Predictors of successful outcome of acute paraquat poisoning: An analysis of 602 cases / 대한내과학회지

BACKGROUND: Acute paraquat poisoning has been notorious for fatal outcome. Even though many studies focus on successful treatment modality, there is no standard treatment so far. The purpose of this study was to determine the predictors of successful outcome of acute paraquat poisoning in 602 patients. METHODS: The paraquat exposure was assessed based on the estimated amount of paraquat and a semi-quantitative measure of urine paraquat. Initial laboratory parameters including hemoglobin, white blood cell count, pH, PaCO2, PaO2, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, total bilirubin, amylase, lipase, and glucose were obtained at the time of emergency room visit. Outcomes after acute paraquat poisoning were determined as survival and death. Multiple logistic regression analysis was applied to assess the predictors of outcome after acute paraquat poisoning. RESULTS: The estimated amount of paraquat was 45.6+/-74.1 mL and overall mortality after acute paraquat poisoning was 41.5%, whereas all were survived after skin contact or inhalation of paraquat. In multiple logistic regression analysis, death after acute paraquat poisoning increased significantly with the decreases in pH and PaCO2 and increases in white blood cell count, amylase, lipase, glucose, and paraquat exposure. CONCLUSION: In conclusion, percutaneous or inhalational route, smaller exposure of paraquat, and lesser degrees of leukocytosis, acidosis, pancreatic failures on admission are good prognostic factors of survival after acute paraquat poisoning.

Associations between asthma and anthropometric indices in korean adults / 천식및알레르기

BACKGROUND: Obesity is related to asthma symptoms and air way hyperresponsiveness. Both asthma and obesity are becoming worldwide chronic health problems. This study was designed to evaluate the association between asthma and anthropometric indices such as body mass index (TMI), body fat percent, and waist-hip ratio (WHR) in Korean adults. METHODS: Three thousand twenty-four subjects aged. 20-79 years, were enrolled in the survey during April - December, 2001. A standardized questionnaire was used to collect general information and asthma symptoms. Obesity was defined as BMI > or =25kg/m2. Over body fat and central obesity was defined as more than 75th percentile of body fat percent and WHR, respectively. RESULTS: The prevalence of asthma in korean adults was 29.6%(male 29.9% and female 29.33%). Asthma was significantly higher in elderly age (> or = 50 years), cigarette smokers. alcohol drinkers. patients with a family history of parent's asthma, and obesity. After adjusting for possible confounders. BMI [OR=1.33 (1.12-1.59)], over body fat [OR=1.28(10.7-1.54)] and central obesity [OR=1.41(1.17-1.70)] remained significant predictors of asthma. CONCLUSION: Our results showed that general obesity and central obesity are potential risk factors of asthma in relatively non-obese korean adults. Cigarette smokers, alcohol drinkers, patients with a family history of parent's asthma, and obesity may aggravate asthma, whereas regular exercise reduces the attacks of asthma.

Tissue Plasminogen Activator and Plasminogen Activator Inhibitor Type 1 Gene Polymorphism in Patients with Gastric Ulcer Complicated with Bleeding

Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) may be involved in the pathogenesis of peptic ulcers through suppression of fibrinolysis. This study was designed to investigate associations of t-PA and PAI-1 genes with clinical features of the patients with bleeding gastric ulcers. Eighty-four patients with peptic ulcers and 100 controls were studied between January 1998 and April 2000. We used polymerase chain reaction and endonuclease digestion to genotype for 4G/5G polymorphism in the promoter region of the PAI-1 gene and the Alurepeat insertion/deletion (I/D) polymorphism in intron h of the t-PA gene. Various clinical features, including lesion site, bleeding event, recurrence of ulcer, and rebleeding, were assessed using a multiple logistic regression model. The genotype distributions of both the t-PA and PAI-1 genes did not differ between the patient and control groups. The occurrence of the I/D or D/D genotype of t-PA was significantly higher in cases of duodenal ulcer (adjusted OR=4.39, 95% CI=1.12-17.21). When a dominant effect (i.e., 4G/4G or 4G/5G versus 5G/5G) of the 4G allele was assumed, the PAI-1 4G/4G genotype was independently associated with rebleeding after hemostasis (adjusted OR=5.07, 95% CI=1.03-24.87). Our data suggest that t-PA gene polymorphism is associated with duodenal ulcers, and that the PAI-1 gene may be a risk factor leading to recurrent bleeding after initial hemostasis.

