Impact of community health interventions on maternal and child health indicators in the upper east region of Ghana.

BACKGROUND: This paper reports on results of a health system strengthening implementation research initiative conducted the Upper East Region of northern Ghana. Transformative interventions to accelerate and strengthen the health delivery were implemented that included empowering community leaders and members to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, providing basic medical equipment to community clinics, and improving the skills of critical health staff through training. METHODS: A mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. To assess impact, a pre-versus-post randomized cluster survey design was used. Qualitative research was conducted with focus group data and individual in depth interviews to gauge the views of various stakeholders associated with the implementation process. RESULTS: After intervention, significant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage were observed and increases in the proportion of deliveries occurring in health facilities and assisted by skilled health personnel relative to pre-intervention conditions. There was also increased uptake of oral rehydration salts (ORS) for treatment of childhood diarrhoea, as well as marked reductions in the incidence of upper respiratory infections (URI). CONCLUSIONS: A pre-and post-evaluation of impact suggests that the programme had a strong positive impact on the functioning of primary health care. Findings are consistent with the proposition that the coverage and content of the Ghana Community-based Health Planning and Services programme was improved by program interventions and induced discernable changes in key indicators of health system performance.

Decreases in Concentrations and Human Dietary Intakes of Polychlorinated Biphenyls (PCBs) and Polybrominated Diphenyl Ethers (PBDEs) in Korean Seafood Between 2005 and 2017.

Concentrations of polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) were measured in 23 seafood species widely consumed by the Korean population in the periods of 2005-2007, 2010-2011, and 2015-2017. The Σ82PCB (sum of 82 PCB congeners) and Σ19PBDE (sum of 19 PBDE congeners) concentrations in the seafood samples of 2015-2017 were 0.06-6.69 ng/g wet weight and 0.01-1.60 ng/g wet weight, respectively. The Σ82PCB and Σ19PBDE concentrations in the samples were significantly correlated. Elevated PCB and PBDE concentrations were found in fatty fish, such as herring, mackerel, and tuna. The current human intakes of PCBs and PBDEs were much lower than the tolerable daily intake or lowest observed adverse effect level. The levels and human dietary intakes of PCBs and PBDEs in the 2015-2017 survey showed decreases of 17-73% and 57-86%, respectively, compared with those in 2005-2007 and 2010-2011 surveys. This indicates that global bans on PCBs and PBDEs have been effective, and their levels and human exposure to them have been gradually declining.

Contamination characteristics of siloxanes in coastal sediment collected from industrialized bays in South Korea.

Siloxanes have been used as chemical additives in various products since the 1940s. They are known to have potentially toxic effects, to be environmentally persistent, and to be bioaccumulative. Previous studies have reported high levels of siloxanes in various environmental matrices. In this study, 6 cyclic siloxanes (D4-D9) and 13 linear siloxanes (L3-L15) in coastal sediment collected from southeastern bays adjacent to industrial zones in South Korea (Busan, Ulsan, Jinhae, and Gwangyang) were analyzed. The contamination levels and spatial distribution of siloxanes in the coastal sediment samples were investigated, with the hazard quotients (HQs) for siloxanes evaluated using Monte Carlo simulation. Across all samples, the total concentration (Σ19) of siloxanes was in the range of 11.6-3877 (mean: 305; median: 133) ng/g dry weight (dw). The highest average concentration of Σ19 siloxanes was found in Busan (mean: 580; median: 233 ng/g dw), followed by Ulsan (mean: 316; median: 209 ng/g dw), Jinhae (mean: 266; median: 125 ng/g dw), and Gwangyang (mean: 33; median: 27 ng/g dw), all of which are suggested to be affected by both industrial and domestic activities. The highest contributions were from D5 (18%) and D6 (34%), followed by D9 (7.3%) and L11 (5.8%). The HQs for siloxanes were less than 1, indicating that there was no risk to benthic organisms in the study areas; however, further monitoring of various environmental matrices is required to fully assess the potential ecological risks.

