The Efficiency of Radiation Shielding Sheet to Reduce Radiation Exposure during C-arm Fluoroscopy

Purpose@#This study evaluates the radiation shielding performance of a new lead-free tungsten-based sheet to reduce the radiation exposure of operators and patients under C-arm fluoroscopy. @*Materials and Methods@#A non-lead radiation shielding sheet (ROO201128; Pentas, Korea) was fabri-cated using tungsten and bismuth. The dose measurements were conducted using a C-arm fluoroscopy machine at 64 kVp and 1.5 mA, assuming two possible scenarios according to the position of the sheet. In each scenario, measurements were conducted at three distances (30, 60, and 90 cm) away from the beam center and in three directions (cephal, caudal, and operator’s direction). @*Results@#In the area within a radius of 60 cm from the beam center, the measured doses were reduced by 66.3% on mean, and the doses measured at distances more than 60 cm were less than 0.1 mSv/h in both scenarios. The most beneficial utilization of the lead-free shielding sheet was verified during C-arm fluoroscopy by placing the sheet on the X-ray tube. The operator’s radiation exposure was reduced by 56.6% when the sheet was placed under the phantom, and by 81.0% when the sheet was placed on the X-ray tube. @*Conclusion@#The use of lead-free radiation shielding sheets under C-arm fluoroscopy was effective in reducing radiation exposure, and the most beneficial scenario in which the sheet can be utilized was verified when the sheet was placed on the X-ray tube.

Combined effects of soy isoflavone and lecithin on bone loss in ovariectomized mice

BACKGROUND/OBJECTIVES@#Isoflavones (ISFs) are effective in preventing bone loss, but not effective enough to prevent osteoporosis. Mixtures of soy ISF and lecithin (LCT) were prepared and characterized in an attempt to improve the bone loss.MATERIALS/METHODS: The daidzein (DZ) and genistein (GN) solubility in soy ISF were measured using liquid chromatography-mass spectrometry. The change in the crystalline characteristics of soy ISF in LCT was evaluated using X-ray diffraction analysis.Pharmacokinetic studies were conducted to evaluate and compare ISF bioavailability. Animal studies with ovariectomized (OVX) mice were carried out to estimate the effects on bone loss. The Student's t-test was used to evaluate statistical significance. @*RESULTS@#The solubility of DZ and GN in LCT was 125.6 and 9.7 mg/L, respectively, which were approximately 25 and 7 times higher, respectively, than those in water. The bioavailability determined by the area under the curve of DZ for the oral administration (400 mg/kg) of soy ISF alone and the soy ISF-LCT mixture was 13.19 and 16.09 µg·h/mL, respectively. The bone mineral density of OVX mice given soy ISF-LCT mixtures at ISF doses of 60 and 100 mg/kg daily was 0.189 ± 0.020 and 0.194 ± 0.010 g/mm3 , respectively, whereas that of mice given 100 mg/kg soy ISF was 0.172 ± 0.028 g/mm3 . The number of osteoclasts per bone perimeter was reduced by the simultaneous administration of soy ISF and LCT. @*CONCLUSIONS@#The effect of preventing bone loss and osteoclast formation by ingesting soy ISF and LCT at the same time was superior to soy ISF alone as the bioavailability of ISF may have been improved by the emulsification and solvation of LCT. These results suggest the possibility of using the combination of soy ISF and LCT to prevent osteoporosis.

Combined effects of soy isoflavone and lecithin on bone loss in ovariectomized mice

