BACKGROUND: The success of an injury intervention program can be measured by the proportion of successful return to work (RTW). This study examined factors of successful return to employment among workers suffering from work-related injuries. METHODS: Data were obtained from the Social Security Organization, Malaysia database consisting of 10,049 RTW program participants in 2010–2014. The dependent variable was the RTW outcome which consisted of RTW with same employer, RTW with new employer or unsuccessful return. Multinomial logistic regression was performed to test the likelihood of successful return with same employer and new employer against unsuccessful return. RESULTS: Overall, 65.3% of injured workers were successfully returned to employment, 52.8% to the same employer and 12.5% to new employer. Employer interest; motivation; age 30–49 years; intervention less than 9 months; occupational disease; injuries in the lower limbs, upper limbs, and general injuries; and working in the manufacturing, services, and electrical/electronics were associated with returning to work with the same employer against unsuccessful return. Male, employer interest, motivation, age 49 years or younger, intervention less than 6 months, occupational disease, injuries in the upper limbs and services sector of employment were associated with returning to new employer against unsuccessful return. CONCLUSION: There is a need to strengthen employer commitment for early and intensified intervention that will lead to improvement in the RTW outcome.
Case Management* ; Employment* ; Humans ; Logistic Models ; Lower Extremity ; Malaysia ; Male ; Motivation ; Occupational Diseases ; Rehabilitation ; Return to Work ; Social Security ; Upper Extremity

BACKGROUND/AIMS: The purpose of this study is to verify the risk factors associated with Dieulafoy lesion formation in the upper gastrointestinal tract. METHODS: A case-control study was performed by reviewing the electronic medical records of 42 patients who were admitted to a tertiary medical center in the Daejeon region for Dieulafoy lesions from September 2008 to October 2013, and the records of 132 patients who were admitted during the same period and who underwent endoscopic examination for reasons other than bleeding. We analyzed clinical and endoscopic findings retrospectively, and searched for risk factors associated with Dieulafoy lesion formation. RESULTS: All 42 patients diagnosed with Dieulafoy lesion had accompanying bleeding, and the location of the bleeding was proximal in 25 patients (59.5%), the middle portion in seven patients (16.7%), and distal in 10 patients (23.8%). Antiplatelet agents (p=0.022) and alcohol (p=0.001) use showed statistically significant differences between the two groups. The odds ratios (95% confidence intervals) of the two factors were 2.802 (1.263 to 6.217) and 3.938 (1.629 to 9.521), respectively. CONCLUSIONS: This study showed that antiplatelet agents and alcohol consumption were risk factors associated with Dieulafoy lesion formation in the upper gastrointestinal tract.
Alcohol Drinking ; Alcohols ; Case-Control Studies ; Electronic Health Records ; Hemorrhage ; Humans ; Odds Ratio ; Platelet Aggregation Inhibitors ; Retrospective Studies ; Risk Factors* ; Upper Gastrointestinal Tract*

BACKGROUND/AIMS: The purpose of this study is to verify the risk factors associated with Dieulafoy lesion formation in the upper gastrointestinal tract. METHODS: A case-control study was performed by reviewing the electronic medical records of 42 patients who were admitted to a tertiary medical center in the Daejeon region for Dieulafoy lesions from September 2008 to October 2013, and the records of 132 patients who were admitted during the same period and who underwent endoscopic examination for reasons other than bleeding. We analyzed clinical and endoscopic findings retrospectively, and searched for risk factors associated with Dieulafoy lesion formation. RESULTS: All 42 patients diagnosed with Dieulafoy lesion had accompanying bleeding, and the location of the bleeding was proximal in 25 patients (59.5%), the middle portion in seven patients (16.7%), and distal in 10 patients (23.8%). Antiplatelet agents (p=0.022) and alcohol (p=0.001) use showed statistically significant differences between the two groups. The odds ratios (95% confidence intervals) of the two factors were 2.802 (1.263 to 6.217) and 3.938 (1.629 to 9.521), respectively. CONCLUSIONS: This study showed that antiplatelet agents and alcohol consumption were risk factors associated with Dieulafoy lesion formation in the upper gastrointestinal tract.
Alcohol Drinking ; Alcohols ; Case-Control Studies ; Electronic Health Records ; Hemorrhage ; Humans ; Odds Ratio ; Platelet Aggregation Inhibitors ; Retrospective Studies ; Risk Factors* ; Upper Gastrointestinal Tract*

