The context of specific criteria for the recognition of occupational diseases (ODs) due to physical agents in the Enforcement Decree of the Industrial Accident Compensation Insurance Act (ED-IACIA) and the Labor Standard Act (LSA) does not describe definite disease along with the agents but listed symptoms or obscure clinical conditions. Moreover, the needs for an amendment of these Acts have recently attracted renewed interest. To establish agreed criteria for compensable ODs due to physical agents, we reviewed the criteria for recognizing ODs on the basis of International Labor Organization (ILO) documents and European Union (EU) guideline. After providing a brief review of the history of OD outbreaks due to physical exposure in South Korea and the responses to them, we describe the basis for the recent amendments to the IACI Act and LSA and assess their appropriateness. On the basis of these findings, this study could be helpful for determining and compensating process of ODs. However, further work is required to ascertain the scientific relationship between diseases caused by physical agents and the exposure criteria.
Accidents, Occupational ; Humans ; Male ; Noise/*adverse effects ; Occupational Diseases/*economics ; Occupational Exposure/adverse effects ; Radiation Injuries/*economics ; Republic of Korea ; Vibration/*adverse effects ; Workers' Compensation/*economics

The tarsal tunnel is located beneath the flexor retinaculum, which connects the medial malleolus and calacaneus. The tarsal tunnel contains the posterior tibialis tendon, flexor digitorum longus tendon, posterior tibial artery and vein, posterior tibial nerve, and flexor halluces longus tendon. Tarsal tunnel syndrome is a compressive neuropathy of posterior tibial nerve and its branches under the flexor retinaculum. The etiologies of tarsal tunnel syndrome are space-occupying lesion, hypertrophied flexor retinaculum, osteophytes, tarsal coalition, varicose vein, and trauma. The symptoms are foot pain and hypoesthesia or paresthesia at dermatome according to involving nerve branches. Clinical diagnosis can be obtained from a detailed history and physical examination such as compressive test at the tarsal tunnel area. Ultrasonography and magnetic resonance imaging can reveal the space-occupying lesion, such as ganglion, lipoma, and neuroma. The initial treatments of tarsal tunnel syndrome are conservative management, such as physical therapy, night splint, and steroid injection. Surgical decompression is indicated after failure of conservative managements. Variable results of surgical treatment have been reported. Favorable result after decompression could be obtained from young patients, early onset symptoms, and space-occupying lesion.
Decompression ; Decompression, Surgical ; Diagnosis ; Foot ; Ganglion Cysts ; Humans ; Hypesthesia ; Lipoma ; Magnetic Resonance Imaging ; Neuroma ; Osteophyte ; Paresthesia ; Physical Examination ; Splints ; Tarsal Tunnel Syndrome* ; Tendons ; Tibial Arteries ; Tibial Nerve ; Ultrasonography ; Varicose Veins ; Veins

Background: The prevalence of psoriasis differs by population, and it appears to be more common among Europeans than in East Asians. Recent genome-wide association studies (GWAS) have identified alleles that increase the risk of psoriasis, and these alleles may present different frequencies in different geographic regions. Objective: We aimed to gain insights into the causes of differences in disease frequencies according to populations and the factors affecting prevalence and pattern differences. Methods: We collected a total of 147 psoriasis-associated single-nucleotide polymorphisms (SNPs) from the GWAS catalog and compared the allele frequency differences in 27 populations using public population frequency in the 1000 Genomes Project phase 3 (n=2,504) and the Korean Reference Genome Database (n=1,722). Additionally, we calculated the composited genetic risk scores across the population groups. Results: There were distinct patterns of allele frequencies in different population groups.In many cases, East Asians exhibited allele frequencies opposite to that of Europeans. The genetic risk score was higher in Europeans (average: 0.487) and Americans (average: 0.492) than in East Asians (average: 0.471). The prevalence of psoriasis correlated with the average genetic risk score of the population. Conclusion We observed a difference in the allele frequencies of psoriasis-associated SNPs between the studied populations. This result suggests that the difference in the prevalence of psoriasis between population groups can be interpreted to some extent by the genotype.

