Outcomes of Treatment for Malignant Peripheral Nerve Sheath Tumors: Different Clinical Features Associated with Neurofibromatosis Type 1 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Malignant peripheral nerve sheath tumors (MPNSTs) are a rare subtype of sarcoma that occur spontaneously or in association with neurofibromatosis type 1 (NF-1). This study aimed to clinically differentiate these types of MPNSTs. MATERIALS AND METHODS: The study reviewed 95 patients diagnosed with and treated for MPNST at Yonsei University Health System, Seoul, Korea over a 27-year period. The clinical characteristics, prognostic factors, and treatment outcomes of sporadic MPNST (sMPNST) and NF-1 associated MPNST (NF-MPNST) cases were compared. RESULTS: Patients with NF-MPNST had a significantly lower median age (32 years vs. 45 years for sMPNST, p=0.012), significantly larger median tumor size (8.2 cm vs. 5.0 cm for sMPNST, p < 0.001), and significantly larger numbers of imaging studies and surgeries (p=0.004 and p < 0.001, respectively). The 10-year overall survival (OS) rate of the patients with MPNST was 52±6%. Among the patients with localized MPNST, patients with NF-MPNST had a significantly lower 10-year OS rate (45±11% vs. 60±8% for sMPNST, p=0.046). Univariate analysis revealed the resection margin, pathology grade, and metastasis to be significant factors affecting the OS (p=0.001, p=0.020, and p < 0.001, respectively). Multivariate analysis of the patients with localized MPNST identified R2 resection and G1 as significant prognostic factors for OS. CONCLUSION: NF-MPNST has different clinical features from sMPNST and requires more careful management. Further study will be needed to develop specific management plans for NF-MPNST.

A Huge Anterior Mediastinal Thymoma of an Infant: A Case Report / 임상소아혈액종양

A seven months old male infant visited Severance Children's Hospital for evaluation of anterior mediastinal mass. With chest computed tomography (CT) image and biopsy, precursor T-cell lymphoblastic lymphoma was suspected but the ultrasonography guided biopsy specimen was insufficient to confirm the disease. Because there was a life-threatening risk to perform open biopsy to the small infant, we started chemotherapy empirically. The mass decreased, however, the lesion increased again and did not respond to the drugs. Finally we decided to resect the anterior mass with sternostomy and the pathology report finally resulted in thymoma.

A Huge Anterior Mediastinal Thymoma of an Infant: A Case Report / 임상소아혈액종양

A seven months old male infant visited Severance Children's Hospital for evaluation of anterior mediastinal mass. With chest computed tomography (CT) image and biopsy, precursor T-cell lymphoblastic lymphoma was suspected but the ultrasonography guided biopsy specimen was insufficient to confirm the disease. Because there was a life-threatening risk to perform open biopsy to the small infant, we started chemotherapy empirically. The mass decreased, however, the lesion increased again and did not respond to the drugs. Finally we decided to resect the anterior mass with sternostomy and the pathology report finally resulted in thymoma.

A Case of Subdural Empyema Caused by Sinusitis in a Child / 소아감염

The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.

Corrigendum: Suicide Rate Differences by Sex, Age, and Urbanicity, and Related Regional Factors in Korea / 예방의학회지

The funding acknowledgment in this article was omitted as published.

Suicide Rate Differences by Sex, Age, and Urbanicity, and Related Regional Factors in Korea / 예방의학회지

OBJECTIVES: Identify the characteristics related to the suicide rates in rural and urban areas of Korea and discover the factors that influence the suicide rate of the rural and urban areas. METHODS: Using the data on causes of death from 2006 to 2008, the suicide rates were calculated and compared after age-standardization based on gender, age group and urbanicity. And, in order to understand the factors that influence suicide rate, total 10 local characteristics in four domains - public service, social integration, residential environment, and economic status - were selected for multiple regression analysis. RESULTS: The suicide rates were higher in men than women, in rural areas than urban, and in older people than the younger. Generally, although there were variations according to age group and urbanicity, suicide rates were significantly related to residential environment and regional economic status but not related to regional welfare spending and social integration. In addition, the population over the age of 65 years, only regional economic status has significantly influence on their suicide rates. CONCLUSIONS: The influence of characteristics of regions on suicide rate is various by age-group, gender, and urbanicity. Therefore, in order to lower suicide rate and reduce the gap between regions, various approaches must be adopted by taking into account the socioeconomic characteristics of the regions.

