Atelectasis is a collapse of the lung due to absence of air within the alveoli and is a relatively common complication following surgery under general anesthesia, but severe total or segmental collapses rarely develop during anesthesia and surgery. Total or segmental lung collapses usually result from the compression or obstruction of bronchial pathways by mass lesions, foreign bodies, or secretions such as mucus, blood, or pus. Anesthesiologists must carefully manage patients who develop pulmonary atelectasis because it is sometimes fatal. We experienced iatrogenic pulmonary atelectasis by insertion of a sump drainage tube into the trachea during general anesthesia for laparoscopic splenectomy and diagnosed with fiberoptic bronchoscopy and chest X-ray.
Anesthesia ; Anesthesia, General ; Bronchoscopy ; Drainage ; Foreign Bodies ; Humans ; Lung ; Mucus ; Pulmonary Atelectasis ; Splenectomy ; Suppuration ; Thorax ; Trachea

BACKGROUND: Shift work is associated with a higher risk of cardiovascular diseases. Here, we sought to assess the relationship between shift work and plasma homocysteine levels. Determining the correlations between shift work and homocysteine levels may provide a better understanding of the mechanisms underlying cardiovascular diseases. METHODS: This study was performed using data from routine health examinations of steel workers in 2017. In total, 431 male workers (70 daytime workers and 361 shift workers) employed on a rolling departure schedule were recruited. Plasma homocysteine levels > 15 μmol/L were considered elevated. The χ2, analysis of variance, and multiple logistic regression analyses were used to examine the association between shift work and plasma homocysteine levels. RESULTS: In comparison to daytime workers, the odds ratio (OR) of hyperhomocysteinemia in individuals with < 10 years of shift work was 1.14 (95% confidence interval [CI]: 0.64–2.03), compared to 2.01 (95% CI: 1.14–3.54) for workers with ≥ 10 years of experience. After adjusting for confounding variables, the adjusted OR for shift workers with < 10 years of experience was 0.95 (95% CI: 0.50–1.80), compared to 2.00 (95% CI: 1.07–3.74) for workers with ≥ 10 years of experience. CONCLUSIONS: The risk of hyperhomocysteinemia was significantly higher in shift workers compared to those working normal daytime hours, particularly among long-term shift workers.
Appointments and Schedules ; Cardiovascular Diseases ; Confounding Factors (Epidemiology) ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Logistic Models ; Male ; Odds Ratio ; Plasma ; Steel

Purpose: Allomyrina dichotoma larvae are one of the approved edible insects with nutritional value and various functional and medicinal properties. Previously we have demonstrated that the Allomyrina dichotoma larval extract (ADLE) ameliorates hepatic insulin resistance in highfat diet (HFD)-induced diabetic mice through the activation of adenosine monophosphateactivated protein kinase (AMPK). This study investigated the effects of ADLE on insulin resistance in the skeletal muscle and explored mechanisms for enhancing the glucose uptake in palmitate (PAL)-treated C2C12 myotubes. Methods: To induce insulin resistance, the differentiated C2C12 myotubes were treated with PAL (0.5 mM) for 24 hours, and then treated with a 0.5 mg/ml concentration of ADLE, and the resultant effects were measured. The expression levels of glucose transporter-4 (GLUT4), AMPK, and the mitochondrial metabolism-related proteins were analyzed by western blotting. The mRNA expression levels of lipogenesis- related genes were determined by quantitative reverse-transcriptase PCR. Results: The exposure of C2C12 myotubes to 0.5 mg/ml of ADLE increased cell viability significantly compared to PAL-treated cells. ADLE upregulated the protein expression of GLUT4 and enhanced glucose uptake in the PAL-treated cells. ADLE increased the phosphorylated AMPK in both the PAL-treated C2C12 myotubes and HFD-treated skeletal muscle. The reduced expression levels of peroxisome-proliferator-activated receptor gamma co-activator-1 alpha (PGC1α) and uncoupling protein 3 (UCP3) due to the PAL and HFD treatment were reversed by the ADLE treatment. The citrate synthase activity was also significantly increased with the PAL and ADLE co-treatment. Moreover, the mRNA and protein expressions of fatty acid synthesis-related factors were reduced in the PAL and HFDtreated muscle cells, and this effect was significantly attenuated by the ADLE treatment. Conclusion ADLE activates AMPK, which in turn induces mitochondrial metabolism and reduces fatty acid synthesis in C2C12 myotubes. Therefore, ADLE could be useful for preventing or treating insulin resistance of skeletal muscles in diabetes.