A novel occluder for endoscopic closure of gastrotomy: an ex vivo and in vivo animal study.

BACKGROUND AND AIMS: We evaluated the feasibility of a novel occluder for endoscopic closure of natural orifice transluminal endoscopic surgery (NOTES) gastrotomy. METHODS: The occluder is a self-expandable, membrane-covered, metal structure for endoscopic delivery through gastrointestinal (GI) wall defects. The procedure time and air-tightness of endoscopic closure for a 12-mm perforation were compared for a through-the-scope clip group and an occluder group in an ex vivo animal study. The feasibility and safety of the occluder for the closure of NOTES gastrotomy were also evaluated in an in vivo animal study. RESULTS: In the ex vivo study, the median procedure time for closure was significantly shorter and the minimum air-leakage pressure was significantly greater in the occluder group than in the endoclip group. In the in vivo study, immediate air-tight sealing was achieved by application of the occluder and there were no serious adverse events. All animals showed spontaneous detachment of the occluder into the gastric lumen and complete healing within 4 - 8 weeks. CONCLUSIONS: The novel occluder can provide immediate and permanent sealing for NOTES gastrotomy.

Cold snare polypectomy versus cold forceps polypectomy for diminutive and small colorectal polyps: a randomized controlled trial.

BACKGROUND: The optimal technique for removal of diminutive or small colorectal polyps is debatable. OBJECTIVE: To compare the complete resection rates of cold snare polypectomy (CSP) and cold forceps polypectomy (CFP) for the removal of adenomatous polyps ≤7 mm. DESIGN: Prospective randomized controlled study. SETTING: A university hospital. PATIENTS: A total of 139 patients who were found to have ≥1 colorectal adenomatous polyps ≤7 mm. INTERVENTIONS: Polyps were randomized to be treated with either CSP or CFP. After the initial polypectomy, additional EMR was performed at the polypectomy site to assess the presence of residual polyp tissue. MAIN OUTCOME MEASUREMENTS: Absence of residual polyp tissue in the EMR specimen of the polypectomy site was defined as complete resection. RESULTS: Among a total of 145 polyps, 128 (88.3%) were adenomatous polyps. The overall complete resection rate for adenomatous polyps was significantly higher in the CSP group compared with the CFP group (57/59, 96.6% vs 57/69, 82.6%; P = .011). Although the complete resection rates for adenomatous polyps ≤4 mm were not different (27/27, 100% vs 31/32, 96.9%; P = 1.000), the complete resection rates for adenomatous polyps sized 5 to 7 mm was significantly higher in the CSP group compared with the CFP group (30/32, 93.8% vs 26/37, 70.3%; P = .013). LIMITATIONS: Single-center study. CONCLUSION: CSP is recommended for the complete resection of colorectal adenomatous polyps ≤7 mm. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01665898.).

Vitamin D Deficiency Adds an Element of Risk to Insulin Resistance in Colorectal Neoplasms.

BACKGROUND: Both insulin resistance (IR) and vitamin D deficiency (VitDdef) have been suggested as risk factors for colorectal neoplasms (CRNs). However, the associations between the two with regard to CRNs are unclear. AIMS: To determine whether IR is a risk factor for CRNs and whether VitDdef confers an additive risk of CRNs. METHODS: Colonoscopy-naïve asymptomatic women undergoing a routine health screening program were analyzed. IR was defined as homeostatic model assessment of IR >3 and VitDdef set as <20 ng/mL. Multivariable logistic regression was performed between women with and without CRNs, matched for age and body mass index, to investigate associations with CRNs in IR, VitDdef, and VitDdef combined with IR. RESULTS: We analyzed 216 women with CRNs and 216 without CRNs. A significant association was found between IR and CRNs (OR 1.838, 95 % CI 1.029-3.285, P = 0.040) but not with VitDdef. IR conferred a higher risk in advanced CRNs (OR 3.244, 95 % CI 1.588-6.631, P = 0.001) than CRNs. When VitDdef was combined with IR, risks of both CRNs and advanced CRNs increased (OR 2.131, 95 % CI 1.077-4.216, P = 0.030 and OR 4.438, 95 % CI 2.058-9.571, P < 0.001, respectively). CONCLUSIONS: IR increases the risk of CRNs, and a combination of IR and VitDdef further increases this risk. As both VitDdef and IR are modifiable risk factors, such associations may have important clinical implications in the prevention of CRNs.

