Chondrolipoma is a benign tumor composed of mature adipose tissue and mature chondrocytes, and very rarely found. The patient, a 36-year-old woman, presented with a firm, walnut sized, mild tender mass at her left knee. There had been dull pain after long walking. There were no limitation of motion in physical examination. On plane lateral radiograph, radioopaque calcific densities were seen in elliptical soft tissue shadow below inferior pole of the patella. Magnetic resonance image demonstrated well defined mass of mixed signal intensity consistent with fat tissue and cartilaginous tissue. Gross specimen showed that the tumor appeared to be a round, encapsulated and firm nodule with milky whitish yellow cut surface. Microscopically the tumor consisted of nodular cartilage and mature fat tissue. The cartilage cells did not show mitotic figure and were often arranged in small clusters. But there were no cytologic features of malignancy. Thus the authors diagnosed this tumor as chondrolipoma, and report it with the literature review.
Adipose Tissue ; Adult ; Cartilage ; Chondrocytes ; Female ; Humans ; Juglans ; Knee* ; Patella ; Physical Examination ; Walking

Objectives: Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%–70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods: The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results: Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRSrelated conditions.

BACKGROUND: Shift work disturbs workers' biological clocks and this condition can cause various health problems including cardiovascular disease. The elevated albuminuria level has been significantly associated with the risk of the cardiovascular disease even within a normal reference range. Therefore, this study aimed to investigate the association between shift work and microalbuminuria. METHODS: Workers aged over 20 years from the fifth and sixth Korea National Health and Nutrition Examination Survey(KNHANES 2012–2014; n = 3000) were included in this analysis. The multiple logistic regression analysis was performed to determine the association between shift work and microalbuminuria stratified by gender. RESULTS: The prevalence of microalbuminuria in male subjects was higher among day workers, but the difference was not significant. However, the prevalence of microalbuminuria among females was higher in shift workers with statistical significance. For female, the Odds ratio of microalbuminuria in shift workers was significantly higher with 1.86 (95% CI 1.02–3.39) compared with day workers. After dividing into 5 subgroups of the shift work pattern, the odds ratio of microalbuminuria for fixed night shift was significantly higher at 4.68 (95% CI 1.29–17.00) compared with day workers. CONCLUSIONS: This study showed that shift work was associated with microalbuminuria in female workers. Especially we found out the association between fixed night shift and microalbuminuria in female workers.
Albuminuria ; Biological Clocks ; Cardiovascular Diseases ; Female ; Humans ; Korea ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Reference Values

BACKGROUND: Cleanroom air is extremely dry, as it is maintained within 1 % of relative humidity. Few studies have assessed the dermatologic life quality of workers in ultralow-humidity environments. Therefore, we aimed to evaluate the dermatologic life quality of cleanroom workers using the Skindex-29, compared to those of non-cleanroom workers. METHODS: Study participants were 501 cleanroom workers and 157 non-cleanroom workers from a secondary battery factory, who underwent an employee health examination at a single university hospital from September 2014 to September 2015. Results of the self-administered Skindex-29, and McMonnies questionnaire were analyzed. Other information and disease history were also collected during physician's medical examination. Descriptive and multivariate logistic regression analysis were performed. RESULTS: The Skindex-29 score was significantly higher in cleanroom workers than in non-cleanroom workers for all domains, Symptom (16.0 ± 15.9 vs. 6.3 ± 10.2, p < 0.001), Emotion (11.3 ± 17.4 vs. 2.5 ± 7.4, p < 0.001), Function (5.2 ± 11.1 vs. 1.6 ± 4.0, p < 0.001), and Overall (10.8 ± 13.4 vs. 3.5 ± 6.2, p < 0.001). The Skindex-29 score of cleanroom workers was similar to that of patients with skin diseases such as psoriasis, other dermatitis, corns, alopecia etc. Among the cleanroom workers, 37 workers had one or more skin diseases. Among the risk factors, ‘working at cleanroom’, ‘possessing skin disease’ and ‘McMonnies score’ had significant strong correlations with Skindex-29 score, meanwhile age, sex, smoking, drinking and exercise had weak correlations with it.‘Working at cleanroom’ and ‘possessing skin disease’ had highest odds ratios with overall 14.0 (C.I.: 5.9–33.1) and 13.4 (C.I.: 4.5–29.2), and the lowest odds ratios with function domain 3.5(C.I.: 1.7–7.1) and 4.5(C.I.: 2.1–9.5), respectively. The McMonnies score had the highest odds ratio with overall, 6.9(C.I.: 4.5–10.8) and lowest odd ratio with emotion domain 4.2 (C.I.: 2.7–6.4). CONCLUSIONS: Dermatologic life quality among cleanroom workers in the secondary battery factory is shown to be lower than that among non-cleanroom workers in this study. The study suggests that the Skindex-29 may provide helpful information on the dermatologic life quality of cleanroom workers. Therefore, regarding evaluation of dermatologic life quality using Skindex-29, preventive care is necessary for cleanroom workers in ultralow humidity environment.
Alopecia ; Callosities ; Dermatitis ; Drinking ; Humans ; Humidity ; Logistic Models ; Occupational Health ; Odds Ratio ; Psoriasis ; Quality of Life* ; Risk Factors ; Skin ; Skin Diseases ; Smoke ; Smoking ; Zea mays

