This study was conducted to assess the effects of noise exposure and psychosocial factor on blood pressure in manufacturing workers. The study subjects are 414 workers (243 males, 171 females) employed at the noisy department. The mean age of low exposed group (<85dB) was 34.65+/-9.53 years, and that of high exposed group (> or =85dB) was 36.37+/-11.15 years. The difference in mean age wart not significant. The mean and distribution of working duration, smoking status, drinking status were not significantly different between two groups. The mean systolic blood pressure of the low exposed groups was 120.01+/-12.06 mmHg, and that of high exposed group wart 126.27+/-13.84 mmHg. The mean diastolic blood pressure of the low exposed and the high exposed group were 77.18+/-10.83 mmHg, and 83.46+/-11.22 mmHg respectively. These differences of blood pressure were statistically significant(p<0.05). The workers in noisy department have significantly less work environmental satisfaction, higher job demand, and higher social support. The mean values of psychosocial distress were higher in the workers of the noisy department, but the difference was not statistically significant. This study was to speculate whether the work environmental satisfaction and social supports modify the association between the noise exposure level and the blood pressure. The results showed that work environmental satisfaction could not modify the association between the blood pressure and the noise exposure. Social support at work did not modify the association. Furthermore, we evaluated the high job strain from a combination of high job demand and low job control at work. Compared to the low strain group, the olds ratio of the high job strain group for hypertension in diastolic blood pressure were statistically significant, but not in systolic blood pressure. Hierarchical multiple regression analysis was used to determine whether the independent variables contributed to explaining the blood pressure. After controlling for possible confounders, we found that the noise exposure level was a correlate of the diastolic blood pressure. But no association between the noise exposure level and the systolic blood pressure. No significant result was found for psychosocial factor.
Blood Pressure* ; Drinking ; Humans ; Hypertension ; Male ; Noise* ; Psychology* ; Smoke ; Smoking ; Warts

Lymphorrhea is a rare but potentially severe complication that occurs after various surgical procedures. Untreated lymphorrhea may lead to wound dehiscence, infection, and prolonged hospital stay. Currently, there is no standard effective treatment. Early management usually includes leg elevation, drainage, and pressure dressing. However, these methods are associated with prolonged recovery and high recurrence rates. We report a case of lymphorrhea from a calf wound after endoscopic great saphenous vein (GSV) harvesting for coronary artery bypass grafting (CABG). The patient presented with intractable oozing from the postoperative wound on the right calf. Lymphorrhea perGsisted for 6 weeks despite negative-pressure wound therapy with a long-acting somatostatin. We performed unilateral pedal lymphangiography that confirmed wound lymphorrhea, followed by glue embolization. No recurrence was observed after 8 months of follow-up. This case report demonstrates the successful use of lymphangiography with glue embolization in the control of lymphorrhea after GSV harvesting for CABG.

Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Endometriosis is a common disease in women of reproductive age, intestinal involvement has been estimated to occur in 3% to 37% of women with endometriosis, in rectosigmoid colon, appendix, ileum and cecum, in order of decreasing frequency. On the other hand, endometriosis of the small bowel, especially symptomatic small bowel involvement, is very unusual. Endometriosis is a rare cause of intestinal obstruction, and preoperative diagnosis is very difficult. It should be considered in the differential diagnosis of women of reproductive age who present with symptoms of obstruction. The definitive treatment includes resection of the involved segment with primary anastomosis. We report a 34-year-old woman following up infertility and ovarian endometrioma. She had nausea, vomiting and low abdominal pain who was operated on acute intestinal obstruction. Pathologic finding was endometriosis involving the ileum, cecum, appendix We present the case with a brief review of literature.
Abdominal Pain ; Adult ; Appendix ; Cecum ; Colon ; Diagnosis, Differential ; Endometriosis ; Female ; Hand ; Humans ; Ileum ; Infertility ; Intestinal Obstruction ; Nausea ; Vomiting

