Purpose: There are few reports of postoperative long-term malignant risk or postoperative sequelae after surgery for choledochal cysts (CCs). This study aimed to analyze the clinical characteristics of patients with malignancy and the longterm results of operated CC. Methods: The patients who underwent surgical treatments for CC between 2003 and 2020 at Seoul National University Hospital were enrolled. Clinicopathologic factors and pre-/postoperative computed tomography or magnetic resonance imaging were reviewed. Results: Of the 153 patients, Todani classification Ic (36.6%), C-P type (43.8%) anomalous pancreaticobiliary duct union were the most common type respectively. Fourteen patients (9.2%) had biliary tract cancer and a comparison of patients with and without malignancy showed that the diameter of cyst was significantly lower in malignant patients and malignancy was observed to be significantly higher in P-C type. The incidence of long-term complications was 9.8%, and the median time interval was 30 months. The 2 most common complications were cholangitis and stricture (60.0%). There was one case of new cancer near the intrapancreatic remnant bile duct. Conclusion Of the resected CCs, 9.2% had a combined malignancy on the biliary tracts. Long-term complications such as cholangitis, anastomotic stricture, and new cancers may occur. Therefore, continuous surveillance is required.

OBJECTIVES: To investigate the mental health status of migrant workers. We focused on the relationship between depressive symptoms and job stress. METHEOD: A questionnaire was administered to 488 migrant workers who visited NGO migrant worker centers located in Kyung-gi province. A structured, self-reported questionnaire was used to assess each responder's sociodemographics, work related characteristics, health behaviors, past medical history, job stress and depression symptoms. The job stress questionnaire was used according to KOSS-26 and depression symptoms were measured using CES-D, which was translated into Korean. We used multiple logistic regression analysis to assess the relationship between risk factors included job stress and depression symptoms. RESULTS: The prevalence of depression symptoms in survey subjects was 25.2%, but the prevalence of non-Chinese nationalities and illegal workers were 32.1% and 32.8%, respectively. Adjusting for confounding factors, job stress (OR 2.55, 95% CI=1.30-4.99) had a statistical meaningful relationship with depression symptoms. Among job stress domains, physical environment (OR 2.97, 95% CI=1.59-5.53), job demand (OR 2.33, 95% CI=1.26-4.32) and occupational climate(OR 3.10, CI=1.49-6.48) were most likely to experience depression symptoms. CONCLUSIONS: The prevalence of depressive symptoms among the study subjects was similar to the prevalence among the general population in Korea, but higher than that among the Korean workers. In particular, the prevalence among non-Chinese and illegal workers was higher. However, the job stress factor appeared to have a more direct correlation with depressive symptoms than the sociodemographic factors of nationality or residential status. Hence, in order to prevent depressive symptoms of the migrant workers, we believe that intervention on job stress is necessary.
Depression ; Ethnic Groups ; Health Behavior ; Humans ; Korea ; Logistic Models ; Mental Health ; Prevalence ; Questionnaires ; Risk Factors ; Transients and Migrants

OBJECTIVE: To investigate the musculoskeletal symptoms of migrant workers. We focused on the relationship between job stress and musculoskeletal symptoms. METHOD: A questionnaire was administered to 502 migrant workers who visited NGO migrant worker centers located in Gyung-gi province. A structured, self-reported questionnaire was administered to participants in order to capture the following information: sociodemographics, health factors including past medical history, work related characteristics, job stress, and musculoskeletal symptoms. The job stress questionnaires were used according to KOSS-26 and musculoskeletal symptoms were measured using KOSHA Code H-30-2003. We used multiple logistic regression analysis to assess the relationship between risk factors which included job stress, and musculoskeletal symptoms. RESULTS: The prevalence rate of musculoskeletal symptoms in survey subjects was 35.1%. Other than job stress factors, past medical history was the only factor that had a statistical relationship to musculoskeletal symptoms (P<0.01). In the domains of job stress, physical environment (OR 1.62, 95% CI: 1.03~2.54), job demand (OR 2.43, 95% CI: 1.46~4.03), job insecurity (OR 1.59, 95% CI: 1.03~2.47), occupational climate (OR 2.30, 95% CI: 1.27~4.19) were most likely experience musculoskeletal symptoms. CONCLUSION: The job stress factor appeared to correlate more with musculoskeletal symptoms than with sociodemographics or other factors. Hence, in order to prevent migrant worker's musculoskeletal symptoms, we believe that intervention in job stress (physical environment, job demand, job insecurity, occupational climate) is necessary.
Climate ; Humans ; Logistic Models ; Prevalence ; Questionnaires ; Risk Factors ; Transients and Migrants

