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

PURPOSE: We wanted to evaluate the clinical results and the radiological and arthroscopic findings of femoroacetabular impingement (FAI) in young Taekwondo players and to investigate the rate of returning-to-play Taekwondo and the recurrence rate. MATERIALS AND METHODS: Twenty Taekwondo players (16 males and, 4 females) who were arthroscopically treated for FAI from September 2003 to July 2008 were retrospectively analyzed. Their mean age was 21.6 years old (range: 17 to 32 years) and the mean follow up was 33.7 months (range: 24 to 71 months). Plain radiographs and 3 dimensional computed tomography were taken in all patients and magnetic resonance arthrography was performed in 11 with suspicious soft tissue lesions. Labral injury, cartilage injury and associated lesions were evaluated by arthroscopy. The preoperative and postoperative visual analogue scale (VAS), the modified Harris hip score (MHHS), the sports frequency score (SFS), and the non-arthritic hip score (NAHS) were compared. We investigated the rate of returning-to-play at postoperative 1 year and at postoperative 2 years and the recurrence rate within 2 years after surgery. RESULTS: There were 10 cam types, 1 pincer type and 9 mixed types. The mean alpha angle improved from 65.8 degrees preoperatively to 43.2 degrees postoperatively (p<0.001). Acetabular labral tears were accompanied in all cases and the most common tear site and type were at 2 o'clock and degenerative tear, respectively. In descending order, the acetabular cartilage injuries were located in the anterosuperior, posteroinferior and anterior portion, respectively. The femoral cartilage injuries were mostly located in the anterosuperior portion. The range of motion at the final follow-up showed improvement in all except abduction (p=0.262). The VAS, MHHS and SFS showed statistically significant improvement (p<0.001). The NAHS was improved, but without statistical significance (p=0.31). The rates of returning-to-play at postoperative 1 year and postoperative 2 years were 85% (17/20) and 75% (15/20), respectively. The recurrence rate within postoperative 2 years was 15% (3/20). CONCLUSION: As screening test for FAI in young Taekwondo players is necessary at the beginning of Taekwondo. Arthroscopic treatment in symptomatic Taekwondo players is an effective procedure that can improve the postoperative exercise frequency and function. Returning-to-play Taekwondo is associated with the clinical improvements and the patients' will.
Arthrography ; Arthroscopy ; Cartilage ; Femoracetabular Impingement ; Follow-Up Studies ; Hip ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Mass Screening ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Sports ; Sulfides

Background/Aims: Serum fibrosis scores comprised of common laboratory tests have high utility to assess severity of liver fibrosis. We aimed to derive and validate a hepatocellular carcinoma (HCC) risk score based on serum fibrosis scores to predict HCC in treatment-naïve chronic hepatitis B (CHB) patients. Methods: Fifteen thousand one hundred eighty-seven treatment-naïve adult CHB patients were identified to form the training cohort in this retrospective study. Individual fibrosis score was included to construct a new HCC prediction score. The score was externally validated in an independent treatment-naïve Korean CHB cohort. Results: 180/15,187 patients (1.2%) in training cohort and 47/4,286 patients (1.1%) in validation cohort developed HCC during a mean follow-up of 52 and 50 months, respectively. The newly developed HCC risk score, Liang score, is composed of gender, age, hepatitis B virus DNA, fibrosis-4 (FIB-4) index, and ranges from 0 to 22. Area under the time-dependent receiver operating characteristic curve of Liang score was 0.79 (95% confidence interval, 0.70–0.89). A cutoff value of nine provided an extremely high negative predictive value of 99.9% and high sensitivity of 90.0% at 5 years in the validation cohort. Patients with Liang score ≤9 had HCC incidence <0.2% per year in both training and validation cohorts, in whom HCC surveillance might be exempted. Conclusion A novel HCC risk score, Liang score, based on FIB-4 index, is applicable and accurate to identify treatment-naïve CHB patients with very low risk of HCC to be exempted from HCC surveillance.

Background/Aims: Serum fibrosis scores comprised of common laboratory tests have high utility to assess severity of liver fibrosis. We aimed to derive and validate a hepatocellular carcinoma (HCC) risk score based on serum fibrosis scores to predict HCC in treatment-naïve chronic hepatitis B (CHB) patients. Methods: Fifteen thousand one hundred eighty-seven treatment-naïve adult CHB patients were identified to form the training cohort in this retrospective study. Individual fibrosis score was included to construct a new HCC prediction score. The score was externally validated in an independent treatment-naïve Korean CHB cohort. Results: 180/15,187 patients (1.2%) in training cohort and 47/4,286 patients (1.1%) in validation cohort developed HCC during a mean follow-up of 52 and 50 months, respectively. The newly developed HCC risk score, Liang score, is composed of gender, age, hepatitis B virus DNA, fibrosis-4 (FIB-4) index, and ranges from 0 to 22. Area under the time-dependent receiver operating characteristic curve of Liang score was 0.79 (95% confidence interval, 0.70–0.89). A cutoff value of nine provided an extremely high negative predictive value of 99.9% and high sensitivity of 90.0% at 5 years in the validation cohort. Patients with Liang score ≤9 had HCC incidence <0.2% per year in both training and validation cohorts, in whom HCC surveillance might be exempted. Conclusion A novel HCC risk score, Liang score, based on FIB-4 index, is applicable and accurate to identify treatment-naïve CHB patients with very low risk of HCC to be exempted from HCC surveillance.

BACKGROUND: Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. METHODS: A population sample of 240 normotensive (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height(2.7) was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m(2.7) men or 47 g/m(2.7) in women. RESULTS: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height(2.7) (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). CONCLUSION: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy.
Adult* ; Body Mass Index ; Body Size ; Diabetes Mellitus ; Echocardiography ; Female ; Heart Diseases ; Hip ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Mortality ; Obesity* ; Overweight ; Risk Factors ; Thyroid Diseases ; Waist Circumference

BACKGROUND: Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. METHODS: A population sample of 240 normotensive (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height(2.7) was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m(2.7) men or 47 g/m(2.7) in women. RESULTS: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height(2.7) (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). CONCLUSION: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy.
Adult* ; Body Mass Index ; Body Size ; Diabetes Mellitus ; Echocardiography ; Female ; Heart Diseases ; Hip ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Mortality ; Obesity* ; Overweight ; Risk Factors ; Thyroid Diseases ; Waist Circumference

The authors analysed 2,653 cases of transthoracic fine needle aspiration cytology of the lung to evaluate the diagnostic accuracy and its limitation. A comparison was made between the original cytologic and the final histologic diagnoses on 1,149 cases from 1,074 patients. A diagnosis of malignancy was established in 38.3% benign in 48.1%, atypical lesion in 2.3%, and inadequate one in 11.9% of the cases. Statistical data on cytologic diagnoses were as follows; specificity 98.9%: sensitivity of procedure, 76.8%: sensitivity of diagnosis, 95.5%: false positive 5 cases: false negative 18 cases: predictive value for malignancy, 98.8%: predictive value for benign lesion, 79.5%: overall diagnostic efficiency, 87.5%: typing accuracy in malignant tumor, 80%.
Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Lung* ; Sensitivity and Specificity