Oxysterol 25-hydroxycholesterol as a metabolic pathophysiological factors of osteoarthritis induces apoptosis in primary rat chondrocytes

The aim of the present study was to investigate the pathophysiological etiology of osteoarthritis that is mediated by the apoptosis of chondrocytes exposed to 25-hydroxycholesterol (25-HC), an oxysterol synthesized by the expression of cholesterol-25-hydroxylase (CH25H) under inflammatory conditions. Interleukin-1β induced the apoptosis of chondrocytes in a dose- dependent manner. Furthermore, the production of 25-HC increased in the chondrocytes treated with interleukin-1β through the expression of CH25H. 25-HC decreased the viability of chondrocytes. Chondrocytes with condensed nucleus and apoptotic populations increased by 25- HC. Moreover, the activity and expression of caspase-3 were increased by the death ligand-mediated extrinsic and mitochondria-dependent intrinsic apoptotic pathways in the chondrocytes treated with 25-HC. Finally, 25-HC induced not only caspasedependent apoptosis, but also induced proteoglycan loss in articular cartilage ex vivo cultured rat knee joints. These data indicate that 25-HC may act as a metabolic pathophysiological factor in osteoarthritis that is mediated by progressive chondrocyte death in the articular cartilage with inflammatory condition.

Complications and outcomes following inguinal lymphadenectomy for malignant melanoma in an Asian population

Purpose@#Melanoma is a potentially fatal cutaneous malignancy and regional lymph node (LN) metastases are the most important predictors of mortality. This study aimed to analyze clinical features and risk factors of complications associated with inguinal LN dissection (LND) to establish treatment protocols. @*Methods@#This single-center retrospective study (2000 to 2018) consisted of patients who underwent inguinal area sentinel LN biopsy (SLNB) or LND due to malignant melanoma. Risk factors and outcomes were analyzed. @*Results@#One hundred patients underwent SLNB alone (n=67; patients with negative SLNB), complete LND (CLND) after positive SLNB (n=19), or radical LND without SLNB (n=14). Five-year overall survival and disease-free survival rates among these groups were 87.3%, 57.4%, and 61.9%, and 59.0%, 22.7%, and 28.1%, respectively. The complication rate in the SLNB alone group was lower than the other groups (22.4% vs. 47.4% and 35.7%, respectively; P=0.048). Seroma was the most common complication in the SLNB alone group (15.0%); lymphedema was most common in the CLND after SLNB group (21.1%). Multivariate analysis of risk factors for postoperative complications found the hazard ratio for body mass index >28 kg/m2 was 4.376 (95% confidence interval [CI], 1.243–15.401; P=0.022). The hazard ratio for LND (including CLND after SLNB and radical LND without SLNB) was 3.263 (95% CI, 1.248–8.529; P=0.016). @*Conclusion@#Inguinal LND is a higher risk procedure compared to SLNB and other sites for postoperative complications, irrespective of meticulous surgical techniques. More studies are needed to establish treatment protocols (e.g., observation vs. CLND after a positive SLNB result) and the risks and benefits in Asian populations.

Prognosis predictability of combination between lactate and SMART-COPin elderly hospitalized patients with community-acquired pneumoniain the emergency department

Objective@#Community-acquired pneumonia (CAP) in older patients is a potentially life-threatening infection with a poorprognosis. Therefore, is important to predict the mortality rate of CAP for older patients. This study examined the effectsof predictive increases on CAP mortality by adding a biomarker to known CAP severity prediction tools. @*Methods@#A retrospective analysis of information was conducted on patients older than 65 years, who were treated withCAP in five emergency departments from October 2016 to February 2017. The primary outcome was the 28-day mortality.The following were calculated for each patient: qSOFA (quick Sequential Organ Failure Assessment), A-DROP (Age,Dehydration, Respiratory failure, Orientation, blood Pressure), CURB-65 (Confusion, Urea level, Respiratory rate, Bloodpressure, age≥65 years), SMART-COP (Systolic blood pressure, Multilobar infiltrates, Albumin, Respiratory rate,Tachycardia, Confusion, Oxygen and pH), NLR (neutrophil:lymphocyte ratio), PLR (platelet:lymphocyte ratio), and CAR(high-sensitivity C-reactive protein:albumin ratio). The prognostic value for the 28-day mortality was determined by multivariatelogistic regression analysis. @*Results@#The 28-day mortality was 12.0% of 693 CAP patients. Multivariate logistic regression analysis showed that lactate(odds ratio [OR], 1.589; P<0.001) and CAR (OR, 1.208; P=0.006) were correlated with the 28-day mortality. NLR(OR, 1.00; P=0.983) and PLR (OR, 1.00; P=0.784) were not correlated. The area under curve (AUC) was significant asCAR 0.649, lactate 0.737, and SMART-COP 0.735 (P<0.001), and the AUC of lactate+SMART-COP increased significantlyto 0.784 compared to SMART-COP (P=0.014). @*Conclusion@#A combination of lactate and SMART-COP can be used as a tool to assess the severity of older hospitalizedCAP patients who visited emergency departments.

