Epidemiological and clinical aspects of snakebites in the upper Juruá River region, western Brazilian Amazonia

This study addresses the clinical and epidemiological aspects of envenoming cases resulting from snakebites treated at a hospital in Cruzeiro do Sul, in the upper Juruá River region, western Brazilian Amazonia. The specific identity of snakes that caused the envenomings was inferred (a) from the diagnosis of patient symptoms and signs upon hospital admission, (b) by enzyme immunoassay for detection of Bothrops atrox and Lachesis muta venom from serum samples taken from patients before antivenom therapy, or (c) by direct identification of the snake, when it was brought along to the hospital or photographed. There were 133 snakebites (76.2 cases per 100,000 inhabitants) registered during one year (July 2017 to June 2018). Most snakebites (88.7%) were caused by Bothrops spp., and the rest by non-venomous snakes or dry bites. Snakebites tended to occur more often during the rainy season, coinciding with the period of greater reproductive activity of the snakes and greater availability of their prey. In addition, the increase in the water level of rivers and lakes during the rainy season tends to concentrate snakes in dry places and, thus, to increase encounters with humans. Information campaigns on prevention and first aid, specially among the most vulnerable groups (indigenous people, farmers, and children and teenagers in rural areas), and the importance of using protective equipment (boots, leggings, leather gloves) in certain high risk activities (e.g. agriculture and extractivism in forests) are fundamental for the reduction of snakebite morbidity. (AU)

Retrospective evaluation and prediction of clearance and toxicity of high dose methotrexate in childhood acute lymphoblastic leukemia patients

To find the predictors of High Dose Methotrexate toxicities in childhood Acute Lymphoblastic Leukemia Patients. This study included 198 Childhood Acute Lymphoblastic Leukemia patients (303 infusions) who were treated with High Dose Methotrexate. Methotrexate levels at different time point were measured by modified enzyme multiplied immunoassay technique assay. The correlation between Methotrexate levels and toxicity was evaluated by Receiver Operating Characteristic curve. When the Methotrexate level at 42 h was lower than 0.76 µmol/L, the sensitivity for predicting thorough clearance at 66 h was 90.78%. When the Methotrexate level at 42 h was higher than1.5 µmol/L, the sensitivity for predicting delayed clearance was 82.17%. When the Methotrexate level at 66 h was higher than 0.5 µmol/L, the sensitivity for predicting Methotrexate toxicity was 89.09%. When the Methotrexate level at 66 h was lower than 0.1 µmol/L, the sensitivity for predicting Methotrexate nontoxicity was 92.73%. The Methotrexate level at 42 h could be predictor for delayed clearance. The Methotrexate level at 66 h could be predictor for toxicity.

Effect of Color of Light Emitting Diode on Development of Fruit Body in Hypsizygus marmoreus

This study was conducted to identify a suitable color of light for development of the fruit body in Hypsizygus marmoreus. To accomplish this, samples were irradiated with blue (475 nm), green (525 nm), yellow (590 nm), or red (660 nm) light emitting diodes (LEDs) to induce the formation of fruiting bodies after mycelia growth. The diameter and thickness of the pileus and length of stipes in samples subjected to blue LED treatment were similar to those of subjected to fluorescent light (control), and the lengths of the stipes were highest in response to treatment with the red LED and darkness. The commercial yields of plants subjected to blue and green LED treatment were similar to those of the control. In conclusion, cultivation of H. marmoreus coupled with exposure to blue LED is useful for inducing high quality fruit bodies as well as higher levels of ergosterol, DPPH radical scavenging activity, total polyphenol content and reducing power.

RAI Treatment of Distant Metastasis of Thyroid Cancer / 대한갑상선학회지

For the distant metastasis of differentiated thyroid cancers, such as papillary thyroid carcinoma, follicular thyroid carcinoma, and Hurthle cell carcinoma, radioiodine therapy is one of the standard treatment methods after total thyroidectomy. Radioiodine is accumulated in thyroid cells and thyroid cancer cells through sodium iodide symporter which is located in the membrane of cells. This molecular target specific therapy renders a better prognosis and less adverse effects. Radioiodine 131I emits gamma ray for imaging and beta ray for treatment at the same time, we can monitor patients' specific distribution of radioiodine, which let us know unexpected metastasis lesions or differentiated status of thyroid cancer cells. In this article, I reviewed practical points of view about radioiodine therapy for distant metastasis of thyroid cancers such as methods for administration of radioiodine, patients' preparation before radioiodine treatment, follow up of patients, adverse effects, and radiation safety issues.

