In order to ascertain the status of health damage among Korean farmers who spray pesticides regularly in summer, blood and urine samples were collected for 88 volunteers during July to Septembei in 1990. Serum cholinesterase activity, parent compounds of pesticides in blood and urine, SGOT, SGPT, blood pressure, pulse rate were measured. The results were as follows ; 1. Mean cholinesterase activity after spraying pesticides was significantly lower than that before splaying. While proportion of abnormal cholinesterase activity (<1900U/L) group was 2.3% before spraying pesticides, tHe proportion of the group after spraying was 22.8% 2. Cholinesterase activity were decreased over 50% in 14.7% of the suhjects who can be classified into poisoning group 3. While pulse rate and blood pressure were slightly increased in poisoning group, those were significantly decreased in non-poisoning group. 4. Consecutive splaying of pesticide caused further reduction of cholinesterase activity, 5. Five parent compounds of pesticides frequently used during summer farming were analyzed using 106 blood samples. IBP in one sample and Isoprothiolane in four samples were detected. No parent compounds were detected in urine samples.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Cholinesterases* ; Heart Rate ; Humans ; Parents ; Pesticides ; Poisoning ; Volunteers

This paper describes that invasive aspergillosis was found in oral cavity, especially in lower molar periodontium in a immunocompromised 34-year-old woman who had been admitted in hemato-oncology with the diagnosis of acute myeloid leukemia. Antifungal therapy and surgical excision of involved teeth, bone and gingiva were the treatment of choice. After treatment infected area was healed very well. We would like to report our case because we could not find any paper reporting on invasive aspergillosis occurring in lower molar periodontium.
Adult ; Aspergillosis* ; Diagnosis ; Female ; Gingiva ; Humans ; Leukemia, Myeloid, Acute ; Molar* ; Mouth ; Periodontium ; Tooth

Background and Objectives: Preoperative assessment is one of the most important fields in surgery and anesthesia as it can reduce morbidity and mortality from surgery and detect abnormal findings not clinically observed through preoperative examination. However, excessive non-vital preoperative routine tests have been criticized. The aim of the study is to investigate the current use of elective preoperative evaluations using otorhinolaryngologic surgery covering patients of all ages with various levels of difficulty.Subjects and Method Using the Korean National Health Insurance Service National Sample Cohort data, we investigated 98890 subjects who underwent otorhinolaryngologic surgery during the year 2018. We evaluated sociodemographic characteristics, clinical characteristics, medical institutions, and operation characteristics of the subjects and analyzed in detail their routine blood and urine test items, sonographic exams and pulmonary function tests. Results: There were differences in the implementation of preoperative blood and urine tests, sonographic exams and pulmonary function tests according to sociodemographic characteristics, types and locations of medical institutions. Old age, low socioeconomic status, comorbid condition, high Charlson’s Comorbidity Index, tertiary hospital were the factors that increased preoperative evaluation tests. Conclusion Appropriate preoperative evaluation is needed for predicting and preparing for the possibility of treatment complications as well as improving treatment quality while reducing costs for perioperative management.

PURPOSE: The cutting seton technique is a world-wide operative method in management of a complex anal fistula. However it has still some risks of anal deformity and fecal incontinence because of sphincter injury, and also required two-stage operation under the anesthesia. We have modified this conventional method into sphincter-preserving technique using the seton and evaluated the clinical effect of patients with complex anal fistula. METHODS: The operative steps consisted of excision of the fistular tract without cutting the sphincter, and insertion of a non-absorbable suture material as a seton around the sphincter. When enough fibro-granulated tissues grew and pus discharge decreased markedly, the seton was just cut out from the wound without anesthesia at the outpatient basis. The clinical effect following treatment by using this method was assessed retrospectively in 81 patients, including 33 recurrent cases, who were treated during the four and a half-year period. RESULTS: The average follow-up period to remove the seton and to eradicate the fistula was 68.9+/-39.5 and 82.1+/-45.6 days, respectively. No patients experienced fecal incontinence after surgery. The fistula was healed without recurrence in 78 patients (96.3%), preserving integrity of the sphincter. Recurrence developed in 3 patients who had two suprasphincteric fistulas and one transsphincteric fistula with supralevator abscess. CONCLUSION: We suggest that this method is good for treating complex anal fistulas without two-stage operation because it has some advantages such as a lower recurrence, a lower functional impairment, and less anal deformity.
Abscess ; Anesthesia ; Congenital Abnormalities ; Fecal Incontinence ; Fistula ; Follow-Up Studies ; Humans ; Outpatients ; Rectal Fistula* ; Recurrence ; Retrospective Studies ; Suppuration ; Sutures ; Wounds and Injuries

