Experience of Conflict in Three Shift Nurses Rearing more than Two Kids: Phenomenological Study

PURPOSE: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. METHODS: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. RESULTS: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were ‘Regret that I cannot satisfy even the slightest wish’, ‘Fail to care for kids’, and ‘Mutual feeling to care giver between appreciation and inconvenience’. Other themes were as follows: ‘Body and mind are broken’, ‘The need for a three-shift system to support nurses who are rearing children’, ‘Doing my best for work and child rearing’. CONCLUSION: The nature of three-shift nurses working in advanced hospital and caring kids is explained as ‘lives with conflict’ between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.

Character Strengths, Physical, and Mental Health Status of the Homeless in Self-reliance Support Facilities / 정신간호학회지

PURPOSE: The purpose of this study was to investigate character strengths, physical and mental health status of the homeless. METHODS: Data were collected from November 2014 to March 2016 through the VIA-IS questionnaires and the DESC vulnerability assessment tool. The participants were 120 adultmen living in two self-reliance support facilities for homeless people, located in S city, Korea. Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 23.0 program. RESULTS: Physical health status of the participants was as following: ‘chronicmedical conditions that were not well-managed or significant physical impairment’ 11.7%, and ‘stable significant medical or physical issues, or chronic medical conditions that were being managed’ 46.7%. The mental health status included mild 23.3%,moderate 11.7%, and seriousmental health issues 4.2%. There were no significant differences in physical health status by signature character groups, while mental health status (F=2.46, p=.038) of the courage group was worse than that of the temperance group. CONCLUSION: Findings indicate thatmental health status of homeless people should bemanagedmore appropriately and effective nursing interventions need to be developed using their signature character. However, further research about physical health status by signature character of the homeless is needed.

Factors Influencing Level of Health Literacy of Migrant Workers in Korea / 기본간호학회지

PURPOSE: The purposes of the study were to identify level of health literacy and factors influencing health literacy of migrant workers. METHODS: Data were collected using a cross sectional correlational design. Participants were 128 migrant workers in Korea. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Scheffe test, and hierarchical multiple regression with the SPSS 18.0 program. RESULTS: The health literacy level of migrant worker was low and they had difficulty in understanding patient education materials and medical forms. Factors influencing health literacy were residential areas (city or rural), education level, length of stay in Korea, and ability to understand spoken Korean. Regression model accounted for 14.2% of the variance in health literacy. CONCLUSION: Lower levels of health literacy make it difficult for migrant works to visit medical facilities and perform health behaviors appropriately. Therefore, diverse strategies should be developed by nurses to enhance the health literacy level of migrant workers.

An Epidemiological Survey on Serological Diagnosis of Legionnella Infection in Seoul, Korea

Serological investigation of antibodies to Legionella species in 1,802 sera collected in seoul was conducted with indirect fluorescent antibody assay (IFA). With an antibody titer of > or =1:128 to be positive, 17 (0.9%) of these sera were positive and 6 (35.3%) of positive sera showed cross-reactions between Legionella species. The number of sera with antibody titers of > or =1:128 to L. pneumophila serogroup 1, L. pneumophila serogroup 4, L. pneumophila serogroup 5, L. bozemanii, L. micdadei, L. anisa were 6 (35.3%), 3 (17.6%), 3 (17.6%), 2 (11.8%), 1 (5.9%), 2 (11.8%) respectively. Among 17 positive sera, 10 (58.8%) sera were from male and 7 (41.2%) from female. An average age of them was 68.9 (+/-15.3; 27~89). Except for one serum, 16 (94.1%) of positive sera were from those older than 50 years old. The result suggests that the aged over 50 years old should be more careful of Legionella infection.

