To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the result of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment(31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.
Education ; Follow-Up Studies* ; Humans ; Knowledge of Results (Psychology) ; Occupational Diseases ; Occupational Health Services ; Outpatients ; Surveys and Questionnaires

Bordetella hinzii is a nonfermenting, gram-negative rod and a rare opportunistic pathogen that can cause respiratory infections, bacteremia, and cholangitis. Here, we report the first case of bacteremia caused by B. hinzii in Korea. A 59-year-old man was admitted for the biopsy of a mass lesion in the left lower lobe, which was detected during a health screening. The blood cultures collected from the patient with high fever (> 39℃), which developed 4 hours after the biopsy, yielded gram-negative rods. The gram-negative bacilli were identified as B. hinzii using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and PCR sequencing of the 16S rRNA gene. After 9 days of antimicrobial treatment with ampicillin/sulbactam, piperacillin/tazobactam, or meropenem, the patient improved and was discharged.

Background: Rapid detection of carbapenemase-producing Enterobacterales (CPE) is desirable to guide antimicrobial therapy and infection control. The NG-Test Carba5 (Carba5;NG Biotech, France) rapid multiplex lateral flow immunoassay and BD MAX Check-Points CPO Assay (CPO; BD Diagnostic Systems, USA) fully automated real-time PCR assay were evaluated for the detection of KPC, NDM, VIM, IMP, and OXA-48-like group in a culture colony compared to genotyping using conventional PCR. Methods: Among the clinical isolates of carbapenem-resistant Enterobacterales (CRE) collected from 2013 to 2019, up to 20 isolates for each carbapenemase type, and approximately 60 carbapenemase-negative CRE were enrolled. Genotyping of carbapenemases were performed using single-target PCR for KPC, NDM, and OXA-48-like group and the multiplex PCR for VIM, IMP, GIM, SIM, and SPM. All isolates were tested with Carba5 and CPO. The discrepant results were resolved by single-target specific conventional PCR or GeneXpert Carba-R Assay (Carba-R; Cepheid, USA). Results: Of 147 CREs, 82 were CPE (55.8%) including 20 KPC, 22 NDM, 17 VIM, three IMP, and 13 OXA-48-like group, and seven double carbapenemase-positive (three KPC/VIM, two NDM/ VIM, one KPC/NDM, and one NDM/OXA-48-like group) isolates. Carba5 and CPO detected all CPE correctly along with two more IMP-producing CPE. The sensitivity and specificity of both kits were equally 100% and 97%. Two false IMP-positives were confirmed IMP-positive with Carba-R and IMP-specific single-target PCR. Conclusion Carba5 and CPO reliably detect and differentiate five common carbapenemases in cultured colonies. Carba5, faster and simpler, is preferred as a spot test.

Background: The concurrent detection of human cytomegalovirus (CMV) with UL97 and UL54 mutations is crucial for prescribing adequate antiviral treatment when drug-resistant CMV infection is suspected. We investigated the frequency of resistance-conferring mutations among patients with persistent or recurrent CMV infection and further reviewed the subgroup with UL54 mutations without UL97 mutations. Methods: Patients with persistent or recurrent CMV infection after 4 weeks of treatment with ganciclovir or foscarnet were consecutively enrolled between November 2012 and May 2019.The direct sequencing of UL97 and UL54 was performed to detect resistance mutations in CMV. Results: A total of 101 sequencing datasets were obtained from 65 enrolled patients.CMV UL97 and UL54 mutations were detected in 15.4% (10/65) and 9% (6/65) of patients, respectively. The CMV retrieved from two patients (3%) had mutations in both genes. Four patients with CMV UL54 mutations alone had a history of haploidentical peripheral blood stem cell transplantation, and foscarnet was administered for over 4 weeks to these patients; 21.5% of patients had suspected resistant CMV infection with either UL97 or UL54 mutations. Conclusion In this study, CMV UL54 mutations but not UL97 mutations were found in patients subjected to prolonged foscarnet administration for CMV disease.