PURPOSE: The diagnosis of acute cholecystitis is usually made by performing ultrasonography or biliary scintigraphy. We have introduced the (99m)Tc-ciprofloxacin (infecton) scan for diagnosing of acute cholecystitis. The main aim of this study was to evaluate the efficacy of (99m)Tc-ciprofloxacin imaging in comparison with ultrasonographic findings for the diagnosis of acute cholecystitis. METHODS: Sixteen patients who were thought to have acute or chronic cholecystitis, based on the clinical and sonographic findings, were included in this study. We gave intravenous (99m)Tc-ciprofloxacin to sixteen patients and we obtained the SPECT images after one hour. The final diagnosis of acute cholecystitis was made according to the pathologic reports. RESULTS: According to pathologic reports, out of the sixteen patients, twelve patients had acute cholecystitis and four patients had chronic cholecystitis. On the (99m)Tc-ciprofloxacin scans, twelve patients had positive images showing acute cholecystitis on account of the hot uptake in the gallbladder and four patents had negative images showing chronic cholecystitis due to the negative uptake in the gallbladder. Among them, one false positive case and one false negative case were observed. With performing ultrasonography, twelve and four patients were diagnosed as having acute and chronic cholecystitis respectively. Out of them one false positive case and three false negative cases were observed. Based on the pathologic reports, (99m)Tc-ciprofloxacin imaging has a sensitivity of 91.7% and a specificity of 75%. The ultrasonography had a sensitivity of 91.7% and a specificity of 25%. CONCLUSION: As a result of comparing the sensitivity and specificity of the (99m)Tc-ciprofloxacin scan with those of the ultrasonography, the (99m)Tc-ciprofloxacin scan is considered to be useful test method to diagnose acute cholecystitis.
Cholecystitis ; Cholecystitis, Acute* ; Diagnosis* ; Gallbladder ; Humans ; Radionuclide Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography

OBJECTIVE: This study was performed to examine the relationship between community-based social support and psychosocial distress in workers. METHODS: The study subjects were 596 workers recruited from 11 companies in Chungju city. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, job stress, work-based social support, community-based social support and level of psychosocial distress. RESULTS: Hierarchical multiple regression analysis showed that workers with no chronic disease, exercise and sufficient sleep had a higher score of psychosocial distress than those with chronic disease, no exercise, and not enough sleep. Coworker's work-based social support and community-based social support were negatively associated with psychosocial distress. The R square value of total independent variables on psychosocial distress was 0.409, and that of community-based social support on psychosocial distress was 0.052. CONCLUSION: This study showed that community-based social support served as a protective factor against psychosocial distress in some workers. We recommend the establishment of a worksite stress reduction program in occupational level as well as community-based social support.
Chronic Disease ; Chungcheongbuk-do ; Questionnaires ; Workplace

Encapsulating peritonitis (EP) is a rare disease characterized by the formation of a membrane which encases all or part of the abdominal viscera. This disease occurs in patients receiving continuous ambulatory peritoneal dialysis (CAPD). Other etiologies are trauma, colitis, chemical irritation, and infrequently, intraperitoneal tuberculosis. The overall prevalence is 0.7-3.7% of the patients receiving CAPD. EP may be accompanied by intestinal obstruction, strangulation, poor wound healing, and nutritional problems. The diagnosis is usually made by using an exporatory laparotomy, and the treatment of choice is excision of the membrane with complete decortication. Here, we present a case of encapsulating peritonitis associated with tuberculous peritonitis. In this patient, a huge pseudocyst, 40 cm in its largest diameter and 7 kg in weight, was found intraperitoneally. The pseudocyst was removed surgically and proved to be formed due to tuberculous peritonitis by using Tbc-PCR.
Colitis ; Diagnosis ; Humans ; Intestinal Obstruction ; Laparotomy ; Membranes ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis* ; Peritonitis, Tuberculous ; Prevalence ; Rare Diseases ; Tuberculosis ; Viscera ; Wound Healing