Effects of silanation time on shear bond strength between a gold alloy surface and metal bracket / 대한치과교정학회지

OBJECTIVE: We aimed to investigate the effects of silanation time on the shear bond strength (SBS) of metal brackets on gold alloy in a silicoating procedure and compare the SBS of metal brackets on gold alloy and enamel. METHODS: Type III gold alloy plates were sandblasted with 30-microm silicon dioxide. Excess particles were removed with gentle air after silica coating, and silane was applied. Maxillary central-incisor metal brackets were bonded to each conditioned alloy surface with a light curing resin adhesive for 1 s, 30 s, 60 s, or 120 s after applying silane. The brackets were also bonded to 36 upper central incisors with the same adhesive. All samples were cured for 40 s with a light emitting diode curing light. The SBS was tested after 1 h and after 24 h. The adhesive remnant index (ARI) of the samples was also compared. RESULTS: The 60-s and 120-s silanation time groups showed a higher SBS than the other groups (p < 0.05). Samples tested after 24 h showed a significantly higher SBS than did the samples tested after 1 h (p < 0.05). The 1-s group showed higher ARI scores. The one-way analysis of variance and Student-Newman-Keuls test showed that the SBS values of the 60-s and 120-s silanation time groups were not significantly different from the SBS values of enamel. CONCLUSIONS: Adequate silanation time is required to produce sufficient bond strength during silicoating.

Quantitative and qualitative analysis of rat pup ultrasonic vocalization sounds induced by a hypothermic stimulus / 한국실험동물학회지

Ultrasonic vocalizations (USVs) are essential communicative sounds used between rodent pups and their mother. Rat pups emit USVs in stressful situations, such as when they are cold or separated from the nest. We verified the ontogenetic changes in USVs emitted by infant rats isolated from their mother during the pre-weaning period. The number of calls, and the median frequency and first peak of frequency of the calls were measured at 1, 3, 5, 7, 10, 12, and 14 days postnatal age in Wistar-Imamichi rats. Pups were placed in a cold glass beaker and USVs were recorded for 5 min. The number of calls increased to a peak on day 5 and then gradually decreased. The median frequency of calls decreased slowly during the first 12 days, and then increased slightly on day 14. Similarly, the first peak frequency of calls was the highest on day 1, and then decreased gradually by day 12. A small increase was observed on day 14. These changes in frequency were correlated with the physical development of the pups, whose body weights increased significantly with age except during postnatal days 7-10.

Comparative analysis of the intracerebral mouse protection test and serological method for potency assays of pertussis component in DTP vaccine

The aim of this study was to compare the PSPT standardized in-house as an alternative to MPT for potency assays of pertussis component. Statistical analyses have showed similar pertussis potency values when PSPT was compared to MPT. Significant correlation between the potency results obtained by in vivo and in vitro assays was also been observed. Results by PSPT have demonstrated reproducibility and accuracy for potency pertussis control and this approach has been considered promising for use at least during the steps of production.

Research on effect of Light emitting diode(LED) on treating skin ulcer of Hansen's disease / 나학회지

