The objectives of this study were to investigate the prevalence and risk factors of occupationally related carpal tunnel syndrome (CTS) among workers employed in services and manufacturing industries analysing the sensitivity and specificity of clinical symptoms and signs. Three surveys were made for this study. The first survey was done for 1,447 workers employed by 25 companies. The jobs of the employees were repetitive works at VDT and assembly lines. Therefore, employees could be divided to two groups, doing repetitive works and non repetitive works. The second survey was made for 189 workers who were randomly selected from 517 workers complained some symptoms at their hands and wrists. We examined their symptoms and carried out neurological examinations for CTS (Tinel's sign, Phalen's sign, pin prick test, carpal compressive test, toniquet compression test). The third survey was made for nerve conduction study (NCS) for 57 workers who had shown positive signs for CTS. The main results of this study were as follows: 1. From the first survey, we have found that there were significant statistical differences in getting uncomfortable neuromuscular symptoms by sex, job type, total working hours during a week, duration of current work, and kinds of work. Odds ratio in male vs female, repetitive vs non repetitive, service vs manufacturing companies, total working hours during a week, and duration of current work were 1.867(95% CI=1.467-2.377), 1.680 (95% CI=1.121-2.279), 1.663(95% CI=1.213-2.279), 1.016(95% CI=1.006-1.027) and 1.283 (95% CI=1.097-1.501) respectively. 2. From the second survey, we have found that 46 peoples (25.0%) were positive for one or more than one signs in neurological examinations of NIOSH criteria. Positive findings from neurological examinations were high among workers of low level of education (p-value=0.008), manufacturing jobs (p-value=0.00), long hours a week (p-value=0.028), and long duration of current work (p-value=0.00). 3. From the third survey, we diagnosed 35 peoples (61.4%) had CTS by NCS. They had abnormally delayed latent period or velocity in median nerve conduction velocity.
Carpal Tunnel Syndrome* ; Education ; Female ; Hand ; Humans ; Male ; Median Nerve ; National Institute for Occupational Safety and Health (U.S.) ; Neural Conduction ; Neurologic Examination ; Occupations ; Odds Ratio ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Wrist

No abstract available.
Brain* ; Cerebral Palsy* ; Electroencephalography* ; Evoked Potentials*

PURPOSE: This study was carried out to accumulate basic data for nursing intervention development by evaluating the stress and emotional status of patients and their families after receiving hematopoietic stem cell transplantation (HSCT), illucidating and analysing related factors in order to decrease the negative effects of HSCT on their emotion. METHODS: Data were collected using a questionnaire to 53 HSCT patients and 50 families, who were older than 18 at tertiary-care institutions in Seoul, from January, 2000 to August, 2003. RESULTS: There was a significant score difference in stress (t=-2.302, p<0.05). Correlation between stress and emotional status was statistically significant (r=0.486, p<0.01; r=0, p<0.05). Economical burden of cost had significant effects on stress of patients (F=4.194, p<0.05). The series of emotional status of patients without jobs were higher (T=-2.583, p<0.05). The emotional status of families were influenced by monthly income (F=4.036, p<0.05) and patients' diagnosis (F=3.088, p<0.05). CONCLUSION: These results suggest that the cares for families should be considered with great concern as well as the ones for patients. In addition, such factors as economical burden by medical cost, monthly income and job status should not be excluded in transplantation nursing plans.
Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Nursing ; Surveys and Questionnaires ; Seoul

Necrotizing fasciitis (NF) is an uncommon, life-threatening infection of the subcutaneous tissue and superficial fascia. The clinical course of NF is rapid and progressive, and it is often fatal despite the appropriate therapy. The prognosis of NF depends on a timely diagnosis and then proper treatment. At onset it may not be possible to clearly distinguish NF from minor soft-tissue infections. Although infection are common due to the use of steroids and immunosuppressive agents in patients with systemic lupus erythematous (SLE), it is interesting that NF has rarely been reported with SLE. Here, we present two cases of NF with SLE.
Fasciitis, Necrotizing ; Humans ; Immunosuppressive Agents ; Prognosis ; Steroids ; Subcutaneous Tissue

PURPOSE: This study validated the musculoskeletal model of the human lower extremity by comparative study between calculated muscle parameters through simulation using modified hill-type model and measured muscle parameters through isokinetic exercise. The relationship between muscle forces and moments participated in motion was quantified from the results of simulation. MATERIALS AND METHODS: For simulation of isokinetic motion, a three-dimensional anatomical knee model was constructed using gait analysis. The EMG-force model was used to determine muscle activation level exciting muscles. The modified Hill-type model was used to calculate individual muscle force and moment in dynamic analysis. This method was validated by comparing analytical data with experimental data. RESULTS: The results showed that there was a significant correlation between calculated torques from simulation and measured torque from isokinetic motion experiments (R=0.97). We also found that muscle forces and moments during knee flexion and extension have nonlinearly proportional or inversely proportional relationship, since lower extremity muscles were simultaneously involved in flexion/extension motion and inner/outer rotation. CONCLUSION: We concluded that the simulation by using musculoskeletal model may be a useful mean to predict and recover musculoskeletal-related diseases, and analyze complicated experiment such as clash condition.
Gait ; Humans ; Knee Joint* ; Knee* ; Lower Extremity ; Muscles ; Torque

