Unintentional environmental exposure to toxicants is associated with an aggravated health status of the general population. Involuntary smoking (IS) exposure is one of the main routes to involuntary toxicants exposure. However, few studies have attempted to understand the environmental cadmium exposure by IS exposure in the general, non-smoking population. The purpose of the current study was to examine the relationship between blood cadmium level and IS level according to gender and age. We used the Korea National Health and Nutrition Examination Survey (KNHANES) IV–VI data that included heavy metal and urine cotinine sampling with IS exposure history. The final analysis comprised 3,493 adults (1,231 males and 2,262 females) and 395 adolescents (210 males and 185 females). Linear regression was performed to estimate the association between self-reported IS exposure with urine cotinine level and blood cadmium level in non-smokers with gender and age group stratification. In final regression model, the effect values (B) (standard errors [SE]) between blood cadmium and urine cotinine level in men was 0.0004 (0.0001) and 0.0006 (0.0002) in adults and adolescents, the B (SE) in women was 0.0006 (0.0002) and 0.0016 (0.0006) in adults and adolescents. Our study revealed, for the first time, a significant association between blood cadmium and IS exposure in non-smokers. Greater efforts are needed to improve environmental justices of the general population from IS, considering the severe harmful effects of involuntary exposure to even a low level of cadmium.

BACKGROUND: Fractional laser resurfacing treatment has been extensively investigated and is widely used. However, the mechanism underlying its effects is poorly understood because of the ethical and cosmetic problems of obtaining skin biopsies required to study the changes after laser treatment. OBJECTIVE: To evaluate the usefulness of human skin explants for the investigation of fractional photothermolysis. METHODS: Full-thickness discarded skin was treated in 4 ways: no treatment (control), fractional carbon dioxide laser, fractional Er:YAG laser, and fractional 1,550-nm erbium-doped fiber laser. Both treated and non-treated skin samples were cultured ex vivo at the air-medium interface for 7 days. Frozen tissue was sectioned and stained with hematoxylin & eosin for histologic examination and nitro blue tetrazolium chloride for viability testing. RESULTS: Skin explants cultured for up to 3 days exhibited histologic changes similar to those observed in in vivo studies, including microscopic treatment zones surrounded by a thermal coagulation zone, re-epithelialization, and formation of microscopic epidermal necrotic debris. However, the explant structure lost its original form within 7 days of culture. The viability of skin explants was maintained for 3 days of culture but was also lost within 7 days. CONCLUSION: The skin explant model may be a useful tool for investigating the immediate or early changes following fractional photothermolysis, but further improvements are required to evaluate the long-term and dermal changes.
Biopsy ; Cosmetic Techniques ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Laser Therapy ; Lasers, Gas ; Re-Epithelialization ; Skin* ; Tissue Culture Techniques ; Tissue Survival

Coronary artery ectasia is an uncommon disorder diagnosed in 1 to 4% of patients undergoing coronary arteriography. Coronary artery ectasia is often considered a variant of atherosclerotic coronary artery disease, although other causes should be considered. Complications from this disease usually occur as thrombo-embolic phenomena primarily due to thrombosis in the ectatic segment of the coronary artery. A 53-year old man was transferred to our ER, presenting with acute inferior wall infarction. Coronary angiogram showed a gigantic ectatic right coronary artery (RCA) with occlusion of the mid portion by a huge mural thrombus. We injected and infused glycoprotein IIb-IIIa inhibitor in the RCA, however the lysis of thrombus was minimal. Subsequently, we infused Urokinase into the RCA for 2 days. Follow-up angiography revealed partial lysis of the thrombus. The patient demonstrated no thrombo-embolic events during two months of coumadinization, and follow-up angiography revealed a complete lysis of the thrombus.
Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dilatation, Pathologic* ; Follow-Up Studies ; Glycoproteins ; Humans ; Infarction ; Middle Aged ; Myocardial Infarction* ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Warfarin

Hepatobiliary involvement is a rare manifestation of Henoch-Schonlein purpura (HSP). HSP cases related to hepatitis A, B or C virus have been reported but little is known about HSP cases complicated by cholestatic hepatitis without underlying hepatobiliary disease. Here, we report a case of Henoch-Schonlein purpura presenting with cholestatic hepatitis. The patient presented with upper abdominal pain and cholestasis that developed characteristic purpura. The patient was treated conservatively by therapeutic fasting and nutritional support, and liver function recovered 7 weeks after admission.
Abdominal Pain ; Cholestasis ; Fasting ; Hepatitis ; Hepatitis A ; Humans ; Liver ; Nutritional Support ; Purpura ; Purpura, Schoenlein-Henoch ; Viruses

The publisher wishes to apologize for incorrectly displaying the author (Ju Hyung Lee) name.

