. The results were as follows; 1. There was a significant difference in urinary fluoride level (p<0.01), but not in age, in tenure(p>0.05) among workers by the job title. 2. By the two radiologists, eight cases were read as bone fluorosis. The prevalence rate of bone fluorosis was 20.5%. 3. There was not a significant difference in general characteristic such as age, tenure and in muculoskeletal signs and symptoms between the fluorosis group and the normal group. 4. However, a close relationship between the occurence of the change of bone density and the degree of fluorde exposure such as burn was found. The difficulties in diagnosing fluorosis result from the questionable sensitively of x-ray techniques and from the non-specific associated signs and symptoms. A quantitative method such as densitometry to assessosteosclerosis and bone structure alteration and a follow-up study are needed.
Bone Density* ; Burns ; Connective Tissue ; Densitometry ; Fluorides ; Follow-Up Studies ; Hydrofluoric Acid* ; Inorganic Chemicals ; Pelvic Bones ; Prevalence ; Questionnaires

Malignant deciduoid mesothelioma is a rare malignant neoplasm occurring in the peritoneum of young women. We report a case of malignant deciduoid mesothelioma that occurred in the omentum of a 47-year-old woman. The patient had never exposed to asbestos and had no history of cesarean section. The lesions were multiple infiltrative nodules affected the peritoneal cavity, omentum, and surface of the uterus with both ovaries. Microscopically, the nodules were composed of mesothelial cells similar to decidual cells
Asbestos ; Cesarean Section ; Female ; Humans ; Mesothelioma* ; Middle Aged ; Omentum ; Ovary ; Peritoneal Cavity ; Peritoneum ; Pregnancy ; Uterus

Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.
Animals ; Anthocidaris ; Bites and Stings* ; Fingers ; Foreign Bodies ; Granuloma ; Hand* ; Hypersensitivity, Delayed ; Inflammation* ; Joints ; Mycobacterium ; Punctures ; Sea Urchins* ; Skin ; Spine ; Strongylocentrotus purpuratus ; Synovial Membrane ; Wounds and Injuries

Actinomycoces is a gram positive, anaerobic, branching and non-acid fast bacterium which is a normal habitant of the skin, oral cavity, tonsil and gastrointestinal tract and its human infection is rare. Pelvic actinomycoses is frequently caused by Actinomycoces israel-ii. It is chronic, progressive, and more suppurative than granulomatous disease, and the symptoms are usually persistent and gradual, therefore the misdiagnosis and improper trea-tment are not uncommon. Actinomycoses is generally classified as cervicofacial, abdominal and thoracic type ac- cording to the site of the primary infection. Many actinomycotic pelvic infections in women used intrauterine device with long du- ration were reported, in contrast, others suggest that actinomycoces developed opportunistic infection irrespective of intrauterine device presence. We have experienced 4 cases of pelvic actinomycoses, one case with IUD(Lippes' loop) in a 47 year old woman, the other case with abdominal wall ctinomycoses in a 34 year old woman, the third case without IUD in a 41 year old woman, the fourth case with IUD(Cu-7) in a 37 year old woman and reported them with a review of literature.
Abdominal Wall ; Actinomycosis* ; Adult ; Diagnostic Errors ; Female ; Gastrointestinal Tract ; Humans ; Intrauterine Devices ; Middle Aged ; Mouth ; Opportunistic Infections ; Palatine Tonsil ; Pelvic Infection ; Skin

BACKGROUND: Echocardiographic examination is universally considered as an established method for the diagnosis of congenital heart disease, and as a result of many technological advancements in information processing, its utility is being emphasized much more. Cardiac catheterization, by comparison, is usually performed in the past for the purpose of diagnosis and preoperative assessment of infants with isolated ventricular septal defect (VSD), and the risks and complications of cardiac catheterization have been more frequent in the younger ages. Accordingly, we present in this study the effectiveness and safety of echocardiography on the diagnosis and treatment of infants who met the indications of early correction and underwent operations. METHODS: Between May 1994 and April 1997, 66 infants with isolated VSD were submitted for primary correction in the Yonsei Cardiovascular Center. Among the 66 infants (36 males and 30 females), 33 (group 1) underwent surgery on the basis of echocardiography alone and another 33 (group 2), on the basis of cardiac catheterization in addition to echocardiography. The two groups were compared for the diagnostic sensitivity, specificity, complication after surgical correction and frequency of re-operation. RESULTS: 1) The average age was 5.4+/-3.3 months in group 1 and 5.7+/-2.2 months in group 2. 2) There was no significant difference between the two groups in terms of the sensitivity and specificity of diagnostic tools. 3) There was no post-operative death in either group and no significant difference in postoperative hospital stay between the two groups. 4) There was no significant difference between the two groups in complications such as sepsis, pneumonia after surgical correction. CONCLUSION: We concluded that after an accurate selection, most infants with isolated VSD can safely undergo primary repair on the basis of echocardiography alone.
Automatic Data Processing ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Humans ; Infant ; Length of Stay ; Male ; Pneumonia ; Sensitivity and Specificity ; Sepsis

OBJECTIVE: To investigate the prevalence and contributing factor of musculoskeletal pain in preadolescent children. METHOD: Four hundreds and four primary school students without history of trauma or serious medical conditions were investigated. Self-reported questionnaire and physical examination were done. RESULTS: One-week and 1-year overall pain prevalence were 25.9% and 33.7%, respectively. Prevalence of wide spread pain (WSP) was 7.2% and that of myofascial pain syndrome (MPS) was 7.9%. Prevalence of overall pain and MPS was higher in the 6th grade students than the 4th grade. WSP was more frequent in girls than boys. Joint hypermobility, physical fitness, body mass index and life style including computer use, regular exercise and satisfaction to desk-chair did not affect pain prevalence. CONCLUSION: Musculoskeletal pain was common in preadolescent children. Age and sex rather than physical state or life style seem to be the contributing factors to pain prevalence.
Body Mass Index ; Child* ; Female ; Humans ; Joint Instability ; Life Style ; Musculoskeletal Pain* ; Myofascial Pain Syndromes ; Physical Examination ; Physical Fitness ; Prevalence ; Surveys and Questionnaires

