In order to study the exposure level of silica dust and the effects of silica dust on ventilatory function, respirable dust samples were collected by personal air samplers using NIOSH method 0500 from the selected foundry operations, and ventilatory function tests were performed on 209 male foundry workers and 239 male control subjects. Ventilatory indices such as forced vital capacity (FVC) , one-second forced expiratory volume (FEV1), ratio of FEV1 to FVC(FEV1 %), maximal mid-expiratory flow(MMF), peak expiratory flow rate (PEFR) and maximal expiratory flow at 25, 50 and 75 % of expired FVC (FEF25, FEF50, FEF75 were obtained by analyzing forced expiratory spirogram and maximal expiratory flow-volume curve which were simultaneously measured by Vitalography in standing position. The results were as follows : 1. The average quartz concentrations of respirable dust were the highest in melting operation (0.079 mg/m3) and followed by molding operation (0.051 mg/m3), finishing operation (0.041 mg/m3) and coremaking operation (0.023 mg/m3) in the descending order. 2. No significant differences for mean values of all ventilatory indices expressed as percent of predicted value were demonstrated between smokers and nonsmokers In foundry workers and control subjects. 3. Mean values of all ventilatory indices except FVC of foundry workers were significantly lower than those of control subjects. 4. Mean values of FEV1 %, MMF, FEF25, FEF50 and FEF75 expressed as percent of predicted value tended to decrease with increasing cumulative dust exposure. 5. In foundry workers, proportions of workers with low MMF, FEF50 and FEF75 were markedly higher than those with other indices, and were significantly increased with increasing cumulative dust exposure. 6. In foundry workers, 2 workers(1.0 %) were diagnosed as silicosis and the profusion of radiographic opacities were category 1/0 and q type. With the above considerations in mind, it suggested that increasing exposure of silica dust be associated with progressive deterioration in ventilatory function of an obstructive nature and that MMF, FEF50 and FEF75 be more sensitive indices in the detection of the early obstructive changes of air flow of workers exposed to silica dust.
Dust* ; Forced Expiratory Volume ; Freezing ; Fungi ; Humans ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Peak Expiratory Flow Rate ; Quartz ; Silicon Dioxide* ; Silicosis ; Vital Capacity

PURPOSE: This study was to examine the clinical characteristics and mortality risk factors of geriatric hospital patients who visited one region-wide emergency department (ED). It's basically meant to develop criteria for the patient management of geriatric hospitals and to provide related information. METHODS: A retrospective research study was implemented using electronic medical records. The subjects in this study included 484 geriatric hospital patients who were selected from among 15,994 patients that visited one region-wide ED between January 1, 2014, and December 31, 2015. RESULTS: There were significant differences in death, a change for the better and no change for the better, which were results of treatment, according to the length of stay in hospital, hospitalization in a general ward, not having an operation or surgery, the presence or absence of malignant neoplasm, the insertion of foley catheter, intubation, ventilator and the insertion of central venous catheter. CONCLUSION: The results of this study suggest that a patient management system is necessary in geriatric hospitals and that competent healthcare workers who can properly respond to emergencies are required as well.
Catheters ; Central Venous Catheters ; Delivery of Health Care ; Electronic Health Records ; Emergencies* ; Emergency Service, Hospital* ; Hospitalization ; Humans ; Intubation ; Length of Stay ; Mortality* ; Patients' Rooms ; Retrospective Studies ; Risk Factors* ; Ventilators, Mechanical

BACKGROUND: The bispectral index (BIS) has been used as an indicator of a sedative state and has been considered to be related to anesthetic agents and noxious stimulus. In this study, we measured the BIS, blood pressure (BP) and heart rate (HR) during induction of anesthesia after premedication with or without midazolam or morphine and evaluated the bispectral index as an indicator of an objective evaluation of midazolam premedication and relation to the cardiovascular response to the anesthetic induction. METHODS: Seventy five patients scheduled to undergo elective surgery under general anesthesia were divided into 3 groups. Each group received midazolam and glycopyrrolate (midazolam group, n = 25), or morphine and glycopyrrolate (morphine group, n = 25), or glycopyrrolate only (control group, n = 25) as premedication (midazolam 0.08 mg/kg IM, morphine 0.05 mg/kg IM, glycopyrrorate 0.2 mg IM). Then, anesthetic induction (propofol 2 mg/kg, succynylcholine 1 mg/kg) was done. The bispectral index, blood pressure, and heart rate were measured at before induction, after propofol injection, and intubation. RESULTS: The Bispectral index was significantly lower in the midazolam group and the morphine group compared with the control group before anesthetic induction. Blood pressure was not significantly different among the three groups. Heart rate was significantly lower in the midazolam group compared with the control group before anesthetic induction. CONCLSIONS: Midazolam or morphine premedicated patients appear to maintain a stable heart rate and have a low BIS at before induction. The Bispectral index could be objectively used in midazolam-premedicated patients when evaluating the degree of sedation and predicting hemodynamic changes, and probably in morphine-premedicated patients also.
Anesthesia ; Anesthesia, General ; Anesthetics ; Blood Pressure ; Glycopyrrolate ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Midazolam* ; Morphine* ; Premedication* ; Propofol

PURPOSE: The purpose of this retrospective study is to investigate the effect of posterior tibial slope (PTS) on clinical results in total knee replacement arthroplasty (TKA).
Arthroplasty ; Arthroplasty, Replacement, Knee ; Humans ; Knee ; Osteoarthritis ; Patella ; Polyethylene ; Prostheses and Implants ; Range of Motion, Articular ; Retrospective Studies ; X-Ray Film

INTRODUCTION: To prevent hemodialysis-related infections, it is important to maintain hemodialysis system without microbial contamination. In May 2003, routine surveillance showed that dialysis water from dialysis port was contaminated with bacteria. To identify the causes of the contamination, we conducted an investigation as follows. METHODS: Patients undergoing dialysis were carefully monitored to see whether evidences of pyrogenic reactions or infections were present. Factors that could have influence on bacterial contamination in hemodialysis systems were thoroughly examined. In addition, microbiologic surveillances were done 7 times in 1 month. RESULTS: Although pyrogenic reactions or bacteremia did not occur, R. pickettii was repeatedly isolated above the Association for the Advancement of Medical Instrumentation (AAMI) standards from almost all dialysis units. Bacterial counts of specimens were higher in the proximal part of the water supply tube than the other parts in all dialysis machines. The colony count of R. pickettii exceeded the maximum level of technical limit in the specimens collected from the dialysis machines in the early morning after intermission of 48 hours. The structure of the supply tube was suspected as the origin of the colonization because stagnant water is a reservoir for bacterial multiplication. After remodeling the structure of the water supply tube, neither R. pickettii nor any other bacteria were isolated. CONCLUSION: Our investigation successfully identified the source of R. pickettii contamination of reverse osmosis water. Appropriate corrective measures for water distribution systems of hemodialysis center could prevent outbreak of dialysis-associated illnesses.
Bacteremia ; Bacteria ; Bacterial Load ; Colon ; Dialysis ; Humans ; Osmosis ; Ralstonia ; Ralstonia pickettii ; Renal Dialysis ; Water ; Water Supply