No abstract available.
Accidents, Occupational* ; Humans ; Spinal Injuries*

Infantile form of histiocytosis X is commonly presented as multiorgan desseminated form such as Letterer-Siwe disease. Lymph node involvement of histiocytosis X is usually accompanied by adjacent bone or skin lesion. Solitary nodal eosinophilic granuloma without evidence of other organ involvement is very rare. A case herein report is a 11 month-old female infant presented with fever and palpable both inguinal lymph nodes. There was neither skin lesion nor hepatosplenomegaly. Laboratory evaluation was within normal range except increased alkaline phosphatase and many neutrophils in urine. Radiologic examination revealed no remarkable bone lesions. And she showed good clinical outcome without evidence of other organ involvements. On microscopic examination of inguinal lymph node it was replaced by infiltration of histiocytes mainly along the sinusoid. Some of histiocytes showed morphologic features of "histiocytosis X cell" having nuclear grooves or multilobulation. Multinulceated giant cells were frequently see. Numerous eosinphils were also infiltrated and showed multifocal microabscess formation. Immunohistochemical staining revealed that majority of histiocytes were postitive for S-100 protein but multinucleated histriocytes, phagocytic histiocytes and those around the abscess were positive for macrophage marker, suck as CD68 and alpha-1-antichymotrypsin. Interestingly some histiocytes showed positivity for both S-100 protein and macrophage marker. These results suggest that histiocytosis X is proliferative disorder of phenotypically heterogenous population of histiocytes in contrast to the theory that it is a proliferative disorder of Langerhans cells.
Infant ; Male ; Female ; Humans

We have attempted to define the acetabular remodelling after varus derotation osteotomy and limitations of pelvic osteotomy in the treatment of DDH. We studied the case of thirty eight patients (42 hips) who were divided into three groups according to age at operation and into two groups, subluxation with acetabular dyaplasia and complete dislocation. The cases were evaluated the influence of femoral remodeling, age, acetabular response and instability and requirement of other additional surgery. The length of follow up ranged from two to fourteen years. A return to a valgus femoral neck shaft angle by remodeling was observed in case without avascular necrosis of femoral head. Acetabular correction by remodeling occurred in case of well reduced the femoral head in the socket. Acetabular remodeling was observed even in age of 8. Twenty eight of 42 hips which were complete dislocation required no pelvic osteotomy. A varus derotation osteotomy is a necessary procedure for hip stability and open reduction in treatment of DDH. Good results should be anticipated in patient whose femoral head was well seated in the acetablum.
Acetabulum ; Dislocations ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Osteotomy

The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

To evaluate the health risk of the workplace environment of a general hospital toward the hospital workers, a questionnaire survey on the perception of risk at the workplace environment and environmental measurements at 27 locations with 240 workers in the hospital were made from October 25th, 1993 to October 30th, 1994. The results were as follows; 1. By the environmental measurements, 86 workers(36%) were found to be exposed to poor or harmful degree of general illumination, 193 workers(80%) were exposed to poor or harmful local illumination, 34 workers(14%) were exposed to poor or harmful degree of thermal condition and l80 workers(75%) were exposed to poor or harmful noise level, but nobody was exposed to poor or harmful dust and toluene concentration. Also nobody was exposed to poor or harmful level of radiation or anticancer/antibiotic agents. 2. The subjective perceptions on the environmental conditions felt by the workers were different from the objective findings by the environmental measurements. The workers underscored the poor illumination state and overscored the dust concentrations. Also workers oversensitized about the thermal condition, the noise level, the radiation level, the toluene concentration and anticancer/antibiotic agents. 3. The sources of noise were the dialogue(179 workers) and the office instruments(131workers). The sources of dust came from the clothes(108 workers) and the building materials(79 workers). 4. The questionnaire survey showed that the 28 workers were exposed to poor or harmful level of the antibiotics, 10 workers to alkali or acid and 6 workers to drug dust in the pharmacy but the above findings could not be proved by the environmental measurements.
Alkalies ; Anti-Bacterial Agents ; Dust ; Hospitals, General* ; Lighting ; Noise ; Pharmacy ; Surveys and Questionnaires ; Toluene

To identify osteoporosis and examine the relationship between health behavior and the self-efficacy of middle-aged women, a descriptive survey was conducted. The subjects were 465 healthy female residents of Kyunggido, Korea, who underwent ultrasound measurement and a health examination at the Kangmeung-Ci Health Center between July and August 2000. They were 40 to 60 years old, with a mean age of 46.7 years. The subjects completed a self- reported questionnaire that consisted of seven items concerning health behavior and twelve items concerning self-efficacy related to osteoporosis. Bone density was evaluated from ultrasound measurements of the right heel. All the data were analyzed using the program SAS-PC. The study found that the mean T score related to bone density was -1.30, and ranged from -3.52 to 3.06. Based on the T score, 74.8% of the subjects were normal, 12.9% had osteopenia, and 12.3% had osteoporosis. The mean osteoporosis self-efficacy score was 41.17 and ranged from 12 to 60. Osteoporosis self-efficacy differed significantly with health behavior related to health supplementary food (t=5.63, p=.018), exercise (t=6.65, p=.010), alcohol drinking(t=10.80, p=.001), and smoking (t=10.23, p=.001). A community-based health promotion program should be developed to prevent osteoporosis in middle-aged women.
Bone Density* ; Bone Diseases, Metabolic ; Female ; Gyeonggi-do ; Health Behavior ; Health Promotion ; Heel ; Humans ; Korea ; Middle Aged ; Osteoporosis ; Surveys and Questionnaires ; Smoke ; Smoking ; Ultrasonography

