BACKGROUND: On September 27, 2012, at 3:43 pm, a hydrogen fluoride spill occurred in a manufacturing plant located at the 4th complex of the Gumi National Industrial Complex in Gumi City, South Korea. The present study aimed to evaluate the psychological effects of the hydrogen fluoride spill on the members of the community and to investigate their relationships with physical symptoms and changes in psychological effects occurring as time passed after the accident. METHODS: The 1st phase involved a survey of 1359 individuals that was conducted 1 month after the spill, and the 2nd phase involved a survey of 711 individuals that was conducted 7 months after the accident. The questionnaires included items for assessing demographic characteristics, hydrogen fluoride exposure level, physical symptoms, and psychological status. Physical symptoms were assessed to determine the persistence of irritations. Psychological status was assessed to investigate the impact of event level using the Impact of Event Scale – Revised Korean version (IES-R-K), and the anxiety level was assessed using the Beck Anxiety Inventory (BAI). RESULTS: As the hydrogen fluoride exposure level increased, the impact of event and anxiety levels increased significantly both 1 and 7 months after the accident (p < 0.05). The mean score of the impact of event levels decreased significantly from 33.33 ± 14.64 at 1 month after the accident to 28.68 ± 11.80 at 7 months after the accident (p < 0.05). The mean score of the anxiety levels increased significantly from 5.16 ± 6.59 at 1 month after the accident to 6.79 ± 8.41 at 7 months after the accident (p < 0.05). The risk of persistent physical symptoms at 7 months after the accident was significantly higher in females. The risk of persistent physical symptoms also increased significantly, with increasing age, hydrogen fluoride exposure, and impact of event levels (p < 0.05). CONCLUSIONS: The present study found that the impact of event level and anxiety level increased with increasing hydrogen fluoride exposure. Anxiety levels persisted even after time passed. The risk of persistent physical symptoms at 7 months after the accident was higher in females, and it increased with increasing age, hydrogen fluoride exposure level, and impact of event levels.
Anxiety ; Disasters ; Female ; Gyeongsangbuk-do ; Humans ; Hydrofluoric Acid* ; Hydrogen* ; Korea ; Plants

OBJECTIVES: The main goal of this study was to find the incidence of the dimethylacetamide (DMAc) induced toxic liver injury among workers who were exposed to DMAc for about 5 years in a synthetic fiber factory. METHODS: In our investigation, total 1,021 workers had been exposed to DMAc from 1st February, 2000 to 30th June, 2004. Among them, 24 workers who had initial abnormal hepatic enzyme level or was viral hepatitis B carrier were excluded. Finally, 997 DMAc exposed workers were followed up for their incidence of toxic liver injury. To find out DMAc induced toxic liver injury case, we carried out regular examinations including liver enzyme tests such as AST and ALT. RESULTS: We followed up 997 workers and among them 72 cases coincided with our case definition. Incidence density method was 6.05 per 100 person-year. and, a cumulative incidence by life table method was 0.0965 within a year. The incidence of the DMAc-induced toxic liver injury peaked at 4 to 5 in weeks after employment. There was no toxic liver injury case within second week after exposure to DMAc. Five new cases developed in 2th to 3th week, 25 cases in 4th to 5th week, 14 cases in 6th to 7th week, 12 cases in 8th to 9th week, 5 cases in 10th to 11th week, 4 cases in 12th to 13th week, 4 cases in 14th to 15th week, 1 case in 16th to 17th week, 1 case in 30th to 31th week, and there was one case in 48th to 49th week. CONCLUSIONS: The incidence rate of toxic liver injury was considerably high during the 1st year after a worker is placed. So it is needed to take careful monitoring of hepatic enzyme level for newly exposed worker.
Employment ; Hepatitis B ; Incidence* ; Life Tables ; Liver*

