The findings of special medical examinations are not infrequently summarized in the form of health classification. This procedure seems valuable for the protection of workers'health from personal health as well as public health point of view, because health classification of workers provides occupations health workers with birds eye view informations in terms of medical, placement and educational procedures, which are to be followed after medical examinations. In this study, the authors have reviewed the existing systems of special medical examinations and Health classifications in different countries and those recommended by international organizations for the purpose of improving the current system in Korea. The important issues covered in this review in relation to health classification of workers included the categories of diseases, the examination and laboratory tests, the criteria for health level classification and the health instructions to be given at each health levels. It was found that the current health classification system in Korea could be featurea as follows : 1. Special medical examinations are always carried out in combination with general medical examinations, contributing to the detection of risk factors of occupational diseases. 2. The selection of examinees is always made on the basis of work environment monitoring, often resulting in the underdetection of exposed workers. 3. Even if the test items are properly selected according to the principles of occupational medicine, further review is required in the light of recent advances in the pathogenesis as well as early changes of occupational diseases and epidemiologic principles. 4. The criteria for the classfication of health levels are to be reviewed on the basis of clinical epidemiology. 5. The health instructions covered only medical and placement aspects, failing to introduce the concept of health promotion.
Birds ; Classification* ; Epidemiology ; Health Promotion ; Health Status ; Humans ; Korea ; Occupational Diseases ; Occupational Medicine ; Occupations ; Public Health ; Risk Factors

Angiostatin is a potent angiogenesis inhibitor that is composed of the first four kringles of plasminogen fragment. Angiostatin with one less kringle molecule (kringle 1 to 3) was recently demonstrated to be an effective angiogenic inhibitor. To determine whether recombinant plasminogen kringle 1-3 (rPK1-3) can inhibit the corneal neovascularization induced by potent angiogenic factors; angiogenin, bFGF, or VEGF, hydron polymer discs each containing 2.0 microg of angiogenin, 500 ng of bFGF, or 500 ng of VEGF respectively were implanted into the corneal stroma of 138 rabbit eyes, and then discs each containing 10 microg, 12.5 microg, 20 microg or 30 microg of rPK1-3 were implanted randomly. Discs containing phosphate buffered saline were also implanted as a control. The angiogenesis score on number and length of newly formed vessels on the each of the rabbit's cornea were recorded daily by two observers (blinded). The treated corneas were also examined histologically. Recombinant PK1-3 treated corneas showed less neovascularization induced by all angiogenic factors (p < 0.05). and the extent of inhibition of neovascularization was proportional to the concentration of rPK1-3 (p < 0.05). Histologic examination showed leukocyte infiltration into the corneal stroma on the PBS treated eyes whereas rPK1-3 treated eyes showed only traces of leukocytes. These results of the effective rPK1-3 inhibition of corneal neovascularization induced by angiogenin, bFGF, or VEGF suggest that this angiostatin related fragment, rPK1-3, may be useful in the treatment of various neovascular diseases. Copyright 2000 Academic Press.
Angiogenesis Inhibitors/pharmacology* ; Angiogenesis Inhibitors/genetics ; Animal ; Chick Embryo ; Chorion/drug effects ; Chorion/blood supply ; Cornea/pathology ; Cornea/drug effects ; Cornea/blood supply* ; Endothelial Growth Factors/pharmacology ; Fibroblast Growth Factor, Basic/pharmacology ; Kringles/genetics ; Lymphokines/pharmacology ; Microscopy/methods ; Neovascularization, Pathologic/drug therapy* ; Plasminogen/pharmacology* ; Plasminogen/genetics* ; Rabbits ; Recombinant Proteins/pharmacology ; Recombinant Proteins/genetics ; Ribonuclease, Pancreatic/pharmacology

PURPOSE: The planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. MATERIALS AND METHODS: As primary input data, the program takes patients' planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were performed in a 10x12x10 cm3 grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans performed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients' plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. RESULTS: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of 2.8% in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip region of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a 3.4% deviation from the TPS plans. CONCLUSION: The accurate validation of complicate treatment plans is possible with the developed software and the quality of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.
Anisotropy ; Axis, Cervical Vertebra ; Brachytherapy* ; Humans

