PURPOSE: This was a study on the expiration date of Ethylene Oxide (EO) gas sterilization and effects of the environmental factors of temperature, humidity and type of cabinet in sterile goods storage area on the expiration date. METHODS: Sterile goods storage areas from 13 departments in one hospital were selected and 455 EO gas sterilization samples were prepared and kept in those areas over the 14 months of the study. Each sample was tested with a microbiological culture in the laboratory every week. If the result was positive, the sample was regarded as contaminated. The researcher visited once a month to check the temperature, humidity and type of cabinet. RESULTS: With the exception of 1 sample which was positive at 56th week. 454 samples were confirmed as negative. The environment of the samples storage area was measured monthly. The annual average temperature was 24.2+/-1.6degrees C, and the mean relative humidity 34.7+/-15.2%. The types of cabinet were 7 open and 6 closed. CONCLUSION: The results of the microbiological culture at 13 months showed that none of the samples were contaminated. Therefore the hospital's existing Expiration Date can be extended from 6 months to 13~14 months.
Equipment Contamination ; Ethylene Oxide* ; Humidity ; Sterilization*

OBJECTIVE: To evaluate working condition in way of measuring working posture and muscle tension using the desktop personal computer and notebook personal computer having different screen height. METHOD: Seventeen healthy men performed wordprocessing task in three workstation: desktop PC on the conventional computer table (DPC (on)); desktop PC under the 'inside' type computer table (DPC (under)); notebook PC on the table (NPC). The viewing distance and angle, head and neck angle, thoracic bending and trunk inclination were measured. Muscle tension of right posterior neck muscle, upper trapezius, sternocleidomastoid (SCM), and upper back muscle was also measured by integrated electromyogram (IEMG). RESULTS: 1) The viewing distance was the longest in DPC (under). 2) The lower the screen height, the more downward viewing angle and more flexed position in upper neck. 3) The posterior neck muscle tension was the lowest in DPC (on). 4) Stooped position was most frequently seen in NPC and the highest tension of posterior neck muscle and upper back muscle was shown in NPC. 5) In relation between postural analysis and muscle tension, muscle tension decreased with increasing backward reclining position, and the neck and thorax became more erect with increasing in viewing distance. CONCLUSION: These results suggest that the stooped posture was worst and most frequently seen in NPC. If neck flexion is avoided, DPC (under) position could lessen the visual and musculoskeletal problem. More Ergonomical study would be needed about working posture using computer.
Back Muscles ; Head ; Humans ; Male ; Microcomputers ; Muscle Tonus* ; Neck ; Neck Muscles ; Posture* ; Superficial Back Muscles ; Thorax

Lymphocytic hypophysitis, an inflammatory disease of the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse inflammatory cell infiltration of the pituitary gland and some kinds of detectable autoantibodies. We report a case of lymphocytic hypophysitis in a 31-year-old woman presenting with severe hypoglycemia and hyponatremia after delivery. Hormonal study revealed panhypopituitarism and magnetic resonance imaging with enhancement showed the bulging contour of the right side pituitary gland with an ill-defined mass-like lesion and nodular thickening of the stalk. The patient's symptoms and biochemical data improved greatly with replacement of L-thyroxine and glucocorticoid. Partial recovery of panhypopituitarism was also seen. The follow-up tests revealed dramatic resolution of the pituitary lesion.
Adult ; Autoantibodies ; Female ; Follow-Up Studies ; Humans ; Hypoglycemia* ; Hyponatremia ; Hypopituitarism ; Magnetic Resonance Imaging ; Pituitary Gland ; Pregnancy ; Thyroxine

Purpose: To investigate the 5-year outcome of dental implants placed in a grafted maxillary sinus using recombinant human bone morphogenetic protein-2 (rhBMP-2). Materials and Methods: We retrospectively analyzed 27 implants after maxillary sinus floor augmentation (MSFA) using rhBMP-2 in 16 patients between January 2016 and March 2017. The study evaluated two outcome variables: (1) 5-year cumulative survival and success rate of the implant after functional loading and (2) marginal bone loss (MBL) for implant failure. Results: The average residual bone height was 4.78±1.53 mm. The healing period before loading was 8.35±2.34 months. The crown-to-implant ratio was 1.31±0.26. The 5-year cumulative survival and success rate after functional loading were 100% and 96.3%, respectively. The 5-year average MLB was 0.89±0.82 mm. Conclusion Placing dental implants with MSFA using rhBMP-2 is a reliable procedure with favorable long-term survival and success rates.