Leprosy is disease of skin and peripheral nerve especially. Sequale and disability of musculoskeletal system, especially peripheral extremities (hands and foots) can be developed due to severe and irreversible peripheral nerve damage in leprosy. In leprosy, Skin ulcers can relapse very often and progress to deformity and amputation of hands or foot. We need methods to treat skin ulcer effectively. We have used various therapies such as antibiotics in infectious state, disinfectant, variable wet dressing materials(transparent film, foams, gels&hydrogels, hydrocolloids, calcium alignate), silver dressing, Vacuum Assisted Closure unit, debridement, curettage, surgery to treat skin ulcer in leprosy patients. Sometimes we can treat skin ulcer successfully but, we often encounter ulcer resistant to treat. We need to find and develop methods to treat ulcer successfully. Several researches have reported articles to treat wound successfully using light emitting diode(LED). We tried to treat ulcer in old leprosy patients using LED. We divided ulcers patients into case group(conventional dressing therapy + LED therapy) and control group (only conventional dressing therapy) randomly in out patient department and in ward. This research was carried out from February 2012 to September 2012. Case group and control group have composed of 30 patients respectively. Average age of patients was 74 years old in case group and 69 years old in control group. We have used LED device composed of 700 pieces of diodes emitting 635nm and 500 pieces of diodes emitting 830nm, totally 1200 pieces of diodes. We have observed the size of wounds twice per week in control group and case group. Before treatment average size of wounds was 8509.76mm3 in case group and 8625.33mm3 in control group. P-vale was 0.49. There was no significant difference in case and control group. After treatment average size of wounds was 787.83mm3 in case group and 8074.63mm3 in control group. P-vale was 0.02. There was significant difference in case and control group. After treatment average reduction of size per time was 338.02mm3/day in case group and 26.55mm3/day in control group. P-vale was 0.002. There was significant difference in case and control group. Therefore we have concluded that LED device was effective in wound treatment. Some articles have reported that LED Device have helped to treat wounds in DM ulcer, third degree burn, oral ulcer, skin ulcer in Klippel-Trenaunay syndrome patient, some retinopathy etc. We have concluded that LED of infrared or long visible wavelength light can be used effectively in treatment of wound along with conventional treatment concurrently.

Asthma is inversely associated with Helicobacter pylori status

The increase in asthma rates has been linked epidemiologically to the rapid disappearance of Helicobacter pylori, a bacterial pathogen that persistently colonizes the human stomach. Recent evidence indicates that, H. pylori may have protective effects on allergic diseases. The aim of this study was to explore the relationship between asthma and H. pylori infection in a population with high prevalence of H. pyloriinfection. One hundred and seventeen asthma cases were eligible for the study in addition to 86 non asthma cases as control. Pre and post - bronchodilator spirometry, assay of Total serum immunoglobulin E [IgE] by enzyme immunoassay technique [ELISA] and [14]C Urea Breath Test [UBT] were done. Out of 41 asthmatic cases with positive H. pylori were 22 patients had mild asthma, 14 had moderate asthma, and 5 only had severe asthma with statistically significant difference between them. The mean serum level of Total IgE was significantly higher [190.04 +/- 111.9] in patients group than control group [94.13 +/- 46.49] with p-value 0.000, while the mean UBT was significantly lower [325.85 +/- 261.35] in patients group than control group [1068.67 +/- 680.7] with p-value 0.000. AS regard pulmonary function tests [FEV1 and FVC], there was statistically significant difference between positive H. pylori asthmatic and negative H. pylori asthmatic. We demonstrate an inverse association between H. pylori and asthma in a population with a high prevalence of H. pylori

Characterizing Cutaneous Elastic Fibers by Eosin Fluorescence Detected by Fluorescence Microscopy

BACKGROUND: Though elastic fibers are as important as collagen fibers in interpretation of the histopathologic findings, it is impossible to observe them on the hematoxylin & eosin (H&E) stained specimen. OBJECTIVE: Characterizing eosin fluorescence emitted by elastic fibers in H&E stained specimens. METHODS: Normal skin tissue sections were stained in 4 different ways (unstained, hematoxylin only, eosin only, H&E) and observed under a fluorescence microscope using a FITC filter set. Fluorescent findings of 30 H&E-stained specimens showing abnormal dermal findings were compared with bright field findings of Miller's elastic stained specimen. RESULTS: Strong eosin fluorescence was related to the differential binding property of eosin with elastic fibers. Hematoxylin stain quenched excessive eosin fluorescence from other tissue components and contributed to better contrast. Fluorescence microscopy of H&E-stained sections was found to be especially useful in observing mature elastic fibers in the reticular dermis. In 74% of the specimens, eosin fluorescence findings of elastic fibers in reticular dermis matched well with that of specimens with elastic fiber special stain. CONCLUSION: Analysis of skin elastic fibers by fluorescence microscopy is a useful and complementary method to reveal hidden elastic fibers in H&E-stained specimens.

