Investigation of the Status of Laboratory Tests Conducted during Aviation Medical Examination / 항공우주의학회지

Purpose@#The medical certification for pilots is required by the aviation safety authority based with the aviation safety act. @*Methods@#In this study, medical examination items of the year of 2021 performed during the aviation medical examination in Korea were reviewed by retrospective analysis. @*Results@#Data from a total of 27 hospitals were collected. The number of inspection items ranged from a minimum of 22 items to a maximum of 57 items, showing a difference of more than double. Data from tertiary general hospitals and large airlines showed a tendency to perform more items of test compared to clinic-level institutions. The ratios for each inspection item are as follows: 1) 100% inspection items: urine test, ophthalmic test (except fundus test), fasting blood sugar, general blood test (complete blood count), electrocardiogram, electoencephalography, chest posterior anterior, pure tone audiometry, and total cholesterol; 2) 65%–74% inspection items: triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, blood urea nitrogen/creatinine, and hepatitis B surface antigen; 3) 57% inspection items: hepatitis B surface antibody, human immunodeficiency virus, and venereal disease research laboratory; 4) 50% inspection items: urate and fundus examination. @*Conclusion@#There have been many changes in the medical field over the past 40 years, but in terms of examination items, the aviation physical examination does not reflect the flow of change. Over the past years, the number of pilots has increased significantly, the flight environment has changed, and medical examination methods have been developed and diversified. In accordance with this, it is necessary to change the test items.

Problems with diagnostic criteria for humidifier disinfectant lung injury (HDLI): two cases of radiologically improved HDLI

BACKGROUND@#In Korea, to investigate the casual relationship between humidifier disinfectant and lung disease, four rounds of investigation and judgment were conducted. During this investigation, two adults who performed lung biopsy were recognized for their relevance between humidifier disinfectants and lung disease. At first, we did not think of the relationship to humidifier disinfectant because chest computed tomography (CT) finding of 2 cases were improved. However, they performed lung biopsy and it showed typical humidifier disinfectant lung injury (HDLI) pathologic findings, they could be recognized as HDLI. We report these cases here.CASE PRESENTATION We selected 2 cases from the fourth-round investigation at Kangbuk Samsung Hospital. Patient of case 1 used humidifier disinfectants since September 2010. The patient was admitted 6 months later to the intensive care unit (ICU) due to severe dyspnea. Pathology following a lung biopsy revealed typical HDLI finding which was determined to be due to humidifier disinfectant exposure. Patient of case 2 used humidifier disinfectant from 2001 to 2008 for about 3 months each winter. The patient's cough and sputum production symptoms began in December of 2007. The patient was admitted to the respiratory medicine department due to worsening dyspnea. Pathology following a lung biopsy revealed typical HDLI finding. This was determined to have been caused by humidifier disinfectant exposure. @*CONCLUSIONS@#Because the typical radiologic findings associated with HDLI can improve over time, it is necessary to consider the revision of current diagnostic criteria that the presence of radiologic findings is important.

Problems with diagnostic criteria for humidifier disinfectant lung injury (HDLI): two cases of radiologically improved HDLI

Problems with diagnostic criteria for humidifier disinfectant lung injury (HDLI): two cases of radiologically improved HDLI

BACKGROUND@#In Korea, to investigate the casual relationship between humidifier disinfectant and lung disease, four rounds of investigation and judgment were conducted. During this investigation, two adults who performed lung biopsy were recognized for their relevance between humidifier disinfectants and lung disease. At first, we did not think of the relationship to humidifier disinfectant because chest computed tomography (CT) finding of 2 cases were improved. However, they performed lung biopsy and it showed typical humidifier disinfectant lung injury (HDLI) pathologic findings, they could be recognized as HDLI. We report these cases here.CASE PRESENTATION We selected 2 cases from the fourth-round investigation at Kangbuk Samsung Hospital. Patient of case 1 used humidifier disinfectants since September 2010. The patient was admitted 6 months later to the intensive care unit (ICU) due to severe dyspnea. Pathology following a lung biopsy revealed typical HDLI finding which was determined to be due to humidifier disinfectant exposure. Patient of case 2 used humidifier disinfectant from 2001 to 2008 for about 3 months each winter. The patient's cough and sputum production symptoms began in December of 2007. The patient was admitted to the respiratory medicine department due to worsening dyspnea. Pathology following a lung biopsy revealed typical HDLI finding. This was determined to have been caused by humidifier disinfectant exposure. @*CONCLUSIONS@#Because the typical radiologic findings associated with HDLI can improve over time, it is necessary to consider the revision of current diagnostic criteria that the presence of radiologic findings is important.

