Validation of urinary 1,2-dichloropropane concentration as a biological exposure index for workers exposed to 1,2-dichloropropane

Background@#The International Agency for Research on Cancer classified 1,2-dichloropropane (1,2-DCP) as a human carcinogen in 2016. It is necessary to establish a health monitoring system for workers exposed to 1,2-DCP. We investigated the correlation between 1,2-DCP concentration in air and urine to determine whether it is appropriate to measure 1,2-DCP in urine as a biological exposure index (BEI). @*Methods@#Twenty-seven workers from 3 manufacturing industries handling 1,2-DCP participated in this study. Airborne 1,2-DCP was collected by personal air. Urine samples were collected at the end of work and analyzed using gas chromatography-mass spectrometry. Correlation analysis and simple regression analysis were performed to investigate the relationship between 1,2-DCP concentration in urine and air. @*Results@#Pearson correlation coefficients between total 1,2-DCP in air and urine (uncorrected, creatinine-corrected) were 0.720 and 0.819, respectively. For urine samples analyzed within 2 weeks, the Spearman's rho of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.906 and 0.836, respectively. Simple regression analysis of 1,2-DCP in air and urinary 1,2-DCP concentrations within 2 weeks, which showed the highest correlation, revealed that the coefficient of determination of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.801 and 0.784, respectively. @*Conclusions@#As a BEI for workers exposed to 1,2-DCP, urinary 1,2-DCP without creatinine correction better reflects the exposure levels of 1,2-DCP in air.

Risk factors including night shift work of colorectal polyp

Background@#The destruction of circadian rhythms by night shift work affects major circadian genes, which are known to play a role in advancing or killing the cell cycle through tumor suppressor genes. To find out whether night shift work affects the incidence of colorectal cancer, which was found to be associated with long-term night shift work in previous studies, we surveyed effect of night shift work on colorectal polyps that have a higher incidence than colorectal cancer and can progress to colorectal cancer. @*Methods@#To examine the correlation between rotating night shifts and colorectal polyps, a survey was conducted with 299 men aged 40–60 years from two university hospitals. We examined lifestyle, work history, work patterns, and colonoscopy results. The differences in prevalence among the groups was compared, and prevalence ratio (PR) was calculated via generalized linear modeling. @*Results@#The prevalence of colorectal polyps in night shift and non-shift workers were 53.0% and 33.5%, respectively. After adjusting for age, smoking status, dietary habits, family history of colorectal cancer, obesity, job type, night shift work (PR: 1.13, 95% CI: 1.02–1.25) was a risk factor of colorectal polyps. @*Conclusions@#The risk of colorectal polyps was greater in night shift workers than non-shift workers. Also risk of colorectal polyp was higher in older group. Our study investigated colorectal polyp instead of colorectal cancer and lacks information about types and gene mutations of colorectal polyps. Further study is needed to clarify effect of night shift work on development of colorectal cancer.

Validation of urinary 1,2-dichloropropane concentration as a biological exposure index for workers exposed to 1,2-dichloropropane

Background@#The International Agency for Research on Cancer classified 1,2-dichloropropane (1,2-DCP) as a human carcinogen in 2016. It is necessary to establish a health monitoring system for workers exposed to 1,2-DCP. We investigated the correlation between 1,2-DCP concentration in air and urine to determine whether it is appropriate to measure 1,2-DCP in urine as a biological exposure index (BEI). @*Methods@#Twenty-seven workers from 3 manufacturing industries handling 1,2-DCP participated in this study. Airborne 1,2-DCP was collected by personal air. Urine samples were collected at the end of work and analyzed using gas chromatography-mass spectrometry. Correlation analysis and simple regression analysis were performed to investigate the relationship between 1,2-DCP concentration in urine and air. @*Results@#Pearson correlation coefficients between total 1,2-DCP in air and urine (uncorrected, creatinine-corrected) were 0.720 and 0.819, respectively. For urine samples analyzed within 2 weeks, the Spearman's rho of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.906 and 0.836, respectively. Simple regression analysis of 1,2-DCP in air and urinary 1,2-DCP concentrations within 2 weeks, which showed the highest correlation, revealed that the coefficient of determination of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.801 and 0.784, respectively. @*Conclusions@#As a BEI for workers exposed to 1,2-DCP, urinary 1,2-DCP without creatinine correction better reflects the exposure levels of 1,2-DCP in air.