PURPOSE: We evaluated three blood glucose self-monitoring for measuring whole blood glucose levels in preterm and low-birth-weight infants. METHODS: Between December 1, 2012 and March 31, 2013, 230 blood samples were collected from 50 newborns, who weighed, < or =2,300 g or were < or =36 weeks old, in the the neonatal intensive care unit of Eulji University Hospital. Three blood glucose self-monitoring (A: Precision Pcx, Abbott; B: One-Touch Verio, Johnson & Johnson; C: LifeScan SureStep Flexx, Johnson & Johnson) were used for the blood glucose measurements. The results were compared to those obtained using laboratory equipment (D: Advia chemical analyzer, Siemens Healthcare Diagnostics Inc.). RESULTS: The correlation coefficients between laboratory equipment and the three blood glucose self-monitoring (A, B, and C) were found to be 0.888, 0.884, and 0.900, respectively. For glucose levels< or =60 mg/dL, the correlation coefficients were 0.674, 0.687, and 0.679, respectively. For glucose levels>60 mg/dL, the correlation coefficients were 0.822, 0.819, and 0.839, respectively. All correlation coefficients were statistically significant. And the values from the blood glucose self-monitoring were not significantly different from the value of the laboratory equipment , after correcting for each device's average value (P>0.05). When using laboratory equipment (blood glucose < or =60 mg/dL), each device had a sensitivity of 0.458, 0.604, and 0.688 and a specificity of 0.995, 0.989, and 0.989, respectively. CONCLUSION: Significant difference is not found between three blood glucose self-monitoring and laboratory equipment. But correlation between the measured values from blood glucose self-monitoring and laboratory equipment is lower in preterm or low-birth-weight infants than adults.
Adult ; Blood Glucose Self-Monitoring ; Blood Glucose* ; Delivery of Health Care ; Glucose ; Humans ; Hypoglycemia ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Sensitivity and Specificity

PURPOSE: Tumor response of patients with locally advanced rectal cancer after chemoradiation showed 60~70% of tumor volume reduction and T and N downstaging. Curative resection with total mesorectal excision should be followed for good oncologic outcomes. This study was designed to analyze the oncologic outcomes in patients who received preoperative chemoradiation followed by total mesorectal excision for locally advanced rectal cancer according to pathologic T and N stage. METHODS: Total 108 patients with locally advanced rectal cancer treated between 1989 and 2000. All patients were analyzed retrospectively and staged as T3, 4 N (+) by transrectal ultrasonography and pelvic MRI. All patients received a 5, 040 cGy of radiation over 5 weeks and systemic intravenous bolus chemotherapy 5 FU 450 mg/m2 and leucovorin 20 mg/m2 for 5 days was given during first and fifth weeks of radiation treatment, followed four to six weeks later by radical surgery. RESULTS: Among 108 patients there were 74 males and 34 females. Mean age was 54.4 years in male and 52.3 years in female. Mean follow up periods was 41.3 months. Complete follow up was in 96.4% of patients. Curative resection was done in 90 patients (83.3%). The most common type of surgery was low anterior resection in 40 (44.4%) and unresectable patients in 10 (9.3%). Postoperative morbidities were wound infection (n=10, 9.2%), anastomostic leakage (n=2, 1.9%), and anastomotic stricture (n=1, 0.9%). After chemoradiation, tumor stage were as follows: pathologic complete remission was in 7 (6.5%), pT1, T2 N0 (stage I) was in 21 (19.4%), T3N0 (stage II) was in 28 (25.9%) and T3 N (+) (stage III) was in 34 (31.5%). The rate of local recurrence was 10.7% in stage II and 20.6% in stage III. Systemic recurrence was 21.4% in stage II and 47.1% in stage III. 5 year survival rate according to T stage was T0 (100%), T1 (100%), T2 (79.5%), T3 (43.7%), T4 (33.3%) (p=0.0088). According to N stage, N (-)(72.0%) and N (+) (35.7%)(p=0.002). Among T3 patients, 5 year survival rate was N (-)(58.2%) vs. N (+)(32.0%)(P=0.0228). CONCLUSION: Preoperative chemoradiation followed by total mesorectal excision downstaged locally advanced rectal cancer and showed high resectability. Clinical outcomes correlated with pathologic T and N downstaging. Patients who did not show pathologic T and N downstaging showed high local and systemic failure and poor prognosis.
Constriction, Pathologic ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leucovorin ; Magnetic Resonance Imaging ; Male ; Prognosis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden ; Ultrasonography ; Wound Infection