BACKGROUND: Lead and cadmium have been identified as risk factors for hearing loss in animal studies, but large-scale studies targeting the general human population are rare. This study was conducted to investigate the link between heavy metal concentrations in blood and hearing impairment, using a national population-based survey. METHODS: The study participants comprised 6409 Koreans aged 20 or older, who were included in the Fifth and Sixth Korea National Health and Nutrition Examination Surveys (KNHANES 2010–2013). Hearing impairment was categorized into two types, low- and high-frequency hearing impairment, using pure tone audiometry. Low-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 0.5, 1, and 2 kHz exceeding 25 dB, and high-frequency hearing impairment was defined as having a binaural average of hearing thresholds for 3, 4, and 6 kHz exceeding 25 dB. The blood levels of heavy metals (lead and cadmium) were classified into quartiles. Cross-sectional association between hearing impairment and the level of heavy metals (lead and cadmium) was examined in both sexes. Multivariate logistic regression was used to obtain adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Among men, the prevalence of low- and high- frequency hearing impairment was 13.9% and 46.7%, respectively, which was higher than the prevalence among women (11.8% and 27.0%, respectively). Regarding lead, the adjusted OR of high-frequency hearing impairment for the highest blood level group versus the lowest group was significant in both men (OR = 1.629, 95% CI = 1.161–2.287) and women (OR = 1.502, 95% CI = 1.027–2.196), after adjusting for age, body mass index, education, smoking, alcohol consumption, exercise, diagnosis of diabetes mellitus, hypertension, and noise exposure (occupational, loud, firearm noises). No links were found between blood lead levels and low-frequency hearing impairment, or between blood cadmium levels and low- or high-frequency hearing impairment in either sex. CONCLUSIONS: The present study findings suggest that even exposure to low-level lead is a risk factor for high-frequency hearing loss. A prospective epidemiologic study should be conducted to identify the causal relationship between human health and exposure to heavy metals, and efforts to reduce heavy metal exposure in the general population should continue.
Alcohol Drinking ; Animals ; Audiometry ; Body Mass Index ; Cadmium ; Diabetes Mellitus ; Diagnosis ; Education ; Environmental Exposure ; Epidemiologic Studies ; Female ; Hearing Loss ; Hearing Loss, High-Frequency ; Hearing ; Humans ; Hypertension ; Korea ; Logistic Models ; Male ; Metals, Heavy ; Noise ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Prospective Studies ; Risk Factors ; Smoke ; Smoking

Objective: Tracheal intubation is an essential procedure in many emergencies. Direct laryngoscopy is the best method of intubation, but its success is not assured in a difficult airway. This study was designed to compare the performance of two intubation-assisted maneuvers that can help an unskilled person to perform a successful intubation. Methods: A randomized crossover trial for intubation was conducted in three airway scenarios: normal airway, tongue edema (TE) and cervical immobilization (CI). Sixty paramedic students performed intubation on a manikin using single operator intubation (SM), external laryngeal manipulation (ELM), and colleague assisted laryngoscopic maneuver (CALM). The degree of the visual field, intubation success rate, time to ventilation (TTV), tooth fracture, and difficulty of intubation were measured. Results: There was no statistically significant difference in success rates between the three intubation methods, except in CI, where CALM had a significantly higher success rate (91.7%) as compared to ELM (78.3%) and SM (71.7%). There was no significant difference in TTV between the three intubation methods in all scenarios. However, with an improvement in the degree of visual field with ELM and CALM, evaluated using the Cormack-Lehane classification system, there was a statistically significant improvement in both TE and CI. Tooth fractures were lowest when CALM was used. The degree of difficulty felt by operators during intubation also tended to be lower in CALM than other methods, particularly, in CI. Conclusion For a novice, intubation using CALM was on par or better than ELM in the manikin study. And CALM was a more effective assistive method, specifically in CI cases.

