Background: Bronchoscopy is recommended for patients with suspected nontuberculous mycobacterial pulmonary disease (NTM-PD) whose sputum culture results are consistently negative or from whom adequate sputum samples cannot be obtained. Post-bronchoscopy sputum (PBS) collection is recommended for patients with suspected tuberculosis who undergo bronchoscopy. However, it remains unclear whether PBS collection can increase the diagnostic yield of NTM-PD. Methods: Patients with suspected NTM-PD who underwent diagnostic bronchoscopy from January 1, 2017 to June 30, 2020 at the Seoul National University Hospital were included in the study. They were divided into the sputum culture-negative and scanty sputum groups.The results of mycobacterial cultures from bronchial washing specimens and PBS were compared between these groups. Results: In total, 141 patients were included in the study; there were 39 and 102 patients in the sputum culture-negative and scanty sputum groups, respectively. Nontuberculous mycobacteria were cultured from bronchial washing specimens collected from 38.3% (54/141) of all patients (30.7% [12/39] patients in the sputum culture-negative group and 41.2% [42/102] patients in the scanty sputum group; P = 0.345). Nontuberculous mycobacteria were exclusively cultured from PBS collected from 3.5% (5/141) of all patients (7.7% [3/39] patients in the sputum culture-negative group and 2.0% [2/102] patients in the scanty sputum group; P = 0.255). Conclusions Additional PBS collection improved diagnostic yield marginally in patients with suspected NTM-PD who undergo bronchoscopy.

Background: Bronchoscopy is recommended for patients with suspected nontuberculous mycobacterial pulmonary disease (NTM-PD) whose sputum culture results are consistently negative or from whom adequate sputum samples cannot be obtained. Post-bronchoscopy sputum (PBS) collection is recommended for patients with suspected tuberculosis who undergo bronchoscopy. However, it remains unclear whether PBS collection can increase the diagnostic yield of NTM-PD. Methods: Patients with suspected NTM-PD who underwent diagnostic bronchoscopy from January 1, 2017 to June 30, 2020 at the Seoul National University Hospital were included in the study. They were divided into the sputum culture-negative and scanty sputum groups.The results of mycobacterial cultures from bronchial washing specimens and PBS were compared between these groups. Results: In total, 141 patients were included in the study; there were 39 and 102 patients in the sputum culture-negative and scanty sputum groups, respectively. Nontuberculous mycobacteria were cultured from bronchial washing specimens collected from 38.3% (54/141) of all patients (30.7% [12/39] patients in the sputum culture-negative group and 41.2% [42/102] patients in the scanty sputum group; P = 0.345). Nontuberculous mycobacteria were exclusively cultured from PBS collected from 3.5% (5/141) of all patients (7.7% [3/39] patients in the sputum culture-negative group and 2.0% [2/102] patients in the scanty sputum group; P = 0.255). Conclusions Additional PBS collection improved diagnostic yield marginally in patients with suspected NTM-PD who undergo bronchoscopy.

Antiphospholipid syndrome (APS) is an acquired systemic autoimmune disorder characterized by a combination of clinical criteria, including vascular thrombosis or pregnancy morbidity and elevated antiphospholipid antibody titers. It is one of the causes of deep vein thrombosis and pulmonary embolism that can be critical due to the mortality risk. Overall recurrence of thromboembolism is very low with adequate anticoagulation prophylaxis. The most effective treatment to prevent recurrent thrombosis is long-term anticoagulation. We report on a 17-year-old male with APS, who manifested blue toe syndrome, deep vein thrombosis, pulmonary thromboembolism, and cerebral infarction despite adequate long-term anticoagulation therapy.
Adolescent ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Blue Toe Syndrome ; Cerebral Infarction ; Cerebrovascular Disorders ; Embolism* ; Humans ; Male ; Mortality ; Pregnancy ; Pulmonary Embolism ; Recurrence ; Thromboembolism ; Thrombosis ; Veins* ; Venous Thrombosis

