OBJECTIVE: The purpose of this study is to determine the proper hand position during driving by measuring of the wheel rotation strength according to the wheel angle and hand position to the wheel. METHOD: BTE Work Simulator was used to measure the clockwise and counter clockwise static wheel rotation force of twenty healthy men in three different hand position (2~10 spot, 3~9 spot, and 4~8 spot) and two different wheel angle (45 degrees and 60 degrees), average and peak force were measured during maximal isometric contraction. RESULTS: The average and peak force was significantly different by the wheel angle, and hand position (p<0.01), but the direction of rotation didn't an effect on the rotation force. The hand position was the most significant factor, especially wheel rotation force at 2~10 spot hand position was significantly lower than that of 3~9 spot and 4~8 spot (p<0.05). The rotation force by the wheel angle was influenced by hand position, and lower in 60 degrees wheel angle in the 2~10 spot (p<0.05). CONCLUSION: The rotation force of wheel was influenced by the hand position. Therefore proper hand position is recommended during driving to reduce muscle fatigue.
Hand* ; Humans ; Isometric Contraction ; Male ; Muscle Fatigue

BACKGROUND: Currently, the incidence of hepatitis A is on the increase in Korea. Although there is emphasis on contact precautions, the nosocomial outbreak of hepatitis A virus (HAV) in healthcare personnel has increased within endemic areas because these workers inevitably come in close contact with patients and work under suboptimal hygiene conditions. In this study, we evaluated the necessity of immunization against HAV for healthcare personnel. METHODS: We investigated the seropositivity of serum immunoglobulin G (IgG) anti-HAV antibody (Ab) in 672 healthcare personnel on the basis of their age-group, sex, and occupation in Soon Chun Hyang University Hospital and Soon Chun Hyang University Bucheon Hospital. RESULTS: The subjects were divided into 6 groups on the basis of their ages to identify differences among the various age groups in the number of cases with HAV Ab seropositivity. Significant intergroup differences were noted in this respect: 21-25 years, 2/152 (1.3%); 26-30 years, 33/245 (13.5%); 31-35 years, 70/148 (47.3%); 36-40 years, 52/79 (65.8%); >40 years, 44/48 (91.7%). CONCLUSION: The number of seropositive cases was low among young healthy personnel: low seropositivity is an emerging risk for vulnerable population. With the increase in the incidence of hepatitis A, healthcare personnel have become a risk population for hepatitis A, as are community residents. Therefore, for healthcare personnel working in hospitals, immunization against HAV should be recommended for personnel younger than 30 years, and serological testing for older personnel.
Delivery of Health Care ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A Vaccines ; Hepatitis A virus ; Humans ; Hygiene ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Occupations ; Serologic Tests ; Vulnerable Populations

PURPOSE: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Schonlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. METHODS: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. RESULTS: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. CONCLUSION: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.
Abdominal Pain ; Ascitic Fluid ; Biopsy ; Child ; Diarrhea ; Duodenitis ; Duodenum ; Early Diagnosis ; Edema ; Endoscopy ; Endoscopy, Gastrointestinal ; Hematemesis ; Hemorrhage ; Humans ; Ileus ; Joints ; Lymph Nodes ; Melena ; Mucous Membrane ; Nausea ; Occult Blood ; Purpura, Schoenlein-Henoch* ; Skin ; Ultrasonography ; Urinary Bladder ; Vomiting

Olfactory groove meningioma extending into the paranasal sinuses and nasal cavities is unusual. On rare occasions, it presents in the nasal cavity as a polypoid mass with ENT symptoms. We have experienced a case of meningioma presenting as a nasal polyp, in which the only clinical symptom was the sensation of having a foreign body in the left nasal cavity. The patient underwent polypectomy at a local clinic without radiologic evaluation, but because the polyp seemed to have originated from the nasal roof the patient was referred to our hospital. Magnetic resonance imaging (MRI) revealed an extensive intracranial tumor with extracranial extensions into the ethmoid sinuses and nasal cavities, and the tumor was confirmed as meningioma by histological and immunohistochemical examination. The tumor was removed by a transcranial route, and the cranial base defect was repaired with various nasal mucosal flaps and with abdominal fat via an intranasal endoscopic approach. After 8 months of treatment, no evidence of recurrence or of mucosal defect was noted.
Abdominal Fat ; Endoscopy ; Ethmoid Sinus ; Foreign Bodies ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Nasal Cavity ; Nasal Polyps* ; Paranasal Sinuses ; Polyps ; Recurrence ; Sensation ; Skull Base* ; Skull*