BACKGROUND/OBJECTIVES@#Isoflavones (ISFs) are effective in preventing bone loss, but not effective enough to prevent osteoporosis. Mixtures of soy ISF and lecithin (LCT) were prepared and characterized in an attempt to improve the bone loss.MATERIALS/METHODS: The daidzein (DZ) and genistein (GN) solubility in soy ISF were measured using liquid chromatography-mass spectrometry. The change in the crystalline characteristics of soy ISF in LCT was evaluated using X-ray diffraction analysis.Pharmacokinetic studies were conducted to evaluate and compare ISF bioavailability. Animal studies with ovariectomized (OVX) mice were carried out to estimate the effects on bone loss. The Student's t-test was used to evaluate statistical significance. @*RESULTS@#The solubility of DZ and GN in LCT was 125.6 and 9.7 mg/L, respectively, which were approximately 25 and 7 times higher, respectively, than those in water. The bioavailability determined by the area under the curve of DZ for the oral administration (400 mg/kg) of soy ISF alone and the soy ISF-LCT mixture was 13.19 and 16.09 µg·h/mL, respectively. The bone mineral density of OVX mice given soy ISF-LCT mixtures at ISF doses of 60 and 100 mg/kg daily was 0.189 ± 0.020 and 0.194 ± 0.010 g/mm3 , respectively, whereas that of mice given 100 mg/kg soy ISF was 0.172 ± 0.028 g/mm3 . The number of osteoclasts per bone perimeter was reduced by the simultaneous administration of soy ISF and LCT. @*CONCLUSIONS@#The effect of preventing bone loss and osteoclast formation by ingesting soy ISF and LCT at the same time was superior to soy ISF alone as the bioavailability of ISF may have been improved by the emulsification and solvation of LCT. These results suggest the possibility of using the combination of soy ISF and LCT to prevent osteoporosis.

Perioperative Diffuse Alveolar Hemorrhage During Laparoscopic Paraganglioma Removal: a Case Report / 계명의대학술지

Diffuse alveolar hemorrhage is life-threatening situation which is rarely caused by paraganglioma or pheochromocytoma. Here, we describe anesthetic management of 64-year-old man underwent laparoscopic pararenal mass excision and later on this mass diagnosed as paraganglioma. We induced anesthesia with propofol 120 mg, sufentanil 12.5 μg, and rocuronium 50 mg. Anesthesia was maintained with sevoflurane administration. Patient position was changed to right lateral decubitus position for laparoscopic approach. Vital signs were stable until direct stimulation of mass. When surgeon started to manipulate pararenal mass, blood pressure suddenly increased to 274/169 mmHg and heart rate also increased to 140 beat/minute. SpO2 dropped to 69% and bilateral lung sounds decreased. We used intravenous esmolol to control blood pressure and heart rate. In doubt for bronchial spasm, we used intravenous hydrocortisol and chlorpheniramine maleate. Discharge of bloody fluid was obtained from endotracheal tube. Immediate postoperative chest x-ray showed diffuse air space consolidation in right lung field. We assessed as unilateral alveolar hemorrhage and patient was transferred to intensive care unit (ICU) without endotracheal extubation. The patient was followed up with ventilator care and antibiotic treatment in ICU, and daily chest x-ray was taken. He was extubated after showing favorable prognosis on postoperative day (POD) 4, and discharged on POD 7. Anesthesiologist should be aware that incidental manipulation of undiagnosed catecholamine producing tumor can lead to fatal consequences, and should know the management of hypertensive crisis and bronchial spasm.

Intra-abdominal necrotic lipoma diagnosed by computed tomography as a paraprostatic cyst

A dog with a history of diarrhea and dyschezia exhibited an oval-shaped, soft-tissue opacity mass in the abdomen on radiographs. CT examination revealed a large fluid-filled structure displacing the urinary bladder, prostate, and colon. The mass had continuity with the prostate; therefore, it was tentatively diagnosed as a paraprostatic cyst. Cytologic examination was performed and the mass was considered a non-inflammatory cyst. However, after surgery, histopathologic examination revealed a necrotic, inflamed cystic lipoma. This case shows that unusual intra-abdominal lipomas may have a cystic appearance.

Isoegomaketone Upregulates Heme Oxygenase-1 in RAW264.7 Cells via ROS/p38 MAPK/Nrf2 Pathway

Isoegomaketone (IK) was isolated from Perilla frutescens, which has been widely used as a food in Asian cuisine, and evaluated for its biological activity. We have already confirmed that IK induced the HO-1 expression via Nrf2 activation in RAW264.7 cells. In this study, we investigated the effect of IK on the mechanism of HO-1 expression. IK upregulated HO-1 mRNA and protein expression in a dose dependent manner. The level of HO-1 mRNA peaked at 4 h after 15 μM IK treatment. To investigate the mechanisms of HO-1 expression modulation by IK, we used pharmacological inhibitors for the protein kinase C (PKC) family, PI3K, and p38 MAPK. IK-induced HO-1 mRNA expression was only suppressed by SB203580, a specific inhibitor of p38 MAPK. ROS scavengers (N-acetyl-L-cysteine, NAC, and glutathione, GSH) also blocked the IK-induced ROS production and HO-1 expression. Furthermore, both NAC and SB203580 suppressed the IK-induced Nrf2 activation. In addition, ROS scavengers suppressed other oxidative enzymes such as catalase (CAT), glutathione S-transferase (GST), and NADH quinone oxidoreductase (NQO-1) in IK-treated RAW264.7 cells. Taken together, it can be concluded that IK induced the HO-1 expression through the ROS/p38 MAPK/ Nrf2 pathway in RAW264.7 cells.