Deprivation and Mortality at the Town Level in Busan, Korea: An Ecological Study / 예방의학회지

OBJECTIVES: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. METHODS: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. RESULTS: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. CONCLUSIONS: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

Effects of Growth Hormone on the Degenerative Changes in the Intervertebral Disc of Rabbits / 고신대학교의과대학학술지

OBJECTIVES: Growth hormone is expected to delay the degenerative changes of the intervertebral disc and affect the initial recovery process of cartilage injury, but these effects are still open to disputes. METHODS: This researcher injected growth hormone to the intervertebral disc and subcutaneous tissue of rabbits whose degenerative change were induced artificially, and evaluated the treatment effects of growth hormone through a comparison between the injected and control groups of rabbits. The intervertebral discs between the 3th and 4th vertebrae were extracted 4 weeks after the administration of growth hormone and then histologically graded in a quantitative method. Changes in the height of the intervertebral discs were measured after the induction of degenerative changes. After four weeks of the treatment, then, the height changes were measured. RESULTS: In the subcutaneous-growth hormone injected group, any consistent, sequential, and progressive degeneration of the annular fibrosus was not observed through histopathological studies. The disc height also sequentially did not decrease from that at the time of the injury set in this study. CONCLUSIONS: Considering the histopathological findings of the study, the researcher suggests that subcutaneous injection of growth hormone will be a therapeutic model of disc degeneration. But further biochemical or electromicroscopic studies are necessary to clarify the mechanism of delay degenerative disc changes by growth hormone.

Strain Typing of Mycobacterium tuberculosis Isolates from Korea by Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats / 대한진단검사의학회지

BACKGROUND: Mycobacterium tuberculosis is one of the most clinically significant infectious agents. Especially during mass outbreaks, accurate identification and monitoring are required. The proportion of Beijing family members is very high among infecting strains, and spoligotyping is not suitable for strain typing. Therefore, we studied the homogeneity of isolates using the mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) method and identified its utility for carrying out molecular epidemiologic analysis. METHODS: Eighty-one clinical M. tuberculosis isolates that had previously been analyzed by spoligotyping were used in this study. We used the 12 standard MIRU loci and further four exact tandem repeat (ETR) loci (ETR-A, -B, -C, and -F). Four strains each of randomly selected Beijing and Beijing-like families were subjected to IS6110- restriction fragment length polymorphism analysis. RESULTS: All 81 samples showed amplification products of all VNTR loci, and all of them showed differences in at least one locus. The calculation of the Hunter-Gaston diversity index (HGDI) for MIRU-VNTR gave the value of 0.965. Discriminatory index in the six loci (MIRU-10, -16, -26, -31, -39, and ETR-F) were found to be highly discriminated (HGDI >0.6). Beijing and Beijing-like family isolates were discriminated into different MIRU-VNTR types. CONCLUSIONS: MIRU-VNTR analysis by using well-selected loci can be useful in discriminating the clinical M. tuberculosis isolates in areas where the Beijing family is predominant.