Effects of personal experiences on the interpretation of the meaning of colours used in the displays and controls in electric control panels.

A survey was conducted to examine how personal experiences affect the interpretation of the meaning of display and control colours on electric control panels (ECPs). In Korea, the red light on ECPs represents a normal state of operation, while the green light represents a stopped state of operation; this appears to contradict the general stereotypes surrounding these colours. The survey results indicated that the participants who had experience in using ECPs interpreted the colour meaning differently from the other participant group. More than half of the experienced participants regarded the coloured displays and controls as they were designed, while most participants in the other group appeared to interpret the colours in accordance with the stereotypes. It is presumed that accidents related to human errors can occur when non-experienced people use the ECPs, which are easily accessible in many buildings. Practitioner Summary: A survey was conducted to investigate how personal experiences affect the interpretation of the function meanings of coloured lights on electrical control panels. It was found that the interpretation varies according to personal experiences, which can induce accidents related to human errors while operating electrical equipment.

Distributions of PCDD/Fs, PCBs, and PCNs in coastal sediments collected from major industrial bays in South Korea.

Polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs), polychlorinated biphenyls (PCBs), and polychlorinated naphthalenes (PCNs) were assessed in coastal sediments from industrial bays in South Korea to evaluate the pollution levels and their environmental impact. The mean sediment concentrations of Σ17 PCDD/Fs, Σ18 PCBs, and Σ15 PCNs were 198 ± 140, 3427 ± 7037, and 85 ± 336 pg/g dw, respectively. Generally, pollutant concentrations in the inner bay were higher than those in the outer bay, indicating the influence of industrial emissions and harbor activities. The primary sources were identified as steel manufacturing and wastewater treatment plants for PCDD/Fs, harbor and shipbuilding activities for PCBs, and combustion-related sources for PCNs. Notably, PCDD/F concentrations exceeded sediment guideline values. The combined effects of PCDD/Fs and PCBs demonstrated adverse impacts on aquatic organisms. Hence, the release of toxic pollutants into the marine environment could have potential biological effects due to the combined impact of these various compounds.

Polybrominated diphenyl ethers (PBDEs) in breast milk of Korea in 2011: current contamination, time course variation, influencing factors and health risks.

Breast milk is a valuable biological specimen to assess maternal and infant exposure to polybrominated diphenyl ethers (PBDEs). In this study, 208 breast milk samples were collected from 89 participants during lactation period, at <7, 15, 30, and 90 days postpartum, in four cities in Korea, and were determined for 19 PBDE congeners. The total PBDE concentrations (ΣPBDE) ranged from 0.23 to 68.4 (mean: 2.73) ng/g lipid weight, and were within the ranges reported for European and Asian countries. Within a month of lactation after delivery, no significant changes were found in the PBDE concentrations. The predominance of BDE 153 rather than BDE 47 was found in the most samples that BDE 153 was detected, and was likely to be associated with stepwise debromination of BDE 209. No associations were found between PBDE concentrations in breast milk and demographic parameters, except for ΣPBDE with maternal age and delivery mode. Certain types of diet such as corn, seafood and nut correlated significantly with PBDE levels in breast milk. The estimated daily intakes of ΣPBDE for breast-feeding infants were lower than the guidelines proposed by the US EPA, indicating limited health risk from PBDEs through breast feeding.

The value of early wireless esophageal pH monitoring in diagnosing functional heartburn in refractory gastroesophageal reflux disease.

