This Study was performed to investigate the effect of foods containing benzoic acid on the urinary hippuric acid concentration in the toluene exposed workers. The urinary hippuric acid concentration were measured at 0, 30, 60, 90, 120, and 150 minute after intake of soft drink and bread containing benzoic .acid: in volunteers,: who did not have been exposed toluene occupationally. After that urinary hippuric: acids also were measured at the end of shift in toluene exposed workers. And also the concentration of toluene in air were analysed! by gas chromatography. So the relationships between urinary hippuric acid concentration and age, work duration, concentration of toluene in air and intake of benzoic acid containing food were observed. The results were as follows: 1. The urinary hippuric acid concentration reached the highest level at 30 minute after intake of soft drink with bread at a level of 1.41g/g creatinine and soft drink; alone at a level of 1.04g/g creatinine which contained benzoic acid among unexposed toluene, and then gradually decreased. 2. In toluene exposed group no significant effect of general; characteristics siich; as gender, age, work duration, drinking and smoking on urinary: hippuric acid concentration was showed in toluene exposed group. 3. The mean value of urinary hippuric acid concentration of group taking benzoic acid containing foods was significantly higher than that of group not taking. 4. Multiple regression analysis showed that toluene concentration in .air and benzoic acid containing foods were together significantly influence on urinary ; hippuric acid concentration. And the function between variables is Y = 0.014Tpluene +0.489Benzoic acid +0.745 and the contribution rates were 31%. In conclusion, it was suggested that the information on intake of benzoic acid containing foods should be considered in measurement of urinary hippuric acid for the more accurate toluene exposure evaluation.
Benzoic Acid* ; Bread ; Carbonated Beverages ; Chromatography, Gas ; Creatinine ; Drinking ; Occupations ; Smoke ; Smoking ; Toluene* ; Volunteers

BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity

"Hemobilia" upper gastrointestinal bleeding that originates from within the biliary tract, is a rare complication of the laparoscopic cholecystectomy. Only a few cases have been reported in the literature. It is more common in accidential or iatrogenic injury of the liver and bile ducts, even occurring spontaneously in cholelithiasis, several inflamatory processes, and vascular and neoplastic changes. The laparoscopic cholecystectomy is a recently developed and advanced surgical procedure that has rapidly gained acceptance. Its complications remain to be clinically analyzed. The authors experienced a case of massive hemobilia after a laparoscopic cholecystectomy. A 54-years-old man with hemobila resulting from right hepatic artery pseudoaneurysm communicating with the intra-hepatic bile duct was treated with angiographic tanscatheter embolization on the of 24th postoperative day. We report this case with a brief review of the literature.
Aneurysm, False ; Bile Ducts ; Biliary Tract ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Hemobilia* ; Hemorrhage ; Hepatic Artery ; Liver

PURPOSE: The purpose for this study is to compare the clinical differences of the two groups (ie. colonic obstruction and non-obstruction) in colonic surgery. METHODS: A retrospective clinical analysis was done in 149 patients with colorectal disease who had been surgically treated from January 1995 to December 1997 at our institution. RESULTS: 1) The peak age of incidence was in the 7th. and 8th. decades (53.3%)in the obstruction group and 6th. and 7th. decades (54.3%) in the non-obstruction group, the sex ratio of male to female was higher in the obstruction group (2.00:1) than in the non-obstruction group (1.04:1). 2) The most common cause of colonic obstruction was malignant disease in both groups (75.4% in the obstruction group and 78.3% in the non-obstruction group). 3) The most frequent symptom and sign of the two groups were abdominal pain (36.8% and 2.6% respectively). 4) The most common location was cecum (24.6%) followed by sigmoid colon (22.8%) and rectum (15.8%) in the obstruction group, and rectum (40.2%) followed by ascending colon (15.2%), cecum (13.0%), and transverse colon (13.1 %) in the non obstruction group. 5) The right hemicolectomy was the most common procedure in the obstruction group (29.8%) while abdominoperineal resection was most frequently performed in the non-obstruction group (23.9 %). The surgical resection rate was 77.4% and 100% in obstruction group and non-obstruction group, respectively. 6) In the case of colon cancer, the stage of cancer (according to Modified Astler-Coller classification) was much higher in the obstruction group. An average 6.5 metastatic lymph nodes were found from 18.5 dissected lymph nodes in the obstruction group whereas 2.7 out of 13.9 lymph nodes in the non-obstruction group. 7) The postoperative complication rate of obstruction group were 21.4% whereas that of non-obstruction group were 15.0% respectively. The postoperative mortality rate was 14% in the obstruction group and 3.3% in the non-obstruction group. The complication rate and postoperative mortality of the obstruction group was higher than those of the non-obstruction group, especially in the malignant disesae group. CONCLUSIONS: The results of our study indicate that the obstruction group has a different clinical course from the non- obstruction group and associated higher postoperative complication and mortality rate.
Abdominal Pain ; Cecum ; Colon* ; Colon, Ascending ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Mortality ; Postoperative Complications ; Rectum ; Retrospective Studies ; Sex Ratio

Dermatofibroma (DF) is one of the most common benign soft tissue tumors. Various histological variants of DF have been described, and it is important to discern the different variants to evaluate the prognosis. A 43-year-old female patient with no specific medical history presented with multiple brown-colored nodules on the right arm for 5 years. Biopsy specimens showed a predominance of collagen and fibroblasts in a whorled arrangement with moderate cellularity, findings that were consistent with fibrocollagenous DF. The patient underwent excision of the largest lesion and revisited our department 3 months after surgery with local recurrence at the excision site. We report a rare case of multiple fibrocollagenous DF with local recurrence at the excision site.