The association between long working hours and marital status change: middle-aged and educated Korean in 2014–2015

BACKGROUND: We investigated the association between long workhours and marital status change from married to divorced or separated status that might have bad health effects. METHODS: A total of 40,654 participants with married status in 2014 were followed up in 2015. Weekly workhours were categorized into four groups: ≤ 40, 41–52, 53–60, and > 60 hours per week. Univariate and multivariate logistic regression analyses were performed to determine the relationship between groups of workhours and marital status change after adjusting for age, total monthly household income, working type, and depression with sex stratification. RESULTS: The study populations consisted of 8,346 (20.5%) females and 32,308 (79.5%) males. Odd ratios (ORs) of marital status change for females working for more than 60 hours per week was 4.26 (95% confidence interval [CI]: 1.25–14.5), when working less than or equal to 40 hours per week was used as reference in the crude model. ORs of working more than 60 hours per week was 4.57 (95% CI: 1.02–20.5) in female workers when considering age, total household earning per month, working type of daytime, and depression in a dose-response manner. However, for male workers, long workhours were not significantly related to change of marriage status. CONCLUSIONS: Long workhours for more than 60 hours per week had significantly higher risk of divorce or separation in females, but not in males. Further follow-up studies are needed to evaluate long term effects of long workhours on divorce risk.

Relationship between working hours and probability to take alopecia medicine among Korean male workers: a 4-year follow-up study

BACKGROUND: Many studies have reported the negative effects of long working hours on various health problems. However, whether hair loss is associated with working hours has been rarely investigated so far. The main purpose of this study is to explore the relationship between long working hours and the development of alopecia among Korean male workers. METHODS: A total of 13,391 male workers not to take alopecia medicine in 2013 were followed up to see if they have alopecia medicine after 4 years, and that was used to confirm the alopecia development. Weekly working hours were categorized into three groups: reference working hours (RWH; 52 hours/week). Multiple logistic regression analyses were conducted to investigate the relationship between long working hours and the development of alopecia after adjusting age, marital status, education, monthly household income, smoking, and work schedule within strata of the covariates. RESULTS: Long working hours was significantly related to the development of alopecia. The adjusted odds ratios (ORs) for the development of alopecia were 1.57 (95% confidence interval [CI]: 1.21–2.05) for LWH group and 1.74 (95% CI: 1.23–2.47) for MLWH group relative to RWH group. CONCLUSIONS: Our findings suggest that unintentional development of alopecia is another potential health consequence of long working hours among Korean male workers. Preventive interventions to promote appropriate and reasonable working hours are required in our society.

Comparison of work-related musculoskeletal symptoms between male cameramen and male office workers

BACKGROUND: Previous studies have classified cameramen’s job as physiologically heavy work and identified the risk factors of work-related musculoskeletal disorders (WRMDs) in cameramen. However, those studies limited their research subjects to cameramen. In this study, we compared the frequency and severity of WRMDs between cameramen and office workers. METHODS: A total of 293 subjects working in four broadcasting companies in Korea were recruited. A questionnaire survey was conducted for a month, starting in October 2016. The subjects were divided into cameramen and office workers according to their occupation. We compared the frequency and severity of WRMDs and ergonomic risk assessment results between the two groups. RESULTS: The high-risk WRMD group had a higher proportion of cameramen than office workers. Moreover, the high ergonomic risk group also had a higher proportion of cameramen than office workers for WRMDs in the upper extremities and waist+lower extremities. In the multivariable-adjusted model comparing cameramen and office workers, the odds ratio (OR) with 95% confidence interval (95% CI) for high-risk WRMDs was 3.50 (95% CI: 1.92–7.72) for the upper extremities and 3.18 (95% CI: 1.62–6.21) for the waist and the lower extremities. The ORs by body parts were 3.11 (95% CI: 1.28–7.57) for the neck, 3.90 (95% CI: 1.79–8.47) for the shoulders, and 4.23 (95% CI: 1.04–17.18) for the legs and feet. CONCLUSIONS: Our study suggests that cameramen are at high risk of WRMDs. Workplace improvements and management of the neck, shoulders, and lower extremities, which are susceptible to WRMDs, are necessary to prevent musculoskeletal disorders among cameramen.

