Objectives: The prevalence of cumulative trauma disorders of upper extremities mons watch assembly workers in small-scaled industry was studied. Methods: In 83 workers at five watch assembly factories, symptoms and psychosocial questionnaire, ergonomic Interview, physical examination were conducted. Results: Prevalence of self-reported symptoms was 54.2% and neck 34.9%, wrist/hand 31.3%, shoulder 30.1%, elbow/arm 18.0% by anatomical site. Prevalence of cumulative trauma disorders was 45.8%. Most common disease was myofascial pain syndrome (31.3%). The other diseases were De Quervain disease (9.6%), tenosynovitis/tendinitis at wrist/hand (9.6%), bicipital tendinitis(6.0%), fat. epicondylitis(4.8%), meIn. epicondylitis(2.4%), and cervical disc disease(2.4%). As result of ergonomic interview, repetitiveness was 79(98.8%). There were no differences in the prevalence of self-reported symptoms and cumulative trauma disorders for age, sex, marital status, duration of work In the study, The significant factors of cumulative trauma disorders were occupational task and psychosocial stress in the study. The prevalence of cumulative trauma disorders in high strain group was hlgher (68.4%) than other three groups. The prevalence of self-reported symptoms and cumulative trauma disorders in assembly task was higher (70.0%, 64.0%) than other two tasks. Conclusions: Prevalence of self-reported symptoms was 54.2%, prevalence of cumulative trauma disorders was 45.8% in watch assembly workers. In this study, factor related to self-reported symptoms was occupational task and factors relaxed to cumulative trauma disorders were occupational task and psychosocial stress. This results suggest that differences of ergonomics and environment in occupational task cause differences of prevalence of self-reported symptoms and cumulatlve trauma disorders.
Cumulative Trauma Disorders* ; De Quervain Disease ; Human Engineering ; Marital Status ; Myofascial Pain Syndromes ; Neck ; Physical Examination ; Prevalence* ; Questionnaires ; Shoulder ; Upper Extremity*

PURPOSE: The staging of bladder carcinoma is a major determinant of operative management. CT of bladder carcinoma has been widely used to diagnose external extension (pT3b and over), but tumors confined to the bladder wall (from pT1 to pT3a) are poorly delineated. The authors describe CT findings of the superficial bladder carcinoma (below T1, stage A) in thin section CT with air insufflation technique (air insufflation-CT) to facilitate early detection and to aid correct staging of the superficial bladder carcinoma. MATERIALS AND METHODS: The materials consisted of proved 24 cases (1'9 patients, single tumor: 16 patients, multiple tumors :3 patients) of stage A bladder carcinomas. Air insufflation-CT was performed by the infusion of approximately 200 mL of air into the bladder via a Foley catheter. After the routine pelvic CT, bladder tumors were re-scanned with 1.5 to 5 mm thickness and intervals. RESULTS: The superficial bladder carcinomas were detected as nodular(5 cases, 20.8%), papillary(15 cases, 62.5%), pyramidal(2 cases, 8.3%), and domed(2 cases, 8.3%) forms on air insufflation CT. These tumors were classified into three types according to the size of the tumoral neck:type I(pedundulated polypold tumor:4 cases, 16.6%), type II(polypid tumor with short neck :13 cases, 54.2%), and type Ill(sessile tumor :7 cases, 29. 2%). The mean size(tumoral width x height x base o, neck/stalk) of the tumors was 22 x 20 x 16mm. The average tumoral sizes according to each type of the superficial tumors were type 1:22 x 25 x 6mm, type 11:23 x 22 x 18mm, and type III :18 x 15 x 18mm. The mean width of the type I--II tumoral necks was 15mm. The mean length of the type I tumoral neck(pedicle) was 2.5mm. Papillary fronds of the tumors were seen in 10 cases(41.7%) of 24 superficial tumors. Outer margin of the involved bladder wall was smooth in all cases. CONCLUSION: Thin-sectin CT with air insufflation technique for bladder carcinoma was useful in tumoral demonstration, and characteristics of the superficial bladder carcinomas were small polypold tumors had a short neck mostly and smooth outer wall of the involved bladder wall.
Catheters ; Humans ; Insufflation* ; Neck ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: To determine the significance of nerve root contrast enhancement in patients with residual or recurrent symptomatic postoperative lumbar spine. MATERIALS AND METHODS: Eighty-eight patients with 116 postoperative lumbar disc lesions causing radiating back pain underwent enhanced MR imaging. Intradural nerve root enhancement was quantified by pixel measurement, and affected nerve roots were compared before and after contrast administration. Extradural nerve root enhancement was assessed visually, and nerve root enhancement and clinical symptoms were correlated. Associated lesions such as recurrent disc herniation, scar tissue, nerve root thickening and nerve root displacement were also evaluated. RESULTS: Of 26 cases(22.4%) involving intradural nerve root enhancement, 22 (84.6%) showed significant clinical symptoms (p=0.002). and of 59 (50.9%) demonstrating extradural enhancement, clinical symptoms showed significant correlation in 47 (79.7%) (p=0.001). Nerve root enhancement, including eleven cases where this was both intra-and extradural, showed highly significant association with clinical symptoms in 74 of the 116 cases (63.8%) (p=0.000). Among 33 cases (28.4%) of recurrent disc herniation, nerve root enhancement was observed in 28 (84.8%) and in 24 of these 28 (85.7%), significant correlation with clinical symptoms was observed (p=0.000). Where epidural fibrosis was present, correlation between nerve root enhancement and clinical symptoms was not significant (p>0.05). Nerve root thickening and displaced nerve root were, however, significantly associated with symptoms(87.2% and 88.6%, respectively). CONCLUSION: In patients with postoperative lumbar spine, the association between nerve root enhancement revealed by MRI and clinical symptoms was highly significant.
Back Pain ; Cicatrix ; Fibrosis ; Humans ; Magnetic Resonance Imaging* ; Nerve Tissue ; Spine*