N, N-dimethylformamide (DMF) is a solvent which is widely used in the industrial workplace. It causes the liver damages to the chronically exposed workers and is also well known as the harzadous material to generate occupational malignancies. DMF is mainly metabolized into N-hydroxymethyl-N-methylformamide (HMMF) by the microsomal cytochrome p-450. HMMF breaks down to NMF. However, the detailed mechanism of its toxicity are unknown. In this experiment, the metabolism and the toxicity of DMF was investigated using an isolated perfumed liver model. DMF (0, 10, 25mM) were added into recirculating perfusate of the isolated perfused rat liver. Samples were collected at 0, 30, 45, 60, 75, 90 minutes from inferior vena cava. The gas-chromatography was used to analyze the metabolite of DMF, The changes in the oxygen consumption rate by DMF were monitored during perfusion. The enzyme activity (AST, ALT, LDH) in the perfusate were treasured to find out whether DMF causers hepatotoxicity. As perfusion continued, DMF concentration in the perfusate decreased, and NMF 1.16mM was detected. The oxygen consumption rate increased both at 10mM and 25mM DMF concentration. However, when SKF 525A, a known inhibitor of cytochrome p-450, had been pretreated (300uM before DMF addition, the oxygen consumption rate was significantly inhibited, indicating that cytochrome p-450 system is responsible for the conversion to NMF. With DMF addition, the activity of AST, ALT, and LDH significantly increased time dependently and dose dependently. However, the pretreatment of perfused liver with SKF 525A shoved that the release of AST, ALT and LDH was inhibited. In summary, it is found that DMF is metabolized to NMF in liver, and that cytochrome p-450 mono-oxygenase is suggested to play a role in the biotransformation of NMF. The time course of BMF toxicity in relation to NMF formation is compatible with hypothesis that the hepatotoxicity of DMF is mediated via NMF. Further study combined with in vivo experiment through the toxicological approaches is expected.
Animals ; Biotransformation ; Cytochrome P-450 Enzyme System ; Liver* ; Metabolism* ; Oxygen Consumption ; Perfusion ; Rats ; Vena Cava, Inferior

Protein identification by peptide mass fingerprinting using matrix-assisted laser desorption ionization time of fight (MALDI-TOF) mass spectrometry (MS) can analyze unambiguously identity of the spots from a 2-dimensional electrophoresis (2-DE) gel. This study developed a technique for 2-DE of Salmonella enterica serovar Enteritidis (S. enteritidis) by improving the dissolution conditions by 2-DE using a pH 4 - 7 immobilized pH gradient (IPG) strip. This report examines the protein components from the patterns of the S. enteritidis protein. The most abundant protein displayed a great number of clusters within the pH 4.5 - 7 range with a molecular mass ranging from 35-80 kDa. Some of these spots were identified as metabolic related enzymes. The protein fraction was also analyzed using an immobilized pH gradient strip. Different proteins were identified on the spot according to the elongation factors. In addition, this study showed that the 2-DE analysis of S. enteritidis provides useful information regarding the S. enteritidis proteome, and this approach might provide a strategy for identifying bacterial proteins using a proteome technology.
Bacterial Proteins/analysis/*chemistry/isolation & purification ; Electrophoresis, Gel, Two-Dimensional ; Enzymes/chemistry/genetics/isolation & purification ; Molecular Weight ; Salmonella enteritidis/*chemistry/growth & development ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective: To evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs. Materials and Methods: Nine patients (8 females and 1 male; age range, 23–65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics. Results: Feeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions).TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers. Conclusion Single-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.

PURPOSE: To analyze the clinical and angiographic features with outcome of transcatheter arterial embolization in patients with secondary postpartum hemorrhage. MATERIALS AND METHODS: Clinical details and angiographic features with assessment of arterial embolization were reviewed in total 38 patients underwent arterial embolization at single tertiary referral center. RESULTS: Twenty patients (53%) had Cesarean section. The major causes of bleeding were iatrogenic vascular injury, and retained placenta (55%). The patterns of vaginal bleeding were recorded as intermittent (50%), or as persistent (50%). Seven patients (18%) were hemodynamically unstable at presentation. Positive angiographic findings appeared in eighteen patients (47.3%). The frequency of pseudoaneurysm was statistically high in the Cesarean section (p < 0.001). The used embolic agents except gelfoam were N-butyl cyanoacrylate (n = 7), and microcoil (n = 7). Unilateral selective embolization (26.3%) was shown effective in superselective embolization of bleeding focus. Technical and clinical success rate were 100% and 97.4%, respectively with no complication. Sixteen resumed regular menstruation, and one pregnancy were observed in patients with available follow-up of over 6 months. CONCLUSION Considerable rate of hemodynamically unstable patients was observed with high rate of positive angiography findings. Given high successful rate and few complications, early angiographic assessment with embolization should be considered.