OBJECTIVES: Area-based occupational disease surveillance in Kumi (KODS) was used to collect data on occupational diseases. The data was used to estimate the magnitude of the diseases, to analyze for their characteristics, and to find links for their intervention and prevention. METHODS: Since January 2001, occupational physicians and nurses in Occupational Health Service (OHS)have reported six major occupational diseases; occupational musculoskeletal disorders of the upper extremities(MSDUE), occupational dermatoses, toxic hepatitis, occupational asthma (OA), hand-arm vibration syndrome(HAVS), and occupational cancer. For the respective diseases, a reporting sheet and operational diagnostic criteria were developed by the KODS. An analysis of the KODS data, collected over a certain period, was compared with data from the Korea Labor Workers Corporation (KLWC) and the Specific Health Examination (SHE), and the incidence rates of the diseases estimated. RESULTS: Between Jan 2001 and Apr 2002, 287 cases of the six major occupational disease were reported. Of these, there were 132 (46.0%), 100 (34.8%), 34 (11.8%), 16 (5.6%), and 5 (1.7%), cases of MSDUE, occupational dermatoses, toxic hepatitis, OA, and HAVS, respectively. But, there were no cases of occupational cancer. 33 (11.5%) of the incidence were reported via the OHS, 206 (71.7%) from health checkups, and the other 48(16.8%) from other routes. The synthetic fibers and electronic components manufacturing industries accounted for the greatest number of reported cases. With respect to occupation, the greatest numbers of incidence were reported from the elementary occupations, textile workers, assemblers, and cooks and food services worker, in that order. Of the MSDUE cases, carpal tunnel syndrome and epicondylitis were the two most common diseases. Most of the occupational dermatoses were due to contact dermatitis, with organic solvents (59%), nickel (6%), and epoxy resin (5%) accounting for the majority of these cases. All cases of toxic hepatitis were induced by dimethylformamide or dimethylacetamide, which were reported by a unique monitoring system. During same period, there were no cases claimed by workers to the KLWC, and only three cases from SHE, were identified. Using data from workers' number and surveillance, the annual incidences of MSDUE, dermatoses, hepatitis, OA, and HAVS, per 100,000 workers were 63.6, 48.2, 17.9, 7.7, and 2.4, respectively. CONCLUSIONS: These results show that an area-based surveillance system can be very effective for the collection of data on work-related diseases, at least in Kumi.
Asthma, Occupational ; Carpal Tunnel Syndrome ; Dermatitis, Contact ; Dimethylformamide ; Drug-Induced Liver Injury ; Food Services ; Gyeongsangbuk-do* ; Hepatitis ; Incidence ; Korea ; Nickel ; Occupational Diseases ; Occupational Health Services ; Occupations ; Skin Diseases ; Solvents ; Textiles ; Vibration

Transient monocular blindness (TMB) may occur in patients with systemic lupus erythematosus (SLE). Several mechanisms have been suspected as the causes of such TMBs. A 32-year-old female patient with SLE presented recurrent monocular altitudinal visual field defects lasting for several minutes and occurring less than six times per day. Her anticardiolipin antibody level was persistently positive. All cerebrovascular imagings were normal. We report a case of recurrent TMBs in SLE with antiphospholipid antibody syndrome, which may have been induced by vasospasm.
Adult ; Amaurosis Fugax* ; Antibodies, Anticardiolipin ; Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome* ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Visual Fields

Dimethylacetamide is widely used in the production of plastics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide(DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubin, alanine aminotransferase(ALT), and aspartate aminotransferase(AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.
Alanine ; Aspartic Acid ; Bilirubin ; Blood Transfusion ; Crystallization ; Diagnosis ; Dizziness ; Drug-Induced Liver Injury* ; Fatigue ; Female ; Gingiva ; Hepatitis A ; Humans ; Inhalation ; Jaundice ; Liver ; Male ; Plastics ; Resins, Synthetic ; Serologic Tests ; Skin Absorption ; Substance-Related Disorders

OBJECTIVES: This study was conducted to evaluate the prevalence of ocular, respiratory and skin symptoms among solderers and to investigate the relationship between symptom prevalence and exposure intensity. METHODS: We analyzed 126 eligible participants out of a population of 146 male solderers who completed the symptom questionnaires. Fourteen symptoms including 'itchy and red eyes', 'itchy or prickly nose', 'sneezing', 'rhinorrhea', 'blocked nose', 'pricklythroat', 'foreign body sensation in throat', 'sudden bouts of coughing', 'exertional breathlessness ', 'wheezing', 'sputum production', 'itchy face or hands', 'acneiform eruptions on the face'and 'red spots on the face or hands'were contained. Blood lead levels of all the 126 participants were tested and the participants'own assessments of the health risk of soldering were collected. RESULTS: Of the 14 investigated symptoms, 'sudden bouts of coughing'was significantly more prevalent in solderers who worked 4 hours or more a day than those who worked less than 4 hours a day, as for the other symptoms, there were no significant differences in the preva1ences related to daily soldering hours. 2.8% of the solderers considered the risk of flux exposure to be serious. The mean blood lead level was 6.05 microgram/dL (maximum 15.50 microgram /dL). CONCLUSIONS: Soldering may increase the risk of respiratory symptoms. Further investigations on the hazards of soldering processes are warranted and solderers should be educated on these hazards.
Asthma, Occupational ; Humans ; Male ; Prevalence ; Questionnaires ; Sensation ; Skin*

