According to law the employer who has over 50 workers in his enterprise should employ an occupational physician as industrial health manager. The main role of the occupational physician is emphasized to the prevention of occupational diseases rather than the treatment and he should be the team leader of industrial health personnel. But this ideal system in terms of stipulations has lots of problems in operation. Therefore this study was designed to prove the attitude of reception, real condition and work content of the occupational physician in enterprise. The survey was done in 500 stratified random sampled enterprises over the country from July through September in 1987 by mailing questionnaire. As a result of the response from 145 enterprises, more than 85% of enterprise displaced occupational physicians. Among the occupational physicians 43% of them has no allowance for their working as industrial health managers and are payed less than 100,000 won monthly. And 66% of them visited only once a month or none enterprise, where they were nominated as a occupational physician managers. The major work content of occupational physician was doing outpatient clinic or regular physical examination rather than prevention of occupational disease. And it shows a deep discrepancy with the object of law or the expect of enterprise in which industrial hygiene and health education are more stressed for prevention of occupational diseases. The most of industrial workers showed no interest in work of occupational physician. As a conclusion, the current system of industrial health manager has maintained on paper formally and is apt to fall into making outward show. It is urgent for government and enterprise to find a solution which can be practically used the system of occupational physician. The work content of occupational physician is required high advanced knowledge and experience, and it should be operated dual system by special field and nonspecial field.
Ambulatory Care Facilities ; Health Education ; Jurisprudence ; Korea* ; Occupational Diseases ; Occupational Health ; Physical Examination ; Postal Service ; Questionnaires

Subclavian venous catheterization is common technique for a variety of purposes, but this procedure is associated with complications that include damage to the lung, pleura, thoracic duct, nerve and subclavian artery. We recently encountered a case of the tracheal puncture and endotracheal cuff perforation during the subclavian catheterization in a 67-year-old female who was scheduled for tracheal reconstruction. Tidal volume was escaping from around the endotracheal tube during the subclavian catheterization, however, repeated inflation of the cuff failed to maintain the necessary cuff pressure to seal the trachea. After the operation, by using the fiberoptic bronchoscope and injecting dye into the cuff, we confirmed the site of tracheal puncture and endotracheal cuff perforation which caused by the introducer needle of the central venous kit. We suggest that tracheal puncture and endotracheal cuff perforation be added to the list of complication of subclavian catheterization. This complication should be suspected whenever the cuff pressure cannot be maintained during or after an subclavian catheterization.
Aged ; Bronchoscopes ; Catheterization* ; Catheters* ; Female ; Humans ; Inflation, Economic ; Lung ; Methods ; Needles ; Pleura ; Punctures* ; Subclavian Artery ; Subclavian Vein* ; Thoracic Duct ; Tidal Volume ; Trachea ; United Nations

BACKGROUND: As the clinical application of non-invasive shunt estimation to operation under one-lung ventilation has not been reported, this study was carried out to evaluate the validity and accuracy of the non-invasive shunt estimations in one-lung ventilation with hemodilution. METHODS: Following general anesthesia with enflurane 0.5 1 vol.% and 100% oxygen in ten Mongrel dogs (B.W. around 16 kg), tracheostomy and insertion of left-side endobronchial tube and one-lung ventilation were performed. Acute normovolemic hemodilution was produced by sequential hemodilution with hydroxyethyl starch. The intrapulmonary shunt (QS/QT) was calculated by the classic shunt equation, by the oxygen contents-based estimated shunt equation, and by oxygen tension-based estimations such as alveolar to arterial oxygen difference (P(A-a)O2), respiratory index (RI, P(A-a)O2/PaO2), arterial oxygen tension to alveolar oxygen ratio (PaO2/PAO2), and PaO2 to FiO2 ratio. To assess the quantitative accuracy of the estimated shunt, the data were divided arbitrarily into two groups on the basis of the mean arteriovenous oxygen content difference (C(a-v)O2) being 3.6 ml/dl or greater (group 1) and less than 3.6 ml/dl (group 2). Relationships to QS/QT were analyzed by simple linear regression. RESULTS: In 104 measurements, the correlation between QS/QT and non-invasive shunt were poor (r = 0.66 - 0.76). However, in group 1 (n = 45), the correlation between QS/QT and the estimated shunt were very good (r = 0.93) and good for P(A-a)O2 (r = 0.83), RI (r = 0.87), PaO2/PAO2 (r = - 0.84), and PaO2/FiO2 (r = - 0.85). In group 2 (n = 58), the correlation between QS/QT and non-invasive shunt were worse than in group 1. Group 2 had lower hematocrit (20.6% vs 26.7 %, P < 0.001), higher cardiac output, and lower pulmonary and systemic vascular resistance than group 1 (P < 0.05). The difference between the estimated shunt and the classic shunt in group 1 remained constant when the classic shunt was increased further. However, the difference in group 2 was enhanced by the increment of the classic shunt. CONCLUSIONS: We conclude that even if the non-invasive shunt estimation might be affected by hemoglobin and cardiac output, it is a viable method in mild hemodiluted patients with good cardiovascular reserve.
Anesthesia, General ; Animals ; Cardiac Output ; Dogs* ; Enflurane ; Hematocrit ; Hemodilution ; Humans ; Linear Models ; One-Lung Ventilation ; Oxygen ; Starch ; Tracheostomy ; Vascular Resistance