Differences in Patients' Awareness of Doctors' Communication Styles, Patients' Satisfaction, and Patients' Compliance among Patient Social Styles / 한국의학교육

PURPOSE: It has been well known that doctor-patient communication is a key to the better doctor-patient relationship. However, in Korea, there has not been much researches on the causal factors influencing the doctor-patient communication as well as on patient satisfaction and compliance. This study attempts to investigate the relationships between patient social styles and doctors' communication styles as well as patient outcomes. METHODS: Patient subjects were recruited from two mid-size local hospitals. The questionnaires consist of social styles, patient-perceived doctors' communication, and patient satisfaction/compliance measures. One hundred ninety useable data were analyzed. RESULTS: For those highly satisfied patients, patients with analytic style showed the highest percentage of viewing their doctors as highly empathic. On the other hand, for those patients with high compliance, expressive style patients showed the highest rates of regarding their doctors as highly affective. And amiable style patients are most likely to view their doctors as highly cognitive. For analytic style patients, cognitive empathy had positive effects on patient satisfaction. For amiable style patients, doctors' cognitive empathy had positive influence on patient compliance. For expressive style patients, doctors' affective empathic communication had positive effects on both patient satisfaction/compliance while cognitive had positive effects only on patient compliance. CONCLUSION: The results show that the different social styles of patients might influence on the fact how the patients perceive their doctors' communication as well as how much they are satisfied and compliant. Thus, when we as an medical educators need to realize the importance of this mechanism and bring this learning into classrooms.

Prevalence Rate of Cognitive Impairment and Dementia Among the Elderly in Busan / 예방의학회지

OBJECTIVES: To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. METHODS: Total of 1, 101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. RESULTS: With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. CONCLUSIONS: The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.

A Study on Comparison of the Metabolites Related with Working Methods and Immunity of the Toluene diisocyanate-Exposed Workers / 대한산업의학회지

Following recent advanced industrialization. the amount of polyurethane to use as thermal insulating materials, upholstery mattresses and packing materials in automotive and furniture industry is increasing world-widely, and the number of polyurethane-producing worker will be increased. Because the numerous organic solvents are used in polyurethane-producing factory, the workers in this work site is exposed to many organic solvents. Of the organic solvents. Toluene Diisocyanate(TDI) has many hazardous effects to human. The effects of TDI on human are the irritation to respiratory mucosa and gastrointestinal symptoms. Conjunctival irritation, dermal inflammation (redness, pain, vesicular formation) and gastrointestinal symptom(nausea, vomiting, abdominal pain) are reported just after short-term exposure of TDI. TDI is known to give rise to bronchial asthma, as the immune disorder. And because of strongly volatile characteristics of TDI, it is suggested as a more injurious material to human health, especially human immune system, than other organic solvents. Bronchial asthma inducing mechanism of TDI is not clearly known, but on the analogy of TDI-induced symptoms and recent studies, early-onset asthma is type I hypersensitivity reaction mediated by immunoglobulin E(IgE), and late-onset asthma is maybe type III hypersensitivity reaction by circulating IgG. And we know that the complicated human immune function is likely to move in such that mechanisms, there are not studies on immune indices evaluating the bronchial asthma-related immune function. The evaluation of change patterns of humoral immunity including IgE and IgG and cellular immunity including T-helper cell, T-suppressor cell and T-cytotoxic cell will be helpful to evaluate exposure degrees and prognosis in TDI-exposed workers. Because TDA(toluene diamine) as a biological exposure index of TDI becomes the focus of interest, we know that a study on the correlation between urinary TDA and air TDI and immunological indices will make a contribution to biological effect monitoring indicies. We examined human immunity indicators such as WBC. %Lymph (percentile of Lymphocyte in WBC). %T-cell(percentile of T-lymphocyte in total lymphocyte). CD4, CD8, C3, C4, IgA, IgG, IgM, IgE in peripheral blood to evaluate the health hazard of the TDI-exposed workers. And we examined TDA to evaluate correlation between exposure and effect. Total 90 subjects was selected, 45 workers who worked in the polyurethane-producing factories as an exposed group, and 45 cases who were office workers(10 cases), other blue collors(27 cases), and medical college students(8 cases) as a control group. And the results were as follows ; 1. The logarithm of IgE -Log10(IgE)+/-SD- in peripheral blood of a exposed group was significantly higher than a control group, 2 22+/-.62 in case group compared with 1.98+/-.53 in control group.(p0.05). 3. WBC, %Lymph, %T-cell, C3, C4, CD4, CD8, CD4/CDB ratio and IgG in case group were 6,391.1 ea/ml, 37.53%, 59.54%, 76.68 mg/dl, 30.54 mg/dl, 0.76x10(9) ea/L, 0.63x10(9) ea/L, 1.39, and 1606.29 mg/dl, respectively, and 6,974.7 ea/ml, 35.12%, 59.64%, 71.95 mg/dl, 33.94 mg/dl, 0.80x109 ea/L, 0.61x10(9) ea/L, 1.39, and 1581.51 mg/dl in control group. There was no statistical sinificance between two groups. (p>0.05) 4. In the comparison of each other companies, average of individual urinary TDA in polyurethane paint manufacturing companies is higher than that of polyurethane sponge foaming companies. And, the concentration of 2,6-TDA which is a metabolite of well-vaporized 2,6-TDI is higher than that of 2,4-TDA in the polyurethane sponge foaming companies. But, the concentration of 2,4-TDA which is a metabolite of illvaporized but well skin-absorbed 2,4-TDI is higher in polyurethane paint manufactures. 5. There were no statistical significance in the correlations between individual urinary TDA and immunologic indices.