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders. There have been some reports suggesting that directional changing positional nystagmus occurs due to canalolithiasis and cupulolithiasis of the horizontal semicircular canal (HC). The canalolithiasis theory of HC-BPPV is presented with a transient geotropic direction changing horizontal nystagmus as the pathophysiologic mechanism of BPPV. The HC-BPPV cupulolithiasis is characterized by a positional nystagmus that does not fatigue, but persists as long as the position is held, and changes direction in different head positions. There is still a controversy relating to differentiating the lesion side and the otolith adherent sites on the cupula differentiation. The purpose of this study was to differentiate the lesion side and the otolith adherent site on the cupula, and propose a treatment through analyses of clinical features, electronystagmographic (ENG) results, treatment maneuvers and its effectiveness. SUBJECTS AND METHOD: Fifteen patients who showed ageotropic direction changing horizontal nystagmus were included in this study. Supine head turning test was performed to induce positional nystagmus. Various findings of the nystagmus were recorded with ENG. Other ENG tests (visual tracking tests and bithermal caloric test) and magnetic resonance imaging were checked to exclude the possibility of any central lesion. Cupulolith repositioning maneuver (CuRM) was applied on the all patients and these patients were instructed to keep the healthy side at the lateral decubitus position while sleeping. RESULTS: All patients showed significant differences between the intensity of each side nystagmus, and all of them showed stronger ageotropic direction changing horizontal nystagmus when the head was rotated to the unaffected side in a supine head turning test. The nystagmus had a short latency, no fatigability, and persistency in character. Typical nystagmus and spinning sensation in the supine head turning test had completely subsided after physical therapy. CONCLUSION: In the cupulolithiasis of horizontal semicircular canal, ageotropic nystagmus was stronger when the pathological ear was at the uppermost position, and this excitatory nystagmus beats to the lesion side. The proposed CuRM and post-treatment lateral decubitus position kept during the night (while sleeping on the day of treatment) were effective in differentiating the otolith adherent site on the cupula and treating the cupulolithiasis of the horizontal semicircular canal.
Ear ; Fatigue ; Head ; Humans ; Magnetic Resonance Imaging ; Nystagmus, Pathologic ; Nystagmus, Physiologic ; Otolithic Membrane ; Semicircular Canals* ; Vertigo*

BACKGROUND AND OBJECTIVES: For surgery of chronically inflamed submandibular gland, most head and neck surgeons carry out skin incision on the neck, but several clinical problems after surgery has been mentioned. An intraoral approach as an alternative to the standard transcervical approach has been reported. To evaluate a postoperative morbidity in the intraoral approach for excision of submandibular gland. SUBJECTS AND METHODS: A total of 62 surgery cases for chronic submandibular sialoadenitis with or without stone, including those resulting from benign tumor of submandibular gland, were carried out via intraoral approach during a 3-year period. RESULTS: Most patients (85.5%) had sialoadenitis with or without stone. Early postoperative complications developed in 87.1% of the temporary lingual sensory paresis, followed by temporary limitation of tongue movement in 67.7% and 2 cases of postoperative bleeding and 1 case of abscess formation. The tongue paresis resolved spontaneously in all patients in a mean period of 3-4 weeks, whereas late complications developed in 3 cases of residual salivary gland and abnormal sense of mouth floor and one case of gustatory sweating syndrome. No residual inflammation in Wharton's duct was noted. Neurological complications of hypoglossal and marginal mandibular nerves were not observed at all. CONCLUSION: The major advantages of this approach are no external scar, no injury to the marginal mandibular nerve or to the hypoglossal nerve, and no residual Whartons duct inflammation. The disadvantage is a more difficult dissection to transcervical approach before proper expert due to narrow surgical field, especially in the severe adhesion of salivary gland to surrounding tissue. However, with experience, the intraoral dissection of submandibular gland should be easier.
Abscess ; Cicatrix ; Head ; Hemorrhage ; Humans ; Hypoglossal Nerve ; Inflammation ; Mandibular Nerve ; Mouth Floor ; Neck ; Paresis ; Postoperative Complications ; Salivary Ducts ; Salivary Glands ; Sialadenitis ; Skin ; Submandibular Gland* ; Sweating, Gustatory ; Tongue

