Exposure to hazardous substances occurs through multiple pathways. Aggregated risk assessment, which includes all potential exposure pathways to a single toxicant, is necessary to prevent exposure to harmful substances. We aimed to estimate cadmium and lead exposure through various media, such as food, water, air, smoking, cosmetics, and female hygiene products. This study covered 10,733 subjects from the Seventh Korea National Health and Nutrition Examination Survey(2016, 2017). Dietary exposure was estimated using 24-hour recall data. For water and inhalational exposure, regional variations were considered. Water was classified as tap, bottled, and public water. Inhalational exposure was estimated using the '2014 Time Use Survey' based on daily lifestyle and social status. The frequency and volume of cosmetic usage were randomly approximated by sex and age. Post-menarcheal and premenopausal women were assumed to use feminine hygiene products. Non-carcinogenic aggregated risks were estimated using the Aggregate Risk Index from EPAs and the Total Exposure Hazard Index from Korean government guidelines. For carcinogenic risk assessment, excessive cancer risk was estimated. Ingestion, especially food, was the major route for both cadmium and lead exposure. Smoking was also associated with high cadmium exposure. Exposure to lead from cosmetics was remarkable but not critical. In aggregate risk assessments, median cadmium and lead exposure did not exceed the reference value. Sex, age, smoking status, and income affected exposure levels, unlike to regional variations.
Folate, a water-soluble vitamin, acts as a coenzyme for one-carbon metabolism in nucleic acid synthesis and amino acid metabolism. Adequate folate nutritional status during the periconceptional period is known to prevent neural tube defects. In addition, insufficient folate intake is associated with various conditions, such as anemia, hyperhomocysteinemia, cardiovascular disease, cancer, cognitive impairment, and depression. This review discusses the rationale for the revision of the 2020 Korean dietary reference intakes for folate, and suggestions for future revisions. Based on the changes in the standard body weight in 2020, the adequate intake (AI) for infants (5-11 months) and the estimated average requirements (EARs) for 15-18 years of age were revised, but there were no changes in the recommended nutrient intakes (RNIs) and tolerable upper intake levels (ULs) for all age groups. Mean folate intake did not reach RNI in most age groups and was particularly low in women aged 15-29 years, according to the results of the 2016-2018 Korea National Health and Nutrition Examination Survey (KNHANES). The percentages of folate intake to RNI were lower than 60% in pregnant and lactating women, but serum folate concentrations were higher than those in other age groups, presumably due to the use of supplements. Therefore, total folate intake, from both food and supplements, should be evaluated. In addition, the database of folate in raw, cooked, and fortified foods should be further expanded to accurately assess the folate intake of Koreans. Determination of the concentrations of erythrocyte folate and plasma homocysteine as well as serum folate is recommended, and quality control of the analysis is critical.
Min-Chan, Kim;Yong-Hoon, Choi;Han-Sang, Lim;Jae-Sam, Kim
The Korean Journal of Nuclear Medicine Technology
/
v.26
no.2
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pp.32-36
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2022
Purpose There are reports that the COVID-19 vaccine causes false positive uptake of axillary lymph nodes. Therefore, this paper intends to evaluate the change in SUVmax of axillary lymph nodes with the period after the COVID-19 vaccination. Materials and Methods In 134 breast cancer patients who were tested for 18F-FDG PET/CT at Severance hospital, 3.7 MBq/kg of 18F-FDG was intravenously injected and scanned for 2 minutes per bed after 60 minutes. The equipment was Discovery 600 (GE Healthcare, MI, USA). The period was divided into four groups, 0 to 2 weeks, 3 to 6 weeks, 7 to 10 weeks, and 11 weeks or more. SUVmax was measured after checking the uptake of axillary lymph nodes on the ipsilateral side of vaccination and the Kruskal-Wallis test was performed using SPSS Statistics 28 (IBM Corp., Armonk, NY, USA). Results From 0 to 2 weeks groups to 11 weeks or more group, the average of SUVmax was measured in the order of 5.52, 2.85, 1.82, and 1.7. As a result of the Kruskal-Wallis test, there was a significant difference between 0 to 2 weeks group from all other groups (P < 0.05), and there was no significant difference between the remaining three groups. Conclusion The SUVmax of axillary lymph nodes decreased over the period after the COVID-19 vaccination and no significant difference was found after 3 weeks of vaccination. Therefore, it is recommended to record COVID-19 vaccination information before examination.
