PURPOSE: Extremely hazardous pesticides are classified as World Health Organization (WHO) hazard class Ia. However, data describing the clinical course of WHO class Ia OP (organophosphate) poisonings in humans are very scarce. Here, we compare the clinical features of patients who ingested hazard class Ia OPs. METHODS: This retrospective observational case study included 75 patients with a history of ingesting ethyl p-nitrophenol thio-benzene phosphonate (EPN), phosphamidon, or terbufos. The patients were divided according to the chemical formulation of the ingested OP. Data regarding mortality and the development of complications were collected and compared among groups. RESULTS: There were no differences in the baseline characteristics and severity scores at presentation between the three groups. No fatalities were observed in the terbufos group. The fatality rates in the EPN and phosphamidon groups were 11.8% and 28.6%, respectively. Patients poisoned with EPN developed respiratory failure later than those poisoned with phosphamidon and also tended to require longer mechanical ventilatory support than phosphamidon patients. The main cause of death was pneumonia in the EPN group and hypotensive shock in the phosphamidon group. Death occurred later in the EPN group than in the phosphamidon group. CONCLUSION: Even though all three drugs are classified as WHO class Ia OPs (extremely hazardous pesticides), their clinical courses and the related causes of death in humans varied. Their treatment protocols and predicted outcomes should therefore also be different based on the chemical formulation of the OP.
Cause of Death ; Classification ; Clinical Protocols ; Humans* ; Mortality ; Organophosphates* ; Pesticides ; Phosphamidon* ; Pneumonia ; Poisoning* ; Respiratory Insufficiency ; Retrospective Studies ; Shock ; World Health Organization

Age Distribution ; Dislocations ; Emergencies ; Emergency Service, Hospital ; Facial Bones ; Hemorrhage ; Humans ; Incidence ; Retrospective Studies ; Soft Tissue Injuries ; Surgery, Oral ; Temporomandibular Joint ; Tooth Fractures ; Tooth Injuries ; Zygoma

PURPOSE: To evaluate patients' self-recognition of reduced visual acuity due to recurring macular edema in retinal vein occlusion. METHODS: A retrospective review of medical records of patients who were diagnosed with recurring macular edema secondary to retinal vein occlusion was performed. The proportion of patients who recognized reduced visual acuity due to the recurrence of macular edema and who visited the hospital before the scheduled follow-up date was determined. Parameters including age, sex, diagnosis, visual acuity before recurrence of macular edema, and extent of visual acuity reduction due to recurrence of macular edema were compared in patients who recognized a reduction in visual acuity and those who did not. The proportion of patients who visited the hospital promptly was also determined. RESULTS: Forty eyes of 40 patients were included in the analysis. Sixteen and 24 patients were diagnosed with central retinal vein occlusion and branch retinal vein occlusion, respectively. Twenty-one patients (52.5%) recognized reduced visual acuity due to recurring macular edema. These patients were younger (59.2 +/- 7.6 vs. 64.8 +/- 9.4 years, p = 0.046), had better visual acuity before recurrence of macular edema (0.52 +/- 0.48 vs. 1.02 +/- 0.46, p = 0.002), and exhibited a greater reduction in visual acuity after recurrence of macular edema (0.34 +/- 0.24 vs. 0.14 +/- 0.13, p = 0.003). Only four patients visited the hospital before the scheduled follow-up date, and all of these patients lived relatively close to the hospital. CONCLUSIONS: For prompt treatment of recurring macular edema, more intensive education about the self-estimation of visual acuity is necessary, particularly for elderly patients who have relatively poor visual acuity. In addition, a simple and easy way to identify the recurrence of macular edema at the local clinic should be established for patients who live relatively far from the hospital.
Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Macular Edema/*diagnosis/etiology/physiopathology ; Male ; Middle Aged ; *Patient Readmission ; Recurrence ; Retinal Vein Occlusion/*complications/diagnosis/physiopathology ; Retrospective Studies ; Tomography, Optical Coherence ; *Visual Acuity

