Inhalation risk assessment of naphthalene emitted from deodorant balls in public toilets

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.

Inhalation risk assessment of naphthalene emitted from deodorant balls in public toilets

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.

Inhalation risk assessment of naphthalene emitted from deodorant balls in public toilets

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.

Comparative study of oxidative stress caused by anthracene and alkyl-anthracenes in Caenorhabditis elegans

Oxidative stress was evaluated for anthracene (Ant) and alkyl-Ants (9-methylanthracene [9-MA] and 9,10-dimethylanthracene [9,10-DMA]) in Caenorhabditis elegans to compare changes in toxicity due to the degree of alkylation. Worms were exposed at 1) the same external exposure concentration and 2) the maximum water-soluble concentration. Formation of reactive oxygen species, superoxide dismutase activity, total glutathione concentration, and lipid peroxidation were determined under constant exposure conditions using passive dosing. The expression of oxidative stress-related genes (daf-2, sir-2.1, daf-16, sod-1, sod-2, sod-3 and cytochrome 35A/C family genes) was also investigated to identify and compare changes in the genetic responses of C. elegans exposed to Ant and alkyl-Ant. At the same external concentration, 9,10-DMA induced the greatest oxidative stress, as evidenced by all indicators, except for lipid peroxidation, followed by 9-MA and Ant. Interestingly, 9,10-DMA led to greater oxidative stress than 9-MA and Ant when worms were exposed to the maximum water-soluble concentration, although the maximum water-soluble concentration of 9,10-DMA is the lowest. Increased oxidative stress by alkyl-Ants would be attributed to higher lipid-water partition coefficient and the π electron density in aromatic rings by alkyl substitution, although this supposition requires further confirmation.

Comparative study of oxidative stress caused by anthracene and alkyl-anthracenes in Caenorhabditis elegans

Oxidative stress was evaluated for anthracene (Ant) and alkyl-Ants (9-methylanthracene [9-MA] and 9,10-dimethylanthracene [9,10-DMA]) in Caenorhabditis elegans to compare changes in toxicity due to the degree of alkylation. Worms were exposed at 1) the same external exposure concentration and 2) the maximum water-soluble concentration. Formation of reactive oxygen species, superoxide dismutase activity, total glutathione concentration, and lipid peroxidation were determined under constant exposure conditions using passive dosing. The expression of oxidative stress-related genes (daf-2, sir-2.1, daf-16, sod-1, sod-2, sod-3 and cytochrome 35A/C family genes) was also investigated to identify and compare changes in the genetic responses of C. elegans exposed to Ant and alkyl-Ant. At the same external concentration, 9,10-DMA induced the greatest oxidative stress, as evidenced by all indicators, except for lipid peroxidation, followed by 9-MA and Ant. Interestingly, 9,10-DMA led to greater oxidative stress than 9-MA and Ant when worms were exposed to the maximum water-soluble concentration, although the maximum water-soluble concentration of 9,10-DMA is the lowest. Increased oxidative stress by alkyl-Ants would be attributed to higher lipid-water partition coefficient and the π electron density in aromatic rings by alkyl substitution, although this supposition requires further confirmation.

Dislocation of Left Arytenoid Cartilage after Endotracheal Intubation Using Light Wand: A case report / 대한마취과학회지

Complications from use of the light wand have been reported rarely. We present a case of arytenoid cartilage dislocation incurred by using this technique for intubation of a patient. A 35-year-old healthy woman was admitted for microsurgical cervical diskectomy. Anesthesia was induced and a 7.0 mm cuffed endotracheal tube with a light wand was inserted during blind orotracheal intubation. The trachea was extubated without any difficulty in the operating room after the surgery. In the third postoperative day, the patient complained sore throat and mild hoarseness. In the eighth postoperative day, the patient was discharged for follow-up of Department of neurosurgery. In the second day after the discharge, she was consulted to otolaryngology service in our hospital because she suffered from persistent hoarseness. Flexible nasopharyngolaryngoscopy revealed anterior and inferior dislocation of left arytenoid cartilage. The patient was taken to the operating room for reduction of the dislocated cartilage by the otolaryngologists. Despite the delayed reduction, which was performed tenth day after her initial injury, the patient,s hoarseness had resolved completely without further treatment.

Retrograde Nasogracheal Intubation with Laryngeal Mask Airway / 대한마취과학회지

Retrograde intubation has been often used in the patient who reveal difficulty intubation. But, it is time consuming procedure and the patient may be fall into hypoxemia. We have experienced a successful retrograde nasotracheal intubation without hypoxemia by using the Laryngeal Mask Airway. After induction of inhalation anesthesia, ordinary endotracheal intubation was failed in this 45-year-old male patient who was planned to clip the cerebral aneurysm, because the epiglottis could not be seen under direct laryngoscopy. We decided to perform retrograde nasotracheal intubation. Face mask was replaced with Laryngeal Mask Airway and ventilation was continued during procedure. A 18-gauge Tuohy needle was introduced through the cricothyroid membrane and then the epidural catheter was passed cephalad to larynx, distal hole of Laryngeal Mask Airway, and the end of Laryngeal Mask Airway. A 16-F Levin tube was introduced through right nasal cavity and Laryngeal Mask Airway was removed, the Levin tube was tied with epidural catheter in the oral cavity. The epidural catheter was placed from cricothyroid membrane to right nares. The endotracheal intubation was performed successfully by sliding over the catheter. In the postoperative evaluation, significant complications were not detected. The procedure was performed in about 2 minutes and the apneic time was less than 30 seconds. We believe that this procedure may be useful in the patients who may suffer from hypoxemia.