Purpose: This study was conducted to assess the antidepressant effects of capsaicin in chronic depressive rats and elucidate the mechanism underlying its effects. Methods: Male Wistar rats (280~320 g, 8 weeks of age) were subjected to depression induced by chronic unpredictable mild stresses. The rats were exposed to 8 kinds of stresses for 8 weeks. In the last 2 weeks, fluoxetine or capsaicin was injected subcutaneously. The dose of fluoxetine was 10 mg/kg (body weight), while the doses of capsaicin consisted of low (1 mg/kg), middle (5 mg/kg), and high (10 mg/kg). The forced swim test (FST) was conducted to evaluate the immobility time of rats. The immobility time indicates despair, one of symptoms of depression. The change of tryptophan hydroxylase (TPH) in the dorsal raphe was investigated using immunohistochemistry. In the hippocampus cornu ammonis (CA) 1 and 3, glucocorticoid receptor (GR) expression was measured. Results: The immobility time in the FST was significantly lower (p < .05) in the low-dose (M = 32.40 ± 13.41 seconds) and middle-dose (M = 28.48 ± 19.57 seconds) groups than in the non-treated depressive rats (M = 90.19 ± 45.34 seconds). The amount of TPH in the dorsal raphe was significantly higher (p < .05) in the middle-dose (M = 249.17 ± 35.02) and high-dose (M = 251.0 ± 56.85) groups than in the non-treated depressive rats (M = 159.78 ± 41.16). However, GR expression in the hippocampus CA1 and CA3 did not show significant differences between the non-treated depressive rats and the capsaicin-injected rats. Conclusion This study suggests that capsaicin produces an antidepressant-like effect on chronic unpredictable mild stress-induced depression in rats via the serotonin biosynthesis pathway.

Congenital Choanal Atresia is a relatively uncommon anomaly. Among various surgical approaches for treating this ailment that have been proposed to date, transpalatal and transnasal endoscopic approaches are the preferred methods for surgical treatments. Because restenosis is the most important post-surgical concern, some authors used topical application of mitomycin C in the choanal atresia and found it to be effective in the prevention and treatment of scar formation. We have experienced a case of right membranous choanal atresia and left membranous choanal stenosis which were treated with a transnasal endoscopic approach using powered instrumentations and topical application of mitomycin C without an application of prolonged stent. Eight months after the treatment, patent neochoanae remains without evidence of restenosis.
Choanal Atresia* ; Cicatrix ; Constriction, Pathologic* ; Endoscopes ; Mitomycin* ; Stents

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. If a patient had tachypnea, cold sweating and hypoxemia in postoperative period, PTE must be thought to be one of possible causes of tachypnea. We have experienced one case of PTE after operation. A 40 year-old woman underwent total hystrectomy and partial omentectomy due to huge, bizarre shaped and inflammatory myoma presenting as an abdominal mass with abscess pocket accompanied by severe and adhesion. At the 5 th postoperative day tachypnea and hypoxemia were developed suddenly. PTE was confirmed with lung perfusion scan and leg edema with deep vein thrombosis occurred later. Proper cardiopulmonary support and anticoagulant therapy were done and the patient was recovered and discharged in improved condition.
Abscess* ; Adult ; Anoxia ; Diagnosis ; Edema ; Female ; Humans ; Leg* ; Leiomyoma* ; Lung ; Myoma ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Sweat ; Sweating ; Tachypnea ; Venous Thrombosis*

