Mercury occurs in various chemical forms, and it is different to health effects according to chemical forms. In consideration of the point, the evaluation of the mercury exposure to human distinguished from occupational and environmental exposure. With strict to manage occupational exposure in factory, it is declined mercury intoxication cases by metallic and inorganic mercury inhalation to occupational exposure. It is increasing to importance in environmental exposure and public health. The focus on the health impact of exposure to mercury is more on chronic, low or moderate grade exposure—albeit a topic of great controversy—, not high concentration exposure by methylmercury, which caused Minamata disease. Recently, the issue of mercury toxicity according to the mercury exposure level, health effects as well as the determination of what mercury levels affect health are in the spotlight and under active discussion. Evaluating the health effects and Biomarker of mercury exposure and establishing diagnosis and treatment standards are very difficult. It can implement that evaluating mercury exposure level for diagnosis by a provocation test uses chelating agent and conducting to appropriate therapy according to the result. but, indications for the therapy of chelating agents with mercury exposure have not yet been fully established. The therapy to symptomatic patients with mercury poisoning is chelating agents, combination therapy with chelating agents, plasma exchange, hemodialysis, plasmapheresis. But the further evaluations are necessary for the effects and side effects with each therapy.
Chelating Agents ; Diagnosis* ; Environmental Exposure ; Humans ; Inhalation ; Mercury Poisoning ; Mercury Poisoning, Nervous System ; Occupational Exposure ; Plasma Exchange ; Plasmapheresis ; Public Health ; Renal Dialysis

PURPOSE: This was a correlational study to identify effects of perception of clinical ladder system on job satisfaction and intention to leave in perioperative nurses. METHODS: Participants were 154 of perioperative nurses from larger general hospitals in Seoul. Data were collected from April, 16 to 22, 2013 using self-report questionnaires which included items on perception of clinical ladder system, job satisfaction, and intention to leave. Data were analyzed using frequency, t-test, ANOVA, Scheffe? test, Pearson correlation coefficients, and multiple stepwise regression. RESULTS: The average mean score for perception of clinical ladder system was midline at 2.69 point out of 4 point. Perception of clinical ladder system correlated positively with job satisfaction (r=.38, p<.01) and negatively with intention to leave (r=-.88, p<.01). Perception of clinical ladder system was the factor which most influenced job satisfaction explaining 17.1% of the variance, also perception of clinical ladder system was the factor which most influenced intention to leave, explaining 12.7% of the variance. CONCLUSION: Results of this study suggest that there is a need to enhance the perception of the clinical ladder system and to find ways to fulfill the expected effects for improving perioperative nurses' job satisfaction and reducing the intention to leave.
Career Mobility* ; Hospitals, General ; Intention* ; Job Satisfaction* ; Surveys and Questionnaires ; Seoul

Although central catheter-related complications are frequently reported and are inevitable in the neonatal care unit, the incidence of pericardiac tamponade is low but may be fatal. Index of suspicion, prompt diagnosis, and urgent pericardiocentesis are crucial for lifesaving. We encountered two premature cases of central venous catheter-related pericardial tamponade. The first case was a 4-day-old male premature infant (gestational age [GA], 33(+5) weeks; birth weight [BW], 1,864 g), and the second case was a 4-day-old female premature infant (GA, 28(+6) week; BW, 1,050 g). Each infant had an indwelling central venous catheter since birth and at the third day of hospitalization. The conditions of the babies suddenly deteriorated, but both babies were successfully resuscitated with urgent echocardiography and prompt pericardiocentesis.
Birth Weight ; Cardiac Tamponade* ; Central Venous Catheters ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Male ; Parturition ; Pericardiocentesis

Lead, which is widely used in industry, is a common element found in low concentrations in the Earth's crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities. Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children. It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.
Antioxidants ; Child ; Environmental Exposure ; Hematopoietic System ; Human Body ; Humans ; Kidney ; Lead Poisoning ; Liver ; Nervous System