Callosal disconnection results in the functional independence of each hemisphere and usually produces characteristic signs including alien hand, left-sided apraxia, left agraphia and left tactile anomia. Our two patients; a 75-year-old right-handed woman with hypertension and a 71-year-old right-handed woman with diabetes mellitus, showed impairments in the identification of body parts with their left hands in addition to characteristic symptoms such as left ideomotor apraxia, agraphia, tactile anomia, and right alien hand signs with groping and grasping. Brain MRIs of these patients upon admission demonstrated infarcts in the medial portion of the left frontal lobes and in the corpus callosum supplied by the left anterior cerebral artery. The impairment of body parts cognition in our patients can be attributed to the failure of the patient's left hand to communicate with the body schema stored in the left hemisphere.
Aged ; Agraphia ; Anomia ; Anterior Cerebral Artery ; Apraxia, Ideomotor ; Apraxias ; Body Image ; Brain ; Cognition* ; Corpus Callosum ; Diabetes Mellitus ; Emigrants and Immigrants ; Extremities* ; Female ; Frontal Lobe ; Hand ; Hand Strength ; Human Body ; Humans ; Hypertension ; Magnetic Resonance Imaging

OBJECTIVES: The purpose of the study was to assess the risk factors assumed to be related to the high frequency hearing loss in the noise-exposed male workers. METHODS: 712 occupationally noise-exposed male workers were included in this cross sectional study. The subjects filled out a questionnaire on the history of noise exposure, hearing protection, otologic diseases, tobacco smoking, and were tested on height, weight, hematocrit, serum total cholesterol level, fasting plasma glucose level and arterial blood pressure level. Pure tone audiometry and otoscopy were conducted and the subjects were allocated into two groups according to whether they had 4000 Hi hearing loss or not. RESULTS: The multiple logistic regression analysis showed that military noise exposure, poor wearing status of the hearing protection devices, increased age, long noise exposure duration, mean arterial pressure less than 80mmHg, high fasting plasma sugar are the factors significantly related to high frequency hearing loss (P<0.05). On the contrary, there was no significant relationship between noise intensity, body mass index, serum total cholesterol level, smoking and high frequency hearing loss. Low hematocrit was shown to be a significant factor with a p-value less than 0.1. CONCLUSIONS: High frequency hearing loss in the noise-exposed male workers is related to military noise exposure, use of hearing protection devices, age, noise exposure length, fasting glucose level and mean arterial pressure, in this order. Appropriate use of the hearing protection devices has a great impact on the prevention of the noise-induced hearing loss.
Arterial Pressure ; Audiometry ; Blood Glucose ; Body Mass Index ; Cholesterol ; Ear Diseases ; Fasting ; Glucose ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Hearing* ; Hematocrit ; Humans ; Logistic Models ; Male* ; Military Personnel ; Noise ; Occupations ; Otoscopy ; Plasma ; Questionnaires ; Risk Factors ; Smoke ; Smoking

PURPOSE: To demonstrate the proton MR spectroscopic characteristics of non-neoplastic focal basal ganglialesions with high signal intensity on long TR MR images in patients with neurofibromatosis type 1(NF-1), and tocompare them with those of normal-appearing basal ganglia in patients without focal lesions. MATERIALS AND METHODS: Single-voxel proton MR spectroscopy was performed in six patients with NF-1 from two families(three with andthree without non-neoplastic focal brain lesions). All six individual spectra were obtained from basal gangliawith voxel sizes of about 1 x 1 x 1 cm, three from focal pallidal lesions in patients with focal lesions and threefrom normal-appearing basal ganglia in patients without focal lesions. Spectra were acquired using a 1.5T clinicalMR imager and stimulated echo acquisition mode sequence, with the following parameters: 30 ms of echo time, 13.7ms of mixing time, and 2560 ms of repetition time. Zero and first-order phase correction was performed. RESULTS:N-acetyl aspartate(NAA)/creatine(Cr) ratios were similar between focal basal ganglia lesions and normal-appearingbasal ganglia, though the former showed slightly lower choline(Cho)/Cr ratios and slightly higher NAA/Cho ratiosthan the latter. Relatively enhanced resonances around 3.75 ppm, assigned as glutamate/glutamine, were observed inthe spectra of three focal lesions. Lipid resonances around slightly different positions were observed in all sixpatients, regardless of the presence or absence of focal lesions. CONCLUSION: Slightly decreased Cho levels andrelatively enhanced glutamate/glutamine resonances are thought to characterize the focal basal ganglia lesions ofNF-1. Different mobile lipids appear to be present in the basal ganglia of NF-1 patients, regardless of thepresence of focal lesions.
Basal Ganglia* ; Brain ; Ganglia ; Humans ; Magnetic Resonance Spectroscopy* ; Neurofibromatoses* ; Neurofibromatosis 1* ; Protons*

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining then based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC+ program. The results of this study are summarized as follows; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue(80.6%). 2) Main therapies for the terminal cancer patients were pain control(58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device(11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patents. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.
Caregivers* ; Emergencies ; Health Occupations ; Home Care Services ; Hope ; Hospice Care ; Humans ; Internal Medicine ; Mass Media ; Medical Records ; Medical Staff ; Nuclear Family ; Nurses, Community Health ; Nursing Services* ; Nursing Staff ; Nursing* ; Outpatients ; Oxygen ; Quality of Life ; Surveys and Questionnaires ; Seoul ; Transportation