BACKGROUND AND AIMS: It is difficult to differentiate functional heartburn from proton pump inhibitor (PPI) failure. The aims of this study were to assess the role of early wireless esophageal pH monitoring in patients referred with gastroesophageal reflux disease (GERD) and to identify differences in the clinical spectrum among GERD subtypes. METHODS: We enrolled consecutive referred patients with suspected GERD. After endoscopy on the first visit, all underwent wireless esophageal pH monitoring when off the PPI. RESULTS: Two hundred thirty patients were enrolled. These patients were classified into a reflux esophagitis group (20, 8.7 %) and a normal endoscopic findings group (210, 91.3 %). Among the 210 patients in the normal endoscopic findings group, 63 (27.4 %) were diagnosed with pathological reflux, 35 (15.2 %) with hypersensitive esophagus, 87 (37.8 %) with normal acid exposure with negative symptom association, and 25 (10.9 %) with test failure. These groups did not differ in age, body mass index, smoking habit, alcohol consumption, symptom severity, quality of life, presence of atypical symptoms, overlap with irritable bowel syndrome, and the frequency of somatization, depression, and anxiety. PPI responses were evaluated in 135 patients. Fifty patients (37.0 %) were not responsive to the 4-week treatment; 26 (19.3 %) were diagnosed with refractory non-erosive gastroesophageal disease, and 24 (17.8 %) with functional heartburn. The demographics and clinical and psychological characteristics did not differ between the two groups. CONCLUSIONS: Demographic characteristics and symptom patterns alone cannot differentiate functional heartburn from various subtypes of GERD. Wireless esophageal pH monitoring should be considered for the initial evaluation of GERD in the tertiary referral setting.

Efficacy of endoscopic mucosal resection using a dual-channel endoscope compared with endoscopic submucosal dissection in the treatment of rectal neuroendocrine tumors.

BACKGROUND: Conventional endoscopic mucosal resection (EMR) for removing rectal neuroendocrine tumors (NETs) has a high risk of incomplete removal because of submucosal tumor involvement. EMR using a dual-channel endoscope (EMR-D) may be a safe and effective method for resection of polyps in the gastrointestinal tract. The efficacy of EMR-D in the treatment of rectal NET has not been evaluated thoroughly. METHODS: From January 2005 to September 2011, a total of 70 consecutive patients who received EMR-D or endoscopic submucosal dissection (ESD) to treat a rectal NET <16 mm in diameter were included to compare EMR-D with ESD for the treatment of rectal NETs. RESULTS: The EMR-D group contained 44 patients and the ESD group contained 26 patients. The endoscopic complete resection rate did not differ significantly between the EMR-D and ESD groups (100 % for each). The histological complete resection rate also did not differ significantly between groups (86.3 vs. 88.4 %). The procedure time was shorter for the EMR-D group than for the ESD group (9.75 ± 7.11 vs. 22.38 ± 7.56 min, P < 0.001). Minor bleeding occurred in 1 EMR-D patient and in 3 ESD patients (2.3 vs. 7.6 %). There was no perforation after EMR-D or ESD. CONCLUSIONS: Compared with ESD, EMR-D is technically simple, minimally invasive, and safe for treating small rectal NETs contained within the submucosa. EMR-D can be considered an effective and safe resection method for rectal NETs <16 mm in diameter without metastasis.

Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men.

The relationships between occupational characteristics and symptoms of varicose veins and nocturnal leg cramps and their gender differences were explored in a Korean population. The study population was 2165 workers from various occupations (55.6% female). Multiple logistic regression analyses were conducted to reveal factors related to symptoms of varicose veins and nocturnal leg cramps. The prevalence of varicose veins and nocturnal leg cramps was higher among women than men. The characteristics of standing work were different according to gender. In gender stratified analysis, the odds ratio of varicose veins was significantly high for prolonged standing for male and female workers. However, the odds ratio of nocturnal leg cramps was only significant among prolonged standing male workers. The models including gender, prolonged standing and occupations in this order presented that gender is not significantly associated with varicose veins after occupations were added to the model. Prolonged standing at work may be a more important risk factor for varicose veins and nocturnal leg cramps than biological differences between women and men. Therefore, effective interventions to interrupt or reduce prolonged standing at work should be implemented for the prevention of varicose veins and nocturnal leg cramps. PRACTITIONER SUMMARY: This paper shows associations between occupational characteristics and symptoms of varicose veins and nocturnal leg cramps and their gender differences. These findings will contribute to knowledge of gender-specific occupational risk factors for symptoms in the distal lower extremities.