Impact of surface roughness of gypsum materials on adaptation of zirconia cores

PURPOSE: The present study investigated the influences of various gypsum materials on the precision of fit of CAD/CAM-fabricated prostheses and analyzed their correlation with surface roughness. MATERIALS AND METHODS: The master model of the mandibular right first molar was replicated, and four experimental groups based on two types of Type IV stone (GC Fujirock EP, Die keen) and two types of scannable stone (Aesthetic-Basegold, Everest Rock) were created to include a total of 40 specimens, 10 in each group. The surface roughness of the working models for the respective experimental groups was measured. Once the zirconia cores had been fabricated, the marginal and internal fits were measured with a digital microscope using the silicone replica technique. The mean and standard deviation of the respective points of measurement were computed and analyzed through the one-way ANOVA and Tukey's HSD test. The correlation between surface roughness and the precision of fit of the zirconia core was analyzed using the Pearson correlation analysis (alpha=.05). RESULTS: The zirconia cores fabricated from the scannable stone working models exhibited a superior precision of fit as compared to those fabricated from the Type IV stone working models. The correlation analysis results showed a clear positive correlation between surface roughness and the precision of fit of zirconia cores in all of the experimental groups (P<.05). CONCLUSION: The results confirmed that the surface roughness of dental working models has a decisive influence on the precision of fit of zirconia cores.

Cardiac Damage Biomarkers Following a Triathlon in Elite and Non-elite Triathletes

The purpose of the present study was to investigate cardiac damage biomarkers after a triathlon race in elite and non-elite athlete groups. Fifteen healthy men participated in the study. Based on performance, they were divided into elite athlete group (EG: n=7) and non-elite athlete group (NEG: n=8). Participants' blood samples were obtained during four periods: before, immediately, 2 hours and 7 days after finishing the race. creatine kinase (CK), creatine kinase-myoglobin (CK-MB), myoglobin, and lactate dehydrogenase (LDH) were significantly increased in both groups immediately after, and 2 hours after finishing the race (p<.05). CK, CK-MB, and myoglobin were completely recovered after 7 days (p<.05). Hematocrit (Hct) was significantly decreased in both groups (p<.05) 7 days after the race. LDH was significantly decreased in the EG (p<.05) only 7 days after the race. Homoglobin (Hb) was significantly decreased in the NEG (p<.05) only 2 hours after the race. Although cardiac troponin T (cTnT) was significantly increased in the EG but not in the NEG 2hours after the race (p<.05), there was no group-by-time interaction. cTnT was completely recovered in both groups 7 days after the race. In conclusion, cardiac damage occurs during a triathlon race and, is greater in elite than in non-elite. However, all cardiac damage markers return to normal range within 1 week.

Accuracy and precision of polyurethane dental arch models fabricated using a three-dimensional subtractive rapid prototyping method with an intraoral scanning technique / 대한치과교정학회지

OBJECTIVE: This study aimed to evaluate the accuracy and precision of polyurethane (PUT) dental arch models fabricated using a three-dimensional (3D) subtractive rapid prototyping (RP) method with an intraoral scanning technique by comparing linear measurements obtained from PUT models and conventional plaster models. METHODS: Ten plaster models were duplicated using a selected standard master model and conventional impression, and 10 PUT models were duplicated using the 3D subtractive RP technique with an oral scanner. Six linear measurements were evaluated in terms of x, y, and z-axes using a non-contact white light scanner. Accuracy was assessed using mean differences between two measurements, and precision was examined using four quantitative methods and the Bland-Altman graphical method. Repeatability was evaluated in terms of intra-examiner variability, and reproducibility was assessed in terms of inter-examiner and inter-method variability. RESULTS: The mean difference between plaster models and PUT models ranged from 0.07 mm to 0.33 mm. Relative measurement errors ranged from 2.2% to 7.6% and intraclass correlation coefficients ranged from 0.93 to 0.96, when comparing plaster models and PUT models. The Bland-Altman plot showed good agreement. CONCLUSIONS: The accuracy and precision of PUT dental models for evaluating the performance of oral scanner and subtractive RP technology was acceptable. Because of the recent improvements in block material and computerized numeric control milling machines, the subtractive RP method may be a good choice for dental arch models.

