This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.
Adenoma ; Alcohol Drinking ; Blood Glucose ; Cardiovascular Diseases ; Drinking ; Female ; Flushing ; Humans ; Hyperhomocysteinemia ; Hypertension ; Information Dissemination ; Insulin Resistance ; Intraocular Pressure ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Prediabetic State ; Transferases ; Transferrin

We assessed the concomitant impact of cigarette smoking and alcohol consumption in men presenting for primary couple's infertility. Data from 189 infertile men were analyzed. Semen analysis, serum hormones, and sperm DNA fragmentation (SDF) were obtained. Smoking status was categorized as follows: current nonsmoker (-S), moderate smoker (+MS), and heavy smoker (+HS). Alcohol consumption was categorized as follows: abstainer (-D), moderate drinker (+MD), and heavy drinker (+HD). Descriptive statistics and logistic regression models were applied. Among all the participants, 132 (69.8%), 30 (15.9%), and 27 (14.3%) patients were -S, +MS, and +HS, respectively. In addition, 67 (35.4%), 77 (40.7%) and 45 (23.8%) men were -D, +MD and +HD, respectively. Regarding concomitant habits, 52 (27.5%) patients were nonsmokers and abstainers (-S/-D: Group 1), 91 (48.1%) had at least one recreational habit (-S/+D or +S/-D: Group 2), and 46 (24.3%) were both smokers and drinkers (+S/+D: Group 3). Sperm concentration and progressive motility were lower in +HS and +HD, compared with -S and -D (all P < 0.05), respectively. Similarly, both parameters were significantly lower in Group 3 than Groups 1 and 2 (all P < 0.05). SDF values were higher in Group 3 than Groups 1 and 2 (both P < 0.05). In multivariate analysis, follicle-stimulating hormone (FSH) levels and concomitant +S/+D status were independent predictors of impaired sperm concentration and progressive motility (all P < 0.05). Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/abstaining. When concomitant, +S/+D status has an even greater detrimental effect on semen parameters.
Adult ; Alcohol Drinking/adverse effects* ; Alcoholism/complications* ; Cigarette Smoking/adverse effects* ; Cohort Studies ; Female ; Follicle Stimulating Hormone/blood* ; Humans ; Infertility, Male/pathology* ; Male ; Middle Aged ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa/ultrastructure*

BACKGROUND: Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB). METHODS: Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed. RESULTS: Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment. CONCLUSION: In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes.
Alcoholism ; Anemia ; Blood Sedimentation ; Body Mass Index ; C-Reactive Protein ; Diagnosis ; Humans ; Leukocytosis ; Lithuania* ; Logistic Models ; Male ; Risk Factors ; Sputum* ; Thorax ; Thrombocytosis ; Treatment Outcome ; Tuberculosis* ; Tuberculosis, Pulmonary ; Unemployment

BACKGROUND: Alcohol is personal and social problem around the world. Though binge drinking is associated with the elevation of arbohydrate deficient trasnferrin and r-glutamyl transpeptidase, studies of the relationship between heavy drinking and other biological markers are rare. The purpose of this study is to investigate the association between heavy drinking and CBC figures through flushing and non flushing using both NIAAA and Korean guidelines. METHODS: The subjects were 581 Korean adult males: who had undergone a comprehensive medical evaluation at Chungnam National University Hospital between June and December of 2013. 98 of total were non-drinkers, 225 of them flushers, and the rest 258 of them were non-flushers. One standard drink is defined as any drink that contains 14 grams of alcohol. Criteria for immoderate drinking was applied to greater than 14 glasses/week and more than 8 glasses on any day for a non-flush group with reference to the United States' guideline (National Institute in Alcohol Abuse and Alcoholism, NIAAA) and South Korean guideline, and it was also applied to greater than seven glasses/week, and more than four glasses on any day for a flushing group. It was to investigate whether immoderate drinking would be predictable according to increased mean corpuscular volume (MCV), decreased hemoglobin (Hb), and decreased platelet (PLT). Our investigation was to find the correlation with the increased MCV, decreased Hb, and decreased PLT as a means of predictions for immoderate drinking. The study was to examine the CBC's predictability of immoderate drinking through a combination of increased MCV, decreased Hb, or decreased PLT. If one of these three items were abnormal: group A, if two of the three items were abnormal: group B. RESULTS: Predictability of group A was 23.1% in flushing drinkers and 21.7% in non-flushing drinkers for US NIAAA immoderate drinking, whereas 30.8% in flushing drinkers and 30.4% in non-flushing drinkers considering Korean guideline immoderate drinking. Predictability of B group was 100% in flushing and non-flushing drinkers for both NIAAA guidelines and Korean guidelines. CONCLUSIONS: It is desirable for physicians to use any combination of the three CBC indicators (increased MCV, decreased Hb, or decreased PLT) for predicting immoderate drinking.
Adult ; Alcoholism ; Binge Drinking ; Biomarkers ; Blood Cell Count* ; Blood Platelets ; Chungcheongnam-do ; Drinking* ; Erythrocyte Indices ; Eyeglasses ; Flushing* ; Glass ; Humans ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Social Problems