Anti-Heparin-Platelet Factor 4 Antibody is a Risk Factor for Vascular Access Obstruction in Patients Undergoing Hemodialysis

Since heparin is an anticoagulant commonly used in hemodialysis and the patients on hemodialysis are repeatedly exposed to heparin, heparin may be the cause of the development of heparin-dependent antibodies and thrombotic complications in patients on hemodialysis. The purpose of this study was to determine the prevalence and the clinical significance of the antibodies against heparin-platelet factor 4 complexes as determined by enzyme immunoassay in patients on maintenance hemodialysis. The prevalence of anti-heparin-platelet factor 4 antibodies was higher in hemodialysis patients than in normal subjects (8.8 vs 0.0%, p<0.05). The number of past episodes of vascular access obstruction per year was significantly higher in the anti-heparin-platelet factor 4 antibody positive group than antibody negative group. Anti-heparin-platelet factor 4 antibody positive patients experienced more frequent vascular access obstructions than control subjects. In conclusion, anti-heparin-platelet factor 4 antibody might be a risk factor for vascular access obstructions in patients with end-stage renal disease on maintenance hemodialysis.

Helicobacter pylori and Telomerase Activity in Intestinal Metaplasia of the Stomach

BACKGROUND: Helicobacter pylori (H. pylori) has been considered a definitive carcinogen in gastric cancer. Telomerase is activated in gastric cancer and some premalignant gastric lesions, including intestinal metaplasia (IM). In this study, we evaluated the relationships of both H. pylori infection and telomerase activity with endoscopic and histologic features in IM. The effects of H. pylori eradication on endoscopic, histologic and biochemical changes were evaluated. METHODS: Endoscopic biopsies were obtained from 43 patients with IM for rapid urease, histologic and telomerase tests. The endoscopic and histologic features, H. pylori infection and telomerase were assessed. After H. pylori eradication, 15 patients were re-evaluated and compared after 4 months. RESULTS: Thirty-four (79.1%) patients were infected with H. pylori. The incidence of H. pylori infection was borderline correlated to the severity of IM (p=0.076). Telomerase was elevated in eight (18.6%) patients. Telomerase tends to be high in subtype III and endoscopic grade III of IM. After H. pylori eradication, endoscopic extent (p=0.039) and histologic severity (p=0.074) showed improvements, and telomerase decreased significantly (p=0.0001). CONCLUSION: Our data suggest that telomerase is associated with the severity and extent of IM and that H. pylori eradication improves the endoscopic and histologic features in IM, and decreases telomerase activity. H. pylori eradication can be considered one of the methods to prevent gastric cancer in patients with H. pylori-infected IM. Further long-term and large-scaled study will be needed.

Is Tumor Necrosis Factor Genotype (TNFA2/TNFA2)a Genetic Prognostic Factor of an Unfavorable Outcome in IgA Nephropathy?

The purpose of this study was to examine whether there are the associations between TNF alpha and TNF beta gene polymorphisms and the development and progression of Ig A nephropathy (IgAN). A cross-sectional study on TNF alpha and TNF betagene polymorphisms by polymerase chain reaction with restriction fragment length poly-morphisms was performed on 76 patients with primary IgAN confirmed by renal biopsy and 100 healthy controls. The allele with G-->A substitution was designated as TNFA2 for the TNF alpha gene and TNFB2 for the TNF betagene. A patient in whom dialysis treatment was started or whose serum creatinine became double or over during the follow-up duration was designated as a "progressor". The TNFA2/ TNFA2 genotype was more prevalent in the progressor than in the non-pregressor group (20.0 vs 3.3%, p<0.05). Clinical factors such as serum creatinine, systolic and diastolic blood pressure (p<0.001, respectively) were higher and pathologic factor such as Grade IV or V renal lesions was more prevalent (p<0.01) in the progressor than in the non-progressor group. Therefore, TNFA2/TNFA2 genotype may be a risk factor for the progression of IgAN.