The pathogenesis of chronic spontaneous urticaria (CSU) is complex. Though the involvement of functional autoantibodies and imbalance of T helper (Th) cell subsets have been reported, the exact mechanism remains elusive.We report a case of eczematous vesicular eruption and exacerbation of CSU in a patient with psoriasis after treatment with secukinumab, an anti-interleukin (IL)-17 monoclonal antibody. The eczematoid eruption subsided after the administration of systemic steroids, but the exacerbation of CSU was not controlled. After switching the therapy to guselkumab, an anti-IL-23 monoclonal antibody, to supplement the control of the psoriasis lesions, the patient’s urticaria flare-ups were well controlled with only H1 antihistamines. We hypothesize that the Th2-skewed immune response induced by anti-IL-17 treatment in predisposed patients might have resulted in the eczematous eruption and exacerbation of CSU.

Sister-chromatic exchanges measured in the peripheral lymphocytes of 15 non-smoking medical students after exposure to formaldehyde during a 24-week anatomy class showed a small but significant (p=0.0468) increase when compared with samples obtained from the same individuals immediately before exposure. Mean frequencies of sister-chromatic exchange of cultured peripheral lymphocytes were 5.40+/-0.24 from the samples before exposure and 5.87+/-0.22 from the same samples after exposure. Breathing-zone air samples collected by formaldehyde monitoring kit with digital colorimeter (SKC) showed a mean concentration of 0.72+/-0.02 ppm formaldehyde.
Formaldehyde* ; Humans ; Lymphocytes* ; Students, Medical*

BACKGROUND: Anesthetic agents used for general anesthesia are emerging possible influential factors for surgical site infection (SSI). In this retrospective study, we evaluated the incidence of SSI after colorectal surgery according to the main anesthetic agents: volatile anesthetics vs. propofol. METHODS: A total 1,934 adult patients, who underwent elective colorectal surgery under general anesthesia between January 2011 and December 2013, were surveyed to evaluate the incidence of SSI: 1,519 using volatile anesthetics and 415 using propofol for main anesthetic agents. Patient, surgery, and anesthesia-related factors were investigated from all patients. Propensity-score matching was performed to reduce the risk of confounding and produced 390 patients in each group. RESULTS: Within the propensity-score matched groups, the incidence of SSI was higher in the volatile group compared with the propofol group (10 [2.6%] vs. 2 [0.5%], OR = 5.0 [95% CI = 1.1-2.8]). C-reactive protein was higher in the volatile group than in the propofol group (8.4 ± 5.6 vs. 7.1 ± 5.3 mg/dl, P = 0.001), and postoperative white blood cells count was higher in the volatile group than in the propofol group (9.2 ± 3.2 × 10³/µl vs. 8.6 ± 3.4 × 10³/µl, P = 0.041). CONCLUSIONS: The results of this study suggest that intravenous anesthesia may have beneficial effects for reducing SSI in colorectal surgery compared to volatile anesthesia.
Adult ; Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Anesthetics* ; C-Reactive Protein ; Colorectal Surgery* ; Humans ; Incidence ; Leukocytes ; Propofol* ; Research Design ; Retrospective Studies* ; Surgical Wound Infection*

A vertebral compression fracture can cause chronic back pain, and may also result in progressive kyphosis. The traditional treatments of a vertebral compression fracture include bed rest, analgesics and bracing. Balloon kyphoplasty can restore the vertebral height and allow safe bone cement injection into the cavity made by the balloon, which significantly reduces the risk of cement leakage compared to vertebroplasty. An 82-year-old female patient suffered from severe low back pain. Due to the intractable pain and immobility, which could not be relieved by conventional care, as well as the empty vertebral body associated with communicated fractures of the vertebral surfaces, balloon kyphoplasty, with a thicker bone cement injection than usual with balloon kyphoplasty, was chosen. The preoperative intractable pain and immobility were dramatically relieved soon after the procedure, without any complications.
Aged, 80 and over ; Analgesics ; Back Pain ; Bed Rest ; Braces ; Female ; Fractures, Compression ; Humans ; Kyphoplasty* ; Kyphosis ; Low Back Pain ; Pain, Intractable ; Vertebroplasty

BACKGROUND: The aim of this study was to investigate the management of pediatric patients who were referred to the pain center. METHODS: The data was collected based on 32 pediatric patients referred to the pain center from March 2002 to August 2006. The number of patients each year, gender distribution, age, requested departments, clinical causes of consultation, and the pain management before and after the consultation were analyzed retrospectively. RESULTS: 32 pediatric patients (19 males and 13 females), aged 3- 17 years, were enrolled in this study. Fifty-six percent of patients were in adolescence. The major need for the consultation was cancer pain (50.0%), myofascial pain syndrome (10.0%) and central pain (10.0%). Before the consultation, 62.1% of the patients were managed by opioid-based medications of which 26.1% were managed by only partial agonists and 29.6% were managed by only PRN. At the pain center, opioid-based medication was also the main treatment. CONCLUSIONS: The number of pediatric patients referred to the pain center has increased. Under this condition, the pain physician should be concerned about pediatric pain patients and their management.
Adolescent ; Age Distribution ; Humans ; Male ; Myofascial Pain Syndromes ; Pain Clinics* ; Pain Management ; Retrospective Studies