BACKGROUND: It is well-known that organic solvents can cause various neurologic toxicities, and in particular, it had been reported that Parkinson's syndrome can be caused by organic solvents. CASE REPORT: A 53-year-old man who had worked for 13 years as a shipyard spray and brush painter and manifested with moderate cognitive disorder and was diagnosed with chronic toxic encephalopathy. We can assume he had had considerable exposure to organic solvents considering the estimates of the amounts of organic solvents in his work place. He had no specific medical history. The Minnesota Multiphasic Personality Inventory (MMPI) showed mild cognitive deficit, depression, and anxiety. Single Photon Emission Computed Tomography (SPECT) indicated a slightly decreased flow at the edge of the left temporal brain area, while T2 brain Magnetic Resonance Imaging (MRI) showed no specific signs except for ischemic changes in small vessels in the periventricular and subcortical white matter. He was also diagnosed with both carpal tunnel syndrome and peripheral neuropathy through a neuroconductive study. Several years later, he developed progressive bradykinesia and rigidity and, later, resting tremors in the left hand. He was diagnosed with Parkinson's disease and treated with dopaminergic agents, but there was no effect. After that, he was given deep brain stimulation, both. As a result, his tremor is improved. but, the rigidity remained. Three years later, He has continuously received dopaminergic therapy. but, he complains about tremors in both hands and more greatly reduced cognitive function. CONCLUSION: In this case, we assumed by patient's work history and exposure estimates that he was exposed to excessive levels of organic solvents. The clinical symptoms of this patient were very similar to those from Parkinson's disease, but the psychological symptom appeared earlier than the other symptoms and there was no response to dopaminergic agents. We conclude that this case is likely Parkinson's syndrome caused by organic solvents.
Anxiety ; Brain ; Carpal Tunnel Syndrome ; Deep Brain Stimulation ; Depression ; Dopamine Agents ; Hand ; Humans ; Hypogonadism ; Hypokinesia ; Magnetic Resonance Imaging ; Middle Aged ; Mitochondrial Diseases ; MMPI ; Neurotoxicity Syndromes ; Ophthalmoplegia ; Parkinson Disease ; Peripheral Nervous System Diseases ; Solvents ; Tomography, Emission-Computed, Single-Photon ; Tremor ; Workplace

BACKGROUND: It is well-known that organic solvents can cause various neurologic toxicities, and in particular, it had been reported that Parkinson's syndrome can be caused by organic solvents. CASE REPORT: A 53-year-old man who had worked for 13 years as a shipyard spray and brush painter and manifested with moderate cognitive disorder and was diagnosed with chronic toxic encephalopathy. We can assume he had had considerable exposure to organic solvents considering the estimates of the amounts of organic solvents in his work place. He had no specific medical history. The Minnesota Multiphasic Personality Inventory (MMPI) showed mild cognitive deficit, depression, and anxiety. Single Photon Emission Computed Tomography (SPECT) indicated a slightly decreased flow at the edge of the left temporal brain area, while T2 brain Magnetic Resonance Imaging (MRI) showed no specific signs except for ischemic changes in small vessels in the periventricular and subcortical white matter. He was also diagnosed with both carpal tunnel syndrome and peripheral neuropathy through a neuroconductive study. Several years later, he developed progressive bradykinesia and rigidity and, later, resting tremors in the left hand. He was diagnosed with Parkinson's disease and treated with dopaminergic agents, but there was no effect. After that, he was given deep brain stimulation, both. As a result, his tremor is improved. but, the rigidity remained. Three years later, He has continuously received dopaminergic therapy. but, he complains about tremors in both hands and more greatly reduced cognitive function. CONCLUSION: In this case, we assumed by patient's work history and exposure estimates that he was exposed to excessive levels of organic solvents. The clinical symptoms of this patient were very similar to those from Parkinson's disease, but the psychological symptom appeared earlier than the other symptoms and there was no response to dopaminergic agents. We conclude that this case is likely Parkinson's syndrome caused by organic solvents.
Anxiety ; Brain ; Carpal Tunnel Syndrome ; Deep Brain Stimulation ; Depression ; Dopamine Agents ; Hand ; Humans ; Hypogonadism ; Hypokinesia ; Magnetic Resonance Imaging ; Middle Aged ; Mitochondrial Diseases ; MMPI ; Neurotoxicity Syndromes ; Ophthalmoplegia ; Parkinson Disease ; Peripheral Nervous System Diseases ; Solvents ; Tomography, Emission-Computed, Single-Photon ; Tremor ; Workplace

