Sulfuric acid can cause local or systemic effects after exposure by inhalation, ingestion, or topical application. Direct ingestion is the main exposure route for fatal sulfuric acid injury. Fatal accidents involving the inhalation of toxic sulfuric acid vapors are rare. Inhalation of sulfuric acid fumes causes severe irritation or corrosive damage to the upper respiratory tract. Consequently, severe congestion, edema, and inflammation of the mucous membranes of the upper respiratory passages hinder the entry of air into the lungs, possibly leading to fatalities in victims. A 35-year-old man died at his home after complaining of a severe sore throat. One day earlier, he had worked in a sulfuric acid tank in a copper-smelting plant while wearing an ordinary gas mask that offered no protection against sulfurous acid vapors. Upon autopsy, the larynx and epiglottis showed pronounced edema, congestion, and inflammation that histologically mimicked an acute bacterial suppurative inflammation, accompanied by severe pulmonary edema. A field analysis of the air inside the sulfuric acid tank revealed SO4(2-) positivity and a 40% sulfuric acid concentration.
Adult ; Autopsy ; Eating ; Edema ; Epiglottis ; Estrogens, Conjugated (USP) ; Humans ; Inflammation ; Inhalation* ; Larynx ; Lung ; Mucous Membrane ; Pharyngitis ; Plants ; Pulmonary Edema ; Respiratory Protective Devices ; Respiratory System ; Sulfur* ; Sulfuric Acids

BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.
Activities of Daily Living ; Aged* ; Alcohol Drinking ; Anemia ; Dementia ; Depression ; Female ; Gait ; Humans ; Hypertension ; Mental Health ; Osteoarthritis ; Prevalence ; Seoul ; Smoke ; Smoking ; Urinary Incontinence

No Abstract available.
Cross Infection* ; Korea*

PURPOSE: The purpose of this study was to identify the effect of predictive factors related to family strength and develop a structural equation model that explains family strength among married working women. METHODS: A hypothesized model was developed based on literature reviews and predictors of family strength by Yoo. This constructed model was built of an eight pathway form. Two exogenous variables included in this model were ego-resilience and family support. Three endogenous variables included in this model were functional couple communication, family stress and family strength. Data were collected using a self-report questionnaire from 319 married working women who were 30~40 of age and lived in cities of Chungnam province in Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs. RESULTS: Family support had a positive direct, indirect and total effect on family strength. Family stress had a negative direct, indirect and total effect on family strength. Functional couple communication had a positive direct and total effect on family strength. These predictive variables of family strength explained 61.8% of model. CONCLUSION: The results of the study show a structural equation model for family strength of married working women and that predicting factors for family strength are family support, family stress, and functional couple communication. To improve family strength of married working women, the results of this study suggest nursing access and mediative programs to improve family support and functional couple communication, and reduce family stress.
Adult ; Family Characteristics ; Family Relations ; Female ; Humans ; Marriage ; *Models, Theoretical ; Social Support ; Stress, Psychological ; Surveys and Questionnaires ; Women, Working/*psychology

Purpose: This study aimed to identify the aggressive characteristics of children and adolescents with ASD through an integrated literature review. Methods: Data collection was conducted for papers published in Korean or English language from December 2018 to February 2019. Literature search was conducted through keywords, such as 'autism', 'ASD', 'autistic', 'asperger', 'agress', 'violence', 'SIB', 'child', and 'adolescent', and 19 papers were finally selected. In order to identify the aggressive behavior characteristics and influencing factors of children and adolescents with ASD, the contents of the core results were analyzed through repeated review of research results. Results: Characteristics related to aggression in children and adolescents with ASD were classified into biological factors, cognitive factors, social factors, and affective-emotional factors, and related variables affecting aggression were identified with each topic. Conclusion Based on the results of this study, it is suggested that the basis for the development of accessible interventions for children and adolescents with ASD and their caregivers can be prepared.

It is uncommon that Anesthesiologist experience thyroid storm during the elective surgery because of marked reduction of operation for the treatment of hyperthyroidism owing to the development of radio-active iodide, antithyroid drugs and the use of beta-receptor blockers such as propranolol. In the treatment of Graves' disease, the conditions such as persistant symptoms of hyperthyroidism with resistance to the antithyroid drugs, frequent relapses and increasing size of thyroid gland must be considered for the need of surgery. It is essential to maintain the euthyroid state before surgery in these cases, if not, the possibility of thyroid storm is increased from increased release of thyroid hormones owing to manipulation of surgery. In our case, the patient had been medicated for 6 years, however, the euthyroid state had not been achieved before the day of surgery. Under the judgement of difficulty for more control of hyperthyroidism the surgeon requested for operation without delay. Immediately after starting operation, the symptoms suggesting thyroid storm such as the abrupt onset of high fever, the increasing blood pressure and heart rate were occured. The sugery was stopped and then the management for thyroid storm was begun. At arterial blood gas analysis, respiratory acidosis and metabolic acidosis were developed and increased hilar haziness suggesting severe pulmonary edema were present in both lung fields at chest x-ray. The patient was mechanically ventillated until improvement of metabolic and respiratory acidosis and pulmonary edema. Two days after operation, vital signs were stabilized and the patient was transferred to general wards.
Acidosis ; Acidosis, Respiratory ; Antithyroid Agents ; Blood Gas Analysis ; Blood Pressure ; Fever ; Graves Disease ; Heart Rate ; Humans ; Hyperthyroidism ; Lung ; Patients' Rooms ; Propranolol ; Pulmonary Edema ; Recurrence ; Thorax ; Thyroid Crisis* ; Thyroid Gland* ; Thyroid Hormones ; Thyroidectomy* ; Thyrotoxicosis* ; Vital Signs

