Acute pancreatitis is one of the most common diseases of the pancreas. Although the incidence of acute pancreatitis is increasing, the mortality is decreasing. In general, most of fatal cases occur within 2 weeks after admission due to multi-organ failure. Initial medical treatment of acute pancreatitis is important in order to improve the prognosis of the patients with acute pancreatitis. Essential treatment in this early period includes intravenous hydration, paint control, enteral nutrition, and antimicrobial therapy. Although aggressive intravenous hydration with lactated Ringer's solution can improve mortality rates and decrease the development of systemic inflammatory response syndrome in the patients with acute pancreatitis, fluid overload can induce pulmonary edema, increase of the extra-pancreatic fluid collection, intra-abdominal compartment syndrome, sepsis, and increase of the mortality. Therefore, goal-directed therapy, utilizing various parameters to guide fluid administration, reduces the risk of persistent single or multiple organ system failure, infected pancreatic necrosis or mortality from acute pancreatitis. Initiation of early oral feeding is recommended, beginning within 24 hours for mild acute pancreatitis. Enteral nutritional support is favored over parental nutrition in severe acute pancreatitis. Recent guidelines do not support the use of prophylactic antibiotics to prevent infection in necrotizing acute pancreatitis and severe acute pancreatitis.
Anti-Bacterial Agents ; Compartment Syndromes ; Enteral Nutrition ; Humans ; Incidence ; Mortality ; Necrosis ; Nutritional Support ; Paint ; Pancreas ; Pancreatitis ; Parents ; Prognosis ; Pulmonary Edema ; Sepsis ; Systemic Inflammatory Response Syndrome

BACKGROUND: In the construction industry, maintaining health and safety of workers often challenging. Among the workers at construction sites, painters are at particular risk of respiratory diseases and neurotoxicity. However, in Korea there is weak enforcement of workers' health and safety practices in the construction industry in Korea. Poisonings frequently occur at (semi)closed construction sites. In this study, we report a case of acute organic solvent poisoning during construction site painting. CASE PRESENTATION: A 71-year-old man was found unconscious at a construction site and immediately transferred to the emergency room. The consciousness level was 'stupor state' and the body temperature was hypothermic, at 32 degrees (Celsius). There were no acute brain or cardiac lesions that would have accounted for the faintness. In addition, blood and urine tests did not indicate a cause of loss of consciousness. He had been painting epoxy to waterproof the basement floor before fainting. According to exposure simulation, the patient was overexposed to various organic solvents, such as approximately 316–624 ppm toluene during the work before fainting. Considering the ventilation status of the workplace and the status of no protection, it is considered that exposure through the respiratory tract was considerable. CONCLUSIONS: The patient in this case lost consciousness during the epoxy coating in a semi-enclosed space. It can be judged as a result of acute poisoning caused by organic solvent exposure and considered to be highly related to work environment.
Aged ; Body Temperature ; Brain ; Consciousness ; Construction Industry ; Emergency Service, Hospital ; Humans ; Korea ; Occupational Diseases ; Paint ; Paintings ; Poisoning ; Respiratory System ; Solvents ; Syncope ; Toluene ; Unconsciousness ; Ventilation

paint removers. Unlike inhalation injury, contact injury caused by dichloromethane is not well known. Two patients who had undergone skin grafting to treat chemical burn of the hand caused by dichloromethane exposure were evaluated, and a literature review was done. Two healthy men aged 37 and 40 years visited our hospital with chief complaints of pain on the hands due to dichloromethane exposure. The patients had not worn protective clothing. Multiple bullae were initially noted. On the next day, fluctuation in bullae and purulent discharge were observed, and central eschar change was noted. On the 18th day after the burn, escharectomy and full-thickness skin graft were performed. Therefore, workers who use dichloromethane should wear protective clothing at workplaces. If exposed to the chemical, the worker should be instructed to do a quick wash and visit the hospital.]]>
Burns ; Burns, Chemical ; Hand ; Humans ; Inhalation ; Male ; Methylene Chloride ; Paint ; Protective Clothing ; Skin ; Skin Transplantation ; Transplants

