Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.
Cardiopulmonary Bypass ; Critical Care ; Emergencies ; Heart Atria* ; Heart Injuries ; Heart Rupture* ; Humans ; Pericardiocentesis ; Thoracostomy ; Vena Cava, Superior*

We treated a case of extramammary Paget's disease that affected the scalp of a 45-year-old female. It is extremely rare that the disease arises in areas other than the anogenital region and the axillae. The lesion was a round erythematous oozing crusted hairless patch. Histopathologically, many pagetoid cells were found within the epidermis and dermis. The cytoplasms of these cells stained with alcian blue at pH 2.5, CEA, EMA and low-molecular-weight-cytokeratin. The patient underwent a wide local excision. We used a mapping technique to reveal the distribution of microscopically involved lesions.
Alcian Blue ; Axilla ; Cytoplasm ; Dermis ; Epidermis ; Female ; Humans ; Hydrogen-Ion Concentration ; Middle Aged ; Paget Disease, Extramammary* ; Scalp*

We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterist of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionnaire. They are belong to 5 departments of the factory-the Engine-Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration; Of all measured points(52), 9 points(17.2%) exceeded 5mg/m3-the time-weighed PEL- and one department had a upper confidence limit(95%) higher than 5mg/m3. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time-itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne(2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation(1, 0.6%), and non-specific hand eczema(47, 29.3%). 4) The prevalence of any skin diseases was 34.0 per 100 in cutting oil users, and 13.3 per 100 in non-users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 4.3 per 100 in non-users. 5) We tried patch test(standard series, oil series, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independent=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).
Acne Vulgaris ; Automobiles ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Fingers ; Folliculitis ; Hand ; Humans ; Oils ; Physical Examination ; Pigmentation ; Prevalence ; Surveys and Questionnaires ; Skin ; Skin Diseases

Our aim was to identify histologic changes in cervical carcinoma tumor cells due to chemotherapy,by electron microscopic examination. Cisplatin and 5-fluorouracil were used between March 1, 1994 and February 28, 1995 on a total of 16 patients. The treatment schedule consisted of 75 mg/m2 cisplatin via iv with hyperhydration on Day 1, in combination with 1000 mg/m2 5-fluorouracil via continuous iv on Day 1 to 5. The treatment was repeated every 4 weeks with a maxinum of 3 courses. Ultrastructurally, chemotherapy induced apoptosis,indicated by condensation of nucleus and cytoplasm,fragmentation of nuclei, and apoptotic bodies. Due to repeat chemotherapy, increased levels of desmosomes were noted and parts of tumor nests were replaced by mature squamous cells. Tumor nests were reduced in size, mitochondria exhibited swelling, the endoplasmic reticulum was dilated, and infiltration of inflammatory cells increased after chemotherapy. These results suggest that chemotherapy induces apoptosis and injury to the cytoplasm and nuclei of tumor cells. However, the exact selection mechanism of the biochemical pathway of cell death is not fuUy understood. Further study of the molecular biologic actions of cell death after chemotherapy is warranted.
Apoptosis ; Appointments and Schedules ; Cell Death ; Cisplatin ; Cytoplasm ; Desmosomes ; Drug Therapy* ; Endoplasmic Reticulum ; Fluorouracil ; Humans ; Mitochondrial Size

No abstract available.
Electromyography* ; Hand* ; Humans ; Muscle Spasticity* ; Stroke*

Stress fracture of the metatarsal was first described as March fracture by Breithaupt, a Prussian military surgeon in 1855, According to the classical references, the second metatarsal is the most frequently involved and radiological evidence of fracture appears as late as several weeks. The purpose of this study is to document the incidence and clinical feature of march fractures in Korean military soldiers. From may 1991 to April 1994, at one military hospital in Korea, 52 march fractures in 46 patients were detected among infantry soldiers. There are different findings of fracture site and its clinical features from the previous foreign reports. 1. By physical examination, direct point tenderness on the location of the metatarsal shaft is characteristic, with careful history taking. 2. On roentgenographic examination, cortical fissuring or break is seen one week after onset of symptoms and external callus is seen from two weeks or at the latest four weeks. 3. The third metatarsal is the most frequently involved site(34 cases, 65.4%), and the second metatarsal is less frequent(12 cases, 23.1%) 4. The discrepancy between previous reports and present findings should be emphasized and analyzed in further study.
Bony Callus ; Fractures, Stress ; Hospitals, Military ; Humans ; Incidence ; Korea ; Metatarsal Bones ; Military Personnel ; Physical Examination