Clinical observation of acute glyphosate intoxication / 대한내과학회지

BACKGROUND: Although glyphosate, organophosphorus herbicide, has been used extensively in agricultural area, no clinical data of acute poisoning have been reported in Korea. The current study evaluated clinical characteristics of acute intoxication by glyphosate. METHODS: We retrospectively collect and analysed the clinical data of 16 acute glyphosate poisoned patients admitted to the department of internal medicine, Soonchunhyang University Chunan hospital from January 1999 through June 2000. RESULTS: 1) Thirteen of sixteen poisoning were male and mean age was 44.2 year-old. 2) The main cause of glyphosate ingestion was suicide intent (12 cases, 75%), and clinical severity was divided into 3 categories : mild (14 cases), moderate (1 case) and severe (1 case). 3) Nausea and vomiting were the most frequent clinical features (each 6 cases) and dyspnea (4 cases), cough (3 cases), sputum (3 cases) and sore throat (3 cases) were followed. Leucocytosis, hepatotoxicity, anemia, hypoxia and renal toxicity were observed in 9,8,5,6 and 3 cases, respectively. 4) No fatal case and severe complication, except 1 aspiration pneumonia and 1 acute respiratory failure, were observed in acute glyphosate poisonings. CONCLUSION: Our data supported that acute glyphosate poisoning dose not result in fatal in humans even after intentional ingestion of glyphosate.

Prevalence of arthropod antibodies in Korean patients with allergic rhinitis

Arthropod antigens are main causative agents which induce allergic responses in humans. However, little information is known about the prevalence of specific arthropod allergens in Koreans with allergic diseases. The current study was designed to determine the positive rates of arthropod antibodies by the Korean inhalant panel of MAST-CLA. One hundred sixty patients, who were diagnosed with allergic rhinitis from an out-patient center at the Soonchunhyang University Chunan Hospital, were studied between August 1998 to July 2000. The overall positive rate, at least more than one specific antibody of arthropods such as Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and cockroach mix (Cm), was 46.9%. Each positive rate of Df, Dp, and Cm was 45.0%, 43.1%, and 8.8%, respectively. A significant agreement among arthropod allergens was observed (Df and Dp: 95.6%, Kappa = 0.911, P < 0.001). Our data supported the fact that arthropods were the most common allergens in Korean patients with allergic rhinitis; however, the MAST-CLA should be modified to increase specificity of arthropod allergens.

Associations between Lead Exposure and Dose and Protein Kinase C Activation in Erythrocytes Among Lead Workers / 대한산업의학회지

OBJECTIVES: Protein kinase C(PKC), a calcium and phospholipid dependent enzyme, is activated by lead in vitro at picomolar concentrations. However, the effect of lead on PKC has never been studied in a human population. The purpose of the study was to evaluate whether lead exposure was associated with PKC mediated-phosphorylation in erythrocytes among lead workers. METHODS: Two hundred and twelve lead workers were studied. To determine the levels of phosphorylation in vivo, an in vitro back phosphorylation technique was used by adding PKC and gamma-32P to preparations of erythrocyte membranes. We measured back phosphorylations of erythrocyte membrane proteins, spectrin, and 52 kDa and 48 kDa, as an indirect measure of PKC activation in vivo. RESULTS: The mean(SD) age and exposure duration was 39.1(10.0) years and 8.1(6.5) years, respectively. Tibial lead ranged from 0.8 to 290.8 microgram Pb/g bone mineral with a mean(SD) of 34.4(35.2) microgram Pb/g bone mineral. The means(SD) of back phosphorylation levels of the three proteins were 540.7(304.1), 198.6(78.2), and 247.7(83.3) photostimulated luminescence units(PSL), respectively, by phosphoimager. After adjustment for potential confounding factors, tibial lead and exposure duration were significantly and inversely associated with back phosphorylation levels. One unit of increase in tibial lead(1 microgram Pb/g bone mineral) is associated with a decline in spectrin, band 4.9 52 kDa, and band 4.9 48 kDa back phosphorylation levels by 1.4(P<0.05), 0.34(P<0.05), and 0.47(P<0.01), respectively. However, there were no associations between the back phosphorylation levels and either blood lead or ZPP levels. CONCLUSIONS: These findings suggest that the PKC activity in erythrocytes is increased by chronic lead exposure and that erythrocyte membrane protein phosphorylation may be a biomarker of lead exposure.