PURPOSE: To investigate the frequency of underlying diseases associated with respiratory distress in full-term infants, as well as its relation to the mode of delivery and clinical outcomes. METHODS: We conducted a retrospective review of 4,264 infants who had been admitted to the neonatal intensive care unit (NICU) of Chonnam University Hospital (CUH) over 5 years from January 2000 to December 2004. Full-term infants with respiratory distress such as transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), congenital pneumonia, meconium aspiration syndrome (MAS) and pneumothorax were included. We analysed the incidence of underlying disease, its relation to the mode of delivery, rate of mechanical ventilator therapy, prevalence of hypoxic ischemic encephalopathy (HIE), mortality and the length of hospitalization of surviving patients. RESULTS: Of the 4,264 patients who admitted to the NICU of CUH over the last five years, preterm infants made up 2,278 (53.4%) and full-term infants made up 1,982 (46.5%). The number of full-term patients who admitted due to respiratory distress associated with respiratory system problems excluding a congenital anomaly was 246 (12.4%). The most common underlying disease was TTN (n=161, 65.4%), and the next was RDS (n=39, 15.9 %), congenital pneumonia (n=11, 4.5%), MAS (n=7.9, 8.5%), and pneumothorax (n=14, 5.7 %). RDS was more statistically common in full-term infants born by Caesarian section (P<0.05). But there was no difference according to the mode of delivery statistically in other respiratory tract diseases. The rate of mechanical ventilator therapy was significantly higher in RDS and MAS, and the prevalence of HIE was higher in MAS (P<0.05). Mortalities of RDS and MAS were 7.7% and 9.5% each. There was no significant difference in the length of hospitalization of surviving patients. CONCLUSION: TTN was the most common respiratory tract disease in the full-term infant, and RDS was more common in the infant who was born by Cesarean section. The rates of mechanical ventilator therapy and mortality were significantly higher in the infants with RDS and MAS, and HIE was exclusively manifested by infants with MAS.
Cesarean Section ; Female ; Hospitalization ; Humans ; Hypoxia-Ischemia, Brain ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Jeollanam-do ; Meconium Aspiration Syndrome ; Mortality ; Pneumonia ; Pneumothorax ; Pregnancy ; Prevalence ; Respiratory System* ; Respiratory Tract Diseases* ; Retrospective Studies ; Transient Tachypnea of the Newborn ; Ventilators, Mechanical

