Résumé
OBJECTIVE: To investigate symptom prevalence, risk factor, and relationship between job stress and health-related quality of life in visual display terminal (VDT) workers with low back pain. METHOD: 5,005 people aged from 28 to 59 without neck or upper extremity pain, were enrolled and their general characteristics, working period, personal history like smoking, drinking, type of leisure and average housework time were collected via a questionnaire survey. The job stress and the health-related quality of life were measured by using the Korean Occupational Stress Scale (KOSS) and the Korean Short Form Health Survey-36 (KSF-36) respectively. The relationship between general characteristics, working period, personal history, KOSS score, and KSF-36 score were statistically analyzed. RESULTS: The average age of questionnaire respondents was 43.4 years old. Twenty-seven and ninety-one (2,791) VDT workers responded to have experienced low back pain in past 1 year. The symptom prevalence was 58.2%. The KOSS score of all VDT workers was higher than reference range. There were moderate negative correlations between KOSS score and subscale score of KSF-36 like vitality, mental health, and mental component summary in all groups. In a multivariate analysis of all subjects, younger age, female, type of leisure except sports activity, and feeling of body loading were independently associated with low back pain of VDT workers. CONCLUSION: This study provides the basic data about the relationship between job stress and health-related quality of life of VDT workers as well as risk factors of low back pain in VDT workers.
Sujets)
Sujet âgé , Femelle , Humains , Enquêtes et questionnaires , Consommation de boisson , Ménage , Activités de loisirs , Lombalgie , Santé mentale , Analyse multifactorielle , Cou , Prévalence , Qualité de vie , Valeurs de référence , Facteurs de risque , Fumée , Fumer , Sports , Membre supérieurRésumé
A large outbreak of Shigella sonnei gastrointestinal infections occurred at Cheju Island in Korea from May to August 2000. We selected 54 strains which were isolated from the primary treatment failure cases in the outbreak, and characterized the resistance-determining region of the R-plasmid. The 54 strains showed same antimicrobial resistance patterns; resistance against ampicillin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. The resistance to ampicillin, streptomycin, and tetracycline were mediated by a conjugable plasmid of about 80 kb size, but the trimethoprim- sulfamethoxazole resistance was not transferred by this plasmid. The R-determining region of the plasmid was cloned and characterized. The 8,384 bp sequences contained resistance genes in the following order:strA, strB, tetR, tetA, and sul1. Fifty four isolates harbored the same sized plasmid and showed same ribotyping patterns, which suggested the clonal spread of S. sonnei in the outbreak.
Sujets)
Ampicilline , Clones cellulaires , Corée , Plasmides , Ribotypage , Shigella sonnei , Shigella , Streptomycine , Sulfaméthoxazole , Tétracycline , Échec thérapeutique , Association triméthoprime-sulfaméthoxazoleRésumé
A large outbreak of Shigella sonnei gastrointestinal infections occurred at Cheju Island in Korea from May to August 2000. We selected 54 strains which were isolated from the primary treatment failure cases in the outbreak, and characterized the resistance-determining region of the R-plasmid. The 54 strains showed same antimicrobial resistance patterns; resistance against ampicillin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. The resistance to ampicillin, streptomycin, and tetracycline were mediated by a conjugable plasmid of about 80 kb size, but the trimethoprim- sulfamethoxazole resistance was not transferred by this plasmid. The R-determining region of the plasmid was cloned and characterized. The 8,384 bp sequences contained resistance genes in the following order:strA, strB, tetR, tetA, and sul1. Fifty four isolates harbored the same sized plasmid and showed same ribotyping patterns, which suggested the clonal spread of S. sonnei in the outbreak.