OBJECTIVES: Asian migrant workers in Korea have various ethnicities. The purpose of this study was to evaluate the difference in spirometric interpretation made using the set of third National Health and Nutrition Examination Survey (NHANES III) reference equations and the relevant ethnicity-specific reference sets. METHODS: Spirometry was performed on 166 migrant and 498 Korean male workers between March and November 2012. We analyzed the spirometric data of healthy never-smokers. Spirometric patterns were evaluated using the NHANES III reference set and some relevant ethnicity-specific equations (Eom's equation for Koreans, Ip's equation for East Asians, Crapo's equation for Central Asians, Memon's equation for South Asians, and Gnanou's equation for Southeast Asian people). RESULTS: In all migrant groups except the Central Asian group, the forced expiratory volume in 1 second percentage (FEV1%) and forced vital capacity percentage (FVC%) calculated using each of the ethnicity-specific reference equations considered were significantly higher than those calculated using the NHANES III reference set. This study showed that in the evaluation of the spirometric result of subjects from Southeast Asia or South Asia, the percentage of cases with an abnormal FEV1 or FVC increased when the NHANES III set of equations was used as compared to when the ethnicity-specific equations were used. CONCLUSIONS: We found that the spirometric results of all ethnic groups were higher and the composition of the abnormal spirometric result was lower when the ethnicity-specific reference equations were used instead of the NHANES III reference set.
Asia ; Asia, Southeastern ; Asian Continental Ancestry Group* ; Ethnic Groups ; Forced Expiratory Volume ; Humans ; Korea* ; Male ; Nutrition Surveys ; Spirometry ; Transients and Migrants* ; Vital Capacity

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.
Abdominal Muscles ; Abdominal Pain ; Abdominal Wall ; Aged ; Cough ; Epigastric Arteries ; Hematoma* ; Humans ; Pregnancy ; Renal Insufficiency, Chronic* ; Risk Factors ; Rupture

We evaluated the effect of cobalt chloride (CoCl2) on TNF-alpha and IFN-gamma-induced-inflammation and reactive oxygen species (ROS) in renal tubular epithelial cells (HK-2 cells). We treated HK-2 cells with CoCl2 before the administration of TNF-alpha/IFN-gamma. To regulate hemeoxygenase-1 (HO-1) expression, the cells were treated CoCl2 or HO-1 siRNA. CoCl2 reduced the generation of ROS induced by TNF-alpha/IFN-gamma. TNF-alpha/IFN-gamma-treated-cells showed an increase in the nuclear translocation of phosphorylated NF-kappaBp65 protein, the DNA-binding activity of NF-kappaBp50 and NF-kappaB transcriptional activity and a decrease in IkappaBalpha protein expression. These changes were restored by CoCl2. We noted an intense increase in monocyte chemoattractant protein-1 (MCP-1) and regulated on activation normal T cell expressed and secreted (RANTES) production in TNF-alpha/IFN-gamma-treated cells. We demonstrated that this effect was mediated through NF-kappaB signaling because an NF-kappaB inhibitor significantly reduced MCP-1 and RANTES production. CoCl2 effectively reduced MCP-1 and RANTES production. The expression of HO-1 was increased by CoCl2 and decreased by HO-1 siRNA. However, knockdown of HO-1 by RNA interference did not affect MCP-1 or RANTES production. We suggest that CoCl2 has a protective effect on TNF-alpha/IFN-gamma-induced inflammation through the inhibition of NF-kappaB and ROS in HK-2 cells. However, CoCl2 appears to act in an HO-1-independent manner.
Cell Line ; Chemokine CCL2/metabolism ; Chemokine CCL5/metabolism ; Cobalt/*pharmacology ; Epithelial Cells/cytology/metabolism ; Heme Oxygenase-1/antagonists & inhibitors/genetics/metabolism ; Humans ; *Inflammation ; Interferon-gamma/pharmacology ; Kidney Tubules, Proximal/cytology ; NF-kappa B/antagonists & inhibitors/genetics/*metabolism ; NF-kappa B p50 Subunit/genetics/metabolism ; Oxidative Stress/*drug effects ; Phosphorylation ; Protein Binding ; RNA Interference ; RNA, Small Interfering/metabolism ; Transcription Factor RelA/metabolism ; Tumor Necrosis Factor-alpha/pharmacology

