Comparison of Cardiovascular Disease Status Between Large Scale Industry Office and Self Employed Male Workers / 대한산업의학회지

OBJECTIVES: The aim of this study is to compare the cardiovascular disease status between large scale industry office and self employed male workers who have gaps in their intensive health management. METHODS: The cross sectional study was carried out with subjects composed of 244 shipyard office male workers and 381 self employed male workers, aged 30 to 55 years. They were given a health exam in a general hospital from January 2007 to June 2009. Information was based on data from self-administered questionnaires, physical examination and laboratory results on blood samples. The degree of coronary artery calcification and stenosis was evaluated by a 64 channel multi-detector computed tomography angiography. RESULTS: The prevalence of hypertension(p<0.01) and diabetes mellitus(p=0.02) and waist circumference(p<0.01) was significantly lower in the shipyard office workers than in self employed workers. Proper drinking(p<0.01) was more commmon in shipyard office workers. The rates of coronary artery calcification and stenosis were estimated to be 18.4% and 11.5% respectively for shipyard office workers and were significantly lower than the 26.5% and 21.5% for self employed workers. After adjustment for age, the probability of coronary artery stenosis in shipyard office workers was lower than in self employed workers (OR=0.56, 95% CI=0.35~0.90). CONCLUSIONS: The study results verified the benefits of a health promotion and intervention program and the healthy worker effect for cardiovascular diseases. More specifically, it verified the benefits regarding coronary artery stenosis in large scale industry office workers. This result should encourage the establishment of health promotion programs and the study of occupational epidemiology.

The Usefulness of 64-Multidetector CT Cholangiography for Diagnosis of Distal Common Bile Duct Obstruction: Comparison with Endoscopic Retrograde Cholangiopancreatography / 대한소화기내시경학회지

BACKGROUND/AIMS: The aim of this study was to evaluate the diagnostic accuracy of 64-multidetector CT (MDCT) cholangiography for determining the causes of distal common bile duct (CBD) obstruction. METHODS: Two hundred fifty consecutive patients underwent 64-MDCT for diagnosing the clinical and biochemical signs of bile duct obstruction. The causes of bile duct obstruction were assessed by the pre- and post-enhanced axial and coronal multiplanar reformation images of 64-MDCT. The results were compared with ERCP, biopsy and surgery. RESULTS: The sensitivity and specificity of MDCT for CBD stones were 96.1% and 84.9%, respectively. In seven patients, The CBD stones in 7 patients could not be detected on MDCT. Eleven patients with stones in the distal CBD, as detected on MDCT, had no stones seen on ERCP. For malignant obstruction, the sensitivity and specificity of MDCT were 97.0% and 98.6%, respectively. Three patients who were diagnosed with periampullary cancers on MDCT were disclosed to have severe papillitis on ERCP. One patient who was diagnosed with CBD stone by MDCT was disclosed to have ampullary cancer. The overall accuracy of MDCT for determining the causes of biliary obstruction was 90.5%. CONCLUSIONS: MDCT cholangiography is a non-invasive method with relatively high sensitivity and high specificity for diagnosing the causes of distal CBD obstruction.