OBJECTIVES: The study was performed to investigate the changes of urinary thiodiglycolic acid (TDGA) concentration in workers exposed to vinyl chloride monomer (VCM) according to the time of sampling urine. METHODS: The personal exposure to airborne VCM was assessed and urinary TDGA concentration was sampled in 31 workers employed in a VCM and polyvinyl chloride (PVC) manufacturing factory. Urinary TDGA was sampled three times: before the start of the shift after 3 days off (TDGA1), after the end of the first-day shift (TDGA2) and before starting the following day shift after completing the oneday shift (TDGA3). Urinary TDGA in 30 workers who had not been exposed to airborne VCM was sampled after the end of the shift. A gas chromatography/pulsed flame photometric detector (GC/PFPD) was utilized to analyze TDGA concentration in urine after the urine was methylated with trimethylsilyldiazomethane(2.0M in diethyl ether). RESULTS: The creatinine level was 0.179+/-0.271 mg/g in the control workers and 0.218+/-0.443 mg/g in the workers before the start of the shift after 3 days off (TDGA1), showing no significant difference (p=0.7035). Urine samples were compared according to sampling time in order to investigate the change of urinary TDGA concentration in the case of continuous exposure to airborne VCM. In VCM-exposed workers, urinary creatinine concentration was 0.434+/-0.623 mg/g in TDGA2 and 0.767+/-1.056 mg/g in TDGA3, which indicated a gradual but significant increase (p=0.024). In terms of the statistical correlation between airborne VCM and urinary TDGA to evaluate exposure dose per day, of the three urinary TDGA concentrations, TDGA3 showed the highest degree of regression (R(2)=0.4215) with 8h-TWA airborne VCM concentration. CONCLUSION: Based on this result, the excretion half-life of urinary TDGA was assumed to be less than 3 days, because the concentration of urinary TDGA at 3 days after exposure to airborne VCM was decreased to the level of urinary TDGA concentration in the control workers. The concentration of urinary TDGA increased in the case of continuous shift, due to the accumulation of residual metabolites of TDGA. It was considered that TDGA3 can be applied as a useful biological index to evaluate the exposure dose of airborne VCM during one day because TDGA3 showed the highest correlation with the exposure dose of airborne VCM in the previous shift day.
Creatinine ; Half-Life ; Humans ; Polyvinyl Chloride ; Vinyl Chloride*

Followings are the results obtained from the observation on the microangiograms and Geon D11 Alatex molding casts in the rabbit, canine and Korean human Kidneys. 1. The findings of microangiograms in the rabbit and canine Kidneys are uniform interlobar arteries run toward lateral border of Kidney in radiating form without branching, divide the Kidney into similar sized segments and segmental distribution is evident. The arcuate arteries arising from the interlobar arteries run toward lateral border to form numerous interlobular arteries, make angle nearly horizontal with av. 152.8 degree in rabbit and with av. 151.6 degree in canine. In Korean human Kidney, it is difficult to confirm the interlobar arteries and arcuate arteries because of ununiform size and length of these. And the angle between arcuate arteries is sharp with av. 40.6 degree. 2. The findings of the molding casts in rabbit and canine Kidneys are that interlobar arteries running toward lateral border of Kidney with radiating form are evident, which are 6-9 branches from anterior division and 5-7 from posterior in rabbit and 7-9 from anterior and 5-7 from posterior in canine. The angle between arcuate arteries dividing from interlobar arteries with right angle is nearly horizontal with av. 162.3 degree in rabbit and with av. 159.8 degree in canine. The numerous interlobular arteries arise from arcuate artery with right angle. In Korean human Kidneys it is difficult to confirm interlobar arteries which are 2-4 branches originating from anterior because of ununiform size and length of these. And the angle between arcuate arteries in sharp degree with av. 43.7 degree. 3. The renal collecting system which has close relation to are pathway of interlobar arteries by molding casts shows that calyces are symmetrical, 2 rows and regular in rabbit and canine Kidneys while irregular in human. 4. Nephrotomy line, that is, junction of anterior and posterior division blood supply in the Kidney by molding casts is different between canine and human. Nephrotomy line in human is in posterior aspect of lateral border of Kidney almost 2/3 but there is no avascular area in the lateral borden of Kidney, the so called Brodels line as advocated by Brodel because interlobular arteries branching from arcuate arteries are interdigitated together as end arteries. 5. Gross anatomic differences of renal vasculature among rabbit, canine and human on the basis of microangiograms and molding casts suggest that rabbit and canine may not be suitable subjects for surgical experimentation.
Arteries* ; Fungi ; Humans* ; Kidney* ; Polyvinyl Chloride ; Renal Artery ; Running

