n-Hexane and benezene are organic compounds which have been widely used as industrial solvents. However, they are also increasingly recognized as important pollutants in working environment. The purpose of this study is to analyze neurotoxicity of benzene and n-Hexane. In this study, tibial nerve of Sprague-Dawley rats were observed after exposing them to two different concentrations of these compounds (6000 ppm of n-Hexane and 2000 ppm of benezene) which were known to be the levels to cause subacute toxicity for the three different periods; two weeks, four weeks, and sex weeks. The following results were obtained from the analysis of variance, Duncan's multiple comparison test, and regression analysis: 1) Myelin sheath thickness of nerve fiber for two n-Hexane exposed groups (four weeks and six weeks) were both reduced compared with the control group and the benezene exposed group. 2) There were positive relationships between nerve fiber diameter and myelin sheath thickness for both exposed and control groups. 3) There were significant difference in myelin sheath thickness from equal diameter nerve fibers between benzene exposed group and control group, but the greater number of thin myelin sheath were observed for n-Hexane exposed group compared with control group. Thus, it is concluded that n-Hexane tends to reduce the rate of growth of nerve fiber more than the benzene and control group. While these results shed light on understanding the effects of benzene and n-Hexane, the duration of exposure was not long enough to apply these results to real working environments. In addition, to further understand the mechanism of nerve degeneration caused by organic solvents, both epidemiological and biochemical studies should accompanied by this kind of study.
Animals ; Benzene* ; Myelin Sheath ; Nerve Degeneration ; Nerve Fibers ; Rats* ; Rats, Sprague-Dawley ; Solvents ; Tibial Nerve*

The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.
Delivery of Health Care ; Surveys and Questionnaires ; Solvents ; Toluene*

A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

PURPOSE: Laparoscopic cholecystectomy has become the standard modality of acute and chronic gallbladder disease. This study was performed to evaluate a change in the indication for laparoscopic cholecystectomy according to period by analyzing our experiences. METHODS: We retrospectively analyzed 2,096 cases of laparoscopic cholecystectomy that were treated at the Department of Surgery, Dong-A University. They were divided into 3 groups from October 1992 to December 1996 (Group 1), from January 1997 to December 2001 (Group 2) and from January 2002 to March 2007 (Group 3). RESULTS: The mean age was 50.14+/-13.89 years and the male-to-female ratio was 1 : 1.23. Previous abdominal surgery was noted in 12.24% from Group 1, 14.96% from Group 2 and 21.48% from Group 3. Chronic cholecystitis was the most common pathologic diagnosis in all cases. However, while the incidence of acute cholecystitis and gallbladder empyema in Group 1 was 3.36% and 0%, that of Group 2 was 12.52% and 3.88% and that of Group 3 was 31.79% and 7.59%, which was increased. The mean operation time of each group was 101.00+/-51.00, 69.86+/-40.55, 78.01+/-45.55 minutes (P<0.05). The conversion rate of each group was nine cases (6.04%), 21 cases (3.02%), and 51 cases (4.07%). The surgical complication rate was 7.38%, 3.88% and 4.71%, respectively. The length of hospital stay was 6.08+/-3.65, 3.16+/-2.99 and 2.91+/-3.34 days, which was significantly decreased (P<0.05). CONCLUSION: As surgical experience increased and laparoscopic surgical skills developed, the indication for laparoscopic cholecystectomy changed. The results of this study showed that laparoscopic cholecystectomy was feasible for the treatment of complicated gallbladder lesion.
Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Gallbladder Diseases ; Incidence ; Length of Stay ; Retrospective Studies

Primary extrapulmonary small cell carcinoma (EPSCC) of the appendix is an extremely rare entity, and there has been only one previous report on this in the English medical literature. We report here on the first Korean case of EPSCC of the appendix in a 55-year-old woman. The patient had no history of an identified pulmonary tumor, and she presented with constipation and lower abdominal pain. The patient underwent right hemicolectomy with regional lymph node dissection and bilateral salphigo-oophorectomy. The histology of the entire appendiceal tumor revealed pure EPSCC with diffuse immunoreactivity for pancytokeratin, cytokeratin 7, cytokeratin 20, CD56, thyroid transcription factor 1, c-kit and carcinoembryonic antigen, and there was focal weak immunoreactivity for chromogranin A and synaptophysin. After the second cycle of chemotherapy, the condition of the patient gradually deteriorated due to cancer peritonei and the patient died 7 months later. EPSCC of the appendix is a distinctive clinicopathological entity that displays highly aggressive behavior and an unfavorable outcome.
Abdominal Pain ; Appendix ; Carcinoembryonic Antigen ; Carcinoma, Small Cell ; Chromogranin A ; Constipation ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Lymph Node Excision ; Middle Aged ; Nuclear Proteins ; Synaptophysin ; Thyroid Gland ; Transcription Factors