Objective: Tracheal intubation is an essential procedure in many emergencies. Direct laryngoscopy is the best method of intubation, but its success is not assured in a difficult airway. This study was designed to compare the performance of two intubation-assisted maneuvers that can help an unskilled person to perform a successful intubation. Methods: A randomized crossover trial for intubation was conducted in three airway scenarios: normal airway, tongue edema (TE) and cervical immobilization (CI). Sixty paramedic students performed intubation on a manikin using single operator intubation (SM), external laryngeal manipulation (ELM), and colleague assisted laryngoscopic maneuver (CALM). The degree of the visual field, intubation success rate, time to ventilation (TTV), tooth fracture, and difficulty of intubation were measured. Results: There was no statistically significant difference in success rates between the three intubation methods, except in CI, where CALM had a significantly higher success rate (91.7%) as compared to ELM (78.3%) and SM (71.7%). There was no significant difference in TTV between the three intubation methods in all scenarios. However, with an improvement in the degree of visual field with ELM and CALM, evaluated using the Cormack-Lehane classification system, there was a statistically significant improvement in both TE and CI. Tooth fractures were lowest when CALM was used. The degree of difficulty felt by operators during intubation also tended to be lower in CALM than other methods, particularly, in CI. Conclusion For a novice, intubation using CALM was on par or better than ELM in the manikin study. And CALM was a more effective assistive method, specifically in CI cases.