PURPOSE: Recently, different results about factors affecting accurate quantitation of 24-hr urinary protein(24UP) amount using spot urine protein/creatinine ratio(PCR) have been reported. The current study was designed to evaluate correlation between 24UP amounts and PCR in children, and the effect of 24UP amounts, age, sex, and glomerular filtration rate(GFR) on this correlation. METHODS: Among 94 patients who visited the department of pediatrics in Busan Paik Hospital from March 2002 to August 2002, 68 patients whose urinary creatinine excretion was > or = 15 mg/kg/day were included in this study. All the patients were divided into I, II/A, B group(I : 24UP < 500 mg/day, II : 24UP > or = 500 mg/day, A : < 10 years of age, B : > or = 10 years of age). Pearson correlation analysis was performed between 24UP and PCR to evaluate the relationship. We defined fractional difference between 24UP and PCR, and then performed multiple regression analysis with 24UP amount, age, GFR and fractional difference. RESULTS: There was a strong positive linear correlation between 24UP and PCR(R=0.936, P < 0.0001) in all patients, and the correlation was also good in each group. Using PCR cutoff values of 0.5, the PCR provided high sensitivity, specificity, positive and negative predictive value in predicting 24UP amount > or = 500 mg. The factors affecting accurate quantitation of proteinuria using spot urine PCR was age, not 24UP amount, GFR or sex. CONCLUSION: Spot urine PCR is a useful test but has limitations in predicting 24UP amount. Therefore, it should be used only as screening method. Age-adjusted PCR cutoff values may be necessary to predict 24UP amount in children with proteinuria.
Busan ; Child* ; Creatinine ; Filtration ; Humans ; Mass Screening ; Pediatrics ; Polymerase Chain Reaction ; Proteinuria* ; Sensitivity and Specificity

The global coronavirus disease 2019 (COVID-19) pandemic spurred an urgent need for vaccination and herd immunity. Recently, mRNA vaccines for COVID-19 have been used widely despite reports of several adverse events. Most adverse effects are mild, although a few are associated with neurological complications. Unfortunately, there is a scarcity of information on peripheral nerve complications after COVID-19 mRNA vaccination. We report the case of an immunocompetent young male patient who suffered from ipsilateral wrist drop with multiple lymphadenopathy in the cervical and axillary region after Pfizer–BioNTech vaccination.He experienced unilateral wrist drop, which significantly improved with corticosteroid treatment. Based on knowledge of this adverse effect, careful surveillance and increased awareness are needed for early diagnosis. To the best of our knowledge, this is the first reported case in the English literature of radial neuropathy resulting in wrist drop in a recently vaccinated and young immunocompetent patient.

BACKGROUND: Iron deficiency still remains the most common single nutrient deficiency disorder in the world, especially among young children and adolescent girls. As little is recently known about iron deficiency in infants and preschool children in Korea, this study is aimed to determine the prevalence of iron deficiency in healthy population and to determine the proportion of children in whom iron deficiency goes undetected using the current screening technique. METHODS: We collected venous samples from 410 apparently healthy preschool children during March to June, 1997, as a part of a regular health check-up program. We measured hemoglobin, hematocrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), serum ferritin, serum iron, and total iron binding capacity(TIBC). RESULTS: A total of 410 infants and preschool children aged 1~6 years were included in this study. The prevalence of anemia was 7.9%(3/38) in infants and children aged 1~2 years, 6.3%(12/190) in 3~4 years and 1.6%(3/182) in 5~6 years. The prevalence of iron deficiency(ferritin <10 ng/mL or transferrin saturation <10%) was 31.6%(12/38) in 1~2 years, 23.7%(45/190) in 3~4 years and 14.3%(26/182) in 5~6 years. The prevalence of IDA was 5.3% (2/38) in 1~2 years, 1.1% (2/190) in 3~4 years and 0.5%(1/182) in 5~6 years. Microcytic anemia was found in only 2 cases, both of which is included in 1~2 years of age. CONCLUSION: The prevalence of iron deficiency and IDA was relatively high in 1~2 years of age, critical period for neurologic development. Nutritional education including iron fortification for mothers having caring babies especially of this age group should be warranted.
Adolescent ; Anemia ; Anemia, Iron-Deficiency ; Child ; Child, Preschool* ; Critical Period (Psychology) ; Education ; Female ; Ferritins ; Hematocrit ; Humans ; Infant ; Iron* ; Korea ; Mass Screening ; Mothers ; Prevalence* ; Transferrin

PURPOSE: To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants. METHODS: We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group. RESULTS: Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received 3.1+/-2.9 transfusions, and the control group received 1.0+/-1.1 transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis. CONCLUSION: The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.
Apgar Score ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Erythrocyte Transfusion ; Erythrocytes ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Logistic Models ; Membranes ; Parturition ; Rupture