PURPOSE: Single-port laparoscopic surgery is a rapidly advancing technique in laparoscopic surgery. However, there is currently limited evidence on the learning curve for this procedure. The aim of this study was to estimate the number of single port laparoscopic cholecystectomies required until improvement in the performance of the technique ceases. METHODS: This is a descriptive, single-center study using routinely collected clinical data from 70 patients who underwent single port laparoscopic cholecystectomy between May 2009 and June 2010 at Dong-A University Medical Center in Busan, Korea. The review includes the mean operating time, conversion cases, intra-operative GB perforation, post-operative wound infection and mean hospital stay. RESULTS: The mean operating time of the first 30 cases (the learning period) was 91.83 minutes. After 30 operations (the experience period), it plateaued to an average of 75.25 minutes, which remained steady in the next 40 operations - a reduction of more than 16%. Reduction in the operating time was significant (P<0.001) between the learning period and the experience period. Other factors including additional ports, intraoperative gall bladder perforation, mean hospital stay, post-operative wound infection were not significantly different between the two periods. CONCLUSION: We suggest that the learning curve for single port laparoscopic cholecystectomy should be around thirty cases for a surgeon with prior conventional laparoscopic cholecystectomy experience and for self-taught single port technique.
Academic Medical Centers ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Humans ; Korea ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Urinary Bladder ; Wound Infection

Atrial fibrillation is a major cardiac cause of stroke, and a pathogenesis involving thrombus formation in patients with atrial fibrillation is well established. A strategy for rhythm control that involves catheter ablation and anticoagulation therapy is evolving. A strategy for rhythm control that restores and maintains sinus rhythm should reduce the risk of ischemic stroke that is associated with atrial fibrillation; however, this is yet to be proven in large-scale randomized controlled trials. This paper reviews the emerging role of rhythm control therapy for atrial fibrillation to prevent stroke.
Atrial Fibrillation* ; Catheter Ablation ; Humans ; Stroke* ; Thromboembolism ; Thrombosis

No abstract available.
Management Information Systems* ; Occupational Health Services* ; Occupational Health*

In an attempt to assess the effect of occlusion to improvement of visual acuity, we analyzed data from 55 patients with strabismic amblyopia(mean; 5.5 years old) who received strabismus surgery with occlusion(combined therapy) or surgery only. The results were as follows: 1. The younger the patients at onset, the better the visual acuity obtained. The improvement in visual acuity was higher in 27 of 32 cases(84.4%) with the combined therapy than in 5 of 18 cases(27.8%) who underwent surgery only, and the difference between those two groups was significant statistically(p<0.05). 2. In exotropes, improvement of visual acuity was shown in 19 of 32 cases(59.3%) and there was no significant difference in the improvement of visual acuity between the intermittent and constant types. 3. In 23 esotropes, 18 patients(78.3%) showed the improvement of visual acuity; 13 of 16 cases in infantile esotropia and all of 7 cases in acquired one. 4. In the final results of surgery, the alignment was satisfactory in 50 of 55 cases(90.9%), showing less than 10 prism diopters. From the results of our study, we confirmed that the occlusion during pre-and postoperative periods is the effective therapy to treat amblyopia in the children with strabismic amblyopia, and its importance was reported.
Amblyopia* ; Child ; Esotropia ; Humans ; Postoperative Period ; Strabismus ; Visual Acuity*

BACKGROUND: As the elderly population grows and increasing average life expectancy, medical needs and utilization by elderly people are rapid increase in recent years. It is thus essential that elderly people are included in clinical studies. There are also needed the standardization of age grouping and guideline of the elderly for the purpose of relative review between studies. And a study must include what age was used as a cut off value. So we set out to discover age grouping, cut off ages and guideline age of the elderly in two major Korean medical journals. METHODS: We examined all original research papers in all the issues of the Korean Journal of Medicine (KJM), and the Journal of The Korean Surgical Society (JKSS) between January 1995 and December 1997. We excluded animal works and papers concerned with special age (children, soldiers). Of the remaining 931 (386 KJM/545 JKSS) papers, we reviewed how many papers included elderly people in them, age grouping and regularity, age group intervals, cut off age, and of the specific to the elderly papers, what age was used as guideline age of the elderly. RESULTS: Of the reviewed 931 papers, included above 60-year were 701 (75.3%), excluded were 166 (17.8%), and no age limit was set in 64 (6.9%) papers. Of the 701 papers that included above 60 years, no age grouping were 349 (49.8%), and 352 (50.2%) had age grouping. Among them, 341 papers used regular intervals, while 11 papers used irregular intervals. Of the 341 regular age interval papers, five year interval were 4, ten year were 322, fifteen year were 2, and twenty year were 13. The cut off age as a specific value were 118, and cut off as a group of ages were 223. Ten papers were specifically about elderly people. Of these papers, the guidelines of the elderly were 60-year in 6, and 65-year in 4 papers. CONCLUSION: Many Korean medical papers included above 60-year people. But near half of them had no age grouping, and no age limit sets were 6.9%. And there were mixed use of 60 and 65 years for guideline of the elderly. So more elderly people should be included in future clinical studies. The standardization of age grouping and guideline of the elderly are also needed.
Aged* ; Animals ; Humans ; Life Expectancy