The study conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the puretone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every fifth person from 6,700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1kHz and 4kHz was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1kHz and 4kHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2kHz and 50dB at 4kHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.
Daegu ; Female ; Follow-Up Studies ; Hearing ; Hearing Loss, Noise-Induced* ; Humans ; Male ; Mass Screening* ; Military Personnel ; Occupational Health ; Surveys and Questionnaires ; Reproducibility of Results ; ROC Curve

PURPOSE: Endothelin-1(ET-1) is a potent vasoconstrictor peptide. It has potent contractile and proliferative effects on vascular smooth muscle cells. Congenital heart diseases are often accompanied by pulmonary hypertension, and the severity of pulmonary hypertension is important in the prognosis. The aim of this study was to elucidate changes of ET-1 after pulmonary venous stenosis in a dog model, and investigate the interaction between pulmonary venous pressure and ET-1. METHODS: Plasma ET-1 levels were measured by radioimmuno-assay at the thoracic aorta, left pulmonary artery and left pulmonary vein. Pressures were also monitored at the same sites. Immunohistochemical staining of ET-1 was performed in the lung tissue. RESULTS: Increased serum ET-1 levels were noted at 1 hour after left pulmonary vein stenosis in the left pulmonary vein and aorta, and at 2 days after stenosis in the left pulmonary artery. Left pulmonary venous pressure was significantly increased at 1 hour after pulmonary vein stenosis, and systolic pulmonary artery pressure at 2 days after stenosis. Increased expression of ET-1 was noted by immunohistochemical staining at the lung tissue at 7 days after stenosis of left pulmonary vein. CONCLUSION: Increased serum ET-1 level and expression of ET-1 in immunohistochemical staining at lung tissue were noted after stenosis of pulmonary vein. Serum ET-1 level would be useful in the diagnosis and prediction of pulmonary artery hypertension. (J Korean Pediatr Soc 2000;43:769 778)
Animals ; Aorta ; Aorta, Thoracic ; Constriction, Pathologic* ; Diagnosis ; Dogs ; Endothelin-1* ; Endothelins ; Heart Diseases ; Hypertension ; Hypertension, Pulmonary ; Lung ; Muscle, Smooth, Vascular ; Plasma ; Prognosis ; Pulmonary Artery ; Pulmonary Veins ; Venous Pressure

BACKGROUND: The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS. RESULTS: The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted. CONCLUSION: This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.
Anti-Infective Agents, Local ; Catheterization ; Catheters ; Cross Infection ; Data Collection ; Decontamination ; Disinfectants* ; Disinfection ; Education ; Endoscopes ; Glutaral ; Glycine ; Humans ; Incidence ; Infection Control ; Korea* ; Membranes ; Mouth ; Patient Discharge ; Povidone-Iodine ; Quaternary Ammonium Compounds ; Skin ; Sodium ; Surveys and Questionnaires

The purpose of this study was to identify nursing interventions performed by neonatal nursing unit nurses. For data collection this study used the taxonomy of Nursing Intervention Classification(NIC : 486 nursing intervention) which was modified by McCloskey & Bulecheck(2000). The new 58 nursing interventions was translated into Korean, and then modified by pannel group, which consist of clinical experts and nursing scholars and finally the 419 nursing interventions was selected. The data were collected from 112 nurses. 168 nursing interventions were performed at least monthly by 50% or more of the nurses. The high frequency of performed nursing interventions were Family domain. 37 nursing interventions were performed at least once a day. The nursing interventions receiving the highest item mean score were neonatal care, neonatal monitoring, phototherapy; neonate, bottle feeding and temperature regulation. 56 nursing interventions were rarely performed by 90% or more of the nurses. Most of them were in the behavioral domain. The rarely used interventions were urinary bladder training, art therapy, religious addiction prevention, religious ritual enhancement and bladder irrigation. Therefore, neonatal nursing units nurses used interventions in the Physiological: basic domain most often on a daily basis and the interventions in the behavioral domain least often. These findings will help in building of a standardized language for the neonatal nursing units and enhance the quality of nursing care. Further study will be needed to classify each intervention class and nursing activity and validate NIC in pediatric care unit.
Art Therapy ; Bottle Feeding ; Classification ; Data Collection ; Humans ; Infant, Newborn ; Neonatal Nursing* ; Nursing Care ; Nursing* ; Phototherapy ; Urinary Bladder ; Child Health

