Relationship of Simple Renal Cyst to Hypertension / 가정의학회지

BACKGROUND: Simple renal cyst is the most common cystic deformation found in adults. However, there were a few systematic Korean reports for the clinical symptoms and complications of simple renal cysts. The author's purpose was to determine the relationship between simple renal cysts diagnosed by abdominal ultrasonography and hypertension. METHODS: Among 13,482 persons who took a routine physical examination at Ulsan University Hospital in 2002, 5,127 persons who took medical examinations again in 2010 were selected. We excluded persons who had renal cyst, hypertension, diabetes, liver cirrhosis, kidney disease, thyroid disease, and cancer in 2002. Analysis was conducted for 505 subjects with newly diagnosed simple renal cyst and 2,744 subjects without renal cyst in 2010. The simple renal cyst group was compared to a control group without renal cyst. RESULTS: Among 3,249 subjects, simple renal cyst and hypertension were newly diagnosed in 505 subjects and 503 subjects. The subjects who had simple renal cysts had significantly higher hypertension incidence (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.20 to 1.94). Significant hypertension incidence was observed especially when the subjects had cysts located on both kidneys (OR, 3.48; 95% CI, 2.12 to 5.71), two (OR, 3.08; 95% CI, 1.84 to 5.15) or more cysts (OR, 3.12; 95% CI, 1.38 to 7.04), and larger cysts more than 1 cm in diameter (OR, 1.55; 95% CI, 1.16 to 2.07). CONCLUSION: The presence of simple renal cysts was significantly positively related to the incidence of hypertension. Bilateral distribution, two or more number, and larger size than 1 cm diameter were the characteristics of simple renal cyst related to hypertension.

The General Characteristics and Results of the Cold Provocation Test in the Risk Group of HAVS / 대한산업의학회지

OBJECTIVES: The cold provocation test for diagnosing the vascular component in hand-arm vibration syndrome (HAVS) is likely to be accepted as an objective test, and a few studies have been performed. However, controversy has continued regarding the diagnostic performance of this method. Although objective methods such as plethysmography and laser doppler flowmetry have been studied, they have not received as much attention as other diagnostic methods. Therefore, our study aim was to spread the awareness of HAVS by reporting the results of the cold provocation test in a hand-transmitted vibration exposure group. METHODS: The study subjects were 549 workers who had been exposed to hand-transmitted vibrations and reported symptoms in their hands. While the subject immersed both their hands in 10degrees C water for 10 minutes, the skin temperature of 10 fingers was recorded from pre-immersion time to 20 minute postimmersion including 10 minutes immersion time. The recovery rates were calculated from the recorded skin temperatures. The 'decreased recovery rate' criteria were less than 30% at 5 minutes post-immersion and 60% at 10 minute post-immersion. RESULTS: Of the subjects, 69.1% and 30.9% had more severe symptoms in the right and left hands, respectively. The mean finger skin temperature of the right hand after cold-water immersion for 10 minutes was approximately 10degrees C, which increased gradually with time, but they did not reach the baseline temperature at 20 minutes post-immersion. The deviations of the skin temperature in the subjects were higher in the recovery phase than in the baseline and cold immersion phase. The 3rd finger of both hands showed the lowest 5-minute recovery rate among the fingers examined, and the left 4th finger and right 3rd finger showed the lowest 10-minute recovery rate. Of the subjects, 37.6% and 10.4% of subjects showed a lower recovery rate at 5 and 10 minutes in at least one finger, respectively, while 10.2% showed a lower recovery rate at both 5 and 10 minutes simultaneously in at least one finger. CONCLUSIONS: The larger deviations in the recovery phase than in the other phases indicated that interindividual differences are more prominent in the recovery phase. There might be no benefit in observing the finger skin temperature for an additional 10 minutes after 10 minutes post-immersion. Overall, approximately 10% of the subjects in the HAVS risk group had HAVS.

Two Case of Erythroleukemia and Myelodysplastic Syndrome in a Non-Destructive Inspector / 대한산업의학회지

BACKGROUND: Ionizing radiation is a group 1 carcinogen according to the IARC(International Agency for Research on Cancer) classification. With the development of the radiation related industry, the number of radiation exposed workers has been increasing. There have been several reports on AML(Acute Myeloid Leukemia) on exposure to ionizing radiation; however, there are no reports of occupational malignant lymphohematopoietic disease related to non-destructive inspection. CASE REPORT 1: A 35-years-old male, who had worked for 10 years in non-destructive inspection, was diagnosed with myelodysplastic syndrome. He worked 8 hours a day, for three weeks per months, where he was exposed to 192Ir and 60Co radiation sources. Because he had not worn a film badge for monitoring his radiation exposure dose, the accurate exposure dose was not reported. The estimate exposure dose calculated via a chromosomal study was 1.20 Gy, which exceed the dose limits of Korean radiation dose standards, which are 50 and 100 mSv annually and quinquennially respectively. CASE REPORT 2: A 26-years-old male, who had worked for 2.5 years in the same company was also diagnosed with myelodysplastic syndrome. CONCLUSION: Non-destructive inspection is the main source of ionizing radiation in the workplace, which could be the cause of malignant lymphohematopoietic diseases. Therefore, more practical plans and guidelines are needed to prevent non-destructive inspectors from workplace radiation exposure.

Occupational Neurologic Disorders in Korea

This article presents a schematic review of the clinical manifestations of occupational neurologic disorders in Korea and discusses the toxicologic implications of these conditions. Vascular encephalopathy, parkinsonism, chronic toxic encephalopathy, cerebellar dysfunction, peripheral neuropathy, and neurodegenerative diseases are common presentations of occupational neurotoxic syndromes in Korea. Few neurotoxins cause patients to present with pathognomic neurologic syndrome. Detailed neurologic examinations and categorization of the clinical manifestations of neurologic disorders will improve the clinical management of occupational neurologic diseases. Physicians must be aware of the typical signs and symptoms of possible exposure to neurotoxins, and they should also pay attention to less-typical, rather-vague symptoms and signs in workers because the toxicologic characteristics of occupational neurologic diseases in Korea have changed from typical patterns to less-typical or equivocal patterns. This shift is likely to be due to several years of low-dose exposure, perhaps combined with the effects of aging, and new types of possibly toxicant-related neurodegenerative diseases. Close collaboration between neurologists and occupational physicians is needed to determine whether neurologic disorders are work-related.