The Relationship between Psychosocial Distress and Lead Exposure Indices in Lead Workers / 대한산업의학회지

OBJECTIVES: This study was carried out to assess psychosocial distress of lead workers and to examine the relationship between lead exposure indices and psychosocial distress. METHODS: The study design was cross-sectional and research subjects were 234 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), -aminolevulinic acid in urine(ALAU) were selected as indicators of lead exposure. RESULTS: There was significant difference in PWI according to lead exposure level and job characteristics. The results of correlation analysis showed that PWI was significantly correlated with PbB(r=0.203, P=0.002). CONCLUSIONS: Our results supported the association between lead exposure and psychosocial distress. The inclusion of psychosocial distress measurement as a special health examination for lead workers was highly recommended for the effective health management.

Expression of MMP-2 (Matrix Metalloproteinase Type 2) and TIMP-2 (Tissue Inhibitor of Metalloproteinase Type 2) in Color

PURPOSE: The matrix metalloproteinases (MMPs) have been implicated in proteolysis of basement membrane for initiation of metastatic cascade. Tissue inhibitors of metalloproteinases (TIMPs) are specific inhibitors of MMPs. The purpose of this study was to evaluate the expression of MMP-2 and TIMP-2 in human colorectal carcinomas. METHODS: The paraffin blocks of 140 colorectal carcinomas were recalled and immunostained with monoclonal antibodies specific for MMP-2 and TIMP-2. These antibodies were effective on formalin fixed, paraffin embedded sections. The rate of stain was estimated, and the relationships between the expression and the stage, the differentiation, lymph node metastasis, distant metastasis and the survival rate were assessed. RESULTS: MMP-2 was present in 31.4% of colorectal cancers. TIMP-2 was identified in 63.6% of tumors. The expression of MMP-2 was significantly associated with the presence of lymph-node metastasis, the stage, and the presence of distant metastasis. However the expression of TIMP-2 was not correlated with any risk factors. CONCLUSIONS: These results suggest that MMP-2 could predict the ability of cancer invasion and be used as a prognostic factor for the colorectal adenocarcinoma.

A study of HLA-DR polymorphism in four physical constitution groups classified by Korean traditional medicine / 대한내과학회지

BACKGROUND: In Korean traditional medicine, human beings are classified into 4 groups accordance with the characteristics of physical constitution, named; Taeum, Taeyang, Soum, and Soyang. Most of Korean traditional doctors believe that the back ground of pathophysiology is differ among each group in many diseases. HLA is the most polymorphic gene and related with human immune response. It has been used for determination of individual identification, genetic diversity and a study of disease association in different ethnic group. It has well known that the most human inflammatory disease which thought to have some autoimmune basis are in some way promoted by genes of the HLA region. The purpose of this study is to observe the distribution of HLA-DR genotypes in 4 types of physical constitution in Korean traditional medicine. METHODS: Three hundred and ten Korean subjects(Soyang : 58cases, Soum :142cases, Taeum : 92cases, Taeyang : 18cases) were enrolled for this study. Genomic DNAs extracted by phenol/chroloform were amplified with allele specific primers and determined by 2% agarose gel electrophoresis with ethidium bromide staining for analysis of HLA-DR polymorphism. RESULTS: The genotype frequency of HLA-DR in a total or 310 Koreans was DR1 ; 7.2%, DR 2; 10.5%, DR 3;1.7%, DR 4; 19.9%, DR 5; 11.9%, DR 6;19.9%, DR 7; 7.0%, DR 8; 10.6%, DR 9; 8.7%, DR10;1.9%. There was no significant diffrence of HLA-DR genotype distribution among four physical constitution groups classified by Korean traditional medicine. CONCLUSION: Our results suggest that the classification of physical constitution in Korean traditional medicine is not related to HLA-DR genotypes.