Primary liver tumor, especially hepatocellular carcinoma (HCC), is a common cause of cancer death worldwide. The incidence is generally higher in Asian countries than in western countries. Carcinogenesis of HCC is often associated with hepatitis viral infections. Current standard treatment of HCC is surgical resection or transplantation in patients with early stage disease. However, the patient with advanced stage disease, surgical resection is often limited. Sorafenib or other treatment modalities are not so effective as well. We report a case of unusual radiation super-sensitivity in advanced stage HCC, and review the literature.
Asian Continental Ancestry Group ; Carcinogenesis ; Carcinoma, Hepatocellular ; Hepatitis ; Humans ; Incidence ; Liver ; Radiotherapy

OBJECTIVE: The effect of acute noise on cognitive function has long been a topic of study, yet these effects remain a serious problem for learning performance in school children. METHODS: From November 15, 2010 to December 8, 2010, we enrolled 268 students from three elementary schools (135 boys and 133 girls, 10–12 years old) in Ulsan, Korea. The study subjects were divided into two groups according to their test conditions (background versus additional noise), and tests were conducted using psychological examination tools. Chi-square tests and general linear models were used to assess the differences of impacts on cognition between the two groups. RESULTS: After adjusting for socio-demographic covariates, the noise significantly affected the results of full-scale IQ, verbal IQ, Continuous Performance Test scores, and Children’s Color Trails Test and Stroop test scores. The groups at high risk of learning difficulties were more affected by noise than low-risk groups. CONCLUSION: These findings suggest that noise is hazardous to the attention and performance of elementary school students, particularly for groups at greater risk for poor academic achievement. Additional studies are needed to identify subject-specific levels of noise that can affect attention and cognitive function.
Child* ; Cognition* ; Female ; Humans ; Korea ; Learning ; Linear Models ; Noise* ; Non-Randomized Controlled Trials as Topic* ; Stroop Test ; Ulsan

Objectives: Severe mental illness has become one of the leading concerns for the cost of health services. This study analyzed the demographic characteristics and compared the patterns of medical health service use according to the diagnosis of severe mental illness, including schizophrenia spectrum disease, bipolar disease, and major depressive disorder. Methods: The data from the National Health Insurance Corporation were analyzed, selecting subjects diagnosed at least once for severe mental illness between 2014 and 2019. Severe mental illness included the following: schizophrenia, schizotypal, and delusional disorders (F20– 29); manic episodes and bipolar affective disorder (F30–31); and moderate depressive episodes with psychotic features and recurrent depressive disorder (F32.3–F33). The demographic factors and patterns of medical services, such as outpatient, hospitalization, and re-admission differences, were compared according to the diagnostic categories. Results: This study included 842459 patients, with 39.6% people in F20–F29, 33.7% in F32.3– F33, and 26.8% in the F30–F31 category. There were significant differences in gender, age, insurance type, Charlson Comorbidity Index score, and economic level according to the diagnostic categories. The engagement of medical health services also showed significant differences among the diagnostic categories. F32.3–F33 showed higher engagement of outpatients than the out-groups, while F20–F29 showed a higher admission rate. The hospitalization duration was significantly longer in F20–F29, and the re-admission rate after discharge within one year was significantly higher in the same group. Conclusion This paper reviewed the differences in medical care utilization among severe mental illness. The result emphasizes the need for a mental health care system broadening to the community, facilitating psychosocial intervention, and case management.

In the present study, we investigated whether apigenin significantly affects tumor necrosis factor-alpha (TNF-alpha)-induced production and gene expression of MUC5AC mucin in airway epithelial cells. Confluent NCI-H292 cells were pretreated with apigenin for 30 min and then stimulated with TNF-alpha for 24 h or the indicated periods. The MUC5AC mucin gene expression and mucin protein production were measured by reverse transcription - polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Apigenin significantly inhibited MUC5AC mucin production and down-regulated MUC5AC gene expression induced by TNF-alpha in NCI-H292 cells. To elucidate the action mechanism of apigenin, effect of apigenin on TNF-alpha-induced nuclear factor kappa B (NF-kappaB) signaling pathway was also investigated by western blot analysis. Apigenin inhibited NF-kappaB activation induced by TNF-alpha. Inhibition of inhibitory kappa B kinase (IKK) by apigenin led to the suppression of inhibitory kappa B alpha (IkappaBalpha) phosphorylation and degradation, p65 nuclear translocation. This, in turn, led to the down-regulation of MUC5AC protein production in NCI-H292 cells. Apigenin also has an influence on upstream signaling of IKK because it inhibited the expression of adaptor protein, receptor interacting protein 1 (RIP1). These results suggest that apigenin can regulate the production and gene expression of mucin through regulating NF-kappaB signaling pathway in airway epithelial cells.
Apigenin* ; Blotting, Western ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression* ; Mucins* ; Necrosis* ; NF-kappa B ; Phosphorylation ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; Tumor Necrosis Factor-alpha

