Antibacterial effect of biodegradable gelatin methacryloyl loaded with ginger rhizome extract / 대한치과재료학회지

Gelatin methacryloyl 3d mesh mimics the natural extracellular matrix which allow loading as promising drug delivery systems.However, insufficient mechanical and degradation properties remain the biggest obstacle for this material application. In this study, a modified hydrogel with natural phytochemical was developed to improve the antibacterial effect by the addition of ginger extract, a natural spicy used in traditional medicine. GelMA hydrogels with ginger extract were fabricated and their chemical and morphological characteristics were analyzed by Fourier transformer infrared spectroscopy and scanning electron microscopy, structural characteristic were evaluated by compressive test and surface wettability analysis. S. mutans, S. aureus and P. gingivalis were used to confirm the antibacterial effect of the modified hydrogels. The FT-IR spectra of the hydrogels modified with ginger presented an increase in intensity of some peaks in comparison with the 10% GelMA hydrogel. The pores of ginger-modified hydrogels decreased it size which affected the hydrogels physical properties, decreasing the compressive modulus and increasing the durability, swelling ratio and, hydrophobicity of the surface. The ginger-modified hydrogels exhibited excellent antibacterial properties against S. mutans and S. aureus at high concentrations of ginger extract, while P. gingivalis presented a higher sensitivity at all tested concentrations. Hence, this study concludes that ginger-modified GelMA hydrogels presented better antibacterial effect, durability over time and, swelling stability.

Evaluation of bone regeneration ability of Mg mesh coated with calcium phosphate by cyclic precalcification treatment / 대한치과재료학회지

Surface treatment was conducted to reduce dissolution of Mg mesh and to improve bioactivity in physiological environment. Mg mesh was immersed in 40 wt% hydrofluoric (HF) solution for 2 hours to form a protective coating layer. Then, hydrothermal treatment was performed in a mixed solution of Ca(NO3)2·4H2O and Na2HPO 4 at 90 ℃ for 30 minutes, and cyclic precalcification treatment was conducted by soaking in each 0.06 M NH 4H 2PO4 solution and 0.011 M Ca(OH)2 solution in turn at 90 ℃. Immersion test was performed in simulated body fluid (SBF) to investigate solubility and bioactivity. Release characteristics were investigated after loading ibandronate to suppress initial bone resorption. Bone regeneration ability was evaluated through micro-CT analysis and conforming inflammatory cytokines levels in blood. Fine granular calcium phosphate-based materials were precipitated as clusters on the surface treated in cyclic precalcification. Agglomerated calcium phosphate precipitates on the surface were observed after SBF immersion. pH in SBF during immersion increased slowly in hydrothermal treatment and cyclic precalcification groups compared to pure Mg group. Release of ibandronate occurred over 6 days in cyclic precalcification treatment group (CP-H1). IL-1β and IL-6 were significantly lower than those of untreated group in all test groups except for the group (CP-H4) that was heat-treated at 400 ℃ after pretreatment with circulating calcification. As a result of micro-CT analysis, the new bone volume and density were significantly higher in the CP-H1 group. It was concluded that cyclic precalcification treatment after formation of fluorine protective layer on Mg mesh could retard the dissolution and enhanced bone regeneration ability.

Osteoblast cytocompatibility and antibacterial effect of ginger main compounds / 대한치과재료학회지

Ginger has been used worldwide in traditional medicine. It has been reported that phenolic compounds such as gingerol and shogaol in ginger have beneficial cellular effect and antibacterial effect. The purpose of this study was to investigate the effect of gingerol and shogaol on the cytocompatibility for the osteoblastic cells and antibacterial activity against oral microorganisms. Chemical structures of gingerol and shogaol were determined by Fourier transform infrared (FT-IR). Thermal and pH stability was analyzed by UPLC assay. Streptococcus mutans, and Porphyromonas gingivalis were used to confirm the antibacterial effect of the ginger compounds and MC3T3-E1 cells were used to identify biocompatibility test. Cell viability and bacterial growth was determined by water-soluble tetrazolium salt (WST-8) colorimetric assay. Cellular morphology was identified with optical microscope after crystal violet staining. Cell differentiation and oxidative stress were evaluated by Alkaline phosphatase (ALP) assay and hydrogen peroxide colorimetric assay. The chemical bonding related with hydroxyl groups, carbonyl groups and aromatic ring was identified in all ginger compounds. Gingerol and shogaol presented good stability at acid and neutral pH at room temperature. All compounds showed better antibacterial effect against Porphyromonas gingivalis than Streptococcus mutans. 10-gingerol and all shogaol groups below 10-6 M presented suitable cytocompatibility for osteoblastic cells compared to control group. All groups showed similar Oxidative stress to control group, and ALP activity in all groups below 10-6 M was not statistically significant compared to control. Hence, this study concludes that shogaol groups presented better antibacterial effect and suitable cytocompatibility than gingerol groups.