Specific-accumulation and trophic transfer of UV filters and stabilizers in marine food web.

The occurrence and distribution of benzotriazole UV stabilizers (BUVs) and UV filters in marine environments (sediment and seawater) and 20 biota species in the South Korea were investigated to assess their transfer through the marine food web. The total concentrations in the seawater samples were 4.73-8.60 ng/L for BUVs and 1.20-4.88 ng/L for UV filters; while, the total concentrations in the sediment samples were 0.581-6.62 ng/g dw for BUVs and 1.05-6.79 ng/g dw for UV filters, respectively. The total concentrations of BUVs and UV filters were a little higher in benthic invertebrates (BUVs: 131 ng/g lipid weight [lw], UV filters: 41.7 ng/g lw) than fish (BUVs: 99.2 ng/g lw, UV filters: 28.0 ng/g lw) but there were no statistical differences (Mann-Whitney U test, p > 0.05). UV-326 was dominant (fish: 37.9%, benthic invertebrate: 48.7%) of the total BUVs. While, benzophenone-3 (fish: 34.1%, benthic invertebrate: 40.8%) and ethylhexyl methoxy cinnamate (fish: 41.0%, benthic invertebrate: 37.8%) were the dominant UV filters. The bioaccumulation factor and trophic magnification factor indicated that UV-326 can both bioaccumulate and biomagnify (bioaccumulation factor >5000 and biota-sediment accumulation and trophic magnification factors >1). Several other BUVs were found to be able to either bioaccumulate (UV-320, UV-P, UV-329, and UV-234) or biomagnify (UV-327 and UV-928). Most of the analyzed UV filters were found not to be likely to bioaccumulate.

Characteristic occurrence patterns of micropollutants and their removal efficiencies in industrial wastewater treatment plants.

The concentrations and removal efficiencies of various kinds of micropollutants were investigated and the relationships between the input sources of industrial wastewater and occurrence patterns of each micropollutant were identified at nine on-site industrial wastewater treatment plants (WWTPs). The distribution pattern of each compound varied according to the WWTP type and several micropollutants were significantly related with specific industries: chlorinated phenols (ClPhs) with paper and metal industries, polycyclic aromatic hydrocarbons (PAHs) with petrogenic- and pyrogenic-related industries, polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) with the paper industry, and chlorinated benzenes (ClBzs) with dye-related industries. The activated sludge (AS) process was very efficient in the removal of ClPhs and PAHs, and the filtration process in the removal of PCDD/Fs and 1,4-dioxane. Generally, the removal efficiencies of each micropollutant varied according to the WWTP type.

The effects of age, viewing distance, display type, font type, colour contrast and number of syllables on the legibility of Korean characters.

This study evaluated the effects of age (20s and 60s), viewing distance (50 cm, 200 cm), display type (paper, monitor), font type (Gothic, Ming), colour contrast (black letters on white background, white letters on black background) and number of syllables (one, two) on the legibility of Korean characters by using the four legibility measures (minimum letter size for 100% correctness, maximum letter size for 0% correctness, minimum letter size for the least discomfort and maximum letter size for the most discomfort). Ten subjects in each age group read the four letters presented on a slide (letter size varied from 80 pt to 2 pt). Subjects also subjectively rated the reading discomfort of the letters on a 4-point scale (1 = no discomfort, 4 = most discomfort). According to the ANOVA procedure, age, viewing distance and font type significantly affected the four dependent variables (p < 0.05), while the main effect of colour contrast was not statistically significant for any measures. Two-syllable letters had smaller letters than one-syllable letters in the two correctness measures. The younger group could see letter sizes two times smaller than the old group could and the viewing distance of 50 cm showed letters about three times smaller than those at a 200 cm viewing distance. The Gothic fonts were smaller than the Ming fonts. Monitors were smaller than paper for correctness and maximum letter size for the most discomfort. From a comparison of the results for correctness and discomfort, people generally preferred larger letter sizes to those that they could read. The findings of this study may provide basic information for setting a global standard of letter size or font type to improve the legibility of characters written in Korean. STATEMENT OF RELEVANCE: Results obtained in this study will provide basic information and guidelines for setting standards of letter size and font type to improve the legibility of characters written in Korean. Also, the results might offer useful information for people who are working on design of visual displays.

