Glutaraldehyde is commonly used as a biocide to disinfect delicate instruments such as dental instruments, to treat warts, hyperhidrosis and bullous diseases and as a preservative in various materials. Contact sensitivity to glutaraldehyde may not be detected, because it is not included in the standard screening chemicals recommended in the screening tests. We report a case of allergic contact dermatitis caused by Wydex(2% glutaraldehyde). A 54-year-old female made a visit to our departrnent with eczematous dermatitis of both hands, neck and face. She worked as a cleaner in delivery room and newborn nursery, and had developed the dermatitis 1 month after Wydex' containing 2% glutaraldehyde had been to clean the rooms. She had no family or personal history of atopy or contact dermatitis. Patch tests with Korean Standard(KS-1000) and Wydex were performed, and patch tests with 2% glutaraldehyde, 0.2% gluteraldehyde and rubber mix followed. The positive results were, Wydex 2% ++, 0.2% +, 0.02% + and. glutaraldehyde 2% aq. +, 0.2% aq. + on day 2 and day 4. We confirmed that the skin lesions had been caused by Wydex . The symptoms were eradicated after she changed her work environment and there has been no evidence of recurrence.
Delivery Rooms ; Dental Instruments ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Eczema ; Female ; Glutaral* ; Hand ; Humans ; Hyperhidrosis ; Infant, Newborn ; Mass Screening ; Middle Aged ; Neck ; Nurseries ; Patch Tests ; Recurrence ; Rubber ; Skin ; Warts

No abstract available.
Joints* ; Range of Motion, Articular* ; Spine*

No abstract available.
Breast* ; Female ; Mammaplasty* ; Mastectomy*

PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
Breast Neoplasms* ; Cardiac Volume ; Feedback, Sensory ; Heart ; Humans ; Lung ; Patient Compliance ; Radiotherapy* ; Respiration* ; Tomography, X-Ray Computed

The latissimus dorsi muscle or musculocutaneous flap is one of the most useful flaps in reconstructive surgery. This flap has many advantages, such as its reliable anatomy, long pedicle with large caliber vessels, minimal functional deficit of the donor site, and low incidence of donor site complications. However, the bulkiness of the flap has been considered a disadvantage, so various modifications of technique have been devised. The cutaneous portion of the flap can be safely elevated based on the cutaneous perforating branch of the thoracodorsal vessel. From March 1997 to February 1998, 10 patients underwent reconstructive procedures with thoracodorsal perforator-based free flaps. The composition of the flaps varied in accordance with the nature of the defect. The variances in the flaps were as follows; 3 were cutaneous, 6 musculocutaneous, and 1 osteomusculocutaneous including the rib. All flaps survived with good contour. We concluded that this thin and reliable flap was useful for reconstruction of various defects, and that the composition of the flap, such as subcutaneous, muscle and bone, gave it considerable flexibility as needed.
Free Tissue Flaps* ; Humans ; Incidence ; Myocutaneous Flap ; Pliability ; Ribs ; Superficial Back Muscles ; Tissue Donors

Cubitus varus deformity is the late complication of the supracondylar fracture of humerus which is common in growing children. If the deformity is severe it causes tunctional problems as well as cosmetic ones necessitating conective osteotomy. Though many authors devised different methods of corrective osteotomy, the cosmetic results are not always satisfactory because of the development of the lazy S deformity hy the lateral prominence. Technically. the initial stahility of the osteotomy is also poor due to the poor contact of the osteotomy site. So we have devised a new quadrilateral displacement osteotomy to increase the initial stability of the osteotomy by creating a wedge on the osteotomy site & also to prevent the development of the lazy S deformity hy elimination of the Interal prominence. We treated 9 cases of cubitus varus deformity with the new quadrilateral displacement osteotomy. The correction technique was not difficult & the initial stahility of the osteotomy is rather good & the osteotomy is fixed by the conventional methods, & all of the cases were healed uneventfully. There developed no the lazy & deformity after osteotomy. We would like to report the details ot the supracondylnrquadrilateral displacemenl osteotomy.
Child ; Congenital Abnormalities* ; Humans ; Humerus ; Osteotomy*