Different Effect of Blood Lead on Zinc Protoporphyrin by Gender in Korean Lead Workers / 예방의학회지

OBJECTIVES: To evaluate whether a relation between blood lead and zinc proto porphyrin(ZPP) was modified by gender in Korean lead workers. METHODS: A cross-sectional study was conducted with 1,304 male and 101 female subjects in 1997. The relation between blood lead and ZPP were evaluated with linear, exponential, and quadratic models. Then, the different effect of gender on the relation was examined by adding the interaction terms in the each model. RESULTS: Mean+/-SD of blood lead and ZPP level was different between male(27.7+/-10 microgram /dl and 51.3+/-23.4 microgram/dl) and female subjects(22.5+/-9.2 microgram/dl and 78.7+/-38.6 microgram/dl). After adjusting for possible confounders, the effect modification by gender was significant in linear(beta=1.119, p<0.001), exponential(beta=Exp(0.008), p<0.05), and quadratic model(beta= 1.388, p<0.001). In separate analysis, a quadratic relation between blood lead and ZPP was shown in male lead workers(beta=0.036, p<0.001), but an exponential relation in female lead workers(n=Exp(0.029), p<0.001). CONCLUSION: Our data showed that the increasing rate of ZPP in female were always higher than in male lead workers, suggesting that females were more susceptible to occupational lead exposure than males.

The effect of smoking and drinking habit on the health status of lead workers / 예방의학회지

To investigate the effect of smoking and drinking habit on the health status in lead using industries, 2,785 male workers in lead using industries (7 storage battery industries, 7 secondary smelting and related industries, and 4 primary metal and other manufacturing industries) were selected for this study. This study was carried out as a part of periodic health examination. Selected study variables were zinc protoporphyrin in whole blood (ZPP), SGOT and SGPT for laboratory test. Questionnaire for lead related symptoms and smoking and drinking habit was provided to all the workers and filled up by themselves and reconfirmed by physician. The results obtained were as follows; 1. The overall smoking and drinking rate of study population were 69.8% and 73.6%, respectively. While the smoking and drinking rate of storage battery workers were 68.8% and 72.3%, those of secondary smelting industries and other industries were 66.0% and 66.4% and 74.6 and 80.3% respectively. 2. While the mean values of blood ZPP of lead exposed workers were significantly higher than other group, those of SGOT of storage battery workers were significant higher than other worker. But there were no differences of mean values of other variables. 3. Smoking habit did not affect on the mean value of blood ZPP of workers in special health examination group, but there were significant differences of blood ZPP and SGOT between drinker and non-drinker. 4. Symptom prevalence of lead exposure were higher in drinking and smoking group than non-drinking and non-smoking group. 5. In multiple regression analysis of the total lead related symptoms, blood ZPP, SGOT, and SGPT as dependent variable, respectively, and age, work duration, blood ZPP, pack year and amount of alcohol drinking as independent variables, work duration, pack year, amount of alcohol drinking, age contributed to total symptoms; and age, work duration, pack year contributed to blood ZPP; and age, amount of alcohol drinking, work duration contributed to SGOT; and pack year contributed to SGPT.