Comparison of thymidine phosphorylase expression and prognostic factors in gallbladder and bile duct cancer.

BACKGROUND: Biliary tract cancers have limitations in information about different location-related pathogenesis and clinico-pathological characteristics. The goal of this study was to investigate anatomical site-related similarities and differences in biliary tract cancers and to assess the expression and clinical significance of functional proteins such as p53, cyclin D1, survivin, thymidine phosphorylase, and ERCC1. METHODS: One hundred and sixty-one patients with biliary tract adenocarcinomas, who underwent curative or palliative surgery in a single institution between October 1994 and December 2003 were evaluated, retrospectively. The level of protein expression of p53, cyclin D1, survivin, thymidine phosphorylase, and ERCC1 was assessed by immunohistochemistry. RESULTS: With respect to clinico-pathological characteristics, gallbladder cancer was more frequent in women, and bile duct cancer was more common in men. Perineural invasion was more common in bile duct cancer. Recurrence as a distant metastasis was more common in gallbladder cancer. Immunohistochemical analysis revealed that thymidine phosphorylase expression was significantly higher in gallbladder cancer than in bile duct cancer. Positive thymidine phosphorylase and p53 staining were associated with an advanced stage. Differentiation, vascular invasion, perineural invasion, lymphatic invasion, lymph node metastasis, and TNM stage independently predicted poor prognosis in biliary tract cancer. These correlations were seen more clearly in gallbladder cancer. The immunohistochemical staining patterns of p53, cyclin D1, survivin, thymidine phosphorylase, and ERCC1 showed no prognostic significance in biliary tract cancers. CONCLUSIONS: We concluded that gallbladder and bile duct cancers are considered to be separate diseases with different clinico-pathological characteristics and prognostic factors. In addition, we hypothesize that high expression of thymidine phosphorylase by gallbladder cancer results in a higher response rate to capecitabine by gallbladder cancer than bile duct cancer.

Capsule endoscopy in small bowel tumors: a multicenter Korean study.

BACKGROUND AND AIM: Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions in a variety of clinical conditions, but studies concerning the practical impact of CE on small bowel tumors are still scarce, especially in the Asian population. The aim of this study was to evaluate the diagnostic and therapeutic impact of CE in the field of small bowel tumors. METHODS: CE records consecutively pooled from the beginning of use of CE in Korea, October 2001 until April 2008, in 14 centers throughout Korea were reviewed. Clinical information and CE video images of small bowel tumors were analyzed. RESULTS: A total of 1332 cases undergoing CE were reviewed with all clinical indications. Small bowel tumors were diagnosed with CE in 57 (4.3%) of 1332 patients. The tumors were malignant in 33 cases, and included three adenocarcinomas, eight lymphomas, 20 gastrointestinal stromal tumors, and two metastatic cancers. The most frequent indications for CE in malignant tumors were obscure gastrointestinal bleeding, followed by abdominal pain and weight loss. Thirty of 57 tumors were identified exclusively by CE (diagnostic impact = 30/57), and they were smaller in size (mean, range: 14.3 mm, 2-35 mm) compared to the other tumors detected in radiological studies (48.7 mm, 10-110 mm). Seven patients underwent surgical resection (therapeutic impact = 7/57). CONCLUSION: CE effectively identifies small bowel tumors that are undetectable by conventional radiological studies (diagnostic impact = 52.6%) and can critically change the therapeutic course (therapeutic impact = 12.3%).

