BACKGROUND: Lead (Pb), mercury (Hg), and cadmium (Cd) are well-known environmental pollutants. They are unnecessary in the biological processes of humans. This study was performed to estimate the representative background exposure levels to the metals by measuring concentrations in whole blood of the Korean general population. METHODS: This population-based cross-sectional study included 4,000 subjects (1,886 males and 2,114 females) 0–83 years of age in 2010 and 2011. Adult subjects (≥ 19 years of age) were collected by sex- and age-stratified probability method, and preschool- and school-aged subjects were recruited by a cluster sampling method. Written consent was provided prior to blood sampling. Pb and Cd blood concentrations were determined by a flameless atomic absorption spectrophotometry, and blood Hg was analyzed by a direct Hg analyzer. RESULTS: The geometric mean, median and 95th percentile of blood Pb was 1.82 µg/dL, 1.83 µg/dL, and 3.78 µg/dL, respectively. The respective values were 2.92 µg/L, 2.87 µg/L, 9.12 µg/L for Hg, and 0.56 µg/L, 0.59 µg/L, 2.20 µg/L for Cd. Blood Pb and Hg were higher in males than in females, but no sex difference was observed, respectively, in subjects 0–4 years of age for Pb and in subjects less than 20 years for Hg. However, blood Cd was higher in females than in males and no sex difference was observed in subjects < 30 years of age. CONCLUSION: This study provides representative data of human exposure to Pb, Hg, and Cd covering whole age groups of the general population in Korea.
Adult ; Biological Processes ; Cadmium ; Cross-Sectional Studies ; Environmental Pollutants ; Female ; Humans ; Korea ; Male ; Metals ; Methods ; Sex Characteristics ; Spectrophotometry, Atomic

Colorectal cancer is the third most common cancer in Korea; it is the second most common cancer in men and the third most common in women. The incidence rate in Korea has continuously increased since 1999 when the National Cancer Registry statistics began. Currently; there are several screening modalities; that have been recommended by expert societies, including fecal occult blood test, colonoscopy, computed tomographic colonography The annual fecal immunochemical test (FIT) has been used in adults aged 50 and older as part of the National Cancer Screening Program in Korea since 2004. Although several study results from regional or national colorectal cancer screening programs in other countries have been reported, the National Cancer Screening Program in Korea has not yet been evaluated with evidence-based methods. Herein report the consensus statements on the National Screening Guideline for colorectal cancer developed by a multi-society expert committee in Korea, as follows: 1) We recommend annual or biennial FIT for screening for colorectal cancer in asymptomatic adults, beginning at 45 years of age and continuing until 80 years (recommendation B). 2) There is no evidence for the risks or benefits of FIT in adults older than 80 years (recommendation I). 3) Selective use of colonoscopy for colorectal cancer screening is recommended, taking into consideration individual preference and the risk of colorectal cancer (recommendation C). 4) There is no evidence for the risks or benefits of double-contrast barium enema for colorectal cancer screening in asymptomatic adults (recommendation I). 5) There is no evidence for the risks or benefits of computed tomographic colonography for colorectal cancer screening in asymptomatic adults (recommendation I).
Adult ; Barium ; Colonography, Computed Tomographic ; Colonoscopy ; Colorectal Neoplasms* ; Consensus ; Early Detection of Cancer ; Enema ; Female ; Humans ; Incidence ; Korea ; Male ; Mass Screening* ; Occult Blood

OBJECTIVE: The purpose of this study was to differentiate true progression from pseudoprogression of glioblastomas treated with concurrent chemoradiotherapy (CCRT) with temozolomide (TMZ) by using histogram analysis of apparent diffusion coefficient (ADC) and normalized cerebral blood volume (nCBV) maps. MATERIALS AND METHODS: Twenty patients with histopathologically proven glioblastoma who had received CCRT with TMZ underwent perfusion-weighted imaging and diffusion-weighted imaging (b = 0, 1000 sec/mm2). The corresponding nCBV and ADC maps for the newly visible, entirely enhancing lesions were calculated after the completion of CCRT with TMZ. Two observers independently measured the histogram parameters of the nCBV and ADC maps. The histogram parameters between the true progression group (n = 10) and the pseudoprogression group (n = 10) were compared by use of an unpaired Student's t test and subsequent multivariable stepwise logistic regression analysis to determine the best predictors for the differential diagnosis between the two groups. Receiver operating characteristic analysis was employed to determine the best cutoff values for the histogram parameters that proved to be significant predictors for differentiating true progression from pseudoprogression. Intraclass correlation coefficient was used to determine the level of inter-observer reliability for the histogram parameters. RESULTS: The 5th percentile value (C5) of the cumulative ADC histograms was a significant predictor for the differential diagnosis between true progression and pseudoprogression (p = 0.044 for observer 1; p = 0.011 for observer 2). Optimal cutoff values of 892 x 10-6 mm2/sec for observer 1 and 907 x 10-6 mm2/sec for observer 2 could help differentiate between the two groups with a sensitivity of 90% and 80%, respectively, a specificity of 90% and 80%, respectively, and an area under the curve of 0.880 and 0.840, respectively. There was no other significant differentiating parameter on the nCBV histograms. Inter-observer reliability was excellent or good for all histogram parameters (intraclass correlation coefficient range: 0.70-0.99). CONCLUSION: The C5 of the cumulative ADC histogram can be a promising parameter for the differentiation of true progression from pseudoprogression of newly visible, entirely enhancing lesions after CCRT with TMZ for glioblastomas.
Adult ; Aged ; Brain Neoplasms/*pathology/physiopathology/therapy ; Cerebrovascular Circulation/*physiology ; Combined Modality Therapy ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging/*methods ; Disease Progression ; Female ; Glioblastoma/*pathology/physiopathology/therapy ; Humans ; Male ; Middle Aged ; Prognosis ; ROC Curve ; *Regional Blood Flow ; Reproducibility of Results ; Retrospective Studies