It has been demonstrated that inhibitors of advanced glycation end products (AGE), such as aminoguanidine, can suppress peritoneal AGE in rats on peritoneal dialysis (PD). However, it is unknown whether late administration of a putative crosslink breaker, alagebrium, could reverse peritoneal AGE. We therefore compared alagebrium with aminoguanidine in their ability to reverse peritoneal AGE in rats on PD. Male Sprague-Dawley rats were randomly divided into 3 groups: group I dialyzed with 4.25% glucose solution for all exchanges; group II dialyzed with 4.25% glucose solution containing aminoguanidine, and group III dialyzed with 4.25% glucose solution containing alagebrium for last 8 weeks of 12-week dialysis period. Dialysis exchanges were performed 2 times a day for 12 weeks. Immunohistochemistry was performed using a monoclonal anti-AGE antibody. One-hour PET was performed for comparison of transport characteristics. The immunolabelling of AGE in peritoneal membrane was markedly decreased in the alagebrium group. Consistent with this, the alagebrium group exhibited significantly higher D/Do glucose and lower D/P urea, suggesting low peritoneal membrane transport. But there were no significant differences between the control and the aminoguanidine group. These results suggest that the alagebrium may be the optimal therapeutic approach, compared with treatment with inhibitors of AGE formation, in rats on PD.
Animals ; Biological Transport ; Body Weight ; Cell Membrane/metabolism ; Glycosylation End Products, Advanced/*metabolism ; Guanidines/metabolism ; Immunohistochemistry/methods ; Male ; Peritoneal Dialysis/*methods ; Peritoneum/metabolism/*pathology ; *Permeability ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Afferent loop syndrome is an uncommon complication of a gastric resection in which intestinal continuity has been restored by using a gastrojejunostomy. It may cause symptoms at any time from the first postoperative day to many years after the gastrectomy, although most symptoms are manifestated during the second postoperative week. Due to difference in the degree and the permanence of the obstruction, the symptoms and the courses of patients with afferent loop syndrome may be acute or chronic. METHODS: We performed a retrospective clinical analysis of 29 patients who had been treated with operations from January 1982 to December 1996 at the Department of Surgery, Catholic University Medical Center. RESULTS: Afferent loop syndrome occurred in 29 cases (0.46%) of gastric surgery involving 1882 peptic-ulcer cases and 4390 stomach cancer cases. The original conditions requiring gastric surgery were gastric ulcers (8/752, 1.06%), duodenal ulcers (10/1130, 0.88%), and stomach cancer (11/4390, 0.25%). This syndrome occurred more frequently for a truncal vagotomy and a Billroth II type antrectomy (1.76%) than for other surgical procedures. The etiologic factors of afferent loop syndrome were an adhesive band (41.4%), volvulus (24.1%), retroanastomotic internal herniation (20.7%), and stomal stenosis (13.8%). The time interval from the first operation to the onset of symptoms was less than two weeks in 58.6% of the patient. Epigastric pain was the most common symptom (93.1%), followed by nausea and/or vomiting (51.7%), tachycardia (41.3%), and fever (27.5%). The diagnostic procedure mainly performed was an upper gastrointestinal series (69%). Hyperamylasemia was noted in 17 patients (65%). Theoperations performed included a bypass jejunojejunostomy in 17 patients (58.6%), a Roux-en-Y enterostomy in 6 patients (20.7%), a tube duodenostomy in 2 patients (6.9%), a bypass jejunostomy with tube duodenostomy in 2 patients, and a pancreaticoduodenectomy in 2 patients. The postoperative complications were wound infections (34.5%), pleural effusion (13.8%), enterocutaneous fistulas (17.2%), and subphrenic abscesses (13.8%). The operative mortality rate (within 2 months) was 13.8%. CONCLUSIONS: If afferent loop syndrome is suspected, it may be demonstrated by using an upper gastrointestinal contrast study. Endoscopy should be performed in all patients in whom the diagnosis of afferent loop obstruction is suspected. It's main value is to rule out other causes for the patient's complaints, especially in alkaline reflux gastritis. Once the diagnosis is made, surgical correction is indicated. The most satisfactory measure to prevent afferent loop syndrome is to avoid a long afferent loop. If a Billroth I or a Roux-en-Y pattern gastrointestinal anastomosis is difficult, this complication is best avoided by using a short afferent loop and by fashioning the anastomosis to prevent an obstruction at the stoma.
Academic Medical Centers ; Adhesives ; Afferent Loop Syndrome* ; Constriction, Pathologic ; Diagnosis ; Duodenal Ulcer ; Duodenostomy ; Endoscopy ; Enterostomy ; Fever ; Gastrectomy ; Gastric Bypass ; Gastritis ; Gastroenterostomy ; Humans ; Hyperamylasemia ; Intestinal Fistula ; Intestinal Volvulus ; Jejunostomy ; Mortality ; Nausea ; Pancreaticoduodenectomy ; Pleural Effusion ; Postoperative Complications ; Retrospective Studies* ; Stomach Neoplasms ; Stomach Ulcer ; Subphrenic Abscess ; Tachycardia ; Vagotomy, Truncal ; Vomiting ; Wound Infection

OBJECTIVE: The fallopian tube is considered as the site of origin of serous ovarian cancer, and risk-reducing salpingectomy (RRS) has been proposed as a new and safe strategy for preventing ovarian cancer. However, little is known about the public perception of RRS. METHODS: We performed a questionnaire survey of 100 healthy female volunteers in November 2014. Questionnaire for this survey included questions on demographics, medical history, knowledge of and belief about RRS, and barrier to its application. RESULTS: Among 100 respondents, 71% did not realize the seriousness of ovarian cancer, 79% were unaware of the fact that salpinx was the origin of ovarian cancer, and 87% stated that they had never heard of RRS as a preventive method for ovarian cancer. Also, 98% of respondents replied that they had the right to be informed about RRS and the choice given. The respondents' fears about RRS included increased risk of surgical complications (68%), no benefit (8%), and increased surgical costs (3%). CONCLUSION: Most general women were unaware of RRS as a method for preventing ovarian cancer in women at average risk. Therefore, physicians should discuss RRS with patients and consider this procedure at the time of abdominal or pelvic surgery.
Surveys and Questionnaires ; Demography ; Fallopian Tubes ; Female ; Humans ; Ovarian Neoplasms* ; Salpingectomy* ; Volunteers