OBJECTIVETo observe the effect of composite factors, like long-term high-salt & fat diet and alcohol abuse on blood viscosity and blood pressure in rats, and compare with a model induced by high molecular dextran, in order to build a chronic hyperviscosity aminal model which is similar to human hyperviscosity in clinic and lay a foundation for efficacy evaluation on traditional Chinese medicines.

METHODMale SD rats were randomly divided into the normal group, the high molecular dextran (HMD) group and the high salt & fat and alcohol (HSFA) group. The HMD group was given normal diet and water for 23 day and then 10% HMD through tail vein for 5 days. The HSFA group was fed with high salt and high fat diets every day and alcohol for 20 h x d(-1) for 13 weeks. After the modeling, whole blood viscosity and plasma viscosity were measured in the 5th, 8th and 11th week. Blood pressure was measured in the 5d, 7h, and 10th week. Red cell count (RBC) and hematocrit (HCT) were measured in the 11th week. PAgT, Fb, ET-1, NO, PGI, TXA2 contents of the normal group and the HSFA group were measured in the 13th week, and IECa21 content was measured with flow cytometry. Result: After the modeling, the HMD group was in good conditions with glossy hairs and active behaviors. The HSFA group was depressed with withered hairs and less activities. During the 5th-11th weeks, the HMD group and the HSFA group showed higher values in high and low shear whole blood viscosity (WBV) than the normal control group. The plasma viscosity (PV) of HMD rats was significantly increased only in the 5th week, and that of HSFA rats significantly increased in the 8"' and 11th week, particularly in the 11'h week. In the 111h week, the HSFA group showed significant increases in RBC and HCT. After the modeling, the blood pressure of HMD rats showed no significant changes, but the blood pressure of HSFA rats significantly increased during 7' and 101h weeks, particularly in the 10"' week. In the 13th week, PAgT, IECa2+, Fb, ET-1 of HSFA rats significantly increased, but with decreases in NO and PGI2.

CONCLUSIONLong-term high salt & fat and alcohol diets can cause abnormal blood viscosity in rats. WBV significantly increased since the 5th week in rats, and PV increased since the 8th week. The mechanism for increasing BV may be: (1) increases in RBC, HCT, and IECa2+, (2) PAgT increase, (3) Fb content increase, or (4) TXA2/PGI2, ET-1/NO imbalance. Although the modeling time with the method is longer than that with the HMD method, the model is more stable and moderate, and could lead to abnormal increases in WBV and PV; Whereas the HMD method only induced transient increase in plasma viscosity and abnormal increase in SBP. The model is more similar to traditional Chinese medicine syndromes and pathogenesis, with higher value for studies on efficacy of traditional Chinese medicines.