OBJECTIVE: This retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review. METHODS: Clozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT. RESULTS: The average number of ECT sessions was 13.4 (±4.6). Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by 17.9 (±12.8) points (p=0.0384) on average, which represented a reduction of 25.5% (±14.3). 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects. CONCLUSION: This study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy.
Clozapine ; Electroconvulsive Therapy* ; Humans ; Psychopathology ; Retrospective Studies ; Schizophrenia*

Respiratory involvement in Crohn disease (CD) is rare condition with only about a dozen reported cases. We report the first case of CD with tracheal involvement in Korea. An 18-year-old woman with CD was hospitalized because of coughing, dyspnea, and fever sustained for 3 weeks. Because she had stridor in her neck, we performed computed tomography of the neck, which showed circumferential wall thickening of the larynx and hypopharynx. Bronchoscopy revealed mucosal irregularity, ulceration, and exudates debris in the proximal trachea, and bronchial biopsy revealed chronic inflammation with granulation tissue. Based on these findings, we suspected CD with tracheal involvement and began administering intravenous methylprednisolone at 1 mg/kg per day, after which her symptoms and bronchoscopic findings improved.
Adolescent ; Biopsy ; Bronchoscopy ; Cough ; Crohn Disease* ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Granulation Tissue ; Humans ; Hypopharynx ; Inflammation ; Inflammatory Bowel Diseases ; Korea* ; Larynx ; Methylprednisolone ; Neck ; Respiratory Sounds ; Trachea ; Ulcer

Acute pericarditis may be caused by a variety of disorders. Most cases of acute pericarditis without any initial apparent cause are idiopathic, although presumably viral in origin. While staphylococcus aureus, streptococcus pneumonias and streptococcus pyogens were the predominant organisms recovered prior to 1950, gram negative bacilli, anaerobic bacteria and fungus were recovered after 1950. These changes of the etiologic diversity of acute pericarditis were related to the development and advances of cardiac surgery, antibiotics, chemotherapy for cancer and immunosuppressive treatments. It is important for the therapy of acute bacterial pericarditis to establish the proper regimen of antibiotics and to drain pericardial effusion, if needed. We report a case of acute pericarditis, caused by Klebsiella pneumoniae, an uncommon pathogen that caused purulent pericarditis with cardiac tamponade.
Anti-Bacterial Agents ; Bacteria, Anaerobic ; Cardiac Tamponade ; Drug Therapy ; Fungi ; Klebsiella pneumoniae* ; Klebsiella* ; Pericardial Effusion ; Pericarditis* ; Pneumonia ; Staphylococcus aureus ; Streptococcus ; Thoracic Surgery

Background: Inflammatory bowel disease (IBD), including both Crohn’s disease and ulcerative colitis, are chronic human diseases that are challenging to cure and are often unable to be resolved. The inbred mouse strain C57BL/ 6 N has been used in investigations of IBD as an experimental animal model. The purpose of the current study was to compare the inflammatory responsiveness of C57BL/6NKorl mice, a sub-strain recently established by the National Institute of Food and Drug Safety Evaluation (NIFDS), with those of C57BL/6 N mice from two different sources using a dextran sulfate sodium (DSS)-induced colitis model. Results: Male mice (8 weeks old) were administered DSS (0, 1, 2, or 3%) in drinking water for 7 days. DSS significantly decreased body weight and colon length and increased the colon weight-to-length ratio. Moreover, severe colitisrelated clinical signs including diarrhea and rectal bleeding were observed beginning on day 4 in mice administered DSS at a concentration of 3%. DSS led to edema, epithelial layer disruption, inflammatory cell infiltration, and cytokine induction (tumor necrosis factor-α, interleukin-6, and interleukin-1β) in the colon tissues. However, no significant differences in DSS-promoted abnormal symptoms or their severity were found between the three sub-strains. Conclusions These results indicate that C57BL/6NKorl mice responded to DSS-induced colitis similar to the generally used C57BL6/N mice, thus this newly developed mouse sub-strain provides a useful animal model of IBD.

Background/Aims: We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. Methods: The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. Results: The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden’s J to classify frailty by both the CHS scale and CGAFI. Conclusions The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.