We herein present a case of rare disease developed in a 43-year-old healthy woman. On her visit, we found several gray colored, well defined, pale, soft, wrinkled atrophic patches on the anterior portion of right upper chest area that is unusual location. The histologic findings showed typical features of lichen sclerosus et atrophicus.
Adult ; Female ; Humans ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Rare Diseases ; Thorax*

Since the widespread application of hyperbaric oxygenation in clinical medicine, the problems of oxygen toxicity have been attracting a deep interest from the researchers on hyperbaric medicine as a practical issue. Among extensive research trials, the study on the protective agents oxygen toxicity occupied one of the most challenging field. As the mechanisms of oxygen toxicity, the role of the oxygen free radicals produced by peroxidation process are strongly accepted by the leading researchers on oxygen toxicity, the probable protective effects of antioxidant against oxygen toxicity are sustaining a sufficient rational. Maltol(2-methyl-3-hydroxy-gamma-pyrone) which is known to be a component of Korean red ginseng has been reporting to have an antioxidant action. But, further study is needed to provide definite evidence for this compound to be an antioxidant, since the action was based on the results which were obtained under in vitro experiment. In this study, the author attempted to evaluate the effect of maltol as protective agent against oxygen toxicity through the observation of death rate, convulsion rate, time to convulsion and microscopic pathological changes in some organs of experimental rats exposed to various conditions. The findings observed are as follows: 1) The death rate, convulsion rate, time to convulsion, lung/weight ratio and microscopic pathological finding of lung were identified as reliable objective and quantitative indices for oxygen toxicity. 2) Maltol showed excellent protective effect against pulmonary oxygen toxicity as an antioxidant.
Animals ; Clinical Medicine ; Free Radicals ; Hyperbaric Oxygenation ; Lung ; Mortality ; Oxygen* ; Panax ; Protective Agents ; Rats ; Seizures

BACKGROUND: Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of air pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. METHOD: This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i.e., mainly potential environmental diseases. We reconstructed a nested case-control study with Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects'. Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are probable chronic environmental diseases, while controls are mainly acute environmental diseases. For exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, O3, SO2, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results: Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-attainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of O3and CO exceedance counts(to corrected error level - 0.017) and less strongly and consistently with SO2 and TSP. SO2and TSP showed weaker and less consistent relationship. O3and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). CONCLUSIONS: Although not decisive due to potential misclassication of exposure, these results were drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. O3might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.
Air Pollutants ; Air Pollution* ; Asthma ; Bronchitis, Chronic ; Cardiovascular Diseases ; Case-Control Studies ; Cohort Studies ; Information Storage and Retrieval ; Environmental Monitoring ; Heart ; Heart Failure ; Humans ; Insurance ; Korea ; Logistic Models ; Lung Diseases, Obstructive ; Lung Neoplasms* ; Lung* ; Motor Vehicles ; Physical Examination ; Pulmonary Disease, Chronic Obstructive* ; Surveys and Questionnaires ; Smoke ; Smoking

To determine the recovery time from noise-induced temporary threshold shift (TTS), a prospective field study was conducted at three worksites where workers are known to be exposed high level of noise. Subjects were selected according to answers on a questionnaire which inquired about otological history and previous noise exposure, including avocational, military and occupational exposures. After excluding employees with past otologic problems, recent exposure to high level noise, and under medications, total 92 employees participated in the study. Among 92 participants, complete consecutive audiometric examinations were carried out at 0~2 hours, 5~7 hours, 14~16 hours after worktime noise exposure on 26 participants wearing hearing protectors and 22 participants wearing no protective devices. The difference between the hearing level 0~2 hours after noise exposure and 5~7 hours is statistically significant by paired t-test(p<0.01). The median recovery times calculated from the data of 22 participants wearing no protective hearing devices are 15.6 hours at 4000 Hz, and 7.7 hours, 10.3 hours, 8.4 hours at 1000 Hz, 2000 Hz and 8000 Hz respectively. These data suggest that when measuring the pure tone audiometry for noise exposed workers, at least 16 hours noise-free interval is required.
Audiometry ; Hearing ; Hearing Loss, Noise-Induced ; Humans ; Military Personnel ; Noise ; Occupational Exposure ; Prospective Studies ; Protective Devices ; Questionnaires ; Workplace

To determine the recovery time from noise-induced temporary threshold shift (TTS), a prospective field study was conducted at three worksites where workers are known to be exposed high level of noise. Subjects were selected according to answers on a questionnaire which inquired about otological history and previous noise exposure, including avocational, military and occupational exposures. After excluding employees with past otologic problems, recent exposure to high level noise, and under medications, total 92 employees participated in the study. Among 92 participants, complete consecutive audiometric examinations were carried out at 0~2 hours, 5~7 hours, 14~16 hours after worktime noise exposure on 26 participants wearing hearing protectors and 22 participants wearing no protective devices. The difference between the hearing level 0~2 hours after noise exposure and 5~7 hours is statistically significant by paired t-test(p<0.01). The median recovery times calculated from the data of 22 participants wearing no protective hearing devices are 15.6 hours at 4000 Hz, and 7.7 hours, 10.3 hours, 8.4 hours at 1000 Hz, 2000 Hz and 8000 Hz respectively. These data suggest that when measuring the pure tone audiometry for noise exposed workers, at least 16 hours noise-free interval is required.
Audiometry ; Hearing ; Hearing Loss, Noise-Induced ; Humans ; Military Personnel ; Noise ; Occupational Exposure ; Prospective Studies ; Protective Devices ; Questionnaires ; Workplace

