Malignant Apocrine Lesions of the Breast: Multimodality Imaging Findings and Biologic Features / 한국유방암학회지

The apocrine morphology of the breast is observed in a broad pathological spectrum, ranging from benign cysts to invasive carcinomas. However, the number of clinical research investigating malignant apocrine lesions is limited. This study retrospectively reviewed the data of patients with malignant apocrine lesions admitted in a tertiary center between January 2004 and December 2021, based on the radiology-pathology correlation and the recent advances in their status to enhance the therapeutic implications of androgen receptor (AR). Among the 37 patients with lesions, 27 (73.0%) had triple-negative subtypes with predominant AR expression. The radiological features of malignant apocrine lesions did not differ from those of typical invasive ductal carcinoma or ductal carcinoma in situ. This study demonstrated that knowledge on the imaging features of malignant apocrine lesions and their histological basis could enhance the adoption of new targeted therapies in patients with this particular type of breast cancer.

Association of Nutrient Intakes with Cognitive Function in Koreans Aged 50 years and Older

This study attempted to investigate whether nutrient and food intake were related with mild cognitive impairment (MCI) in adults and elderly over 50 years of age in Korea. Questionnaires and anthropometric measurements were conducted on general aspects of the research, and food frequency questionnaires (FFQs) were conducted to determine nutritional status. The relative theta power (RTP) through electroencephalography (EEG) measurements, neurocognitive function test (NFT; CNS Vital Signs), and cognitive function was measured. The MCI group consumed significantly lower C18:4, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) among the N-3 fatty acids, N-6 fatty acids dihomo-γ-linolenic acid (DGLA), mono unsaturated fatty acids, C22:1, biotin, vitamin D in the nutrients, and sweet potato (12.35g/day, p = 0.015), mackerel (3.38g/day, p = 0.017), mandarin orange (p = 0.016), persimmon (p = 0.013) and apple (p = 0.023) in the food than the normal group did. And the MCI group consumed salted fish (3.14g/day, p = 0.041) and ice-cream (5.01g/day, p = 0.050) at a significantly higher level. Delayed verbal score, delayed visual score, and verbal memory score of the NFT and RTP values of the prefrontal cortex among the EEGs were significantly lower in the MCI group compared to those in the normal group. From this study, we found that nutrient and food intake are closely related to MCI in Korean aged 50 years and older, but more human studies are needed to verify these findings.

Factors related to Nurses' Patient Identification Behavior and the Moderating Effect of Person-organization Value Congruence Climate within Nursing Units

PURPOSE: This research was an empirical study designed to identify precursors and interaction effects related to nurses' patient identification behavior. A multilevel analysis methodology was used. METHODS: A self-report survey was administered to registered nurses (RNs) of a university hospital in South Korea. Of the questionnaires, 1114 were analyzed. RESULTS: The individual-level factors that had a significantly positive association with patient identification behavior were person-organization value congruence, organizational commitment, occupational commitment, tenure at the hospital, and tenure at the unit. Significantly negative group-level precursors of patient identification behavior were burnout climate and the number of RNs. Two interaction effects of the person-organization value congruence climate were identified. The first was a group-level moderating effect in which the negative relationship between the number of RNs and patient identification behavior was weaker when the nursing unit's value congruence climate was high. The second was a cross-level moderating effect in which the positive relationship between tenure at the unit and patient identification behavior was weaker when value congruence climate was high. CONCLUSION: This study simultaneously tested both individual-level and group-level factors that potentially influence patient identification behavior and identified the moderating role of person-organization value congruence climate. Implications of these results are discussed.

