Background: Lead, which is widely used in various industrial settings, is a major health hazard for manufacturing workers. Therefore, control of lead exposure has been implemented in an effort to prevent lead-related health problems. In this study, our aim was to evaluate temporal trends in occupational lead exposure in Korean lead workers using data from monitoring of workplace exposure. Methods: A nationwide work environment monitoring database, data from a work environment monitoring institution, and data extracted from a review paper were utilized. Different versions of standard industrial classification codes were aligned with the 10th Korean Standard Industrial Classification, which is generally consistent with the 4th revision of the International Standard Industrial Classification. The multiple data sources were combined and temporal trends over the period from 1994–2021 were estimated. In addition, separate estimation of temporal trends in the storage battery manufacturing industry over the period from 1987–2021 was also performed. Results: A total of 444,296 personal airborne lead measurements were used for the estimation process. The temporal trends in occupational exposure to lead declined by −6% annually over the study period. In particular, levels of lead exposure in the storage battery manufacturing industry showed a steeper decline of −12% annually. Conclusions Findings of our study showed that occupational exposure to lead declined over the period from 1994 to 2021 in Korea. However, adverse effects of exposure to lead on health should be regarded with caution. The results will be useful in conduct of epidemiological studies examining lead-related effects on health.

OBJECTIVE: Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. METHODS: The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. RESULTS: The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. CONCLUSION: The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease.
Aging ; Back Pain ; Early Diagnosis ; Female ; Humans ; Leg* ; Ligamentum Flavum* ; Magnetic Resonance Imaging ; Male ; Prevalence* ; Rare Diseases ; Retrospective Studies ; Spinal Diseases ; Spine

Cysts ; diagnosis ; surgery ; Female ; Humans ; Infant ; Intestinal Diseases ; diagnosis ; surgery ; Meckel Diverticulum ; diagnosis

There has been a considerable increase in the number of patients with olfactory disorder due to head and facial injuries. Conventional olfactory function evaluation methods, such as T&T olfactometer, the Schneider test and the Alinamin test have been widely used in clinical practice. Among these, the Schneider test can determine whether the patient is a malingerer. A woman who sustained head and facial injuries visited our department with the chief complaint of anosmia. The patient underwent conventional olfactory function tests, including T&T olfactometer and the Schneider test. T&T olfactometer revealed olfactory loss, but the Schneider test did not. Thus, she was diagnosed with malingering. However, her diagnosis of olfactory disorder and concurrent trigeminal nerve injury was made definite during the follow-up period. We herein report a 30-year-old female patient with olfactory disorder who was misdiagnosed with olfactory malingering based on the negative result of the Schneider test. A brief review of the literature has been included.
Adult ; Craniocerebral Trauma ; Facial Injuries ; Female ; Follow-Up Studies ; Head ; Humans ; Malingering ; Olfaction Disorders ; Thiamine ; Trigeminal Nerve ; Trigeminal Nerve Injuries

Sunken upper eyelids are one of the common and complicated problems that occur with an aging process or after double eyelidplasty. Autologous microfat grafting is a technique that has frequently been used for sunken eyelids. The traditional blind method of microfat grafting has a some complications. Therefore, we performed the open method with incisional double eyelidplasty. Between June, 2005 and February, 2008, we performed incisional double eyelidplasty and autologous microfat grafting into orbital septum in 63 patients(124 cases) with sunken upper eyelids. The fat was harvested from periumbilical regionand centrifuged at 3000 rpm for 3 minutes. After the middle fat layer was obtained by 1cc syringe, we made skin incision and separated orbital septum(inner layer) and levator aponeurosis. And then, we injected the microfat into orbital septum with 0.9 mm blunt cannula. At this time, one of the important things was to make the patient gaze upward during the fat injection. All the patients were satisfied, except 5 cases which were 3 cases of undercorrection and 2 cases of asymmetry. Surgical revision was required for only the above 5 cases(4%). Patients with some transient complications of ptosis (13 cases), overcorrection(4 cases) and nodular appearance(2 cases) were self-improved. We found that the method using incisional double eyelidplasty and autologous microfat grafting into orbital septum has many advantages which include less traumatic, less complication rate, less absorption rate of fat. and less burden of patients.
Absorption ; Aging ; Catheters ; Eyelids ; Humans ; Orbit ; Reoperation ; Skin ; Syringes ; Transplants

