1-Hydroxypyrene and oxidative stress marker levels among painting workers and office workers at shipyard.

OBJECTIVES: The objective of this study was to assess the association between exposure to polycyclic aromatic hydrocarbons (PAHs) and oxidative stress among shipyard workers. METHODS: We recruited 82 painting workers in a shipyard and age/sex matched 137 office workers from the same shipyard company. Urine samples were used to assess for 1-hydroxypyrene (1-OHP) as an exposure biomarker for PAHs and to assess for 8-iso-prostaglandin F2α (iPF) as a biomarker for oxidative stress. Demographics, smoking, alcohol consumption, and working conditions information were obtained from a questionnaire survey. RESULTS: Geometric mean concentration (±standard deviation) of urinary 1-OHP among painting workers (587.9 ± 3.45 ng/g creatinine) was approximately 6.9 times higher than that among office workers (85.6 ± 2.09 ng/g creatinine; P value < 0.001). Compared to the office workers (163.5 ± 1.84 ng/g creatinine), the painting workers (190.6 ± 1.64 ng/g creatinine) had significantly higher urinary levels of iPF (P value = 0.044). Smokers had significantly higher urinary levels of iPF than nonsmokers in both painting workers (smokers 217.0 ± 1.63; nonsmokers 159.2 ± 1.52 ng/g creatinine; P value = 0.011) and office workers (smokers 181.3 ± 1.79; nonsmokers 138.4 ± 1.90 ng/g creatinine; P value = 0.015). Smokers among office workers had higher urinary levels of iPF than nonsmokers among painting workers, but difference was not significant. CONCLUSION: Our results demonstrated that among shipyard workers, painting works were significantly associated with the exposure to PAHs, compared with the office works. However, iPF should be cautiously used to characterize the oxidative stress associated with the occupational PAHs exposure, because iPF is substantially affected by other factors such as smoking status.

Evaluation of the prevalence of musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal service workers.

BACKGROUND: Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence and risk factors of subjective musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal workers. METHODS: We analyzed the results of musculoskeletal disease screening of 1581 female school meal workers. The screening consisted of self-administered questionnaire, history taking by occupational physicians, and physical examination. The prevalence of subjective musculoskeletal symptoms, presumptive diagnosis after initial examination by occupational physicians, use of medical care for more than 7 days, and sick leave due to musculoskeletal diseases during the past year were evaluated in this study. The relative risk of four outcome indicators of musculoskeletal disorders was compared with respect to potential factors, such as age, subjective physical loading, present illness, injury experience, and type of school, using log-binomial regression. RESULTS: The prevalence of subjective musculoskeletal symptom was 79.6%; presumptive diagnosis, 47.6%; hospital visits over 7 days, 36.4%; and sick leave, 7.3%. The relative risk of musculoskeletal symptoms by age (≥50 years vs < 50 years) was 1.04 (95% confidence interval (CI): 1.00-1.09); presumptive diagnosis of musculoskeletal disease, 1.17 (95% CI: 1.06-1.30); hospital visits over 7 days, 1.26 (95% CI: 0.85-1.85); and sick leave, 1.17 (95% CI: 1.02-1.34). The relative risk of musculoskeletal symptoms due to subjective physical loading (very hard vs low) was 1.45 (95% CI: 1.33-1.58); presumptive diagnosis, 2.92 (95% CI: 2.25); hospital visits over 7 days, 1.91 (95% CI: 1.02-3.59); and sick leave, 2.11 (95% CI: 1.63-2.74). CONCLUSIONS: Subjective physical loading was a more important factor in musculoskeletal disorders than the age of female school meal workers.

Therapeutic effect of intracameral amphotericin B injection in the treatment of fungal keratitis.

PURPOSE: To study the therapeutic efficacy of intracameral amphotericin B (ICAMB) injection in the treatment of fungal keratitis. METHODS: Fourteen patients with fungal keratitis received ICAMB, 10 microg/0.1 mL (group A), and 17 patients received conventional treatment only (group B). Visual acuity, time to hypopyon disappearance, time to epithelial defect closure, time to final improvement, and final outcome were analyzed and compared between the 2 groups. The concentration of amphotericin B in the aqueous humor after injection was measured using high-performance liquid chromatography. RESULTS: The mean final visual acuity (log MAR) was 1.6 +/- 1.1 in group A and 1.3 +/- 1.4 in group B (P = 0.24). The mean time to disappearance of hypopyon, epithelial defect closure, and final improvement was 9.4 +/- 9.4, 19.8 +/- 10.4, and 26.6 +/- 9.2 days in group A and 26.7 +/- 21.3 (P = 0.03), 32.6 +/- 22.8 (P = 0.08), and 52.8 +/- 38.2 days (P = 0.04) in group B, respectively. At the last follow-up, treatment success was achieved in 92.9% of group A and 82.4% of group B (P = 0.38). The mean concentration of intracameral amphotericin B was 601.6 +/- 51.3 ng/mL at 6 hours, 98.8 +/- 43.1 ng/mL at 1 day, 57.0 +/- 11.6 ng/mL at 3 days, and 52.3 +/- 8.3 ng/mL at 7 days after injection. CONCLUSIONS: ICAMB seems to be effective in reducing time to disappearance of hypopyon and final improvement in the treatment of fungal keratitis.

