Parkes Weber syndrome is a rare congenital vascular anomaly, related to the RAS p21 protein activator 1 (RASA1) gene. It is characterized by capillary cutaneous malformations, bony and soft tissue hyperplasia, and multiple arteriovenous fistulas throughout the affected upper or lower extremity. These arteriovenous fistulas can be associated with life-threatening complications such as bleeding, thrombosis, and high output heart failure. In this report, we present a neonate who had a disproportionately hypertrophied left upper limb with port-wine stain, dystrophy of the left humerus, and hypertrophy of the left clavicle on X-ray, and arteriovenous malformation and massive dilatation of the left subclavian artery on magnetic resonance angiography. Exome sequencing analysis revealed a novel heterozygous splicing mutation (c.1776+2T>A) in the RASA1 gene. To the best of our knowledge, this report is the first case of RASA1-related Parkes Weber syndrome in Korea.
Arteriovenous Fistula ; Arteriovenous Malformations ; Capillaries ; Clavicle ; Dilatation ; Exome ; Heart Failure ; Hemorrhage ; Humans ; Humerus ; Hyperplasia ; Hypertrophy ; Infant, Newborn* ; Korea ; Lower Extremity ; Magnetic Resonance Angiography ; Port-Wine Stain ; Sturge-Weber Syndrome* ; Subclavian Artery ; Thrombosis ; Upper Extremity

BACKGROUND: Korea is a highly prevalent area of isolated anti-HBc with a rate of 15%, but there is neither vaccination nor management guideline agreed. To know the management for Hepatitis B Vaccination for adults with isolated anti-HBc, we investigated immune response to hepatitis B vaccination in adults with isolated anti-HBc. METHODS: The 23 adults with persistent isolated anti-HBc, who visited a health promotion center from Dec. 1998 to Aug. 1999, were vaccinated with Hepavax?-B by the standard schedule (0, 1, 6 month) and anti-HBs titers were measured 1 month after 1st and 3rd vaccinations (1, 7 month). RESULTS: After the 1st vaccination, 18 (78.26%) developed anti-HBs seroconversion. Among them, 4 (17.39%) had titers of 10~49 mIU/ml, 8 (34.78%) 50~99 mIU/ml, and 6 (26.09%) more than 100 mIU/ml. All non-responders after the 1st vaccination remained as such even with 3 doses of complete vaccination. The majority of seroconverted group did not show more anti-HBs response with further vaccination. CONCLUSIONS: Since none of adults with isolated anti-HBc had a primary response, which indicated few false positive results. Therefore they should be excluded on vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine with a follow-up anti-HBs test is preferable for adults with isolated anti-HBc. If the test shows a seroconversion it would indicate protective immunity, if not, then occult infection may be suspected.
Adult* ; Appointments and Schedules ; Follow-Up Studies ; Health Promotion ; Hepatitis B Core Antigens* ; Hepatitis B* ; Humans ; Korea ; Vaccination*

OBJECTIVE: The objective of this study was to elucidate the relationship between job stress and pulse wave velocity (PWV) as a cardiovascular risk factor. METHOD: The study design was cross-sectional, and a total of 234 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude) using a modified Karasek model. Cuffs were applied to the extremities and a microphone for phonocardiography was placed at the second intercostal space at the margin of the sternum. The subjects rested in a supine position for 5 min, and PWV was measured using a VP-1000(Colin Waveform analyzer). RESULTS: There were significant correlations between blood pressure, glucose, total cholesterol, coagulation factor and PWV. The group with low decision latitude and high decision latitude showed higher levels of PWV, but the differences were not significan. The PWV (left) was significantly higher in the high strain group than in the lower strain group. After adjustment for age and cardiovascular risk factors, job strain was still associated with PWV. CONCLUSION: These result suggest that the high strain group among workers is related to an increased risk of PWV as a marker of atherosclerosis.
Atherosclerosis ; Blood Coagulation Factors ; Blood Pressure ; Cholesterol ; Extremities ; Glucose ; Phonocardiography ; Pulse Wave Analysis* ; Risk Factors* ; Sternum ; Supine Position