Background: Rapid detection of carbapenemase-producing Enterobacterales (CPE) is desirable to guide antimicrobial therapy and infection control. The NG-Test Carba5 (Carba5;NG Biotech, France) rapid multiplex lateral flow immunoassay and BD MAX Check-Points CPO Assay (CPO; BD Diagnostic Systems, USA) fully automated real-time PCR assay were evaluated for the detection of KPC, NDM, VIM, IMP, and OXA-48-like group in a culture colony compared to genotyping using conventional PCR. Methods: Among the clinical isolates of carbapenem-resistant Enterobacterales (CRE) collected from 2013 to 2019, up to 20 isolates for each carbapenemase type, and approximately 60 carbapenemase-negative CRE were enrolled. Genotyping of carbapenemases were performed using single-target PCR for KPC, NDM, and OXA-48-like group and the multiplex PCR for VIM, IMP, GIM, SIM, and SPM. All isolates were tested with Carba5 and CPO. The discrepant results were resolved by single-target specific conventional PCR or GeneXpert Carba-R Assay (Carba-R; Cepheid, USA). Results: Of 147 CREs, 82 were CPE (55.8%) including 20 KPC, 22 NDM, 17 VIM, three IMP, and 13 OXA-48-like group, and seven double carbapenemase-positive (three KPC/VIM, two NDM/ VIM, one KPC/NDM, and one NDM/OXA-48-like group) isolates. Carba5 and CPO detected all CPE correctly along with two more IMP-producing CPE. The sensitivity and specificity of both kits were equally 100% and 97%. Two false IMP-positives were confirmed IMP-positive with Carba-R and IMP-specific single-target PCR. Conclusion Carba5 and CPO reliably detect and differentiate five common carbapenemases in cultured colonies. Carba5, faster and simpler, is preferred as a spot test.

PURPOSE: We investigated the expression of vasoactive intestinal peptide (VIP), VIP receptor 1 (VPAC1), VIP receptor 2 (VPAC2) genes in the human umbilical cord blood CD34 cells, and the ability of VIP to stimulate human primitive as well as monopotent hematopoietic progenitors. METHODS: We isolated RNA from umbilical cord blood CD34 cells, and then performed RT-PCR, and sequencing. The umbilical cord blood CD34 cells were cultured with the various concentrations of VIP for burst-forming unit of erythrocyte (BFU-E), colony-forming unit of granulocyte/monocyte (CFU-GM), colony-forming unit of graulocyte/erythrocyte/monocyte/megakaryocyte (CFU-GEMM), and colony-forming unit of megakaryocyte (CFU-Mk). RESULTS: The RNA coding for VPAC1 was detected in human umbilical cord blood CD34 cells. VIP significantly stimulated the growth of CFU-GEMM and CFU-Mk. CONCLUSION: The present results suggest that VIP is an important neuropeptide in the early proliferation of human primitive as well as megakaryocyte progenitors.
Clinical Coding ; Erythrocytes ; Fetal Blood* ; Humans ; Megakaryocyte Progenitor Cells ; Megakaryocytes ; Myeloid Progenitor Cells ; Neuropeptides ; Receptors, Vasoactive Intestinal Peptide ; RNA ; Stem Cells ; Vasoactive Intestinal Peptide*

In order to improve the quality of life and to prevent chronic complications related to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain. If metformin is difficult to use as a first-line treatment, other appropriate medications should be selected in view of the clinical situation. If the goal of achieving glycemic control is not achieved by monotherapy, a combination therapy with different mechanisms of action should be initiated promptly.
Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diagnosis ; Humans ; Hypoglycemia ; Hypoglycemic Agents ; Life Style ; Metformin ; Quality of Life ; Weight Gain

PURPOSE: Gynecomastia, a benign enlargement of the male breast due to proliferation of the glandular component, is a common clinical condition with various causes. This study investigates the changes of serum sexual hormones levels and the causes of patients with gynecomastia. METHODS: The conditions associated with gynecomastia were evaluated in 68 gynecomastia patients. The levels of serum estradiol (E2), and testosterone (T), and the estradiol to testosterone (E2/T) ratio were measured in 37 of these 68 subjects along with 10 healthy male controls. Ultrasound for the adrenal gland and liver diseases, liver function test, and physical examination or ultrasound for testicular pathology were also performed. RESULTS: The most common cause of gynecomastia was idiopathic (50.0%). The conditions associated with gynecomastia were drugs (23.5%), hormone (10.3%), and various associated diseases (16.2%) including liver diseases (8.8%), chronic lung diseases (4.4%), lung cancer (1.5%) and chronic renal failure (1.5%). The levels of E2 and T, and the E2 to T ratio in the control group were 35.3+/-3.9 pg/ml, 5.0+/-0.4 ng/ml and 7.1+/-0.5 respectively. Those in the gynecomastia group were 48.7+/-7.1 pg/ml, 4.3+/-0.3 ng/ml and 12.0+/-1.8 respectively. The differences between the two groups for the E2 to T ratio as well as the levels of E and T were not significant, though the average E2 level and the E2 to T ratio in the gynecomastia group were higher than those in the control group. The causes of gynecomastia varied according to the patient age. CONCLUSION: The differences of the E2 to T ratio, and the level of E2 and T in the patients with gynecomastia were not the only cause of gynecomastia, Thus, considerations need to be given to the changes of sexual hormones as well as associated diseases or drugs to enable better understanding of the causes of gynecomastia.
Adrenal Glands ; Breast ; Estradiol ; Gynecomastia* ; Humans ; Kidney Failure, Chronic ; Liver Diseases ; Liver Function Tests ; Lung Diseases ; Lung Neoplasms ; Male ; Pathology ; Physical Examination ; Testosterone ; Ultrasonography