The Measurement of Optimal Power Distance in LEDs / 대한피부과학회지

BACKGROUND: The use of light technology in dermatology has grown rapidly over the last decade, with many developments in its use for the treatment of a wide variety of skin conditions from non-melanoma skin cancers to facial resurfacing for photo-damaged skin. Light-emitting diodes (LEDs) have attracted much attention in medical fields. OBJECTIVE: (1) To assess the optimal distance of 630 nm LEDs (OmniLux(R), (Phototherapeutics Ltd, the UK)) and 830 nm LEDs (Healite(R) (Lutronic, Korea)) for maximum power as determined by a power meter and (2) to apply theory to practical use. METHODS: Two separate hinged planar light emitting diode arrays were studied: 1) the Omnilux Revive(TM) (Phototherapeutics Ltd, the UK), which delivers non-coherent red light at a wavelength of 633+/-3 nm and 2) the Lutronic Healite (Korea), which delivers non-coherent light at a wavelength of 830+/-5 nm. An X93 power meter (Gigahertz-Optik, Germany) was placed against a black background in order to reduce the amount of reflected light. We measured the LED powers over a range of 3~25 cm in 1 cm increments. RESULTS: On the irradiation side of the LED, power increases according to the mass effect of the radiation angle. However, at a certain distance, the power decline effect predominated over the amassment effect. In this respect, the LED light was estimated to be emitted in a reverse V shape. The proper irradiation distance for use in medical fields can thus be determined. CONCLUSION: The proper irradiation distance of LED will be useful and the proper use of LED under the subjects' shape will be done in many medical fields.

Development of Laser Ruler in Rigid Laryngoscope

OBJECTIVES: The objective of this study was to develop a new device that provides a simple, noninvasive method of measuring accurate lesion size while using an endoscope. METHODS: We developed a rigid laryngoscope with a built-in laser-ruler using a one-light emitting diode and an acrylic plate. The invention incorporates a built-in laser diode that projects an auto-parallel beam into the optical path of the rigid laryngoscope to form two spots in the field of view. RESULTS: While the interspot distance remains consistent despite changes in focal plane, magnification, or viewing angle of the laryngoscope, projection to an uneven surface introduces certain variations in the shape, and size of the spots, and the distance between the two spots. CONCLUSION: The device enables a laryngologist to easily measure the distance between landmarks, as well as the change in real size, and the progressive change of vocal fold lesions in an outpatient setting.

Recent Advances in Image-enhanced Endoscopy

The desire to better recognized such malignancies, which may be difficult to distinguish from inflammation or trauma, has accelerated the development of endoscopy with new optical technologies. Narrow-band imaging is a novel endoscopic technique that may enhance the accuracy of diagnosis using narrow-bandwidth filters in a red-green-blue sequential illumination system. Autofluorescence imaging is based on the detection of natural tissue fluorescence emitted by endogenous molecules. I-scan technology using a digital filter that modifies normal images through software functions, is the newly developed image-enhanced endoscopic technology from PENTAX. Flexible spectral imaging color enhancement enhances the visualization of mucosal structure and microcirculation by the selection of spectral transmittance with a dedicated wavelength. Confocal laser endomicroscopy images were collected with an argon beam with a scanning depth of 0 (epithelium) to 250 microm (lamina propria) and analyzed using the reflected light.

Effect of the difference in spectral outputs of the single and dual-peak LEDs on the microhardness and the color stability of resin composites / 대한치과보존학회지

OBJECTIVES: To determine the effect of the spectral output of single and dual-peak light emitting diode (LED) curing lights on the microhardness and color stability of commercial resin composites formulated with camphorquinone and alternative photoinitiators in combination. MATERIALS AND METHODS: Three light-polymerized resin composites (Z100 (3M ESPE), Tetric Ceram (Ivoclar Vivadent) and Aelite LS Posterior (Bisco)) with different photoinitiator systems were used. The resin composites were packed into a Teflon mold (8 mm diameter and 2 mm thickness) on a cover glass. After packing the composites, they were light cured with single-peak and dual-peak LEDs. The Knoop microhardness (KHN) and color difference (DeltaE) for 30 days were measured. The data was analyzed statistically using a student's t-test (p < 0.05). RESULTS: All resin composites showed improved microhardness when a third-generation dual-peak LED light was used. The color stability was also higher for all resin composites with dual-peak LEDs. However, there was a significant difference only for Aelite LS Posterior. CONCLUSIONS: The dual-peak LEDs have a beneficial effect on the microhardness and color stability of resin composites formulated with a combination of camphorquinone and alternative photoinitiators.