Measurement of Trachea with MRI in the Normal Korean Adults / 대한마취과학회지

It is clinically important to know the size of normal trachea for airway management and respiratory care. The knowledge is useful for avoiding many possible complications due to tracheal intubation by appropriate choice of endotracheal tube size. Therefore, we investigated antero-posterior(A-P) diameter, transverse diameter and cross- sectional area(CSA) of trachea at various level with MRI(magnetic resonance imaging) in 70 males and 79 females who were divided into three age groups(group 1: 16-39 year of age, group 2: 40-59 year of age, group 3: 60-83 year of age), and they had no abnormalities in cardiopulmonary system. The results were as follows; 1. A-P 2. Transverse 3. Narrowing portion 4. CSA 1. A-P diameter of trachea was 17.1+/-1.4 mm in male and 13.9+/-1.3 mm in female. Transverse diameter of trachea was 15.1+/-1.6 mm in male and 13.3+/-1.5 mm in female(Table 1). A-P and Transverse diameters were greater in male than in female (P<0.05). 2. C-7 was the narrowest portion of A-P diameter in both sex (P<0,05). C-5 was the narro- west portion of transverse diameter in both sex (P<0.05). 3. A-P diameters of trachea among male patients were 17.1+/-1.2 mm, 17.41.6 mm, and 16.6+/- 1.3 mm in group 1, 2 and 3 (Table 3, Fig. 4). A-P diameters of trachea in female age group 1, group 2 and group 3 were 13.7+/-1.2 mm, 14.3+/-1.3 mm, and 13.6+/-1.5 mm(Table 3, Fig. 4). Transverse diameters of trachea in male age group 1, group 2 and group 3 were 14.8+/-1.4 mm, 15.1+/-1.7 mm, and 15.4+/-1.6 mm(Table 3, Fig. 4). Transverse diameters of trachea in female age group 1, group 2 and group 3 were 13.0+/- 1.2 mm, 13.6+/-1.9 mm and 13.5+/-1.4 mm(Table 3, Fig. 4). 4. CSA(cross sectional area) of trachea were 201.1+/-31.3 mm(2) in male and 145.4+/-27.7(2) mm in female(Table 4). 5. CSA at C5, C6, C7 and Tl in male were 175.9+/-61.1 mm(2), 201.1+/-43.8 mm(2), 196.2+/-36.2 mm(2) and 230.9+/-463 mm(2) (Table 4, Fig. 5). CSA at C5, C6, C7 and Tl in female were 127.0+/- 33.4 mm(2), 138.434.6 mm(2), 140.734.7 mm(2) and 171.7+/-42.0 mm(2) (Table 4, Fig. 5). 6. CSA of trachea among male patients were 198.1+/-28,5 mm(2), 206.2+/-33.0 mm(2) and 198.3+/-33.1 mm(2) in group 1, 2 and 3 (Table 5, Fig. 6). CSA of trachea in female age group 1, group 2 and group. 3 were 140.2+/-25.0 mm(2), 152.8+/-32.4 mm(2) and 145.6+/-25.1 mm(2) (Table 5, Fig. 6). But there was no significant difference between groups according to the sex. 7. CSA of trachea in age groups were stastically insignificant for both sex.

Clinical Evaluation of Brachial Plexus Block with Alkalinized Bupivacaine / 대한마취과학회지

To define the effect of alkalinization of bupivacaine 0.5% in supraclavicular approch of brachial plexus bock, the onset of sensory and motorblock were determined. Fourty physical status ASA 1 were randomly allocated to two groups.: Group 1 (n=20); bupivacaine 0.5% 20 ml (pH 6.0-6.2). Group 2 (n=20); alkalinized buivacaine 0.5% 20 ml (pH 6.9-7.2). Onest of sensory blockade were determined by pinprick in the C4 - T2 skin dermatome, and extend of sensory block was assessed by the number of dermatomes blocked while motor blockade was assessed by scoring on a scale: Grade 1; inability to flex the elbow against resistance. Grade 2; inability to flex the elbow against gravity. Grade 3; inability to flex the wrist against gavity. The results were as follows. 1) The average time for sensory blockade of five dermatonies was significantly more rapid in group 2 (within 15 min) than those in group 1 (over 25 min). 2) The average time of motor blockade was significantly more rapid in group 2 (Grade 1: 2 min 43 sec, Grade 2: 11 min 36 sec) than those in group 1 (Grade 1: 5 min 4 sec, Grade 2: 18 min 36 sec). 3) There was no pneumothorax, phrenic nerve paralvsis and general seizure or other side effects but Horners syndrome in 10 cases and hematoma in 2 cases were observed. The results indicate that alkainized bupivacaine for supraclavicular approch of rachial plexus block has more rapid onset than plain bupivacaine.