In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group
Aging ; Aircraft* ; Airports ; Blood Pressure* ; Female ; Hearing Loss* ; Hearing* ; Humans ; Hypertension ; Male ; Military Personnel ; Noise* ; Presbycusis ; Psychological Tests ; Stress, Psychological*

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

With changing mechanisms of injury, heightened clinical awareness, and better diagnostic technology, odontoid fractures constitute 9~18% of cervical fractures in recent reports. The odontoid type II fracture is the most common axis fracture and it is also the most difficult to treat. Type II fractures with greater than 6mm dens dislocation have a higher incidence of nonunion with nonoperative therapy and should be offered early operative reduction with fusion. Recently we have experienced a young male patient with odontoid type II fracture. The degree of dens dislocation was 8mm. The fractured odontoid process was removed through transoral-transpharyngeal approach and bone fusion was performed with iliac bone. And the inserted bone was fixed with screws and mini-plate for further stabilization. The operative result was good without any serious complications. The operation technique is detailed.
Axis, Cervical Vertebra ; Dislocations ; Humans ; Incidence ; Male ; Odontoid Process

OBJECTIVE: Subdural hygroma (SDG) is a complication occurring after head trauma that may occur secondary to decompressive craniectomy (DC). However, the mechanism underlying SDG formation is not fully understood. Also, the relationship between the operative technique of DC or the decompressive effect and the occurrence and pathophysiology of SDG has not been clarified. Purpose of this study was to investigate the risk factors of SDG after DC in our series. METHODS: From January 2004 to December 2008, DC was performed in 85 patients who suffered from traumatic brain injury. We retrospectively reviewed the clinical and radiological features. For comparative analysis, we divided the patients into 2 groups : one group with SDG after craniectomy (19 patients; 28.4% of the total sample), the other group without SDG (48 patients; 71.6%). The risk factors for developing SDG were then analyzed. RESULTS: The mean Glasgow Outcome Scale (GOS) scores at discharge of the groups with and without SDG were 2.8 and 3.1, respectively (p<0.0001). Analysis of radiological factors showed that a midline shift in excess of 5 mm on CT scans was present in 19 patients (100%) in the group with SDG and in 32 patients (66.7%) in the group without SDG (p<0.05). An accompanying subarachnoid hemorrhage (SAH) was seen in 17 patients (89.5%) in the group with SDG and in 29 patients (60.4%) in the group without SDG (p<0.05). Delayed hydrocephalus accompanied these findings in 10 patients (52.6%) in the group with SDG, versus 5 patients (10.4%) in the group without SDG (p<0.05). On CT, compression of basal cisterns was observed in 14 members (73.7%) in the group with SDG and in 18 members of the group without SDG (37.5%) (p<0.007). Furthermore, tearing of the arachnoid membrane, as observed on CT, was more common in all patients in the group with SDG (100%) than in the group without SDG (31 patients; 64.6%) (p<0.05). CONCLUSION: GOS showed statistically significant difference in the clinical risk factors for SDG between the group with SDG and the group without SDG. Analysis of radiological factors indicated that a midline shifting exceeding 5 mm, SAH, delayed hydrocephalus, compression of basal cisterns, and tearing of the arachnoid membrane were significantly more common in patients with SDG.
Arachnoid ; Brain Injuries ; Craniocerebral Trauma ; Decompressive Craniectomy ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Membranes ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage ; Subdural Effusion

To elucidate some DNA adducts as a biological marker for workers of chromate pigment, the effects of chromium exposure on the formation of 8-hydroxydeoxyguanosine(8-OH-dG) and sister chromatid exchanges(SCEs) frequency in 38 workers of a pigment plant in Bucheon which utilized lead chromates, were examined. The chromium contents of venous blood and urine were measured as working environmental exposure level. The concentrations of 8-OH-dG in DNA isolated from lymphocytes were determined with high performance liquid chromatography and electrochemical detector and denoted as a molar ratio of 8-OH-dG to deoxyguanosine(dG). The SCEs frequency were analyzed in DNA isolated from lymphocytes. A significant correlation was found between creatinine adjusted urine chromium concentration and the molar ratio of 8-OH-dG to dG(r=0.47, p<0.01). After adjusting the current smoking habit, the correlation coefficient was increased(r=0.62, p<0.05). However, there was no significant correlation between the SCE frequency and chromium exposure. This significant results between molar ratio of 8-OH-dG to dG and chromium exposure are in good agreement with in vitro studies that support the importance of DNA adduct formation for the carcinogenic effect of chromium.
Biomarkers ; Chromates ; Chromatids ; Chromatography, Liquid ; Chromium* ; Creatinine ; DNA ; DNA Adducts ; Environmental Exposure ; Gyeonggi-do ; Humans ; Lymphocytes ; Molar ; Plants ; Siblings* ; Sister Chromatid Exchange* ; Smoke ; Smoking