Osteoblast cytocompatibility and antibacterial effect of ginger main compounds / 대한치과재료학회지

Ginger has been used worldwide in traditional medicine. It has been reported that phenolic compounds such as gingerol and shogaol in ginger have beneficial cellular effect and antibacterial effect. The purpose of this study was to investigate the effect of gingerol and shogaol on the cytocompatibility for the osteoblastic cells and antibacterial activity against oral microorganisms. Chemical structures of gingerol and shogaol were determined by Fourier transform infrared (FT-IR). Thermal and pH stability was analyzed by UPLC assay. Streptococcus mutans, and Porphyromonas gingivalis were used to confirm the antibacterial effect of the ginger compounds and MC3T3-E1 cells were used to identify biocompatibility test. Cell viability and bacterial growth was determined by water-soluble tetrazolium salt (WST-8) colorimetric assay. Cellular morphology was identified with optical microscope after crystal violet staining. Cell differentiation and oxidative stress were evaluated by Alkaline phosphatase (ALP) assay and hydrogen peroxide colorimetric assay. The chemical bonding related with hydroxyl groups, carbonyl groups and aromatic ring was identified in all ginger compounds. Gingerol and shogaol presented good stability at acid and neutral pH at room temperature. All compounds showed better antibacterial effect against Porphyromonas gingivalis than Streptococcus mutans. 10-gingerol and all shogaol groups below 10-6 M presented suitable cytocompatibility for osteoblastic cells compared to control group. All groups showed similar Oxidative stress to control group, and ALP activity in all groups below 10-6 M was not statistically significant compared to control. Hence, this study concludes that shogaol groups presented better antibacterial effect and suitable cytocompatibility than gingerol groups.

In vitro wear behavior between enamel cusp and three aesthetic restorative materials: Zirconia, porcelain, and composite resin

PURPOSE: The aim of this study was to identify the effects of three aesthetic restorative materials on the wear between tooth and restoration by a pin-on-disk manner. MATERIALS AND METHODS: Six aesthetic restorative materials were used to prepare disk specimens for wear test, which were Lava Zirconia as zirconia group, Vintage MP and Cerabien ZR as veneering porcelain group, Gradia Direct microhybrid composite containing prepolymerized fillers, Filtek Z250 microhybrid composite containing zirconia glass and colloidal silica particles, and Filtek Z350 nanocomposite as composite resin group. Vertical loss of the worn cusp, change of the surface roughness of the restoration materials, and the surface topography were investigated after wear test under 9.8-N contact load. RESULTS: The porcelain groups (Vintage MP and Cerabien ZR) caused the largest vertical loss of teeth when compared with those of the composite resin and zirconia groups, and Filtek Z250 microhybrid composite results in the second-largest vertical loss of teeth. The surface of Filtek Z350 nanocomposite was deeply worn out, but visible wear on the surface of the zirconia and Gradia Direct microhybrid composite was not observed. When the zirconia surface was roughened by sand-blasting, vertical loss of teeth considerably increased when compared with that in the case of fine polished zirconia. CONCLUSION: It was identified that microhybrid composite resin containing a prepolymerized filler and zirconia with reduced surface roughness by polishing were the most desirable restorative materials among the tested materials to prevent the two-body wear between aesthetic restorative material and tooth.