Peripheral T cell lymphoma, unspecified (PTCL-U) comprises a heterogenous group of mature T-cell lymphomas that do not match with any defined T-cell entities in the current classification system. A 68-year-old man presented with extensive erythematous to brownish ulcerative tumors with yellowish discharge on the neck, trunk, and both upper extremities that had persisted for the past 7 months. Histological findings showed medium- to large-sized pleomorphic lymphocytes with cellular atypia infiltrating the deep dermis and subcutis. Immunohistochemical analysis of specimens from this patient revealed positive staining for CD2, CD45, and granzyme B and mildly positive staining for CD3, CD4, CD30, and CD79a. Based on these clinico-pathological findings, the patient was finally diagnosed with PTCL-U. We report herein a rare case of PTCL-U presenting as multiple ulcerative tumors.
Aged ; Classification ; Dermis ; Granzymes ; Humans ; Lymphocytes ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Neck ; T-Lymphocytes ; Ulcer ; Upper Extremity

Azathioprine (AZA) treatment in transplant or autoimmune patients and subsequent appearance squamous cell carcinomas at various sites, particularly skin and cervix, has shown a close relationship. However, it remains uncertain whether this is true for the patients with Crohn's disease. We report a case of squamous cell carcinoma of the breast occurred in a 35-year-old female with Crohn's disease taking AZA. She was first diagnosed with Crohn's disease 10 years ago and has taken AZA with 5-aminosalicylic acid (5-ASA) on regular follow up in gastrointestinal department for 9 years. She had no family history of breast cancer. She visited breast cancer clinic due to incidentally found right breast mass. A mastectomy on the right breast was performed and 6.3x5.5 cm mass was removed. The mass was microscopically proven to be poorly differentiated squamous cell carcinoma with focal keratin pearl formation. At age of 25, she was first diagnosed with active Crohn's disease. 5-ASA and corticosteroid induced remission. Then, steroid was tapered off and AZA was maintained at 1 mg/kg due to leukopenia at higher dose. She stopped taking AZA at her discretion during her two pregnancies and reported total of 67 months of AZA medication on her breast cancer diagnosis.
Adult ; Azathioprine/*therapeutic use ; Breast Neoplasms/*diagnosis/pathology/therapy ; Carcinoma, Squamous Cell/*diagnosis/pathology/therapy ; Colonoscopy ; Combined Modality Therapy ; Crohn Disease/*drug therapy ; Female ; Humans ; Immunosuppressive Agents/*therapeutic use ; Mesalamine/therapeutic use ; Positron-Emission Tomography

Gastric mucosal calcinosis (GMC) is a very rare condition that is characterized by the nodular deposition of calcium salts in the gastric mucosa. It has been associated with renal failure, gastric cancer, ingestion of aluminum- containing antacids and the use of sucralfate in organ transplant patients. The etiology of this condition is uncertain, but several theories have been proposed; the condition is due secondarily to hyperparathyroidism in renal failure and to the alkalinization of the gastric mucosa. We report here on two patients who had long-term use of bismuth and/or aluminum-containing antacids to treat their gastro-esophageal reflux symptoms. The esophagogastroduodenoscopy revealed acute gastritis patterns, and GMC was confirmed histologically with biopsy. When one patient stopped ingesting bismuth-containing antacid solution, the follow-up esophagogastroduodenoscopy and the biopsy revealed a completely improved state. We report here on these interesting cases and we include a brief review of the literature.
Antacids ; Biopsy ; Bismuth ; Calcinosis* ; Calcium ; Eating ; Endoscopy, Digestive System ; Follow-Up Studies ; Gastric Mucosa ; Gastritis ; Gastroesophageal Reflux ; Humans ; Hyperparathyroidism ; Renal Insufficiency ; Salts ; Stomach Neoplasms ; Sucralfate ; Transplants

