A cross-sectional study was performed to evaluate the effects of chronic low-dose sol-vent on neurobehavioral performance of 118 male car painters. A control group of 113 workers matched for age was selected from different sections of the factory. The mean age and the mean duration of employment were 33 years and 6.7 years in both groups. Mean years of education were 11.4 years in car painters and 11.8 years in controls. Each worker completed a medical and occupational questionnaire and four tests of Swedish performance evaluation system. These included simple reaction time, symbol digit, digit span and finger tapping speed. Although the mean duration of employment was 6.7 years, comparison of mean performance showed a significantly poorer performance on simple reaction time (P<0.05), symbol digit (p<0.01) and digit span(p<0.05) in car painters. In univariate analysis, age and educational level contributed to poorer performance on symbol digit and digit span smoking appeared to slow finger tapping speed in car painters. Performance of four tests of car painters exposed to high level of solvent was poorer than that of car painters exposed to low level. In multiple regression models, controlling for age, alcohol, smoking and shift work, solvent exposure was found to be associated with performance of simple reaction time, symbol digit and digit span and exposure to high level of solvent was related to poorer performance of symbol digit and digit span.
Cross-Sectional Studies ; Education ; Employment ; Fingers ; Humans ; Male ; Surveys and Questionnaires ; Reaction Time ; Smoke ; Smoking ; Solvents*

Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Digit Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol , Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, factor analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.
Education ; Fingers ; Korea ; Motivation ; Solvents

Histiocytosis-X is a term used to define three diseases with similar morphologic characteristics : Letterer-Siwe diseae, Hand-Schuller-Christian disease and Eosinophilic granuloma. In general, they differ in terms of their age of onset, severity of clinical course and site of involvement. Eosinophilic granuloma typically is seen in young adults. Eosinophilic granuloma is diagnosed in the presense of diffuse pulmonary infiltrate, bony involvement. However, the Pulmonary radiologic findings of eosinophilic granuloma are variable accordinary to stage of disease. therefore pathologic diagnosis of involving site is essential for confirmative diagnosis of eosinophilic grananuloma. Pathologically. the three disease are characterized by granulomatous infiltration of alveolar septa and bronchial walls and often involvement of bone. The hallmark of this disease is proliferation of the Langerhans' cell. The identifying feature is the X-body or Birbeck granule that is present in Langerhans' cells and histiocytic cells found in the lung of EG patient. We report a case of bilateral, recurrent and spontaneous pneumothoraces in a 21 year old man with pulmonary histiocytosis-X which is confined by eosinophilc granuloma in bone marrow biopsy and ultrastructural examination in cells obtained from BAL.
Age of Onset ; Biopsy ; Bone Marrow ; Diagnosis ; Eosinophilic Granuloma ; Eosinophils ; Granuloma ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Pneumothorax* ; Young Adult

BACKGROUND: Hormone replacement therapy (HRT) has been used as a effective therapeutic strategy of postmenopausal osteoporosis. However, the studies on HRT are insufficient, particularly in early postmenopausal women in Korea. This study was designed as a community based clinical trial and was conducted for 1 year. METHODS: One hundred and forty early postmenopausal women aged 49 to 54 years who resided in Ulsan in Korea were enrolled in this study. The osteoporosis prone life style and general characteristics of the participants and their measured BMD were investigated. The therapy groups included 45 women who were assigned to one of the following regimens in 28 day cycles for 1 year: (1) conjugate equine estrogen (CEE), 0.625 mg/d daily, medroxyprogesterone acetate (MPA) 2.5 mg/d daily and calcium 500 mg/d daily (2) CEE 0.625 mg/d daily, MPA 10 mg/d for days 1 through 12 and calcium 500 mg/d daily. RESULTS: The women in the therapy groups had an average gain of 5.4%, 4.2%, 2.1%, 4.9% in BMD in the lumbar spine, femur total, femur neck and ward's area, respectively. HRT has significantly influenced the BMD after controlling age, month since menopause, alcohol intake, smoking, calcium intake, exercise, body mass index and baseline BMD. The baseline BMD and the BMI were factors that influenced the effect of HRT in BMD. CONCLUSION: HRT had positively influenced the BMD in Korean women. The baseline BMD and the BMI were predictors of the effect of HRT in BMD change.
Body Mass Index ; Bone Density* ; Calcium ; Estrogens ; Female ; Femur ; Femur Neck ; Hormone Replacement Therapy* ; Humans ; Korea ; Life Style ; Medroxyprogesterone Acetate ; Menopause ; Osteoporosis ; Osteoporosis, Postmenopausal ; Smoke ; Smoking ; Spine ; Ulsan