A cross-sectional study was conducted to assess the association between perceived occu-pational psychosocial stress at work and the work-related musculoskeletal disorders (WRMSD) among employees using video display terminals. The study included 111 female telecommunication employees from three companies at ChungBuk province. Cases of WRMSD were defined using symptom questionnaire and physical examination conducted by rehabilitation specialist. Information on demographics, individual factors, and perceived psychosocial stress, were obtained by self-administered questionnaire. For assessing perceived psychosocial stress, we used variables from 'job strain model' proposed by Karasek. Associations between perceived psychosocial stress and WRMSD were assessed by multiple logistic regression models. Forty nine (44% to the total) subjects met our operational definition for WRMSD. Age, seniority, housing load were not associated with WRMSD. Perceived psychosocial stress was associated with WRMSD [odds ratio=3.28, 95% confidence interval: 1.05-10.19]. This study suggests that perceived occupational psychosocial stress is related to the prevalence of WRMSD.
Chungcheongbuk-do ; Computer Terminals* ; Cross-Sectional Studies ; Demography ; Female ; Housing ; Humans ; Logistic Models ; Physical Examination ; Prevalence ; Questionnaires ; Rehabilitation ; Specialization ; Telecommunications

Congenital agenesis, aplasia or hypoplasia of the internal carotid artery is rare vascular disease and usually combine with intracranial aneurysm, subarachnoid hemorrhage, or intracerebral hemorrhage. We report a case of bilateral congenital hypoplasia of internal carotid artery in a 36 year-old woman presented with semicomatose mentality. The brain computed tomography(CT) revealed intracerebral hemorrhage with intraventricular hemorrhage, and cerebral angiography showed hypoplasia of bilateral internal carotid artery without narrowing of the bony carotid canal on the temporal bone CT.
Adult ; Brain ; Carotid Artery, Internal* ; Cerebral Angiography ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Subarachnoid Hemorrhage ; Temporal Bone ; Vascular Diseases

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

PURPOSE: To determine the intraocular pressure (IOP) lowering effects on the change of anterior chamber depth (ACD), corneal thickness, corneal cell area and density in normal eyes. METHODS: We investigated 58 eyes of 29 volunteers for this study whose refractive error was +/-3 D, IOP was below 21 mmHg, anterior segment and fundus was within normal limit. All of them had normal visual fields. They were randomly classified into two groups. Anterior chamber depth, IOP, central corneal thickness, cell density, cell area, and coefficient of variation of corneal endothelium were measured by single observer in each group. After oral medication of 50% glycerin 1 cc/kg (body weight) in group 1 and Diamox 500 mg and K-contin 600 mg in group 2, IOP, anterior chamber depth, central corneal thickness, cell density, cell area, and coefficient of variation were measured at 1, 2, and 3 hours. RESULTS: In glycerin group after 1 hour, decreased IOP was stastically significant (P<0.05). In Diamox group after 2 hours, decreased IOP was stastically significant (P<0.05). But the change of anterior chamber depth, central corneal thickness, cell density, cell area, and coeff icient of variation was not stastically significant (p>0.05). There was no significant correlation between decreased IOP and the change of anterior chamber depth, central corneal thickness, cell density, cell area, and coefficient of variation. The IOP change was not statistically different between the two groups. CONCLUSIONS: There was no stastically significant correlation between decreased IOP in normal range and the change of ACD, central corneal thickness, cell density, cell area, and coefficient of variation.
Acetazolamide ; Anterior Chamber* ; Cell Count ; Endothelium, Corneal ; Glycerol ; Intraocular Pressure* ; Reference Values ; Refractive Errors ; Visual Fields ; Volunteers

PURPOSE: We investigated the results of cementless total hip arthroplasty using a tapered titanium-alloy stem. MATERIALS AND METHODS: We followed 72 hips in 60 patients who underwent total hip arthroplasty and received the using Mallory-Head femoral component for a mean of 9.1 years. The most common disease was avascular necrosis (56 hips; 77.7%). Their mean age was 50.1 years at the time operation. We analysed the clinical results by the Merle d'Aubigne and Postel scoring system and the radiographic outcome according to Engh's criteria. RESULTS: The mean hip score was 16.4 at the last followup. An excellent or good clinical result was obtained in 62 hips (86.1%). Thigh pain was present in 3 hips (4.1%), and femoral osteolysis was observed in 8 hips (11.1%), which did not progress to the distal part. Two femoral components were revised for loosening and for periprosthetic fracture. Thus, 69 stems survived at the last follow up. Sixty-six hips (91.7%) had fixation by bone ingrowth, and three (4.1%) showed stable fibrous fixation. CONCLUSION: These results shows that excellent fixation can be obtained by using a tapered titanium alloy femoral component by medium-term followup.
Alloys ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Necrosis ; Osteolysis ; Periprosthetic Fractures ; Thigh ; Titanium