Chromosome Aberrations and Sister Chromatid Exchanges of Hospital Workers Exposed to Radiation / 예방의학회지

In order to evaluate the cytogenetic hazard among hospital workers potentially exposed to low dose of radiation, the analysis of chromosome aberrations(CA) and sister chromatid exchanges(SCE) in lymphocytes were performed in 79 hospital workers and 79 non-exposed workers. The mean frequency of chromosomal exchange and deletion(respectively, 0.20X10-2/cell and 0.39X10(-2)/cell) in the exposed group were significantly higher than those(0.07X10(-2)/cell and 0.23X10-2/cell) in control group. The frequency of sister chromatid exchanges was 5.04/cell in the control vs. 6.57/cell in the exposed group. There were also significant differences in the mean frequencies of CA and SCE adjusted for age, sex, smoking, drinking between two groups. There were no evidence of significant increase of CA and SCE according to the department or duration of employment. But the frequency of cells having chromosome aberration was significantly higher in the exposed group than in the control group related to duration of employment. There was no dose-effect relationship between the cumulative doses and the frequency of CA and SCE. But in the case of last 1 yr cumulative dose, there were evidence of significant dose-dependant increase of chromosome type CA and percentage of cells with aberration. The result suggest that there is cytogenetic hazard in risk group like hospital workers handling low dose radiation. And the analysis CA and SCE are useful biological indicators for the exposure of low dose level of radiation.

A Study on Immunity of Welders / 대한산업의학회지

The authors examined human immunity indicators such as CD4, CD8, Natural Killer (NK) cell, IgG, IgA, and IgM, and heavy metals such as Pb, Cr, Cd to evaluate the health hazard of welders. We selected total 126 male subjects, 60 welders who had more than 5 year working history as an exposure group, and 66 office workers and medical college students as a control group. This immunity evaluation approach is the first newly designed study that has never been tried in past studios on welder's heath evaluation. And the results were as follows. 1. Total lymphocyte count of peripheral blood was significantly higher in welder group, 2,615+/-650 ea/microliter compared with 2,368+/-681 ea/microliter in control group (p or =0.05). 3. IgG, IgA, and IgM in welder group were 15.9 mg/dl, 2.7 mg/dl, and 1.5 mg/dl, respectively, and 15.6 mg/dl, 2.9 mg/dl and 1.7 mg/dl in control group. There was no statistical significance between two groups(p> or =0.05). 4. Blood lead, cadmium and chromium concentrations were 4.2+/-1.8 microgram/dl, 0.4+/-0.38 microgram/dl, 1.2+/-0.6 microgram/dl in welder group and 3.2+/-1.7 microgram/dl, 0.44+/-0.29 microgram/dl, 1.1+/-0.6 microgram/dl in control group, respectively, and these value were within normal ranges.