OBJECTIVES: To determine the prevalence and related factors of work related musculoskeletal symptoms in hairdressers. METHODS: Informations on general characteristics, job strain, and musculoskeletal symptoms were obtained by a self-administered questionnaire, through adopting NIOSH instrument and JCQ(Job content questionnaire), from 267 hairdressers, between March and May, 2000. RESULTS: The symptom prevalence by NIOSH surveillance criteria in total was high as 94.4%; shoulder (61.0%), neck (59.9%), low back (53.2%), hand and wrist (41.6%), etc. In multiple logistic regression, significant factors affecting the symptoms by body region; job insecurity on neck' gender, alcohol, decision latitude on low back; alcohol on hand and wrist; smoking on thigh and knee,' smoking, decision latitude on ankle and foot; job insecurity on upper back. CONCLUSIONS: Musculoskeletal symptoms of hairdresser were highly prevalent, and associated with job strain and their health habits. This is a basic data of work related musculoskeletal disorders among hairdressers who are not the subjects of occupational health service at the present time in Korea.
Ankle ; Body Regions ; Foot ; Hand ; Korea ; Logistic Models ; National Institute for Occupational Safety and Health (U.S.) ; Neck ; Occupational Health Services ; Prevalence ; Questionnaires ; Shoulder ; Smoke ; Smoking ; Thigh ; Wrist

A review of sixteen cases of the modified Bristow operation for recurrent anterior dislocation of the shoulder from Feb. 1987 to Feb. 1989 was presented and the following results were obtained. 1. The age of initial dislocation varied from 12 years to 27 years of age with the average of 17.3 years. 2. The age at operation varied from 21 years to 30 years of age with the average of 23.3 years. 3. The times of dislocation vaaried form 7 to 40 times with the average 23.8 times. 4. The average loss of abduction and external rotation were 5.9 and 12.5 degree respectively. 5. The complications and recurrence were not observed in this period
Dislocations ; Recurrence ; Shoulder

In order to prepare the fundamental data for the health promotion by assessing the exposure level of styrene, the author determined the concentration of mandelic acid and phenylglyoxylic acid in urine of 42 workers who were exposed to styrene by high performance liquid chromatography and surveyed 16 symptoms, by questionnaire and also tested neurobehavioral test(digit symbol, benton visual retention) in 2 FRP plants of Kyung Nam area from July to September, 1995. Control was sampled by age sex matching method. The concentration of styrene in air was determined by gas chromatography. The results were as follows; 1. Geometric mean concentration of styrene in air was 17.4ppm, geometric mean concentration of mandelic acid(MA) in urine were 404.3mg/g creatinine for exposure group, 46.4mg/g creatinine for control group, geometric mean concentration of phenylglyoxylic acid(PGA) in urine were 57.5mg/g creatinine for exposure group, 9.5mg/g creatinine for control group. Mean concentration of MA and PGA showed statistically significant difference between exposure group and control group(p<0.01). 2. Number of symptom were 2.9 for exposure group, 3.3 for control group, number of digit symbol were 24.1 for exposure group, 32.5 for control group, number of Benton visual retention test were 6.1 for exposure group, 6.0 for control group, respectively. As result of adjusting the education year, number of Benton visual retention test showed statistically significant difference between exposure group and control group(p<0.05). 3. Excellent correlation were observed between environmental styrene exposure and urinary MA(r=0.80), PGA(r=0.73), and MA+PGA(r=0.81).
Chromatography, Gas ; Chromatography, Liquid ; Creatinine ; Education ; Health Promotion ; Surveys and Questionnaires ; Styrene*

Background: Extra-articular distal humerus locking plates (EADHPs) are precontoured anatomical plates widely used to repair distal humeral extra-articular diaphyseal fractures. However, EADHPs frequently cause distal protrusion and resulting skin discomfort. The purpose of this study was to predict the occurrence of anatomic fit mismatch. We hypothesized that the smaller the humerus size, the greater the anatomic fit mismatch with EADHP. Methods: Twenty humeri were analyzed in this study. Humeral length and distal humeral width were used as parameters of humeral size. Plate protrusion was measured between the EADHP distal tip and the distal humerus. We set the level of unacceptable EADHP anatomic fit mismatch as ≥10 mm plate protrusion. Results: A significant negative linear correlation was also confirmed between humeral size and plate protrusion, with a coefficient of determination of 0.477 for humeral length and 0.814 for distal humeral width. The cutoff value of humeral length to avoid ≥10 mm plate protrusion was 293.6 mm (sensitivity, 88.9%; specificity, 81.8%) and for distal humeral width was 60.5 mm (sensitivity, 100%; specificity, 81.8%). Conclusions Anatomic fit mismatch in distal humeral fractures after EADHP fixation has a negative linear correlation with humeral length and distal humeral width. For patients with a distal humeral width <60.5 mm, ≥10 mm plate protrusion will occur when an EADHP is used, and an alternative implant or approach should be considered.