Agonistic Anti-CD137 Monoclonal Antibody Treatment Induces CD11b+Gr-1+ Myeloid-derived Suppressor Cells

CD137 (4-1BB/tnfrsf9) has been shown to co-stimulate T cells. However, agonistic anti-CD137 monoclonal antibody (mAb) treatment can suppress CD4+ T cells, ameliorating autoimmune diseases, whereas it induces activation of CD8+ T cells, resulting in diverse therapeutic activity in cancer, viral infection. To investigate the CD137-mediated T cell suppression mechanism, we examined whether anti-CD137 mAb treatment could affect CD11b+Gr-1+ myeloid-derived suppressor cells (MDSCs). Intriguingly, anti-CD137 mAb injection significantly increased CD11b+Gr-1+ cells, peaking at days 5 to 10 and continuing for at least 25 days. Furthermore, this cell population could suppress both CD8+ T cells and CD4+ T cells. Thus, this study demonstrated that, for the first time, anti-CD137 mAb treatment could induce CD11b+Gr-1+ MDSCs under normal conditions, suggesting a possible relationship between myeloid cell induction and CD137-mediated immune suppression.

Prognostic Value of Vascular Endothelial Growth Factor (VEGF) and Basic Fibroblast Growth Factor (bFGF) Expression in Resected Non-small Cell Lung Cancer / 결핵및호흡기질환

BACKGROUND: Tumor angiogenesis plays an important role in tumor growth, maintenance and metastatic potential. Tumor tissue produces many types of angiogenic growth factors. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) have both been implicated to have roles in tumor angiogenesis. In this study, the expression of tissue VEGF and bFGF from non-small cell lung cancer (NSCLC) patients were analyzed. METHODS: We retrospectively investigated 35 patients with a histologically confirmed adenocarcinoma or squamous cell carcinoma of the lung, where the primary curative approach was surgery. An ELISA was employed to determine the expression of VEGF and bFGF in extracts prepared from 35 frozen tissue samples taken from the cancer patients. RESULTS: VEGF and bFGF concentrations were significantly increased in lung cancer tissue as compared with control (non-cancerous) tissue. The VEGF concentration was significantly increased in T2 and T3 cancers as compared with T1 cancer. Expression of VEGF was increased in node-positive lung cancer tissue as compared with node-negative lung cancer tissue (p=0.06). VEGF and bFGF expression were not directly related to the stage of lung cancer and patient survival. CONCLUSION: Expression of VEGF and bFGF were increased in lung cancer tissue, and the expression of VEGF concentration in lung cancer tissue was more likely related with tumor size and the presence of a lymph node metastasis than the expression of bFGF. However, in this study, expression of both VEGF and bFGF in tissue were not associated with patient prognosis.

B Cells Transduced with HPV16 E6/E7-expressing Adenoviral Vector Can Efficiently Induce CTL-dependent Anti-Tumor Immunity

BACKGROUND: Human papillomavirus (HPV) infection is responsible for cervical cancer, a common cancer in women. Since HPV infection and cancer development are controlled by the host immune system, immunotherapy against HPV can be helpful in preventing or treating HPV-associated cervical cancer. Two oncoproteins of HPV16, E6 and E7, are promising targets for immunotherapy against cervical cancer, because they are constitutively expressed in cervical cancer. METHODS: Since cellular vaccines using B cells as well as dendritic cells offer an efficient approach to cancer immunotherapy, we opted to use B cells. We evaluated the immunogenicity and anti-tumor effects of a B cell vaccine transduced with HPV16 E6/E7-expressing adenovirus. RESULTS: Vaccination with HPV16 E6/E7-transduced B cells induced E6/E7-specific CD8+ T cell-dependent immune responses and generated anti-tumor effects against E6/E7-expressing TC-1 tumor. The anti-tumor effect induced by this B cell vaccine was similar to that elicited by DC vaccine, showing that B cells can be used as an alternative to dendritic cells for cellular vaccines. CONCLUSION: Thisstudy has shown the feasibility of using B cells as immunogenic APCs and the potential for developing prophylactic and therapeutic vaccines against HPV-associated cervical cancer using a B cell vaccine transduced with adenovirus expressing HPV16 E6/E7.

