OBJECTIVES: This study was undertaken to evaluate correlation between the levels of hippuric acid in blood plasma (HAP) and those of toluene concentration in the workplace air. METHODS: Study subjects were composed of two groups; 21 workers who were occupationally exposed to toluene and 25 rural-area residents who were not exposed to any known occupational toluene source, as an exposed group and a reference group, respectively. Mean age and work duration of the exposed was 42 years and five years, respectively. Mean age of the reference was 42 years. To determine toluene concentrations in the workplace air, air sampling has been conducted for more than six hours using a personal sampler, and analyzed by a gas chromatography-flame ionization detector. Concentrations of hippuric acid in biological samples were determined by a high performance liquid chromatography-ultraviolet detector. RESULTS: Geometric mean(geometric standard deviation) of HAP and hippuric acid in urine(HAU) for the exposed was 1.39(2.21) mg/L and 2.77(1.46) g/L, respectively, which were significantly different from those of the reference [HAP, 0.45(2.94); HAU, 0.37(0.45)]. Toluene concentration in the workplace air was 86.92(range: 45.18~151.23) ppm. The level of HAP or HAU was significantly correlated (r=0.70 and r=0.63, respectively) with that of toluene in the workplace air. The estimated regression equation was logHAP(mg/L)=-3.60+1.93 log(toluene, ppm) or logHAU(g/L)=-0.85+0.67 log(toluene, ppm). The magnitude of correlation was further enhanced when analyzing relationship between toluene concentrations lower than 100 ppm and its corresponding HAP levels. CONCLUSION: Overall, plasma hippuric acid levels were well correlated with toluene concentrations in the workplace air, and a statistically significant correlation was observed for the samples with toluene concentration lower than 100 ppm.
Chromatography, High Pressure Liquid ; Humans ; Occupations ; Plasma* ; Toluene*

Recently, after reviewing the online journal, Journal of the Korean Association of Oral and Maxillofacial Surgeons , we found a recently published original article by Manzano et al., entitled, “Retrospective study of osteoradionecrosis in the jaws of patients with head and neck cancer”. Although this original article was well written and provided a great deal of information regarding osteoradionecrosis in the jaws, we would like to add a few additional recommendations based on our small concerns and recently updated articles.

Crohn's disease can cause intestinal strictures, perforations, fistulas, or abscesses. Although fistulas and abscesses are common complications of Crohn's disease, a presacral abscess with neuromuscular complications is very unusual. A delayed diagnosis and treatment may increase morbidity. The diagnosis is frequently delayed, because the clinical features of presacral abscess are variable and nonspecific. We experienced a case of a presacral abscess with bilateral sciatica in a 25-year-old male patient. He was diagnosed with Crohn's disease of the terminal ileum 2 months previously and has been managed with mesalazine. He visited our hospital due to pain in the buttocks and severe neuralgia in both thighs. We confirmed enteric fistulas, resulting in a presacral abscess, which extended symmetrically through both sciatic notches and the gluteus medius muscles. He was managed with antibiotics after a small bowel segmentectomy, right hemicolectomy, fistulectomy, and surgical drainage. The bilateral radicular pain resolved completely within 2 weeks of surgery. The patient has remained in remission and asymptomatic 1 year after surgery.
Abscess ; Adult ; Anti-Bacterial Agents ; Buttocks ; Constriction, Pathologic ; Crohn Disease ; Delayed Diagnosis ; Drainage ; Fistula ; Humans ; Ileum ; Male ; Mastectomy, Segmental ; Mesalamine ; Muscles ; Neuralgia ; Sciatica ; Thigh