OBJECTIVE: To discuss the pressure changing characteristics of upper esophageal sphincter (UES), lower esophageal sphincter (LES) and the esophagus kinetic characteristics of pharyngeal paraesthesia patients. METHOD: To take high resolution manometry in 44 cases of pharyngeal paraesthesia patients and 23 normal subjects separately. According to the RSI score,the 44 patients were divided into group A (the group without reflux, RSI < 13, n = 25) and group B (the group with reflux, RSI ≥ 13, n = 19). RESULT: The UES average resting pressure and average residual pressure of patients group were higher than the control group (P < 0.05); The UES average resting pressure and average residual pressure of group B were higher than group A (P < 0.05); The LES average resting pressure and average residual pressure of group B were lower than group A and the control group (P < 0.05); The comparison of LES average resting pressure and average residual pressure between group A and the control group was not statistically significant (P > 0.05). The esophagus DCI of group B was lower than that of group A and control group (P < 0.05). The esophagus DCI comparison between group A and control group was not statistically significant (P > 0.05). CONCLUSION The pharyngeal paresthesia symptoms of'patients was associated with the increasing of UES pressure. The pharyngeal paresthesia symptoms of group with reflux was related to low pressure of LES and high pressure of UES. The last part of esophagus of group with reflux had obstacles in powers, which weaken the peristalsis and declined the ability to clear the bolus and gastric reflux material.
Case-Control Studies ; Esophageal Sphincter, Lower ; physiopathology ; Esophageal Sphincter, Upper ; physiopathology ; Gastroesophageal Reflux ; physiopathology ; Humans ; Manometry ; Paresthesia ; diagnosis ; pathology ; Peristalsis ; Pharynx ; physiopathology ; Pressure

OBJECTIVE: To explore the application value of needle electromyography (EMG) and nerve conduction study (NCS) in the forensic appraisal; to provide scientific basis for establishing normative and unified assessment methods of the peripheral nerve study in forensic medicine. METHODS: One hundred and sixty-four samples with injured peripheral nerve (injury group) and 138 samples with normal peripheral nerve (control group) were collected and tested with methods of EMG and NCS respectively. The relevance rate of two methods were compared and statistical analysis was performed. RESULTS: In the injury group, there was no statistical difference on the relevance rate between the application of EMG and that of NCS (P > 0.05). In the control group, there was no statistical difference on the negative rate between the two methods (P > 0.05). The false negative rate of the injury group and the false positive rate of the control group were both 0% when using the two methods together. CONCLUSION When the injured peripheral nerve in forensic appraisal is in doubt, application of both EMG and NCS could disclose truth from falsehood. The accuracy and credibility of identification results could be enhanced.
Action Potentials ; Adolescent ; Adult ; Case-Control Studies ; Electromyography/methods* ; Female ; Forensic Medicine/methods* ; Humans ; Lower Extremity/injuries* ; Male ; Middle Aged ; Muscle, Skeletal/physiopathology* ; Needles ; Neural Conduction/physiology* ; Peripheral Nerve Injuries/physiopathology* ; Trauma Severity Indices ; Upper Extremity/injuries* ; Young Adult

Monomelic amyotrophy (MA), also known as Hirayama disease, occurs mainly in young men and manifests as weakness and wasting of the muscles of the distal upper limbs. Here, we sought to identify a genetic basis for MA. Given the predominance of MA in males, we focused on candidate neurological disease genes located on the X chromosome, selecting two X-linked candidate genes, androgen receptor (AR) and ubiquitin-like modifier activating enzyme 1 (UBA1). Screening for genetic variants using patients' genomic DNA revealed three known genetic variants in the coding region of the AR gene: one nonsynonymous single-nucleotide polymorphism (SNP; rs78686797) encoding Leu57Gln, and two variants of polymorphic trinucleotide repeat segments that encode polyglutamine (CAG repeat; rs5902610) and polyglycine (GGC repeat; rs3138869) tracts. Notably, the Leu57Gln polymorphism was found in two patients with MA from 24 MA patients, whereas no variants were found in 142 healthy male controls. However, the numbers of CAG and GGC repeats in the AR gene were within the normal range. These data suggest that the Leu57Gln polymorphism encoded by the X-linked AR gene may contribute to the development of MA.
Case-Control Studies ; Clinical Coding ; DNA ; Genes, X-Linked ; Humans ; Male ; Mass Screening ; Muscles ; Peptides ; Receptors, Androgen ; Reference Values ; Spinal Muscular Atrophies of Childhood ; Trinucleotide Repeats ; Upper Extremity ; X Chromosome