A Study on the Possibility of Occupational Noise-Induced Hearing Loss in Firefighters

BACKGROUND AND OBJECTIVES: Firefighters face serious risks to their health and safety in the performance of their duties. In addition to the diverse occupational hazards well-known to the public, firefighters are also occasionally exposed to high levels of noise, such as sirens, horns, and electronic alerting signals. MATERIALS AND METHODS: We first measured the noise emitted by two fire trucks and one ambulance. Next, we enrolled 171 firefighters (164 males, seven females). We designated the employees of a private school as controls for the firefighter group. After selecting workers, including audiometric testing at 1,000 and 4,000 Hz, the groups were age- and gender-matched. Both groups were included separately for the right and left ears at pure-tone test frequencies at 1,000 and 4,000 Hz. We chose the better ear thresholds and analyzed the differences in hearing levels at each frequency and each age group between the firefighters and controls. RESULTS: The sound pressure levels of the siren in and out of an ambulance, the first fire truck, and the second fire truck were 99.3 dB (A) and 108.9 dB (A), 92.3 dB (A) and 108.3, and 78.8 dB (A) and 99.0 dB (A), respectively. At 4,000 Hz, the hearing threshold was significantly increased by work period (p<0.01). Each hearing threshold level was significantly higher than controls (p<0.01). CONCLUSIONS: Many of the noise sources produce sounds exceeding 90 dB (A), and some firefighters may be exposed for brief periods to levels that exceed 105-110 dB (A). The hearing threshold level in firefighters is higher than the general population and noise-induced hearing loss in firefighters is possible. In the future, consistent, effective, and long-standing implementation of hearing conservation programs are needed, and special health examinations for hearing levels in firefighters must be conducted.

A Study on the Possibility of Occupational Noise-Induced Hearing Loss in Firefighters

BACKGROUND AND OBJECTIVES: Firefighters face serious risks to their health and safety in the performance of their duties. In addition to the diverse occupational hazards well-known to the public, firefighters are also occasionally exposed to high levels of noise, such as sirens, horns, and electronic alerting signals. MATERIALS AND METHODS: We first measured the noise emitted by two fire trucks and one ambulance. Next, we enrolled 171 firefighters (164 males, seven females). We designated the employees of a private school as controls for the firefighter group. After selecting workers, including audiometric testing at 1,000 and 4,000 Hz, the groups were age- and gender-matched. Both groups were included separately for the right and left ears at pure-tone test frequencies at 1,000 and 4,000 Hz. We chose the better ear thresholds and analyzed the differences in hearing levels at each frequency and each age group between the firefighters and controls. RESULTS: The sound pressure levels of the siren in and out of an ambulance, the first fire truck, and the second fire truck were 99.3 dB (A) and 108.9 dB (A), 92.3 dB (A) and 108.3, and 78.8 dB (A) and 99.0 dB (A), respectively. At 4,000 Hz, the hearing threshold was significantly increased by work period (p<0.01). Each hearing threshold level was significantly higher than controls (p<0.01). CONCLUSIONS: Many of the noise sources produce sounds exceeding 90 dB (A), and some firefighters may be exposed for brief periods to levels that exceed 105-110 dB (A). The hearing threshold level in firefighters is higher than the general population and noise-induced hearing loss in firefighters is possible. In the future, consistent, effective, and long-standing implementation of hearing conservation programs are needed, and special health examinations for hearing levels in firefighters must be conducted.

Measurements and Comparative Considerations of Velocities of Primary Bloodstain Spatters using a High Speed Camera / 대한법의학회지

Bloodstain pattern analysis is a forensic discipline that reconstruct events of a crime scene by analyzing sizes, shapes, distributions, positions of bloodstains. Bloodstain pattern can be classified into the low velocity, medium velocity, and high velocity system. Velocities in this system represent the velocity of the wounding agent (the force applied) and not to the velocity of the blood in flight. Thus there is no reference system about the velocity of the blood in flight in the existing bloodstain classification system. Applying bloodstain pattern analysis to the real crime case, we needed to have the reference system of velocities of impact spatter, cast-off spatter, and expectorate spatter. Therefore we measured the velocities of these spatters using high speed camera and we analyzed the results. In this experiments the average velocity of impact spatter that generated by swinging a hammer with all experimenter's strength at the pool of blood is about 4.7 times faster than that of swing cast-off spatter that generated by swinging a red-wat hammer with all experimenter's strength, and about 3.9 times faster than that of expectorate spatter that generated by emitting blood from the mouth with all experimenter's strength. The velocities of cast-off spatter and expectorate spatter, however, showed similar distributions. Our experiments that measure the velocities of droplets of blood spatters in flight under the specific conditions that generated at fastest speed can give some reference to the classification system of velocities of bloodstains which is not distinct up to now, as well as some real bloodshed crime cases.