A case of generalized argyria presenting with muscle weakness

BACKGROUND: Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness. CASE PRESENTATION: A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids. CONCLUSIONS: Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.

Comparison of sleep quality based on direction of shift rotation in electronics workers

BACKGROUND: Previous studies have reported the effects of direction of shift rotation on sleep, however, the findings are inconsistent. In this study, we investigated sleep quality related to direction of shift rotation using large-scale data from shiftwork-specific health examinations of electronics workers. METHODS: This study included 4750 electronics workers working in a rotating 3-shift system who completed a medical examination for shift workers survey from January 1 to December 31, 2014, at a general hospital. The subjects were categorized into one of two groups according to direction of shift rotation. We compared sleep quality index between the subjects who worked in forward rotation and backward rotation systems. RESULTS: Backward rotation was positively associated with prevalence of poor sleep quality. In the multivariable-adjusted model, when comparing backward rotation to forward rotation, the odds ratio (OR) with 95 % confidence interval (95 % CI) for poor sleep quality was 1.95 (1.58–2.41). After stratifying by gender, the ORs (95 % CIs) for poor sleep quality in male and female was 1.92 (1.47–2.49) and 2.13 (1.47–3.08), respectively. In subgroup analyses, backward rotation was significantly associated with poor sleep quality in workers ≥30 years of age compared with workers <30 years of age (adjusted OR 2.60 vs. 1.89, respectively; P for interaction <0.001). CONCLUSIONS: Our study supports that a backward rotation system is associated with poor sleep quality. Forward rotation systems should be considered to reduce sleep problems.

Association of cadmium with diabetes in middle-aged residents of abandoned metal mines: the first health effect surveillance for residents in abandoned metal mines

OBJECTIVE: The aim of this study was to determine the association between urinary cadmium (U-cd) concentration and diabetes in middle-aged Korean residents of abandoned mines using the first Health Effect Surveillance for Residents in Abandoned Metal mines (HESRAM). METHODS: This study was cross-sectional study conducted on 719 residents between 40-70 years in 38 abandoned metal mines in Korea. Data was collected by HESRAM from 2008 to 2011. The correlation coefficient of U-cd and fasting blood glucose, odds ratio in urinary cadmium tertiles and diabetes prevalence was analyzed according to the sex category. RESULTS: The correlation coefficient U-cd concentration and fasting blood glucose was 0.182 in male. Logistic regression analysis in male revealed a third tertile odds ratio of U-cd (2 mug/g creatinine < U-cd) while diabetes prevalence was 1.81 (95 % CI 1.05-3.12) with adjusted age, BMI, smoking and alcohol consumption, region, family income. On the other hand, the odds ratio for third tertile of U-cd (3 mug/g creatinine < U-cd) between diabetes prevalence in female was 1.39 (95 % CI 0.52-3.72) in addition to adjusted menopausal status. CONCLUSIONS: Environmental exposure to cadmium in abandoned mine residents was associated with diabetes in male. Closed monitoring and periodic evaluation of the health effects of chronic environmental exposure on abandoned mines residents will be needed.

A Cohort Study of Gallstones and Incidence of Diabetes in a Korean Population

BACKGROUND: Gallstones are associated with insulin resistance but the relation between gallstone disease and the risk of developing diabetes mellitus (DM) is unclear. We examined if gallstones are associated with an increased incidence of DM compared to no gallstones. METHODS: A cohort study was performed in 41,518 Koreans aged 30-59 without DM, who underwent a health checkup during 2005-2006 and then were followed annually or biennially until December 2011. Throughout the study period, gallstones were defined as ultrasound-documented gallstones by standard criteria and DM was defined as fasting serum glucose > or =7.0 mmol l-1, A1c > or =6.5%, or use of DM medications. RESULTS: During 192999 person-years of follow-up, 2,232 participants developed DM (incidence rate 11.6 per 1,000 person-years). The incidence of DM was higher in subjects with gallstones or cholecystectomy than in those without gallstones for women but not for men. In multivariate-adjusted models, the hazard ratios (95% confidence intervals) for DM comparing gallstones and cholecystectomy vs. no gallstones were 0.95 (0.63-1.42) and 1.13 (0.53-2.38), respectively, in men and 1.64 (1.13-2.40) and 2.04 (1.01-4.11), respectively, in women. These associations did not differ significantly between relevant subgroups. CONCLUSIONS: In an apparently healthy population, gallstones were independently and modestly associated with increased incidence for DM in women but not in men. Women with gallstones should be provided with adequate measures for preventing DM.