Palatoplasty using Furlow's double-opposing Z-plasty has been performed from June, 1995 to September, 1999 at Seoul National University Children's Hospital. The goal of this study is to determine the optimal timing of repair and cleft severity affecting velopharyngeal function. This is the retrospective study of patients operated by the second author. The mean age of patients was 10.53 months. The patients could be divided into three groups-isolated cleft palate(n=70), unilateral cleft lip and palate(n=88), and bilateral cleft lip and palate(n=42). To evaluate the velopharyngeal function, we used two parameters, speech evaluation and cineofluorography using DSR(digital subtraction radiography). Also, to determine the relevance between cleft severity and speech development, we measured the distance between maxillary tuberosities and cleft margins. Among 200 patients, about 96% had no or minimal hypernasality and 87% had no or mild nasal emission. The cleft width and length of soft palate seemed not to be related with the speech development. Palatoplasty at the age under 12 months resulted in less 'nasal emission' and better 'articulation' of the parameters that were assessed at the age of 7 years. It can be concluded Furlow palatoplasty shows satisfactory results and also it seems that it is better to perform the operation before the age of 12 months.
Cleft Lip ; Cleft Palate* ; Humans ; Palate, Soft ; Retrospective Studies ; Seoul

We report two cases of adrenal abscesses that occurred following a Histoacryl(R) (N-butyl-2-cyanocrylate) injection for variceal bleeding. Patients had been diagnosed with alcoholic liver cirrhosis and gastric varices bleeding and received a Histoacryl(R) injection for the variceal bleeding. Patients had fever and abdominal tenderness and were diagnosed with an adrenal abscess at 2 months following the Histoacryl(R) injection. One patient received open drainage and the other underwent percutaneous drainage. When a patient has previously been injected with Histoacryl(R) for the treatment of variceal bleeding and presents with fever, an evaluation for an unusual complication such as adrenal abscess is recommended.
Abscess ; Drainage ; Enbucrilate ; Esophageal and Gastric Varices ; Fever ; Hemorrhage ; Humans ; Liver Cirrhosis, Alcoholic

PURPOSE: Template-guided implant therapy has developed hand-in-hand with computed tomography (CT) to improve the accuracy of implant surgery and future prosthodontic treatment. In our present study, the accuracy and causative factors for computer-assisted implant surgery were assessed to further validate the stable clinical application of this technique. MATERIALS AND METHODS: A total of 102 implants in 48 patients were included in this study. Implant surgery was performed with a stereolithographic template. Pre- and post-operative CTs were used to compare the planned and placed implants. Accuracy and related factors were statistically analyzed with the Spearman correlation method and the linear mixed model. Differences were considered to be statistically significant at P< or =.05. RESULTS: The mean errors of computer-assisted implant surgery were 1.09 mm at the coronal center, 1.56 mm at the apical center, and the axis deviation was 3.80degrees. The coronal and apical errors of the implants were found to be strongly correlated. The errors developed at the coronal center were magnified at the apical center by the fixture length. The case of anterior edentulous area and longer fixtures affected the accuracy of the implant template. CONCLUSION: The control of errors at the coronal center and stabilization of the anterior part of the template are needed for safe implant surgery and future prosthodontic treatment.
Axis, Cervical Vertebra ; Dental Implants ; Humans ; Methods ; Prosthodontics ; Surgery, Computer-Assisted