Malignant Peripheral Nerve Sheath Tumor is a neoplasm that most often arises in anatomically discernible peripheral nerves or neurofibroma. This rare tumor usually has a strong association with neurofibromatosis type 1. Nearly half of these malignant tumors arise in individuals affected with neurofibromatosis type 1. Neurofibromas often first appear around the time of puberty, increase in size and number during pregnancy, and shrink after giving birth. Because growth hormone (GH) concentration increases during puberty and pregnancy, it is possible that GH influences the growth of these tumors. A 33-year-old pregnant woman presented with a 4-month history of a painful, huge mass growing on the right breast. She suffered from neurofibromatosis type 1, with multiple cafe au lait spots and neurofibromas. The clinical and histopathological findings showed a malignant peripheral nerve sheath tumor. We report a case of malignant peripheral nerve sheath tumor on the right breast in a pregnant woman with neurofibromatosis type 1.
Adolescent ; Adult ; Breast ; Cafe-au-Lait Spots ; Female ; Growth Hormone ; Humans ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Parturition ; Peripheral Nerves* ; Pregnancy* ; Pregnant Women ; Puberty

This study was started to find out if plasma malondialdehyde(MDA), alpha-tocopherol and erythrocyte superoxide dismutase(SOD) activity could be markers of biological activity resulting from exposed to lead in workers. Blood samples were randomly obtained from lead -exposed workers(n=29), CO2 welders(n=60) and office workers(n=60). We used whole blood to analyse blood lead with atomic absorption spectrophotometer. Superoxide dismutase activity in erythrocyte was measured with spetrophotometer. MDA and alpha-tocopherol in plasma were measured with high performance liquid chromatography. Lead-exposed workers was significantly high in blood lead concentration(29.37 ng/dl) compared with welders(6.42 ng/dl) and office workers(5.01 ng/dl). The level of plasma MDA was significantly higher in the lead-exposed workers(1.87 nmol/g cholesterol) than the welders(1.41 nmol/g cholesterol) and office workers(1.41 nmol/g cholesterol). Erythrocyte SOD activity in lead-exposed workers(56.80 U/g Hb) was significantly increased than those of welders(37.63 U/g Hb) and office workers(20.47 U/g Hb). The plasma alpha-tocopherol level of lead-exposed workers(4.93 ng/g cholesterol) was statistically different from welders(4.25 ng/g cholesterol) and office workers(4.28 ng/g cholesterol). Neither age nor smoking was related to SOD or MDA level. Blood lead was significantly correlated with erythrocyte SOD activity(r=0.405), plasma MDA(r=0.296) and alpha-tocopherol(r=0.207). Plasma MDA was also significantly correlated with SOD (r=0.217). In multiple regression analysis, the change of MDA and SOD activity level related to the blood lead concentration. These results suggested that the increase of plasma MDA and erythrocyte SOD activity in lead-exposed workers had a close relationship with the oxidative stress induced by lead.
Absorption ; alpha-Tocopherol ; Antioxidants* ; Chromatography, Liquid ; Erythrocytes ; Lipid Peroxidation* ; Oxidative Stress ; Plasma ; Smoke ; Smoking ; Superoxide Dismutase ; Superoxides

Background: Goiter has been a common problem in the thyroid disease. The exact mechanism of goiter had not been clarified yet, but some goiters were increased with TSH(thyrotropin releasing hormone) dependent manner. TSH might be a major influencing factor for increasing size of goiter(goitrogen) and theres many cofactors those influenced to goiter size. One of the rnost prominent growth factor as a goitrogen is a IGF-I(insulin-like growth factor-I). IGF-I play a great role as a cofactor of goitrogen with TSH. This study, therefore, is aimed to investigate intracellular activation of IGF-I gene promoter in the surgical specimens of thyroid tumor. Methods: We used surgical specimen of various thyroid tissues from normal to malignant along its cell nature. Actually we used normal liver tissue as a IGF-I control tissue, normal thyroid, benign adenoma, and papillary thyroid cancer tissue with its malignat nature. We checked Mrna expression of whole IGF-I and IGF-I exon 6 by Northern blot method, and IGF-I, promoter 1 expression by RT-PCR-transcription method. Autoradiographied signals were analysed with densitometer. Results: We found whole IGF-I mRNAs were expressed with alternate splicing in exon 1, 2 and exon 4, 5 respectively. Striking events of IGF-I transcription were multiple tranascription initiatian in Pl and P2, and 3 sites for polyadenylation in exon 6. Four or more Mrna bands in Northern blot analysis of IGF-I(0.8, 1.4, 4.2, and 7.8kb) were noted. In low molecular weight IGF-I Mrna did not change their signal intensity with tissues, but exan 6(7.8kb) signals were significantly increased to its hepatic expression levels in malignant tissue. IGF-I, exon 1 expression by RT-PCR-T7 transcription was strikingly increased in thyroid cancer tissue, but exon 6 expression was not a great expession. Conclusion: One possible guess for this expression discrepancy of each exon may be originated from different Mrna degradation of each IGF-I signals. We need more preeise experiment for Mrna degradation speed of IGF-I.
Adenoma ; Alternative Splicing ; Blotting, Northern ; Exons ; Goiter ; Insulin-Like Growth Factor I ; Liver ; Methods ; Molecular Weight ; Polyadenylation ; RNA Stability ; RNA, Messenger ; Strikes, Employee ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms

BACKGROUND/AIMS: Small bowel intussusception is rarely diagnosed in children. And its studies have not been frequently reported. While surgical treatment has been considered as standard treatment in small bowel intussusception in adult population, spontaneous reduction of it is increasingly reported recently. Therefore, we analyzed the clinical features and outcome of small bowel intussusception in children compared with ileocolic intussusception. METHODS: 95 children with the diagnosis of intussusception who visited Sanggye-Paik hospital were included in this study between March 2000 and December 2003. We retrospectively reviewed the clinical records and imaging findings. Ultrasonographic studies were performed by an experienced pediatric radiology staff using SEQUOIA 512 machine (probe 4-8 MHz). RESULTS: A total of 80 patients with ileocolic intussusception (41 male, 39 female) and 15 patients (11 male, 4 female) with small bowel intussusception were diagnosed. Children with small bowel intussusception were older than ileocolic intussusception (mean age: 40 months vs. 16 months). The presenting symptoms of small bowel intussusception were vomiting, irritability, abdominal pain, bloody stool, and abdominal mass in order and were not different with those of ileocolic intussusception. While in ileocolic intussusception group, reduction was done by gastrograffin enema (73.8%), spontaneous reduction (0%) and surgical reduction (26.3%), spontaneous reduction was done in 73.3% and surgical reduction in 20% in small bowel intussusception group. CONCLUSIONS: Small bowel intussusception in children occurred in older age than ileocolic intussusception and was reduced spontaneously in large proportion.
Child, Preschool ; Female ; Humans ; Ileal Diseases/diagnosis/therapy ; Infant ; Infant, Newborn ; Intestine, Small ; Intussusception/*diagnosis/therapy ; Male

Rhinoliths result from calcification of an endogenous or exogenous nidus within the nasal cavity. Patients typically present symptoms of long-standing unilateral nasal obstruction, pain and foul-smelling discharge. Rhinoliths are most often found on the floor of the nose and maxillary antrum. Rhinoliths are most often found on the floor of the nose and maxillary antrum. Rhinoliths present complications involving erosion or perforation of nasal mucosa, septum and palate. Sinusitis is a rare complication of rhinoliths. The authors experienced a case of frontal sinus rhinoliths in 36 years old man who complained of a headache and had a history of a frontal area trauma. At first we suspected it to be fungal sinusitis or mucocele, but finally confirmed it to be frontal sinus rhinolith after carrying out a frontal sinus osteoplastic operation.
Adult ; Frontal Sinus* ; Headache ; Humans ; Maxillary Sinus ; Mucocele ; Nasal Cavity ; Nasal Mucosa ; Nasal Obstruction ; Nose ; Palate ; Sinusitis

Anxiety ; Benzodiazepines ; Conscious Sedation ; Consciousness Disorders ; Dentistry ; Humans ; Midazolam ; Physical Stimulation ; Surgery, Oral

Regional anesthesia in the maxillofacial region is safer and more efficient than general anesthesia when its indications are carefully considered. In addition, the majority of medical institutions in developing countries are not well equipped for proper anesthesia and elective surgery. In this review, we describe regional anesthesia and cutaneous nerve divisions in the maxillofacial region. In addition, we summarize detailed regional anesthetic techniques adapted for representative cleft lip cases in developing countries.
Anesthesia ; Anesthesia, Conduction* ; Anesthesia, General ; Cleft Lip ; Developing Countries* ; Surgery, Oral*