Risk factors of work-related upper extremity musculoskeletal disorders in male cameramen

OBJECTIVE: The aim of this study is to determine the risk factors related to upper extremities work-related musculoskeletal disorders (WRMSDs) in cameramen. METHODS: A questionnaire survey was performed on 166 cameramen in a broadcasting station. The questionnaire consisted of questions on the general characteristics, the health behavior, work type and duration, physical burden, ergonomic posture, and musculoskeletal symptoms. Definition of musculoskeletal disorders was based on NIOSH criteria. RESULTS: The positive rate of WRMSDs symptoms by parts of the body was turned out to be the highest in the shoulder (14.5%) and the lowest in arm and elbow (6%). Logistic regression analysis revealed that symptoms in the shoulders increased with BMI (OR = 3.62, 95% CI = 1.03-12.71), physical burden (OR = 9.29, 95% CI = 1.72-61.78 in the very hard group) and ergonomic factors (OR = 4.50, 95% CI = 1.03-19.68). Ergonomic factors were only related to the symptoms of hand and wrist (OR = 10.21, 95% CI = 1.02-102.20). WRMSDs symptoms, in the whole upper extremities, were higher in the 50 or older age group (OR = 5.86, 95% CI = 1.03-33.26), higher BMI group (OR = 3.26, 95% CI = 1.28-13.53), non-exercise group (OR = 2.37, 95% CI = 1.24-12.59), high physical burden group (OR = 7.6, 95% CI = 1.34-52.74), and high grade ergonomic risk group (OR = 4.82, 95% CI = 1.29-16.06). CONCLUSION: The most serious musculoskeletal disorders of male cameramen were shoulder pain. Ergonomic factors and physical burden were the most significant factors affecting WRMSDs in cameramen in this study. Cameramen should be educated to be able to improve the ergonomic occupational environment and to set up preventive measures against the risk factors during work.

Relationship Between Symptoms of Depression and Smoking and Obesity in Korean Office Workers Younger than 40 Years

BACKGROUND: Though many factors have been found to be associated with depression, still many others remain uncovered. There are few studies that have focused on the younger population whose depressive symptoms are socioeconomically more important than that of the older population. This study is designed to clarify if there is a relationship between depression and smoking and obesity in the young population. METHODS: Office workers from 40 companies who underwent medical check-ups in 2011 were initially selected. Of these, 65,309 subjects had responded to self-reported questionnaires on depressive symptoms with 4,187 subjects being excluded on the basis of past medical history and current medication. Logistic regression was performed to evaluate the relationship between depression and the selected variables. RESULTS: The proportion of high risk groups for depression was significantly high in females. Statistically significant results were only seen in females. Smoking and obesity were related to depression in females as assessed by the Center for Epidemiological Studies-Depression Scale score. Logistic regression analysis also showed that smoking (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.62-2.05) and obesity (OR, 1.48; 95% CI, 1.18-1.82) were related to depressive symptoms in females. CONCLUSIONS: Depressive symptoms in young female office workers under 40 years of age are related to smoking and obesity. By acting towards stopping smoking and being in a healthy weight category, females may lessen their risk for depression, and thereby lessen their socioeconomic losses.

Relationship Between Symptoms of Depression and Smoking and Obesity in Korean Office Workers Younger than 40 Years

BACKGROUND: Though many factors have been found to be associated with depression, still many others remain uncovered. There are few studies that have focused on the younger population whose depressive symptoms are socioeconomically more important than that of the older population. This study is designed to clarify if there is a relationship between depression and smoking and obesity in the young population. METHODS: Office workers from 40 companies who underwent medical check-ups in 2011 were initially selected. Of these, 65,309 subjects had responded to self-reported questionnaires on depressive symptoms with 4,187 subjects being excluded on the basis of past medical history and current medication. Logistic regression was performed to evaluate the relationship between depression and the selected variables. RESULTS: The proportion of high risk groups for depression was significantly high in females. Statistically significant results were only seen in females. Smoking and obesity were related to depression in females as assessed by the Center for Epidemiological Studies-Depression Scale score. Logistic regression analysis also showed that smoking (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.62-2.05) and obesity (OR, 1.48; 95% CI, 1.18-1.82) were related to depressive symptoms in females. CONCLUSIONS: Depressive symptoms in young female office workers under 40 years of age are related to smoking and obesity. By acting towards stopping smoking and being in a healthy weight category, females may lessen their risk for depression, and thereby lessen their socioeconomic losses.