Objectives: . Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging. Methods: . Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained. Results: . Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea. Conclusion . Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.

Objectives: . Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging. Methods: . Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained. Results: . Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea. Conclusion . Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.

Background: Disease-specific factors that predispose patients to diverse cardiac diseases in systemic lupus erythematosus (SLE) have been established. The aim of this study was to identify risk factors for cardiac involvement in patients with SLE drawn from the Korean Lupus Network (KORNET) registry. Methods: A total of 437 patients with SLE recruited from the KORNET registry were included in the analysis. The Cox proportional hazard model was used to identify risk factors for the development of cardiac involvement during the follow-up period. The hazard ratios for risk factors of cardiac involvement were assessed using Kaplan-Meier curves and log-rank test. Results: Of 437 patients with SLE, 12 patients (2.7%) developed new cardiac involvement during a median follow-up period of 47.6 months. Frequencies in men and in patients with anti-Sm antibody, anti-Ro antibody, and at least one Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SDI) score in patients with cardiac involvement were higher, compared to those without cardiac involvement (P < 0.001, P = 0.026, P = 0.015, and P < 0.001, respectively). Men gender, older age, anti-Sm antibody, SDI, and corticosteroid dosage were potent predictors for cardiac involvement in patients with SLE in the determination of risk factors for cardiac involvement. Men, anti-Sm antibody positivity, and SDI ≥ 1 increased incidence rates of cardiac involvement for (P < 0.001, P = 0.036, and P < 0.001, respectively). Conclusion The results of this study reveal that SLE-related factors such as anti-Sm antibody, SDI, and corticosteroid dosage at baseline are risk factors for cardiac involvement in SLE.

PURPOSE: Prevalence of food allergy and perceptions on food allergen labeling in school foodservice among elementary, middle, and high school students were investigated in Korea. METHODS: A total of 1,000 elementary, middle, and high schools were selected in 16 cities and provinces of Korea and students attending the schools were surveyed using a questionnaire modified from the Korean International Study of Asthma and Allergies in Childhood questionnaire in July 2012. Responses from 27,679 students were used for data analysis. RESULTS: The ratio of the students who had experienced food allergy was 12.6%; 7.6% of the responding students had food allergy reactions last 12 months and 6.8% of the students had been diagnosed for food allergy by doctors. Eggs, milk, peach, and crabs were the most frequent allergenic foods for the elementary school 1st graders, 5th graders, middle, and high school students, respectively, who had experienced food allergy last 12 months. The students with food allergy read menus more frequently and were more interest in food allergen labeling in school foodservice than their counterparts. Both of the student groups with and without food allergy perceived food allergen labeling important for the students with food allergy and their parents. CONCLUSION: The prevalence of food allergy and major allergenic foods varied by school years. The Korean students had positive perception on allergic food labeling in school foodservice. An effective food allergen labeling system for school foodservice should be developed and implemented that reflects prevalence, symptoms, and food allergens among Korean students.
Allergens ; Asthma ; Eggs ; Food Hypersensitivity ; Food Labeling ; Humans ; Hypersensitivity ; Korea ; Milk ; Ovum ; Prevalence ; Prunus persica ; Surveys and Questionnaires