The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).
Humans ; Incisor ; Osseointegration ; Survival Rate

PURPOSE: A colorectal carcinoma is the fourth most common malignancy in the world. Unfortunately, only approximately 20% of the liver metastases are resectable at the initial presentation. Neoadjuvant chemotherapy has been used for downsizing in unresectable disease. In addition, the use of newer biologic agents, such as cetuximab and bevacizumab, has much improved responses in patients with unresectable colorectal liver metastases. The aim of this study was to report on patients who had received a curative resection following neoadjuvant chemotherapy including a molecularly targeted agent for unresectable colorectal liver metastases. METHODS: Following the neoadjuvant chemotherapy using cetuximab plus FOLFIRI (irinotecan and infused fluorouracil plus leucovorin) or bevacizumab plus FOLFOX (oxaliplatin and infused fluorouracil plus leucovorin), 10 patients with initially unresectable colorectal liver metastases underwent a curative surgical resection between September 2005 and June 2007. RESULTS: One patient underwent a right lobectomy, three patients a segmentectomy and five a wedge resection with or without radiofrequency ablation. With a median postoperative follow-up of 14 months (range, 1 to 22 months), five recurrences (50%) occurred. The common toxic effects were grade 2/3 skin toxicity (60%), grade 4 hematologic toxicity (20%), grade 3 gastrointestinal toxicity (10%), and grade 3 neurologic toxicity (10%). CONCLUSIONS: Our preliminary data suggests that neoadjuvant chemotherapy including a molecularly targeted agent may improve resectability in patients with initially unresectable colorectal liver metastases although a high recurrence rate exists. Randomized prospective studies comparing neoadjuvant chemotherapy including a targeted agent in cases of unresectable colorectal liver metastases are warranted.
Antibodies, Monoclonal, Humanized ; Bevacizumab ; Cetuximab ; Colorectal Neoplasms ; Fluorouracil ; Follow-Up Studies ; Humans ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Recurrence ; Skin

Ischemic optic neuropathy may occur in giant cell arteritis, hypertension, diabetes mellitus, atherosclerosis, various hematologic diseases, and rarely after sirgery. We performed tonometer, indirect ophthalmoscopy, fluorescein angiography(FAG), and visual evoked potential(VEP)on a 54-year-old malle who complained visual disturbance(visual acuity: finger count 30cm, OS) after gerneal anesthesia with prone position for ankylosing spondylitis corrective surgery. The aptient was diagnosed as ischemic optic neuropathy, and followed up for 10 months. It is mainly caused by ocular compression during operation and we should keep the patient`s eye uncompressed during prone position surgery.
Anesthesia ; Anesthesia, General* ; Atherosclerosis ; Diabetes Mellitus ; Fingers ; Fluorescein ; Giant Cell Arteritis ; Hematologic Diseases ; Humans ; Hypertension ; Middle Aged ; Ophthalmoscopy ; Optic Neuropathy, Ischemic* ; Prone Position* ; Spondylitis, Ankylosing

