Idiopathic thrombocytopenic purpura is an uncommon illness but most common form of thrombocytopema in pregnancy. Corticosteroids, splenectomy, immunosuppressive drugs, and immunoglobulin therapy have been recommended for manaaement. The optimal method of delivery is controversial. We have experienced a case of idiopathic thrombocytopenic purpura diagnosed previously and managed with corticosteroid and vincrstine, which was followed by pregnancy, vaginal delivery and postpiirtum splenectomy.
Adrenal Cortex Hormones ; Immunization, Passive ; Pregnancy* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

No abstract available.
Pemphigus

No abstract available.
Hamartoma*

The influence of lead exposure on renal function was studied. Eighty nine lead exposed workers who worked in 2 storage battery factories, and seventy one control workers were chosen for this study. Blood lead(pbB) and zinc protoporphyrin in whole blood(ZPP) were selected as indicators of lead exposure. As indicators of renal function, urinary N-acetyl-beta-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(S-Cr), total protein in urine(U-Tp),and serum uric acid(S-Ua) were selected. The results obtained were as follows: 1. while the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. 2. BUN, logarithmic U-TP, logarithmic NAG and S-Cr showed statistically significant correlation with pbB. 3. The proportion of workers whose values of renal function indicators were over the normal limits(NAG7.5 U/g cr; U-TP 10.9mg/dl; BuN20 mg/dl; S-Cr1.2 mg/dl; S-Ua7.0 mg/dl) by the level of lead absorption in terms of pbB and ZPP were calculated. The proportion of workers with over the normal limits of U-TP among total workers showed the dose-response relationship. when age is adjusted, U-TP showed significantly strong dose-response relationship with the level of pbB and ZPP.
Absorption ; Blood Urea Nitrogen ; Humans ; Male* ; Urea ; Zinc

Thyroid diseases, including autoimmune thyroid diseases and thyroid cancer, are known to have high heritability. Family and twin studies have indicated that genetics plays a major role in the development of thyroid diseases. Thyroid function, represented by thyroid stimulating hormone (TSH) and free thyroxine (T4), is also known to be partly genetically determined. Before the era of genome-wide association studies (GWAS), the ability to identify genes responsible for susceptibility to thyroid disease was limited. Over the past decade, GWAS have been used to identify genes involved in many complex diseases, including various phenotypes of the thyroid gland. In GWAS of autoimmune thyroid diseases, many susceptibility loci associated with autoimmunity (human leukocyte antigen [HLA], protein tyrosine phosphatase, non-receptor type 22 [PTPN22], cytotoxic T-lymphocyte associated protein 4 [CTLA4], and interleukin 2 receptor subunit alpha [IL2RA]) or thyroid-specific genes (thyroid stimulating hormone receptor [TSHR] and forkhead box E1 [FOXE1]) have been identified. Regarding thyroid function, many susceptibility loci for levels of TSH and free T4 have been identified through genome-wide analyses. In GWAS of differentiated thyroid cancer, associations at FOXE1, MAP3K12 binding inhibitory protein 1 (MBIP)-NK2 homeobox 1 (NKX2-1), disrupted in renal carcinoma 3 (DIRC3), neuregulin 1 (NRG1), and pecanex-like 2 (PCNXL2) have been commonly identified in people of European and Korean ancestry, and many other susceptibility loci have been found in specific populations. Through GWAS of various thyroid-related phenotypes, many susceptibility loci have been found, providing insights into the pathogenesis of thyroid diseases and disease co-clustering within families and individuals.
Autoimmunity ; Genes, Homeobox ; Genetics ; Genome-Wide Association Study* ; Graves Disease ; Hashimoto Disease ; Humans ; Leukocytes ; Neuregulin-1 ; Phenotype ; Protein Tyrosine Phosphatase, Non-Receptor Type 22 ; Receptors, Interleukin-2 ; T-Lymphocytes, Cytotoxic ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin ; Thyroxine