OBJECTIVES: This study aims to compare the fluoride-release between different fluorine varnish under in vitro experimental conditions.METHODS: In this study, 5 fluoride varnish products distributed in Korea were selected. V-varnish™ (Vericom, Korea: VV), CavityShield™ (3M ESPE, USA: CS), Clinpro™ White varnish™ (3M ESPE, USA: CP), MI Varnish™ (GC, Japan: MI), and Fluor Protector (Ivoclar Vivadent, Liechtenstein: FP). For the in vitro study, 10 mg of each fluoride varnish was thinly applied to the same area of the specimen. The specimen was then immersed in 3 ml of distilled water at consistent intervals to confirm fluoride release. Nine specimens per group were used. Fluoride ion electrodes were used to measure the fluoride concentration of the solution. The Kruskal-Wallis nonparametric test was performed to compare between each experimental group, and the Wilcoxon signed-rank nonparametric test was performed to compare experimental groups over time. The significance level for a Type I error was set at 0.05. All statistical analyses were performed using SPSS 25.0 (IBM Co., Armonk, NY, USA).RESULTS: In vitro experiments showed that the amount of fluoride released from MI was higher than the other groups during the first 12 hours after application. However, the amount of fluoride released from CP and CS was higher than MI as the immersion time increased over 12 and 20 hours, respectively. The fluoride release from FP was the lowest at all measurement points.CONCLUSIONS: The results of this study showed that the remaining fluoride effect from rosin type fluoride varnishes was higher than liquid type fluoride varnishes. There were differences in the residual fluoride concentrations despite each fluoride varnish having the same fluoride content.
Dental Caries ; Electrodes ; Fluorides ; Fluorides, Topical ; Fluorine ; Immersion ; In Vitro Techniques ; Japan ; Korea ; Liechtenstein ; Paint ; Water

BACKGROUND: Labial melanotic macules (LMMs) are benign pigmented lesions that usually take the shape of flat asymmetrical macules with tan-brown to black color and variable size. Whereas the dermoscopic features of other pigmented skin lesions have been relatively well described, little is known about LMMs. OBJECTIVE: To describe the dermoscopic features and find typical and schematic dermoscopic patterns in LMMs. METHODS: A retrospective dermoscopic study was conducted on 80 lesions with histopathologically proved LMMs. RESULTS: We described and defined, for the first time to our knowledge, landscape painting patterns found in 65 of 80 melanotic lesions (81.3%), characterized by parallel lines or circle lines, overlapping vessels with background brown pigmentation. The background brown pigmentations were observed in 74 of 80 lesions (92.5%), the parallel lines in 62 (77.5%), the circle lines in 20 (25.0%), and overlapping vessels in 69 (86.3%). The structureless black pigmentations were only presented in 26 of 80 (32.5%). CONCLUSION: Dermoscopy can be useful for the clinical detection of LMMs, and “Landscape painting patterns” may represent a dermoscopic clue for the diagnosis of these lesions.
Dermoscopy ; Diagnosis ; Paint* ; Paintings* ; Pigmentation ; Retrospective Studies ; Skin

The purpose of this study was to examine effects of bioactive glass on Vickers hardness of bleached enamel surface. Enamel specimens were bleached with 15% carbamide peroxide (CP) for 14days. After bleaching, Artificial saliva (AS), 45S5 bioactive glass (BAG) and fluoride varnish (FV) are applied each specimens (n=10). The Vickers hardness of the specimens was measured before and after the bleaching, after the remineralized treatment at 1 day and after 7 and 14 days. The Vickers hardness on enamel surface after bleaching decreased statistically (p < 0.05) compared to before bleached enamel surface. The Vickers hardness increased significantly in the BAG and FV groups compared to the AS group values at 1 day and 7 days after remineralization (P < 0.05). 45S5 bioactive glass rapidly increase Vickers hardness of the bleached enamel surface.
Dental Enamel ; Fluorides ; Glass ; Hardness ; Paint ; Saliva, Artificial ; Urea