BACKGROUND: Recently, several studies have assessed the association between diabetes and hearing impairment. However, the effect of diabetes on hearing impairment is not well known in diabetic patients exposed to noise, a typical cause of hearing impairment. The aim of this study is to longitudinally analyze the effect of diabetes on hearing impairment in workers exposed to similar noise levels from 2013 to 2017 who had experienced little change in their working conditions. METHODS: The study subjects included 2,087 male workers exposed to noise in a single company and who underwent health examinations at the same hospital in Ulsan city in 2013 and 2017. Hearing impairment was defined that a pure-tone average of pure-tone audiometry (PTA) thresholds at 1,000, 2,000, 3,000, and 4,000 Hz was 25 dB and over in both ears. Statistical analyses were conducted using χ2 tests, ANOVA, and Cox proportional hazard models. We analyzed covariates that might affect hearing impairment, including age; working period; levels of total cholesterol, triglyceride, and serum creatinine; smoking and alcohol history; and noise level. RESULTS: The average PTA thresholds and their average changes between 2013 and 2017 were significant in the diabetes mellitus (DM) group than those in the normal and impaired fasting glucose group. Among the subjects with the same status of fasting glucose group in 2013 and 2017, the adjusted hazard ratios for incident hearing impairment among those in the DM group compared to normal group were 3.35 (95% confidence interval [CI], 1.54–7.29) in the left ear and 5.66 (95% CI, 2.01–15.98) in the right ear. CONCLUSIONS: This study suggested that the risk of hearing impairment in the DM group was significantly higher than that in the normal group in both ears, even when exposed to similar noise levels.
Audiometry, Pure-Tone ; Blood Glucose ; Cholesterol ; Creatinine ; Diabetes Mellitus ; Ear ; Fasting ; Glucose ; Hearing Loss ; Hearing ; Humans ; Longitudinal Studies ; Male ; Noise ; Proportional Hazards Models ; Smoke ; Smoking ; Triglycerides ; Ulsan

In this study, artesunate, an antimalarial agent, was investigated for its potential effect on the gene expression of airway MUC5AC mucin. The human pulmonary epithelial NCI-H292 cells were pretreated with artesunate for 30 min and then stimulated with phorbol 12-myristate 13-acetate (PMA), for the following 24 h. The effect of artesunate on PMA-induced nuclear factor kappa B (NFkB) signaling pathway was also examined. Artesunate inhibited the glycoprotein production and mRNA expression of MUC5AC mucins, induced by PMA through the inhibition of degradation of inhibitory kappa Bα (IkBα) and NF-kB p65 nuclear translocation.These results suggest artesunate suppresses the gene expression of mucin through regulation of NF-kB signaling pathway, in human pulmonary epithelial cells.

Background: Gastroesophageal reflux disease is highly prevalent among overweight and obese individuals. This study aimed to investigate the effect of weight change on the development of erosive esophagitis (EE). Methods: A retrospective review of medical records from a university hospital in South Korea identified 7,123 subjects who underwent routine health checkups in 2012 and 2014. We excluded participants with EE in 2012. Body mass index (BMI) changes were classified as loss, stable, mild gain, or moderate gain. Results: Mild and moderate weight gain increased the odds of EE development (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06–1.84 and OR, 2.80; 95% CI, 1.87–4.21, respectively) relative to weight stability. Weight loss decreased the odds of EE development (OR, 0.58; 95% CI, 0.38–0.90) relative to weight stability. After stratifying subjects into three groups by baseline BMI, those with mild and moderate weight gain in the obese group and moderate gain in the overweight group showed increased odds of EE development relative to members of those groups whose weights remained stable (OR, 2.08; 95% CI, 1.29–3.36; OR, 3.92; 95% CI, 1.99–7.73 in obese group, and OR, 3.30; 95% CI, 1.64–6.64 in overweight group, respectively). In comparison, weight loss in the normal weight group decreased the odds of EE development relative to weight stability (OR, 0.38; 95% CI, 0.15–0.97). Conclusion Weight gain was positively associated with EE development in overweight or obese individuals. Weight loss was negatively associated with EE development in normal-weight individuals.