BACKGROUND/AIMS: The aim of this study was to assess the diagnostic use of endoscopic ultrasonograpy (EUS) in detecting the cause of common bile duct (CBD) dilatation in patients in whom abdominal ultrasonography or abdominal CT scan could not identify the cause of dilatation. METHODS: Thirty-seven patients (23 men, 14 women, mean age 62.2 years) with uncertain causes of CBD dilatation on abdominal sonogram and CT scan between October 1999 and November 2003 were enrolled. All patients were evaluated by EUS and endoscopic retrograde cholangiopancreatography (ERCP). Final diagnosis were determined by ERCP, surgical exploration and clinical follow-up. RESULTS: The following diagnosis were made by EUS: choledocholithiasis in 11 patients, CBD dilatation only in 12, benign stricture of distal CBD in 8, periampullary tumor in 6. The definitive diagnosis of choledocholithiasis (n=11), benign stricture of distal CBD (n=10), ampullary tumor (n= 5) were determined by ERCP with or without sphincterotomy and surgical exploration. EUS provided the accurate explanation for CBD dilatation in 32 of the 37 patients (86%). CONCLUSIONS: When the diagnosis of biliary obstruction remains obscure on abdominal sonography or CT scan, EUS may be useful.
Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct* ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Endosonography* ; Female ; Follow-Up Studies ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography

Most submucosal tumors of the stomach are of mesenchymal origin. Gastric schwannoma, which is a subset of mesenchymal tumors, is a rare tumor taking origin from Schwann's cells. A 61-year-old woman whose endoscopy showed a well circumscribed submucosal mass measuring 2.5 cm on the midbody of the stomach. Endosonographically, the tumor was well circumscribed, low echoic submucosal mass with cystic lesion in the 4th layer of the gastric wall. The patient underwent wedge resection. Microscopically, the cells were made up of irregular fasciculating bundles of spindle cells featured with benign nuclear atypia and peripheral lymphoid cell cuffing, involving muscularis propria. Immunohistochemical staining showed positivity for S-100 protein and the neuron-specific enolase, but were negative to CD 34, desmin and smooth muscle actin. From these findings, this tumor was diagnosed as a schwannoma.
Actins ; Desmin ; Endoscopy ; Female ; Humans ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Neurilemmoma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Stomach

BACKGROUND/AIMS: The purpose of this study was to investigate the malignant potential of aberrant crypt foci (ACF) by measuring the multiplicity of crypts and lectin expression in the early and late stages of 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis. METHODS: Six-week-old Wistar rats were injected subcutaneously with DMH for 27 weeks. We classified ACF according to the number of crypts per ACF as a few crypts (< or =3 crypts, FC ACF) or numerous crypts (> or =4 crypts, NC ACF). Immunohistochemistry was used to evaluate lectin expression. RESULTS: In the early stage, FC ACF (590/1,902, 31.0%) occurred more frequently than NC ACF (35/449, 7.8%); whereas in the late stage, NC ACF (176/449, 39.2%) occurred more frequently than FC ACF (324/1,902, 17.0%). The number of ACF peaked at 15 to 20 weeks. The ratio of NC/FC ACF increased gradually during carcinogenesis. The expression of both UEA1 and PNA was higher in NC ACF than FC ACF. Lectin expression increased in the late stage compared with the early stage. CONCLUSIONS: The expression of lectin was higher in NC ACF and ACF in the late stage. Therefore, ACF with higher multiplicities in the late stage may have more malignant potential in DMH-induced colon carcinogenesis.
1,2-Dimethylhydrazine ; Aberrant Crypt Foci ; Animals ; Colon ; Dimenhydrinate ; Immunohistochemistry ; Peanut Agglutinin ; Rats ; Rats, Wistar

PURPOSE: To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns of Care Study. MATERIALS AND METHODS: A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all Korean hospitals (48 hospitals). Thirty three (69%) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields for rectal cancer. RESULTS: The following guidelines were developed: superior border between the lower tip of the L5 vertebral body and upper sacroiliac joint; inferior border 2~3 cm distal to the anastomosis in patient whose sphincter was saved, and 2~3 cm distal to the perineal scar in patients whose anal sphincter was sacrificed; anterior margin at the posterior tip of the symphysis pubis or 2~3 cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin 1.5~2 cm posterior to the anterior surface of the sacrum, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases (70%), the inferior margin after sphincter saving surgery in 13 (39%), the inferior margin after abdominoperineal resection in 32 (97%), the lateral margin in 32 (97%), the posterior margins in 32 (97%) and the anterior margin in 16 (45%). CONCLUSION: These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved by following the Korean Patterns of Care Study.
Anal Canal ; Cicatrix ; Consensus ; Humans ; Lymph Nodes ; Radiotherapy ; Rectal Neoplasms* ; Sacroiliac Joint ; Sacrum ; Seoul

Nutcracker esophagus is thought to be a common cause of noncardiac chest pain although has not been clearly established, and the effective treatment is lacking. The usual forms of therapy for noncardiac chest pain by nutcracker esophagus have been directed traditionally toward reducing esophageal hypermotility and muscle tone such as nitrate and calcium channel blocker. However, the results of this treatment in the long term care of patient with esophageal symptoms have been generally disappointing and often unsatisfactory. Recently, psychosomatic aspect of esophageal motility disorder including antidepressant treatment has been accepted in the treatment of noncardiac chest pain. We report a 48 year old female with nutcracker esophagus associated chest pain by ambulatory 24 hour esophageal manometry who failed diagnosis by conventional manometry. The symptoms of chest pain, quality of life, and depression of the patient were improved after antidepressant medication.
Calcium Channels ; Chest Pain* ; Depression ; Diagnosis ; Esophageal Motility Disorders* ; Female ; Humans ; Long-Term Care ; Manometry ; Middle Aged ; Quality of Life ; Thorax*