PURPOSE: Tracheal intubation in a hemorrhagic airway is a difficult procedure because the visibility can be obscured by blood or vomitus. Several devices and methods have been developed to overcome such obstacles, but they are not available at all practical sites. Therefore, this study was conducted to assess the time and success rate of tracheal intubation according to the type of suction tip used in a hemorrhagic airway manikin model. METHODS: This study was a randomized crossover manikin simulation study. We recruited 18 emergency physicians to perform intubation with suction using a Yankauer suction tip and a polyvinyl chloride (PVC) catheter suction tip in a hemorrhagic airway manikin model. We then measured the time and success rate of intubation for each suction tip. RESULTS: The mean intubation time using the Yankauer suction tip was 42.3 seconds, and the mean intubation time using the PVC catheter suction tip was 91.1 seconds (p < 0.001). Two cases of esophageal intubation occurred when the PVC catheter suction tip was used (success rate, 88.9%). In contrast, there was no esophageal intubation when the Yankauer suction tip was used (success rate, 100%) (p=0.217). CONCLUSION: Intubation of a hemorrhagic airway manikin model can be performed in a shorter time when a Yankauer suction tip is used than when a PVC catheter suction tip is used.
Catheters ; Emergencies ; Hemorrhage ; Intubation ; Manikins ; Polyvinyl Chloride ; Polyvinyls ; Suction

PURPOSE: The cisplatin and etoposide had been reported to be an effective anti-tumor drug for small cell lung cancer, ovarian cancer, breast cancer and so on. The aim of this study was to evaluate the stability of cisplatin and etoposide in aqueous solution. MATERIALS AND METHODS: Cisplatin 200 microgram/ml was prepared in 0.9% sodium chloride and stored in either glass bottle or polyvinyl chloride (pvc) bag and protected from light or exposed to fluorescent light. Etoposide solution was prepared in 0.9% sodium chloride, and contained in glass bottle. Precipitating concentration was achieved using 200 microgram/ml, 400microgram/ml, 600 microgram/ml, and 1000 microgram/ml of etoposide solution. Samples were stored at room temperature and visually inspected and assayed for etoposide and cisplatin content by high-performance liquid chromatography after 15 minutes, 2, 4, 8, 12, 16 and 24 hours of storage. RESULT: 1) Cisplatin concentration decreased less than 10% from initial concentration for 24 hours of storage, both in glass bottle and pvc bag. Stability of cisplatin 200 microgram/ml in both container were not different. and Condition of light exposure did not have significant effect on stability of cisplatin 200 microgram/ml in glass bottle. 2) The etoposide 200 microgram/ml was not precipitated and stable for 24 hours, but we could find the precipitates of etoposide with the concentration of 400 microgram/ml or higher for 24 hours. CONCLUSION: Cisplatin 200 microgram/ml and etoposide 200 microgram/ml in 0.9% sodium chloride were stable at room temperature under room fluorescent light for 24 hours.
Breast Neoplasms ; Chromatography, Liquid ; Cisplatin* ; Etoposide* ; Glass ; Ovarian Neoplasms ; Polyvinyl Chloride ; Small Cell Lung Carcinoma ; Sodium Chloride

BACKGROUND: There have been a lot of methods that prevent catatrophic airway fires during laser surgery, but none of them can protect endotracheal tube cuff exposed directly to laser beam. This study was performed to know the preventive effect of viscous lidocaine-filled cuffs on laser-induced combustion, and to know how long we can maintain positive pressure ventilation if laser beam broke out cuff perforation. METHODS: Transparent acrylic trachea attached to artificaial lung was intubated with 8.0 ID polyvinylchloride endotracheal tube. Cuff was filled with 8ml of saline or saline and viscous lidocaine mixture with 2:1 or 4:1 ratio. Positive pressure ventilation with air in tidal volume of 500 ml was begun. The laser output was set to 10 watt/sec in the continuous mode with beam diameter of 1 mm. Laser beam was directed perpendicularly at the part of the cuff protruding between endotracheal tube shaft and acrylic trachea, and laser emission was continued until the cuff was perforated or combusted. RESULTS: There was no case of laser-induced fires. After the perforation of cuff, the tidal volume was slowly decreased in 2:1 mixture of saline and viscous lidocaine filled cuff compared to others (P<0.05). CONCLUSION: 2:1 mixture of saline and viscous lidocaine may be used as an efficient inflating material of endotracheal tube cuffs on laser airway surgery.
Fires* ; Laser Therapy ; Lidocaine ; Lung ; Polyvinyl Chloride* ; Polyvinyls* ; Positive-Pressure Respiration ; Tidal Volume* ; Trachea