The authors performed a retrospective review on 27 eyes of 23 children with vitreous hemorrhage, to assess the natural history, the outcome of vitrectomy and the important prognostic factors. Mean age was 3. 7 years(range: birth~13.5 years). The causes of vitreous hemorrhage included trauma(6 patients), retinopathy of prematurity(5 patients), persistent hyperplastic primary vitreous(4 patients)and others(8 patients). Spontaneous absorption of vitreous hemorrhage in 11 of 27 eyes was observed and took mean 2. 5 months. Sixteen eyes had undergone vitrectomy for persistent vitreous hemorrhage(mean duration: 3. 4 months). Follow up period was mean 32. 8 months(range: 20~79 months). Visual improvement was achieved in 70%of all patients and there was no statistical significance between spontaneous absorption group and vitrectomy group. Deprivation amblyopia was complicated in 7 of 9 patients whose visual acuity could be measured in both eyes. anisometropic myopia(> OR =2. 0 diopter)was observed in 7 of 14 patients. Our results supported that causes of vitreous hemorrhage in children was variable and early vitrectomy and postoperative correction with occlusion therapy might be essential in treatment of childhood vitreous hemorrhage.
Absorption ; Amblyopia ; Child* ; Follow-Up Studies ; Humans ; Natural History ; Prognosis* ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage*

BACKGROUND: The aims of this study were to test if amrinone or milrinone reverses cardiac depression induced by the exposure to isoflurane in the isolated heart and to determine whether amrinone or milrinone dilates the coronary artery directly. METHODS: Using the isolated Sprague-Dawley rat hearts, heart rate, left ventricular pressure, dp/dt (differentiated rate of pressure development), O2 delivery(DO2), myocardial oxygen consumption(MVO2), and percent O2 extraction were measured. After the isolated hearts were exposed to isoflurane at 1.2 vol% during 10 min, amrinone(10, 50, 100 M) or milrinone(1, 5, 10 M) was separately given to six groups. RESULTS: Amrinone and milrinone reversed, not statistically significant, the depression of cardiac contractility induced by isoflurane, while the isoflurane-induced bradycardia substantially returned to normal by amrinone 100 M. And amrinone and milrinone elevated coronary flow, DO2, MVO2, while isoflurane increased in coronary flow and DO2, except MVO2. CONCLUSIONS: These results suggest that amrinone and milrinone did not counteract the isoflurane-induced cardiac depression and indirectly increased in coronary blood flow through the elevation of cardiac work.
Amrinone* ; Animals ; Bradycardia ; Coronary Vessels ; Depression ; Heart Rate ; Heart* ; Isoflurane ; Milrinone* ; Myocardium* ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Ventricular Pressure

OBJECTIVES: In order to evaluate the relationship between daily mortality and air pollution in Deagu for the period by the data from January 1993 to December 1997. METHODS: Deaths from accident(International Classification of Disease, Revision 9; 800-999 and Revision 10; V01- Y89) were excluded, Daily counts of deaths were analysed by general additive poisson model on the current day to 5 days before death, with controlling for effects of year, season, weather, weekday and holiday. The air pollutants examined included total suspended particulate (TSP), sulfur dioxide (SO,), nitrogen dioxide (NO,), carbon monoxide (CO) and ozone (03). RESULTS: Mortality was associated with NO, SO and CO in the air. Total mortality was estimated to increase by 1. 6 % (95 % CI 0. 3-3 %) with each 10 ppb rise in NOy on the current day and the preceding 1 day, 9. 4 % (95 % CI 7 13 %) with each 100 ppb rise in SOy and 2. 7 % (95 % CI 0. 1 5 %) with each 1 ppm rise in CO on the current day. The NO was more evident for the elderly who were 65 years and more. Cardiovascular-specific mortality was associated with the levels of CO on the current day. Respiratory-specific mortality was associated with the levels of TSP and NO 5 days before death. Excess mortality risk is clearly evident in the upper range of NO levels and increased monotonically with NO. CONCLUSIONS: This study suggested that the air pollution status below the current Korean ambient air quality standard might have an adverse effect on daily mortality. Then, it is impertive that the strategy for control of the air pollution-related daily mortality should be developed.
Aged ; Air Pollutants ; Air Pollution* ; Carbon Monoxide ; Classification ; Daegu* ; Holidays ; Humans ; Mortality* ; Nitrogen Dioxide ; Ozone ; Seasons ; Sulfur Dioxide ; Weather