OBJECTIVES: We report on a case-study of a silicosis sufferer with lung cancer, who was exposed to cement dust through plastering and waterproof work in the construction industry. METHODS: We reviewed his personal history including employment, medical record and estimated level of carcinogenic materials in the work place in order to evaluate the possible source of his lung cancer. RESULTS: The patient was a non-smoker and there was no family history of lung cancer. His medical record did not reveal anything of concern. He was exposed to cement dust while he had worked for 20 years as a plasterer and waterproof worker. After complaining of chest pain, he was examined and subsequently diagnosed with lung cancer (RUL, adenocarcinoma; cT4N2M1). He was treated in a hospital for 3 months before passing away. Radiological evaluation by high resolution computed tomography (HRCT) revealed micronodules with a profusion category 1 (p/p, 1/1) in the perilymphatic distribution, which indicated silicosis. Small amounts of cement dust which included silica was identified by environmental evaluation of his work place. He never worked with asbestos related material, which was confirmed by HRCT examination. CONCLUSIONS: We concluded that the patient's silicosis with lung cancer was an occupational-caused disease due to exposure to cement dust.
Asbestos ; Chest Pain ; Dust ; Employment ; Humans ; Hypogonadism ; Lung ; Lung Neoplasms ; Medical Records ; Mitochondrial Diseases ; Ophthalmoplegia ; Silicon Dioxide ; Silicosis ; Stress, Psychological ; Workplace

With the increasing use of the internet and the spread of smartphones, health information seekers obtain considerable information through the internet. As the amount of online health information increases, the need for quality management of health information has been emphasized. The purpose of this study was to investigate the factors affecting the intention of using accredited online health information by applying the extended technology acceptance model (Extended-TAM). An online survey was conducted from September 15, 2016 to October 3, 2016, on 500 men and women aged 19–69 years. The results showed that the greatest factor influencing the acceptance of the accredited health information was perceived usefulness, and the expectation for the quality of the accreditation system was the most important mediator variable. In order to establish the health information accreditation system as a means to provide easy and useful information to the consumers, it is necessary to carry out quality management and promote the system through the continuous monitoring of the accreditation system.
Accreditation ; Female ; Humans ; Intention ; Internet ; Male ; Smartphone

Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.

BACKGROUND: Hypomagnesemia is a common complication after cardiac surgery with cardiopulmonary bypass. The purpose of this study was to assess the clinical beneficial effect of administration of magnesium sulfate in cardiac surgery. MATERIAL AND METHOD: Thirty five patients scheduled for elective cardiac surgery were randomly assigned to magnesium group (n=20) which received magnesium sulfate in priming solution (1 g) and cardioplegic solution (1 g) or control group (n=15) which did not receive it. Arterial blood samples were drawn for measuring Mg++ and electrolytes contents, blood gas analysis, CBC, total protein, albumin, blood urea nitrogen (BUN), creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-10 (IL-10), creatine phosphokinase (CpK), creatine kinase-MB (CK-MB), lactate dehydrogenase(LDH), troponin-I (TNI), prothrombin time (PT) and activated pratial thromboplastin time level (aPTT). Venous blood samples were drawn before and after the operation for measuring activated clotting time level (ACT). RESULT: Mg++ levels in magensium group were higher than those of control group at intraoperative and postoperative periods (p<0.05). dysrhythmias were lower in magnesium group (8 cases out of 17 patients, 46.4%) than in control group (10 cases out of 10, 100%, p=0.050). CONCLUSION: These results showed that administration of low dose magnesium sulfate during cardiac surgery prevented hypomagnesemia and lowered incidence of dysrhythmia.
Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Blood Gas Analysis ; Blood Urea Nitrogen ; Cardioplegic Solutions ; Cardiopulmonary Bypass ; Creatine ; Creatine Kinase ; Creatinine ; Electrolytes ; Humans ; Incidence ; Interleukin-10 ; Interleukin-6 ; Lactic Acid ; Magnesium Sulfate* ; Magnesium* ; Postoperative Period ; Prothrombin Time ; Thoracic Surgery* ; Thromboplastin ; Troponin I ; Tumor Necrosis Factor-alpha