OBJECTIVES: This study, using case-crossover design, search a relationship between changing levels of air pollutants and asthma attack in asthma patients. METHODS: We searched the daily total number of asthmatic patients at hospital' s emergency room in Seoul, Korea by investigating total 49 general hospitals emergency room records. Otherwise, We investigated medical records of asthmatic patients at one of the 49 hospitals we have searched. We investigated addresses that they are living, diagnosis, smoking history, whether respiratory infection or not, medications. We analyzed the data by 1:m conditional logistic regression used when matched case-control study is analyzed. Control periods were chosen by bidirectional paired matching technique 7, 14 days before and after case periods. RESULTS: the relative risk of asthmatic attack by 100 ppm ozone increase between June and September were 1.348(95 % CI = 1.010~1.619). Between November and February, the relative risk by 100 /m TSP increase, 100ppb sulfur dioxide and nitrogen dioxide were respectively 1.278(1.010~1.619), 1.237(1.019~1.502), 1.285(1.006~1.640). In stratified analysis, the relative risk were significant when the asthmatic patients were children aged 15 years or below, when there were respiratory infection, and when the patients took medications irregularly CONCLUSIONS: There was statistically significant association between ambient levels of air pollutants and asthmatic attack. So, we have to exert our efforts to minimize the air pollution effectively, to protect public health from air pollution.
Air Pollutants ; Air Pollution* ; Asthma* ; Case-Control Studies ; Child ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Medical Records ; Nitrogen Dioxide ; Ozone ; Public Health ; Seoul ; Smoke ; Smoking ; Sulfur Dioxide

We report here on a rare case of papillary and follicular carcinoma of the thyroid gland that developed in a 31 years old woman who was previously diagnosed with Hashimoto's thyroiditis. Her chief complaint was a palpable neck mass. The antimicrosomal and antithyroglobulin antibody levels were elevated. Ultrasonography of the left thyroid gland revealed a 2.5x2.0 cm sized thyroid nodule. Fine needle aspiration biopsy of the thyroid nodule was done and this was diagnosed as Hashimoto's thyroiditis. There was no evidence of thyroid cancer. After 1 year, thyroid ultrasonography and biopsy were repeated for examining an enlarged thyroid nodule. Total thyroidectomy was then performed. The histopathologic examination revealed that the right and left thyroid glands were in accordance with the diagnosis of papillary and follicular cancer, respectively. Until now, no known case of simultaneous papillary and follicular carcinoma in Hashimoto's thyroiditis has been reported. This case suggests that adequate follow up for Hashimoto's thyroiditis patients with thyroid nodule may help the early detection and management of thyroid cancer.
Adult ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Female ; Humans ; Neck ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroiditis* ; Ultrasonography

A mushroom bezoar is an unusual type of bezoar and a rare cause of small bowel obstruction, with the only cases being previously described in the foreign literature. Common sites of obstruction are the gastric outlet, the terminal ileum as well as segments of pre-existing gastrointestinal stenosis of various etiologies. Predisposing factors include a high fiber intake, inadequate chewing, gastric hyposecretion and hypomotility, and a previous gastrectomy and vagotomy. Computed tomography has the capability of directly showing the bezoar and displaying the resulting small bowel obstruction. We report a case of incomplete small bowel obstruction in a 38-year-old woman, caused by a mushroom bezoar in the terminal ileum.
Adult ; Agaricales* ; Bezoars* ; Causality ; Constriction, Pathologic ; Female ; Gastrectomy ; Humans ; Ileum ; Mastication ; Vagotomy

This cohort study is a collaborative effort of 8 institutions. The goal is to establish a large scale cohort that can be followed for 10 or more years to assess the relationship between life-styles and cancer occurrence, and to evaluate the role of environmental exposures in the development of six major sites of cancers(stomach, liver, lung, colorectum, uterine cervix and female breast) in the rural population. Since 1993, 11,304 men and women aged over 35 living in four areas have been recruited. The number of target population is 30,000 persons, which is expected to be successfully recruited until 1999. Each subject has completed a detailed questionnaire on general life-styles, reproductive factors, and agricultural chemical exposures through the interview. Anthropometric measurements with body fat composition and the routine clinical laboratories were examined. For the cancer-free cohort, physical examination by the physicians and serologic tests for hepatitis markers, some tumor markers, and lipid profile have been done, but not all. In order to provide an opportunity to incorporate barious biomarkers of exposure and effect as well as genetic susceptibility, a biologic tissue bank has been established from blood and urine sample(plasma, WBC buffy-coat, RBC clots, and urine supernatant) stored at-70degrees C. Re-examination of changes in exposere to risk factors will be done periodically. Disease occurrence will be ascertained by the active(mainly through diagnosis by physicians) and the passive surveillance(through both death certificate and screening of medical utilization records).
Adipose Tissue ; Biomarkers ; Cervix Uteri ; Cohort Studies* ; Death Certificates ; Diagnosis ; Environmental Exposure ; Female ; Genetic Predisposition to Disease ; Health Services Needs and Demand ; Hepatitis ; Humans ; Korea* ; Liver ; Lung ; Male ; Mass Screening ; Physical Examination ; Risk Factors ; Rural Population ; Serologic Tests ; Tissue Banks ; Biomarkers, Tumor ; Surveys and Questionnaires