Sujets)
Ampicilline , Clones cellulaires , Corée , Plasmides , Ribotypage , Shigella sonnei , Shigella , Streptomycine , Sulfaméthoxazole , Tétracycline , Échec thérapeutique , Association triméthoprime-sulfaméthoxazoleRésumé
BACKGROUND: Increased aortic stiffness is a independent risk factor of cardiovascular disease in patients with hypertension. Acute changes of the heart rate (HR) have been reported not to affect the aortic stiffness in pacing. However, it is unknown whether acute changes in HR caused by sympathomimetics can affect the aortic stiffness in patients with hypertension. We investigated the effect of acute changes in HR produced by isoproterenol on the aortic stiffness in 17 hypertensive patientss (mean age: 59 +/- 9 years). METHODS: All vasoactive drugs were discontinued at least 3 days before the study. The carotid-tofemoral pulse wave velocity (PWV) was measured by the foot-to-foot method. The pulse waves were recorded at the baseline and at every increase of HR by 5 to 10 bpm with a gradual increase of the dose of isoproterenol. The blood pressures and HR were measured simultaneously. For the analysis, HR, PWV, compliance (C), and compliance index (Ci) were converted as percent changes (delta) from the baseline values. Percent changes of the parameters of the aortic stiffness, i.e., delta PWV, delta C, and delta Ci, were grouped by every 10% increase in delta HR. RESULTS: There was no significant difference among groups in delta PWV, delta C and delta Ci (p> 0.05 for each of the group). The regression analysis showed no significant correlation of delta HR with delta PWV and delta C (r=0.18, 0.13 respectively, p> 0.05 for each). delta Ci had a poor correlation with delta HR (r=0.22, p< 0.05). However, only 4.6% of delta Ci could be referred to delta HR (r2=0.046). CONCLUSION: Aortic stiffness was not affected by acute changes in HR produced by isoproterenol which suggests that it is not necessary to consider acute changes in HR when measuring aortic PWV.
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Aorte/effets des médicaments et des substances chimiques , Douleur thoracique/étiologie , Maladie coronarienne/complications , Élasticité/effets des médicaments et des substances chimiques , Rythme cardiaque/effets des médicaments et des substances chimiques , Hypertension artérielle/complications , Isoprénaline/pharmacologie , Modèles linéaires , Écoulement pulsatoire/physiologie , Sympathomimétiques/pharmacologieRésumé
Anomalous systemic arterial supply to the lung is a rare congenital anomaly. The lung supplied by the anomalus systemic artery has a normal bronchial tree, which is usually in the basal segment of the lung, especially in the left lung. Most of patients are asymptomatic, but the main clinical symptoms of this disease are hemoptysis and exertional dyspnea. CT is useful for the diagnosis and showed a retrocardiac nodular shadow connected to the descending aorta branching into the basal segments of the relatively normal lower lobe. Surgery is indicated for all patients. Here we report a case of anomalous systemic arterial supply to normal basal segments of left lower lobe in a patient with hemoptysis with a review of the relevant literature.
Sujets)
Humains , Aorte thoracique , Artères , Diagnostic , Dyspnée , Hémoptysie , PoumonRésumé
BACKGROUND: Increased aortic stiffness (AS) is an independent risk factor of cardiovascular disease in patients with hypertension. Elevation of blood pressure (BP) or sympathetic tone increases AS. It was reported that acute changes in heart rate by artificial pacemaker did not affect AS. However, it is unknown whether changes in HR by sympathomimetics can affect AS in patients with hypertension. We investigated the effect of changes of HR by isoproterenol (ISO) on AS in 17 hypertensives (mean age: 59+/-9 years). METHODS: All vasoactive drugs were discontinued at least 3 days before the study. Carotid-to-femoral pulse wave velocity (PWV) was measured by foot-to-foot method. Pulse wave recordings were done at baseline and at every increase of HR by 5 to 10 bpm with gradual increase of dose of ISO. BPs were measured simultaneously by the fluid-filled manometer system through the side arm of arterial sheath of femoral artery. HR was measured by electrocardiography. Compliance (C) and compliance index (Ci) were calculated from PWV, pulse pressure, systolic and diastolic blood pressure by established formulas. For analysis, HR, PWV, C and Ci were converted as percent changes (delta) from the baseline values. Percent changes of parameters of AS, i.e., deltaPWV, deltaC, and deltaCi, were grouped by every 10% increase in HR. RESULTS: There was no significant difference among groups in deltaPWV, deltaC and deltaCi (p>0.05 for each). With simple regression analysis, deltaPWV and deltaC showed no significant correlation with deltaHR (r=0.18, 0.13 respectively, p>0.05 for each). deltaCi was weakly correlated with deltaHR (r=0.22, p<0.05). However, only 4.6% of deltaCi could be referable to deltaHR (r2=0.046). CONCLUSION: AS was not affected by changes in heart rate by isoproterenol, suggesting that it is not necessary to consider changes of HR when measuring aortic PWV.
