This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas—including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter—along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas—including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter—along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas—including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter—along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas—including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter—along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

Purpose: We report an atypical case of ischemic oculomotor palsy occurring sequentially in both eyes and then improving, followed by a new abducens palsy in a diabetic patient with poor blood sugar control.Case summary: A 51-year-old woman presented with diplopia, dizziness, and pain in the right eye and was diagnosed with oculomotor palsy in the right eye. Magnetic resonance imaging of her brain was normal but glycated hemoglobin concentration was 13.4%. After 2 months, the third nerve palsy in the right eye had recovered completely but a new third nerve palsy occurred in the left eye. 1 month later, the symptoms had improved, and the patient did not return to our clinic until 18 months later, when she returned with new diplopia. This time, she was diagnosed with a sixth nerve palsy in the left eye and was observed while controlling her blood sugar. She recovered after 4 months. Conclusions Generally, cranial nerve palsies occur unilaterally in situations that can cause ischemia, such as diabetes, high blood pressure, and hyperlipidemia. Rarely, they occur bilaterally, or two or more cranial nerve palsies occur simultaneously. However, it is very rare that cranial nerve palsy occurs sequentially in both eyes under the same systemic blood sugar control. Diabetic patients with poor blood sugar control require long-term monitoring, considering the possibility of symptoms developing in both eyes with a time lag or other forms of ischemic cranial nerve palsy.

Background: Errors in counting spinal segments are common during interventional procedures when there are transitional vertebrae. In this study, we investigated the prevalence of the transitional vertebrae including thoracolumbar transitional vertebra (TLTV) and lumbosacral transitional vertebrae (LSTV). The relationship between the existence of TLTV and abnormal rib count or the existence of LSTV were also evaluated. Methods: The vertebral levels were counted craniocaudally, starting from C1, based on the assumption of 7 cervical, 12 thoracic, and 5 lumbar vertebrae, using whole spine spiral three-dimensional computed tomographic images. The 20th and 25th vertebrae were defined as L1 and S1, respectively. Results: In total, 150 patients had TLTV, with a prevalence of 11.2% (150/1,340). LSTV was observed in 111 of 1,340 cases (8.3%). Sacralization was observed in 68 of 1,340 cases (5.1%) and lumbarization in 43 of 1,340 cases (3.2%). There was a significant relationship between the existence of TLTV and the abnormal rib count (odds ratio [OR]: 117.26, 95% confidence interval [95% CI]: 60.77–226.27; P < 0.001) and LSTV (OR: 7.38, 95% CI: 3.99–13.63; P < 0.001). Conclusions Our study results suggest that patients with TLTV are more likely to have an abnormal rib count or LSTV. If a TLTV or LSTV is seen on the fluoroscopic image, a whole spine image is necessary to permit accurate numbering of the lumbar vertebra.

Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.
Abdominal Pain ; Abdominal Wall ; Follow-Up Studies ; Hernia ; Hernia, Umbilical* ; Herniorrhaphy ; Humans ; Intestinal Obstruction ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Prevalence ; Rupture

BACKGROUND: Intravenous lipid emulsion has been used to treat systemic toxicity of local anesthetics. The goals of this in vitro study were to determine the ability of two lipid emulsions (Intralipid(R) and Lipofundin(R) MCT/LCT) to reverse toxic dose local anesthetic-induced vasodilation in isolated rat aortas. METHODS: Isolated endothelium-denuded aortas were suspended for isometric tension recording. Vasodilation was induced by bupivacaine (3 x 10(-4) M), ropivacaine (10(-3) M), lidocaine (3 x 10(-3) M), or mepivacaine (7 x 10(-3) M) after precontraction with 60 mM KCl. Intralipid(R) and Lipofundin(R) MCT/LCT were then added to generate concentration-response curves. We also assessed vasoconstriction induced by 60 mM KCl, 60 mM KCl with 3 x 10(-4) M bupivacaine, and 60 mM KCl with 3 x 10(-4) M bupivacaine plus 1.39% lipid emulsion (Intralipid(R) or Lipofundin(R) MCT/LCT). RESULTS: The two lipid emulsions reversed vasodilation induced by bupivacaine, ropivacaine, and lidocaine but had no effect on vasodilation induced by mepivacaine. Lipofundin(R) MCT/LCT was more effective than Intralipid(R) in reversing bupivacaine-induced vasodilation. The magnitude of lipid emulsion-mediated reversal of vasodilation induced by high-dose local anesthetics was as follows (from highest to lowest): 3 x 10(-4) M bupivacaine-induced vasodilation, 10(-3) M ropivacaine-induced vasodilation, and 3 x 10(-3) M lidocaine-induced vasodilation. CONCLUSIONS: Lipofundin(R) MCT/LCT-mediated reversal of bupivacaine-induced vasodilation was greater than that of Intralipid(R); however, the two lipid emulsions equally reversed vasodilation induced by ropivacaine and lidocaine. The magnitude of lipid emulsion-mediated reversal of vasodilation appears to be correlated with the lipid solubility of the local anesthetic.
Amides ; Anesthetics, Local ; Animals ; Aorta ; Bupivacaine ; Emulsions ; Lidocaine ; Mepivacaine ; Rats ; Solubility ; Vasoconstriction ; Vasodilation

We recently encountered a case of hereditary spherocytosis coexisting with Gilbert's syndrome. Patient was initially diagnosed with Gilbert's syndrome and observed, but other findings suggestive of concurrent hemolysis, such as splenomegaly and gallstones were noted during the follow-up period. Therefore, further evaluations, including a peripheral blood smear, osmotic fragility test, autohemolysis test, and red blood cell membrane protein test were performed, and coexisting hereditary spherocytosis was diagnosed. Genotyping of the conjugation enzyme uridine diphosphate-glucuronosyltransferase was used to confirm Gilbert's syndrome. Because of the high prevalence rates and similar symptoms of these 2 diseases, hereditary spherocytosis can be masked in patients with Gilbert's syndrome. In review of a case and other article, the possibility of the coexistence of these 2 diseases should be considered, especially in patients with unconjugated hyperbilirubinemia who also have splenomegaly and gallstones.
Adult ; Erythrocytes/physiology ; Gallstones/etiology ; Genotype ; Gilbert Disease/complications/*diagnosis/genetics ; Glucuronosyltransferase/genetics ; Hemolysis ; Humans ; Hyperbilirubinemia/etiology ; Male ; Polymorphism, Single Nucleotide ; Spherocytosis, Hereditary/complications/*diagnosis/genetics ; Splenomegaly/etiology

Toxoplasmosis is an infection caused by Toxoplasma gondii. It can be lethal in immunocompromised hosts, such as a transplant recipients or patients infected with human immunodeficiency virus. In solid organ transplant recipients, toxoplasmosis results mainly from transmission of the parasite with an allograft in cases of serological mismatch. Toxoplasmosis in an immunocompromised host is associated with high mortality. Thus, early diagnosis and treatment is very important. We report on a case of toxoplasmosis in a 51-year-old male patient who had undergone deceased donor kidney transplantation. He suffered from fever of unknown origin. He was finally diagnosed with toxoplasmosis, and treated successfully with trimethoprim-sulphamethoxazole.
Early Diagnosis ; Fever ; Fever of Unknown Origin ; HIV ; Humans ; Immunocompromised Host ; Kidney Transplantation* ; Kidney* ; Male ; Middle Aged ; Mortality ; Parasites ; Tissue Donors ; Toxoplasma ; Toxoplasmosis* ; Transplantation ; Transplantation, Homologous ; Transplants