Complications and outcomes following inguinal lymphadenectomy for malignant melanoma in an Asian population

Purpose@#Melanoma is a potentially fatal cutaneous malignancy and regional lymph node (LN) metastases are the most important predictors of mortality. This study aimed to analyze clinical features and risk factors of complications associated with inguinal LN dissection (LND) to establish treatment protocols. @*Methods@#This single-center retrospective study (2000 to 2018) consisted of patients who underwent inguinal area sentinel LN biopsy (SLNB) or LND due to malignant melanoma. Risk factors and outcomes were analyzed. @*Results@#One hundred patients underwent SLNB alone (n=67; patients with negative SLNB), complete LND (CLND) after positive SLNB (n=19), or radical LND without SLNB (n=14). Five-year overall survival and disease-free survival rates among these groups were 87.3%, 57.4%, and 61.9%, and 59.0%, 22.7%, and 28.1%, respectively. The complication rate in the SLNB alone group was lower than the other groups (22.4% vs. 47.4% and 35.7%, respectively; P=0.048). Seroma was the most common complication in the SLNB alone group (15.0%); lymphedema was most common in the CLND after SLNB group (21.1%). Multivariate analysis of risk factors for postoperative complications found the hazard ratio for body mass index >28 kg/m2 was 4.376 (95% confidence interval [CI], 1.243–15.401; P=0.022). The hazard ratio for LND (including CLND after SLNB and radical LND without SLNB) was 3.263 (95% CI, 1.248–8.529; P=0.016). @*Conclusion@#Inguinal LND is a higher risk procedure compared to SLNB and other sites for postoperative complications, irrespective of meticulous surgical techniques. More studies are needed to establish treatment protocols (e.g., observation vs. CLND after a positive SLNB result) and the risks and benefits in Asian populations.

Oxysterol 25-hydroxycholesterol as a metabolic pathophysiological factors of osteoarthritis induces apoptosis in primary rat chondrocytes

The aim of the present study was to investigate the pathophysiological etiology of osteoarthritis that is mediated by the apoptosis of chondrocytes exposed to 25-hydroxycholesterol (25-HC), an oxysterol synthesized by the expression of cholesterol-25-hydroxylase (CH25H) under inflammatory conditions. Interleukin-1β induced the apoptosis of chondrocytes in a dose- dependent manner. Furthermore, the production of 25-HC increased in the chondrocytes treated with interleukin-1β through the expression of CH25H. 25-HC decreased the viability of chondrocytes. Chondrocytes with condensed nucleus and apoptotic populations increased by 25- HC. Moreover, the activity and expression of caspase-3 were increased by the death ligand-mediated extrinsic and mitochondria-dependent intrinsic apoptotic pathways in the chondrocytes treated with 25-HC. Finally, 25-HC induced not only caspasedependent apoptosis, but also induced proteoglycan loss in articular cartilage ex vivo cultured rat knee joints. These data indicate that 25-HC may act as a metabolic pathophysiological factor in osteoarthritis that is mediated by progressive chondrocyte death in the articular cartilage with inflammatory condition.