Pulmonary thromboembolism (PTE) is a serious postoperative complication. Prompt diagnosis of PTE is important but it is difficult because clinical manifestations of PTE are not obvious in most cases. If a patient had tachypnea, cold sweating and hypoxemia in postoperative period, PTE must be thought to be one of possible causes of tachypnea. We have experienced one case of PTE after operation. A 40 year-old woman underwent total hystrectomy and partial omentectomy due to huge, bizarre shaped and inflammatory myoma presenting as an abdominal mass with abscess pocket accompanied by severe and adhesion. At the 5 th postoperative day tachypnea and hypoxemia were developed suddenly. PTE was confirmed with lung perfusion scan and leg edema with deep vein thrombosis occurred later. Proper cardiopulmonary support and anticoagulant therapy were done and the patient was recovered and discharged in improved condition.
Abscess* ; Adult ; Anoxia ; Diagnosis ; Edema ; Female ; Humans ; Leg* ; Leiomyoma* ; Lung ; Myoma ; Perfusion ; Postoperative Complications ; Postoperative Period ; Pulmonary Embolism* ; Sweat ; Sweating ; Tachypnea ; Venous Thrombosis*

OBJECTIVES: Cholesteatoma destructs bony tissue by the interactions between hyperproliferative epithelial cells and subepithelial inflammatory cells. The aim of this study was to evaluate the expression of epidermal growth factor receptor (EGFR) and microvessel density (MVD) in middle ear cholesteatoma tissue in an effort to determine the relationship between expression of EGFR and neovascularization. METHODS: We evaluated the expression of EGFR and MVD by immunohistochemical staining for CD31 and Factor VIII in 32 cholesteatoma tissue samples and 7 normal postauricular skin samples. We also analyzed the correlation between EGFR expression and MVD. RESULTS: The expression of EGFR was higher in cholesteatoma than in postauricular skin, but the difference was not statistically significant. EGFR was more highly expressed in the suprabasal layer than in the basal layer. Using CD31 and Factor VIII, we analyzed the MVD and found that it was significantly higher in cholesteatoma than in postauricular skin, and significantly correlated with the expression of EGFR. CONCLUSION: Our results suggest that overexpression of EGFR and neovascularization are correlated with the growth of cholesteatoma.
Cholesteatoma ; Cholesteatoma, Middle Ear ; Ear, Middle ; Epithelial Cells ; Factor VIII ; Microvessels ; Receptor, Epidermal Growth Factor ; Skin

PURPOSE: The purpose of this study was to evaluate the clinical and abdominal ultrasonogra- phic (US) features of spontaneously reduced transient small bowel intussusception in chlidren. METHODS: We retrospectively reviewed the clinical and US findings of 98 children with intussusception who were admitted to the Pediatric Department of Ulsan Dong-Kang General Hospital from Mar. 1999 to Feb. 2000. RESULTS: 1) Among 98 cases, there were 12 cases (12.3%) of transient small bowel intussusception (TSBI) and 86 cases (87.7%) of classic intussusception (CI). 2) The peak incidence of age in TSBI was over 3 years, which was older than that in CI. With regard to sex distribution, male predominated in both type. 3) Clinical symptoms and signs including cyclic irritability, vomiting, bloody stool, and abdominal mass in TSBI group were less common than those in CI group (41.7%, 33.4%, 0.0%, 0.0% vs 91.9%, 59.3%, 41.9%, 26.7%, respectively) but persistent abdominal pain was more common in TSBI group than in CI group (58.5% vs 11.2% ). 4) The size of total target sign and surrounding peripheral hypoechoic rim of TSBI group on US were smaller than those of CI group (11.9±2.61 mm, 2.08±1.15 mm vs 26.91±5.98 mm, 7.86±2.77 mm, respectively). 5) Concomittant illness was found more frequently in TSBI group than in CI group (66.7% vs 26.7%). 6) All case of TSBI group were reduced spontaneouly, which were confirmed by US, but none of CI group. CONCLUSION: Transient small bowel intussusception is probably more common than generally thought and its clinical and US findings is quite different from classical obstructing intussus-ception. Because all of our cases resulted in spontaneous reduction, we recommend careful observation and repeat examination rather than an immediate operation in transient small bowel intussusception.
Abdominal Pain ; Child ; Hospitals, General ; Humans ; Incidence ; Intussusception ; Male ; Retrospective Studies ; Sex Distribution ; Ulsan ; Ultrasonography ; Vomiting