Evaluation of bioactivity and osseointegration for ti-6al-4v alloy implant modified by anodic oxidation and cyclic precalcification treatments / 대한치과재료학회지

The aim of this study was to examine the bioactivity and osseointegration of Ti-6Al-4V alloy implant which was modified by an anodic oxidation and a cyclic precalcification treatments. After blasting treatment using HAp (Hydroxyapatitie; HAp) powder which is resorbable blasting media (RBM) on the surface of Ti-6Al-4V alloy implants, the anodic oxidation treatment and the cyclic precalcification treatment were conducted to form nanotube TiO2 layer and HAp precipitation respectively. The surface morphology of the surface-treated Ti-6Al-4V alloy implant was investigated after immersion in the simulated body fluid(SBF) for 3 days to investigate the bioactivity. To investigate the effect of surface treatment on bonding between the implant and bone, RBM treated implant and RBM-anodization-cyclic precalcification(RACP) treated implant were placed on the distal side of both tibia diaphysis of rats, and then the removal torque of the implant was measured after 4 weeks. On the surface of RACP treated group, bone-like apatite precipitation was observed after immersion in SBF for 3 days. The removal torque was significantly higher in the RACP treated group than in the RBM treated group. The interfacial fracture between the implant and the new bone was observed in the RBM treated group, but both the cohesive fracture at the new bone and the interfacial fractures between the implant and the new bone were observed in the RACP treated group.

Effects of conditions for anodization and cyclic precalcification treatments on surface characteristics and bioactivity / 대한치과재료학회지

The purpose of this study was to investigate the effects of the anodization and cyclic calcification treatment on the surface characteristic and bioactivity of the titanium thin sheet in order to obtain basic data for the production of bioactive titanium membrane. A 30×20×0.08 mm titanium sheets were prepared, and then they were pickled for 10 seconds in the solution which was mixed with HNO₃: HF: H₂O in a ratio of 12: 7: 81. The TiO₂ nanotube layer was formed to increase the specific surface area of the titanium, and then the cyclic calcification treatment was performed to induce precipitation of hydroxiapatite by improvement of the bioactivity. The corrosion resistance test, wettability test and immersion test in simulated body solution were conducted to investigate the effect of these surface treatments. The nanotubes formed by the anodization treatment have a dense structure in which small diameter tubes are formed between relatively large diameter tubes, and their inside was hollow and the outer walls were coupled to each other. The hydroxyapatite precipitates were well combined on the nanotubes by the penetration into the nanotube layer by successive cyclic calcification treatment, and the precipitation of hydroxyapatite tended to increase proportionally after immersion in simulated body solution as the number of cycles increased. In conclusion, it was confirmed that induction of precipitation of hydroxyapatite by cyclic calcification treatment after forming the nanotube TiO₂ nanotube layer on the surface of the titanium membrane can contribute to improvement of bioactivity.

A Case of Esophageal Perforation Cured by Conservative Management after Stent Insertion / 대한소화기내시경학회지

Esophageal cancer may induce progressive dysphagia. Insertion of a self-expandable metallic stent is widely used to relieve dysphagia. There are previous case reports that have described the use of membrane-covered stents to seal esophageal perforations. Complications of the use of an esophageal stent include bleeding, fistula formation, perforation, pain, tumor ingrowth and migration of the stent. A perforation may occur during or after the insertion of a stent from a contact ulcer due to the sharp ends of the metallic stents. We report a case of esophageal perforation after the insertion of a membrane-covered esophageal stent, which showed perforation at the middle portion of stent due to expansion of the stent. The perforation was sealed without surgical treatment or additional stent insertion.

Bilateral Facial Nerve Palsy after Mycoplasma Pneumoniae Infection: A Variant of Guillain-Barre Syndrome?

A 9-year-old girl presented with bilateral facial weakness since 10 days after upper respiratory infection. Blink reflex studies and nerve conduction studies suggested bilateral lesions of proximal facial nerves. Her serum was strongly positive for IgM antibodies to Mycoplasma pneumoniae and mildly for IgM to galactocerebroside and albuminocytologic dissociation was found in her cerebrospinal fluid. This case is of the bilateral facial neuropathy by Mycoplasma pneumoniae infection suggesting a variant of Guillain-Barre syndrome.

A Case of Sclerosing Cholangitis Showing Response to Prednisolone / 대한소화기학회지

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by progressive fibrosis and destruction of intra- and extrahepatic bile ducts resulting in hepatic failure and death. Only the liver transplantation is the possible treatment for patients to survive. There has been a few reports that steroid is an effective treatment in autoimmune variant sclerosing cholangitis, which is thought to be a familial diseases with different etiology, and steroid responsive biliary strictures be named as immunoglobulin G4 (IgG4)-associated cholangitis (IAC). There is no reliable data regarding effective steroid treatment in autoimmue variant sclerosing cholangitis in Korea. We report a case of 32-year-old male with sclerosing cholangitis, who was diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and liver biopsy, showing favorable response to prednisolone therapy.