Alcoholism ; blood ; metabolism ; Animals ; Blood Pressure ; Blood Viscosity ; Diet, High-Fat ; adverse effects ; Disease Models, Animal ; Ethanol ; adverse effects ; metabolism ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Sodium Chloride, Dietary ; adverse effects ; metabolism

Phlegmonous esophagogastritis is a rare bacterial infection that has been reported to result in mortality. The pathophysiology of phlegmonous gastrointestinal infection is unclear, but some predisposing factors are reported. Those include immunocompromised status, alcohol abuse, malignancy and uncontrolled diabetes mellitus. We report two cases of phlegmonous esophagogastritis with newly diagnosed diabetes mellitus. A 26-year-old woman and a 56-year-old woman individually visited our hospital for sore throat, neck pain and fever. The laboratory findings of both patients demonstrated leukocytosis, and elevated serum glucose levels. HbA1c of both patients was above 11%. Enhanced computed tomography of young woman showed submucosal edema with intramural abscess along the esophagus and stomach, and that of older woman showed the same defined to esophagus. In both cases, empirical antibiotic therapy with intravenous third generation cephalosporin and metronidazole were started. Later, we identified Klebsiella pneumonia through pus culture in both cases. The symptoms of case 1 improved with conservative management with antibiotics only. However, case 2 required surgical drainage and esophagectomy. Early radiologic diagnosis of this disease and accurate identification of pathogens are important factors for good prognosis. Therefore, we emphasize suspicion of such a rare disease is needed, especially when the patient has risk factors such as diabetes mellitus.
Abscess ; Adult ; Alcoholism ; Anti-Bacterial Agents ; Bacterial Infections ; Blood Glucose ; Causality ; Cellulitis* ; Diabetes Mellitus ; Diagnosis ; Drainage ; Edema ; Esophagectomy ; Esophagus ; Female ; Fever ; Humans ; Klebsiella ; Leukocytosis ; Metronidazole ; Middle Aged ; Mortality ; Neck Pain ; Pharyngitis ; Pneumonia ; Prognosis ; Rare Diseases ; Risk Factors ; Stomach ; Suppuration

OBJECTIVE: This study was performed to analyze the clinical variables associated with occurrence of delirium tremens (DT) in inpatients with alcohol dependence initially admitted with diseases unrelated to alcohol. METHODS: This study included 132 inpatients seeking treatment for medical problem with acute alcohol withdrawal. The cases were divided into two groups : with DT group (n=44), without DT group (n=88). We compared the epidemiologic data, alcohol withdrawal symptoms and serum analysis data between two groups. We used the logistic regression to predict risk factors for DT. RESULTS: The DT group had more severe alcohol withdrawal symptoms, more amount of drinking alcohol, more number of drinking per month, higher blood urea nitrogen (BUN), creatinine, amylase, C-reactive protein and lower serum total protein than the without-DT group. According to the result of a logistic regression, occurrence of DT showed correlation with the following factors : sweating, hallucination, agitation, amount of alcohol consumption, number of drinking per month. CONCLUSION: Our study suggests development of DT was correlated with severe alcohol withdrawal symptoms, high BUN, creatinine and low total serum protein. Therefore, during assessment of alcohol dependent patients, clinicians should keep these parameters in mind in order to prevent DT.
Alcohol Drinking ; Alcohol Withdrawal Delirium* ; Alcoholism* ; Amylases ; Blood Urea Nitrogen ; C-Reactive Protein ; Creatinine ; Dihydroergotamine ; Drinking ; Hallucinations ; Humans ; Inpatients ; Logistic Models ; Risk Factors ; Substance Withdrawal Syndrome* ; Sweat ; Sweating

OBJECTIVETo investigate the relationship between serum sex hormone levels, liver function, and pathogenic mechanisms related to cutaneous lesions involving the facial skin in male patients with liver cirrhosis.

METHODSFifty male cirrhotic patients with facial skin lesions, including spider angiomas, angiotelectasis and special type rash, (mean age: 48.1 +/- 12.2 years) were randomly selected for study and enrolled as the case group. Thirty cirrhotic male patients without facial skin lesions (mean age: 44.5 +/- 11.7 years) were enrolled as the control group. Serum levels of luteinizing hormone (LH), follicular stimulating hormone (FSH), prolactin (PRL), estradiol (E2), progesterone (PRGE), and testosterone (T) were detected and compared between cases and controls by the t-test. All patients were sub-categorized according to severity of cirrhosis (Child-Pugh classification) and comparisons between cases and controls were carried out by single factor analysis of variance. Logistic regression modeling was used to evaluate whether the presence of skin lesions is related to changes in markers of liver impairment, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), serum albumin (Alb), prothrombin time (PT-SEC), creatinine (CREA), platelet count (PLT), and alcoholism.