Breast ultrasonography is difficult to image in fatty breasts and to find micro-calcification, but the discovery of micro-calcification is very important for breast cancer screening. Among the color Doppler artifact of ultrasound, twinkle artifact mainly occur on strong reflectors such as stones or calcification in images, and evaluation methods using them are clinically being used. In this study, we are conducting experiments on the color Doppler settings of ultrasound equipment, such as repetition frequency, ensemble, persist, wall filtering, smoothing, linear density, and dissociation value, by producing a breast simulation phantom using the largest amount of calcium phosphate among breast implants. The purpose of this study was to improve the contrast of twinkle artifact in breast ultrasound examinations and to maximize their use in clinical practice. As a result, the pulse repetition frequency occurred in the range of 3.6 kHz to 7.2 kHz, and did not occur above 10.5 kHz. For ensembles, twinkle artifact occurred in all sizes of calcification under low conditions, and in threshold settings, the twinkle artifact increased slightly only under 80 to 100 conditions, and did not occur in 1 mm size calcification. Persist, wall filter, smoothing, and line density settings did not have much meaning in the setting variable because conditions did not increase by condition, and pulse repetition frequency, ensemble, and thresholds had the greatest impact on the twinkling artifact image. This study is expected to help examiners select optimal conditions to effectively increase twinkle artifact by adjusting color Doppler settings.
Se Jin Choi;Sung Joo Kim;Dong Wook Kim;Seung Soo Lee;Seung-Mo Hong;Kyung Won Kim;Jin Hee Kim;Hyoung Jung Kim;Jae Ho Byun
Korean Journal of Radiology
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v.24
no.12
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pp.1232-1240
/
2023
Objective: To investigate the imaging characteristics of large duct pancreatic ductal adenocarcinoma (LD-PDAC) on computed tomography (CT) and magnetic resonance imaging (MRI). Materials and Methods: Thirty-five patients with LD-PDAC (63.2 ± 9.7 years) were retrospectively evaluated. Tumor morphology on CT and MRI (predominantly solid mass vs. solid mass with prominent cysts vs. predominantly cystic mass) was evaluated. Additionally, the visibility, quantity, shape (oval vs. branching vs. irregular), and MRI signal intensity of neoplastic cysts within the LD-PDAC were investigated. The radiological diagnoses rendered for LD-PDAC in radiology reports were reviewed. Results: LD-PDAC was more commonly observed as a solid mass with prominent cysts (45.7% [16/35] on CT and 37.1% [13/35] on MRI) or a predominantly cystic mass (20.0% [7/35] on CT and 40.0% [14/35] on MRI) and less commonly as a predominantly solid mass on CT (34.3% [12/35]) and MRI (22.9% [8/35]). The tumor morphology on imaging was significantly associated with the size of the cancer gland on histopathological examination (P = 0.020 [CT] and 0.013 [MRI]). Neoplastic cysts were visible in 88.6% (31/35) and 91.4% (32/35) of the LD-PDAC cases on CT and MRI, respectively. The cysts appeared as branching (51.6% [16/35] on CT and 59.4% [19/35] on MRI) or oval shapes (45.2% [14/35] on CT and 31.2% [10/35] on MRI) with fluid-like MRI signal intensity. In the radiology reports, 10 LD-PDAC cases (28.6%) were misinterpreted as diseases other than typical PDAC, particularly intraductal papillary mucinous neoplasms. Conclusion: LD-PDAC frequently appears as a solid mass with prominent cysts or as a predominantly cystic mass on CT and MRI. Radiologists should be familiar with the imaging features of LD-PDAC to avoid misdiagnosis.
