BACKGROUND: Lead (Pb), mercury (Hg), and cadmium (Cd) are well-known environmental pollutants. They are unnecessary in the biological processes of humans. This study was performed to estimate the representative background exposure levels to the metals by measuring concentrations in whole blood of the Korean general population. METHODS: This population-based cross-sectional study included 4,000 subjects (1,886 males and 2,114 females) 0–83 years of age in 2010 and 2011. Adult subjects (≥ 19 years of age) were collected by sex- and age-stratified probability method, and preschool- and school-aged subjects were recruited by a cluster sampling method. Written consent was provided prior to blood sampling. Pb and Cd blood concentrations were determined by a flameless atomic absorption spectrophotometry, and blood Hg was analyzed by a direct Hg analyzer. RESULTS: The geometric mean, median and 95th percentile of blood Pb was 1.82 µg/dL, 1.83 µg/dL, and 3.78 µg/dL, respectively. The respective values were 2.92 µg/L, 2.87 µg/L, 9.12 µg/L for Hg, and 0.56 µg/L, 0.59 µg/L, 2.20 µg/L for Cd. Blood Pb and Hg were higher in males than in females, but no sex difference was observed, respectively, in subjects 0–4 years of age for Pb and in subjects less than 20 years for Hg. However, blood Cd was higher in females than in males and no sex difference was observed in subjects < 30 years of age. CONCLUSION: This study provides representative data of human exposure to Pb, Hg, and Cd covering whole age groups of the general population in Korea.
Adult ; Biological Processes ; Cadmium ; Cross-Sectional Studies ; Environmental Pollutants ; Female ; Humans ; Korea ; Male ; Metals ; Methods ; Sex Characteristics ; Spectrophotometry, Atomic

OBJECTIVES: This survey was designed to conduct the first nationwide dietary exposure assessment on hazardous substances including the intakes of functional food and herbal medicine. In this paper, we introduced the survey design and the results of the dietary exposure status and internal exposure levels of lead (Pb), cadmium (Cd), and mercury (Hg). METHODS: We selected 4867 subjects of all ages throughout Korea. We conducted a food survey, dietary survey, biomonitoring, and health survey. RESULTS: Pb and Cd were the highest (median value) in the seaweed (94.2 mug/kg for Pb; 594 mug/kg for Cd), and Hg was the highest in the fish (46.4 mug/kg). The dietary exposure level (median value) of Pb was 0.14 mug/kg body weight (bw)/d, 0.18 mug/kg bw/d for Cd, and 0.07 mug/kg bw/d for Hg. Those with a blood Pb level of less than 5.00 mug/dL (US Centers for Disease Control and Prevention, reference value for those 1 to 5 years of age) were 99.0% of all the subjects. Those with a blood Cd level with less than 0.30 mug/L (German Federal Environmental Agency, reference value for non-smoking children) were 24.5%. For those with a blood Hg level with less than 5.00 mug/L (human biomonitoring I, references value for children and adults, German Federal Environmental Agency) was 81.0 % of all the subjects. CONCLUSIONS: The main dietary exposure of heavy metals occurs through food consumed in a large quantity and high frequency. The blood Hg level and dietary exposure level of Hg were both higher than those in the European Union.
Adult ; Body Weight ; Cadmium ; Centers for Disease Control and Prevention (U.S.) ; Child ; Eating ; Environmental Monitoring ; European Union ; Food Safety* ; Functional Food ; Hazardous Substances* ; Health Surveys ; Herbal Medicine ; Humans ; Korea ; Metals, Heavy ; Reference Values ; Seaweed