A Study on obesity pattern and related factors of the doctors / 예방의학회지

The author surveyed overall obesity indicies and factors concerned with obesity such as dietary intake, physical activity, stress and life style with the subject of doctors. The number of subjects was total 508 with 396 men and 112 women. They were subgrouped into surgical part, medical part and service and basic part by speciality. And also subgrouped into intern and resident, pay doctor, and practitioner by working type. The results were as follows. 1) Obesity indices: BMI of total doctor was 23.1+/-2.8, and WHR was 0.87+/-0.08 and overweight prevalence(BMI>25.0) was 23.6 %. It was within normal limit but slightly over the Korean standard. The degree of obesity indices of subgroups by speciality was "surgical part > medical part > service and basic part", and by working type was "practitioner > pay doctor > intern and resident". 2) Dietary intake and Physical activity: Average dietary intake was 2148+/-451 kcal/day. The degree of dietary intake by speciality was "surgical part > medical part > service and basic part". By working type it was "practitioner > pay doctor > intern and resident". Average physical activity was 29+/-5 METs/day. The degree of physical activity also showed similar pattern. But there was no significant difference among each groups. 3) Comparison between over-weight and non-over-weight group: The items that showed significant difference between two groups were dietary intake, skip breakfast, regular exercise, smoking, heavy drinking, chronic disease etc.

A Study on the Neuropsychiatric Symptom and Neurobehavioral Effects of Occupational Exposure to Trichloroethylene / 대한산업의학회지

No abstract available.

Alterations of immune response in workers occupationally exposed tolead / 대한산업의학회지

No abstract available.

A Study on the Induction of Sister-Chromadd Exchanges in Chinese Hamster Ovary Kl Cells by Exposure to Cadmium / 예방의학회지

In order to exmaine the mutagenicity of cadmium dichloride the author studied the induction of sister chromatid exchanges in chinese hamster ovary K1 cells which treated with cadmium dichloride at various concentrations. The results obtained were as follows: 1. In cells treated with 10(-4) M cadmium dichloride, a small number of cells were visable but no mitosis was bound. 2. The frequencies of sister chromatid exchanges in cells treated with 10(-5) M and 10(-6) M cadmium dichloride as 10.7 +/- 1.9 and 8.3 +/- 2.1, respectively, were significantly increased for control (6.0 +/- 2.3). (p<0.05). 3. There were dose-dependent relationship between the concentration of cadmium dichloride and frequency of sister chromatid exchanges in cells treated with cadmium dichloride at concentration ranging from 10(-5) to 10(-7) M.

A Study on the Urinary Metabolites and Sister Chromatid Exchanges of Peripheral Lymphocytes in Workers Exposed to the Organic Solvents / 대한산업의학회지

In order to know the possibility of utilizing the sister chromatid exchanges as an index which could evaliiate the effect of organic solvents on Lhe health in industrial workers, the authors Studied the effects of the inductivity of sister chromatid exchanges in peripheral lymphocyces from 90 female workers espoxed to organic solvents .and 20 lion-exposed female workers. The results obtained were as follows: 1. The frequency of sister chromatid exchanges in peripheral iympnocytes from 90 female workers exposed to organic solvents was significantly increased in comparison with 20 coatiol subiect. 2. The frequency of sister chromatid exchanges was significantly Increased in the workers who were employed in the manufacture of plastic materials than the other manufactures. 3. There were no significant differences in the frequency of sister chrornatid exchanges by carriera of the exposed workers. 4. The correlation between the frequency of sister chromatid exchanges and urinary hippuric acid was significant with the coefficient of 0.5902 showing Y=1.867X+15.188 in which Y indicate the frequency of sister chromatid exchanges per cell and X indicate the urinary hippuric acid concentration by g/l.