OBJECTIVES: Many studies have reported an association between overwork and hypertension. However, research on the health effects of long working hours has yielded inconclusive results. The objective of this study was to identify an association between overtime work and hypertension in wage workers 45 years and over of age using prospective data. METHODS: Wage workers in Korea aged 45 years and over were selected for inclusion in this study from among 10,254 subjects from the Korean Longitudinal Study of Ageing. Workers with baseline hypertension and those with other major diseases were excluded. In the end, a total of 1,079 subjects were included. A Cox proportional hazards model was used to calculate hazard ratios and adjust for baseline characteristics such as sex, age, education, income, occupation, form of employment, body mass index, alcohol habit, smoking habit, regular exercise, and number of working days per week. Additional models were used to calculate hazard ratios after gender stratification. RESULTS: Among the 1,079 subjects, 85 workers were diagnosed with hypertension during 3974.2 person-months. The average number of working hours per week for all subjects was 47.68. The proportion of overtime workers was 61.0% (cutoff, 40 h per week). Compared with those working 40 h and less per week, the hazard ratio of subjects in the final model, which adjusted for all selected variables, working 41-50 h per week was 2.20 (95% confidence interval [CI], 1.19-4.06), that of subjects working 51-60 h per week was 2.40 (95% CI, 1.07-5.39), and that of subjects working 61 h and over per week was 2.87 (95% CI, 1.33-6.20). In gender stratification models, the hazard ratio of the females tended to be higher than that of the males. CONCLUSION: As the number of working hours per week increased, the hazard ratio for diagnosis of hypertension significantly increased. This result suggests a positive association between overtime work and the risk of hypertension.
Body Mass Index ; Diagnosis ; Education ; Employment ; Female ; Humans ; Hypertension* ; Korea ; Longitudinal Studies ; Male ; Occupations ; Proportional Hazards Models ; Prospective Studies ; Salaries and Fringe Benefits* ; Smoke ; Smoking

BACKGROUND: Adjuvant chemotherapy is the most accepted treatment for localized osteosarcoma. We studied the effectiveness of preoperative cisplatin and adriamycin combination chemotherapy in non-metastatic osteosarcoma. METHODS: Twenty four cases of patient with osteosarcoma were divided into two groups except four patients treated only conservatively. Group A (14 patients) received chemotherapy before operation and Group B (6 patients) received chemotherapy after operation. The chemotherapy regimen consisted of cisplatin (120 mg/m2 on day 1) and adriamycin (adriamycin 25 mg/m2 on days 2 to 4). RESULTS: The average age of the 20 patients was 27.5 years and the median follow-up duration was 39.3 months. 12 patients of group A were treated with limb-salvage operation and 2 patients with amputation because of tumor growing. According to Kaplan-Meier's plot, one year, three year overall survival rate were 100%, 85% in Group A and 100%, 75% in Group B. Histologic responses were assessed in patients received preoperative chemotherapy. Tumor necrosis over 90% is noted in 9 patients, under 90% necrosis is noted 5 patients. Their mean survival was 82 months and 25 months, respectively (p>0.05). CONCLSUION: Adjuvant chemotherapy with cisplatin and adriamycin was feasible in non-metastatic osteosarcoma and clinically significant adverse effect was neutropenia.
Amputation ; Chemotherapy, Adjuvant ; Cisplatin* ; Doxorubicin* ; Drug Therapy* ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Limb Salvage ; Necrosis ; Neutropenia ; Osteosarcoma* ; Survival Rate

A patient with idiopathic hypereosinophilic syndrome is reported who developed a drug fever that may be related to the administration of hydroxyurea. Typically, this form of fever develops after a few weeks of exposure to the drug and disappears with withdrawal of the drug and recurs on reexposure to the drug. The mechanism of hydroxyurea-induced fever remains unclear.
Fever* ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome

PURPOSE: I-131 labeled (2'-deoxy-2-iodo-p-D-arabinofuranosyl) adenine (IAD) may be involved in DNA synthesis during active proliferation of tumor cells. We conducted this study to find out the biodistribution of IAD and its feasibility for scintigraphic tumor imaging. MATERIALS AND METHODS: Tosyl acetyl-adenosine was dissolved in acetonitrile, and I-131-NaI was added and heated to synthesize IAD. Female Fisher 344 rats innoculated with breast tumor cells were injected witb 0.27 MBq of IAD. Rats were sacrificed at 0.5, 1, 2, 4, 24h and the % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy, rats bearing breast cancer were administered with 1.11 MBq of IAD and imaging was perforrned after 2 and 24h. Then, rat body was fixed and rnicrotomized slice was placed on radiographic film for autoradiography, RESULTS: %ID/g of tumor wa.' 0.74 (0.5h), 0.73 (1h), 0.55 (2h), 0.38 (4h), and 0.05 (24h), respectively. At 1h after injection, %ID/g of tumor was higher than that of heart (0.34), liver (0.42), spleen (0.47), kidney (0,69), muscle (0.14), bone (0.33) and intestine (0.51). However, %1D/g of tumor was lower than blood (1.06), lung (0.77), and thyroid (177.71). At 4h, %ID/g of tumor in comparison with other tissue did not change. Tumor contrast expressed by tumor to blood ratio was 0.69 and tumor to muscle ratio was 5.11 at 1h. However, these ratios did not improve through 24h. On autoradiogram and scintigraphy at 2 and 24 hour, the tumor was well visualized. CONCLUSION: This results suggest that Ial) may have a potential for tumor scintigraphy. However, further work is needed to improve localization in tumor tissue.
Adenine ; Animals ; Autoradiography ; Breast Neoplasms* ; Breast* ; DNA ; Female ; Heart ; Hot Temperature ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Radionuclide Imaging* ; Rats* ; Spleen ; Thyroid Gland ; X-Ray Film