Case series of keratitis in poultry abattoir workers induced by exposure to the ultraviolet disinfection lamp.

BACKGROUND: An outbreak of eye diseases occurred among workers at a poultry abattoir in South Korea from December 2012 to June 2013. An epidemiological investigation of the causative agent was conducted. The workers were given a special health examination and workplace environmental monitoring was performed. Workers with ocular symptoms subsequently underwent an ophthalmic examination. CASE PRESENTAION: From a total of 41 workers, 26 (63.4 %) were diagnosed with keratoepitheliopathy by ophthalmic examination. Environmental monitoring of the workplace revealed that the ultraviolet (UV) apron-disinfection lamp had not been turning off at the set times, and so the workers' faces had been exposed to UV radiation. Effective radiation dose measurement showed a UV-B exposure of 7-30 µW/cm(2), and a UV-C exposure of 40-200 µW/cm(2); both values exceed the occupational exposure limits. The outbreak ceased after the lamp was repaired. CONCLUSIONS: This case shows that inappropriate use of the UV disinfection lamp can cause mass photokeratitis. In order to prevent this, the UV disinfection lamp must be checked regularly, workers must be educated on the health effects of UV radiation, and appropriate eye protection must be worn.

Evaluation of mercury exposure level, clinical diagnosis and treatment for mercury intoxication.

Mercury occurs in various chemical forms, and it is different to health effects according to chemical forms. In consideration of the point, the evaluation of the mercury exposure to human distinguished from occupational and environmental exposure. With strict to manage occupational exposure in factory, it is declined mercury intoxication cases by metallic and inorganic mercury inhalation to occupational exposure. It is increasing to importance in environmental exposure and public health. The focus on the health impact of exposure to mercury is more on chronic, low or moderate grade exposure-albeit a topic of great controversy-, not high concentration exposure by methylmercury, which caused Minamata disease. Recently, the issue of mercury toxicity according to the mercury exposure level, health effects as well as the determination of what mercury levels affect health are in the spotlight and under active discussion. Evaluating the health effects and Biomarker of mercury exposure and establishing diagnosis and treatment standards are very difficult. It can implement that evaluating mercury exposure level for diagnosis by a provocation test uses chelating agent and conducting to appropriate therapy according to the result. but, indications for the therapy of chelating agents with mercury exposure have not yet been fully established. The therapy to symptomatic patients with mercury poisoning is chelating agents, combination therapy with chelating agents, plasma exchange, hemodialysis, plasmapheresis. But the further evaluations are necessary for the effects and side effects with each therapy.

Evaluation and management of lead exposure.

Lead, which is widely used in industry, is a common element found in low concentrations in the Earth's crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities. Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children. It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.

Color vision impairments among shipyard workers exposed to mixed organic solvents, especially xylene.

OBJECTIVES: We evaluated color vision impairment in workers exposed to organic solvents, especially xylene. METHODS: Three groups of subjects, comprising 63 workers occupationally exposed to organic solvents, 122 non-exposed workers in the same industry, and 185 subjects from the general population as controls, were evaluated for color vision. Exposure to solvents was indirectly evaluated by measuring the concentration of a urinary metabolite. Color vision was assessed using the Lanthony Desaturated 15-hue (Lanthony D-15) panel. RESULTS: Color confusion index (CCI) values in the exposed group were significantly higher than in the non-exposed workers or the general population, after adjustment for age and education, and significantly correlated with the concentration of methylhippuric acid. Color vision impairments were detected more frequently among the exposed group, and the most common types were type III and complex impairments. The rate of type III impairments was 9.52% in the exposed group, 1.64% in the non-exposed group, and 1.62% in the general population. CONCLUSION: Our results support the hypothesis that acquired color vision impairments could be induced by exposure to xylene. Testing for color vision impairment is a relatively simple, non-invasive and sensitive diagnostic method for relatively low-level exposures to xylene.

Gonadotropin-releasing hormone stimulation test for precocious puberty.

BACKGROUND: Gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard to identify central precocious puberty (CPP). This test requires multiple blood samples at different time points to measure gonadotropin levels, and is therefore expensive, time-consuming, and uncomfortable for patients. We aimed to simplify the GnRH stimulation test to require fewer blood samples. METHODS: A study of 166 girls with precocious puberty was undertaken. Blood samples were obtained at 0, 15, 30, 45, 60, 90, and 120 min after GnRH administration, and the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured. For each parameter, the sensitivities and specificities were estimated and ROC curves were constructed. RESULTS: One hundred and twenty-eight patients (77.1%) were diagnosed for CPP. Peak LH levels were achieved 30 min after GnRH stimulation in patients with CPP. Further, 98.4% of the 45-min samples were diagnostic for CPP, and the cumulative frequency of LH values of ≥5 IU/L was 100% at 45 min. Using this cut-off value for LH, the ROC curve for LH at 45 min showed the highest sensitivity (98.4%) and specificity (100%) in the diagnosis of CPP. CONCLUSIONS: Values of LH measured from a single blood sample obtained at 45 min in the GnRH stimulation test may be adequate for the diagnosis of CPP. Two samples, taken at 30 and 45 min after stimulation, were able to accurately diagnose CPP in 100% of the patients in this study.