Effects of Heat Shock Protein 70 (HSP70) Induction after Lipopoly?saccharide Exposure on the IL-6 Production and the Cell Viability after Subsequent Lipopolysaccharide Challenge in Murine Alveolar Epithelial Cells / 결핵및호흡기질환

BACKGROUND AND AIMS: Pre-induction of heat shock protein 70 (HSP70) is known to effectively attenuate the lipopolysaccharide (LPS)-induced inflammatory response in lung tissue. However, it is unclear if HSP70 induction after LPS exposure attenuates the subsequent LPS-induced inflammatory response in alveolar epithelial cells. This study examined the effects of HSP70 induction after LPS exposure on the IL-6 production and the cell viability after a subsequent LPS challenge in murine alveolar epithelial cells, and investigated whether or not HSP70 itself may be involved in those effects. METHODS: Murine alveolar epithelial cells were cultured and divided into two groups; the Non-Pre-LPS group without a LPS pre-treatment and the Pre-LPS group with a LPS pre-treatment. Each group was subdivided into the following four subgroups: subgroup C (control), subgroup Q (quercetin), subgroup HSP70 (HSP70 induction), and subgroup HSP70-Inh (HSP70 inhibition). HSP70 expression, which was induced by sodium arsenite and inhibited by quercetin, was analyzed by western blot analysis. The IL-6 levels in the culture supernatant were measured by ELISA, and the cell viability was measured using a simplified MTT assay. RESULTS: The IL-6 levels were lower in subgroup HSP70 than in subgroup C (p<0.01), and were higher in subgroup HSP70-Inh than in subgroup HSP70 in both the Non-Pre-LPS and Pre-LPS groups (p<0.05, p<0.01). The cell viability tended to decrease in the Pre-LPS group compared with the Non-Pre-LPS group. While the cell viability was higher in subgroups Q, HSP70, and HSP70-Inh than in subgroup C in the Non-Pre-LPS group (p<0.05, p<0.05, p<0.01), there was no difference in cell viability among the subgroups in the Pre-LPS group. CONCLUSION: HSP70 induction after a LPS pre-treatment in murine alveolar epithelial cells inhibits the subsequent LPS-induced IL-6 production without affecting the cell viability, and HSP70 by itself may play an important role in this proccess.

The Preventive Effect of Allergic Inflammation by Induction of Oral Tolerance in a Mouse Model of Chronic Asthma / 결핵및호흡기질환

BACKGROUND: Induction of oral tolerance (OT) has been known to prevent allergic inflammation in acute asthma model within 4 weeks. However it is remained whether induction of OT may effectively prevent allergic inflammation in chronic asthma model over 4 weeks. We observed the effect of induction of OT on allergic inflammation and airway remodeling in chronic asthma model up to 8 weeks. METHODS: 5-week-old female BALB/c mice divided into 4 groups-control group, asthma group, low dose OT group, and high dose OT group. To induce oral tolerance mice were fed ovalbumin (OVA) before sensitization with OVA and aluminum hydroxide-1 mg for 6 consecutive days in the low dose OT group and 25 mg once in the high dose OT group. Mice in the asthma group were fed phosphate buffered saline instead of OVA. After sensitization followed by repeated challenge with aerosolized 1% OVA during 6 weeks, enhanced pause (Penh), inflammatory cells, IL-13, and IFN-gamma levels in bronchoalveolar lavage (BAL) fluids as well as OVA-specific IgE, IgG1, and IgG2a levels in serum were measured. In addition the degree of goblet cell hyperplasia and peribronchial fibrosis were observed from lung tissues by PAS and Masson's trichrome stain. RESULTS: Both OT groups showed a significant decrease in Penh, inflammatory cells, IL-13, and IFN-gamma levels in BAL fluids as well as OVA-specific IgE, IgG1, and IgG2a levels in serum compared with the asthma group (P<0.05). In addition, the degree of goblet cell hyperplasia and peribronchial fibrosis were significantly attenuated in both OT groups compared with the asthma group (P<0.01). CONCLUSION: These results suggest that induction of OT may effectively prevent allergic inflammation as well as airway remodeling even in chronic asthma model up to 8 weeks.