Distribution of Pathogenic Vibrio Species in the Coastal Seawater of South Korea (2017–2018)

OBJECTIVES: Pathogenic Vibrio species are widely distributed in warm estuarine and coastal environments, and can infect humans through the consumption of raw or mishandled contaminated seafood and seawater. For this reason, the distribution of these bacteria in South Korea was investigated.METHODS: Seawater samples were collected from 145 coastal area points in the aquatic environment in which Vibrio species live. Environmental data (i.e., water temperature, salinity, turbidity, and atmospheric temperature) was collected which may help predict the distribution of the species (data not shown). Seawater samples were filtered, and incubated overnight in alkaline peptone water, at 37°C. Using species-specific polymerase chain reaction methods, screening tests were performed for the hlyA, ctxA, vvhA, and tlh genes. Clones of pathogenic Vibrio species were isolated using 3 selective plating media.RESULTS: In 2017, total seawater isolation rates for Vibrio vulnificus, Vibrio cholerae (non-pathogenic, non-O1, non-O139 serogroups), and Vibrio parahaemolyticus were 15.82%, 13.18%, 65.80%, respectively. However, in 2018 isolation rates for each were 21.81%, 19.40%, and 70.05%, respectively.CONCLUSION: The isolation rates of pathogenic Vibrio species positively correlated with the temperature of seawater and atmosphere, but negatively correlated with salinity and turbidity. From 2017 to 2018, the most frequent seawater-isolated Vibrio species were V. parahaemolyticus (68.10 %), V. vulnificus (16.54%), and non-toxigenic V. cholerae (19.58%). Comprehensive monitoring, prevention, and control efforts are needed to protect the public from pathogenic Vibrio species.

Evaluation of clinical usefulness of pneumococcal urinary antigen test: single center experience

OBJECTIVE: A pneumococcal urinary antigen (PUA) test, which can be performed quickly and easily, is performed frequently in emergency rooms because of its high sensitivity and specificity. On the other hand, it is a relatively expensive test, and it is not known how it affects the clinicians' prescription of antibiotics. This study evaluated the clinical utility of the PUA test. METHODS: This study was conducted retrospectively on patients aged ≥18 years, who underwent a PUA test and were hospitalized with a diagnosis of pneumonia in an emergency room from January to December 2016. The patients were divided into a PUA test positive group and negative group, and the clinical characteristics and antibiotic regimen were compared. RESULTS: A total of 533 patients were enrolled, of which 54 were positive and 479 were negative. The antibiotic prescriptions were similar in the positive and negative groups. After the PUA test result, only two of the positive group used the antibiotics recommended by the Infectious Diseases Society of America and the American Thoracic Society for Streptococcus pneumoniae. Furthermore, there was an appropriate change in eight patients after the blood culture test, but the PUA test result was judged to be meaningful in only two patients. CONCLUSION: The results of the PUA test did not affect the clinician's antibiotic prescription significantly. A prescription standard for the PUA test is needed, and it should be performed after admission rather than in the emergency room.

Evaluation de la protection auditive des travailleurs d'une usine de transformation de fèves de cacao de 2010 à 2011 en Côte d'Ivoire

En raison de la gravité de l'impact du bruit sur la santé des travailleurs exposés, la prévention apparaît comme l'alternative essentielle pouvant en supprimer ou en limiter l'impact.Objectif : Evaluer l'efficacité des mesures de protection auditive des opérateurs.Matériel et méthodes : Une étude descriptive et transversale d'une durée de 8 mois a été conduite dans une entreprise de transformation de fèves de cacao. L'étude comportait une étude de poste avec mesurage des niveaux sonores au moyen d'un sonomètre intégrateur conforme à la norme IEC 61672 : 2003 calibré, une analyse des équipements de protection auditive et un examen ORL avec des tests audiométriques.Résultats : L'échantillon était composé de 235 opérateurs dont 212 hommes (90%) et 23 femmes. La moyenne d'âge était de 37 ans (IC variant de 37,5 ± 17,5). Dans l'atelier de torréfaction, le bruit émis atteignait jusqu'à une intensité de 101,3 Lex, d (dB) en 2008. Le broyeur et la plate-forme produisaient une intensité sonore de 99,7 Lex, d (dB) en 2010. Les niveaux sonores variaient de 80,3 à 101,3dB. Cinq formations et 6 réunions du CHSCT ont été organisées de 2006 à 2012. Les casques 3M™ 1435 avaient un degré d'atténuation plus élevé (25dB). Les bouchons d'oreilles Ear Tracer™ présentaient un degré d'atténuation plus élevé.L'audition était normale chez 142 opérateurs dont deux groupes de 3 et de 6 personnes présentaient respectivement une surdité de perception et une surdité de transmission. Deux autres travailleurs étaient atteints d'une surdité de transmission.Conclusion : Le bruit est une nuisance professionnelle grave en raison de son impact négatif sur la santé des travailleurs. Elle est omniprésente en milieu industriel. Cependant l'observation rigoureuse des mesures de prévention permettent d'éviter ce risque ou d'en réduire la gravité