Changes in biologic markers of oxidative stress and plasma endotoxin levels in gynecologic cancer patients treated with pelvic radiotherapy: a pilot study / 부인종양

OBJECTIVE: We conducted a pilot study to evaluate the effects of pelvic radiotherapy on biologic markers of oxidative stress and plasma endotoxin levels, and to assess the relationship between the changes of such factors and radiotherapy-related complications. METHODS: Twelve gynecologic cancer patients who were treated via pelvic radiotherapy with or without concurrent chemotherapy were enrolled in this study. Biologic markers of oxidative stress, such as glutathione (GSH) and oxidized glutathione (GSSG), as well as endotoxin levels, were measured weekly during treatment. Subjective symptoms were assessed using the Korean version of the EORTC QLQ-C30 at the baseline and on the 5th week of radiotherapy. RESULTS: No changes were noted in the level of GSH in whole blood, but the GSH/GSSG ratio was reduced dramatically after the initiation of radiotherapy. The mean plasma endotoxin for all patients tended to increase and persisted during radiotherapy, and the number of patients who evidenced clinically significant endotoxin levels (defined as >0.005 EU/mL) also increased. Nausea/vomiting and diarrhea were significantly changed (p=0.019 and p<0.001, respectively). A significant relationship was noted to exist between the changes in the endotoxin level and nausea/vomiting (p=0.001). However, such symptoms did not correlate with the changes of oxidative stress markers. CONCLUSION: Pelvic radiotherapy oxidized the GSH redox system and increased plasma endotoxin. Further investigations containing interventional and longitudinal studies will be required to assess the effects of the changes in oxidative stress markers and endotoxin on radiotherapy-related adverse events.

Nutritional Status and Hair Mineral Content of Elementary School Children with Behavioral Problems

This study was performed to assess the nutritional status and hair mineral content of children with behavioral problems and compare the values with a gender, age-matched control group. The subjects were recruited from S elementary school children in Seoul, Korea. Students scored higher than 60 points were diagnosed with behavioral problems according to the Korean-Child Behavior Checklist. Nutritional assessment of the two groups (behavior problem group: male n=15, female n=24; 9.6+/-1.6 years, control group: male n=16, female n=18; 9.5+/-1.9 years) was performed using a nutritional survey and by measuring hair mineral contents. In the results, food frequency questionnaire analysis showed that the intakes of anchovy (P<0.05), soybean curb (P<0.01), radish (P<0.05), bean sprouts (P<0.05), spinach (P<0.05), carrot (P<0.05), pumpkin (P<0.05), lettuce (P<0.05), cabbage (P<0.01), apple (P<0.05), and milk (P<0.01) were higher in the control group than the behavior problem group, whereas intakes of ramyeon (P<0.05), cookies (P<0.05), and coke (P<0.01) were higher in the behavior problem group than the control group. Intakes of most nutrients such as plant-derived protein (P<0.05), fiber (P<0.05), plant-derived calcium (P<0.05), phosphorus (P<0.05), plant-derived iron (P<0.05), vitamin B2 (P<0.05), vitamin B6 (P<0.05), vitamin C (P<0.01), vitamin E (P<0.05), and folate (P<0.05) were significantly higher in the control group than the behavior problem group. Hair analysis showed that the levels of arsenic (P<0.05), mercury (P<0.001), uranium (P<0.05), iron (P<0.001), boron (P<0.01), and germanium (P<0.001) were lower, but the levels of phosphate (P<0.05), chromium (P<0.001), sodium (P<0.05), and sulfur (P<0.001) were higher in the behavior problem group than the control group. Conclusively, behavioral problems constitute a complicated condition in which nutritional factors may play major roles. However, it is still under investigation as to whether or not modification of dietary habits or nutritional supplementation can improve children's behavior, since symptoms require a broad understanding of the environmental and genetic interactions.

Increased whole grain, fruits and vegetable intake reduced oxidative stress in high school students

There is increasing evidence that dietary factors in plant-based diets are important for the prevention of chronic disease. Especially, phytonutrients in fruits and vegetables have been recognized as major contributors for the decreased level of oxidative stress. In this study, the effect of switching the dietary habit to high consumption of fruits and vegetables were evaluated on the parameters of serum antioxidant status in healthy high school students. Forty one students participated in a randomized controlled trial and were assigned to the control group (n = 18) or the intervention group (n = 23). The intervention group was provided for 8 weeks with the main food source being whole grain and vegetables. Anthropometric measurements, blood parameters and dietary intakes were measured, and compared before and after study. After 8 weeks, weight and BMI were significantly decreased in the intervention group (p = 0.000). The serum diacron reactive oxygen metabolites (d-ROMs) test resulted in a significantly decreased level only in the intervention group (p < 0.05) after 8 weeks, but serum biological antioxidant potential (BAP) was increased significantly in both groups (p < 0.001). Intake of energy, total fat, cholesterol and sodium in the intervention group were significantly decreased after 8 weeks (p < 0.05). Also, the intervention group had significantly increased vitamin and phytonutrient intakes of all-trans-beta-carotene, alpha-carotene, alpha-tocopherol, ascorbic acid, and total phenols (p < 0.05). Overall, the results of this study suggest that whole grain, fruits, and vegetables supplementation showed improvement of the adolescent health.

