OBJECTIVE: The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program f'or analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. METHODS: The quality control program runs twice a year with mandatory items of blood lead and urine hippuvic acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a proficient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is +/-15% and that of the others is within 3 SD(standard deviation) from the reference values. RESULTS: The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide(NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. CONCLUSIONS: In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually contributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.
Cadmium ; Diagnosis ; Environmental Monitoring ; Korea ; Manganese ; Metals, Heavy ; Occupational Diseases ; Occupational Health ; Phenol ; Poisoning ; Quality Control ; Reference Values ; Trichloroethylene

No abstract available.
Female ; Humans ; Prevalence*

No abstract available.
Cerebellopontine Angle*

BACKGROUND: Candida species are the fourth leading cause of nosocomial bloodstream infections and have one of the highest mortality rates among nosocomial pathogens. C. tropicalis has been reported to be one of the leading Candida species other than C. albicans to cause Candida infection in patients who have malignancy, diabetes mellitus, and burn. This study was designed to determine whether burn might influence the species distribution and susceptibilities of azoles against clinical isolates of Candida species including C. tropicalis. METHODS: A total 372 Candida isolates from various samples in a tertiary burn center were studied, and the MICs of Candida isolates to fluconazole, itraconazole, and voriconazole were tested by broth microdilution method of the Clinical and Laboratory Standards Institute (CLSI) M27-A2. A comparison was made between Candida isolates from burn patients and non-burn patients. RESULTS: The percentages of C. albicans, C. tropicalis, C. parapsilosis and C. glabrata isolates from burn patients and non-burn patients were 42.3% and 64.2% (P=0.000), 35.7% and 21.6% (P=0.002), 11.9% and 7.8%, and 10.1% and 6.4%, respectively. Decreased susceptibilities to fluconazole, itraconazole, and voriconazole were observed more frequently in burn patients (4.76%, 19.05%, and 0.60%, respectively) than non-burn patients (2.45%, 14.22%, and 0%, respectively). CONCLUSION: The results of this study suggest that burn may lead to influence the species distribution and susceptibilities to azoles of Candida species.
Azoles ; Burn Units ; Burns ; Candida ; Candida tropicalis ; Danazol ; Diabetes Mellitus ; Fluconazole ; Humans ; Itraconazole ; Pyrimidines ; Triazoles

PURPOSE: The management of cuffed endotracheal (ET) tubes is routine practice for emergency physicians. Although various cuff inflation techniques are used, there is no standard technique identified in the literature as the method for cuff inflation or intracuffed pressure (ICP). A loss of resistance (LOR) syringe has been used for years and this is located in the epidural space. The purpose of this study was to measure the actual ICP obtained by a new estimation technique. METHODS: Using a manikin simulation model, we assessed how physicians inflated the cuff in 5.5, 6.5, 7.5 mm inner diameter ET tubes. We measured the inflated air volumes and the ICPs obtained by the conventional technique (A group), by the commercial 10-ml syringe + passive release technique (B group), and by a LOR syringe + PRT (C group). Subsequently, a manometer was used to measure the actual ICP (normal: 16 to 40 cmH2O). RESULTS: We sampled 90 participants. They were classified into three groups: those who underwent the conventional inflation technique (A group, n=30), those who underwent the commercial syringe technique (B group, n=30) and those who underwent the Perifix(R) LOR syringe technique (C group, n=30). In the control group, the mean recorded ICPs were 78.2+/-30.7 cmH2O (A group) and 56.1+/-16.0 cmH2O (B group). The initial cuff pressures were greater than 40 cmH2O in 25 (83.3%) cases. For the experimental group, the mean recorded ICP was 19.1+/-1.8 cmH2O. With respect to the rate of optimal cuff inflation, the LOR syringe technique was significantly higher than the conventional method or the PRT + 10-ml syringe method (100% vs. 16.7 and 23.3%, respectively, p<0.001). CONCLUSION: Using conventional syringe technique, most cuff pressures exceeded a safe pressure and they required correction. Ultimately, PRT using the Perifix(R) LOR syringe is a useful alternative cuff inflation method when direct intracuff pressure measurement is not available.
Emergencies ; Epidural Space ; Inflation, Economic ; Intubation ; Manikins ; Statistics as Topic ; Syringes ; Trachea

PURPOSE: Laparoscopic gastrectomy in obese patients has been investigated in several studies, but its feasibility has rarely been examined in morbidly obese patients, such as in those with a body mass index (BMI) of > or =30 kg/m2. The present study aimed to evaluate the technical feasibility and safety of laparoscopic gastrectomy in morbidly obese patients with gastric cancer. MATERIALS AND METHODS: A total of 1,512 gastric cancer patients who underwent laparoscopic distal gastrectomy (LDG) were divided into three groups: normal (BMI<25 kg/m2, n=996), obese (BMI 25~30 kg/m2, n=471), and morbidly obese (BMI> or =30 kg/m2, n=45). Short-term surgical outcomes, including the course of hospitalization and postoperative complications, were compared between the three groups. RESULTS: The morbidly obese group had a significantly longer operating time (240 minutes vs. 204 minutes, P=0.010) than the normal group, but no significant differences were found between the groups with respect to intraoperative blood loss or other complications. In the morbidly obese group, the postoperative morbidity and mortality rates were 13.3% and 0%, respectively, and the mean length of hospital stay was 8.2 days, which were not significantly different from those in the normal group. Subgroup analysis showed that postoperative complication rates were not high in morbidly obese patients, independent of the type of anastomosis technique used and level of lymph node dissection. CONCLUSIONS: LDG is technically feasible and safe in morbidly obese patients with a BMI of > or =30 kg/m2 and early gastric carcinoma. Except for a longer operating time, LDG might represent a reasonable treatment option in these patients.
Body Mass Index ; Gastrectomy* ; Hospitalization ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Mortality ; Obesity, Morbid ; Postoperative Complications ; Stomach Neoplasms*