OBJECTIVE: A growing body of literature has documented that job stress is associated with the development of cardiovascular disease. Nevertheless, the pathophysiological mechanism of this association remains unclear. Therefore, we tried to elucidate the relationship between job stress, heart rate variability and metabolic syndrome. METHOD: The study design was cross-sectional, and 169 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude). Heart rate variability (HRV) was recorded using SA-2000 (medi-core). HRV was assessed by time-domain and by frequency-domain analyses. Time domain analysis was performed for SDNN (Standard Deviation of NN interval), and spectral analysis for low-frequency (LF), high-frequency (HF) and total frequency power. Metabolic syndrome was defined on the basis of clustering of risk factors, when three or more of the following cardiovascular risk factors were included in the fifth quintile: glucose, systolic blood pressure, HDL-cholesterol (bottom quintile), triglyceride and waist-hip ratio. RESULTS: The results showed that job characteristics were not associated with cardiovascular risk factors. The high strain group had a less favorable cardiovascular risk profile with higher levels of blood pressure, glucose, homocysteine, and clotting factor than the lower strain group (low strain+passive+active group), but the difference was not statistically significant. The SDNN of HRV was significantly lower in the high strain group than in the low strain group. The prevalence of metabolic syndrome in the low strain, passive, active and high strain groups was 9.7%, 13.9%, 14.9% and 23.8%, respectively. In the high strain group, the metabolic syndrome was significantly related to a decreased SDNN. However, we could not find a significant association in LF/HF ratio. CONCLUSION: This result suggests that decreased HRV does not play a role in the development of disease; however, it can induce cardiovascular abnormalities or dysfunctions related to the onset of heart disease among high risk groups.
Blood Pressure ; Cardiovascular Abnormalities ; Cardiovascular Diseases ; Glucose ; Heart Diseases ; Heart Rate* ; Heart* ; Homocysteine ; Prevalence ; Risk Factors ; Triglycerides ; Waist-Hip Ratio

OBJECTIVE: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases METHODS: 11 hospitals participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. RESULTS: Between Apri1 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. Most of the HAVS cases came from shipbuilding, and 172 of them (92.7 %) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9 %). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6 %) and 4 (12.1 %) cases of occupational asthma, the agents included isocyanate and welding fume, respectively. 64.7 % of the cases of occupational skin diseases were contact dermatitis, and organic solvents and welding fume were the main agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10 (58.8 %) of the cases were diagnosed as squamous cell carcinoma and 5 (29.4 %) as adenoma. CONCLUSION: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.
Adenoma ; Asthma, Occupational ; Busan* ; Carcinoma, Squamous Cell ; Carpal Tunnel Syndrome ; Dermatitis, Contact ; Hand ; Hand-Arm Vibration Syndrome ; Lung Neoplasms ; Occupational Diseases* ; Occupational Medicine ; Prevalence ; Risk Factors ; Skin Diseases ; Solvents ; Specialization ; Ulsan* ; Welding

OBJECTIVES: This study examines the problem of the preplacement health examination in terms of hearing loss case, where workers have been experiencing job instability in the labor market. METHODS: In order to measure the 2-year job retention rate of employees in 79 shipbuilding subcontracted companies in Kyongnam province, we utilized the same methods as those used by Neumark et al(1999), and Bernhardt et al(1999). We surveyed 79 heath and safety personnel from the companies with a questionnaire to evaluate the present status of the preplacement health examination. We reviewed the preplacement health certificates(result of audiometric hearing thresholds) of 1,818 recruits issued by Daewoo hospital from January 1 to June 30, 2001. RESULTS: The job retention rate was 40.3 %(male 38.53 %, female 52.01 %). Of the 79 health and safety personnel of companies, 44(55.7 %) perceived the preplacement health examination as a tool for the selection of recruits, 3(3.8 %) as a procedure for job fitting and 31(39.2 %) as both. Most of them were against the acceptance of recruits with hearing loss, spinal disease and hepatitis. Among the 1,818 workers who underwent the preplacement health examination, 530(29.1 %) were examined after employment, but 1,096(60.3 %) were examined before employment. The number with previous job experience was 1,591(87.5 %). In the audiometric hearing threshold results, the prevalence of hearing loss was positively correlated with age. There was a significant difference in the prevalence of hearing loss depending on previous job and number of quitting at 4,000 Hz. CONCLUSIONS: The comparison of 2-year job retention rates before and after the Korean economic crisis of 1997 suggests that job stability has been aggravated especially for cohorts of long tenure, irregular job, and old age. This evidence shows that previous job and age play a role in determining worker employment based on perceived results from the preplacement health examination. This result suggests that a pre-employment health examination be substituted for the preplacement health examination based on the essential job functions and reasonable accommodation. Because it has little relevance in a wide range of employment and minor health problems, the results of this examination should not debar applicants from employment.
Cohort Studies ; Employment ; Female ; Gyeongsangnam-do ; Hearing Loss* ; Hearing* ; Hepatitis ; Humans ; Prevalence ; Questionnaires ; Spinal Diseases