The purpose of this study is to evaluate the usefulness of high-b-values diffusion weighted magnetic resonance imaging for the preoperative detection of focal rectum cancers. 60patients with diffusion weighted imaging were evaluated for the presence of rectal cancers. Forty were male and twenty were female, and their ages ranged from 38 to 71 (mean, 56) years. Used equipment was 1.5Tesla MRI((GE, General Electric Medical System, Excite HD). Examination protocols were used the fast spin echo T2, T1 weighted imaging. All examination protocols were performed by the same location with diffusion weighted imaging for accuracy detection. The b-values used in DWI were 250, 500, 750, 1000. 1500, 2000$(s/mm^2)$. The rectum, bladder to tumor contrast-to-noise ratio (CNR) of MR images were quantitativlely analyzed using GE software Functool tool, four experienced radiologists and three radiotechnologists qualitatively evaluated image quality in terms of image artifacts, lesion conspicuity and rectal wall. These data were analysed by using ANOVA and Freedman test with each b-value(p<0.05). Contrast to noise ratio of rectum, bladder and tumor in b-value 1000 were 27.21, 24.44, respectively(p<0.05) and aADC value was $0.73\times10^{-3}$. As a qualitative analysis, the conspicuity and discrimination from the rectal wall of lesions were high results as $4.0\pm0.14$, $4.4\pm0.16$ on b-value 1000(p<0.05), image artifacts were high results as $4.8\pm0.25$ on b-value 2000(p<0.05). In conclusion, DWI was provided useful information with depicting the pre-operative detection of rectal cancers, High-b-value 1000 image was the most excellent DWI value.
From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.
Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.
Park, Hee-Ju;Oh, Jai-Min;Kim, Sung-Hoon;Lee, Chang-Hoon;Kim, Sang-Sik
Clinical and Experimental Pediatrics
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v.46
no.9
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pp.876-882
/
2003
Purpose : To find out the myocardial protective effect of cardioxane for the myocardial damage by doxorubicin. Methods : Using Eighteen rabbits(2.0-3.2 kg), doxorubicin($30mg/m^2$) was injected intravenously once a week in group I(12 rabbits) and cardioxane($600mg/m^2$) was injected at 20-30 minutes before doxorubicin administration in group II(6 rabbits). After this, we operated on the rabbits when the total cumulative dose of doxorubicin was reached at 210, 240, 270 and $300mg/m^2$ and observed the degree of myocardial damage with light and electronic microscope. Results : In group I, rabbits with less than $210mg/m^2$ of total cumulative dose of doxorubicin, there was no definite myocardial damage but with $240mg/m^2$, focal degenerative change was observed and with $300mg/m^2$, severe degenerative change was detected with light microscopic examination. With electronic microscope, rabbits with less than $180mg/m^2$ of total cumulative dose of doxorubicin in group I, there was no evidence of myocardial damage. In $210mg/m^2$, focal degenerative change was detected. With $240mg/m^2$, degenerative change was much more advanced and with $300mg/m^2$, severe degenerative change was detected. In group II, no definite myocardial damage was observed even though the total cumulative dose of doxorubicin reached $300mg/m^2$, but with $360mg/m^2$, there was a focal area where myocardial fibers were somewhat decreased, but it's difficult to say whether these decrement were due to adriamycin in the electronic microscopic examination. Conclusion : Cardioxane have a good protective effect for the doxorubicin induced cardiomyopathy and it will be used safely in pediatric cancer patients.
Background/Aims: It is well recognized that all aerobic cells have the protective mechanisms in order to minimize the tissue damage induced by various reactive oxygen species(ROS). Thioredoxin peroxidase(TPX) which has been recently identified and characterized functions to convert peroxide to water. The protein is also found in various subtypes(TPX-A & B, MER5, HS22 and HORF-06) and is known to be ubiquitous in most human cells. Especially, ischemic brain injuries, partial hepatectomy and radiation induced DNA damages. In treating lung cancer, radiation therapy has a major place in the local control and the relief of symptoms, but radiation induced free radical injury and resulting pulmonary fibrosis has been the major drawback of the therapy. However, little is known about the protective mechanisms and biologic modulations against radiation-induced tissue damages. Methods: Eighteen mice were divided into six groups, 3 in each group, and fifteen had received 900cGy of radiation. The mice were sacrificed according to the pre determined time schedule; immediate, 1, 2, 3 and 6 weeks after irradiation. Extracts were made from the lungs of each mice, Western blot analysis of various subtypes of TPX were done after SDS-P AGE. Examination of H & E stained slides from the same irradiated specimens and the control specimens were also performed. Results: No difference in the intensity of the immunoreactive bands in the irradiated lung samples of the mice compared to the unirradiated control was observed regardless of the time intervals, although H & E examination of the sample specimens demonstrated progressive fibrotic changes of the irradiated lung samples. Conclusion: In conclusion, according to our data, it is suggested that various thioredoxin peroxidase subtypes and catalase which are known to be increased in many repair processes may not be involved in the repair of the radiation injury to the lung and subsequent fibrosis.
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