Vascular calcification (VC) and malnutrition associated with cardiovascular disease are common in patients with chronic kidney disease (CKD) treated with dialysis. VC, which reflects vascular aging, and malnutrition are also encountered in the non-CKD elderly population. This similarity of clinical findings suggests that the progression of CKD is related to aging and the existence of a causal relationship between VC and malnutrition. To retard renal progression, a low- or very-low-protein diet is usually recommended for CKD patients. Dietary education may induce malnutrition and deficiency of important nutrients, such as vitamins K and D. Menaquinone-7, a type of vitamin Kâ‚‚, is under investigation for inhibiting VC in elderly patients without CKD, as well as for prevention of VC in patients with CKD. Nutritional vitamin D, such as cholecalciferol, may be considered to decrease the required dose of active vitamin D, which increases the risk of VC due to increased calcium and phosphate loads. Omega-3 fatty acids are important nutrients and their ability to inhibit VC needs to be evaluated in clinical trials. This review focuses on the ability of supplementary nutrients to prevent VC in patients with CKD, in whom dietary restriction is essential.

Osteoblastoma is a rare tumor which forms osteoid and bone with highly vascular stroma, account for less than 1 percent of all bone tumors. The lesion had been though to be controlled with curettage and local excision. In recent years, osteoblastomas have been described as aggressive osteoblastoma or malignant osteoblastoma, separated from the innocuous behavior of usual osteoblastoma. It represents the histologic characteristics of the presence of epithelioid osteoblasts, trabecular rather than lace-like osteoid, low mitotic rate with no atypical form with prominent giant cells of osteoclastic type. The differential diagnosis between aggressibe osteoblastoma and osteogenic sarcoma is extremely difficult, but its peculiar histologic pattern and its different clinical and radiologic features and better prognosis are helpful. We report here a case of aggressive osteoblastoma of 17 years old female patient with 3 years and 4 months follow-up period and review the literature.
Curettage ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Giant Cells ; Humans ; Osteoblastoma ; Osteoblasts ; Osteoclasts ; Osteosarcoma ; Prognosis

The purposes of this study were to evaluate and compare the frequency of ceramic bracket fracture, frequency of enamel fracture, bond fracture site, adhesive remnant index after mechanical and electrothermal debracketing, to evaluate effectiveness of high and low speed rotary instrument and ultrasonic instrument during residual adhesive remnants removal, and to measure resin film surface(percentage) using by image artalyser(Leco 300). Bond fracture site, bracket fracture, and enamel surface damage were examined by scanning electron microscope. The following results were obtained: 1. In the mechanical debracketing group, the bond failed predominantly at enamel-adhesive interface with the bulk of adhesive remaining on bracket base. 2. In the eletrothermal debracketing group, the bond failed predominantly at adhesive-bracket interface with the bulk of adhesive remaining on enamel surface. 3. The most effectiveness of residual resin removal was obtained by means of the resin polishing bur and the order of scratch formation was the precedure using tungsten carbide bur, ultrasonic scaler, sot-lex disc, and polishing bur. 4. The order of the resin film surface percentage was ultrasonic scaler, tungsten carbide bur, sot-lex disc, and resin polishing bur.
Adhesives ; Ceramics* ; Dental Enamel* ; Tungsten ; Ultrasonics