BACKGROUND/AIMS: Hilar cholangiocarcinoma is a tumor with poor prognosis although curative surgical resection is known to be the most effective treatment. To obtain negative resection margin is still a challenging problem for surgeons. We designed this study to investigate further the treatment strategies of the hilar cholangiocarcinoma by comparing the prognosis of patients managed by different modalities with special emphasis on the polarity of the resection margin. METHODS: A retrospective clinical study was performed at the Inha University Hospital for 70 patients managed for hilar cholangiocarcinoma from June 1996 to May 2002. RESULTS: The patients consisted of 45 men and 25 women. The average age of the patients was 66.4 years old. The survival rate for 1 year and 3 years and the median survival period were investigated. For the negative resection margin sub-group, those were 100%, 28.6% and 23 months respectively, while those for the positive resection margin sub-group were 70.6%, 10.8% and 19 months respectively. For the palliative bypass surgery sub-group, those were 0%, 0%, and 5 months, for the biliary stent sub-group, those were 5.3%, 0% and 5 months and for the intraductal radiotherapy sub-group, those were 20%, 0% and 7 months respectively. When the patients were divided between the resection and the non- resection groups, those figures were 79.2%, 12.1% and 20 months for the resection group while for the non-resection group, those were 11.9%, 0% and 6 months respectively. Statistical analysis showed that the survival rates for the resection and the non-resection groups were different (p=0.0001). However, the survival difference for the negative and the positive resection margin sub-groups were insignificant (p= 0.2401). For the three sub-groups of the non-resection group, the survival difference for each sub-groups were also insignificant (p=0.2979). Postoperative complication was observed in 12 patients (38.7%). Three patients died and the postoperative mortality rate was 9.7%. CONCLUSION: To improve the survival of the hilar cholangiocarcinoma patients, it is believed that the best treatment is the aggressive resection of the tumor even if it is difficult to obtain negative resection margin. Considering the high morbidity and mortality rate of extensive surgery and comparable survival of the positive resection margin patients, further extension of the extent of resection to obtain negative resection margin should be performed in selected patients.
Cholangiocarcinoma* ; Female ; Humans ; Male ; Mortality ; Postoperative Complications ; Prognosis* ; Radiotherapy ; Retrospective Studies ; Stents ; Survival Rate

PURPOSE: Although the resectability of hepatocellular carcinoma has increased due to recent advances in diagnostic methods and surgical techniques, the long-term results are unsatisfactory due to their invasiveness and frequent association with cirrhosis. This study was designed to identify the prognostic factors affecting the long term survival and recurrence of tumors in patients having undergone a hepatic resection for a hepatocellular carcinoma. METHODS: Between June 1996 and March 2002, 51 consecutive patients underwent a hepatic resection for a hepatocelluar carcinoma at the Inha University Hospital. The overall cumulative and disease free survival rates for these patients were analysed. Twenty-five clinicopathological factors were evaluated by univariate and multivariate analyse to determine any significant prognostic factors. RESULTS: The cumulative 1, 3 and 5-year survival rates were 84, 70 and 58%, respectively. There were 26 recurrences, and the 1, 3 and 5-year disease free cumulative survival rates were 60, 53 and 31%, respectively. From the univariate analysis, all the factors associated with ascites (P=0.0000), total bilirubin (P=0.0015), albumin (P=0.0271), prothrombin time (P=0.0392), HBe antigen (P=0.0283), Child classification (P=0.0000), celluar differentiation (P=0.0043) were found to correlate with the overall survival. From a Cox regression analysis, the HBe antigen (P=0.019), ascites (P=0.028) were found to be independent prognostic factors of the overall survival. The only factor with an independent effect on disease free survival was the HBe antigen (P=0.037). CONCLUSION: Because prognosis of HBe antigen-positive patients with ascites is poor, frequent postoperative follow up surveys in these patients are needed.
Ascites ; Bilirubin ; Carcinoma, Hepatocellular* ; Child ; Classification ; Disease-Free Survival ; Fibrosis ; Follow-Up Studies ; Humans ; Prognosis ; Prothrombin Time ; Recurrence ; Survival Rate

Hypoxia-induced cell damage is known to be mediated by increase in intracellular calcium. In the present study, the effect of calcium channel blockers on the hypoxia-induced cell damage was investigated in iat pheochromocytoma cells line, PC12 cells. The cultured cells were exposed to hypoxia under 95% N2 plus 5% C02 gas phase and incubated in the media devoid of fetal bovine seruril The cell demage was assessed by measuring the release of lactate dehydrogenase (LDH) from the cells into the incubation media. Exposure of the cells to hypoxia for 2 hours caused a 28% of the total LDH to be released from cells -into media. The pretreatment of the cells with 1 mM each of diltiazem, nifedipine, and verapamil depressed the LDH release to the extent of 52%, 42%, and 30% inhibition, respectively. The inhibitory effects of diltiazem and verapamil were more marked at 1 mM than at 10 mM. The influx of 45 Ca2+ into the cells was rapidly increased within 2 minutes after exposure of the cells to hypoxia. Diltiazem at 1 mM almost completely inhibited Ca2+ influx, while nifedipine and verapamil exhibited only, 30% inhibition of Ca2- influx. The results lend support to the notion that mcreased intracellular calcium triggers a series of cascade reactions leadmg to cell death. It is suggested that the inhibitory effects of various calcium antagonists on hypoxia-induced cell damage differ from each other in their potency.
Animals ; Anoxia* ; Calcium Channel Blockers ; Calcium* ; Cell Death ; Cells, Cultured ; Diltiazem ; L-Lactate Dehydrogenase ; Nifedipine ; PC12 Cells* ; Pheochromocytoma ; Verapamil