BACKGROUND: Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). METHODS: The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. RESULTS: Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT>37℃ 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. CONCLUSION: Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.
Aged* ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Early Diagnosis ; Fever ; Follow-Up Studies ; Hemoptysis ; Humans ; Lung Diseases, Obstructive ; Lung Neoplasms ; Medical Records ; Mortality ; Pneumonia ; Retrospective Studies ; Seoul ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

This study intended to obtain an useful information for health management of lead exposed measuring the lead exposure indices and workers and determine biological monitoring interval in early period of exposure by work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration(PBB), Zinc-protoporphyrin concentration(ZPP), Hemoglobin(HB) and personal history; also measured lead concentration in air(PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below 0.05mg/m3, B; When it is between 0.05 and 0.10mg/m3, and C; When it is above 0.10mg/m3. The results obtained were as follows: 1. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were 29.5+/-12.4 microgram/100ml, 52.9+/-30.0 microgram/100ml and 15.2+/-1.1 gm/100ml. 2. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in control group were 5.8+/-1.6 microgram/100ml, 30.8+/-12.7 microgram/100ml and 15.7+/-1.6 microgram/100ml, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and Zpp concentration among group A were 21.9+/-7.6 microgram/100ml, 41.4+/-12.6 microgram/100ml; those of group B were 29.8+/-11.6 microgram/100ml, 52.6+/-27.9 microgram/100ml; those of group C were 37.2+/-13.5 microgram/100ml, 66.3+/-40.7 microgram/100ml. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration(month) was as follows; when the work duration was 1-2 month, it was 24.1+/-12.4 microgram/100ml,; When the work duration was 3-4 month, it was 29.2+/-13.4 microgram/100ml; and it was 28.9+/-34.5 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration(month) was as follows; When the work duration was 1 2 month, it was 40.6 18.0 g/100ml, When the work duration was 3-4 month, it was 53.4+/-38.4 microgram/100ml; and it was 51.5+/-60.4 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than 40 microgram/100ml and 7.1% had ZPP concentration higher than 100 microgram/100ml; In workers of factory group A, those were 0.9% and 0.0%; In workers of factory group B, those were 17.1% and 6.9%; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than 25 microgram/100ml and ZPP concentration lower than 50 microgram/100ml were 39.7% and 61.9%, respectively; In workers of factory group A, those were 65.5% and 82.3%; In workers of factory group B, those were 36.1% and 60.2%; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP(r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration. 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration(dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within 3~4 month.
Education ; Environmental Monitoring ; Humans ; Hygiene ; Linear Models ; Male* ; Workplace

PURPOSE: To estimate the reporting rate of tuberculosis in one medium-sized city in Korea. METHODS: Data claimed by national health insurance corporationand notification data of KTBS (Korea Tuberculosis Surveillance System) were compared through medical record-linkage method. Regarding the cases that were claimed medical care fee as tuberculosis but not notified to KTBS, we reviewed medical charts of the patients and investigated the reasons of failure to notify. RESULTS: Number of cases claimed health insurance fee as tuberculosis occurrences in Cheonan was 2,331 in 2007, while 956 cases were matched as notified cases to KTBS after electronic record-linkage by personal identifier. Among remaining 1,375 cases that were not matched, real missed cases through medical record review survey were found to be 104. The reasons of failure to notify were because of 'not tuberculosis patients' (500, 36.4%), 'notified in 2006' (421, 30.6%), 'diseases coding error' (341, 24.8%) and 'notified as other diseases' (9, 0.7%). Therefore, the corrected reporting rate was calculated at 93% (95% CI: 91.6% - 94.2%). Notably, reporting rate of clinics (58.1%) was significantly lower than those of hospitals (93.4%) or general hospitals (96.6%). CONCLUSIONS: All cases of tuberculosis diagnosis, which were claimed and not notified, were verified, the reporting rate was not as low as that of the data known through media. However, to reach the goal of tuberculosis elimination (reporting rate over 95%), more effort into improvement of the reporting system is necessary.
Clinical Coding ; Disease Notification ; Electronics ; Electrons ; Fees and Charges ; Hospitals, General ; Humans ; Insurance, Health ; Mandatory Reporting ; Medical Record Linkage ; Medical Records ; National Health Programs ; Private Sector ; Tuberculosis

