This study was conducted to evaluate the workers' health conditions, nutritional status, food habits, and their needs for the nutrition programs at the worksite. Three hundred and fifty one(men 260, women 91) employees from 11 companies in urban area were recruited for the study. The results of this study were as follows : The average consumption of nutrients in the subjects' diets were found to be deficient such as total energy, calcium, iron, vitamin A and B2. More than 42% of the subjects have at least one of the chronic diseases like obesity, diabetes mellitus, anemia, hypercholesterolemia, liver disease, and hypertension. Most subjects did not recognize their own blood cholesterol levels, blood pressure, or blood sugar level. Nutrition knowledge scores of the subjects were very low, which was only 52.4%. It should be noted that weight problems and other health problems of the employees at the worksite were frequently found among the employees who had relatively low nutrition knowledge scores. The nutrition programs for prevention of the obeses, hypercholesterolemia, diabetes mellitus, stress, and smoking were urgently needed by the subjects. Many subjects also wanted the nutrition education programs for their family.
Anemia ; Blood Glucose ; Blood Pressure ; Calcium ; Cholesterol ; Chronic Disease ; Diabetes Mellitus ; Diet ; Education ; Female ; Food Habits ; Humans ; Hypercholesterolemia ; Hypertension ; Iron ; Korea* ; Liver Diseases ; Nutritional Status* ; Obesity ; Smoke ; Smoking ; Vitamin A ; Workplace

BACKGROUND: Ureteral stone(UTS) and acute pyelonephritis are the most common causes of nontraumatic acute flank pain in adults. Urography(IVU) is known as the most ideal diagnostic modality of obstructive uropathy to date. However, it has many practical limitations in overcrowding Korean emergency department to perform IVU as the diagnostic test of UTS. So we have performed prospective analytic study to compare IVU with its alternative diagnostic modalities. METHOD AND RESULTS: Our study was performed at Asan Medical Center from March, 1998 to July, 1999. We performed urinalysis, KUB, grayscale ultrasonography, and IVU in 243 patients, suspected to have UTS, based on histories, physical examination. After excluding patients with undetermined results(n=7) or spontaneous passage of stone before IVU(n=24), 212 patients were enrolled in our study. All of the other diagnostic tests were performed within one hour after emergency room presentation except IVU (53+/-24 hours). Diagnostic agreement among tests are as follows: Urinalysis shows good agreements with KUB(0.53) and IVU(0.62). KUB shows good agreement with IVU(0.48). Ultrasonography shows good agreement with IVU(0.58). Sensitivity(%), specificity(%), positive predicitive value(%), negative predicitive value(%), accuracy(%), and odds ratio of each diagnostic methods are as follows: Urinalysis is 91, 19, 78, 42, 74, 3.88; KUB is 55, 33, 72, 19, 50, 2.49; ultrasonography is 58, 92, 96, 41, 66, 45.61, and IVU is 81, 96, 98, 62, 84, 107.72. CONCLUSION: Although IVU seems to be the most ideal diagnostic modality for the UTS to date, it takes too long time for emergency physicians to confirm the diagnostic using IVU. We can performed other diagnostic modalities within one hour. However, emergency physicians suffer from poor diagnostic accuracy. Therefore, it is concluded that we are in need of more accurate alternative diagnostic modalities for UTS.
Adult ; Chungcheongnam-do ; Diagnosis* ; Diagnostic Tests, Routine ; Emergencies* ; Emergency Service, Hospital* ; Flank Pain ; Humans ; Odds Ratio ; Physical Examination ; Prospective Studies ; Pyelonephritis ; Ultrasonography* ; Ureter* ; Urinalysis

There is a variation in the range of normal occlusion, and we must fit our treatment to the needs of each patient. If the upper or lower incisors are congenitally missing, malformed, or crowded, the extraction of the incisor has some advantages over the extraction of premolars and nonextractions. The advantages are l) simple mechanics, 2) reduced treatment time, 3) less relapse tendency, and 4) fewer facial profile changes. In order to decide which incisor should be extracted, we must consider certain factors: l) discrepancies in anterior arch length, 2) anterior tooth ratio, 3) periodontal and tooth health condition, and 4) the relationship between the upper and lower midline. Diagnostic set-up can be helpful to plan the treatment and show us the post treatment result.
Bicuspid ; Esthetics ; Humans ; Incisor* ; Mechanics ; Recurrence ; Tooth

BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac* ; Arterial Pressure ; Heart ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Respiration, Artificial* ; Respiratory Insufficiency* ; Risk Factors* ; Ventilation ; Ventilators, Mechanical

In the case of a soft tissue defect which requires thin & pliable tissues, the choice of donor site is limited due to flap bulkiness and donor site morbidity. To overcome these problems, a variety of perforator-based flaps such as paraspinous and parasacral perforator flap, deep inferior epigastric perforator flap, gluteal perforator flap, and thoracodorsal artery perforator flap have recently been introduced. We experienced 8 cases of soft tissue defects from December 1996 to March 1999 using the thoracodorsal artery perforator flap for reconstruction. We could elevate the cutaneous flap with preservation of the latissimus dorsi muscle flap only when it was based on one cutaneous perforator. Defatting procedure was possible for further thinning of skin flap. In one case, axillary defect after release of postburn scar contracture was repaired with island perforator flap and the other seven cases were repaired with free flap. The results were satisfactory. We believe the thoracodorsal artery perforator flap is useful for reconstruction of soft tissue defects which are large or under conditions requiring thin flap.
Arteries* ; Cicatrix ; Contracture ; Free Tissue Flaps ; Humans ; Perforator Flap ; Skin* ; Superficial Back Muscles ; Tissue Donors

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*

No abstract available.
Cesarean Section* ; Cicatrix* ; Endometriosis* ; Female ; Pregnancy

No abstract available.
Bronchiolitis* ; Humans

The word "Delayed" in the legend of Figure 2 should have been written as "Controls."

BACKGROUND: Because systolic and diastolic dysfunction frequently coexist in acute myocardial infarction(AMI), we hypothesize that a combined measure of ventricular performance using Doppler echocardiography may be more sensitive and time-saving diagnostic tool for the evaluation of patients presenting with cardiogenic chest pain. METHOD AND RESULTS: Seventy-one patients with AMI (47 male, 59+/-11 years) and 45 patients with normal coronary artery (29 male, 52+/-11 years) were included in the study for measurement of cardiac performance index and established parameters of ventricular function using conventional echo-Doppler methods. a new derived index of cardiac performance: (ICT+IRT)/ET, was obtained by subtracting ejection time(ET) from the interval between cessation and onset of the mitral inflow velocity to give the sum of isovolumic contraction time(ICT) and isovolumic relaxation time(IRT). The mean value of the index was significantly different between normal and AMI(p<0.01). The degree of inter-group overlap was smaller for the index compared to other parameters. within functional groups, the value of the index did not appear to be related to heart rate, mean arterial pressure and the degree of mitral regurgitation. CONCLUSION: cardiac performance index is a conceptually new, simple and reproducible Doppler index of combined systolic and diastolic myocardial performance, and it is useful as screening test for patients with cardiac dysfunction due to AMI.
Arterial Pressure ; Chest Pain ; Coronary Vessels ; Echocardiography, Doppler ; Heart Rate ; Humans ; Male ; Mass Screening* ; Mitral Valve Insufficiency ; Myocardial Infarction* ; Relaxation ; Ventricular Function