The aim of this study was to investigate the antibacterial effect of fluoride varnish with antibacterial agents on Streptococcus mutans (S. mutans). Experimental fluoride varnish (EFV) with 5% NaF was fabricated. Five antibacterial agents were tested with 1 mM and 10 mM concentrations, respectively: Bakuchiol (BAK), Bavachalcone (BCC), Isobavachromene (IBC), and Bavachromene (BCM). MIC and MBC test was performed by antibacterial agents with and without EFV using 1.1 × 10¹⁰ CFU/ml of S. mutans. Cell viability test were performed using MTT test. Statistical analysis was done with ANOVA and Duncan's multiple range test at α=0.05. In the antibacterial agents without EFV, the MIC of BAK, BCC, and IBC was the lowest (0.015 mM), and the MBC of BAK was the lowest (0.031 mM). For the antibacterial agents with EFV, the MIC (0.031 mM) and MBC (0.062 mM) of BAK was the lowest, respectively. In MTT test, 1 mM BCM showed the highest cell viability (P < 0.05). This study suggest that BAK can be applied the fluoride varnish under the control of the concentration to develop antibacterial fluoride varnish.
Anti-Bacterial Agents ; Cell Survival ; Fluorides ; Microbial Sensitivity Tests ; Paint ; Streptococcus mutans

BACKGROUND: Organic solvent-induced chronic toxic encephalopathy (CTE) is known as a non-progressive disorder that does not progress after diagnosis. The authors present a case those symptoms worsened after continued exposure to organic solvent after returning to work. Because such a case has not been reported in South Korea to the best of our knowledge, we intend to report this case along with literature review. CASE PRESENTATION: A 59-year-old man, who performed painting job at a large shipyard for 20 years, was receiving hospital treatment mainly for depression. During the inpatient treatment, severe cognitive impairment was identified, and he visited the occupational and environmental medicine outpatient clinic for assessing work relatedness. In 1984, at the age of 27, he began performing touch-up and spray painting as a shipyard painter. Before that he had not been exposure to any neurotoxic substances. In 2001, at the age of 44, after 15 years of exposure to mixed solvents including toluene, xylene and others, he was diagnosed with CTE International Solvent Workshop (ISW) type 2A. After 7 years of sick leave, he returned to work in 2006. And he repeated return-to-work and sick leave in the same job due to worsening of depressive symptoms. He had worked four times (2006–2010, 2011–2011, 2011–2011, 2016–2017) for a total of 5 years as a shipyard painter after first compensation. During the return-to-work period, the mean values of the mixed solvent index ranged from 0.57 to 2.15, and except for a one semiannual period, all mean values were above the standard value of 1. We excluded other diseases that can cause cognitive impairment like central nervous system diseases, brain injury, psychological diseases and metabolic diseases with physical examinations, laboratory tests, and brain image analysis. And finally, throughout neuropsychological tests, an overall deterioration in cognitive function was identified compared to 2002, and the deterioration types was similar to that often shown in the case of CTE; thus a diagnosis of CTE (ISW) type 3 was made. CONCLUSION: This case is showing that CTE can go on with continued exposure to mixed solvents. Appropriate “fitness to work” should be taken to prevent disease deterioration especially for the sick leave workers.
Ambulatory Care Facilities ; Brain ; Brain Injuries ; Central Nervous System Diseases ; Cognition ; Cognition Disorders ; Compensation and Redress ; Depression ; Diagnosis ; Education ; Environmental Medicine ; Humans ; Inpatients ; Korea ; Metabolic Diseases ; Middle Aged ; Neuropsychological Tests ; Neurotoxicity Syndromes ; Occupational Diseases ; Paint ; Paintings ; Physical Examination ; Return to Work ; Sick Leave ; Solvents ; Toluene ; Xylenes