Dermatomyositis (DM) is an idiopathic inflammatory myopathy, characterized by inflammation of the proximal skeletal muscles and typical skin manifestations, which results in symmetric muscle weakness. A 43-year-old man was presented with skin rash and left leg weakness, and he had a history of poliomyelitis. Initially, he was diagnosed as having post-polio syndrome (PPS) due to unilateral muscle weakness and a result of an the electromyography (EMG), which had shown patterns of PPS. After 4 months with conservative therapy for PPS, weakness of bilateral upper arms had developed and skin rashes on his entire body had aggravated and progressed. He was diagnosed as having dermatomyositis, based on elevated muscle enzyme levels, typical skin rashes, and typical EMG findings, which indicated muscle disease. When a patient with previous poliomyelitis has a newly developed muscle weakness or pain, we should consider various possible causes other than PPS.
Adult ; Arm ; Dermatomyositis* ; Diagnosis, Differential* ; Electromyography ; Exanthema ; Humans ; Inflammation ; Leg ; Muscle Weakness* ; Muscle, Skeletal ; Myositis ; Poliomyelitis* ; Postpoliomyelitis Syndrome* ; Skin Manifestations

Elevated blood pressure (BP) is the most common cause of cardiovascular disease. Salt intake has a strong influence on BP, and plasma sodium (pNa) is increased with progressive increases in salt intake. However, the associations with pNa and BP had been reported inconsistently. We evaluated the association between pNa and BP, and estimated the risks of all-cause-mortality according to pNa levels. On the basis of data collected from health checkups during 1995-2009, 97,009 adult subjects were included. Positive correlations between pNa and systolic BP, diastolic BP, and pulse pressure (PP) were noted in participants with pNa > or =138 mM/L (P<0.001). In participants aged > or =50 yr, SBP, DBP, and PP were positively associated with pNa. In participants with metabolic syndrome components, the differences in SBP and DBP according to pNa were greater (P<0.001). A cumulative incidence of mortality was increased with increasing pNa in women aged > or =50 yr during the median 4.2-yr-follow-up (P<0.001). In women, unadjusted risks for mortality were increased according to sodium levels. After adjustment, pNa > or =145 mM/L was related to mortality. The positive correlation between pNa and BP is stronger in older subjects, women, and subjects with metabolic syndrome components. The incidence and adjusted risks of mortality increase with increasing pNa in women aged > or =50 yr.
Adult ; Blood Pressure/*physiology ; Cardiovascular Diseases/blood/*mortality ; Female ; Humans ; Hypertension/*physiopathology ; Incidence ; Male ; Metabolic Syndrome X/blood ; Middle Aged ; Risk ; Risk Factors ; Sex Factors ; Sodium/*blood

Previous studies reported the beneficial effect of erythropoietin (EPO) in acute injuries. We followed patients with and without acute kidney injury (AKI) after coronary artery bypass grafting (CABG) and evaluated the effect of EPO on long-term outcome. We also assessed the efficacy of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictive marker of AKI. Seventy-one patients scheduled for elective CABG were randomly given either 300 U/kg of EPO or saline before CABG. The primary outcome was AKI, and the secondary outcome was the all-cause-mortality and composite of all-cause-mortality and end stage renal disease (ESRD). Twenty-one patients had AKI, 14 (66.7%) in the placebo group and 7 (33.3%) in the EPO group (P = 0.05). Also, uNGAL was higher in the patients with AKI than in those without AKI at baseline, 2, 4, 24, and 72 hr after CABG (P = 0.011). Among patients with AKI, 2-week creatinine (Cr) was not different from baseline Cr in the EPO group, but 2-week Cr was significantly higher than baseline Cr in the placebo group (P = 0.009). All-cause-mortality (P = 0.022) and the composite of all-cause-mortality and ESRD (P = 0.003) were reduced by EPO. EPO reduces all-cause-mortality and ESRD in patients with AKI, largely due to the beneficial effect of EPO on recovery after AKI.
Acute Kidney Injury/etiology/mortality/*prevention & control ; Acute-Phase Proteins/urine ; Aged ; Aged, 80 and over ; Biological Markers/urine ; Coronary Artery Bypass/*adverse effects ; Creatinine/analysis ; Double-Blind Method ; Erythropoietin/*therapeutic use ; Female ; Hematinics/*therapeutic use ; Humans ; Kaplan-Meier Estimate ; Lipocalins/urine ; Male ; Middle Aged ; Placebo Effect ; Prospective Studies ; Proto-Oncogene Proteins/urine ; ROC Curve ; Recombinant Proteins/therapeutic use ; Risk Factors ; Treatment Outcome