BACKGROUND: Propofol (2,6-diisopropylphenol) is one of the intravenous anesthetic drugs used for induction and maintenance of general anesthesia as well as for sedation in ICU patients and one-day surgery. The monitoring of propofol in blood helps to maintain anesthetic state and promote earlier recovery. So we attempted to find the rapid and simple method for blood propofol determination. METHODS: We compared the precipitation method with extraction one using whole blood, plasma and deionized water added a fixed amount of propofol. According to the extraction method, propofol was extracted from 500 microliter sample adding KH2PO4, ethyl acetate, and tetra-ethylammonium hydroxide using thymol as an internal standard. For the precipitation method, the precipitating solution (500 microliter) containing thymol was added to a 500 microliter sample, then mixed. After centrifugation, the supernatant was injected into HPLC system. A Waters 2690 separations module, Waters 474 fluorescence and 486 UV detector and a Symmetry column were used. We used Millennium software to control analyzing process and quantify propofol. RESULTS: The precipitation method using thymol as an internal standard and Waters 474 fluorescence detector showed the most excellent results. For the calibration curves, we found very good linearity in whole blood, plasma and deionized water (r> or =9976). Intra-assay and inter-assay coefficient of variation (CV) values of propofol for the precipitation method were 4.4% and 8.9% at 2 microgram/mL of propofol and 2.0% and 6.2% at 8 microgram/mL, respectively. The recovery rates of propofol for plasma and whole blood were 104.1% and 92.7% at 2 microgram/mL and 99.4% and 91.6% at 7 microgram/mL, respectively. CONCLUSIONS: For the measurement of the blood propofol level, the precipitation method using thymol as an internal standard and fluorescence detector seemed to be the rapid and simple method to apply for the clinical purpose.
Anesthesia, General ; Anesthetics ; Calibration ; Centrifugation ; Chromatography, High Pressure Liquid* ; Fluorescence ; Humans ; Plasma ; Propofol* ; Thymol ; Water

Bacterial endophthalmitis is a very difficult ophthalmic disease to treat because of the consistently poor results with conventional therapy. lntravitreal injection of antibiotics is increasingly gaining the acceptance as a method of producing high vitreal concentrations that may be useful in the treatment of bacterial endophthalmitis. The author performed this experiment to determine the clerance rare of intravitreal gentamicin in the rabbit eyes. We observed the clearance of gentamicin in phakic and aphakic rabbit eyes into which 20 micro gram/0.1 ml of gentamicin was injected. In phakic eyes, about 52% of gentamicin was cleared at 24 hours after injection. In aphakic eyes with intact posterior capsule, 64% of gentamicin was cleared at 24 hours after injection. In aphakic eyes with incised posterior capsule, the clearance rate at 24 hours after injection was about 70%. Intravitreal gentamicin was cleared more rapidly from the aphakic eyes than from that of phakic eyes.
Anti-Bacterial Agents ; Endophthalmitis ; Gentamicins*

The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was 0.83+/-0.12 by non surgical treatment and 0.82+/-0.14 by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving non-surgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.
Adult ; Male ; Female ; Humans