We experienced three cases of high signal intensity observed by Brain Magnetic Resonance Imaging in CO2 arc welders of steel-frame manufacturing industry. Case 1 was a 35 years old man who has been an CO2 arc welder for 10 years, admitted a sudden onset of tonic clonic seizure. He complained fever, chilling and myalgia since 3 days before admission. On admission, in the test of manganese exposure indices, manganese concentrations of blood, urine and scalp hair were 5.17 microgram/dL, 22.00 microgram/l and 31.25 ppm respectively. Case 2 was a 35 years old man who has been an CO2 arc welder for 20 years. On admission, He complained fatigue, numbness and weakness of extremities, and decrease of libido. In the test of manganese exposure indices, manganese concentrations of blood, urine and scalp hair were 6.34 microgram/dL, 14.62 microgram/l and 57.87 ppm respectively. In neurologic examination, Palmo-mentis reflex and Myerson sign were observed. Case 3 was a 33 years old man who has been an CO2 arc welder for 16 years. On admission, He complainer loss of appetite, numbness of extremities, fatigue and decrease of attention. In the test of manganese exposure indices, manganese concentrations of blood, urine and scalp hair were 5.14 microgram/dL, 13.79 microgram/l and 50.08 ppm respectively. In neurologic examination, Myerson sign was observed. In brain magnetic resonance imaging, T1WI showed symmetrical high signal intensity in basal ganglia and midbrain of three cases. Authors argued that they were developed by manganese exposure, and we considered that follow up study would be necessary.
Adult ; Appetite ; Basal Ganglia ; Brain* ; Extremities ; Fatigue ; Fever ; Follow-Up Studies ; Hair ; Humans ; Hypesthesia ; Libido ; Magnetic Resonance Imaging* ; Manganese ; Mesencephalon ; Myalgia ; Neurologic Examination ; Reflex ; Scalp ; Seizures

Purpose: Laparoscopic pylorus-preserving gastrectomy (LPPG) has a nutritional advantage over laparoscopic distal gastrectomy (LDG), however, may be less beneficial in overweight patients in terms of weight loss. The purpose of this study was to compare LPPG and LDG in overweight patients with early gastric cancer. Methods: Clinicopathologic data of overweight patients (body mass index [BMI], ≥25 kg/m2 ) who underwent LPPG (n = 63) or LDG (n = 183) in 2016–2018 were retrospectively reviewed. In the LDG group, patients with Billroth-II anastomosis were separately grouped (LDG B-II, n = 66). Changes in BMI, hemoglobin, albumin, and total protein were compared among groups. Results: Changes in BMI were not significant different among groups. The LPPG group had significantly higher albumin than the LDG group at postoperative 6 months and 1 year. The LPPG group had higher total protein than the LDG group at postoperative 2 years. The LPPG group had a higher complication rate of Clavien-Dindo classification III or higher (20.6%) than the LDG group (8.2%, P = 0.007). However, after excluding pyloric stenosis, there was no significant difference among groups (LPPG vs. LDG, P = 0.290; LPPG vs. LDG B-II, P = 0.921). Conclusion LPPG and LDG groups showed similar weight loss. However, the LPPG group had higher albumin and protein levels than the LDG group of overweight patients. Thus, it is not necessary to select LDG only for weight loss. LPPG may be selected as one option due to its potential nutritional benefit when pyloric stenosis is properly managed.

Purpose: De novo malignancy is common after liver transplantation (LT); however, there are limited reports on the clinical outcomes of gastric cancer surgery after LT. Our study aimed to investigate the feasibility and safety of gastric cancer surgery after LT. Methods: Seventeen patients underwent gastric cancer surgery after LT at a single institution between January 2013 and June 2021. We retrospectively collected data on surgical complications, survival, and recurrence status of these cases. Results: Fifteen patients (88.2%) underwent curative gastrectomy, with 10 open distal (66.7%) and 5 laparoscopic distal (33.3%) gastrectomies. Surgical and severe complication rates were 3 of 15 (20.0%) and 1 of 15 (6.7%), respectively. There were no significant differences between laparoscopic (33.3%) and open surgery (66.7%) in terms of operation time and complication rate. No surgery-related mortalities occurred. Immunosuppressants could be maintained without difficulty, and no suspicious acute rejection was identified during the perioperative period. There was 1 recurrence after curative surgery (recurrence rate, 6.7%), and the 5-year cancer-specific survival rate after curative surgery was 93.3%. Conclusion Laparoscopic gastrectomy can be safely done even after LT in terms of postoperative complications and graft safety.