BACKGROUND: Double-lumen endobronchial tube (DLT) malposition and displacement can occur easily by blind intubation or moving a patient into the lateral position. We compared a silicon DLT (Silbroncho(R)) with a polyvinyl chloride tube (Broncho-Cath(R)) to determine whether Silbroncho(R) can reduce the incidence of DLT malposition and displacement during anesthesia for one lung ventilation in right-side thoracic surgery. METHODS: Thirty nine patients requiring right lung deflation were randomly assigned to one of two groups. Eighteen patients received a Broncho-Cath(R) DLT and 21 patients received a Silbroncho(R) in the left mainstem bronchus. After blind intubation, we checked the incidence of right DLT intubation and tracheobronchial injury by fiberoptic bronchoscopy (FOB). After correcting DLTs for exact position and moving patients into the lateral position, we assessed the incidence of DLT displacement and changes of peak inspiratory pressure according to this position change during one lung ventilation. RESULTS: The incidence of right DLT intubation and tracheobronchial injury were not significantly different (P > 0.05) in the two groups (16.7% vs 0%, 38.9% vs 14.3%, Broncho-Cath(R) vs Silbroncho(R), respectively). After position change, the incidence of DLT displacement in the Silbroncho(R) group (4.8%) was lower (P < 0.05) than in the Broncho-Cath(R) group (44.8%). No significant difference was found between the two groups in terms of peak inspiratory pressure (P > 0.05). CONCLUSIONS: Our results suggest that Silbroncho(R) can reduce the incidence of DLT displacement because of the small-sized bronchial cuff, which is located more distally than the Broncho-Cath(R) cuff. We conclude that Silbroncho(R) is superior to Broncho- Cath(R) for one lung ventilation during thoracic surgery.
Anesthesia ; Bronchi ; Bronchoscopy ; Humans ; Incidence ; Intubation ; Lung ; One-Lung Ventilation ; Polyvinyl Chloride* ; Polyvinyls* ; Silicones* ; Thoracic Surgery*

OBJECTIVETo Investigate necessity of safety evaluation, research ideas, evaluation methods of DEHP in PVC medical devices.

METHODSThe ideas of The United States, Japan and the European Union on safety evaluation of DEHP in PVC medical devices was reviewed and sorted, regarding to currently requirements for PVC medical devices in our country, the research ideas and methods of DEHP in PVC medical devices was explored.

RESULTSDEHP released from High-risk PVC medical devices may exceed human tolerance intake values and thus potentially be harmful to human health. So it is necessary for production enterprise to assess safety of DEHP in PVC medical device. The assessment can be done by material control and detecting release of DEHP from PVC medical devices.

CONCLUSIONIn order to assess safety of DEHP in PVC medical device, production enterprise can firstly assess materials according to national standard. Secondly, production enterprise can detect release of DEHP from PVC medical devices simulating clinical application. By comparing release of DEHP from PVC medical devices and TI, safety of DEHP in PVC medical device can be evaluated.

DEHP is largely used in soft PVC products as the plasticizer, which is also widely applied in medical devices. Due to its potential and widespread toxicity and medical devices' specific use, the safety of DEHP's application in medical devices has received extensive attention. In this paper, a comprehensive review of the application and potential toxicity of DEHP in PVC medical devices is made on the basis of the research results all over the world. Besides, the safety evaluation in medical devices is discussed and some possible coping strategies are explored.
Diethylhexyl Phthalate ; adverse effects ; Equipment Safety ; Equipment and Supplies ; adverse effects ; Plasticizers ; adverse effects ; Polyvinyl Chloride

As we all know, DEHP is seriously harmful to human health and consequently has been acquired critical attention. DEHP is able to migrate from PVC medical devices for the non-chemically bound to PVC, thus contact with user and patient. The DEHP migration is influenced by various parameters. In order to assess the security of PVC-tubes medical devices scientifically of DEHP migration, we develop an experimental model by analyzing the parameters comprehensively and systematically, taking into account the clinical practices. For example, assessing the security of DEHP migration from infusion sets by utilizing this model.
Diethylhexyl Phthalate ; adverse effects ; Equipment and Supplies ; Humans ; Models, Theoretical ; Plasticizers ; adverse effects ; Polyvinyl Chloride

The work explored the DEHP migration parameters in PVC infusion in clinic,based on the previous research on the test model of DEHP migrated from PVC infusion,to assess the safety of PVC infusion.The leaching solution samples in different conditions were evaluated by analysis of the DEHP in leaching solution using GC-MS under simulated clinical transfusion way.The release behavior of DEHP was significantly affected by the storage time,storage temperature,surrounding temperature,dripping speed,sterilization process,volume of the leaching solution,and the property of the leaching solution.
Diethylhexyl Phthalate ; pharmacokinetics ; Gas Chromatography-Mass Spectrometry ; Plasticizers ; pharmacokinetics ; Polyvinyl Chloride ; pharmacokinetics ; Temperature