Comparison of knowledge, attitude, and experience about complementary and alternative medicine between primary care physicians and academic physicians in Korea

Despite the recent increase in the use of complementary and alternative medicine (CAM) among the general population and patients, little is known about Korean physicians' attitudes about and interest in CAM. We conducted a web-based survey of knowledge, attitude, and experience in CAM among primary care physicians (PCPs) and academic physicians (APs) in Korea. A total of 826 physicians (341 PCPs and 485 APs) responded. Respondents in both groups felt that they were not sufficiently knowledgeable about CAM. PCPs, however, had a significantly higher composite index score in CAM knowledge than that of APs. Although APs were more skeptical about the scientific evidence of CAM than PCPs, both groups had a positive attitude toward CAM. The level of experience in utilizing CAM in their practice was 23.2% among PCPs, which was much higher than that among APs (2.7%). Experience rates of referring patients to CAM were 11.7% in PCPs and 4.5% in APs (P<0.001). Despite the discrepant rates in CAM education between the two groups (58.7% in PCPs and 26.0% in APs, P<0.001), the majority of doctors in both groups (85.0% in PCPs and 70.0% in APs) expressed an intention to participate in authorized CAM coursework. In conclusion, despite the lack of scientific evidence, both PCPs and APs have an interest in incorporating CAM into their conventional medical practices. To meet physicians' increasing needs for CAM the Korean medical societies should promote education and research about CAM in the conventional medical system.

Effect of Cis-9-Cetylmyristoleate Containing Fatty Acids Complex Extracted from Vegetable Oils on Knee Pain in Patients with Osteoarthritis / 가정의학회지

BACKGROUND: Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. METHODS: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant-FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster's Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. RESULTS: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical significance (P = 0.47). CONCLUSION: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.

Effect of Cis-9-Cetylmyristoleate Containing Fatty Acids Complex Extracted from Vegetable Oils on Knee Pain in Patients with Osteoarthritis / 가정의학회지

BACKGROUND: Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. METHODS: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant-FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster's Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. RESULTS: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical significance (P = 0.47). CONCLUSION: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.

Strategic Approaches of Medical Field against Establishment State-run National Graduate School of Oriental Medicine

The Government decided to establish a graduate school of oriental medicine at Pusan National University despite strong opposition from medical field. By establishing a graduate school of oriental medicine, the Government aims at educating competitive healthcare professionals in research to meet fast-changing medical circumstances such as aging society, increasing chronic diseases, public interests in alternative medicine and its evidence-based approach. The Government is also taking this as an opportunity to improve the quality of healthcare service by settling a collaborative treatment system between western and orinetal medicine as well as fostering oriental medicine into high value-added industry. However, it raises a concern that evidence-based approach and standardization of oriental medicine through establishment of a graduate school might leave little room for oriental medicine doctors who depend mainly on traditional experiences and thus lose their leading roles in oriental medicine. Field of western medicine is no exception. If they continue to neglect scientific research in oriental medicine and complementary alternative medicine, the leadership of integrative medicine will shift to oriental medical doctors equipped with scientific knowledge. The situation asks medical field to take active steps and show their propose on education model is more ompetitive by achieving excellent research results through establishment of research center for oriental medicine and complementary alternative medicine within the framework of medical college education.

Analysis of Complications after Treatment of Calcaneal Fracture / 대한족부족관절학회지

PURPOSE: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. MATERIALS AND METHODS: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. RESULTS: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. CONCLUSION: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.