OBJECTIVE: On the magnetic resonance image (MRI) of the infiltrating brain tumor, enhancement is usually higher in malignant tumor than in benign tumor, and tumor cells can invade into the peritumoral area without definite enhancement. In various pathological conditions, the blood brain barrier (BBB) becomes changed to pathological condition, allowing various materials extravasating into the interstitial space, and degree of enhancement is depend on the pathology. Authors performed dynamic MRI on enhancing and surrounding edematous area in order to evaluate the degrees of opening of BBB, to differentiate tumor from non-tumorous condition, and to determine its relationship with the recurrence of the tumor. METHODS: Dynamic MRI was performed in 25 patients. Dynamic scans were done every 15 seconds after administration of Gd-DTPA on the enhancing and surrounding area for maximum 300 seconds, and the patterns of enhancement were analysed. The enhancement curve with initial steep increase followed by slow decrease was defined as "N pattern", those with initial steep increase followed by additional slow increase as "T pattern", and those with initial steep increase followed by plateau as "E pattern". Histopathological findings were compared with the dynamic scan. RESULTS: The graphs taken from enhancing area showed "T pattern" regardless of pathology. In the surrounding area, "T pattern" was noticed in the malignant tumors, but "E pattern" or "N pattern" was noted in low-grade or benign tumors and non-tumorous condition. "T pattern" in the surrounding area was related to the malignancy with tumor cell infiltration and recurrence. CONCLUSION: The results suggest that the malignant tumor infiltration changes the condition of BBB enough to extravasate the Gd-DTPA. Enhancement pattern in the surrounding edematous area may be a useful information to differentiate the malignant glioma with the low-grade and benign tumors or other non-tumorous conditions.
Blood-Brain Barrier ; Brain Neoplasms* ; Brain* ; Gadolinium DTPA ; Glioblastoma ; Glioma ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Recurrence

Background: There are incoherent studies about the effect of night shift work on circadian diurnal rhythms of cardiovascular parameters. Our study aimed to assess the alteration of circadian diurnal rhythms of cardiovascular parameters by night shift work. Methods: We studied 26 healthy nurse volunteers engaged in 3 shift work. From March 16 to April 30, 2006, ABPM (ambulatory blood pressure monitoring) was performed to each nurse two times during the day and night shift. Three nurses were excluded due to pain omdiced by ABPM. Blood pressure and heart rate was monitored every 30 minutes. Paired T-test was used for statistical analysis. Results: The mean arterial pressure, the mean systolic pressure, the mean heart rate and the mean pulse pressure during the overall period were significantly higher in the night shift than the day shift (P-value: <0.05, <0.001, <0.05, and <0.001, respectively). The mean arterial pressure, the mean diastolic pressure and the mean heart rate during in-hospital working period were significantly higher in the day shift (P-value: <0.05, <0.001, and <0.05, respectively). All parameters during the daytime sleep period after the night shift were significantly higher than during the nighttime sleep period after the day shift (P-values: <0.001). Proportional percentile falls of 3 parameters (systolic pressure, diastolic pressure, and heart rate) during the daytime sleep period after the night shift were significantly less than during the nighttime sleep period after the day shift (P-values: <0.001). Conclusion: The night shift work caused significant alteration in homeostasis of autonomic nervous system associated with circadian diurnal rhythms of cardiovascular parameters.
Arterial Pressure ; Autonomic Nervous System ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Circadian Rhythm* ; Heart ; Heart Rate ; Homeostasis ; Volunteers