OBJECTIVES: This study was carried out to assess psychosocial distress of lead workers and to examine the relationship between lead exposure indices and psychosocial distress. METHODS: The study design was cross-sectional and research subjects were 234 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), -aminolevulinic acid in urine(ALAU) were selected as indicators of lead exposure. RESULTS: There was significant difference in PWI according to lead exposure level and job characteristics. The results of correlation analysis showed that PWI was significantly correlated with PbB(r=0.203, P=0.002). CONCLUSIONS: Our results supported the association between lead exposure and psychosocial distress. The inclusion of psychosocial distress measurement as a special health examination for lead workers was highly recommended for the effective health management.
Humans ; Osmeriformes ; Questionnaires ; Research Subjects ; Zinc

Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is 100 ng/dl which is supposed to match the level of 40 ng/dl of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level(100 ng/dl) of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over 40 ng/dl. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin(Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were 79.5+/-46.7 ng/dl, 38.7+/-15.1 ng/dl, and 14.8+/-1.2 g/dl, respectively. There were significant differences in blood ZPP, PbB and Hb by industry(P<0.01). 2. The percents of lead workers whose blood ZPP were above 100 ng/dl in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above 40 ng/dl in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below 40 ng/dl, 40-59 ng/dl and above 60 ng/dl were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below 100 ng/dl, 100-149 ng/dl and above 150 ng/dl were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant(P<0.05) and as PbB was 40 ng/dl, blood ZPP was 82.1 ng/dl. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB over 40 ng/dl were observed in the cut-off level of 50 ng/dl and 100 ng/dl of blood ZPP, respectively, the highest validity(sensitivity+specificity) of blood ZPP to detect lead workers with PbB over 40 ng/dl was observed in the cut-off level of around 70 ng/dl of blood ZPP. But even with optimal cut-off level of around 70 ng/dl of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from 100 ng/dl to somewhat lower level such as around 70 ng/dl and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.
Absorption ; Humans ; Korea ; Linear Models ; Male ; Mass Screening ; Sensitivity and Specificity ; Zinc*

Pharyngeal and laryngeal foreign bodies are common problem at ENT clinic. Removal of a foreign body is mostly simple with the manipulation of endoscope and various instruments. Rarely, migration of swallowed sharp foreign body makes complication. We describe a 74-year-old patient diagnosed with foreign body in larynx involving thyroid. In this case, we present this disease and the treatment course which has been successfully treated by surgical removal and conservative treatment. Furthermore, we discuss its symptoms, physical examinations through literature review.
Aged ; Endoscopes ; Foreign Bodies* ; Humans ; Larynx* ; Physical Examination ; Thyroid Gland*

PURPOSE: We evaluated the efficacy of an arterial embolization in patients with a renal cell carcinoma. MATERIALS AND METHODS: We studied 17 patients with a renal cell carcinoma that underwent a transcatheter arterial embolization between 1995 and 2004. We studied the patients' character, performance status (ECOG), tumor location, size, stage, symptoms, cause of embolization, prognosis, and survival rate, as well as the follow up period. Patients were classified into three groups: group (I) consisted of patients where the procedure was performed with an angioinfarction only; group (II) consisted of patients where the procedure was performed with an angioinfarction, followed by additional immunotherapy with interferon; group (III) consisted of patients where the procedure was performed with an angioinfarction, followed by additional immunotherapy with interleukin-2, interferon, 5-flourouracil, 13-cis-retinoic acid and H2-blocker. RESULTS: The patients' ECOG (Eastern Co-operative Oncology Group criteria) scores were 1, 2, 3 and 4 in 2, 6, 6 and 3 patients, respectively. After the transcatheter arterial embolization, symptomatic improvement of the hematuria and pain were observed. All patients had disease progression, with the exception of one stable disease. Group I had a better survival than groups II or III (p=0.036). CONCLUSIONS: Transcatheter arterial embolization is a safe treatment for patients with a renal cell carcinoma where an operation is unavailable due to a poor performance status or advanced stage. The procedure may not influence the survival rate, but does improve the symptoms; additional immunotherapy may not improve the survival rate either.
Carcinoma, Renal Cell* ; Disease Progression ; Embolization, Therapeutic ; Follow-Up Studies ; Hematuria ; Humans ; Immunotherapy ; Interferons ; Interleukin-2 ; Isotretinoin ; Prognosis ; Survival Rate