Most of the congenital diaphragmatic hernia (CDH) cases are diagnosed at prenatal period or immediately after birth with severe respiratory symptom. The classic triad, which is respiratory distress, apparent dextrocardia and a scaphoid abdomen, is usually seen in this period. Several case reports have described older infants and children with a wide spectrum of symptoms of CDH, whereas extremely few cases were reported in neonatal period except classic triad such as straungulation of the bowel. These atypical manifestations can lead physician to delayed diagnosis. We report two cases of CDH newborns. First case was diagnosed with pneumoperitoneum following tension pneumothorax, transient diaphragm eventration on 5 days after birth. The other case was diagnosed with failure to thrive and mediastinal mass on 30 days after birth. These cases suggest physicians to consider CDH in late newborn period with pneumoperitoneum following tension pneumothorax, transient diaphragm eventration, failure to thrive, and mediastinal mass.
Abdomen ; Child ; Delayed Diagnosis ; Dextrocardia ; Diaphragmatic Eventration ; Failure to Thrive ; Hernia, Diaphragmatic* ; Humans ; Infant ; Infant, Newborn* ; Parturition ; Pneumoperitoneum ; Pneumothorax

BACKGROUND: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results. CASE: A 46-year-old man, who had worked as a foundry worker for 27 years and had a 12 1/2 packyear history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomerulonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA (0.0106 mg/m3), which was calibrated for overtime. CONCLUSION: Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure.
Anti-Glomerular Basement Membrane Disease ; Antibodies, Antineutrophil Cytoplasmic ; Autoantibodies ; Biopsy ; Bronchoscopy ; Chest Pain ; Cough ; Crystallins ; Dyspnea ; Glomerulonephritis ; Granuloma ; Hematuria ; Hemorrhage ; Humans ; Hydrocarbons ; Kidney ; Lung ; Middle Aged ; Occupational Health ; Plasmapheresis ; Proteinuria ; Renal Dialysis ; Respiratory Tract Infections ; Risk Factors ; Silicon Dioxide ; Smoke ; Smoking ; Threshold Limit Values ; Tobacco Products ; Urea ; Vasculitis

BACKGROUND: Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results. CASE: A 46-year-old man, who had worked as a foundry worker for 27 years and had a 12 1/2 packyear history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomerulonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA (0.0106 mg/m3), which was calibrated for overtime. CONCLUSION: Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure.
Anti-Glomerular Basement Membrane Disease ; Antibodies, Antineutrophil Cytoplasmic ; Autoantibodies ; Biopsy ; Bronchoscopy ; Chest Pain ; Cough ; Crystallins ; Dyspnea ; Glomerulonephritis ; Granuloma ; Hematuria ; Hemorrhage ; Humans ; Hydrocarbons ; Kidney ; Lung ; Middle Aged ; Occupational Health ; Plasmapheresis ; Proteinuria ; Renal Dialysis ; Respiratory Tract Infections ; Risk Factors ; Silicon Dioxide ; Smoke ; Smoking ; Threshold Limit Values ; Tobacco Products ; Urea ; Vasculitis

Background: Macrosomia, as an infant with birth weight over 4 kg, can have several perinatal, and neonatal complications. This study aimed to estimate the incidence of macrosomia in Korea and to identify the growth and developmental outcomes and other neonatal complications. Methods: In total, 397,203 infants who were born in 2013 with birth weight ≥ 2.5 kg and who underwent infant health check-up between their 1 st and 7 th visit were included from the National Health Insurance Service database. The information was obtained by the International Classification of Diseases-10 codes or self-reported questionnaires in the National Health Screening Program. Results: The distribution of infants by birth weight was as follows: 384,181 (97%) infants in the 2.5–3.99 kg (reference) group, 12,016 (3%) infants in the 4.0–4.49 kg group, 772 (0.2%) infants in the 4.5–4.99 kg group, and 78 (0.02%) infants in the ≥ 5 kg group. Macrosomia showed significantly higher incidence of sepsis, male sex, and mothers with GDM and birth injury. There was a significant difference in weight, height, and head circumference according to age, birth weight group, and combination of age and birth weight, respectively (P < 0.001). The number of infants with the weight above the 90 th percentile in macrosomia at each health check-up showed higher incidence than in reference group. The mean body mass index significantly differed among the groups, as 50.6 in infants with 2.5–3.99 kg of birth weight, 63.5 with 4.0–4.49 kg, 71.0 with 4.5–4.99 kg, and 73.1 with ≥ 5 kg. There was a significant difference in the incidence of poor developmental results between infants with macrosomia and the reference group at 24, 36 and 48 month of age. Conclusion Macrosomia was significantly associated with the risk of sepsis, birth injury, obesity and developmental problem especially in a boy born from mothers with gestational diabetes mellitus. Careful monitoring and proper strategies for monitoring growth and development are needed.