The Korean Breast Cancer Society (KBCS) has reported a nationwide breast cancer data since 1996. We present a comprehensive report on the facts and trends of breast cancer in Korea in 2013. Data on the newly diagnosed patients in the year 2013 were collected from 99 hospitals by using nationwide questionnaire survey. Clinical characteristics such as stage of cancer, histologic types, biological markers, and surgical management were obtained from the online registry database. A total of 19,316 patients were newly diagnosed with breast cancer in 2013. The crude incidence rate of female breast cancer including carcinoma in situ was 76.2 cases per 100,000 women. The median age at diagnosis was 50 years, and the proportions of postmenopausal women with breast cancer accounted for more than half of total patients. The proportion of early breast cancer increased consistently, and the pathologic features have changed accordingly. Breast-conserving surgery was performed in more cases than total mastectomy in the year. The total number of breast reconstruction surgeries markedly increased approaching 3-fold in last 11 years. According to annual percentile change of invasive cancer incidence, the incidence increased rapidly until 2010. And thereafter the increase of it became steadier. For ductal carcinoma in situ, the incidence consistently increased during the same period without any joinpoint. Analysis of nationwide registry data will contribute to defining of the trends and characteristics of breast cancer in Korea.
Biomarkers ; Breast Neoplasms* ; Breast* ; Carcinoma in Situ ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mammaplasty ; Mastectomy, Segmental ; Mastectomy, Simple ; Online Systems ; Registries

PURPOSE: Gynecomastia, a benign enlargement of the male breast due to proliferation of the glandular component, is a common clinical condition with various causes. This study investigates the changes of serum sexual hormones levels and the causes of patients with gynecomastia METHODS: The conditions associated with gynecomastia were evaluated in 68 gynecomastia patients. The levels of serum estradiol (E2), and testosterone (T), and the estradiol to testosterone (E2/T) ratio were measured in 37 of these 68 subjects along with 10 healthy male controls. Ultrasound for the adrenal gland and liver diseases, liver function test, and physical examination or ultrasound for testicular pathology were also performed. RESULTS: The most common cause of gynecomastia was idiopathic (50.0%). The conditions associated with gynecomastia were drugs (23.5%), hormone (10.3%), and various associated diseases (16.2%) including liver diseases (8.8%), chronic lung diseases (4.4%), lung cancer (1.5%) and chronic renal failure (1.5%). The levels of E2 and T, and the E2 to T ratio in the control group were 35.3+/-3.9 pg/ml, 5.0+/-0.4 ng/ml and 7.1+/-0.5 respectively. Those in the gynecomastia group were 48.7+/-7.1 pg/ml, 4.3+/-0.3 ng/ml and 12.0+/-1.8 respectively. The differences between the two groups for the E2 to T ratio as well as the levels of E and T were not significant, though the average E2 level and the E2 to T ratio in the gynecomastia group were higher than those in the control group. The causes of gynecomastia varied according to the patient age. CONCLUSION: The differences of the E2 to T ratio, and the level of E2 and T in the patients with gynecomastia were not the only cause of gynecomastia, Thus, considerations need to be given to the changes of sexual hormones as well as associated diseases or drugs to enable better understanding of the causes of gynecomastia.
Adrenal Glands ; Breast ; Estradiol ; Gynecomastia* ; Humans ; Kidney Failure, Chronic ; Liver Diseases ; Liver Function Tests ; Lung Diseases ; Lung Neoplasms ; Male ; Pathology ; Physical Examination ; Testosterone ; Ultrasonography