Cerebral infarction is caused by decreased perfusion to the brain. In the evaluation of the infarction, CT has been widely used but MRI ans SPECT recently tend to increase in use. The purpose of this study is to compare the efficacy of MR imaging with that of 99mTc-hexamethylpropylene amine(HMPAO) single photon emission computed tomography(SPECT) in the patients with cerebral infarction in the points of (1) number of detected lesion, (2) size of the lesion, and (3) correlation with clinical neurologic deficits. Sixty-one patients with cerebral infarctions(acute: 23, subacute:30, chronic:8) were reviewed. In all patients, MRI and corresponding 99mTc-HMPAO SPECT examinations were performed within a reasonable time span. We analyzed the fiadings of (1) clinical neurologic examination, (2) MR and, (3) Tc-99m-HMPAO SPECT independently they were compared later on. The lesion of SPECT was larger than the seen on MRI in 9 of 23 acute cases, 13 of 30 subacute cases, and 3 of 8 chronic cases. The lesion on MRI was larger than that on SPECT in seven acute cases, six subacute, and only one case in chronic stage. In the remaining cases, the size of the lesion was similar to that on both SPECT and MRI. For the detection of lesion, MRI was superior to SPECT in 15 acute cases, 13 subacute cases, and four chronic cases, while SPECT was super or to MRI in four of 30 cases at subacute stage, and one of 8 cases at chronic stage. In conclusion, there was a tendency that the detection rate of the lesion was higher on MRI but the lesion was larger on SPECT. The lesions detected on both MRI and SPECT correlated well with clinical symptoms.
Brain ; Cerebral Infarction* ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Neurologic Examination ; Neurologic Manifestations ; Perfusion ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Humans

Percutaneous transhepatic cholangiography(PTC) is of value in differential diagnosis of cholestatic diseases. Authors had performed PTC in 120 patients with flexible needle of 23 gauge at the Department of Radiology, KangNam St, Mary's Hospital and Myung Dong St. Mary's Hospital during the period from Jan. 1976 to April 1980. PTC was accomplished successfully in 112 of 120 patients. Diagnoses included cholangiocarcinomas (27 cases), arcinomas ofpancreas head (21 cases), ampullary carcinomas (4 cases), metastatic carcinomas(4 cases), metastatic carcinomas (5cases), bile duct stones(27 cases), sclerosing cholangitis(6 cases), hepatitis(6 cases), liver cirrhosis(6 cases), post operative adhesions(5 cases), chronic pancreatitis(3 cases), stomach carcinomas(3 cases), clonorchiasis(2cases), blood clot (1 case), and remaining normal 4 cases. Some characteristic PTC findings were (1) segmentalannular narrowing and abrupt complete obstruction and polypoid filling defects of the bile duct incholangiocarcinoma, (2) typical nipple or rat-tail appearance of the distal commmon bile duct in pancreatic headcarcinoma, (3) single or multiple sharply and smoothly outlined filling defects whthin bile duct in all cases ofstones, (4) complete obstruction with shallow concavity in ampullary carcinoma, (5) diffuse or segmental narrowingof the intrahepatic bile duct and common bile duct in sclerosing cholangitis, (6) multiple tiny polypoid fillingdefects of gallbladder, common hepatic duct, and common bile duct in clonorchiasis, (7) normal appearance inhepatitis. The overall diagnostic accuracy of PTC in 66 operated cases was 89.4%, and complications following the examination were signficantly reduced by using a fine flexible needle(23 gauge). From the present study it is concluded as follows; 1. To evaluate obstructed or stenosed site accurately, aspiration of bile juice must bepreceded by a 23 gauge needle connected to either 10mo or 5ml syringe. 2. To diagose carcinoma of hte ampullaryportion, serial spot filmings were indispensible ot demonstrated modified appearance of obstructive lesions due tocontraction of Oddi sphincter. 3. In contrast to other reports, the most common site of cholangiocarcinomas wasthe common hepatic duct (12 of 27 cases) in our series. Rat-tail appearance was seen in both pancreatic headcarcinoma and carcinoma involving the distal end of the common bile duct. 4. PTC was a more valuable method for diagnosis of clonorchiasis.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangiography ; Cholangitis, Sclerosing ; Clonorchiasis ; Common Bile Duct ; Diagnosis ; Diagnosis, Differential ; Gallbladder ; Head ; Hepatic Duct, Common ; Humans ; Liver ; Methods ; Needles ; Nipples ; Sphincter of Oddi ; Stomach ; Syringes

The permeability of rabbit corneal endothelium stored at 4 degrees C in M-K medium for period of 3, 5, 9 and 14 days to radioactive sucrose(molecular weight 360), inulin (molecular weight 5,200), and dextran (morecular weight 82,400) was measured. The corneal endothelium stored in M-K medium up to 14 days was examined with light and electron microscope. The endothelial permeability to non-electrolytes was decreased according to the molecular weight of these increased. The permeability of fresh cornea to suerose was about 4 times greater than to inulin and 50 times than to dextran, but in M-K medium stored groups the permeability to sucrose was about 2.5 times greater than to inulin and 36 times than to dextran. The permeability of M-K medium preserved cornea for 14 days was significantly different from that of fresh corneal endothelium. The light and electron microscopic findings of 3, 5 and 9 days stored corneal endothelium were almost normal except of early changes of mitochondria, but in the 14 days-stored groups there were marked degenerative change of cytoplasm and nucleus were noted.
Cornea ; Cytoplasm ; Dextrans ; Endothelium, Corneal* ; Inulin ; Mitochondria ; Molecular Weight ; Permeability* ; Sucrose