Acute Pancreatitis Induced by Quetiapine in an Elderly Patient

Quetiapine is an atypical antipsychotic that is frequently used to manage delirium in geriatric patients. Acute pancreatitis associated with quetiapine has rarely been reported. A 70-year-old male presented with severe abdominal pain a few hours after taking a dose of quetiapine prescribed for delirium. Despite the lack of risk factors of pancreatitis in his medical history, the patient had a slight increase of serum lipase and amylase levels. His general condition improved on discontinuation of quetiapine. A month later, quetiapine was readministered for the recurrence of delirium. Subsequently, the patient developed the same symptom with a significant increase in serum pancreatic enzyme levels, confirming that quetiapine induced the pancreatitis. We reported the first case of quetiapine-induced pancreatitis in Korea, together with a review of the literature.

Risk Factors for Cystic Periventricular Leukomalacia in Very Low Birth Weight Infants

PURPOSE: In the present study, we aimed to determine the risk factors for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight (VLBW) infants. METHODS: We reviewed the medical records of 309 infants weighing less than 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Medical Center, Seoul from April 2007 to December 2012. Thirty-nine infants died within 28 days of birth. Of the remaining 270 infants, 21 with CPVL established by cranial ultrasonography, and 63 without CPVL, who were matched for gestational age, were enrolled in this study. Univariate and multivariate analyses of maternal, perinatal, and neonatal risk factors for CPVL were performed through retrospective assessment of data collected from the medical records. RESULTS: Necrotizing enterocolitis (NEC > or =stage II: 42.9% vs. 9.5%, P=0.002), culture-proven sepsis (66.7% vs. 34.9%, P=0.021), hypotension with sepsis (33.3% vs. 6.3%, P=0.004), and severe intraventricular hemorrhage (> or =grade III: 61.9% vs. 22.2%, P=0.002) were associated with the development of CPVL on univariate analysis. Using multivariate logistic regression analysis, two variables were found to be statistically significant independent risk factors: NEC (> or =stage II: adjusted OR, 5.12; 95% CI, 1.219-21.514; P=0.026) and hypotension with sepsis (adjusted OR, 8.23; 95% CI, 1.194-56.713; P=0.032). CONCLUSION: NEC (> or =stage II) and hypotension with sepsis were associated with an increased risk of developing CPVL in VLBW infants.

Proportion of Multidrug-Resistant Tuberculosis in Human Immunodeficiency Virus/Mycobacterium tuberculosis Co-Infected Patients in Korea

Much controversy surrounds the issue of whether HIV infection is a risk factor for developing multidrug-resistant tuberculosis (MDR-TB). In this study, we evaluated the prevalence of and risk factors for MDR-TB in HIV-infected patients at the National Medical Center of Korea. We reviewed the medical records of HIV/TB co-infected patients from January 2005 to May 2011; the drug susceptibility profiles were available for 55 patients. Of these, 32.7% had MDR-TB, which was approximately 3.6 times higher than the prevalence among the general population. Additionally, there were more additional AIDS-defining clinical illnesses in the MDR-TB group than in the non-MDR-TB group (27.8% vs 5.4%, P = 0.032). These results suggest that HIV infection and HIV-related immunosuppresion may contribute to the development of MDR-TB.

An Evaluation of Effects on Hypertension and Diabetes Mellitus Management of a Community-Based Nursing Care Center Using Cost-Benefit Analysis / 간호행정학회지

PURPOSE: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. METHODS: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. RESULTS: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. CONCLUSION: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.

Use of Home Nursing Therapy and Need of Home Care Equipments

This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.

