Clinical manifestations of chronic exposure to organic mercury usually have a gradual onset. As the primary target is the nervous system, chronic mercury exposure can cause symptoms such as fatigue, weakness, headache, and poor recall and concentration. In severe cases chronic exposure leads to intellectual deterioration and neurologic abnormality. Recent outbreaks of bovine spongiform encephalopathy and pathogenic avian influenza have increased fish consumption in Korea. Methyl-mercury, a type of organic mercury, is present in higher than normal ranges in the general Korean population. When we examine a patient with chronic fatigue, we assess his/her methyl-mercury concentrations in the body if environmental exposure such as excessive fish consumption is suspected. In the current case, we learned the patient had consumed many slices of raw tuna and was initially diagnosed with chronic fatigue syndrome. Therefore, we suspected that he was exposured to methyl-mercury and that the mercury concentration in his hair would be below the poisoning level identified by World Health Organization but above the normal range according to hair toxic mineral assay. Our patient's toxic chronic fatigue symptoms improved after he was given mercury removal therapy, indicating that he was correctly diagnosed with chronic exposure to organic mercury.
Animals ; Cattle ; Disease Outbreaks ; Encephalopathy, Bovine Spongiform ; Environmental Exposure ; Fatigue ; Fatigue Syndrome, Chronic ; Hair ; Headache ; Humans ; Influenza in Birds ; Korea ; Nervous System ; Reference Values ; Tuna ; World Health Organization

A peritoneal loose body is reported to develop because of torsion and separation of the epiploic appendages. The condition is usually symptomless and may be incidentally during abdominal surgery or autopsy. It usually occurs in middle-aged and elderly adults and is very rare in children. In this paper, we report a case of a peritoneal loose body in the pelvic cavity of a 10-year old-girl who presented with urinary frequency and left lower abdominal discomfort. A second plain X-ray film of the abdomen, obtained before surgery, in a different view than the first, revealed that the calcified mass had migrated to a lower position. The mass was laparoscopically resected, and histological examination revealed it to be a fibrotic nodule with central liquefaction and calcification.
Abdomen ; Adult ; Aged ; Autopsy ; Child ; Humans ; X-Ray Film

BACKGROUND: The glycemic index (GI) indicates the rise in blood glucose caused by carbohydrate-containing foods. In Korea, there have been few studies on the understanding adults have of GI. Thus, this study investigated differences GI knowledge among the korean adults. METHODS: A questionnaire on the perspective of GI and experience in GI education, participational intent to learn, general knowledge level, and dietary practice was conducted among those living in agricultural areas. Respondents were visitors to the health promotion center of a university hospital. RESULTS: When asked about the GI familiarity, the standard of education, the relationships between diseases and GI, the diabetes group was better able to answer correctly than the other groups. However, the diabetes group showed either no difference or less correct responses for general knowledge of GI. With respect to their usual consideration and low GI dietary practice, the diabetes group provided higher responses than the other groups. On the whole, the diabetes group was better than the other groups for GI relative factor but none of the groups showed high levels for perspective, education, dietary practice of GI. CONCLUSIONS: The groups other than the diabetes group had a low perspective of GI, a lack of correct knowledge of GI, and did not follow a proper diet without considering GI. Even in the diabetes group the perspective, knowledge, and proper dietary practices were not adequate. Accordingly, further education of GI is necessary for diabetic patients, patients with chronic diseases and also people without diseases.
Adult* ; Blood Glucose ; Cardiovascular Diseases ; Chronic Disease* ; Diet* ; Education ; Glycemic Index* ; Health Promotion ; Humans ; Korea ; Recognition (Psychology) ; Surveys and Questionnaires

BACKGROUND: While the correlation between metabolic syndrome (MS) and serum uric acid (sUA) levels has already been identified, the correlation between MS and the sUA/creatinine ratio has not been studied in Korea. Accordingly, the present study examined the correlation between MS and the sUA/creatinine ratio using data from the seventh Korea National Health and Nutrition Examination Survey (2016). METHODS: The study population consisted of healthy adults aged 19 years or older medical diseases. The five components of MS and the presence of MS were used as independent variables, while the sUA/creatinine ratio was selected as the dependent variable. After adjusting for confounding variables, a complex samples logistic regression test was performed to analyze the correlations between the sUA/creatinine ratio and MS and its components. RESULTS: The following variables showed positive correlation with the sUA/creatinine ratio: systolic blood pressure (BP) (95% confidence interval [CI], 1.051–1.243; P=0.002), diastolic BP 1.144 (95% CI, 1.054–1.241; P=0.001), fasting blood sugar level 1.166 (95% CI, 1.070–1.271; P < 0.001), triglyceride level 1.340 (95% CI, 1.259–1.427; P < 0.001), high density lipoprotein level 1.163 (95% CI, 1.100–1.230; P < 0.001), waist circumference 1.342 (95% CI, 1.239–1.455; P < 0.001), and the presence of MS 1.041 (95% CI, 1.034–1.049; P≤0.001). CONCLUSIONS: The findings of the present study demonstrated a statistically significant correlation between the sUA/creatinine ratio and the presence of MS as well as with each component of MS. The significance of the present study is that it is the first study to investigate Koreans.
Adult ; Blood Glucose ; Blood Pressure ; Confounding Factors (Epidemiology) ; Creatinine ; Fasting ; Humans ; Korea ; Lipoproteins ; Logistic Models ; Nutrition Surveys ; Triglycerides ; Uric Acid ; Waist Circumference