Some Renal Function Indices in Workers Occupationally Exposed to Lead / 대한산업의학회지

The influence of lead exposure on renal function was studied. Three hundred forty two male lead exposed workers who worked in 3 storage battery factories, 5 secondary smelting factories and 3 litharge making factories, and 60 male control workers who were not exposed to lead occupationally were chosen for this study. Blood lead (PbB), zinc protoporphyrin in whole blood (ZPP) and delta-aminolevulinic acid in urine (DALA) were selected as indicators of lead exposure. As indicators of renal function blood urea nitrogen(BUN) , serum creatinine(S-Cr), serum uric acid (S-UA), N-acetyl-beta-D-glucosaminidase in urine (NAG) and urine protein (U-TP) were selected. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of renal function indicators of exposed except S-UA were significantly different from non-exposed. The frequency of workers whose value of renal function indicators were over the nor mal criteria (BUN>20 mg/dl ; S-Cr>1.2 mg/dl ; S-UA>7.0 mg/dl ; NAG>8.0 U/liter; U-TP>8.0 mg/dl) by the level of lead absorption in terms of PbB, ZPP and DALA were calculated. Age adjusted odds ratio of over the normal value of BUN and NAG were statistically significant by the level of ZPP and that of BUN only showed the dose-dependant relationship. But the frequency of over the normal criteria of renal function indicators were not increased by the level of PbB and DALA. On stepwise multiple regression using renal function indicators as a dependent variable and each lead exposure indicator and age as independent variables, only BUN, NAG and U-TP were contributed by the lead exposure indicators. It was found that only NAG of renal function indices was most reliable indicator who showed dose-response relationship with lead exposure and the measurement of NAG for lead workers whose relatively high exposure is highly recommended.

Occupational Lead Exposure of Storage Battery Industry Workers in Korea / 대한산업의학회지

In order to investigate the level of lead absorption of lead workers and to evaluate the effect of blood lead on blood zinc protoporphyrin (ZPP) and prevalence of lead related symptoms, 1,782 lead workers(male: 1,506, female: 276) from 8 storage battery industries were studied. Selected variables as indices of lead exposure were blood lead, blood ZPP, and hemoglobin (HB). Fifteen questionnaires of lead related symptoms were provided to all lead workers and filled up by themselves and confirmed by medical doctors. Personal variables such as age, work duration, smoking and drinking habits were also collected. The results were follows : 1. While the mean blood lead of lead workers of all lead companies was 31.0+/-3.0 ug/100ml (male: 31.5+/-2.9 ug/100ml, female: 27.9+/-3.3 ug/100m1), the mean blood ZPP of all lead workers was 66.7+/-4.1 ug/100ml (male: 59.6+/-3.3, female: 105.3+/-3.0 ug/100ml). The mean hemoglobin of male lead workers was 15.7+/-.3 gm/100ml and that of female lead workers was 13.0+/-.3 gm/100ml. 2. The percentage of lead workers whose blood lead was over 60.0 ug/100m1 and 40.0-59.9 ug/100ml was 2.81 % and 19.08 %, respectively. On the other hand, the percentage of lead workers whose blood ZPP was over 150 ug/100ml and 100-149 ug/100ml was 5.89 % and 8.31 %, respectively. 3. The slopes of simple linear regression of blood lead (independent variable) and blood ZPP in female lead workers was significantly steeper than that of male lead workers. The slope of storage battery industries with better working condition in terms of low air concentration of lead were less steeper than those with poor working condition with high mean air concentration of lead. 4. Stepwise multiple regression analysis, using overall symptom prevalence as a dependent variables, blood lead, blood ZPP, hemoglobin, age, work duration, drinking and smoking habits as independent variables, indicated that only drinking habit and age were significantly contributed to the dependent variable.