Sujets)
Humains , Aorte , Bras , Pression sanguine , Maladies cardiovasculaires , Compliance , Électrocardiographie , Artère fémorale , Rythme cardiaque , Coeur , Hypertension artérielle , Isoprénaline , Pacemaker , Analyse de l'onde de pouls , Facteurs de risque , Sympathomimétiques , Rigidité vasculaireRésumé
BACKGROUND: Despite increasing importance of Acinetobacter baumannii in nosocomial infections and rapid development of multi-antimicrobial resistance in this strain, the resistance mechanisms of beta-lactam antimicrobials in A. baumannii were not clearly defined. In order to observe the resistance mechanisms against beta-lactams and carbapenem, we characterized the production of beta-lactamases and outermembrane protein (OMP) profiles for the 44 clinical isolates of A. baumannii. METHODS: The MICs of antimicrobials were determined by agar dilution test. The secondary beta-lactamases were characterized by isoelectric focusing, polymerase chain reactions and nucleotide sequencing, and the production of chromosomal beta-lactamases was quantitated by spectrophotometric method. For two strains with an elevated MIC of carbapenem, outermembrane protein (OMP) profile was analyzed by ultracentrifugation of the sonicated bacteral cells and SDS-PAGE. RESULTS AND CONCLUSION: Twenty two or 4 of 44 strains produced TEM-1-like beta-lactamase or PER-1 extended-spectrum beta-lactamase, respectively. However, when we analyzed the MICs of several beta-lactams with the beta-lactamase production, the resistance level of beta-lactam was mainly determined by the production of chromosomal beta-lactamase, not by the secondary beta-lactamases in the clinical isolates of A. baumannii. In two strains with an elevated MIC of imipenem, a decrease or loss of about 35 kDa and 22 kDa proteins in OMP was observed, which suggested that the change of OMP played a role in carbapenem resistance.
Sujets)
Humains , Acinetobacter/effets des médicaments et des substances chimiques , Infections à Acinetobacter/traitement médicamenteux , Lactames/pharmacologie , Protéines de la membrane externe bactérienne/biosynthèse , Carbapénèmes/pharmacologie , Infection croisée/traitement médicamenteux , Résistance bactérienne aux médicaments , bêta-Lactamases/biosynthèseRésumé
In most of the previous studies, invasive and discrete techniques have been used to monitor the healing process of the gingival graft. However, Laser Doppler Flowmetry(LDF, floLAB, Moor Instruments Ltd., England) is a non-invasive technique for measurement of blood flow in the tissue and also allows continuous monitoring. Thus, we tested the usefulness of LDF in monitoring the healing process of free gingival graft at gingival recession. Eleven gingival graft site of 7 patients, including 5 males and 2 females, aged between 21 and 41 years (mean age 28.5) were monitored for the blood flow. The blood flow in gingival graft at coronal site, central site, apical site, mesial site and distal site was measured using LDF. Blood flow was measured at 1- week, 2- week, 3- week and 4- week after gingival graft surgery from 10 a.m. to 2 p.m. Time-course of the healing process was evaluated by statistical analysis using repeated ANOVA and Duncan test. The results were as follows : (1) Blood flow stayed increased for 2 weeks, and then, it was a tendency to decrease. (2) The blood flow at distal site had always higher than mesial site during the measuring periods. (3) The blood flow was high orderly after 1 week ; most coronal site, most apical site, central site. But that was high orderly after 2 week, 3 week, 4 week ; most coronal site, central site, most apical site. In conclusion, LDF was a useful and clinically adaptable method to monitor wound healing process. Our study suggested that it was important to protect surgical site to promote initial wound healing.
Sujets)
Femelle , Humains , Mâle , Récession gingivale , Fluxmétrie laser Doppler , Transplants , Cicatrisation de plaieRésumé
Rhododendron brachycarpum has been known as a panacea in Korean folk medicine, and is used to treat various diseases including hypertension. Excessive ingestion can cause intoxication by grayanotoxin. We experienced a 59 year-old man suffering of grayanotoxin intoxication following excessive ingestion of Rhododendron brachycarpum. The patient presented dizziness, weakness, and chest discomfort with cold sweats. Electrocardiography showed marked sinus bradycardia with atrio-ventricular dissociation. With intravenous saline and atropine, the patient recovered. This case calls attention to the potential cardiotoxicity of Korean folk medicine Rhododendron brachycarpum.
