BACKGROUND: In korea, tsutsugamushi disease is one of the common diseases which occurs in more than 40% among acute febrile diseases during Autumn. The diagnosis is confirmed with Rickettsia tsutsugamushi antibody, and is characterised by fever, chill, headache, myalgia, skin rash, escha and lymphadenopathy. METHODS: We have conducted a survey on 16 clinically and serologically confirmed cases of Tsutsugamushi disease occurring during the period of October -November, 2000. RESULTS: Of 16 cases,7 were males and 9 were females with an average age of 67.76. Most patients had fever, chill, headache, myalgia, sore throat, cojunctival injection, cough, abdominal, pain, nausea, vomiting, hematuria in order of frequency. The physical findings were eachar (81.257) and skin rash (62.77) . Serologically 7 cases (43.75%) of 16 cases were confirmed positively R.tsutsugamushi antibody. General hematologic findings were decreased platelet count (37.57) , increased or decreased WBC (31.25% and 25% each other) , and anemia (25%) , Test for liver function included elevated AST, ALT (68.76%) , alkaline phosphatase (62.6%) , hypoalbuminemia (12.6%) , and hyperbilirubinemia(6.25) . Urinalysis showed hematuria (50%) , proteinuria (50%) , and pyuria (12.67) . Doxyrcycline therapy decreased fever in 2.85 days and after 5-6 days patients were discharged with improvement of almost all symptoms. CONCLUSION: Primary care physician in a community should always consider tsutsugamushi disease when he encounters patients with acute febrile disease in late Autumn and early winter and expect good prognosis with early diagnosis and treatment.
Alkaline Phosphatase ; Anemia ; Cough ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Headache ; Hematuria ; Humans ; Hypoalbuminemia ; Jeollabuk-do* ; Korea ; Liver ; Lymphatic Diseases ; Male ; Myalgia ; Nausea ; Orientia tsutsugamushi ; Pharyngitis ; Physicians, Primary Care ; Platelet Count ; Prognosis ; Proteinuria ; Pyuria ; Scrub Typhus* ; Urinalysis ; Vomiting

OBJECTIVES: To investigate effects of genetic polymorphism of glutathione S-transferase M1 (GSTM1), glutathione S-transferase T1 (GSTT1), glutathione S-transferase P1 (GSTP1), N-acetyltransferase (NAT2), cytochrome P450 2E1 (CYP2E1) and cytochrome P450 1A1 (CYP1A1) on pneumoconiosis. METHODS: Eighty-five pneumoconiosis patients and 122 age and sex matched healthy controls were enrolled. Direct interview and standard questionnaire were conducted and the genotypes of GSTM1, GSTT1, GSTP1, NAT2, CYP2E1 and CYP1A1 were investigated using multiplex PCR or PCR-RFLP methods with DNA extracted from venous blood. The relationship was investigated between the severity of pneumoconiosis and the polymorphism of GSTM1, GSTT1, GSTP1, NAT2, CYP2E1 and CYP1A1, and also with various environmental factors including smoking. RESULTS: We observed a significantly higher rate of genetic polymorphism in pneumoconiosis patients than in normal subjects. The odds ratio (95% CI) of NAT2 was 2.09 (1.19-3.68). In addition, smoking was related significantly with pneumoconiosis (OR 2.89, 95% CI 1.40-5.95). In multiple logistic regression analyses, NAT2 and smoking were significant risk factors for the development of pneumoconiosis (OR 1.84, 95% CI 1.00-3.37; OR 2.98, 95% CI 1.40-6.35, respectively). The age of onset of the disease and smoking were significantly related with moderate or severe pneumoconiosis (OR 0.91, 95% CI 0.83-0.99; OR 6.94, 95% CI 1.54-31.30, respectively). However there was no significant difference between the rate of genetic polymorphism of GSTM1, GSTT1, GSTP1, CYP2E1 and CYP1A1 in the two groups. CONCLUSION: NAT2 genetic polymorphism was higher in pneumoconiosis patients than in normal subjects. The age of onset of the disease and smoking were significantly related with pneumoconiosis. However, the genetic polymorphism of GSTM1, GSTT1, GSTP1, CYP2E1 and CYP1A1 was not related with development or severity of pneumoconiosis.
Age of Onset ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 CYP2E1* ; Cytochrome P-450 Enzyme System ; DNA ; Genotype ; Glutathione Transferase ; Humans ; Logistic Models ; Multiplex Polymerase Chain Reaction ; Odds Ratio ; Pneumoconiosis* ; Polymorphism, Genetic* ; Questionnaires ; Risk Factors ; Smoke ; Smoking