We report a case of serous gonarthritis with nonproductive cough successfully treated with Eppikajutsuto. A 37-year-old Japanese man developed a right genicular arthrocele with nonproductive cough, in October X. Over 100 ml of serous synovial fluid was drained via an arthrocentesis puncture procedure. Although he was treated with nonsteroidal anti-inflammatory agents by an orthopedist, under a diagnosis of serous gonarthritis, his symptoms did not improve. Laboratory findings suggested inflammatory conditions (serum CRP 3.4 mg/dl, ESR 76 mm/h). At the time of his first visit in January X+1, orthopedic examinations revealed that rheumatoid arthritis was unlikely, based on negative physical and laboratory findings. A contrast MRI knee joint scan did not demonstrate any tumor-like mass of synovium which would indicate pigmented villonodular synovitis. And orthopedists found it difficult to specify the cause of his serous gonarthritis. After a common cold in December X, cough stimulated by cold exposure was superimposed on serous gonarthritis.We utilized Eppikajutsuto under the interpretation that both his genicular arthrocele and nonproductive cough were due to a “sui” disturbance. This Eppikajutsuto therapy reduced his genicular arthrocele and nonproductive cough in1month. His symptoms and inflammatory reactions were completely improved in 3 months, regardless of gradual withdrawal of his medication.
Coughing ; Upper case ecks ; symptoms <1> ; Serous ; Treated with

The purpose of this study was to investigate an optimal 25-hydroxyvitamin D3 [25(OH)D] level for Japanese frail elderly people aged 65 and above from the standpoint of quality of life, functional capacity, and physical function. A longitudinal study was conducted in two towns (latitude 36 degrees north) from 2006 to 2008. The subjects were 125 frail elderly individuals living in a rural setting and attending a 3-month exercise class for prevention of age-related diseases in order that they could do without receiving nursing care. An interview was conducted based on a questionnaire, and blood data, and physical fitness tests were administered to them at baseline and at the end of the 3-month exercise class. Functional capacity and physical fitness were compared on the basis of 25(OH)D≥50 nmol/L as a usual cut-off point, and 25(OH)D≥75 nmol/L as a severer cut-off point. A comparison of changes in physical fitness between before and after exercise class was done. The mean 25(OH)D level (±SD) was 58.9±13.6 nmol/L at baseline. The ratios of 25(OH)D level less than 50.0 nmol/L and less than 75.0 nmol/L were 23.9%, and 87.2%, respectively. The rates of house-bound subjects and those with worse scores of QOL were significantly higher in the group with 25(OH)D<50.0 nmol/L compared with the group with 25(OH)D≥50 nmol/L. The rate of those with superior functional capacity was significantly higher in the group with 25(OH)D≥75 nmol/L than the group with 25(OH)D<75 nmol/L. At the end of the 3-month exercise, Timed Up & Go indicating walking ability improved significantly in the group with 25(OH)D≥50 nmol/L, and an alternate step test indicating lower extremity strength significantly improved in the group with 25(OH)D≥75 nmol/L. From these findings, it was suggested that 25(OH)D level more than 50 nmol/L would be needed to maintain walking ability of the Japanese frail elderly and that 25(OH)D level more than 75 nmol/L would be needed to maintain lower extremity strength or functional capacity.
hydroxyl group ; Nanomole/liter ; Upper case dee ; Frail Elderly ; Exercise

The effect of water extracts of Euphorbia hirta on the histological features and expressions of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in the rat articular cartilage was investigated. Arthritis was induced in rats using Freund's Complete Adjuvant containing heat-killed M. tuberculosis, and treated with water extracts of E. hirta. Paraffin tissue sections of the arthritic joints were evaluated. The extent of cartilage degeneration was found to be greatest in rats treated with the highest dosage of E. hirta, followed by rats in the untreated group. Rats treated with the intermediary and low dosages of Euphorbia hirta showed improved histology. MMP-13 levels were found to be decreased with decreasing dosages of E. hirta. TIMP-1 levels were found to increase with decreasing dosages of E. hirta. MMP-3 levels fluctuated without any appreciable pattern. Low dosages of E. hirta seem to be beneficial in reducing cartilage degeneration in cases of arthritis.
Upper case ee ; Rattus norvegicus ; Euphorbia ; Water ; Degeneration, NOS

During a forensic entomological study conducted at an oil palm plantation in Tanjung Sepat, Kuala Langat, Selangor, a Bengalia emarginata Malloch, 1927 (Diptera: Calliphoridae: Calliphorinae: Bengalini) was collected for the first time. Two adults were collected nearby the pig carcass by the first author and identified by the second. Prior to this finding, nine species of Bengalia were recorded from peninsular Malaysia or Borneo. Male of B. emarginata are different from Bengalia varicolor Fabricious by the following characters: Sternite 5 projection rounded with small identation and mid tibia double-fringed in ventral surface.
Calliphoridae ; Malaysia ; Diptera ; Upper case Bee ; Status pre-