Amyloidosis is the definition for a group of diseases that have, in common, the infiltration of one or more tissues by an abnormal protein material-the amyloid substance, which is detected histologically by their green polarization color after Congo red staining. Despite increased interest on basic nature of amyloidosis by recent immunohistochemical or experimental study, the knowledge about the incidence and neurotoxic effect of cerebral amyloid or concomitant occurrence with brain tumor is still inchoate. We examined the incidence and clinico-pathologic characteristics of the patients with amyloid deposits in supratentorial meningiomas. Particularly about their neurotoxic effect to adjacent brain is considered one of the possible cause of seizure in 33 patients who underwent resection surgery for meningioma at the Keimyung University during the past three years. The pathological review and subgrouping by histologic type were done in all 33 specimens with sufficient size of paraffin block, defined by their morphology and polarization color after Congo red staining for diagnosis of amyloid deposits localized in the tumor. Immunohistochemical studies using monoclonal antibodies for amyloid-A protein(AA) and beta-amyloid(A beta) were evaluated to identify subtypes of amyloidosis. The rate of incidence of amyloid deposit in meningioma was 21%, i.e. seven out of thirty three cases. All laboratory findings and clinical studies did not suggest a systemic form. Seizure occurrence was one out of seven cases(14%), which was of no statistical significance. Immunohistochemical study for AA subtype was all negative, but showed all positive for A beta protein around the vessels. Recent reports has also demonstrated that Amyloid precusor protein(APP) and A beta is related in Alzheimer's disease, hereditary cerebral hemorrhage with amyloidosis-Dutch type(HCHWA-D) and amyloid angiopathy. Our research data indicates that the incidence of amyloid deposit is as high as 21% in supratentorial meningiomas. It seems that it is one of the possible cause of seizure. Nonsystemic microdeposits of amyloid and their subtype and it's relationship to neurotoxic effect in meningiomas remain to be confirmed by immunoelectron microscopic examination or immunohistochemical methods.
Alzheimer Disease ; Amyloid* ; Amyloidosis ; Antibodies, Monoclonal ; Brain ; Brain Neoplasms ; Cerebral Hemorrhage ; Congo Red ; Diagnosis ; Humans ; Incidence ; Meningioma* ; Paraffin ; Plaque, Amyloid* ; Seizures

OBJECTIVES: We conduct this study to investigate the common features between Attention Deficit Hyperactivity Disorder(ADHD) and epileptic patients compared to normal control. METHODS: Epileptic patients were recruited from the department of pediatic in Jesus Hospital. ADHD patients were recruited from the department of neuropsychiatry in Jesus Hospital. We excluded mental retardation or brain organic pathology. We use ADHD Diagnostic System and Korean-Child Behavior Checklist(K-CBCL) to assess features of ADHD. Electroencephalogram(EEG) of ADHD, epileptic patients and normal control were analyzed and compared. RESULTS: Compared to normal control group, inattention, reaction time deviation were increased in both ADHD and epilepsy group. EEG abnormalities(control 13.8%, epilepsy 97.1%, ADHD 40%) in three groups were reported. CONCLUSION: There are common features of ADHD and epileptic patients.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Brain ; Electroencephalography ; Epilepsy ; Humans ; Intellectual Disability ; Neuropsychiatry ; Reaction Time

Purpose: To determine the effectiveness of salvage radiation therapy (RT) in patients with locoregional recurrence (LRR) following initial curative resection of non-small cell lung cancer (NSCLC) and identify the prognostic factors affecting survival. Materials and Methods: Between January 2009 and January 2019, 54 patients with LRR after NSCLC surgery were treated with salvage RT (83.3%) or concurrent chemoradiation therapy (16.7%). Twenty-three (42.6%), 21 (38.9%), and 10 (18.5%) patients had local, regional, and both recurrences, respectively. The median RT dose was 66 Gy (range, 37.5 to 70 Gy). The radiation target volume included recurrent lesions with or without regional lymphatics depending on the location and recurrence type. Results: The median follow-up time from the start of RT was 28.3 months (range, 2.4 to 112.4 months) and disease-free interval (DFI) from surgery to recurrence was 21.0 months (range, 0.5 to 92.3 months). Tumor response after RT was complete response, partial response, stable disease, and progressive disease in 17, 29, 5, and 3 patients, respectively. The rates of freedom from local progression at 1 and 2 years were 77.2% and 66.0%, respectively. The median survival duration after RT was 24.8 months, and the 2-year overall survival (OS) rate was 51.1%. On univariate analysis, initial stage, recurrence site, DFI, and tumor response after RT were significant prognostic factors for OS. DFI ≥12 months and tumor response after RT were statistically significant factors on multivariate Cox analysis for OS. Conclusion Our results demonstrated the effectiveness of salvage RT for LRR of NSCLC following curative surgery.