Contamination characteristics of polycyclic aromatic hydrocarbons in river and coastal sediments collected from the multi-industrial city of Ulsan, South Korea.

River and coastal sediments were collected at 17 stations in Ulsan, the largest industrial city in South Korea, to evaluate the levels, profiles, emission sources, and spatial distribution of polycyclic aromatic hydrocarbons (PAHs). The mean concentration of Σ16 PAHs was 722 ng/g, and fluoranthene was a predominant compound. PAHs with 4-6 rings showed higher proportions than PAHs with 2-3 rings. The stations located near industrial complexes showed elevated levels of indicator compounds for petroleum, coal, coke, and fuel combustion. Therefore, petrochemical industries, coal pier, non-ferrous industries, and vehicles were identified as the emission sources. As industrialization and urbanization progressed, an increase in PAH levels and profile changes were observed as a result of the increasing industrial fuel consumption and the increasing number of vehicles. This is the first study that confirmed the change of PAHs in sediment caused by the change of emission sources over time in Ulsan.

Species and habitat-dependent accumulation and biomagnification of brominated flame retardants and PBDE metabolites.

The occurrence, species- and habitat-dependent distribution of brominated flame retardants (BFRs) and PBDE metabolites comprising 27 polybrominated diphenyl ethers (PBDEs), 3 hexabromocyclododecanes (HBCDs), tetrabromobisphenol A (TBBPA), 17 methoxylated (MeO-) BDEs, and 8 hydroxylated (OH-) BDEs were determined in marine environments (sediment and seawater) and 20 biota species in food web in the southern part of Korea. The concentration of HBCDs was statistically higher in both pelagic (5.73-60.1 ng/g lipid weight [lw]) and demersal fish (2.45-31.3 ng/g lw), whereas a higher level of OH-BDEs was observed in benthic invertebrates (2.48-40.7 ng/g lw), suggesting different composition of BFRs and PBDE metabolites between species. The concentrations of TBBPA and MeO-BDEs were significantly higher in pelagic fish (1.31-11.3, 6.15-61.5 ng/g lw) than in demersal fish (not detected [N.D.]-4.45, 0.956-8.52 ng/g lw) and benthic invertebrates (N.D.-8.11, 0.182-4.65 ng/g lw), reflecting a dependence on habitat. Additionally, analogue distribution of PBDEs in pelagic fish was similar to that in seawater, whereas the distribution in demersal fish and benthic invertebrates was similar to the distribution in sediment. The bioconcentration factor (BCF) and trophic magnification factor (TMF) of α-HBCD, some of PBDEs, and 6-MeO-BDE47 were up to 5000 and 1, respectively, suggesting strong bioaccumulation and biomagnification.

Chronic gastrointestinal symptoms and quality of life in the Korean population.

AIM: To evaluate the prevalence of chronic gastrointestinal symptoms and their impact on health-related quality of life (HRQOL) in the Korean population. METHODS: A cross-sectional survey, using a reliable and valid Rome II based questionnaire, was performed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey (SF-36). RESULTS: Of the 1807 eligible subjects, 1417 (78.4%: male 762; female 655) were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastroesophageal reflux disease (GERD), defined as heartburn and/or acid regurgitation experienced at least weekly, was 3.5% (95% CI, 2.6-4.5). The prevalence of uninvestigated dyspepsia, irritable bowel syndrome (IBS) and chronic constipation based on Rome II criteria were 11.7% (95% CI, 10.1-13.5), 2.2% (95% CI, 1.5-3.1), and 2.6% (95% CI, 1.8-3.5) respectively. Compared with subjects without chronic gastrointestinal symptoms (n=1153), those with GERD (n=50), uninvestigated dyspepsia (n=166) and IBS (n=31) had significantly worse scores on most domains of the SF-36 scales. CONCLUSION: The prevalence of GERD, uninvestigated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health-related quality of life was significantly impaired in subjects with GERD, uninvestigated dyspepsia and IBS in this community.