Purpose: The aim of this study was to investigate the oncologic safety and identify potential candidates for proximal gastrectomy (PG) in upper third advanced gastric cancer (AGC) and esophagogastric junction (EGJ) cancers. Materials and Methods: Among 5,665 patients who underwent gastrectomy for gastric adenocarcinoma between January 2011 and December 2017, 327 patients who underwent total gastrectomy with standard lymph node (LN) dissection for upper third AGC and Siewert type II EGJ cancers were enrolled. We analyzed the correlation between the metastatic rates of distal LNs (No. 4d, 5, 6, and 12a) around the lower part of the stomach and the clinicopathological characteristics. We identified subgroups with no metastasis to the distal LNs. Results: The metastatic rate of distal LNs in proximal AGC and Siewert type II EGJ cancers was 7.0% (23 of 327 patients). On multivariate analysis, pathological T stage (P=0.001), tumor size (P=0.043), and middle third invasion (P=0.003) were significantly associated with distal LN metastases. Pathological ‘T2 stage’ (n=88), or ‘T3 stage with ≤5 cm tumor size’ (n=87) showed no metastasis in distal LNs, regardless of middle third invasion. Pathological T3 stage with tumor size > 5 cm (n=61) and T4 stage (n=91) had metastasis in the distal LNs. Conclusions In the upper third AGC and Siewert type II EGJ cancer, pathological T2 and small-sized T3 stage groups are possible candidates for PG in cases without distal LN metastasis. Further validation studies are required for clinical application.

PURPOSE: Gastric cancer with lymph node metastasis (LNM) more than 15 (N3b) was defined as stage IV until the 6th AJCC system. However, it has been reclassified as a localized disease (stage IIb or III) since the 7th system. The aim of this study is to demonstrate that the survival of N3b is comparable to cytology-only positive (CY1-only) stage IV and to propose a new TNM system interpreting N3b as an eligibility criterion for receiving more intensive chemotherapy regimens. MATERIALS AND METHODS: 1,430 patients who underwent gastric cancer surgery at Seoul National University Hospital from 2007 to 2012 were retrospectively analyzed. The 5-year survival rate (5YSR) and 3-year recurrence-free survival (RFS) were evaluated according to the 7th and 8th systems, as well as a new categorization based on N-classification; N0-2 (LNM<7), N3a (LNM 7–15), or N3b (LNM>15). RESULTS: The survival of N3b is comparable to that of CY1-only stage IV (log rank test, P=0.671) and is distinct from that of grossly stage IV (log rank test, P<0.001). The survival of the remaining stage IIIc (T4bN3a) was comparable to those of N3b and CY1-only stage IV. Most N3b patients had significantly shorter 3-year RFS and mean RFS than those with IIb–IIIc, as if N3b itself was a higher TNM stage. CONCLUSIONS: In terms of survival, T4bN3a, N3b, and CY1-only stage IV were unified as stage IVa, while grossly stage IV was defined as stage IVb. N3b can be regarded as an eligibility criterion for undergoing more intensive chemotherapy regimens.
Classification ; Drug Therapy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Seoul ; Stomach Neoplasms ; Survival Rate

Purpose: Targeted next-generation sequencing (NGS) panels for solid tumors have been useful in clinical framework for accurate tumor diagnosis and identifying essential molecular aberrations. However, most cancer panels have been designed to address a wide spectrum of pan-cancer models, lacking integral prognostic markers that are highly specific to gliomas. Materials and Methods: To address such challenges, we have developed a glioma-specific NGS panel, termed “GliomaSCAN,” that is capable of capturing single nucleotide variations and insertion/deletion, copy number variation, and selected promoter mutations and structural variations that cover a subset of intron regions in 232 essential glioma-associated genes. We confirmed clinical concordance rate using pairwise comparison of the identified variants from whole exome sequencing (WES), immunohistochemical analysis, and fluorescence in situ hybridization. Results: Our panel demonstrated high sensitivity in detecting potential genomic variants that were present in the standard materials. To ensure the accuracy of our targeted sequencing panel, we compared our targeted panel to WES. The comparison results demonstrated a high correlation. Furthermore, we evaluated clinical utility of our panel in 46 glioma patients to assess the detection capacity of potential actionable mutations. Thirty-two patients harbored at least one recurrent somatic mutation in clinically actionable gene. Conclusion We have established a glioma-specific cancer panel. GliomaSCAN highly excelled in capturing somatic variations in terms of both sensitivity and specificity and provided potential clinical implication in facilitating genome-based clinical trials. Our results could provide conceptual advance towards improving the response of genomically guided molecularly targeted therapy in glioma patients.