RESULTSIn the cases with spider veins, LH level was significantly elevated (t = 2.01) and T level was significantly decreased (t = -2.20) (both, P less than 0.05 vs. controls). In the cases with telangiectasia, the LH level (t = 3.76, E2 (t = 2.08) and E2/T ratio (t = 2.98) were significantly elevated and T level was significantly decreased (t = -3.77) (all, P less than 0.05 vs. controls). In the cases with special type rash, FSH level was significantly elevated (t = 2.03) and T level was significantly decreased (t = -2.01) (both, P less than 0.05 vs. controls). In the case group, E2 levels decreased as severity of liver damage increased, while in the control group, E2 levels increased as severity of liver damage increased; however, the difference in average E2 values of the two groups did not reach statistical significance (P more than 0.05). In both cases and controls, the T levels were decreased as the severity of liver damage increased (F = 3.70, P less than 0.05). Multivariate logistic regression analysis showed that increased incidence of facial skin lesions is associated with alcoholism (odds ratio (OR) = 4.46, 95% confidence interval (CI) = 1.45-13.7, P less than 0.05) and elevated serum levels of AST (OR = 11.87, 95% CI = 1.24-113.1, P less than 0.05).

CONCLUSIONAlcoholism, impaired liver function, and perturbed levels of circulating sex hormones are associated with cirrhosis-related facial lesions and may play important roles in the pathogenesis of cutaneous lesions in patients with cirrhosis.

Adult ; Alcoholism ; physiopathology ; Case-Control Studies ; Face ; pathology ; Gonadal Steroid Hormones ; blood ; Humans ; Liver Cirrhosis ; blood ; pathology ; physiopathology ; Logistic Models ; Male ; Middle Aged ; Skin ; pathology

OBJECTIVE: The current understanding reveals that chronic subdural hematoma (CSDH) is mostly the results of direct or indirect head trauma. Other factors such as alcoholism, medication (such as anticoagulants or antiplatelet agents), liver cirrhosis, chronic renal failure and hematologic disease are also well known as causes of CSDH. Of them, the authors attempted to identify the risk factors of CSDH by focusing on the age with a view point of recent increase in the elderly population. METHODS: We retrospectively reviewed 216 consecutive CSDH patients who underwent surgery at our institute between 2002 and 2011. We classified them into two groups according to the patients' age (Group A: <65 years old, Group B: > or =65 years old). Various factors were investigated for risk factor of CSDH, such as head trauma, chronic alcoholism, epilepsy, previous shunt surgery, underlying disease having bleeding tendency or medication affecting blood coagulation. And these factors were compared between the two groups for statistical significance. RESULTS: Among the 216 patients, group A included 81 patients (37.5%), group B included 135 patients (62.5%). The medication of group B had significantly more proportion than group A, comparing to the result that group B had relatively less proportion of head trauma and alcoholism (p<0.05). And medication was more associated with non-traumatic CSDH, especially in group B. CONCLUSION: As previously reported, head trauma or alcoholism are also most important causes as a risk factor of CSDH of all ages in our study. But medication is more closely related to the incidence of CSDH in group A, than group B.
Aged ; Alcoholism ; Anticoagulants ; Blood Coagulation ; Craniocerebral Trauma ; Epilepsy ; Hematologic Diseases ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic ; Liver Cirrhosis ; Retrospective Studies ; Risk Factors

OBJECTIVE: To explore the general features and the keypoints of forensic medical examination in tumbling injury cases. METHODS: Twenty-eight cases dying of tumbling injury were collected and the locations and features of injury were analyzed. RESULTS: The occiput of head was the common position for the tumbling injury cases. Force, disease and alcohol were the main reasons for tumbling injury. CONCLUSION The injury is mild outside and severe inside from tumbling injury cases. The craniocerebral contrecoup is the significant feature in tumbling injury cases.
Accidental Falls/mortality* ; Adolescent ; Adult ; Aged ; Alcoholism/blood* ; Autopsy ; Cause of Death ; Contusions/pathology* ; Craniocerebral Trauma/pathology* ; Female ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Scalp/pathology* ; Skull Fractures/pathology* ; Young Adult