Purpose: Although many studies have evaluated the association between intestinal microorganisms and the risk of colorectal cancer (CRC), only a few studies have investigated the changes in microorganisms following curative treatment for CRC. The current study analyzed changes in intestinal microbiota following curative surgery in CRC patients. Methods: Stool samples were collected before and 6 months after surgery, from 11 patients with clinical stage III CRC, who underwent curative surgery between May 2017 and June 2017. Next, 16S rRNA gene sequencing was performed. Operational taxonomic units (OTUs) and alpha diversity were evaluated using the Shannon index. The bacterial compositions of the stools were analyzed according to taxonomic rank at genus and phylum levels. Results: OTUs and alpha diversity were significantly decreased following surgery (P < 0.001 and P = 0.019, respectively). The compositions of several bacterial taxa changed after surgery. At genus level, proportions of pathogens such as Campylobacter, Fusobacterium, Haemophilus, Porphyromonas, and Prevotella, decreased after surgery (adjusted P < 0.05). At phylum level, the proportion of Fusobacteria decreased after surgery (adjusted P < 0.001). Conclusion Significant changes in intestinal microbial communities were noted following curative resection of CRC patients. Especially, decreases in pathogenic bacterial populations, such as Fusobacterium and Prevotella, which are known to be associated with CRC development, were detected even though OTUs and alpha diversity were decreased following curative resection. To determine and validate the clinical significance of these findings, large scale, prospective studies that include cancer prognoses are required.

BACKGROUND/AIMS: Tetraploid cells are frequently observed in the inflamed mucosal epithelial cells of the patients with Barrett's esophagus or chronic ulcerative colitis. Polyploidy often occurs during cell fusion, abortive cell cycle, and endoreplication. Most tetraploid cells are engaged to apoptotic pathway, but some remaining stable tetraploid cells consequently cause aneuploidization and chromosomal instability. We investigated whether tetraploid cells could acquire survival advantage and hold a dominant position for natural selection. METHODS: We established tetraploid cell line (HCT116GH) from parental diploid colorectal cancer cell line (HCT116) via PEG-mediated cell fusion and compared its cell viability, cell cycle response and apoptotic fractions responded to H2O2 with diploid HCT116 and p53 suppressed HCT116/H6 cell lines. RESULTS: Using MTT assay, plating efficiency and clonogenicity, we evaluated the survival of each cell line. Tetraploid cell line HCT116GH demonstrated an 83 fold greater resistance to 100 microM H2O2 than the parental diploid HCT116, and 6 fold greater than even the p53 negative diploid HCT116/E6. Cellular sensitivity, G2/M arrests, and apoptotic proportion were observed less in response to H2O2 in HCT116GH compared with HCT116 and HCT116/E6. HCT116GH expressed lower level of p53 and p21 than diploid HCT116. CONCLUSIONS: Stable tetraploid cell lines showed enhanced viability in comparison to parental diploid cell lines. The enhanced viability observed in tetraploidization surpassed that from downregulation of p53. Frequent appearance of tetraploid cells in stressful condition can be caused by natural selection owing to their enhanced viability and may consequently contribute to cancer cell transformation.
Apoptosis ; Cell Division ; Cell Line, Tumor ; Cell Survival ; Chromosomal Instability ; Colonic Neoplasms/*genetics/metabolism ; Cyclin-Dependent Kinase Inhibitor p21/metabolism ; G2 Phase ; Humans ; Hydrogen Peroxide/toxicity ; Oxidative Stress ; *Polyploidy ; Tumor Suppressor Protein p53/metabolism