OBJECTIVES: To investigate the general health status and severity of exposure to hazardous agents - with a focus on heavy metals - of migrant workers utilizing the 2005 Special Health Examination data. METHODS: With data from the 2005 Special Health Examination, we examined the biologic exposure indices and several major clinical exam items of 25,086 migrant workers in the whole country in comparison with those of 19,616 native Korean workers in Kyunggi-do province. Of these we chose homogeneous samples from the same 3 health service centers in Kyunggi-do. (native workers:19,616, migrant workers:1,886) to be more precise. RESULTS: The results from the samples of the 3 centers were as follows. Blood lead (natives: 6.09 microgram/dl migrants: 8.37 microgram/L) and cadmium (natives: 0.29 microgram/dl, migrants: 0.36 microgram/L) were higher in the migrant workers than in the native Korean workers, whereas the biologic exposure indices of organic solvents were higher in the native workers. As for major clinical exam items, the liver battery was worse in the natives with incidence of abnormal AST/ALT level (natives: 8.1/6.8% migrants: 5.7/5.4%, p-value<0.01 for AST). Anemia was more prevalent in the migrant workers (natives: 9.0% migrants: 11.0%, p-value<0.05). CONCLUSIONS: Migrant workers in Korea are more frequently or more severely exposed to a hazardous working environment containing heavy metals. However, we were not able to explain the results for the exposure indices or organic solvents, and such an explanation will require further study in the future.
Anemia ; Cadmium ; Health Services ; Humans ; Incidence ; Korea ; Liver ; Metals, Heavy ; Population Groups ; Solvents ; Transients and Migrants

BACKGROUND: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens- Johnson syndrome. CASE REPORT: Case 1. A 24-year-old Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (personal exposure level) with TWA. Case 2. A 47-year-old Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset of the first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (personal exposure level) and 116.5~229.7 ppm (area exposure level close to the degreasing machine) with TWA. Case 3. A 22-yearold Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (personal exposure level) with TWA. DISCUSSION: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.
Asian Continental Ancestry Group ; Dermatitis, Exfoliative ; Drug-Induced Liver Injury ; Environmental Exposure ; Exanthema ; Female ; Humans ; Korea ; Latency Period (Psychology) ; Liver ; Liver Failure ; Male ; Middle Aged ; Occupational Exposure ; Occupational Health ; Sepsis ; Stevens-Johnson Syndrome ; Trichloroethylene ; Young Adult