BACKGROUND: The importance of pro-inflammatory cytokines, especially tumor necrosis factor α(TNF-α) and interleukin-1β(IL-1β), have been extensively documented in the generation of inflammatory lung disease. Lung epithelial cells are also actively involved in initiating and maintaining inflammation by producing pro-inflammatory mediators. Understanding the mechanism of pro-inflammatory cytokine expression in lung epithelial cells is crucial to the development of new therapeutic modalities for inflammatory lung disease. Transcription of most pro-inflammatory cytokines is dependent on the actiation of NF-κB. However, the relationship between pro-inflammatory cytokine expression and NF-κB/IκB pathway in lung epithelial cells is not clear. METHODS: BEAS-2B, A549, NCI-H719 cells were stimulated with IL-1β or TNF-α at various times, and then IL-8 and TNF-αmRNA expressions were assayed by Northern blot analysis. IL-1β or TNF-α-induced NF-κB activation was assessed by the nuclear translocation of p65 NF-κB subunit. The degradation of IκBα and IκBβ by IL-1βor TNF-α stimulation was assayed by Western blot analysis. The phosphorylation of IκBαwas evaluated by Western blot analysis after pre-treating cells with proteasome inhibitor followed by IL-1β or TNF-α stimulation. The basal level of IKKα expression was evaluated by Western blot analysis. RESULTS: IκBαand IκBβ was repidly degraded after 5 minutes of incubation with IL-1β or TNF-α in BEAS-2B, A549, and NCI-H157 cells. The activation of NF-κB and the induction of IL-8 and TNF-α mRNA expressions were observed by IL-1β or TNF-α stimulation in these cells. In contrast, neither the changes in NF-κB/IκB pathway nor IL-8 and TNF-α mRNA expression was induces by IL-1β or TNF-α stimulation in NCI-H719 cell. IL-1β and TNF-α-induced IκB phoshorylation was observed in BEAS-2B, A549, and NCI-H157 cells, but not in NCI-H719 cells. The basal level of IKKα expression was not different between cells. CONCLUSION: NF-κB/IκB pathway plays an important role in the ixpression of pro-inflammatory cytokine in most lung epithelial cells. The absence of the effect on NF-κB/IκB pathway in NCI-H719 cells seems to be due to the defect in the intracellular signal transduction pathway upstream to IKK.
Blotting, Northern ; Blotting, Western ; Cytokines ; Epithelial Cells* ; Inflammation ; Interleukin-8 ; Lung Diseases ; Lung* ; Phosphorylation ; Proteasome Inhibitors ; RNA, Messenger ; Signal Transduction ; Tumor Necrosis Factor-alpha

INTRODUCTIONThis study was conducted to provide an overview of the community-based hypertension and diabetes control programme of 19 cities in Korea and to evaluate its effectiveness in controlling hypertension at the community level.

MATERIALS AND METHODSIn this longitudinal observational study, we analysed the data of 117,264 hypertensive patients aged ≥65 years old from the time of their first enrolment in July 2012 to October 2013 (up to their 2-year follow-up).

RESULTSThe hypertension control rate of 72.5% at the time of enrolment increased to 81.3% and 82.4% at 1 and 2 years after enrolment. Treatment continuity, completion of hypertension self-management education, and longer enrolment duration in the programme contributed to improvements in hypertension control rate.

CONCLUSIONThis programme was characterised by a public health-clinical partnership at the community level. Despite its simplicity, the programme was evaluated as a successful attempt to control hypertension among patients aged >65 years at the community level.

Aged ; Community Networks ; Humans ; Hypertension ; drug therapy ; Longitudinal Studies ; Patient Education as Topic ; Program Evaluation ; Republic of Korea ; Self Care