PURPOSE: Information regarding antimicrobial prophylaxis (AMP) for gastric cancer surgery is limited. The present study investigated the efficacy of single-dose AMP for the prevention of surgical site infection (SSI) in patients undergoing gastrectomy for gastric carcinoma. MATERIALS AND METHODS: Between 2011 and 2013, 1,330 gastric carcinoma surgery patients were divided into two AMP administration groups depending on the duration of treatment. Postoperative outcomes including morbidity and SSI were compared between the two groups overall and in matched patients. Risk factors for SSI were analyzed. RESULTS: The extended group (n=1,129) received AMP until postoperative day 1 and the single-dose group (n=201) received singledose AMP only during an operation. Postoperatively, there were no significant differences between the two groups with respect to overall morbidity, mortality, or length of hospital stay. The SSI rate of the single-dose group was not significantly different from that of the extended group overall (4.5% vs. 5.5%, respectively, P=0.556) or in matched patients (4.5% vs. 4.0%, respectively, P=0.801). There was no increase in the SSI rate of the single-dose group compared to the extended group in subgroups based on different clinicopathological and operative factors. Univariate and multivariate analyses revealed male gender, open surgery, and operating time (> or =180 minutes) as independent risk factors for SSI. CONCLUSIONS: Single-dose AMP showed no increase in the postoperative SSI rate compared to postoperative extended use in patients undergoing gastrectomy for gastric carcinoma. The efficacy of single-dose AMP requires further investigation in randomized clinical trials specific to gastric cancer surgery.
Antibiotic Prophylaxis ; Gastrectomy* ; Humans ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; Surgical Wound Infection

PURPOSE: Recombinant human growth hormone (rhGH) has been widely used to treat short stature. However, there are some concerns that growth hormone treatment may induce skeletal maturation and early onset of puberty. In this study, we investigated whether rhGH can directly affect the neuronal activities of of gonadotropin-releasing hormone (GnRH). METHODS: We performed brain slice gramicidin-perforated current clamp recording to examine the direct membrane effects of rhGH on GnRH neurons, and a whole-cell voltage-clamp recording to examine the effects of rhGH on spontaneous postsynaptic events and holding currents in immature (postnatal days 13-21) and adult (postnatal days 42-73) mice. RESULTS: In immature mice, all 5 GnRH neurons recorded in gramicidin-perforated current clamp mode showed no membrane potential changes on application of rhGH (0.4, 1 microgram/mL). In adult GnRH neurons, 7 (78%) of 9 neurons tested showed no response to rhGH (0.2-1 microgram/mL) and 2 neurons showed slight depolarization. In 9 (90%) of 10 immature neurons tested, rhGH did not induce any membrane holding current changes or spontaneous postsynaptic currents (sPSCs). There was no change in sPSCs and holding current in 4 of 5 adult GnRH neurons. CONCLUSION: These findings demonstrate that rhGH does not directly affect the GnRH neuronal activities in our experimental model.
Adult ; Animals ; Brain ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Human Growth Hormone ; Humans ; Membrane Potentials ; Membranes ; Mice ; Models, Theoretical ; Neurons ; Puberty ; Synaptic Potentials

PURPOSE: Recombinant human growth hormone (rhGH) has been widely used to treat short stature. However, there are some concerns that growth hormone treatment may induce skeletal maturation and early onset of puberty. In this study, we investigated whether rhGH can directly affect the neuronal activities of of gonadotropin-releasing hormone (GnRH). METHODS: We performed brain slice gramicidin-perforated current clamp recording to examine the direct membrane effects of rhGH on GnRH neurons, and a whole-cell voltage-clamp recording to examine the effects of rhGH on spontaneous postsynaptic events and holding currents in immature (postnatal days 13-21) and adult (postnatal days 42-73) mice. RESULTS: In immature mice, all 5 GnRH neurons recorded in gramicidin-perforated current clamp mode showed no membrane potential changes on application of rhGH (0.4, 1 microgram/mL). In adult GnRH neurons, 7 (78%) of 9 neurons tested showed no response to rhGH (0.2-1 microgram/mL) and 2 neurons showed slight depolarization. In 9 (90%) of 10 immature neurons tested, rhGH did not induce any membrane holding current changes or spontaneous postsynaptic currents (sPSCs). There was no change in sPSCs and holding current in 4 of 5 adult GnRH neurons. CONCLUSION: These findings demonstrate that rhGH does not directly affect the GnRH neuronal activities in our experimental model.
Adult ; Animals ; Brain ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Human Growth Hormone ; Humans ; Membrane Potentials ; Membranes ; Mice ; Models, Theoretical ; Neurons ; Puberty ; Synaptic Potentials

Acantholytic squamous cell carcinoma is a well-defined variant of squamous cell cancer in which significant portions of the neoplastic proliferation show a pseudoglandular or tubular microscopic pattern. It usually presents as a nodule with various colors, and it is accompanied by scaling, crusting, and ulceration on the sun-exposed areas of older aged individuals. Histologically, the tumor consists of a nodular, epidermal-derived proliferation that forms island-like structures. At least focally or sometimes extensively, the tumor cells shows a loss of cohesion within the central gland-like or tubular spaces. This tumor resembles the structure of eccrine neoplasms, but it is negative for dPAS, CEA and mucicarmine and it is only positive for EMA and cytokeratins. Herein we report a case of acantholytic squamous cell carcinoma that occurred on the face of an 82-year-old woman.
Adenoids ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; Carmine ; Humans ; Keratins ; Neoplasms, Squamous Cell ; Skin ; Ulcer