Asymptomatic Primary Hematuria in Children

Localized or solitary fibrous tumor (SFT) of the pleura has been classified as a type of mesothelioma, arising from the submesothelial connective tissue cells. The preoperative diagnosis of the tumor at the cytologic or histologic level is very important for the proper handling of the lesion. This preoperative diagnosis is now possible by means of the advance in the transthoracic fine needle aspiration biopsy (FNA) techniques and in the very experience of the cytopathologists. We describe FNA cytologic feature of two cases of SFT arising from the pleura. Cytologic, histologic, immunohistochemical, and electron microscopic characteristics of pleural SFT are discussed. The tumor cells of SFT are spindle or oval in shape with a variable amount of cytoplasm. They are arranged in irregular trabeculae intimately ass- ociated with capillaries. A unique cytologic feature observed in this tumor is that thick, eosinophilic, amorphous collagen bundles are scattered between tumor cells

Relationship between Bronchial Hyperresponsiveness by Methacholine Provocation and the Severity of Asthma Symptoms, Pulmonary Function and Atopy

PURPOSE: Bronchial asthma is a disorder that is characteized by symptoms of reversible airway obstruction and increased responsiveness of the bronchus and to quantify the degree of br onchial hyperresponsivenes can be very helpful in determing the severity of disease and the prognosis. But the Methacholine provocation test is not always easy to be performed in all patients. Thus we designed this trial to know the relationship between the degree of bronchial hype rresponsiveness by Methacholine and the severity of asthma symptoms, pulmonary function te st and atopic findings. METHODS: Methacholine provocation test was performed on 60 clinically stable asthma patients who visited the pediatric allergy clinic of Taegu Fatima Hospital from July, 1992 to June, 1 993. All patients were free of URI for at least 6 weeks and medications were withhold for 2 weeks for corticosteroid or beta receptor agonist and at least 2 days for theophylline. All subjects ha d FEV1 more than 70% of predicted value, and more than 20% of reversible obstruction. Disease severity score(DSS) was compared by the number of asthmatic attacts, clinical picture, therapeutic medications and the Airway reactivity score(ARS) was measured on the number of nonspecipic irritants provoking the bronchial hyperresponsivess. Methacholine provocation test was performed as follows; Normal saline was inhaled 5 times by tidal breath through De Vilbiss 646 inhaler and FEV1 was measured as baseline. According to Chai standardized method, Mathacholine was diluted to 0.075-25mg/ml concentration and inhaled 5 times and accumulated Methacholine was graded 0.375-225.0 Breath Units(One BU = 1 inhalation of 1 mg/ml). PD20 was determined to the concentration at which the FEV1 faIled to 20% below the baseline. RESULTS: 1) PD20 were distributed variably between 0.375 BU and 225.0 BU 2) Bronchial hyperresponsiveness was high on asthma with allergic rhinitis(p<0.05). 3) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation both DSS(r= -0.473; p<0.01) and ARS(r= -0.32; p<0.05). 4) Bronchial hyperresponsiveness by Methacholine provocation test had significant correlation to baseline FEV1/FVC ratio(r= -0.63; p<0.01). 5) Bronchial hyperresponsiveness by Methacholine provocation test had no statistical significant correlation to serum IgE value(r= -0.24; p<0.05). CONCLUSIONS: The severity of bronchial hyperresponsiveness by Methacholine provocation t est had significant correlation with DSS and ARS, and there was a close relation BHR to the baseline FEV1/FVC1 ratio too. Thus exact history about clinical pictures, medications, provocating irritants in asthmatic patients and baseline FEV1/FVC ratio can be very helpful in assessing the bronchial hyperresponsiveness.

