A Case of Acute Toxic Hepatitis induced by brief exposure to Dimethylformamide / 대한산업의학회지

Dimethylformamide (DMF), a widely used industrial solvent, has been reported to induce subtle to clinically overt hepatotoxicity. Liver injury due to occupational exposure through inhalation and skin contact has been sporadically reported. We report a 23-year-old male who developed intermittent abdominal pain, anorexia, nausea, vomiting, chest discomfort, and general weakness for 4 days after working in a plastic-coated-glove factory. An acute hepatitis episode occurred after working in an enclosed workplace for 3 days. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis, could be excluded or were considered to be unlikely. Based on occupational history, serological examination and serial liver function examinations, the case was compatible with DMF-induced acute toxic hepatitis. Hepatotoxicity due to occupational exposure to solvents (e.g., DMF) should be considered in any patient with unexplained hepatitis. The fast improvement of the clinical symptoms and the progressive normalization of the liver function tests once the DMF exposure has been stopped, supports the diagnosis.

A Case of Malignant Pleural Mesothelioma Induced by Crocidolite / 대한산업의학회지

Asbestos exposure may cause asbestosis, pleural plaques and benign pleural disease, and may give a predisposition to malignant mesothelioma in occupationally exposed workers. This case report describes a 50-year-old man, dying from histologically confirmed, diffuse, malignant mesothelioma after asbestos exposure. As a young man, he had been exposed at the workplace to crocidolite for 2 years, but he had no other known history of occupational or environmental asbestos exposure. The patient presented with chest pain and general weakness. Computed tomography showed bilateral irregular pleural thickening along both lower lateral chest walls and a low attenuating mass in the anterior portion of the left lobe. Pathological examinations revealed that it was an epithelial type with tubulopapillary structures and it tested immunohistochemically positive for antibodies against cytokeratin, calretinin and vimentin. The patient was started on chemotherapy but he died to the disease at ten months after the first onset of the symptoms. Mesothelioma is a rare neoplasm in the general population. Nevertheless, the importance of close medical surveillance of the high-risk population is emphasized, because of increased asbestos exposure.

Psychosocial Factors Associated with Suicidal Idea among Korean Elderly

OBJECTIVES: The aim of this study was to analyze psychosocial factors associated with suicidal idea among Korean elderly. METHODS: The sociodemographic data and psychopathology were evaluated by questionnaire and psychiatric interview in community-dwelling elderly with age over 60 (N=100) and adults with age 30-49 (N=60). Suicidal idea was assessed by 9th item of Beck Depression Inventory (BDI). To analyze factors associated with suicidal idea in Korean elderly, we assessed family function (Family Adaptation Partnership Growth Affection Resolve, APGAR), alcohol problem (Cut Annoyed Guilty Eye-Opener, CAGE), depressive symptoms (HAM-D, BDI), cognitive function (CDR, MMSE-K, GDS), and functional activities (ADL, I-ADL). RESULTS: 1) The frequency of suicidal idea of the elderly with age over 60 (20.0%) was significantly higher than that of adult with age 30-49 (6.7%)(p<0.05). 2) The factors associated with suicidal idea were major depressive disorder (OR=42.17, 95% C.I. : 2.62-679.03), physical illness (OR=27.01, 95% C.I. : 1.18-616.50), depressive symptoms (OR=12.18, 95% C.I. : 2.91-49.98), poor economic status (OR=7.18, 95% C.I. : 1.05-48.86). 3) The means of variables in the elderly with suicidal idea were ADL 6.4+/-1.1, HAM-D 17.8+/-7.7, BDI 30.0+/-9.5, APGAR 4.8+/-2.6, which were significantly higher than those of the elderly without suicidal idea (p<0.05, respectively). 4) The HAM-D score in the Korean elderly had statistically significant correlation with APGAR (gamma=0.376, p<0.01), BDI (gamma=0.808, p<0.01), ADL (gamma=0.316, p<0.01), GDS (gamma=0.282, p<0.01), CDR (gamma=0.258, p<0.01) and education level (gamma=-0.208, p<0.05). The BDI score had statistically significant correlation with APGAR (gamma=0.341, p<0.01), HAM-D (gamma=0.808, p<0.01), GDS (gamma=0.340, p<0.01), CDR (gamma=0.301, p<0.01), ADL (gamma=0.325, p<0.05) and I-ADL (gamma=0.206, p<0.05). CONCLUSION: These results suggested early detection, psychogeriatric intervention of the elderly with high risk factors and active treatment of medical illness could reduce suicidal idea among them.