The correlation and prognostic significance of MGMT promoter methylation and MGMT protein in glioblastomas.

OBJECTIVE: The aim of this study was to evaluate the correlation and prognostic significance of MGMT promoter methylation and protein expression in patients with glioblastoma. METHODS: Eighty-three patients with glioblastoma underwent surgery followed by radiotherapy and temozolomide chemotherapy between October 2000 and June 2008. To investigate the correlation between MGMT methylation and MGMT expression, methylation-specific polymerase chain reaction (MSP) and immunohistochemical staining was performed. To analyze the correlation between MGMT methylation and MGMT expression according to location, biopsies were obtained from 37 different sites within the tumors in 12 patients. Age, sex, Karnofsky Performance Scale status, extent of removal, chemotherapeutic methods, and MGMT promoter methylation and protein expression were analyzed as prognostic factors. RESULTS: The total median survival was 15.8 months (range, 12.6-19.1 months). The results of MSP were the same at various sites in 12 patients. A correlation between MSP and immunohistochemical staining was observed in 50% of the patients. In 73 patients, negative MGMT expression was detected in 70.5% of 44 patients with MGMT promoter methylation, and positive expression was observed in 55.2% of the 29 patients with unmethylated promoters. Multivariate analysis revealed that the extent of removal (P = 0.001) and the combination of MGMT promoter methylation and negative MGMT expression (median survival, 20.06 months; P = 0.006) were significantly associated with longer survival. CONCLUSION: We report the feasibility of using MSP combined with immunohistochemical staining as a prognostic factor. The results of the present study suggest that MGMT promoter methylation in combination with negative MGMT expression might be a good prognostic factor in patients with glioblastoma.

[Usefulness of color vision test for early detection of neurological damages by neurotoxic substances].

This paper reviews the published literature that is concerned with color vision impairment from industrial and environmental exposure to neurotoxic substances, and we evaluated whether testing for color vision impairment could be an affordable procedure for assessing these neurotoxic effects. In general, most cases of congenital color vision impairment are red-green, and blue-yellow impairment is extremely rare. However, most of the acquired color vision impairment that is related to age, alcohol or environmental factors is blue-yellow impairment. Therefore, many studies have been performed to identify this relationship between exposure to neurotoxic substances, such as organic solvents and heavy metals, and the prevalence of blue-yellow color vision impairment. The test for color vision impairment is known to be very sensitive to the early signs of nervous system dysfunction and this can be useful for making the early diagnosis of neurotoxic effects from exposure to very low concentrations of toxic substances.

Effect of green tea consumption on endothelial function and circulating endothelial progenitor cells in chronic smokers.

BACKGROUND: The present study was designed to investigate the effect and relationship of endothelial function and endothelial progenitor cells (EPCs) by green tea consumption in chronic smokers. The numbers of circulating EPCs have an inverse correlation with chronic smoking and endothelial dysfunction. Green tea catechin improved endothelial dysfunction in chronic smokers. METHOD AND RESULTS: In 20 young healthy smokers, endothelial functions, defined by flow-mediated endothelium dependent vasodilation (FMD) of the brachial artery via ultrasound as well as the number of EPCs isolated from peripheral blood, were determined at baseline and at 2 weeks after green tea consumption (8 g/day). Circulating EPCs were quantified by flow cytometry as CD45lowCD34+KDR2+ cells and by acyl-low-density lipoprotein and fluorescein isotiocyanate-lectin double positive cells after culture for 7 days. Clinical characteristics and laboratory findings were not significantly different between the baseline and at 2 weeks after green tea intake. EPC levels were inversely correlated with the number of cigarettes smoked. Circulating EPCs by flow cytometry (78.6+/-72.6 vs 156.1+/-135.8 /ml, p<0.001) and cultured EPCs (118.2+/-35.7 vs 169.31+/-58.3/10 field, p<0.001) increased rapidly at 2 weeks after green tea consumption. FMD was significantly improved after 2 weeks (7.2+/-2.8 vs 9.3+/-2.4, p<0.001). The FMD correlated with EPC counts (r=0.67, p=0.003) before treatment and after 2 weeks (r=0.60, p=0.013). CONCLUSIONS: A short-term administration of green tea consumption induces a rapid improvement of EPC levels and FMD. Green tea consumption may be effective to prevent future cardiovascular events in chronic smokers.