BACKGROUND: While the correlation between metabolic syndrome (MS) and serum uric acid (sUA) levels has already been identified, the correlation between MS and the sUA/creatinine ratio has not been studied in Korea. Accordingly, the present study examined the correlation between MS and the sUA/creatinine ratio using data from the seventh Korea National Health and Nutrition Examination Survey (2016). METHODS: The study population consisted of healthy adults aged 19 years or older medical diseases. The five components of MS and the presence of MS were used as independent variables, while the sUA/creatinine ratio was selected as the dependent variable. After adjusting for confounding variables, a complex samples logistic regression test was performed to analyze the correlations between the sUA/creatinine ratio and MS and its components. RESULTS: The following variables showed positive correlation with the sUA/creatinine ratio: systolic blood pressure (BP) (95% confidence interval [CI], 1.051–1.243; P=0.002), diastolic BP 1.144 (95% CI, 1.054–1.241; P=0.001), fasting blood sugar level 1.166 (95% CI, 1.070–1.271; P < 0.001), triglyceride level 1.340 (95% CI, 1.259–1.427; P < 0.001), high density lipoprotein level 1.163 (95% CI, 1.100–1.230; P < 0.001), waist circumference 1.342 (95% CI, 1.239–1.455; P < 0.001), and the presence of MS 1.041 (95% CI, 1.034–1.049; P≤0.001). CONCLUSIONS The findings of the present study demonstrated a statistically significant correlation between the sUA/creatinine ratio and the presence of MS as well as with each component of MS. The significance of the present study is that it is the first study to investigate Koreans.

During the 2009 novel influenza (H1N1) pandemic, the sensitivity of direct immunofluorescence assay (DFA) for H1N1 infection was 62% (266/429) of that of the polymerase chain reaction (PCR) test. The sensitivity of the DFA differed significantly with the age of patients: the sensitivity was the highest (71.8%) for patients aged <10 years and the lowest for patients aged > or =30 years. The sensitivity of DFA in patients aged > or =30 years was 40.7%. Furthermore, the sensitivity (67.3%, 171/254) of DFA was higher for patients who had a high temperature at admission. An increase in the incidence of H1N1 infection did not influence the sensitivity of DFA (62.1% vs. 62%; p=0.984) test, but resulted in a decrease in the negative predictive value, from 92.4% (700/757) to 69.6% (247/355). PCR may be useful as the initial test for diagnosing H1N1 infection in patients aged > or =30 years with a normal temperature at presentation.
Adolescent ; Adult ; Age Factors ; Body Temperature ; Child ; Fever/virology ; *Fluorescent Antibody Technique, Direct ; Humans ; Influenza A Virus, H1N1 Subtype/genetics/*isolation & purification ; Influenza, Human/epidemiology/*virology ; Pandemics ; *Polymerase Chain Reaction ; Sensitivity and Specificity