Dorsal Angulation after Proximal Dome Osteotomy for Hallux Valgus / 대한족부족관절학회지

PURPOSE: We try to retrospectively evaluated the amount of dorsal angulation angle of the first metatarsal commonly occurring as the complication of proximal dome osteotomy for hallux valgus. MATERIALS AND METHODS: Between January 2004 and March 2004, 34 patients who underwent proximal dome osteotomy for moderate to severe hallux valgus. Two of 34 patients were male, and thirty-two were female. The average age was 57.6 years. We measured and compared hallux valgus angle, 1st-2nd intermetatarsal angle, dorsal angulation angle of 1st metatarsal on preoperative, postoperative, postoperative 3 weeks', postoperative 3 months' X-ray. RESULTS: Osteotomy sites were completely united on plane X-ray in all cases. The hallux valgus angle averaged 41.2 degrees (30~60 degrees) at preoperative, 4.3 degrees (-10~20 degrees) at postoperative, 5.5 degrees (-1~20 degrees) at 3 weeks after operation, 7.8 degrees (-2~20 degrees) at 3 months after operation. The 1st-2nd intermetatarsal angle averaged 17.1 degrees (12~24 degrees) at preoperative, 6.3 degrees (0~13 degrees) at postoperative, 7.2 degrees (0~15 degrees) at 3 weeks after operation, 8.7 degrees (0~18 degrees) at 3 months after operation. The dorsal angulation angle averaged 0.4 degrees (0~3 degrees) at postoperative, 1.6 degrees (0~7 degrees) at 3 weeks after operation, 2.1 degrees (0~8 degrees) at 3 months after operation. There were no statistically correlation between increase of dorsal angulation angle of the distal segment of the first metatarsal and increase of hallux valgus angle or 1st-2nd intermetatarsal angle. CONCLUSION: Our results shows that the dorsal angulation of distal fragment occurring after the proximal dome osteotomy in the treatment of hallux valgus may be minimized with meticulous surgery and patient's education.

Surgical Treatment for Painful Instability of the Second Metatarsophalangeal Joint: 1 Case Report / 대한족부족관절학회지

An unstable second metatarsophalangeal joint may produce pain in the forefoot. Plication of stretched lateral ligament and capsule and transfer of the extensor digitorum brevis under the transverse intermetatarsal ligament performed as the primary procedure to stabilize this painful joint. But the pain was not subsided and the proximal phalanx was resubluxated. So, we osteotomized the second metatarsal to restore a normal alignment of the second toe. Then the symptom was subsided. We report a case of painful instability of the metatarsophalangeal joint of the second toe.

A Case of Cardiac Tamponade Caused by Acute Pancreatitis

The accumulation of fluid in the pericardium in an amount sufficient to cause serious obstruction to the inflow of blood to the ventricles results in cardiac tamponade. This complication may be fatal if it is not recognized and treated promptly. We report a case of cardiac tamponade caused by acute pancreatitis, which resolved after catheter drainage.

A Case of Rhino-orbital Mucormycoses with Orbital Apex Syndrome in Diabetic Patient / 대한내분비학회지

Rhino-orbital mucormycosis is a rare fungal infection that involves paranasal sinus and orbits and usually presented as acute invasive fungal sinusitis or orbital apex syndrome. It often occurs in patients with poorly controlled diabetes mellitus especially during or following episode of diabetic ketoacidosis. If the condition is not treated, the fungal infection may disseminated into the brain and death usually occurs in a day to week. Exenteration is often needed as a therapy. We have experienced a case of rhino-orbital mucormycosis that presented as a orbital apex syndrome and confirmed by maxillary and periorbital soft tissue biopsy. A 56-year-old female suffered from diabetes mellitus for 3 years was admitted with rapidly progressive visual acuity loss and left hemi-facial numbness. She was treated with daily intravenous amphotericin B and intraconal amphotericin B irrigation and packing. Exenteration was not neccisated.