Shear bond strength between gold alloy and orthodontic metal bracket using light emitting diode curing light / 대한치과교정학회지

OBJECTIVE: The need to bond orthodontic brackets onto various alloys has increased because of the increasing demand for adult orthodontic treatment. This study tried to evaluate the shear bond strength between gold alloy and metal bracket using light emitting diode (LED) light curing after metal primer and silicoating surface conditioning. METHODS: Half of the type III gold alloy plates were treated with sandblasting with aluminum oxide and metal primer containing 4-META, the other half were treated with silica and silane. Metal brackets were bonded with Transbond XT light curing adhesive on these plates and shear bond strength were evaluated 1 hour, 6 hours, and 24 hours later. The differences of shear bond strength between groups were evaluated with two-way ANOVA. RESULTS: The results showed higher bond strength in the silicoating group and a tendency of bond strength increase over time. CONCLUSIONS: When using LED curing lights for metal bracket bonding to alloy surfaces, long curing time and silicoating can produce a reliable bonding strength.

A Comparison of Red and Blue Light Emitting Diode Lights in Photodynamic Therapy for the Treatment of Acne Vulgaris / 대한피부과학회지

BACKGROUND: Acne vulgaris is a very common inflammatory disease, particularly in adolescents and young adults. Problems such as the inconvenience of long term treatment, the resistance of Propionibacterium acnes to antibiotics and the side effects of isotretinoin have led to investigate photodynamic therapy for the treatment of acne vulgaris. OBJECTIVE: We wanted to evaluate of the efficacy and safety of topical methyl aminolevulinate-photodynamic therapy (MAL-PDT) using red and blue light emitting diode (LED) lights on acne vulgaris. METHODS: Thirty two patients with inflammatory facial acne were treated with topical MAL-PDT with red LED light on the right side and blue LED light on the left side at 2-week intervals for three sessions. MAL was applied to the acne lesions on the entire face with a 45-minutes incubation time. Evaluation was performed by counting the acne lesions at baseline, 2, 4, 6, 8 and 12 weeks after the beginning of the treatment. RESULTS: After 12 weeks of PDT, we found a statistically significant reduction of the inflammatory and non-inflammatory acne lesions from baseline using both red and blue LED lights. Yet there was no significant difference in effectiveness between the two treatments on the inflammatory and non-inflammatory acne lesions. Some of the patients experienced transient erythema, stinging, pain and hyperpigmentation with both treatments. CONCLUSION: Photodynamic therapy with red and blue LED lights appeared to be an effective and safe therapeutic modality for the inflammatory and non-inflammatory acne lesions of mild to moderate acne vulgaris, although there was no significant difference in the efficacy between the two kinds of lights.

The Effect of Full Spectrum Light Phototherapy for Patients with Tinea pedis / 대한의진균학회지

BACKGROUND: Tinea pedis is the most common dermatophytosis which is usually treated by antifungal agent. Recently, there has been a resurgence of interest in potential phototherapy for the local treatment of bacterial and fungal infection. OBJECTIVE: The aim of this study is to evaluate the therapeutic effect of full spectrum light (F.S.L) phototherapy for patients with tinea pedis. METHODS: Lesions were irradiated for 20 minutes, 2 times a week for 4 consecutive weeks with F.S.L. emitting wavelengths from 320 nm to 5000 nm. Clinical symptoms were observed and KOH direct smear and fungal culture were done. RESULTS: Global assessment score was improved after the application of eight sessions of F.S.L phototherapy. 18% of total patient were cleared, 45.4% a marked improvement, 27.3% a mild improvement and 9.1% of patients had no effect. And the fungal exams, KOH direct smear and culture, were conversion to negative in 7 out of 11 patients. Significant adverse effects were not observed. CONCLUSION: F.S.L phototherapy might be another treatment option for the tinea pedis patients.