Hydrogen peroxide is commonly used as a disinfectant that has been reported to cause chemical colitis. We report a case of 49 year-old man who presented with chemical colitis caused by self-inflicted hydrogen peroxide enema. In the sigmoidoscopic examination, diffuse erythematous and edematous mucosal change with multiple ulcerations and easy touch bleeding was noted from the rectum to the proximal sigmoid colon. Abdominal computed tomography showed diffuse wall thickening of the rectum and the sigmoid colon with inflammatory and reactive change at surrounding. The patient was treated with NPO, intravenous fluid, and antibiotic therapy. On 5th hospital day, abdominal pain and bloody stool disappeared, and the patient started oral feeding. He discharged on 6th hospital day with fully recovered state.
Abdominal Pain/etiology ; Colitis/*chemically induced/therapy ; Enema/*adverse effects ; Gastrointestinal Hemorrhage/etiology ; Humans ; Hydrogen Peroxide/*adverse effects ; Male ; Middle Aged ; Sigmoidoscopy ; Tomography, X-Ray Computed

BACKGROUND/AIMS: All epithelial cells emit autofluoresce, with tumor cells emitting weaker autofluorescence. We categorized patterns of autofluorescence imaging (AFI) and compared their clinical characteristics and pathology findings after endoscopic submucosal dissection. METHODS: Twenty patients were enrolled, comprising 4 adenomas and 16 early gastric cancers. AFI findings were classified as follows: G0 (well-defined pink lesion on a green background with a clear interface over > or =50% of its area), G1 (pink-green mottled lesion on a green background with a clear interface over <50% of its area), P1 (pink-green mottled lesion on a purple background with a clear interface over <50% of its area), and P2 (vague lesion on a purple background with a clear interface over < or =10% of its area). RESULTS: Most of the patients (80%) were male, and their median age was 62.4 years (range: 46-78 years). The lesion sizes by white-light mode, AFI mode, and pathology were 20.8+/-13.1, 22.8+/-15.4, and 20.0+/-17.7 mm (mean+/-SD), respectively. Sixteen cases of adenocarcinoma were classified as follows: G0 (n=10), G1 (n=2), P1 (n=2), and P2 (n=2). The G0 group has no p53 positive lesions, unlike the non-G0 group (p=0.044). All cases with the P1 and P2 patterns were of the gastric and intestinal types, respectively. CONCLUSIONS: AFI images of gastric tumors were categorized into four patterns that were useful for defining the resection margin in 87.5% of cases, with G0 being the most common pattern (62.5%).
Adenocarcinoma ; Adenoma ; Enzyme Multiplied Immunoassay Technique ; Epithelial Cells ; Humans ; Male ; Optical Imaging ; Stomach Neoplasms

The purpose of this study was to examine the anti-oxidative activity of pectin and other polysaccharides in order to develop a cosmeceutical base having anti-oxidative effects towards retinyl palmitate (RP). The anti-oxidative stabilizing effects of pectin and other polysaccharides on RP were evaluated by DPPH assay and then the stabilizing effect of pectin on RP was examined as a function of time. Among the polysaccharides we examined, pectin exhibited a considerably higher anti-oxidative activity, with an approximately 5-fold greater DPPH radical scavenging effect compared to other polysaccharides. The DPPH radical scavenging effect of pectin increased gradually with increasing concentrations of pectin. At two different RP concentrations, 0.01 and 0.1% in ethanol, addition of pectin improved the stability of RP in a concentration dependent manner. The stabilizing effect of pectin on RP was more effective for the lower concentration of RP (0.01%, v/v). Further, degradation of RP was reduced following the addition of pectin as measured over 8 hours. From the results obtained, it can be suggested that pectin may be a promising ingredient for cosmeceutical bases designed to stabilize RP or other pharmacological agents subject to degradation by oxidation.
Ethanol ; Pectins ; Polysaccharides ; Vitamin A

Aged ; Female ; Humans ; Mandible ; Mucous Membrane ; Neck ; Prostheses and Implants