BACKGROUND/AIMS: It is not clear which tests are indicative of the activity and severity of tuberculosis (TB). This study aimed to investigate the predictive value of neuron-specific enolase (NSE) and to determine the origin of NSE in TB patients. METHODS: A single-center retrospective analysis was conducted on newly diagnosed TB patients between January and December 2010. Patients were categorized into one of two disease groups (focal segmental or extensive) based on chest X-ray. Pre- and post-treatment NSE concentrations were evaluated. To determine the origin of serum NSE concentration, NSE staining was compared with macrophage-specific CD68 staining in lung tissues and with a tissue microarray using immunohistochemistry and immunofluorescence. RESULTS: A total of 60 newly diagnosed TB patients were analyzed. In TB patients, NSE serum concentration was significantly increased and NSE level decreased after treatment (p < 0.001). In proportion to serum high-sensitivity C-reactive protein concentration, the mean serum concentration of NSE in the extensive group (25.12 ng/mL) was significantly higher than that in the focal segmental group (20.23 ng/mL, p = 0.04). Immunohistochemical staining revealed a large number of macrophages that stained positively for both NSE and CD68 in TB tissues. In addition, NSE signals mostly co-localized with CD68 signals in the tissue microarray of TB patients. CONCLUSIONS: Our results suggest that NSE may be a practical parameter that can be used to monitor TB activity and treatment response. Elevated serum NSE level originates, at least in part, from macrophages in granulomatous lesions.
C-Reactive Protein ; Diagnosis ; Fluorescent Antibody Technique ; Humans ; Immunohistochemistry ; Lung ; Macrophages ; Phosphopyruvate Hydratase* ; Retrospective Studies ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

OBJECTIVES: This study was conducted to develop a worksite-based, post-examination, health care management system for continuous and systematic management of workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT detected by periodic health examination and to assess the effectiveness such a system as an intervention study. METHODS: Study subjects were selected from workers with hypertension, diabetes mellitus, hyperlipidemia, and abnormal LFT according to the selection criteria. The intervention group, but not the control group, received medical treatment of disease, follow up examination, and health education which consisted of information about the disease and the importance of life-style modification through periodic interview using the resources of occupational health service center in the worksite. To assess the effectiveness of this system, we compared follow up examination data from the intervention group with periodic examination data from the worksite control group. RESULTS: In the intervention group a significant reduction trend was recorded for systolic and diastolic blood pressure, fasting blood sugar, postprandial 2 hour glucose, total cholesterol, triglyceride, LDL-cholesterol, AST, ALT, and gamma-GTP, and a rising trend for HDL-cholesterol. Significant group differences ware recorded for fasting blood sugar, postprandial 2 hour glucose, total cholesterol, AST, and ALT. CONCLUSIONS: The worksite-based, post-examination, health care management system was effective for the continuous and systematic management of workers who had abnormal findings detected by periodic health examination.
Blood Glucose ; Blood Pressure ; Cholesterol ; Delivery of Health Care* ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Glucose ; Health Education ; Hyperlipidemias ; Hypertension ; Intervention Studies ; Occupational Health Services ; Patient Selection ; Triglycerides ; Workplace

Methyl bromide is a commonly used fumigant to disinfect soil, grains, and warehouses. The accumulation of danger-ous concentrations can produce various neurotoxic effects in humans. A 45-year-old man, who had worked in the fumi-gation business, presented with polyneuropathy, optic neuropathy, and cerebellar sign, and serially sampled blood, urine and cerebrospinal fluid showed significant elevation of methyl bromide concentration. Regular education to workers and strict adherence to the safety precautions are needed to avoid the risk of toxicity associated with methyl bromide fumigation.
Edible Grain ; Cerebellar Ataxia* ; Cerebrospinal Fluid ; Commerce ; Education ; Fumigation ; Humans ; Middle Aged ; Optic Nerve Diseases* ; Poisoning* ; Polyneuropathies* ; Soil