Relationship Between Symptoms of Depression and Smoking and Obesity in Korean Office Workers Younger than 40 Years

BACKGROUND: Though many factors have been found to be associated with depression, still many others remain uncovered. There are few studies that have focused on the younger population whose depressive symptoms are socioeconomically more important than that of the older population. This study is designed to clarify if there is a relationship between depression and smoking and obesity in the young population. METHODS: Office workers from 40 companies who underwent medical check-ups in 2011 were initially selected. Of these, 65,309 subjects had responded to self-reported questionnaires on depressive symptoms with 4,187 subjects being excluded on the basis of past medical history and current medication. Logistic regression was performed to evaluate the relationship between depression and the selected variables. RESULTS: The proportion of high risk groups for depression was significantly high in females. Statistically significant results were only seen in females. Smoking and obesity were related to depression in females as assessed by the Center for Epidemiological Studies-Depression Scale score. Logistic regression analysis also showed that smoking (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.62-2.05) and obesity (OR, 1.48; 95% CI, 1.18-1.82) were related to depressive symptoms in females. CONCLUSIONS: Depressive symptoms in young female office workers under 40 years of age are related to smoking and obesity. By acting towards stopping smoking and being in a healthy weight category, females may lessen their risk for depression, and thereby lessen their socioeconomic losses.

Analysis of Methylmercury Concentration in the Blood of Koreans by Using Cold Vapor Atomic Fluorescence Spectrophotometry

BACKGROUND: Methylmercury is an organic form of mercury that is highly toxic to humans. Here, we present and establish a novel method to detect methylmercury concentrations in the blood of Koreans. METHODS: Methylmercury concentration was analyzed with an automated methylmercury analytic system (MERX, Brooks Rand Co., USA) using cold vapor atomic fluorescence spectrophotometry (CVAFS). A variety of biological materials were digested in methanolic potassium hydroxide solution. The analysis method was validated by examination of certified reference material (955c, National Institute of Standard and Technology, USA). We randomly selected 30 Korean adults (age 20 yr or older) to analyze total blood mercury and methylmercury concentrations. RESULTS: The detection limit and methylmercury recovery rate using this method were 0.1 pg/L and, 99.19% (range: 89.33-104.89%), respectively. The mean blood concentration of methylmercury was 4.54+/-2.15 microg/L (N=30). The mean proportion of methylmercury to the total mercury concentration was 78.27% (range: 41.37-98.80%). CONCLUSIONS: This study is the first report to analyze blood methylmercury concentration using CVAFS in Korea. We expect that this method will contribute to the evaluation of mercury exposure and the assessment of the toxicological impact of mercury in future studies.

Interobserver Variability in Diagnosing High-Grade Neuroendocrine Carcinoma of the Lung and Comparing It with the Morphometric Analysis

BACKGROUND: Distinguishing small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC) of the lung is difficult with little information about interobserver variability. METHODS: One hundred twenty-nine cases of resected SCLC and LCNEC were independently evaluated by four pathologists and classified according to the 2004 World Health Organization criteria. Agreement was regarded as "unanimous" if all four pathologists agreed on the classification. The kappa statistic was calculated to measure the degree of agreement between pathologists. We also measured cell size using image analysis, and receiver-operating-characteristic curve analysis was performed to evaluate cell size in predicting the diagnosis of high-grade neuroendocrine (NE) carcinomas in 66 cases. RESULTS: Unanimous agreement was achieved in 55.0% of 129 cases. The kappa values ranged from 0.35 to 0.81. Morphometric analysis reaffirmed that there was a continuous spectrum of cell size from SCLC to LCNEC and showed that tumors with cells falling in the middle size range were difficult to categorize and lacked unanimous agreement. CONCLUSIONS: Our results provide an objective explanation for considerable interobserver variability in the diagnosis of high-grade pulmonary NE carcinomas. Further studies would need to define more stringent and objective definitions of cytologic and architectural characteristics to reliably distinguish between SCLC and LCNEC.