OBJECTIVES: To integrate the results of studies which assess an association between blood lead and blood pressure. METHODS: We surveyed the existing literature using a MEDLINE search with blood lead and blood pressure as key words, including reports published from January 1980 to December 2000. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers exposed to lead, and 2) both blood pressure and blood lead must have been measured and presented with sufficient details so as to estimate or calculate the size of the association as a continuous variable. Among the 129 articles retrieved, 13 studies were selected for quantitative meta-analysis. Before the integration of each regression coefficient for the association between blood pressure and blood lead, a homogeneity test was conducted. RESULTS: As the homogeneity of studies was rejected in a fixed effect model, we used the results in a random effect model. Our quantitative meta-analysis yielded weighted regression coefficients of blood lead associated with systolic blood pressure and diastolic blood pressure results of 0.0047 (95% confidence interval [CI]: -0.0061, 0.0155) and 0.0004 (95% CI: -0.0031, 0.0039), respectively. CONCLUSIONS: The published evidence suggested that there may be a weak positive association between blood lead and blood pressure, but the association is not significant.
Blood Pressure*

OBJECTIVES: This study was conducted to assess the concentration of xylene exposure and exposure variability of a similar exposure group(SEG) in accordance with job title and confined space. METHOD: The study subjects included 28 workers working in the painting process in the ship-building industry. Measurement of subjects were repeated three times. Within and between-worker exposure variance components were estimated from log-transformed exposure concentrations employing a one-way nested random effects analysis of variance model. A uniformly exposed group was defined as one where the between-worker variance(sigmaB2) was less than or equal to 0.031 or bwR95 or=0.031) and the ratios of the 97.5th and 2.5th percentile workers of the log normally distributed exposures of each group of workers was more than 2. However dividing job title into confined space(in-block, out-block, in/out-block) decreased the between-worker exposure variability. CONCLUSION: This study focused on the quantitative aspects of exposure in painters in the ship-building industry. We cannot accept the assumption that SEG are uniformly exposed, as a major component of variation in exposure relates to differences in tasks or other factors. Therefore, the observational schemes can be improved by investigating jobspecific task and practice.
Confined Spaces ; Paint ; Paintings ; Xylenes*

OBJECTIVES: The association of workplace cumulative noise exposure and blood pressure was investigated in this study using cross-sectional design. METHODS: The study population comprised 852 manufacturing male workers of whom occupational health examination data, questionnaire and personnel records were available. Workplace ambient noise monitoring data was used for calculating individual cumulative noise exposure level. Mean of each systolic and diastolic blood pressure of occupational health examination data was used for individual systolic and diastolic blood pressure level. Possible confounding variables including family history of hypertension, smoking habit, alcohol drinking habit were collected by questionnaire. On the basis of job location and duration of work at the location, a cumulative time-weighted average noise level was calculated for each workers. According to this cumulative noise exposure level, each study subject was categorized as low noise exposure group, moderate noise exposure group, high noise exposure group, very high noise exposure group. Among noise exposure groups, mean of systolic and diastolic blood pressure was compared after adjusting possible confounding variables such as age, body mass index, serum cholesterol level, family history of hypertension, smoking history, alcohol drinking habit. RESULTS: After adjusting possible confounding variables, noise exposure group was significant explanatory variables for both systolic and diastolic blood pressure, and mean of both systolic and diastolic blood pressure of very high exposure group was higher than that of low exposure group. CONCLUSIONS: These findings suggested that the high cumulative noise exposure might elevate the blood pressure.
Alcohol Drinking ; Blood Pressure* ; Body Mass Index ; Cholesterol ; Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Humans ; Hypertension ; Male ; Noise* ; Occupational Health ; Questionnaires ; Smoke ; Smoking

OBJECTIVES: The strategy for the labor flexibility through subcontracted labor have brought a negative effect on the lives of the workers, such as the increase of the unstable employment. This study was conducted to analyze the relationship between the employment of subcontracted firms and the health status of them, and to find out some problems which have been caused in the process of health evaluation and the characteristics of social exclusion. METHODS: We reviewed the periodical health examination and preemployment health examination in order to compare health status of the subcontracted workers with those of the parent firm workers. The SF-36 questionnaire was administered to assess the self-perceived health status. RESULTS: The result shows that compared to the working duration of the parent firm workers, those of the subcontracted workers were shorter, and the job transfer rate was higher. In the periodical health examination, the prevalence of occupational and general disease was higher in the parent firm(10%) than in the subcontracted firms(6%). Preemployment health examination plays an important role in worker's health management. Among 6,260 workers who received preemployment health examination, the prevalence of disease was 37.9%. Mean scores of health status measured by SF-36 were lower in the subcontracted firm than in the parent firm. CONCLUSIONS: Due to social exclusion of the subcontracted workers from the periodical health examination, there is a possibility that the periodical health examination have the healthy worker effect. These results suggests that the preemployment health examination could be a more appropriate indicator which is able to assess the health status of the subcontracted workers than the periodical health examination.
Employment ; Healthy Worker Effect ; Humans ; Parents ; Pliability ; Prevalence ; Questionnaires