Evaluation of the color reproducibility of all-ceramic restorations fabricated by the digital veneering method

PURPOSE: The objective of this study was to evaluate the clinical acceptability of all-ceramic crowns fabricated by the digital veneering method vis-a-vis the traditional method. MATERIALS AND METHODS: Zirconia specimens manufactures by two different manufacturing method, conventional vs digital veneering, with three different thickness (0.3 mm, 0.5 mm, 0.7 mm) were prepared for analysis. Color measurement was performed using a spectrophotometer for the prepared specimens. The differences in shade in relation to the build-up method were calculated by quantifying DeltaE* (mean color difference), with the use of color difference equations representing the distance from the measured values L*, a*, and b*, to the three-dimensional space of two colors. Two-way analysis of variance (ANOVA) combined with a Tukey multiple-range test was used to analyze the data (alpha=0.05). RESULTS: In comparing means and standard deviations of L*, a*, and b* color values there was no significant difference by the manufacturing method and zirconia core thickness according to a two-way ANOVA. The color differences between two manufacturing methods were in a clinically acceptable range less than or equal to 3.7 in all the specimens. CONCLUSION: Based on the results of this study, a carefully consideration is necessary while selecting upper porcelain materials, even if it is performed on a small scale. However, because the color reproducibility of the digital veneering system was within the clinically acceptable range when comparing with conventional layering system, it was possible to estimate the possibility of successful aesthetic prostheses in the latest technology.

Evaluation of the marginal and internal gap of metal-ceramic crown fabricated with a selective laser sintering technology: two- and three-dimensional replica techniques

PURPOSE: One of the most important factors in evaluating the quality of fixed dental prostheses (FDPs) is their gap. The purpose of this study was to compare the marginal and internal gap of two different metal-ceramic crowns, casting and selective laser sintering (SLS), before and after porcelain firing. Furthermore, this study evaluated whether metal-ceramic crowns made using the SLS have the same clinical acceptability as crowns made by the traditional casting. MATERIALS AND METHODS: The 10 study models were produced using stone. The 20 specimens were produced using the casting and the SLS methods; 10 samples were made in each group. After the core gap measurements, 10 metal-ceramic crowns in each group were finished using the conventional technique of firing porcelain. The gap of the metal-ceramic crowns was measured. The marginal and internal gaps were measured by two-dimensional and three-dimensional replica techniques, respectively. The Wilcoxon signed-rank test, the Wilcoxon rank-sum test and nonparametric ANCOVA were used for statistical analysis (alpha=.05). RESULTS: In both groups, the gap increased after completion of the metal-ceramic crown compared to the core. In all measured areas, the gap of the metal cores and metal-ceramic crowns produced by the SLS was greater than that of the metal cores and metal-ceramic crowns produced using the casting. Statistically significant differences were found between cast and SLS (metal cores and metal-ceramic crown). CONCLUSION: Although the gap of the FDPs produced by the SLS was greater than that of the FDPs produced by the conventional casting in all measured areas, none exceeded the clinically acceptable range.