A Case of Peripheral Polyneuropathy Induced by Occupational 2,5-hexanedione Exposure / 대한산업의학회지

OBJECTIVES: This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process. METHODS: In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione. RESULTS: Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05). CONCLUSIONS: 2.5-hexandione can induce peripheral polyneuropathy in male workers.

The Usefulness of Endoscopic Ultrasonoraphy for Discriminating Gastric Mucosal Cancer from Submucosal Invasion / 대한소화기내시경학회지

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) has been used to discriminate gastric mucosal cancer (T1m) from submucosal invasion (T1sm). Thus the aims of this study are 1) to determine the accuracy of EUS for diagnosing tumor depth, 2) to compare the accuracy of EUS with the endoscopic impressions of variously experienced endoscopists and 3) to compare the accuracy of performing EUS by one doctor according to the experience. METHODS: The EUS and pathologic reports of early gastric cancer patients were analyzed. The same endoscopic images were reviewed again by 3 endoscopists, who had one-, three- and five-years experience, respectively. The accuracies of EUS and conventional endoscopy were analyzed. RESULTS: 77 patients were included from November 2003 to October 2005. The kappa of the EUS for actual examiner and conventional endoscopy for reviewer 1, reviewer 2 and reviewer 3 were 0.421, 0.134, 0.359 and 0.307, respectively and accuracies were 68.8%, 45.5%, 67.5% and 62.3%, respectively. Of the 52 T1m patients, 23 (44.2%) were overstaged as T1sm with performing EUS. But of 25 T1sm patients, only 1 (4.0%) was understaged as T1m with performing EUS. The accuracy and kappa of the EUS for one doctor during the first-year experience were 60.6% and 0.316, respectively, and they were 75.0% and 0.508, respectively during the second-year experience. CONCLUSIONS: EUS is useful for complementing the conventional endoscopic discrimination of gastric mucosal cancer from submucosal invasion. Yet physician should keep in mind the relatively common overstaging.

Incidence of Dimethylacetamide Induced Toxic Liver Injury among Workers in a Synthetic Fiber Manufacturing Company / 대한산업의학회지

OBJECTIVES: The main goal of this study was to find the incidence of the dimethylacetamide (DMAc) induced toxic liver injury among workers who were exposed to DMAc for about 5 years in a synthetic fiber factory. METHODS: In our investigation, total 1,021 workers had been exposed to DMAc from 1st February, 2000 to 30th June, 2004. Among them, 24 workers who had initial abnormal hepatic enzyme level or was viral hepatitis B carrier were excluded. Finally, 997 DMAc exposed workers were followed up for their incidence of toxic liver injury. To find out DMAc induced toxic liver injury case, we carried out regular examinations including liver enzyme tests such as AST and ALT. RESULTS: We followed up 997 workers and among them 72 cases coincided with our case definition. Incidence density method was 6.05 per 100 person-year. and, a cumulative incidence by life table method was 0.0965 within a year. The incidence of the DMAc-induced toxic liver injury peaked at 4 to 5 in weeks after employment. There was no toxic liver injury case within second week after exposure to DMAc. Five new cases developed in 2th to 3th week, 25 cases in 4th to 5th week, 14 cases in 6th to 7th week, 12 cases in 8th to 9th week, 5 cases in 10th to 11th week, 4 cases in 12th to 13th week, 4 cases in 14th to 15th week, 1 case in 16th to 17th week, 1 case in 30th to 31th week, and there was one case in 48th to 49th week. CONCLUSIONS: The incidence rate of toxic liver injury was considerably high during the 1st year after a worker is placed. So it is needed to take careful monitoring of hepatic enzyme level for newly exposed worker.