The Association between Serum Gamma-Glutamyltransferase within Normal Levels and Metabolic Syndrome in Office Workers: A 4-Year Follow-up Study / 가정의학회지

BACKGROUND: Serum gamma-glutamyltransferase (GGT) has been suggested as a predictor for development of the metabolic syndrome in non-Korean population, but studies in Korean population are scarce. Therefore, we examined the association between serum GGT levels and the incidence of the metabolic syndrome in Korean male office workers. METHODS: The study population consisted of 32,692 office workers who underwent health checkups in both 2005 and 2009. A total of 17,583 with elevated GGT levels, the presence of metabolic syndrome, medication history at baseline, and female office workers were excluded. Finally, 15,109 subjects were included in the final analysis. We measured serum GGT levels and individual metabolic components. RESULTS: As a quartile of serum GGT increased, 4-year follow-up incidence of the metabolic syndrome increased. After adjustment for age, alcohol drinking status and smoking status in 2005, logistic regression analysis showed that the odds ratios (95% confidence interval) for incident metabolic syndrome in 2009 compared to the lowest quartile and upper quartiles were 1.00 (reference), 1.57 (1.24-2.00), 2.73 (2.17-3.43), 3.78 (3.02-4.74), and statistically significant (P < 0.001), respectively. CONCLUSION: These results showed that the higher serum GGT predicted the future development of metabolic syndrome. In Korean male office workers without the metabolic syndrome, the serum GGT levels despite normal levels were associated with an increased risk of incident metabolic syndrome.

Four-Year Change of Metabolic Syndrome Incidence According to Serum Uric Acid

BACKGROUND: Serum uric acid has been suggested as a predictor for development of the metabolic syndrome, but retrospective cohort studies in Korean population is scarce. Therefore, we investigated the association between serum uric acid levels and the incidence of the metabolic syndrome in Korean people. METHODS: The study population consisted of 9,746 Korean male employees, 30 to 59 years of age, without cardiovascular disease and metabolic syndrome, who underwent health checkups from 2002 to 2006. We analyzed incidence of metabolic syndrome according to serum uric acid levels and odds ratio of metabolic syndrome using logistic regression. RESULTS: As a quartile of serum uric acid increased, 4 year follow-up incidence of the metabolic syndrome increased. After adjustment sex, age, alcohol drinking status, and smoking status, homeostasis model assessment of insulin resistance and high sensitive C-reactive protein, odds ratios (95% confidence interval) for incidence of metabolic syndrome comparing the lowest uric acid quartile to the upper quartiles were 1.0 (reference), 1.15 (0.96-1.39), 1.52 (1.29-1.80), 2.00 (1.68-2.37), respectively. After futher adjustment of metabolic components, this association remained significant. CONCLUSIONS: These results showed that increasing levels of serum uric acid predicted an increased incidence of metabolic syndrome. Physicians should be observant regarding future development of metabolic syndrome among patients with increasing concentration of serum uric acid.

Hydrofluoric Acid Burns: A Case Report / 대한산업의학회지

BACKGROUND: Hydrofluoric acid_(HF) is widely used in many industrial and domestic settings such as etching glass, and polishing metals. HF is one of the most corrosive inorganic acids and can produce progressive and serious tissue necrosis with severe pain. Since HF chemical burns can be asymptomatic for the first few hours, it is crucial to understand its toxicity and the early use of antidote. CASE: A 37-year-old man presented with erythematous lesion and pain on his face, anterior neck, both forearms, both thighs, and left ankle after injury resulting from a chemical burn caused by HF. He showed normal vital signs and dyspnea, but complained of a sore throat. Liquid form of HF had splashed on his face and anterior neck first and run down his forearms and thighs while working at HF supply tanks. Some of the HF was splashed into his mouth. He immediately removed his clothes and showered with abundant water. A 4.5% calcium gluconate jel was applied to the involved area. He was given subcutaneous injection of 10% calcium gluconate solution. During 17 days of admission he didn't show any signs of systemic intoxication or deep tissue defects. CONCLUSIONS: Immediate cleansing of the affected area with running cold water is the first critical treatment for a chemical burn due to HF. Applying calcium gluconate gel within one hour was very effective for preventing further damage to the injured area as well as systemic injury. In order to reduce the risk of accident and perform first-aid treatment quickly, it is imperative to provide workers with safety education and establish safety facilities.