Combined effects of food and exercise on anaphylaxis

Food-dependent exercise-induced anaphylaxis (FDEIAn) is induced by different types and various intensities of physical activity, and is distinct from food allergies. It has been shown that consumption of allergenic food followed by exercise causes FDEIAn symptoms. Intake of allergenic food or medication before exercise is a major predisposing factor for FDEIAn. Urticaria and severe allergic reactions are general symptoms of FDEIAn. Dermatological tests and serum IgE assays are the typical prescreening methods, and have been used for several decades. However, these screening tests are not sufficient for detecting or preventing FDEIAn. It has been found that exercise may stimulate the release of mediators from IgE-dependent mast cells that can result in FDEIAn when a certain threshold level has been exceeded. Mast cell degradation might be a major factor to induce FDEIAn but this has not been determined. A number of foods have been reported to be involved in the onset of FDEIAn including wheat, eggs, chicken, shrimp, shellfish, nuts, fruits, and vegetables. It is also known that aspirin increases the occurrence of type I allergy symptoms when combined with specific foods. Moreover, high intensity and frequent exercise are more likely to provoke an attack than low intensity and less frequent exercise. In this paper, we present the current views of the pathophysiological mechanisms underlying FDEIAn within the context of exercise immunology. We also present a detailed FDEIAn definition along with etiologic factors and medical treatment for cholinergic urticaria (UC) and exercise-induced anaphylaxis (EIA).

Sudden Pulseless Ventricular Tacchycardia during the Emergence of a Child after the General Anesthesia, and Suspected Viral Myocarditis

A 10-year-old female child was underwent the tonsillectomy and adenoidectomy. She was relieved from the upper respiratory tract infection about 1 week before the operation. Her heart rate was recorded 100 to 110 per minute at the preanesthetic period, and then increased to about 140 per minute during the operation. We speculated that tacchycardia resulted from the inhalation anesthesia of sevoflurane as other common cases, so we didn't consider it as a serious problem. But the taccycardia was not relieved after the termination of anesthesia, and after the extubation, it was severely and rapidly aggravated to the ventricular tacchycardia with the circulatory collapse during the emergence period. After the rapid defibrillation and the chest compression, her resuscitation was successfully finished. We suspected her event was derived from the childhood cardiomyopathy, especially the viral myocarditis. So we reviewed viral myocarditis and focused a new aspect of childhood cardiac disease and screening.

A case of Haemophilus aphrophilus native valve endocarditis / 대한내과학회지

Haemophilus aphrophilus, a fastidious, gram-negative oropharyngeal species grouped as a HACEK organism, is a rare cause of infective endocarditis. Three cases of endocarditis with Haemophilus aphrophilus were reported in Korea, and all of them required valve replacement surgery. We describe a case of native valve infective endocarditis with cerebral embolism and infarction caused by Haemophilus aphrophilus in a 61-year-old woman who was successfully treated with antibiotic therapy for 6 weeks without valve replacement surgery.

Gluteal and Thigh Compartment Syndrome due to Rhabdomyolysis Following Prolonged Immobilization: A Case Report / 대한신장학회지

Compartment syndrome is rarely associated with non-traumatic rhabdomyolysis. We report the case of a 23-year-old man who developed compartment syndrome associated with rhabdomyolysis caused by prolonged immobilization after antidepressive drug overdose. Elevation of serum creatine phosphokinase and myoglobinuria indicated rhabdomyolysis. Painful swelling of the right buttock and thigh and right lower limb paralysis with sensory and motor deficit were suggestive of gluteal and thigh compartment syndrome with the complication of sciatic nerve injury. The patient received an immediate fasciotomy, medical treatment and rehabilitation. At five months after initial treatment, the patient could walk independently with nearly full recovery of his right lower limb function.

A Case of Encapsulating Peritoneal Sclerosis, Presenting as Hemoperitoneum, Successfully Treated by Enterolysis / 대한신장학회지

Encapsulating peritoneal sclerosis (EPS) is an uncommon but fatal complication of peritoneal dialysis (PD). Recently, there were some reports of advanced EPS cases that were successfully treated by enterolysis although an intestinal perforation or leakage from intestinal anastomosis were associated with a high mortality. We experienced a case of EPS in a 53-year-old man on PD for 3.5 years without a previous history of episode of peritonitis who presented with hemoperitoneum during treatment of peritonitis. EPS was diagnosed radiologically according to typical CT findings; The series of CT scans revealed how to develop in sequence from a very subtle findings to full-blown findings of EPS. Enterolysis was performed because the patient did not respond to conservative management such as cessation of PD with transfer to hemodialysis, nutritional support and steroid therapy. In spite of intestinal perforation during surgery, he was successfully treated with enterolysis. Therefore, we report this case with review of the literature.