MR Findings of Tolosa-Hunt Syndrome

PURPOSE: To assess the MR findings of Tolosa-Hunt syndrome and to evaluat differential point of cavernous sinus lesions. MATERIALS AND METHODS: Eleven cases of Tolosa-Hunt syndrome were evaluated by MRI with specific regard to the shape of cavernous sinus, signal intensity, and pattern of enhancement. Other associated findings were also anlaysed. RESULTS: Two patients had normal MR features of the cavernous sinus. When compared with the contralateral normal cavernous sinus, the involved cavernous sinus was enlarged in six of the nine patients. The outer dural margin was convex and bulged laterally in 6 cases, flat in 2 cases, and concave in 1 case. Of the nine patients, five had iso-signal intensity and four had low signal intensity relative to gray matter on short TR/short TE. Three had isosignal intensity and 6 were not detectale on long TR/short and long TE pulse sequence. Contrast enhancement was seen in 8 cases ;7 cases showed homogeneous enhancement, 1 case heterogeneous enhancement. CONCLUSION: In the appropriate clinical setting of painful ophthalmoplegia, MR findings of cavernous sinus abnormality that consist of iso to low signal intensity on short TR/short TE images and isointense or undetectale mass on long TR/short TE or long TR/Iong TE images may suggest the dignosis of Tolosa-Hunt syndrome.

Necessity of Site-specific BMD Measurements using Dual X-ray Absorptiometry

PURPOSE: To determine the necessity of site-specific bone mineral density(BMD) measurement and the difference between the BMD of the two femora using DXA in the evaluation of osteoporosis. MATERIALS & METHODS: Total BMD and regional BMD(Lumbar spine, femoral neck, Ward's area, intertrochanter area) were measured on seventy-eight healthy persons without previons diseases, and the statistical significance analyzed. RESULTS: Total BMD did not reliably reflect the site-specific BMD. There was a high correlation between BMD in opposing femora. Correlation coefficients between the femoral neck, Ward's area, trochanter area were 0. 939, 0.874 and 0.916 respectively. CONCLUSION: We conclude that a measuremnt of site-specific BMD is necessory because the total BMD can not reliably predict the regional BMD. The measurement of BMD in one femur can predict the BMD of the contralateral femur. If there is no history of femoral neck disease, unilateral BMD measurement is recommended for femoral evaluation.

Peripheral Lung Mass Attached to The Pleural Diagnostic Effectiveness of Ultrasonically Guided Biopsy

PURPOSE: To evaluate the usefulness of real-time ultrasound-guided biopsy as an aid in diagnosing pleural attached lung lesions. MATERIALS AND METHODS: Over a 2-year period (March 1992 through February 1994), 52 US-guided diagnostic biopsies were performed in 50 patients with peripheral lung lesions in contact with chest wall. 15 cases were performed with gun biospy and 37 cases with fine needles. Final diagnosis was confirmed by surgery and clinical follow-up. RESULTS: In 44 of 52 cases(84.6%), we obtained histologic or cytologic material by US-guided biopsy. Diagnostic accuracy and tissue type specific accuracy for malignancy were 83.9%(26/31) and 67.7% (21/31), respectively. Eighteen case% were reported to be benign and one of them was proven to be metastatic lesion. We could not find any complications such as hemoptysis or pneumothorax. CONCLUSION: Ultrasound-guided biopsy is a simple, safe and accurate diagnostic procedure for evaluation of peripheral lung lesion attached to the pleura.

Peripheral Arterial Thrombolysis by Modified Pulse-Spray Method

PURPOSE: The purposes of this study were to evaluate the efficacy of thrombolysis and to find optimal dose of urokinase and injection time by modified pulse-spray method with multiside-hole catheter in patients of arterriosclerosis obliterans of lower limbs. MATERIALS AND METHODS: Over a 2 month period, 5 cases of peripheral arterial occlusion of lower limbs were treated with 0.7--1.3 million unit of urokinase by modified pulse spray method. With antegrade puncture at the site of superficial femoral artery, the tip of modified pig tail catheter was initially placed approximately 2cm proximal to the distal end of the clot. The procedure started with the use of initial bolus dose of UK(100,000U) of lacing, and then small pulses of highly concentrated urokinase, which are forcefully sprayed throughout the thrombus at a rate of 20,000U/min. After the initial rapid period of deposition, the concentration of UK was reduced to 4,000U/min for residual thrombus. RESULTS: Complete clot lysis were achieved in 3 of 5 occlusions. Mean duration for completion of lysis was 140 min(40-180min) and initial recanalization of artery required 45min(20-90min). Total required dose of UK was 1,120,000U and mean dose for initial recanalization was 660,000U. No significant complications occurred except distal vasospasm in one case. CONCLUSION: Modified pulse spray method using ultrahigh and high dose urokinase is safe, reguires less time and has cost effectiveness in the management of peripheral arterial thrombolysis. Further study is warranted.