Association of QT Dispersion with Left Ventricular Hypertrophy in Essential Hypertensives

BACKGROUND: Left ventricular hypertrophy(LVH) is a powerful indepedent risk factor of ventricular tachycardia and sudden death. Even though it is not clear the mechanism of sudden death in patients with LVH, inhomogenous ventricular repolarization is highly suggested. QT dispersion which reflecting regional inhomogeneity of repolarization is defined as interlead variation in QT intervals of 12 leads ECG. The purpose of this study was to assess whether QT dispersion is associated with LVH in hypertensive patients. METHODS: We assessed 23 untreated hypertensives with echocardiographic LVH and normal left ventricular systolic function. The criteria of 5th Joint National Committee stage I-III was used to define hypertension. Thirty four normotensives was assessed as controls. On a standard 12 lead ECG, the intervals between onset of QRS to end of T wave were measured(QT intervals) and corrected by heart rate(QTc). QT dispersion was calculated by the difference of maximal and minimal QTc. Left ventricular mass(LVM) was calculated from Devereux's formula using the parameters measured by the recommendation of American Society of Echocardiography. LVH was defined by LVM indices over 130 g/m2. RESULTS: LVM indices of hypertensive group were significantly greater than those of controls (162.2+/-39.3 g/m2 vs 84.2+/-16.1 g/m2, p<0.001). Maximal QT and QTc of hypertensive group were significantly prolonged than those of controls(maximal QT=401+/-31 ms vs 380+/-35 ms, p<0.05 ; maximal QTc=432+/-19 ms vs 414+/-17 ms, p<0.001). QT dispersions were significantly greater in hypertensive group than in controls(60.2+/-15.7 ms vs 33.2+/-11.7 ms, p<0.001). In hypertensive group, there was significant association between LVM index and QT dispersion(r=0.492, p=0.017). CONCLUSIONS: Hypertensives with LVH have a prolonged QT and QTc and increased QT dispersion in comparision with controls. QT dispersion in these patients correlates with degree of LVH.

Quantitative Sensory and Vascular Tests in the Assessment of Hand-Arm Vibration Syndrome / 대한산업의학회지

This study was conducted on 103 male workers exposed to local vibration (exposure workers) and 23 male clergical workers not exposed to local vibration (reference workers) to evaluate the effect of local vibration in a automobile industry workers who had used vibratory tools such as electric bolt impacter or grinder. The assessment methods of this study were some tests recommended by Wasserman and Taylor. None of reference workers complained sensorineural symptoms, but 43.7% of exposed workers complained over one of those symptoms. The proportion of non-recovery type, which means that there was no full recovery of temperature of finger tips, was from 0% to 31. 3% in reference workers and from 10.7% to 15.5% in exposure workers. There was statistically significant difference of recovery time of plethysmogram after cold provocation between mean recovery time of 0.44 minutes in reference workers and that of 3.05 minutes in exposure workers. The proportion of bad plethysmogram was from 0% to 4.4% in reference workers and from 3.9% to 7.8% in exposure workers. There was statistically significant difference of discrimination sense between mean length of 2.04 mm in reference workers and that of 2.9 mm in exposure workers. There were also statistically significant difference of pain sense between mean weights of from 5.02 g to 5.26 g in reference workers and those of from 6.81 g to 7.6 g in exposure workers. By the results of multiple stepwise regression analysis the statistically significant variable affecting discrimination and pain sense was exposure and those affecting vibration sense were exposure and age. We concluded that exposure of local vibration in automobile workers was significaritly associated with decrease of sensorineural sense regardless of age and other, possible related variables.

Quantitative Sensory and Vascular Tests in the Assessment of Hand-Arm Vibration Syndrome / 대한산업의학회지