Localization of E-cadherin Along the Nephron Segments in the Rat Kidney / 대한해부학회지

E-cadherin is a cell adhesion molecule that is expressed abundantly in the kidney. However, the expression pattern in various renal epithelial cells is not well established. The purpose of this study was to determine the cellular localization along the nephron segments in the rat kidney. Kidneys from adult Sprague Dawley rats were fixed in 4% paraformaldehyde and processed for immunohistochemistry. Bumetanide-sensitive Na+/K+/2Cl- cotransporter (BSC1), thiazide-sensitive Na+/Cl- cotransporter (TSC), calbindin D28k, and H+-ATPase were used to identify the thick ascending, distal convoluted stubule, connecting tubule, and collecting duct, respectively. In the rat kidney, Ecadherin was expressed mainly in the basolateral domain of the collecting duct and papillary surface epithelial cells. The expression level of E-cadherin changed gradually in the connecting tubule and became moderate in the distal convoluted tubule, thick ascending limb, and loop of Henle. The S1 and S2 segment of the proximal tubule showed weak immunoreactivity. However, E-cadherin was not expressed in the S3 segment of the proximal tubule in the rat kidney. These results suggest that E-cadherin is a major adhesion molecule in the collecting duct and papillary surface epithelium, and that E-cadherin may play a critical role in maintaining the epithelial polarity of these nephron segments.

Dehydration Increases Osteopontin Expression in Rat Kidney / 대한해부학회지

Osteopontin (OPN), is a secreted phosphoprotein that is expressed in the normal kidney. However, little is known about the role of OPN in the kidney. The purpose of this study was to establish the effect of dehydration on renal OPN expression. Dehydrated rats had free access to normal rat chow, but were deprived of water for 3 days. Kidney tissues were preserved by in vivo perfusion with paraformaldehyde-lysine-periodate (PLP) and processed for immunocytochemistry and in situ hybridization. Serum sodium concentration and urine osmolality were increased in dehydrated rats. Both OPN mRNA and protein were expressed restrictively in the descending thin limb (DTL) and papillary surface epithelium (PSE) in control kidneys. In dehydrated kidneys, there was an increase in OPN mRNA and protein expression in the thick ascending limb (TAL) as well as DTL and PSE. Electron microscopy revealed that OPN immunoreactivity in the DTL and TAL cells was located in the Golgi apparatus and in small cytoplasmic vesicles. These results demonstrate that dehydration status increases the expression of OPN in renal tubules and stimulates the secretion into the urine.

Working Conditions in Home Health Care Nursing: A Survey of Home Care Nurses in Hospitals in Korea / 간호학회지

PURPOSE: The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals. METHOD: The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of 71.8%. RESULT: (a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid penalties (65.9%). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain (61.5%), lower back pain (54.1%), knee pain (39.4%), and gastrointestinal problems (33.0%). CONCLUSION: These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.

A Clinical Study on the Effect of a Cream Containing Ramulus Mori Extract and Tea Tree Oil on Acne Vulgaris and Aerobic Skin Flora / 대한피부과학회지

BACKGROUND: The exact role of aerobic bacteria in the pathogenesis of acne remains controversial but several reports showed that these microorganisms were important in the development of acne lesions and affected the severity of acne by being involved in the inflammatory process. There were several attempts to improve and prevent the acne lesions by using soap or cosmetics containing anti-microbial agents. OBJECTIVE: The purpose of this study was to compare the sebum secretion rates and the number of aerobic bacteria in acne patients after 4 weeks trial of RT cream containing 0.1% tea-tree oil and 0.01% Ramulus mori extract. METHODS: We studied 10 normal controls and 20 acne patients. Sebum secretion was measured by Sebumeter. Clinical efficacy was evaluated by comparing numbers of non-inflammatory and inflammatory lesions. Aerobic bacteria was also cultured from control group and acne patients group before and after RT cream use. RESULTS: Sebum secretion rates in acne patients were higher than those in control, but not statistically significant. Total number of aerobic bacteria in acne patients was higher than that in control (p<0.05). The aerobic bacteria consisted of coagulase negative Staphylococcus, Streptococcus sp., S. aureus in both acne patients and control. After 4 weeks, the number of inflammatory lesions had decreased (p<0.05%). In addition, the number of aerobic bacteria showed the tendency of decrease after RT cream use. CONCLUSION: RT cream consisting of 0.1% tea tree oil and 0.01% Ramulus mori extract was found to be effective and safe for acne patients with especially inflammatory lesions.