Effect of High Frequency Ventilation on Tension Pneumothorax Induced by Conventional Ventilator

Four cases of newborn with tension pneumothorax induced by a conventional ventilator were admitted to our nursery from January 1. 1992 to June 30. 1992 and they were managed by high frequency ventilator (Infrasonic Infant Star Ventilator). In contrast, four cases of newborn with tension pneumothorax who were continuously on the conventional ventilator, were included as a control group. They were admitted to our nursery from July 1. 1991 to december 31. 1991 and they were managed by conventional ventilator with conservative treatment. 1) In the control group, who were continuously managed by the conventional ventilator after thoracostomy with water seal drainage, we changed ventilator setting appropriately in control group but they had poor arterial blood gas analysis. The arterial blood gas analysis within 24hr/within 72hr in control group were pH 7.192/7.195, Paco2 72.15/82.25, PaO2 78.92/83.875, HCO3-26.975/27.925 and conventional ventilator care did not show any definite benefit for improvement of arterial blood gas analysis and tension pneumothorax as well. 2) Two cases in control group expired on the 6th day of thoracostomy without any resolution of tension pneumothorax. 3) In contrast, four cases with tension pneumothorax managed by high frequency ventilator were improved. Tension pneumothorax and arterial blood gas analysis to normalize from 6hr of high frequency ventilation and four cases of tension pneumothorax were completely reabsorbed within 4days.

Circadian Variation of Transient Myocardial Ischemia

BACKGROUND: Quyyumi et al described circadian variation of ischemic eletrocardio-graphic changes and heart rate in patients with and without significant coronary disease in 1985. Rocco et al also described circadian variation of transient myocaldial ischemia in patients with coronary artery disease. They also noted an increse in ischemic eletrocardiographic abnormalities in the morning hours.In recent years the important of circadian variation of cardiovascular phenomena has generated a great deal of interest. Such phonomena include the occurrence of ischemia in patients with both chronic stable angina and variant angina, myocaldial infarction, sudden cardiac death, ventricular arrhythmia and platelet aggregability. METHOD: To examine whether a significant circadain variation of transient myocardial ischemia exists and to better understand the character of such variation, 35 patients with againa pectoris(15 patients treated with nitrate and/or caclcum channel blocker and 20 patients without treatment) underwent 24 hours ambulatory monitoring of ischemic ST segment changes during daily life. RESULT: Only 21% of the episodes of ST depression were accompanied by chest pain. While 79% were asymptomatic. A significant circadian increase in ischemic activity was found with 44% of episodes and 40% of total ischemic time in not treated group, and 52% of episodes and 56% of total ischemic time in treated group, occuring between 6 A.M. to 12 P.M.(P<0.05 respectively) When the distribution of ischemic episodes was corrected for the variable time of waking, the peak ischemic activity was occuring in the 1st and 2nd hours after rising. There were no significant differences in heart rate at onset and heart rate at 1 min before onset. CONCLUSION: Is summary, transient myocardial ischemia in the absence of pain was more common and there were a significant circadian variation of transient myocardial ischemia with peak activity in the morning. In addition most of transient myocardial were not preceded by a rise in heart rate.