For the purpose of providing the basic data for health management of workers who are exposed to chromium and for improving the quality of working environment, the authors evaluated blood and urinary level of chromium, the occupational history, AST, ALT, Hb, Hct, nasal specular examination on 287 workers who have been dealed chromium compounds in 56 manufacturing industries of five types, that is, 38 metal plating services(plating), 4 manufacture of other fabricated metal products (fabricated metal product), 5 manufacturing of dyestuff(dyestuff), 6 dressing and dyeing of leather (leather), 3 others (manufacture of pottery and ceramic household wares, motor vehicles, electronic valves and tubes and other electronic components) and also measured the level of chromium in air from February to october 1993. The results were as follows; 1. The utilized type of chromium compounds was the hexavalent state in plating, fabricated metal product, dyestuff leather and the trivalent state in other, and atmospheric chromium concentration as geometric mean was 0.0138m3(0.001~0.068 mg/m3) in plating, 0.0115 mg/m3(0.006~0.015 mg/m3) in fabricated metal product, 0.068 mg/m3 (0.002~0.019 mg/m3)in dyestuff, 0.0083 mg/m3(0.002~0.028 mg/m3) in leather, 0.0039 mg/m3(0.003~0.005 mg/m3) in other by the type of industry and it exceeded TLV-TWA (0.05 mg/m3) in five(13.6%) of plating services. 2. The geometric mean of chromium in blood was 1.54 microgram/dl(0.10~3.62 microgram/dl) in planting, 0.94 microgram/dl(0.27~2.82 microgram/dl) in fabricated metal product, 0.51 microgram/dl(0.10~3.25 microgram/dl) in dyestuff, 0.87 microgram/dl(0.15~8.00 microgram/dl) in leather 0.55 microgram/dl(0.20~2.28 microgram/dl) in other by the type of industry(P<0.001). 3. The geometric mean of chromiurn in urine was 14.47 microgram/l(6.90~28.00 microgram/l) in planting, 4.63 microgram/l(0.24~43.00 microgram/l) in fabricated metal product, 5.93 microgram/l(1.00~33.00 microgram/l) in dyestuff. 11.09 microgram/l(0.80~48.00 microgram/l) in leather, 12.41 microgram/l(10.10~41.00 microgram/l) in other by the type of industry(P<0.001). 4 As the result of nasal specular examination, twenty four cases(8.4%) of nasal septal perforation among 287 total subjects was observed, and there were 17(9.7%) cases in plating, 4 cases(14.3%) in dressing and dyeing of leather. In the comparison of chromium concentration in blood and urine between the perforated group and nonperforated group the perforated group showed a significantly higher value as 1.883+/-3.055 microgram/dl and 0.793+/-0.815 microgram/dl(P<0.001). 21.31+/-34.610 microgram/L and 9.304+/-11.079 microgram/L(P<0.001). 5. The mean concentration of chromium in blood, urine and the mean level of AST, ALT, Hb and Hct in exposure group were higher than those of control group(P<0.001).
Bandages ; Ceramics ; Chromium Compounds ; Chromium* ; Electroplating ; Family Characteristics ; Motor Vehicles ; Nasal Septal Perforation ; Plants ; Threshold Limit Values

BACKGROUND: Invasive aspergillosis (IA) is associated with high morbidity and mortality, particularly among immunocompromised patients, such as lung transplant recipients. Voriconazole, the first-line therapy for IA, shows a non-linear pharmacokinetic profile and has a narrow therapeutic range. Careful and appropriate administration is necessary, primarily because it is used for critically ill patients; however, the clinical usefulness of therapeutic drug monitoring (TDM) has not been sufficiently verified. Therefore, in this study, we validated the safety and efficacy of voriconazole TDM in lung transplant recipients receiving only voriconazole for IA treatment. METHODS: The electronic medical records of lung transplant recipients (≥19 years of age) administered only voriconazole for > 7 days for treatment of IA from June 1, 2013 to May 31, 2018 were analyzed retrospectively. RESULTS: Among the 54 patients, 27 each were allocated to TDM and non-TDM groups, respectively. There were no significant differences in patient characteristics between the two groups except for ICU-hospitalization status. Of the TDM group patients, 81.5% needed adjustment of voriconazole dosage because the levels were out of target range. Comparison of two groups showed that treatment response was higher throughout treatment and switching rates of second-line agents were significantly lower in the TDM group, but it was insufficient to confirm safety improvements through voriconazole TDM. CONCLUSION: Considering that the treatment response tended to be higher and the rates of switching to second-line antifungal agents were lower in the TDM group, voriconazole TDM may increase the therapeutic effect on IA in lung transplant patients.
Antifungal Agents ; Aspergillosis ; Critical Illness ; Drug Monitoring ; Electronic Health Records ; Humans ; Immunocompromised Host ; Lung Transplantation ; Lung ; Mortality ; Retrospective Studies ; Transplant Recipients ; Voriconazole