Risk factors including night shift work of colorectal polyp

Background@#The destruction of circadian rhythms by night shift work affects major circadian genes, which are known to play a role in advancing or killing the cell cycle through tumor suppressor genes. To find out whether night shift work affects the incidence of colorectal cancer, which was found to be associated with long-term night shift work in previous studies, we surveyed effect of night shift work on colorectal polyps that have a higher incidence than colorectal cancer and can progress to colorectal cancer. @*Methods@#To examine the correlation between rotating night shifts and colorectal polyps, a survey was conducted with 299 men aged 40–60 years from two university hospitals. We examined lifestyle, work history, work patterns, and colonoscopy results. The differences in prevalence among the groups was compared, and prevalence ratio (PR) was calculated via generalized linear modeling. @*Results@#The prevalence of colorectal polyps in night shift and non-shift workers were 53.0% and 33.5%, respectively. After adjusting for age, smoking status, dietary habits, family history of colorectal cancer, obesity, job type, night shift work (PR: 1.13, 95% CI: 1.02–1.25) was a risk factor of colorectal polyps. @*Conclusions@#The risk of colorectal polyps was greater in night shift workers than non-shift workers. Also risk of colorectal polyp was higher in older group. Our study investigated colorectal polyp instead of colorectal cancer and lacks information about types and gene mutations of colorectal polyps. Further study is needed to clarify effect of night shift work on development of colorectal cancer.

Prediction of Intravenous Immunoglobulin Nonresponse Kawasaki Disease in Korea / 소아감염

PURPOSE: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. METHODS: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. RESULTS: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet ( or =0.4 mg/dL), (6) alkaline phophatase (> or =227 IU/L), (7) lactate dehydrogenase (> or =268 IU/L), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. CONCLUSION: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.

A Case of Anaphylaxis after the First Dose of Sublingual Immunotherapy with House Dust Mite / 소아알레르기및호흡기학회지

The advantages of sublingual immunotherapy (SLIT) are its friendly route of administration and less frequent occurrence of severe side-effects. The most frequently reported events were irritation of the throat and oral itching. According to the recent data, the number of side effects seems to be dose-dependent. We report on one case of anaphylaxis after the first dose of SLIT with house dust mite drop. A 10-year-old girl suffered from severe allergic rhinitis with perennial symptoms and asthma for which a low dose inhaled corticosteroid was used. Her allergy workup disclosed a positive skin prick test to Dermatophagoides pteronyssinus, Dermatophagoides farinae, birch, hazel tree, alder, dog, cat, platane, and acacia pollens. We started SLIT (Pangramin SLIT, ALKAbello, Madrid, Spain) with D. pteronyssinus and D. farinae. Fifteen minutes after the first dose taken at home, she experienced local irritation, lip swelling, facial rash, rhinorrhea and cough. Provocation test was performed in the clinic with the same drug (0.00015 microg/drop, 1.6 STU/mL of D. pteronyssinus and D. farinae, respectively). After twenty minutes, she reported lip swelling, perioral wheals, rash and cough. Wheezing was aggravated, and peak expiratory flow rate (PEFR) dropped by 13% compared to prechallenge PEFR. We stress to have the first dose of SLIT taken in the clinic with an observation period.

Initial Experience with Posterior Retroperitoneoscopic Adrenalectomy for the Adrenal Tumors / 대한내분비외과학회지

PURPOSE: Posterior retroperitoneoscopic adrenalectomy (PRA) for small adrenal tumors has recently been in the spotlight due to its several benefits. Compelling advantages for endoscopic surgeons include direct, safe, and fast approach to the adrenal gland without trespass to the intraperitoneal organ. This study reports our initial experiences of PRA for the management of adrenal tumors. METHODS: From December 2009 to August 2011, 63 patients underwent PRA for the management of adrenal tumor. Among these patients, laparoscopic adrenalectomy and robotic adrenalectomy were performed in 54 and nine patients, respectively. We retrospectively reviewed records of all surgical outcomes. RESULTS: Of the 54 patients, 22 were male and 32 were female, and mean age was 51.7±14.0 years. Mean body mass index was 24.6±3.6 kg/m² and mean dimension of the tumors was 2.66±1.36 cm. Six patients were diagnosed with Cushing's disease, 22 patients with primary aldosteronism, seven patients with pheochromocytoma, one patient with metastatic adrenal gland cancer, and 18 patients with nonfunctioning adrenal tumors. Mean operative time was 88.5±27.1 min, mean blood loss was 17.4±37.4 ml, and mean duration to first oral intake was 0.83±0.4 days. Mean number of postoperative analgesics used was 2.28±2.54, and mean postoperative hospital stay was 2.85±1.43 days. There was no open conversion during the operation and no post-operative complication. CONCLUSION: PRA is a safe and fast procedure. In experienced hands, PRA represents one of the ideal approaching methods in the adrenal gland surgery.