PURPOSE: To determine the time of magnetic resonance(MR) signal intensity changes in denervated skeletal muscle and to compare MR imaging with electromyography(EMG) in the evaluation of peripheral nerve injury. MATERIALS AND METHODS: We evaluated MR imagings of denervated muscles after experimental transection of the sciatic nerve in five rabbits using 1.0T MR unit. MR imaging and EMG were performed 3 days and 1, 2 and 3 weeks after denervation. T1-weighted images(T1-WI), T2-WI and Short Tau Inversion Recovery(STIR) images were obtained. The signal intensity (SI) of muscles in the denervated and normal sides were visually and quantitatively compared. After measuring the SI of the normal and abnormal areas, the time of SI change was determined when there was significant difference (P<0.05) of SI between the normal and denervated sides. RESULTS: On STIR images, two of the five rabbits showed significant SI changes at the third day(P<0.05) and all showed significant changes(P<0.05)at the first week. On T2-WI, one rabbit showed significant SI changes at the third day, and all showed significant SI changes at the first week. On T1-WI, significant SI changes were seen in one rabbit at the second week and in one at the third. One week after denervation, all showed denervation potential on EMG. CONCLUSION: This study suggests that MR imaging using STIR images is a useful method in the evaluation of denervated muscle, and that MR signal changes of denervated muscle may precede EMG changes after denervation. To localize and to determine the severity of the peripheral nerve injury, future analysis of the distribution of abnormal MR SI in denervated muscles would be helpful.
Denervation ; Magnetic Resonance Imaging* ; Muscle, Skeletal* ; Muscles ; Peripheral Nerve Injuries ; Rabbits* ; Sciatic Nerve

BACKGROUND: Recently, the emergence of long working hours and the associated conditions such as coronary heart disease (CHD) and stroke have gained attention. The aim of this study was to investigate the association between long working hours and the 10-year-risk of CHD and stroke, estimated by Jee’s health risk-appraisal model for ischemic heart disease. METHODS: We analyzed data from Koreans who randomly enrolled in Korean National Health and Nutrition Examination Survey 2008–2012 and finally included 13,799 participants. The participants were classified as per their working hours: 0–30 h/week, 31–39 h/week, 40 h/week, 41–50 h/week, 51–60 h/week, 61–70 h/week, 71–80 h/week, and >80 h/week. The risks for CHD and stroke were determined using Jee’s health risk-appraisal model. Multiple logistic regression was used to analyze the association between working hours and 10-year risk for CHD. RESULTS: The 10-year risks for CHD and stroke were significantly and positively associated with working hours in both men and women. Furthermore, higher risks for CHD and stroke were associated with longer working hours in women. CONCLUSION: Long working hours are significantly associated with the risks of CHD and stroke, estimated by Jee’s health risk-appraisal model. This study suggests the need for proper management of working hours to reduce CHD risk and stroke risk in the Korean population. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40557-016-0149-5) contains supplementary material, which is available to authorized users.
Coronary Disease* ; Female ; Humans ; Korea* ; Logistic Models ; Male ; Myocardial Ischemia ; Nutrition Surveys* ; Stroke*

BACKGROUND: With the development of technology, extensive use of computers in the workplace is prevalent and increases efficiency. However, computer users are facing new harmful working conditions with high workloads and longer hours. This study aimed to investigate the association between computer use at work and self-reported depressive and anxiety disorder (DAD) in a nationally representative sample of South Korean workers. METHODS: This cross-sectional study was based on the third Korean Working Conditions Survey (2011), and 48,850 workers were analyzed. Information about computer use and DAD was obtained from a self-administered questionnaire. We investigated the relation between computer use at work and DAD using logistic regression. RESULTS: The 12-month prevalence of DAD in computer-using workers was 1.46 %. After adjustment for socio-demographic factors, the odds ratio for DAD was higher in workers using computers more than 75 % of their workday (OR 1.69, 95 % CI 1.30−2.20) than in workers using computers less than 50 % of their shift. After stratifying by working hours, computer use for over 75 % of the work time was significantly associated with increased odds of DAD in 20–39, 41–50, 51–60, and over 60 working hours per week. After stratifying by occupation, education, and job status, computer use for more than 75 % of the work time was related with higher odds of DAD in sales and service workers, those with high school and college education, and those who were self-employed and employers. CONCLUSIONS: A high proportion of computer use at work may be associated with depressive and anxiety disorder. This finding suggests the necessity of a work guideline to help the workers suffering from high computer use at work. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40557-016-0146-8) contains supplementary material, which is available to authorized users.
Anxiety Disorders* ; Anxiety* ; Commerce ; Cross-Sectional Studies ; Depressive Disorder ; Education ; Humans ; Logistic Models ; Occupations ; Odds Ratio ; Prevalence