Step-by-step Management and Treatment Outcome of Bleeding Control for Anastomosis Site after Low Anterior Resection with Double Stapling Technique

PURPOSE: This study reviews our experience with a step- by-step management approach of increasing aggressiveness and evaluates the treatment outcome for intraluminal hemorrhage. METHODS: The study group was comprised of patients who had experienced intraluminal hemorrhage after a low anterior resection with the double stapling technique from 1999 to 2003. The choice of management was selected according to our step-by-step management protocol, and the outcomes were evaluated for each step, lincluding mortality and complications. RESULTS: Nine patients (6 males and 3 females, mean age 55 years) were identified, the mean volume of packed RBC transfusion was 2 pints, and the mean distance of the anastomotic site from the anal verge was 6 cm. The median stapler size was 31 mm. The first step was cold saline irrigation and drainage; four of 9 patients were controlled. The second step was retention enema with topical hemostatics; one of remaining 5 patients stopped bleeding. The third step was colonoscopic hypertonic saline injection around the bleeding site with direct colonoscopic electrocauterization, two of remaining 4 patients were controlled. The last step was suturing the bleeding site through the anus, the remaining 2 patients stopped bleeding. One of the 9 patients developed leakage from the anastomotic site after the last step management, three of the 9 patients had long standing ileus, and one of the 9 patients developed acute renal failure after a massive transfusion. There were no postoperative deaths. CONCLUSIONS: It is safer and easier to control bleeding with step-by-step management system of increasing aggressiveness.

A Case of Multiple Juvenile Xanthogranuloma Involving Skin and Systemic Organs / 소아과

Juvenile xanthogranuloma(JXG) is one of the most common non-Langerhans cell histiocytosis, benign histiocytic proliferative disorder. It typically presents as a solitary, benign, rapidly growing cutaneous tumor that may regress spontaneously. Most cutaneous lesions of JXG occur in the head and neck region of infants and young children. This disease is usually present with cutaneous lesion only; visceral involvement including the lung, bone, testis, gastrointestinal tract, kidney, heart, eye and oral cavity is rare, but may affect various organs. Moreover, JXG is associated with neurofibromatosis type I and juvenile chronic myeloid leukemia. In contrast to the cutaneous form, systemic JXG may be associated with significant complications requiring aggressive medical care. The authors report a case of JXG in a 3-month-old male infant which involved systemic organs, with a brief of the literature. The patient presented with cutaneous, pulmonary, pancreatic, testicular and hepatic nodules. The cutaneous nodule biopsy shows the proliferation of histiocytes which have indistinct borders, round vesicular nuclei, foamy cytoplasm and eosinophils. The patient's follow-up was characterized by slow and progressive clinical improvement without specific treatment.

Prognostic Factors and Treatment Strategies for Acute Viral Encephalitis

PURPOSE: Encephalitis is a cranial nervous system infection that is caused by various etiologies. Most of the patients with encephalitis undergo severe or fatal clinical course with sequelae. This study was conducted to estimate the clinical outcomes and to evaluate factors which can be used to predict clinical outcomes among pediatric patients with encephalitis METHODS: We retrospectively reviewed 46 patients with encephalitis who were admitted to the Department of Pediatrics of Chonbuk National University Hospital, from July 1995 to July 2003. Encephalitis was diagnosed based on the presence of neurologic abnormalities, CSF, Brain CT or MRI findings. Information on sequelae was obtained in the outpatient clinic. RESULTS: In this study, five patients(11.6%) were expired, 17 patients(39.5%) developed neurologic sequelaes and 21 patients(46.5%) were recovered without sequelae. Infants had poorer outcomes compared to older age groups. Twenty nine cases who had seizures showed high morbidity rate(48.3%) compared to the seizure-free group(17.6%). Among six patients with status epilepticus, four(66.7%) developed neurologic sequelae and two(33.3%) expired. The group with normal brain MRI findings had better outcomes (70%) than the group with abnormal MRI findings(55.5%). Gray matter involved patients on MRI had poorer recovery rate(33.3%) than white matter involved patients(69.2%). The group treated with intravenous immunoglobulin(IVIG) had better outcomes(64.7%) than the other group(37.9%). CONCLUSION: The presence of seizure, younger patients, and presence of abnormal findings of brain MRI, especially gray matter lesions were associated with poor clinical outcomes in children with encephalitis.

Serum Ghrelin Concentrations in Type 2 Diabetes Mellitus / 대한소아내분비학회지

PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.