OBJECTIVES: This survey was designed to conduct the first nationwide dietary exposure assessment on hazardous substances including the intakes of functional food and herbal medicine. In this paper, we introduced the survey design and the results of the dietary exposure status and internal exposure levels of lead (Pb), cadmium (Cd), and mercury (Hg). METHODS: We selected 4867 subjects of all ages throughout Korea. We conducted a food survey, dietary survey, biomonitoring, and health survey. RESULTS: Pb and Cd were the highest (median value) in the seaweed (94.2 mug/kg for Pb; 594 mug/kg for Cd), and Hg was the highest in the fish (46.4 mug/kg). The dietary exposure level (median value) of Pb was 0.14 mug/kg body weight (bw)/d, 0.18 mug/kg bw/d for Cd, and 0.07 mug/kg bw/d for Hg. Those with a blood Pb level of less than 5.00 mug/dL (US Centers for Disease Control and Prevention, reference value for those 1 to 5 years of age) were 99.0% of all the subjects. Those with a blood Cd level with less than 0.30 mug/L (German Federal Environmental Agency, reference value for non-smoking children) were 24.5%. For those with a blood Hg level with less than 5.00 mug/L (human biomonitoring I, references value for children and adults, German Federal Environmental Agency) was 81.0 % of all the subjects. CONCLUSIONS: The main dietary exposure of heavy metals occurs through food consumed in a large quantity and high frequency. The blood Hg level and dietary exposure level of Hg were both higher than those in the European Union.
Adult ; Body Weight ; Cadmium ; Centers for Disease Control and Prevention (U.S.) ; Child ; Eating ; Environmental Monitoring ; European Union ; Food Safety* ; Functional Food ; Hazardous Substances* ; Health Surveys ; Herbal Medicine ; Humans ; Korea ; Metals, Heavy ; Reference Values ; Seaweed

PURPOSE: To assess the prevalence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) and the relationships between LUTS, ED, depression, and other factors in Korean men with type 2 diabetes mellitus (T2DM). METHODS: This cross-sectional study included 124 male patients with T2DM who attended a university hospital diabetes clinic between October 2010 and April 2012. Data were collected using structured interviews and chart reviews. LUTS were measured using the International Prostate Symptom Score (IPSS), ED using the five-item Korean version of the International Index of Erectile Function (IIEF), depression using the Center for Epidemiologic Studies Depression Scale, and glycosylated hemoglobin level from clinical data. RESULTS: The IPSS score was 9.2+/-6.6. The total IPSS scores indicated that 53.3% of the subjects had either moderate or severe symptoms. The mean IIEF score was 7.3+/-8.6, indicating the severity of ED to be mild, mild to moderate, moderate, and severe in 10.5%, 9.7%, 1.6%, and 66.9% of the participants, respectively. LUTS showed a significant negative correlation with ED (r=-0.26, P=0.003) and a significant positive correlation with depression (r=0.33, P<0.001). ED was negatively correlated with age (r=-0.44, P<0.001), duration of diabetes (r=-0.26, P=0.004), and depression (r=-0.24, P=0.008). CONCLUSIONS: LUTS and ED were found to have a high prevalence among Korean men with T2DM. More severe ED was associated with worse LUTS, whereas more severe depressive symptoms were found to be associated with more severe ED and LUTS.
Cross-Sectional Studies ; Depression ; Diabetes Mellitus, Type 2* ; Epidemiologic Studies ; Erectile Dysfunction* ; Hemoglobin A, Glycosylated ; Humans ; Lower Urinary Tract Symptoms* ; Male ; Prevalence ; Prostate

Ulcerative colitis is associated with various extra-intestinal manifestations, including rheumatic, dermatologic, ophthalmologic, biliary, and hematologic manifestations. Cutaneous findings are common extra-intestinal manifestations of ulcerative colitis, occurring in 10-20% of patients. Cutaneous manifestations include erythema nodosum, pyoderma gangrenosum, aphthous stomatitis, and acute febrile neutrophilic dermatosis. Treatments for these cutaneous manifestations include corticosteroids, cyclosporine, tacrolimus, mycophenolate mofetil, azathioprine, and infliximab. A 48-year-old male presented with an acute exacerbation of ulcerative colitis associated with multiple skin lesions on his face, thumbs, thighs, and feet. The final impression was neutrophilic folliculitis, which is an early form of pyoderma gangrenosum. The patient's skin lesions and colitis both improved with corticosteroids. There are rare published case reports of ulcerative colitis exacerbations associated with pyoderma gangrenosum that initiated as neutrophilic folliculitis of the face. This case report includes a review of the literature.
Adrenal Cortex Hormones ; Antibodies, Monoclonal ; Azathioprine ; Colitis ; Colitis, Ulcerative ; Cyclosporine ; Erythema Nodosum ; Folliculitis ; Foot ; Humans ; Infliximab ; Male ; Middle Aged ; Mycophenolic Acid ; Neutrophils ; Pyoderma ; Pyoderma Gangrenosum ; Skin ; Skin Manifestations ; Stomatitis, Aphthous ; Sweet Syndrome ; Tacrolimus ; Thigh ; Thumb ; Ulcer