Comparison of Fungus Detection between PCR and Fungus Culture in Chronic Sinusitis and Normal Controls / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fungi are found in normal flora in various amounts. However, fungi in chronic sinusitis are poorly understood, and it is not clearly defined whether it is a pathogen or simply a part of normal flora. The polymerase chain reaction (PCR) is proposed as a more reliable test to detect fungal DNA than the conventional culture technique. The aim of this study was to compare the sensitivity of conventional culture technique and PCR analysis in detecting fungus of the nasal cavity and to compare fungal species found in normal controls and patients with chronic sinusitis. MATERIALS AND METHOD: Sterile saline irrigation was performed and then mucin filled saline was collected from the nasal cavity of patients with chronic sinusitis and normal controls. Fungus culture and PCR analysis were carried out with irrigated saline. RESULTS: PCR for panfungal gene was positive in 92.5% and 97.5% while fungus cultures were positive in 23.3% and 30.5% of patients with chronic sinusitis and normal controls, respectively. There was no significant difference in the prevalence of fungus and species of fungus between patients with chronic sinusitis and normal controls. CONCLUSION: PCR for panfungal gene was more sensitive for fungus detection than fungus culture in patients with chronic sinusitis and normal controls. Presence of fungus alone was insufficient to implicate it as the pathogen of chronic sinusitis. It will be necessary to study further about fungal species in patients with chronic sinusitis and normal controls.

Insulinoma of the Pancreas

Insulinoma is the most common functioning tumor of pancreas even though its prevalence is rare. The diagnosis and the treatment of insulinoma is very important because the tumor can induce critical and permanent neurologic deficit. We experienced ten patients with insulinoma and treated by surgical interventions at the Department of Surgery, Yonsei university college of medicine from 1983 to 1996. All the data were analysed retrospectively. The mean age of patient was 45 years (range: 17 to 69) and the sex ratio of male to female was 1:2.3. The most common clinical manifestation was weakness. The preoperative mean levels of fasting blood sugar, plasma insulin, C-peptide, insulin to glucose ratio were 41(mg/dl), 40.07(U/ml), 4.03(ng/ml), 1.51, respectively. The detection rates of localizing tools on our cases were showed as follows: THPVS(100% in 5 cases), EUS(67% in 3 cases), MRI(33% in 3 cases), CT scan(33% in 9 cases), angiography(33% in 6 cases) and US (20% in 10 cases). The intraoperative ultrasound(IOUS) was performed in the last three cases to try to find occult insulinoma and the relationship with main duct of pancreas in operative field. The types of surgical interventions were enucleation in 5 patients, distal pancreatectomy in 4 patients, pancreatoduodenectomy in 1 patient. The tumors were located in nearly equal frequencies over the entire pancreas: head(30%), neck & body (30%), tail(40%). All of the tumors were single and 90% of them were solid and benign. The mean diameter of the tumors was 1.5cm. Symptoms of hypoglycemia and laboratory values such as fasting blood sugar, plasma insulin, C-peptide, insulin glucose ratio were improved in all the patient after operation. We suggest that the THPVS is the most sensitive preoperative test for localizing insulinomas and recommend the IOUS as a tool for detecting occult or multiple insulinoma and identifing the relationship with main duct of pancreas in operative field.

A case of residual fibrous mass in treated malignant lymphoma / 대한혈액학회지

No abstract available.

A study on prognostic factors influencing treatment results in treated cancer patients

No abstract available.

Idiopathic Thrombocytopenic Purpura in Children: Clinical Prognosis and Evaluation of Treatment

A clinical study was condurted to obtain information which would make it possible to predict whether acute idiopathic thrombocytopenic purpura (ITP) will go into remission or become chronic and to evaluate the effect of treatment with steroids in acute ITP and with gammaglobulin in recurrent and chronic ITP. The most frequent clinical forms were acute ITP (69%), and thrombocytopenic purpura with antecedent viral illness was most frequent in acute ITP (83%). In acute ITP 86% of the patients had hemorrhagic symptoms of short duration, less than 2 weeks, before presentation. There was no information for making a prognosis either in the initial platelet count or in the appearance of anti-platelet antibodies. There was no definite difference in results with or without treatment with corticosteroids in acute ITP. Neither was there any definite difference in outcome for the patient of the platelet response between treatment with gammaglobulin and treatment with steroids In the chronic and recurrent forms. However; it was found that an intial platelet response to steroids may be a good prognostic sign that the acute attack will be followed by a sustained remission.