BACKGROUND: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of metocurine, atracurium, doxacurium, and pipecuronium. This study examine neuromuscu-lar blocking effect and recovery of mivacurium in isolated rat phrenic-hemidiaphragm with two-weeks phenytoin pretreatment. METHOD: After the administration of 14 days of phenytoin 40 mg/kg, administered intraperitoneally twice daily (n=10), ED90, antagonism of neostigmine and 4-aminopyridine on the electrically evoked twitch response and train-of-four (TOF) stimulation were compared to control groups in isolated rat phrenic-hemidiaphragm preparation. RESULTS: ED90 was significantly greater in the phenytoin group than in the control group (319 +/- 39.5 g vs. 209.5 +/- 52.2 g, respectively). After the administration of neostigmine 0.75 M, the recovery of the single twitch and TOF ratio were significantly lesser in the phenytoin group than in the control group (single twitch; 19.6 +/- 6.6% vs. 69.2 +/- 9.4%, TOF ratio; 0.258 +/- 0.149 vs. 0.543 +/- 0.1, respectively). After the administration of 4-aminopyridine 40uM, the recovery of the single twitch and TOF ratio were no significant differrence between the phenytoin group and the control group (twitch; 118.1 +/- 25.3% vs. 122.6 +/- 24.8%, TOF ratio; 0.937 +/- 0.051 vs. 0.949 +/- 0.067, respectively). CONCLUSION: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of mivacurium.
4-Aminopyridine ; Animals ; Atracurium ; Drug Interactions ; Neostigmine ; Neuromuscular Blockade* ; Phenytoin* ; Pipecuronium ; Rats*

OBJECTIVES: A study was conducted for investigating the status of simple X-rays on lumbosacral regions at pre-employment health examination and analysing the effectiveness of simple X-rays on lumbosacral regions. METHODS: The study data were pre-employment health examination data in a university hospital from Jan 3, 1993 through October of 1997. And, 97 newly employed workers who claimed no low back pain at pre-employment health examination of a certain company were follow-up survey about low back pain and related factors in April, 1995 and October of 1997. The data were collected by a self-reported questionnaire and a medical examination with a rehabilitation specialist. RESULTS: Taking the simple X-rays on lumbo-sacral regions was 1, 591 workers(10.5%) among 15,166 pre-employment health examination from Jan 3, 1993 through October of 1997. And yearly application rates of these X-ray tests have been significantly statistical increasing (p<0.01). 2. The abnormal findings of simple X-rays on lumbo-sacral regions at pre-employment health examination were 40 workers. But, there was not significantly statistical difference between normal and abnormal group for the complaint rate of low back pain. 3. The number of case with symptoms of low back pain at the follow-up survey were 46, so the incidence density was 37. 1 persons/ 100 person-years. And the incidence density was not significantly statistical difference between normal and abnormal group of simple X-rays on lumbo-sacral regions. 4. Through the multivariate logistic regression, significantly associated factors with low back pain were found to be tenure(OR=0.36, 95%CI: 0.17-0.79), lifting of heavy materials(OR=5. 86, 95%CI: l. 58-21. 74). CONCLUSION: The simple X-rays on lumbo-sacral regions at pre-employment health examination is required further research for utilizing pre-employment health examination according to above results.
Follow-Up Studies ; Incidence ; Lifting ; Logistic Models ; Low Back Pain ; Lumbosacral Region ; Questionnaires ; Rehabilitation ; Specialization

OBJECTIVES: This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among pupils of "M" primary school and residents near the school in Kyongju from Sept. 24 to Oct. 24, 1998. METHODS: The subjects who completed a questionnaire and a rectal swab for microbiologic examinations were 1,534 persons (781 males, 753 females), including 469 pupils of "M" primary school (268 males, 201 females). Bacteriological examinations of underground water and simple piped water were done. RESULTS: The attack rate of diarrhea was 28.7% in the subjects from Sept. 24 to Oct. 24, 1998. There was no difference in attack rate of diarrhea by gender, but it was significantly higher in the pupils of "M" primary school than others (p<0.01). The attack rate of diarrhea by resident areas was no different to the pupils of "M" primary school, but was significantly higher in the residents of Mohwa 2 Ri except pupils that "M" primary school is located in (p<0.01). The distribution of date of onset revealed the exposure date to be Sept, 22 and 23 in consideration of incubation periods and common source outbreak followed propagative spread in the epidemic curve. The major characteristics of diarrhea were watery (89.1%) in nature, 1~3 days (72.5%) in duration, 2~3 times (63.9%) in frequency. The clinical symptoms among the diarrheal cases included abdominal pain (74.1%), fever (56.4%), headache (55.9%), chill (40.4%) and tenesmus (31.4%). CONCLUSIONS: The source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. It is highly necessary that the management of drinking water and cess pools should be done thoroughly.
Abdominal Pain ; Diarrhea ; Drinking Water ; Dysentery, Bacillary* ; Epidemiology ; Fever ; Groundwater ; Gyeongsangbuk-do* ; Headache ; Humans ; Korea* ; Male ; Pupil ; Surveys and Questionnaires ; Water