An isolated aneurysm of the iliac artery is a very rare disease that can occur as the result of atherosclerotic degeneration, mycosis, trauma, medial necrosis, fibrodysplasia, or Marfan syndrome. This abnormality is often asymptomatic, and it has a potential risk of rupture. Since patients with chronic renal failure on hemodialysis have many comorbid conditions, the risk of rupture is increased. Here, we report the case of an isolated common iliac artery aneurysm that was caused by atherosclerosis in a patient on hemodialysis, and we review the relevant literature.
Aneurysm ; Atherosclerosis ; Humans ; Iliac Aneurysm ; Iliac Artery ; Kidney Failure, Chronic ; Marfan Syndrome ; Necrosis ; Rare Diseases ; Renal Dialysis ; Renal Insufficiency ; Rupture

Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.
Accounting ; Aged ; Biopsy ; Carcinoma, Basal Cell ; Early Diagnosis ; Female ; Head ; Humans ; Incidence ; Neck ; Skin ; Skin Neoplasms ; Solar System ; Vulva

Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: <0.4 mg/dL (Q1), 0.4-0.5 mg/dL (Q2), 0.6-0.7 mg/dL (Q3), and >0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy.
Adult ; Bilirubin/*blood ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/*blood/complications ; Humans ; Hypertension/complications ; Incidence ; Kidney Failure, Chronic/*blood/complications ; Male ; Middle Aged ; Risk ; Risk Factors ; Treatment Outcome

During dissection of the saphenofemoral junction, anatomical variations in the tributaries of the long saphenous vein and external pudendal artery are frequently encountered, but the transpositions of the femoral artery and vein have very rarely been reported. On operation of the varicose vein, the surgical complications can be minimized when the possible deviations in the normal anatomy are taken into the consideration.
Arteries ; Femoral Artery* ; Saphenous Vein ; Varicose Veins* ; Veins*

OBJECTIVE: There are two types of spina bifida aperta: cystic type and flat type. Unruptured cystic sac of spina bifida may interfere free leakage of cerebrospinal fluid into amnionic fluid space. Therefore its presence could influence the appearance of the intracranial signs on prenatal ultrasound. The purpose of this study was to define the ultrasound findings causing the appearance of indirect intracranial signs. METHODS: Twenty-one fetuses with spina bifida were evaluated from Jan/1998 to March/2004. Incidence of indirect cranial signs (changes of ventricular width, morphologic change of cerebellum, obliteration of cisterna magna, decreased biparietal diameter and lemon sign) were evaluated according to gestational age at diagnosis, size, location and morphology of the spinal lesion. RESULTS: Meningeal sac was visible in 10 cases (48%), flat form in 11 cases (52%) on prenatal ultrasound. All of the intracranial signs seemed to appear more frequently on flat spina bifida, but there were no statistical significance. CONCLUSION: It seems like that the presence of the sac in spina bifida aperta did not interfere the appearance of intracranial signs on prenatal ultrasound.
Amnion ; Cerebellum ; Cerebrospinal Fluid ; Cisterna Magna ; Diagnosis ; Fetus* ; Gestational Age ; Incidence ; Neural Tube Defects* ; Neural Tube* ; Spina Bifida Cystica ; Spinal Dysraphism ; Ultrasonography