Identification of Lymph Node Micrometastases in Dukes' B Colorectal Cancer Patients Using Monoclonal Antibodies against Cytokeratin-19

PURPOSE: The aims of this study were to immunohistochemically identify lymph node micormetastases in Dukes' B colorectal cancer patients, and determine the relationship between lymph node micrometastases and other prognostic factors and recurrence rates. METHODS: A retrospective analysis was conducted of 990 lymph nodes from Dukes' B 42 patients who had undergone radical colorectal resection. These lymph nodes were immunohistochemically examined with monoclonal antibodies against cytokeratin-19. The prognostic factors and recurrent rates were compared between patients with and without lymph node micrometastases. RESULTS: Micrometastases were confirmed in 19 nodes (1.9%) from 9 patients (21.4%). No correlations were observed between micrometastases and the prognostic factors, with the exception of the preoperative CEA level. 8 of the 9 (88.9%) patients with micrometastases had preoperative CEA levels significantly elevated above 5 ng/ml (P<0.0001). There were no significant differences in the recurrent rates (P=0.0572) between patients with and without micrometastases during the short term follow up period (14.8 months) at the 95% confidence interval, but there were significant differences at the 90% confidence interval. CONCLUSION: High preoperative CEA levels increase the risk for micrometastases, and the presence of micrometastases might increase the possibility of recurrence. Thus, a routine immunohistochemical technique for identifying micrometastases is recommended in the patients with a high preoperative CEA level. However, a more definite clinical significance of lymph node micrometastases awaits further extensive prospective studies.

Identification of Lymph Node Micrometastases in Dukes' B Colorectal Cancer Patients Using Monoclonal Antibodies against Cytokeratin-19

PURPOSE: The aims of this study were to immunohistochemically identify lymph node micormetastases in Dukes' B colorectal cancer patients, and determine the relationship between lymph node micrometastases and other prognostic factors and recurrence rates. METHODS: A retrospective analysis was conducted of 990 lymph nodes from Dukes' B 42 patients who had undergone radical colorectal resection. These lymph nodes were immunohistochemically examined with monoclonal antibodies against cytokeratin-19. The prognostic factors and recurrent rates were compared between patients with and without lymph node micrometastases. RESULTS: Micrometastases were confirmed in 19 nodes (1.9%) from 9 patients (21.4%). No correlations were observed between micrometastases and the prognostic factors, with the exception of the preoperative CEA level. 8 of the 9 (88.9%) patients with micrometastases had preoperative CEA levels significantly elevated above 5 ng/ml (P<0.0001). There were no significant differences in the recurrent rates (P=0.0572) between patients with and without micrometastases during the short term follow up period (14.8 months) at the 95% confidence interval, but there were significant differences at the 90% confidence interval. CONCLUSION: High preoperative CEA levels increase the risk for micrometastases, and the presence of micrometastases might increase the possibility of recurrence. Thus, a routine immunohistochemical technique for identifying micrometastases is recommended in the patients with a high preoperative CEA level. However, a more definite clinical significance of lymph node micrometastases awaits further extensive prospective studies.

A Case of Toxic Hepatitis in a Worker Exposed to a Cleansing Agent Mainly Composed of Methylene Chloride / 대한산업의학회지

OBJECTIVES: To report a case of toxic hepatitis in a worker exposed to a cleansing agent mainly composed of methylene chloride. METHODS: A 27-year-old female worker who had worked in an inspection and packing position of semiconductor parts in a factory using methylene chloride as a metal cleansing solvent was hospitalized due to fever, chill and generalized aches. We evaluated her with blood tests, abdominal ultrasonographic scan and abdominal CT scan and also took her occupational history. RESULTS: The patient showed acute hepatitis in blood and radiologic tests after admission. The serologic tests for viral hepatitis A, B, C and autoimmune hepatitis were negative. She had no history of significant alcohol use, recent medication or drug allergy. After admission, her symptoms were improved and liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Thereafter, however, her previous symptoms were recurred and she was hospitalized again 2 days after returning to her workplace. After this second admission, she showed acute hepatitis in blood tests and her symptoms were improved and liver enzyme levels were markedly reduced with the same pattern as those of the first admission. On the 11th day of the second admission, liver enzyme levels were normalized and she was discharged from hospital. CONCLUSIONS: We presume that this patient`s liver injury was related to the methylene chloride presence at her workplace due to her clinical symptoms, blood tests, radiologic tests and occupational history.