PURPOSE: Idiopathic thrombocytopenic purpura(ITP) is a relatively common hematologic disease in children. The optimal strategy for treating ITP during childhood is a matter of controversy. In general, platelet count has been the primary, if not the sole measure, on which treatment decisions have been made and outcomes determined. In this study, we tried to find out the correlation between clinical classification of Bolton-Maggs and platelet counts in childhood ITP on initial diagnosis METHODS: Seventy three patients with acute ITP in the Department of Pediatrics, Wonkwang University Hospital from June 1995 to December 2002, were enrolled. We retrospectively analyzed charts and classified our patients into four groups(no, mild, moderate, severe symptoms) according to Bolton-Maggs criteria. RESULTS: The ratio of female to male is 0.82. The peak age incidence was two to five years(41%). It was prevalent in the spring in 23 cases(31%) and winter season in 23 cases(31%). Most common clinical symptoms at presentation were petechiae and purpura in 55 cases(75.1%). According to Bolton-Maggs criteria, our patients, classified into no symptoms, mild symptoms, moderate symptoms and severe symptoms were 9 cases(12%), 22 cases(29%), 23 cases(30%) and 19 cases(25%), respectively. Among the 47 patients with platelet counts below 20,000/mm3, those with no symptoms, mild symptoms, moderate symptoms and severe symptoms were:1 cases(0.02%), 13 cases(27%), 17 cases (36%) and 16 cases(34%) respectively. We found that this classification was highly correlated with the platelet counts on initial diagnosis(P=0.005). CONCLUSION: There was a significant correlation between clinical classification of Bolton-Maggs and platelet counts. Therefore, this classification may be helpful in choosing the appropriate treatment options and evaluating the overall outcomes in childhood ITP.
Blood Platelets* ; Child ; Classification* ; Diagnosis ; Female ; Hematologic Diseases ; Humans ; Incidence ; Male ; Pediatrics ; Platelet Count* ; Purpura ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies ; Seasons

OBJECTIVES: Metabolic syndrome and depression are interconnected disorders. Although many studies have assessed the association between dietary intake and each disorder independently, few studies have examined the association between depression and dietary intake in patients with metabolic syndrome. Our study examined the association between depression and dietary intake in adults with metabolic syndrome. METHODS: We analyzed the second data set (2014) from the sixth KNHNES. Of the patients with metabolic syndrome, the final study population comprised 1,334 patients, aged 20 to 60 years, with metabolic syndrome as defined by KNHNES and depression diagnosed by a physician. We examined the patients??dietary intake obtained using the 24-h recollection method in KNHNES. RESULTS: Depression group had a lower niacin dietary intake than those without depression in both male and female (male P=0.047, female P=0.025). None of the other components had any association between depression group and those without depression group in both male and female. CONCLUSIONS: This study demonstrates that a low dietary intake of niacin may be related to the depression in patients with metabolic syndrome. The results indicate that it is worthwhile to evaluate the nutritional status in patients who have been diagnosed with both metabolic syndrome and depression.
Adult* ; Dataset ; Depression* ; Diet ; Female ; Humans ; Korea* ; Male ; Methods ; Niacin ; Nutrition Surveys* ; Nutritional Status

OBJECTIVE: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%-6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. METHODS: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was > or =5.7% or <5.7%. Lipid levels, blood pressure, BMI (kg/m2), total abdominal, and visceral fat levels were measured by computed tomography. RESULTS: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, 6.03+/-0.8% and 5.88+/-0.72%(p<0.05). Only the mean values of age and visceral fat area were different between HbA1c> or =5.7% and <5.7% in both male and female group (p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c > or =5.7% (odds ratio=1.005, 95% CI 1.002~1.008). CONCLUSIONS: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is > or =5.7%. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs.
Adult ; Blood Pressure ; Cardiovascular Diseases ; Diabetes Mellitus ; Female ; Health Education ; Hemoglobins ; Humans ; Intra-Abdominal Fat ; Male ; Prediabetic State ; Risk Factors

BACKGROUND: There are many studies on lifestyle management of diabetic patients, but few provide sufficient data comparing a diabetic group with an abnormal fasting glucose group and a normal, non-diabetic group. In this study, we compare the lifestyle management of diabetic patients with those of others groups. METHODS: Among patients visiting the health promotion center of a single university hospital, we retrospectively collected medical records and survey responses regarding patient information. RESULTS: No difference was found in smoking status or smoking intake among the three groups. Alcohol consumption was high in the diabetes group, followed by the abnormal fasting glucose group and the normal group. The diabetes group reported a higher frequency of exercise per week than the normal group. With regard to systolic BP, both the diabetes and abnormal fasting glucose groups were higher than the normal group, with a level greater than the therapeutic goal of 130 mmHg. Both the diabetes group and the abnormal fasting glucose group had a higher triglyceride level than the normal group, with a measure greater than the therapeutic goal of 150 mg/d. The diabetes group had a higher highly sensitive C-reactive protein level than other two groups, with a level greater than 1 mg/dL. CONCLUSION: Management of smoking and alcohol consumption is not sufficient in diabetes patients, suggesting the need for tighter control of BP and triglyceride level in such individuals. For these patients, follow-up of highly sensitive C-reactive protein level should also be considered.
Alcohol Drinking ; C-Reactive Protein ; Fasting ; Glucose ; Health Promotion ; Humans ; Life Style* ; Medical Records ; Retrospective Studies ; Smoke ; Smoking ; Triglycerides