This study was to examine the association of the health-related behaviors and subjective symptoms with smoking. Data were collected by questionnaire survey during regular health examination from Mar. 23 to Mar. 31, 1992 for 1,615 male freshmen of a university in Kwangju City. The results obtained were as follows; 1. Among the freshmen, 26.9% reported that they were smokers. 69.4% for smokers started smoking for the recent 4 years, and 63.4% for smokers smoked 10 cigarettes or more a day. 2. Meal regularity, meat eating, use of coffee or tea and alcohol drinking were positively associated with the status, the duration and the amount of smoking while the vegetable preference was negatively associated with the status and the duration of smoking. 3. There was no evidence of familial aggregation in smoking status except that of siblings. 4. Respiratory symptoms like cough or phlegm, dyspnea were positively associated with the status, the duration, and the amount of smoking. General symptoms like chest pain, fatigue, back pain, facial edema, and weight loss were positively associated with the duration and the amount of smoking. Other symptoms like headache, dizziness, and myalgia were not associated with smoking. 5. In multivariate' logistic regression analysis, cough or phlegm, dyspnea, chest pain, facial edema, and back pain were related to smoking status.
Alcohol Drinking ; Back Pain ; Chest Pain ; Coffee ; Cough ; Cross-Sectional Studies ; Dizziness ; Dyspnea ; Eating ; Edema ; Fatigue ; Gwangju ; Headache ; Humans ; Logistic Models ; Male ; Meals ; Meat ; Myalgia ; Surveys and Questionnaires ; Siblings ; Smoke* ; Smoking* ; Tea ; Tobacco Products ; Vegetables ; Weight Loss

To find the factors associated with the teaching evaluation by the students, data were collected through a questionnaire from 106 students in a premedical course at a medical college at November, 1994 after a series of lecture for a semester. The results are as follows : 1. Chronbach's alpha coefficients by part of evaluation were 0.8544 for teacher part, 0.7405 for the learner part and 0.7468 for the environment of the teaching. 2. Students gave low score of the evaluation for the items of questionnaire like contribution to creative thinking by lecture, good communication with the teacher, speed and amount of lecture, the appropriateness of textbook. Students gave high score of evaluation for the items of questionnaire like the scrutiny of the lecture hours, the appropriateness of test and homework assignments, composition and progress of the teaching schedule and preference and expression of the lecture. 3. The evaluation scores were significantly high among the student who were satisfied with the lecture, expected high score for the test, low number of absence, the high perception of the necessity about the subject to medical students. The sex of students, the difficulty of the subjects and the burden of learning were not associated with the point of evaluation. 4. Among the learner's attitude, positive and sincere learning attitude, scrutiny of pressure to the lecture, diligent homework assignment, and good preparation for the lecture were associated significantly with the point of evaluation. 5. The correlation coefficients between evaluation result and associated factors were 0.476 for the learner's attitude, 0.312 for the environmental factor of lecture, 0.296 for the expected score and 0.628 for the degree of satisfaction. Negative correlation were shown between the evaluation point and the number of absence(r=-0.248) and the backside preferred seat at lecture room(r=-0.274). In conclusion teaching evaluation by the students kept relatively high reliability in measurements and the evaluation results were associated with the several factors, so for the effective methods of implementation of teaching evaluation and utilization of the results, systematic of the results, systematic and deeper study must be made.
Appointments and Schedules ; Humans ; Learning ; Students, Medical ; Students, Premedical ; Thinking ; Surveys and Questionnaires

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.
Catheters ; Compliance ; Diabetes Mellitus ; Glasgow Coma Scale ; Hand Disinfection* ; Hand* ; Humans ; Incidence* ; Intensive Care Units* ; Critical Care* ; Intubation ; Length of Stay ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Risk Factors ; Suction* ; Tracheostomy ; Ventilators, Mechanical

This study was performed to find the prevalence and the associated risk factors with low back pain(LBP) of the staffs in a university at Kwang-ju city. The data were collected by a questionnaire including SDS(Self-rating depression Scale) battery from September 1st to October 15th, 1996. The results were as follows; 1. The prevalence rate of LBP during lifetime was 73.1%, 53.1% for the last one year, and 23.6% for the last one week. 2. Statistically significant factors related to LBP during lifetime were sex and satisfaction with job. Sex, smoking, alcohol drinking, occupation, work posture, forward bending of trunk and satisfaction with job were selected as significant factors related to LBP during the last one year. The significant determinants related with LBP during the last one week were sex, smoking, alcohol drinking, occupation, forward bending of trunk and satisfaction with job. 3. Through the analysis of self-rating depression scores according to LBP during lifetime were selected to be female(OR=2.63, 95% CI: 1.08~6.40), dissatisfaction with job(OR=2.16, 95% CI: 1.16~4.15), those for the last one year were chosen to be female(OR=2.30, 95% CI: 1.03~5.12), forward bending of trunk(OR=2.18, 95% CI: 1.26~3.79), dissatisfaction with job(OR=1.84, 95% CI: 1.06~3.21), and those for the last one week were female(OR=3.00, 95% CI: 1.17~7.69), forward bending of trunk(OR=2.85, 95% CI: 1.38~5.88). In conclusion, for effective prevention of the LBP at work site, appropriate improvement of work posture and various psychological factors should be considered.
Alcohol Drinking ; Depression ; Gwangju ; Low Back Pain* ; Occupations ; Posture ; Prevalence ; Psychology ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Workplace