163 Cases of Decompression Sickness Among Korean Divers / 대한산업의학회지

This study was performed to obtain an useful and basic information of the decompression sickness (DCS) among Korean divers. The medical records of 163 cases of Korean civilian diver, who were diagnosed as DES and received recompression therapy according to U.S. Navy Standard Recompression Treatment Table at Ocean & Underwater Medical Research & Training Center of ROK Navy, for 10 years from Jan. 1983 to Dec.1992. The total of 163 cases of DCS were catagorized into 2 groups as Type I DCS and Type II DGS group. The major results obtained were as follows: 1. 70.5% of total cases were classified as type II DCS, and the ratio of type I to type II DCS was 1'2.5 and the ratio of male to female of DCS cases was about 4:1. 2. About one third of cases occurred in May and June, and 38.7% of cases occurred at Chung-mu and Chin-hae in Kyung-nam province, the Southern Coast of Korean Peninsula. 3. Among the type II DGS group, 85.2% occured in diving for harpshell, and 85.2% with hookah diving gear. 4. There were no cases following the decompression procedure such as well known U.S. Navy's, and 86.7% of cases did not follow the any kinds of decompression procedure for preventing DCS and most of dives were conducted repetitively with 4.2 times on an average. 5. The mean depth between type I(27.3m) and type 11 DCS group(33.3m) showed significant difference statistically (p0.05) . 6. The rate of symptoms appeared on surfacing and within 10 min. after surfacing of type I and type II DCS were 40.0% and 70.5%, respectively. And 80.9% of type I and 92.2% of type II DCS group were aware of dysbaric symptoms within the first hour after surfacing. 7. The most frequent symptoms and its percentages were "Both limb pain (37.6%) ",Joint pain(27.1%)., and "Scapular pain(22.9%)" in type I DCS group, and "Limb weakness or paralysis (68.7%)" , "Respiratory chokes(27.8%)" and "Bladder dysfunction(22.2%)"intypellDCSgroup. . 8. Among the type II DCS group, 54.8% attempted inwater recompression as a primary management, but 54.2% of type I DCS group did not take any kinds of therapeutic measure after onset of dysharic symptoms till commencing recompression treatment. 9. Recompression treatment was delayed 126.9 hours in type I and 89.7 hours in type II DCS group on an average, and the cases of DCS, who delayed more than two days till visiting the recompression facility, were occupied 52.1% in type I and 29.6% in type II DCS group. 10. Among the total cases, 32.6% were experienced one more of dysbaric symptoms in the past.

Relationship of between blood lead level and lead related symptoms in low level lead exposure / 예방의학회지

This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead (PBB), Zinc-protoporphy (ZPP), hemoglobin (HB) and personal history, and completed 15 questionnaires related to symptoms of lead absorption; also measured lead concentration in air (PBA) in the workplace. The results obtained were as follow; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were 26.1+/-8.8 microgram/dl, 28.3+/-26.0 microgram/dl and 16.2+/-1.2g/dl; whereas those of nonexposed workers were 18.7+/-5.1 microgram/dl, 20.6+/-8.7 microgram/dl and 17.3+/-1.1g/dl. The means of above three indicies between two groups showed significant difference statistically (p0.05). 3. The most frequently by complained symptom was "Generalized weakness and fatigue", and fewest symptom was "Intermittent pains in abdomen". 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were "Intermittent pains of abdomen" and "Joint pain or arthralgia" (p<0.05). No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms. 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.

A cross-sectional study on prevalence rate and contributing factors of fatty liver diagnosed by ultrasonography / 예방의학회지

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.

A study on the status of working environment control and health management of workers in a manufacturing industries / 예방의학회지

To obtain the useful information for the status of working environment and health management of workers in manufacturing industries, comparision of results on the status of working environmental and health management of workers for 32 manufacturing industries in Chunam area from 1988 to 1989 was carried out. The results were as follows: 1. The rate of over-PEL(Permissible Exposure Limit) to for hazardous factors decreased significantly 23.5% in 1988, 18.3% in 1989 (p<0.05) and, the highest rate of over-PEL was the stone and sand handling industry, the highest rate of over-PEL was the dusty worplace as 38.5% in 1988, 35.2% in 1989. 2. The rate of workers exposed to hazardous factors in 1988 and in 1989 was 22.4% respectively, the rate of workers checked up special health examination was 40.1% in 1988, 75.3% in 1989. In stone and sand handling an dmedicochemical industries, none of workers exposed to hazardous factors was subjected to special health examination in 1988, but 75% of workers exposed to hazardous factors had checked up in 1989. 3. The 6 industries appointed as part-time factory physician among 17 industries which were supposed to have factory physician according to the Safety and Healthy Act of Korea, 6 out of 24 industries only appointed industrial hygienist, furthermore 4 out of 6 hygienists had another duty in addition to occupational hygiene itself.