Characteristics of Subsidiary Pacemaker in Complete Heartblock with Narrow QRS Complex

BACKGROUND: The stability of A-V junctional rhythm is the most important clinical interest in the patients with the complete heart block with narrow QRS complex. The QRS morphology, the basal heart rate & the reponse of subsidiary pacemaker to drugs may be helpful to assess the stability. But it can not be assessed exactly. The recording of the His-bundle was thought to be a means of predicting the clinical course of the patients and the necessity of the artificial pacemaker insertion;also it can assess the A-V block site. But it is invasive study cannot assessed exactly the stability of subsidiary pacemaker. To investigate the characteristics of subsidiary pacemaker, we studied the responses of the artificial pacemaker to ventricular overdrive suppression and the drugs by used the artificial pacemaker in the patient with the complete heart block with the narrow QRS complex, which can be accepted as "stabli" in general. METHOD: There was total of 11 patients diagnosed with the complete AV block with the narrow QRS complex(the escape junctional rhythm was less than 0.10sec) at the Yeungnam University Hospital from May 1988 to June 1989. To investigate the ventricular overdrive suppression of subsidiary pacemaker, the response of the subsidiary pacemaker after IV administatin of drugs (atropine, isoproterenol, lidocaine) and the junctional recovery time were measured. RESULTS: Thtee patterns were obtained in the overdrive suppression test (fig.1). The recovery time of the subsidiary pacemaker was 364.5+/-212.15% of the basal R-R interval. Among seven of the eight patients who showed syncoped, the JRTmax were 3 times higher than the basal R-R interval. In one of eight, CJRT which represent the absolute time, was prolonged to 560 msec. In one case, we examined overdrive suppression test serially was which shows gradual decrement of junctional recovery time, and normal sinus rhythm was recovered at the 14th after the development of complete heart block. After VOS, the junctional recovery time of the subsidiary pacemaker was 364.5+/-212.1% of basal R-R interval in complete heart block group. After injection of atropine, the decrement of R-R interval was 5.51+/-3.88% of basal R-R interval. After injection of isoproterenol, the decrement of R-R interval was 32.76+/-8.09% of basal R-R interval. Marked increase of the basal heart rate was observed. After injection of lidocaine, the increment of R-R interval was 1.72+/-1.82% of basal R-R inteval. CONCLUSION: The results suggest that measurement of the junctional recovery time following overdrive suppression is useful for evaluation of stability of subsidiary pacemaker. And also the subsidiary pacemaker shows the better response to sympathomimetic agent than to parasympathetic blocker.

Frequency and Pattern of Traffic Accidents in Different Atmospheric Phenomena / 예방의학회지

In order to fine out the relationship between traffic accidents and atmospheric phenomena, we have analyzed 2,562 cases, one tenth of the total traffic accidents occurred in Taegu city for a year in 1988. The meteorological elements observed by Taegu Weather Bureau were used. It was divided into two largy categories: the patterns of accident as human injuries and destructions of car. When the accidents were overlapped in each other, it was considered as human injury. Human injuries were subdivided into three parts: death, severe damage. The average number of daily traffic accidents including human injuries were lowest in winter of four seasons. The accident patterns in accordance with the seasons showed statistically significant difference. The frequency was the highest as 3.3 case in an hour at 25.1-30.0 degrees C of atmospheric temperature, the rate of human injury showed the increase by the increased temperature. But there were not significant. Also it was the highest as 3.7 cases in less than 31% of humidity and the rate of human injury was the highest at 41-50%, but not significant. And it was the increasing tendency as wind speed increase, and the rate of human injury was the highest at 6.1-7.0m/sec, but it was not significant. In relation to precipitation, and visibility, were the highest as 5.4 cases at 5.1-10.0 mm of rainfall, the rate of human injury was increased by the increased precipitation and showed statistically significant. And it was highest within 6 Km of visibility, but the rate of the human injury was the lowest within same distance, and also showed significance. The accidents were higher with snow on the road, but the rate of human injury was comparatively lower, but no significance.

Clinical evaluation on 5 cases of lead Poisoning / 영남의대학술지

5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were ill defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2 gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M:E ratio was 0.7:1. The lead concentration in serum was increased in 4 cases (80%) of patients. Lead concentration, delta aminolevulinic acid concentration in 24 hours collected urine were increased in 5 patients (100%).