This study was conducted on 103 male workers exposed to local vibration (exposure workers) and 23 male clergical workers not exposed to local vibration (reference workers) to evaluate the effect of local vibration in a automobile industry workers who had used vibratory tools such as electric bolt impacter or grinder. The assessment methods of this study were some tests recommended by Wasserman and Taylor. None of reference workers complained sensorineural symptoms, but 43.7% of exposed workers complained over one of those symptoms. The proportion of non-recovery type, which means that there was no full recovery of temperature of finger tips, was from 0% to 31. 3% in reference workers and from 10.7% to 15.5% in exposure workers. There was statistically significant difference of recovery time of plethysmogram after cold provocation between mean recovery time of 0.44 minutes in reference workers and that of 3.05 minutes in exposure workers. The proportion of bad plethysmogram was from 0% to 4.4% in reference workers and from 3.9% to 7.8% in exposure workers. There was statistically significant difference of discrimination sense between mean length of 2.04 mm in reference workers and that of 2.9 mm in exposure workers. There were also statistically significant difference of pain sense between mean weights of from 5.02 g to 5.26 g in reference workers and those of from 6.81 g to 7.6 g in exposure workers. By the results of multiple stepwise regression analysis the statistically significant variable affecting discrimination and pain sense was exposure and those affecting vibration sense were exposure and age. We concluded that exposure of local vibration in automobile workers was significaritly associated with decrease of sensorineural sense regardless of age and other, possible related variables.

Reproducibility and diurnal variation of heart rate variability in predischarge period of acute myocardial infarction

BACKGROUND: Decreased heart rate variability(HRV) has been shown to be an independent predictor of poor outcome after acute myocardial infarction, Spectral analysis of HRV has recently been shown to be a reliable noninvasive test for quantiative assessment of cardiovascular autonomic regulatory response. We estimated the reproducibility and circadian rhythm of HRV parameters in patients with acute myocardial infarction. METHODS: Three consecutive 24-hour ambulatory electrocardiographic recordings were made in 24 patients with acute myocardial infarction, with 10~14 days after the acute attack, and analyzed for HRV parameters of both frequency and time domains. Parameters of frequency domain include low frequency(LF) and high frequency(HF) components. Parameters of time domain include sdRR, SDANN, SD, pNN50, rMSSD, HRV index. RESULTS: Mean total, low frequency and high frequency amplitude spectral densities were 33msec, 19msec and 11msec, respectively. Mean values of sdRR, SDANN, SD, rMSSD, pNN50 and HRV index were 103msec, 90msec, 47msec, 28msec, 7% and 32, respectively. Coefficients of variation(CV) of total amplitude spectral density, and low and high frequency components were 7%, 9% and 12%, respectively. CV of most HRV parameters of time domain were also around 10% except rMSSD and pNN50. Heart rate increased in the morning to be sustained during the day time and decreased in the night. Heart rate variability of high frequency component decreased in the early morning to be sustained during day time with increase in the night. CONCLUSIONS: We conclude that in the predischarge period of acute myocardial infarction, HRV parameters of frequency and time domains are reproducible and there are some morning fall of cardiac vagal activity.

Comparisons of Electrocardiograms and Echocardiograms in Soccer Players before and after Intensive Training

BACKGROUND: In athlete's heart, functional and structural alteration are main features. We studied electrocardiograms(ECG's) and echocardiograms(UCG's) in soccer players before and after intensive training. METHODS: Fifteen soccer players with the mean age and career of 19.3 and 8.5 years,respectively,underwent intensive training for 5-5.5 months, which included running of 2 km daily during the last 2-2.5 months. Comparisons of ECG's and UCG's recorded before and after the training were made. RESULTS: The major abnormal finding in pre-training ECG's was high voltage being seen in 40% of the cases, and in UCG's left ventricular(LV) dilatation and/or hypertrophy or asymmetrical septal hypertrophy(ASH) were noted in approximately 80% of the cases. The incidences of these finding after the intensive training were essentially unchanged, and the mean of pre-and post-training fractional shortening(FS) and LV and left atrial dimensions were similar. The high voltage in ECG's showed no close correlation with LV dilatation or hypertrophy on UCG's. After the training, however, the mean values of the thickness of LV posterior wall and ventricular septum along with LV mass were significantly increased, and the right ventricular dimension was significantly decreased. CONCLUSIONS: The most frequent finding in ECG's and UCG's in soccer players, before and after intensive training,were high voltage, LV dilatation and /or hyperophy with or without ASH. The intensive training of 5-5.5 months duration caused no change in F8,but caused significant increase in the thickness of LV posterior wall and ventricular septum, and LV mass.