OBJECTIVES: To analyze the status and characteristics of the industrial accidents of migrant workers with comparison to those of native workers. METHODS: The industrial accident rate of migrant workers was estimated by the annual number of industrial accidents divided by the total number of annual labor population multiplied by the annual admission rate of industrial accident insurance. The characteristics of industrial accidents for total migrant workers were assessed and compared with those of total native workers (from 2004 to 2006). In addition, we compared the industrial accidental characteristics of the 7,210 native workers and the 458 migrant workers employed in the Incheon area who received compensation from the industrial accident insurance in 2006. RESULTS: In 2004, 2005 and 2006, the total annual industrial accident rates of the migrant workers were 0.93%, 0.90%, and 1.06%, the injury accident rates were 0.90%, 0.86%, and 1.00%, the number of injury deaths per 10,000 persons were 2.29, 2.22, and 2.39, and the disease rates were 0.011%, 0.014%, and 0.027%, respectively. As for the cause of injury, rolled/jammed and cutting-type injuries were more prevalent in the migrant workers. With the standardization of job category, industry size and work tenure, the rolled/jammed-type injury was still significantly more prevalent in the migrant workers. CONCLUSIONS: Even considering the exclusion of the possible missing numbers of the submission of industrial accident cases, and the numbers of workplaces not registered for industrial accident insurance, the publicized statistics confirm the higher industrial accident rate of migrant workers compared to ative workers. Especially, the injury death rate was 2.2 times higher for migrant workers than for native workers in 2006. In addition, the remarkably lower occupational disease rate of the migrant workers compared to that of the native workers, suggested that numerous cases of disease were not reported. Finally, the lack of communication and former education that usually lead to the most prevalent injury type, i.e., the rolled/jammed type, supported our conclusion that the migrant workers were in need of more education regarding workplace safety.
Accidents, Occupational ; Compensation and Redress ; Humans ; Insurance ; Korea ; Occupational Diseases ; Transients and Migrants

BACKGROUND: The goal of this study is to evaluate the differences of the rate and the ratio of heart rate changes, which is well known to reflect the vagal reactivation, after peak exercise between ischemic heart disease and normal during treadmill exercise test. Additionally R-wave amplitude changes are evaluated to have the discriminal power between ischemic heart disease and normal. METHODS: We have studied 253 human (196 control, 57 patients) who took the symptom-limited exercise test using Marquette case 8000 model. The 57 patients who showed the positive result by exercise test have confirmed by coronary angiography. The rate of heart rate changes was defined as the absolute difference of the heart rate subtracted by the just-previous stage heart rate. The ratio of heart rate changes was defined as the percentile of the rate of heart rate changes comparing to the just-previous stage heart rate. The changes of R-wave amplitude at lead V5 and aVF were obtained by the subtraction of R-wave amplitude at the peak exercise stage from that at the standing rest stage respectively. Additively heart rate recovery was defined as the rate of heart rate change which was obtained at 1 minute later after peak exercise. RESULTS: In patients and control, the resting heart rate were 70 +/- 13 bpm and 69 +/- 11 bpm (p>0.05), and the peak heart rate were 136 +/- 22 bpm and 155 +/- 18 bpm respectively (p<0.001). The rate of heart rate changes in patients group were significantly lower than that in control at 1 minute, 3 minute, and 5 minute respectively (p<0.001, p=0.008, p=0.002). The ratio of heart rate changes in patients group were also significantly lower than that in control at 1 minute, 3 minute, and 5 minute respectively (p=0.017, p=0.027, p=0.002). With comparing both groups, the incidences of ventricular ectopy were not different during exercise and recovery stages, and the difference in the changes of R-wave amplitude at lead V5 and aVF were not observed respectively. CONCLUSION: The rate and ratio of heart rate changes are significantly lower in iscemic heart disease than in normal, and these are resulted from the depression of vagal reactivation. These findings are supplemental to make a diagnosis and a arrhythmic risk stratification of ischemic heart disease.
Coronary Angiography ; Depression ; Diagnosis ; Exercise Test ; Heart Diseases ; Heart Rate* ; Heart* ; Humans ; Incidence ; Myocardial Ischemia*

Two major salivary glands, submandibular duct, lingual nerve, and vessels are situated beneath the mouth floor. Among these, passing through the pterygomandibular space, lingual nerve is innervated to the lingual gingiva and the mucosa of mouth floor, and is responsible for the general sensation of the anterior two thirds of the tongue. So, the injury of the lingual nerve during an anesthesia or surgery in the retromolar area may cause complications such as a numbness, a loss of taste of the tongue and the other dysfunctions. Therefore, to find out the morphology and the course of lingual nerve and to clarify the topographical relationships of lingual nerve at the infratemporal fossa and paralingual space area, 32 Korean hemi-sectioned heads were dissected macroscopically and microscopically with a viewpoint of clinical aspect in this study. This study demonstrated various anatomical characteristics with relation to the course and topography of the lingual nerve in Koreans. And clinical significances based on the anatomical variations through the topography of the courses and communications between the mandibular nerve branches were described in details.
Anesthesia ; Chorda Tympani Nerve ; Gingiva ; Head ; Hypesthesia ; Lingual Nerve* ; Mandibular Nerve ; Mouth Floor ; Mucous Membrane ; Salivary Glands ; Sensation ; Tongue