BACKGROUND: Brain inducible nitric oxide synthase (iNOS) might be detectable in several pathologic conditions, and it is thought to play an important role in their pathophysiology. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta are believed to be essential factors of iNOS induction of the brain. METHODS: After intrahippocampal stereotaxic injection of lipopoly-saccharide (LPS), the rat brains were removed at 6, 12 and 24 h. The rat brain tissues were examined to clarify the expression patterns of TNF-alpha, IL-1beta and iNOS. RESULTS: The inflammatory cells which were stained with anti-TNF-alpha antibody, appeared in 6 h and increased for 24 h after LPS injection. The iNOS positive cells appeared after 12 h of LPS injection. A semiquantitative analysis of reverse transcription-polymerase chain reaction (RT-PCR) revealed that the TNF-alpha and IL-1beta mRNA arose at 1 h, peaked at 6 h and then declined until 48 h after LPS injection. The iNOS mRNA arose after 6 h, peaked at 12 h, and declined until 48 h after LPS injection. CONCLUSIONS: We conclude that the induction of inflammatory events by intrahippocampal injection of LPS activates TNF-alpha and IL-1beta secretion, and this is followed by an induction of iNOS expression. TNF-alpha and IL-1beta seem to be related with iNOS expression in brain inflammation.
Animals ; Brain ; Encephalitis ; Hippocampus* ; Interleukin-1beta* ; Interleukins ; Nitric Oxide Synthase Type II* ; Rats* ; RNA, Messenger ; Tumor Necrosis Factor-alpha*

BACKGROUND/AIMS: Assessment of Health-related quality of life (HRQOL) outcomes in treatment of chronic disease is increasingly important. The objective of this study was to validate a Korean translation of the Liver Disease Quality of Life instrument (LDQOL version 1.0) for use in patients with chronic liver disease. METHODS: Two native Korean speakers with fluent English translated LDQOL including instructions, items, and response choices. This Korean translation of the LDQOL was administered to 121 patients with chronic liver disease. Cronbach's alpha coefficients were applied to test an internal consistency reliability of disease-specific scales of the LDQOL. MELD and modified CTP scores were calculated for all patients. Associations of MELD and modified CTP scores with severity of liver disease were analyzed with LDQOL. RESULTS: Internal consistency reliability was good (Cronbach's Alpha=0.69-0.94) in liver disease specific scales, except for the quality of social interaction scale (Cronbach's Alpha= 0.56). Mean modified CTP score and MELD score were 6.2+/-1.9 and 9.3+/-5.3, respectively. Both MELD score and modified CTP score showed correlations with most of the scores of liver disease specific scales of LDQOL 1.0, except for the quality of social interaction and sleep scale. CONCLUSIONS: The Korean version of the liver disease specific scales of the LDQOL 1.0 is validated and useful for measuring HRQOL in Korean patients with chronic liver disease.
Adult ; Aged ; Chronic Disease ; Female ; Humans ; Korea ; Language ; Liver Diseases/*diagnosis/psychology ; Male ; Middle Aged ; *Quality of Life ; *Questionnaires ; Reproducibility of Results ; Severity of Illness Index ; Sickness Impact Profile

OBJECTIVE: To reveal the relationship between depression and WMSD. METHOD: Five physiatrists participated in the workplace musculoskeletal survey and diagnosed 724 office workers with WMSD by performing detailed history taking and physical examination. All subjects were asked to answer the Korean version of the Beck depressive inventory (K-BDI), and to express their pain according to the visual analogue scale (VAS) score. We categorized the subjects into 4 groups, myofascial pain syndrome (MPS), herniated intervertebral disk (HIVD), tenosynovitis, and others, and investigated the prevalence of depression in desk workers and relationship between WMSD and depression, and we compared pain intensity between the depression and non-depression groups. Correlation analysis was carried out between K-BDI and VAS scores in each group. RESULTS: The mean K-BDI score were 8.7+/-6.68. The prevalence of depression was higher in females than in male, and there was no relationship between age and depression. There was a significant connection between HIVD and depression (p<0.05). However, the other groups did not have significant connection to depression. The VAS score (5.02) of the depression group was significantly higher than that (4.10) of the non-depression group. In addition, there was a significant difference of VAS scores between the depression group and non-depression group in each disease group. CONCLUSION: The mean VAS score of the depression group in WMSD was significantly higher than in the non-depression group. The correlation between BDI and VAS scores in the subjects was present, and the highest was in the HIVD group.
Depression ; Female ; Humans ; Intervertebral Disc ; Male ; Musculoskeletal Diseases ; Myofascial Pain Syndromes ; Physical Examination ; Prevalence ; Tenosynovitis