Evaluation of the Anti-inflammatory Effect of a Moisturizer Containing Green-Tea Extracts / 대한피부과학회지

BACKGROUND: For the long-term management of chronic dermatitis such as atopic dermatitis or xerotic eczema, it is important for a clinician to choose a medication that has the least side effects. OBJECTIVE: We planned to evaluate the anti-inflammatory effect of a moisturizer containing green-tea extracts compared with 1% hydrocortisone lotion. METHODS: The anti-inflammatory effects of 1% hydrocortisone lotion and a moisturizer containing green-tea extracts were evaluated in the inflammation of skin induced by ultraviolet B(UVB) irradiation and sodium lauryl sulfate(SLS) irritation. Twice a day application of topical agents for reducing artificially induced local inflammation was done. Mexameter and chromameter were used for the evaluation of erythema. RESULTS: UVB induced erythema continued to increase regardless of applying topical agents. In contrast, SLS-induced erythema slowly decreased with time duration. Furthermore, increasing pattern of erythema was irregular after UVB irradiation. These results suggest that SLS-induced erythema was more reliable for evaluation of anti-inflammatory effects of topical agent. In addition, we found that a moisturizer containing green tea extracts showed nearly the same effect as or even more effective than 1% hydrocortisone lotion. CONCLUSION: A moisturizer containing green tea extracts would be effective for improving dry skin and also for the treatment of atopic dermatitis or xerotic eczema.

Hearing Threshold Shifts Among Female Communication Workers Wearing Monaural Headset

BACKGROUND: This study was designed to evaluate the effect of monaural headset to the hearing threshold shifts of the female communication workers. METHODS: Hearing threshold shifts of total 642 subjects, selected after excluding workers with history of ear disease, of ototoxic drug administration, and of neuropsychiatric disease, were determined by pure tone audiometric tests. Each worker's personal and work history was taken by the self-administrative questionnaire. In addition, occupational noise exposure levels in the workplace were assessed by noise dosimetry and each worker's noise exposure from the headset was measured by placing the microphone of a noise dosimeter to the external portion of the headset which was coupled by a silicon tube. The hearing threshold shifts were compared between groups of the alternate and the fixed headset user. RESULTS: The results were as follows: 1> The noise levels in the workplace ranged from 62.1 dBA to 63.9 dBA. The mean equivalent sound levels (LEQ) by the headset volume (minimum, middle, and maximum) were 90.8 dBA, 94.6 dBA, and 97.8 dBA, respectively. The maximum sound level (Lmax) of the headset was from 109.1 to 128.6 dBA. 2> The degree of hearing difference of the one side users was higher than that of the alternate users. Comparing the hearing loss of two groups of subjects, hearing loss was statistically significantly higher in the left-ear fixed and in the alternate headset users with more than 15 years than those with less than 15 years of headset taking duration. 3> Based on the hearing loss evaluation criteria by the Korean Ministry of Labor, 25 required follow-up cases (3.89%) and 16 suspected cases (2.49%) out of the 642 subjects were screened. Although statistically not significant, the required follow-up cases were higher among fixed users (4.3%) than those of alternate users (3.7%). CONCLUSION: The results of this study ascertained the possibility of hearing loss due to monaural-headsets among female workers. Thus, it is recommended that an effective hearing conservation program should be provided for the headset-wearing communication workers.

A Case of Ocular Rosacea Treated with Oral Tetracycline

Rlsacea is chronic disease of the eye and facial skin, which is common in Caucasian. Ocular rosacea is often difficult for ophthalmologists to diagnose, especially when skin manifestations are not evident yet. Early diagnosis and early treatment is important to prevent its serious complications including corneal opacity and corneal perforation. A case of ocular rosacea in a 52-year-old Korean lady is reported. The patient was presented with hyperemic conjunctiva and vascularization, infiltration and thinning of the peripheral cornea. She did not have any specific skin lesion. But 20 years ago, she had suffered from rosacea. After administation of oral tetracycline and topicale and topical corticosteroid, the signs and symptoms of the ocular rosacea was markedly improved.