Arginine vasotocin has long been known as an antidiuretic hormone in non-mammalian vertebrates. The peptide has also been found in mammalian tissues. The physiological significance of the peptide, however, has not yet been clarified in mammals. To define the effect of arginine vasotocin on the water and electrolyte balance in mammalian vertebrates, experiments have been done. Intrarenal arterial infusion of arginine vasotocin, 0.01-10ng/kg/min resulted in dose-dependent decreases in urine volume and free water clearance and an increase in urinary osmolarity. Arginine vasotocin, in a dose of 0.03ng/kg/min, induced an increase in water reabsorption without changes in glomerular filtration rate. Intrarenal infusion of arginine vasotocin in doses ranging from 0.1 to 3.0 or 10.0ng/kg/min resulted in decreases in glomerular filtration rate and renal plasma flow. However, no dose dependence were observed. Intrarenal infusion of arginine vasotocin from 0.3 to 10 ng/kg/min induced dose-dependent natriuretic and kaliuretic effects with concomitant suppression of renin secretion. The renal effects of arginine vasotocin were blocked by arginine vasopressin V2-receptor antagonist [d(CH2)5, D-Phe2, Ile4, Ala9-NH2]-vasopressin but were not blocked by[d(CH2)5, D-Ile2, Ile4, Arg8]- vaso pression. These data suggest that the effect of arginine vasotocin on the renal function are similar to that of vasopressin in mammalian vertebrates. The data also suggest that the renal effects of arginine vasotocin may be coupled to the receptor system which is similar, if not identical, to that of arginine vasopressin.
Arginine Vasopressin ; Arginine* ; Glomerular Filtration Rate ; Mammals ; Osmolar Concentration ; Renal Plasma Flow ; Renin ; Vasopressins ; Vasotocin* ; Vertebrates ; Water ; Water-Electrolyte Balance

BACKGROUND: Mutations eliminating or altering the p53 protein function are the single most common genetic alteration in nearly all types of human cancers. The project of the p53 gene is hypothesized to maintain genomic stability by blocking cell replication or by initiating apoptosis after DNA damage. Many p53 mutations alter the conformation of the protein, which results in abnormal overexpression. METHODS: This study investigated the correlation between p53 mutations detected at the DNA level and the p53 protein expression determined by immunohistochemical staining. Abnormalities of the p53 gene and protein in 30 primary paraffin embedded breast cancer tissues were examined. RESULTS: Mutations in p53 exons 5-8 were identified in 9 of the 30 cases (30%) by using a polymerase chain-reaction single stranded conformational polymorphism (PCR-SSCP) analysis. Overexpression of the p53 protein was detected in 11 of the 30 cases (37%) by using mouse monoclonal p53 antibody (Zymed Essence Co.) Positive immunohistochemical staining without mutations was detected by PCR-SSCP analysis in 4 cases, but a mutation with negative immunohistochemical staining was detected by PCR-SSCP analysis in only one case. p53 abnormality was not associated with TNM stages. The sensitivity between these methods was 73%. CONCLUSIONS: Positive immunohistochemical staining using p53 monoclonal antibody could detect p53 protein expression, but this result did not correlate completely with p53 mutation in exon 5-8.
Animals ; Apoptosis ; Breast Neoplasms* ; Breast* ; DNA ; DNA Damage ; Exons ; Genes, p53 ; Genomic Instability ; Humans ; Immunohistochemistry ; Mice ; Paraffin ; Polymorphism, Single-Stranded Conformational