BACKGROUND: The olfactory bulb is anatomically exposed and thus can be directly damaged by external stimulation. This can occur as an occupational injury owing to contact with organic solvents or other causes. We present cases of eight patients who sustained occupation-related exposure to potentially toxic substances and later presented with signs and symptoms of anosmia. We examined the occupational and medical characteristics of the patients and evaluated their work-relatedness. CASE PRESENTATION: Case 1: A 50-year-old man performed high-frequency heat treatments for approximately 11 years. He experienced decreased senses for olfaction and taste during the later years culminating in the diagnosis of anosmia after 3 years (high work-relatedness). Case 2: A 54-year-old man whose work involved exposure to various organic solvents, such as spray painting and application of paint and thinners for approximately 4 years, was subsequently diagnosed with anosmia based on rhinorrhea, headache, and loss of olfaction (high work-relatedness). Case 3: A 44-year-old-man who performed spray painting for approximately 17 years developed anosmia (high work-relatedness). Case 4: A 44-year-old man was involved in ship engine cleaning once a month, for approximately 7 h per cleaning session; he was diagnosed with anosmia based on loss of olfaction (low work-relatedness). Case 5: A 41-year-old man worked in ship building block construction for approximately 13 years; anosmia diagnosis was based on loss of olfaction (low work-relatedness). Case 6: A 47-year-old woman performed product inspection and labeling at a plant manufacturing automobile parts; anosmia diagnosis was based on decreased olfaction and taste (low work-relatedness). Case 7: A 50-year-old woman performed epoxy coating in a plant manufacturing automobile parts; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). Case 8: A 57-year-old woman performed cleaning of the area where mobile phone parts were manufactured; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). CONCLUSION: The study results confirmed work-relatedness when the subject was young, and the duration of exposure was long without any other cause of anosmia. Regarding compensation for occupational diseases, work-relatedness can be recognized as a relative concept.
Adult ; Automobiles ; Cell Phones ; Compensation and Redress ; Diagnosis ; Female ; Headache ; Hot Temperature ; Humans ; Middle Aged ; Occupational Diseases ; Occupational Injuries ; Olfaction Disorders ; Olfactory Bulb ; Paint ; Paintings ; Plants ; Ships ; Smell ; Solvents

Comprehensive consideration is necessary for setting guidelines to evaluate evidence of occupational cancer in painters due to work-related exposure to carcinogens in paint (a phenomenon termed herein as “work-relatedness”). The aim of the present research is to perform a comprehensive review and to suggest criteria for the provision of compensation for occupational neoplasm among painters in Korea. In order to perform a comprehensive review, this study assessed and evaluated scientific reports of carcinogenicities from the International Agency for Research on Cancer (IARC) and the Industrial Injuries Advisory Council (IIAC), as well as reviewed the existing literature about occupational exposure among painters in Korea and the epidemiologic investigations of claimed cases of cancer among painters in Korea. The IARC declares that occupational exposures in commercial painting are classified as Group 1 carcinogens for lung cancer and bladder cancer among painters. The epidemiologic studies show consistent causal relationships between occupational exposure in painters and cancers such as lung cancer [meta relative risk: 1.34 (95% confidence intervals (CIs): 1.23-1.41)] and bladder cancer [meta relative risk: 1.24 (95% CIs: 1.16-1.33)]. In reviewing occupational cancer risks for commercial painters, the Industrial Injuries Advisory Council (IIAC) confirms occupational cancer risks for lung and bladder cancer among commercial painters. According to the IIAC, however, the elevated cancer risks reported in existing literature are not doubled in either lung or bladder cancer in commercial painters relative to the risks of these cancers in the general population. Based on our review of existing Korean articles on the topic, painters are exposed to potential carcinogens including polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos, and other agents, and relative levels are estimated within commercial painting processes. However, the cancer risks of occupational exposure to Group 1 carcinogens for lung and bladder cancer in painters per se are not fully assessed in existing Korean articles. Total work duration, potential carcinogens in paint, mixed exposure to paints across various industries such as construction and shipbuilding, exposure periods, latent periods, and other factors should be considered on an individual basis in investigating the work-relatedness of certain types of cancer in commercial painters.
Asbestos ; Benzene ; Carcinogens ; Compensation and Redress ; Epidemiologic Studies ; International Agencies ; Korea ; Lung ; Lung Neoplasms ; Occupational Exposure ; Occupations ; Paint ; Paintings ; Polycyclic Hydrocarbons, Aromatic ; Silicon Dioxide ; Urinary Bladder Neoplasms