Bilateral symmetric lacerations of the soft palate after general anesthesia using the laryngeal mask airway ProSeal(TM): A case report / 대한마취과학회지

ProSeal(TM) laryngeal mask airway (PLMA) was developed to be more effective especially with glottic airway sealing and is suppose to be an improved device over the classic laryngeal mask airway (cLMA). The PLMA's cuff is bulkier, softer, and more pliable than the cLMA. We reviewed a case were a patient had hand surgery under general anesthesia using the PLMA. After having the hand surgery, the patient suffered from dyspnea and had difficulty with their respirations at a supine position. The problems with dyspnea and respiration after surgery resulted because of difficulties from inserting PLMA No.5 into the patient. We suspect from this case that the problems in dyspnea and respiration were due to the folded cuff and incomplete placement of the PLMA, which resulted in lacerations of the mucosa in the soft palate of the patient. In this paper, we considered the probable causes for lacerations of the mucosa in the soft palate and reviewed all of the relevant literature, especially about the proper placement of the PLMA.

A Case of Persistent Trigeminal Artery Presenting as Vertebrobasilar Insufficiency

The persistent trigeminal artery(PTA) is the most common type of persistent carotid-basilar anastomosis, usually diagnosed by cerebral angiography or autopsy. PTA is usually associated with hypoplasia or atresia of the vertebrobasilar artery and may result in symptoms of vertebrobasilar insufficiency caused by decreased perfusion of the brainstem. We report a patient with PTA who presented with symptoms of vertebrobasilar insufficiency. An 80-year-old woman with a history of hypertension, hyperlipidemia, and unstable angina pectoris presented with recurrent dizziness, dysarthria, and a tendency to fall to the left side. PTA was identified with hypoplasia of the vertebrobasilar system and mild stenosis of the bilateral proximal internal carotid arteries on brain MR angiography and cerebral angiography.

Blunted erythropoietin response: the common findings in various anemic patients / 대한내과학회지

BACKGROUND/AIMS: The characteristics of erythropoietin response in patients suffering with anemia of chronic disease and in the patients with various other anemias are poorly defined. Thus, we evaluated the clinical factors that influence the erythropoietin response. METHODS: We enrolled the anemic patients (hemoglobin <13 g/dL for males and <12 g/dL for females) who visited the Hematology-Oncology department of Konkuk University Hospital from Mar 2006 to April 2007. The laboratory tests, including the complete blood count, serum ferritin, serum vitamin B12/folate, the peripheral blood morphology and serum erythropoietin, were done. The erythropoietin response to anemia was assessed by the ratio of the log of the measured erythropoietin to the log of the expected erythropoietin. RESULTS: A total of 161 patients, including 42 iron-deficiency anemia (IDA) patients, were analyzed. 119 non-IDA patients were diagnosed with infection (n=46), chronic renal failure (n=27), cancer (n=20), heart failure (n=12), or with other diseases (n=14). Except for the cancer patients, all the patients with other diseases showed a blunted erythropoietin response in comparison with the IDA patients (p=0.000). Among the non-IDA patients, those patients older than 65 years showed more blunted erythropoietin response than did the younger patients (p=0.01), and the diabetics without renal dysfunction also tended to respond better to erythropoietin than did the non-diabetics (p=0.055). CONCLUSION: A blunted erythropoietin response was observed in most of the anemic patients in our study. Old age and diabetes may further blunt the erythropoietin response. The feasibility of erythropoietin testing and supplementation treatment in these patients merits further evaluation.

Analysis of Endoscopic Electronic Image of Intramucosal Gastric Carcinoma Using a Software Program for Calculating Hemoglobin Index

Hemoglobin is the predominent pigment in the gastrointestinal mucosa, and the development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, by using a hemoglobin index (IHb). The aims of this study were to make a software program to calculate the IHb and then to investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma with regard to its value for discriminating between the histologic types. We made a software program for calculating the IHb in the endoscopic images. By using this program, the mean values of the IHb for the carcinoma (IHb-C) and those of the IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type intramucosal gastric carcinomas. We then analyzed the ratio of the IHb-C to the IHb-N (C/N ratio). The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001). In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022). The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for making quantitative measurement of the endoscopic color in the intramucosal gastric carcinoma, and the C/N ratio by using the IHb would be helpful for distinguishing the diffuse-type carcinoma from the intestinal-type carcinoma.