Numerous studies have shown that adenosine or adenosine agonists can stimulate angiogenesis. However, the effect of caffeine (a known adenosine receptor antagonist) on angiogenesis has not been previously studied. Accordingly, this study was undertaken to examine the effect of caffeine on angiogenesis and to clarify the mechanism involved. Chick chorioallantoic membrane assays were used to investigate the effect of caffeine on angiogenesis and proliferation assays using human umbilical vein endothelial cells (HUVECs), were used to study its effects on specific aspects of angiogenesis. The expressions of caspase-3 and Bcl-2 were examined by western blotting, immunofluorescence staining was used to identify HUVEC morphological changes, and fluorescence activated cell sorting (FACS) and DAPI staining were used to detect HUVEC apoptosis. Caffeine was found to inhibit blood vessel formation dose-dependently and to inhibit the proliferation of HUVECs time- and dose-dependently. FACS analysis and DAPI staining showed that inhibitory effect of caffeine on HUVEC proliferation was the result of apoptosis and the up-regulation of thrombospondin-1 (TSP-1). Furthermore, TSP-1 levels were down-regulated by NECA but were unaffected by CGS21680, indicating that caffeine regulated TSP-1 expression via adenosine A2B receptor. In addition, caffeine up-regulated caspase-3 and down-regulated Bcl-2 at the protein level. These results suggest that the inhibitory effect of caffeine on angiogenesis is associated, at least in part, with its induction of endothelial cell apoptosis, probably mediated by a caspase-3 dependent mechanism.
Adenosine ; Adenosine-5'-(N-ethylcarboxamide) ; Apoptosis ; Blood Vessels ; Blotting, Western ; Caffeine ; Caspase 3 ; Chorioallantoic Membrane ; Endothelial Cells ; Flow Cytometry ; Fluorescent Antibody Technique ; Glycosaminoglycans ; Human Umbilical Vein Endothelial Cells ; Indoles ; Phenethylamines ; Receptor, Adenosine A2B ; Receptors, Purinergic P1 ; Thrombospondin 1 ; Up-Regulation

BACKGROUND: Tracheal intubation causes a reflex tracheal constriction that leads to increased airway resistance. Inhalation anesthetics can prevent or minimize this response. Therefore, this study was conducted to evaluate the effect of 1 MAC sevoflurane or desflurane on respiratory mechanics in children after anesthetic induction using propofol and tracheal intubation. METHODS: Sixty children undergoing elective surgery with tracheal intubation were assigned into two groups at random, a 1 MAC concentration of sevoflurane (n = 30) and a desflurane (n = 30) group. Anesthesia was induced using propofol (1.5 mg/kg) and tracheal intubation was facilitated using rocuronium (0.6 mg/kg). A respiratory profile monitor was used to measure the respiratory resistance, dynamic compliance and peak inspiratory airway pressure. The measurements were made at three time points, after three inspirations from the beginning of mechanical ventilation (baseline) and at 5 and 10 min after the administration of inhalation anesthetics. RESULTS: Sevoflurane and desflurane led to a significant decrease in respiratory resistance and increased dynamic compliance at 5 and 10 min when compared to baseline. There were no significant differences in respiratory resistance and dynamic compliance between the two groups. CONCLUSIONS: A 1 MAC concentration of sevoflurane and desflurane has a similar bronchodilatory effect after tracheal intubation in children.
Airway Resistance ; Androstanols ; Anesthesia ; Anesthetics, Inhalation ; Child ; Compliance ; Constriction ; Humans ; Intubation ; Isoflurane ; Methyl Ethers ; Organothiophosphorus Compounds ; Propofol ; Reflex ; Respiration, Artificial ; Respiratory Mechanics

Background: Anemia is a common complication of chronic kidney disease (CKD). In patients with CKD-related anemia, an inverse relationship between vitamin D and hepcidin levels has been observed. Hepcidin is a key regulator of iron homeostasis, mediated via binding to ferroportin. The aim of this study was to investigate the effects of cholecalciferol and omega-3 fatty acids (FA) on hepcidin levels using 5/6 nephrectomized (Nx) rats. Methods: Male Sprague-Dawley rats were divided into five groups: sham control, 5/6 Nx, 5/6 Nx treated with cholecalciferol, 5/6 Nx treated with omega-3 FA, and 5/6 Nx treated with both cholecalciferol and omega-3 FA. We measured the hepcidin and ferroportin levels in the kidney and liver by enzyme-linked immunosorbent assays and Western blots. We evaluated hepcidin expression in the kidney by immunohistochemical staining. Results: Among the five groups, 5/6 Nx rats exhibited the worst kidney function. Compared with the sham controls, 5/6 Nx rats showed significantly increased serum hepcidin levels and decreased vitamin D levels. Supplementation with either omega-3 FA or cholecalciferol decreased hepcidin and increased vitamin D levels, with a concurrent improvement of anemia. Furthermore, 5/6 Nx rats treated with omega-3 FA/cholecalciferol showed decreased ferroportin and ferritin levels, while iron and total iron-binding capacity levels increased. Conclusions Treatment with a combination of cholecalciferol and omega-3 FA may improve anemia in a CKD rat model by decreasing hepcidin levels.

The shape of the maxillary anterior teeth is an essential factor in esthetics because this region is prominently exposed during conversations and smiles, significantly influencing one’s impression. Moreover, the form and color of the gingiva in the anterior teeth play a vital role in determining esthetics. Therefore, various factors should be considered when improving the esthetics of the maxillary anterior teeth. This report is aimed at introducing the use of digital devices and software to analyze various factors, determining the amount of gingival and alveolar bone resection in a patient with esthetically unpleasing maxillary anterior teeth due to a gummy smile or gingival asymmetry. Furthermore, this study describes the method for creating a digital surgical guide using CAD software for esthetic crown lengthening and reports on the achieved esthetic improvements.