Sujets)
Humains , Adulte d'âge moyen , Atropine , Bradycardie , Sensation vertigineuse , Consommation alimentaire , Électrocardiographie , Hypertension artérielle , Médecine traditionnelle , Rhododendron , Sueur , ThoraxRésumé
Diabetes is accompanied by delayed wound healing and insufficient granulation tissue formation, possibly because of a defect in fibroblast function. Maintaining glucose level at acceptable low level is considered to be an important part of the clinical treatment of diabetes, but the exact mechanism by which diabetes delays wound repair is not yet known. This study was designed to evaluate the effects of glucose on proliferation([3H]-thymidine uptake) and collagen synthesis([3H]-proline uptake) in dermal fibroblasts from non-lesional skins and chronic wounds. The subjects were divided into 3 groups: non-diabetic control(n = 5), glucose controlled(glycated Hb 8%) diabetics(n = 5). The fibroblasts were cultured in two conditions, low glucose(5 mM) and high glucose(20 mM) medium. The data were compared using Mann-Whitney test. The results are as follows: 1. There were no significant differences in the proliferation and collagen synthesis of non-lesional skin fibroblasts in all groups. 2. In high glucose medium culture, the proliferation of the fibroblasts from the wound of the glucose uncontrolled diabetic group was significantly lower than those of the other 2 groups(p< 0.05), and the collagen synthesis of the wound fibroblasts of the control group was significantly higher than those of 2 diabetic groups(p< 0.05). 3. The proliferation and collagen synthesis of the wound fibroblasts in all groups were significantly lower than those of the non-lesional skin fibroblasts(p< 0.05). 4. In the control group and the glucose controlled diabetic group, the proliferation of the wound fibroblasts in the high glucose culture media were lower than those in the low glucose culture media(p< 0.05). Also, in the glucose controlled diabetic group, the collagen synthesis of the wound fibroblasts in the high glucose culture medium was lower than that in the low glucose culture medium(p< 0.05). These results demonstrate that the glucose level may affect the proliferation and collagen synthesis of fibroblasts, and the strict blood glucose control is beneficial to the prevention and treatment of diabetic chronic wounds.
Sujets)
Glycémie , Collagène , Milieux de culture , ADN , Fibroblastes , Glucose , Tissu de granulation , Peau , Cicatrisation de plaie , Plaies et blessuresRésumé
It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Sujets)
Animaux , Rats , Abdomen , Hypoxie , Vaisseaux capillaires , Oedème , Cellules endothéliales , Endothélium , Hémorragie , Inflammation , Interleukine-1 , Interleukine-8 , Ischémie , Leucocytes , Nécrose , Granulocytes neutrophiles , Perfusion , Lésion d'ischémie-reperfusion , Reperfusion , Peau , ThromboseRésumé
The efficacy nd tolerance of topical administration of levocabastine(0.5mg/ml)were evaluated in patients with allergic conjunctivitis. A total of 166 patients who had a typical history of atopy and a positive skin test were recruited in this study. Five clinicl symptoms(itch, tearing, chemosis, lid edema and conjunctival injection) were assessed according to a four point scale before the treatment and at 1 and 2 weeks post-therapy. Total symptom severity score before the therapy, 6.68, was remarkably decreased to 2.86 at 1 week and 2.08 at 2 weeks after the treatment. The investigators rated the treatment as globally good or excellent in 68.1% of patients checked at 1 week and 72.5% at 2 weejs after treatment. And the patients evaluated that the therapy ws good to excellent in 66.9% at 1 week and 73.1% at 2 weeks after treatment. Levocabastine eye drops has a fast onet of action with 55.4% of the patients feeling symptom relief within 15 minutes after the first administration. The adverse effect was experienced in 44 patients. Ocular irritation sign, such as foreign body sensation or soreness, was the most frequently reported complaint. These results suggest that levocabastine eye drops is an effective and safe topical alternative for treatment of allergic conjunctivitis.