No abstract available.
Humans ; Surgery, Plastic*

BACKGROUND: Osteoporotic fractures pose a major public problem, not only in Western populations but also of increasing significance in Asian populations. However, most previous studies for the prevalence of osteoporosis in Korea were carried out from the data of hospitalized or out-patient based subjects, hospital staff, healthy volunteers and so forth. The purpose of present study was to evaluate the normative data of bone mineral density (BMD) in Korean young and perimenopausal women and to determine the prevalence and risk factors of low bone mass, including osteoporosis and osteopenia in a community-based population. METHODS: In 1999, a baseline survey was carried out in the Dong-gu of Ulsan city, a urban area but located in seashore of southeastern Korea. The selected community sample of 3,822 inhabitants (all were women aged 49~54 years) were chosen. We studied 1,629 women among them and 127 healthy women aged 20~35 years. BMD of lumbar spine and femur was measured using dual-energy X-ray absorptiometry. For analysis of risk factors, those were excluded who was the current or recent user of estrogen and who had osteoporosis related disease or unknown menopause due to previous hysterectomy. Thus, 1,020 subjects were analysed for the association of low BMD and risk factors. Significant determinants of BMD were investigated using univariate and multiple regression analysis. RESULTS: When our young normal data were used, 9.8% for the lumbar spine and 1.4% for the femoral neck of our study population (n=1,629) were classified as osteoporosis. Among them, the menopausal status of above 1,020 subjects had independent association with low BMD (T-score<-1.0) of both lumbar spine (odds ratio=4.71 in postmenopause, p<0.001) and femoral neck (odds ratio=2.86 in postmenopause, p<0.001). In premenopausal women (n=507), weight and age of menarche were associated independently with low bone mass, including osteoporosis and osteopenia of both lumbar spine and femoral neck. In postmenopausal women (n=513), weight and duration since menopause were associated independently with low bone mass of both lumbar spine and femoral neck. Also, daily amount of calcium intake had significant association (regression coefficient=0.047; p<0.05) independently with BMD of femoral neck. CONCLUSION: The results of this population-based study suggest that it is important to prevent bone loss and screen the BMD in women aged 49~54 years with menopause, low body weight, late menarche, prolonged duration since menopause, low calcium intake.
Absorptiometry, Photon ; Asian Continental Ancestry Group ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Surveys and Questionnaires ; Estrogens ; Female ; Femur ; Femur Neck ; Healthy Volunteers ; Humans ; Hysterectomy ; Korea ; Menarche ; Menopause ; Osteoporosis* ; Osteoporotic Fractures ; Outpatients ; Postmenopause ; Prevalence* ; Risk Factors* ; Spine ; Ulsan

A beneficial radioprotective agent has been used to treat the radiation-induced lung injury. This study was performed to investigate whether curcumin, which is known to have anti-inflammatory and antioxidant properties, could ameliorate radiation-induced pulmonary inflammation and fibrosis in irradiated lungs. Rats were given daily doses of intragastric curcumin (200 mg/kg) prior to a single irradiation and for 8 weeks after radiation. Histopathologic findings demonstrated that macrophage accumulation, interstitial edema, alveolar septal thickness, perivascular fibrosis, and collapse in radiation-treated lungs were inhibited by curcumin administration. Radiation-induced transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF) expression, and collagen accumulation were also inhibited by curcumin. Moreover, western blot analysis revealed that curcumin lowered radiation-induced increases of tumor necrosis factor-alpha (TNF-alpha), TNF receptor 1 (TNFR1), and cyclooxygenase-2 (COX-2). Curcumin also inhibited the nuclear translocation of nuclear factor-kappa B (NF-kappaB) p65 in radiation-treated lungs. These results indicate that long-term curcumin administration may reduce lung inflammation and fibrosis caused by radiation treatment.
Animals ; Blotting, Western ; Collagen ; Connective Tissue Growth Factor ; Curcumin ; Cyclooxygenase 2 ; Edema ; Fibrosis ; Inflammation ; Lung ; Lung Injury ; Macrophages ; Pneumonia ; Rats ; Receptors, Tumor Necrosis Factor ; Tumor Necrosis Factor-alpha

Purpose: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin’s lymphoma (NHL). We reported the busulfan, melphalan, and etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan, cyclophosphamide, and etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL. Materials and Methods: Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenously) administered on days –7, –6, and –5, etoposide (400 mg/m2 intravenously) on days –5 and –4, and melphalan (50 mg/m2/day intravenously) on days –3 and –2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day intravenously) on days –7, –6, and –5, etoposide (400 mg/m2/day intravenously) on days –5 and –4, and cyclophosphamide (50 mg/kg/day intravenously) on days –3 and –2. The primary endpoint was 2-year progression-free survival (PFS). Results: Seventy-five patients were enrolled. Eleven patients (30.5%) in the BuME group and 13 patients (33.3%) in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.746). There were no non-relapse mortalities within 100 days after transplantation. Conclusion There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.