Erratum: A Case of Acute Kidney Injury in a Patient with Pulmonary Tuberculosis Receiving Ethambutol Therapy / 대한내과학회지

We correct the revised date of this article.

A Case of Acute Kidney Injury in a Patient with Pulmonary Tuberculosis Receiving Ethambutol Therapy / 대한내과학회지

Ethambutol is commonly used as a first-line drug for the treatment of tuberculosis. The most serious adverse effect of ethambutol therapy is optic neuropathy. However, ethambutol-induced acute kidney injury is extremely rare. We report herein a case of acute kidney injury secondary to ethambutol-associated acute interstitial nephritis. A 65-year-old man with pulmonary tuberculosis presented with a > 7-day history of nausea and vomiting. He had begun antituberculosis medications including ethambutol 3 weeks previously. His laboratory findings showed elevated blood urea nitrogen and serum creatinine levels (32.6 and 3.6 mg/dL, respectively). Examination of percutaneous renal biopsy specimens showed diffuse interstitial mononuclear cell infiltration with mild interstitial edema. The patient was treated by cessation of ethambutol and supportive care. His renal function completely recovered (creatinine, 1.1 mg/dL) and his clinical symptoms improved.

A Case of Osmotic Demyelination Syndrome in a Patient with Severe Hyponatremia Complicated by Rhabdomyolysis / 영남의대학술지

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia (Na+ 98 mEq/L), hypokalemia (K+ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.

The Relationship between Rhabdomyolysis and Alcohol Ingestion in Doxylamine Intoxicated Patients

PURPOSE: Doxylamine is commonly used for relief of insomnia; in addition, it is also a drug that is freguently used for intoxication in Korea. This drug is relatively safe; however, it is known to occasionally induce rhabdomyolysis. We have seen many cases of alcohol ingestion in doxylamine intoxications; however, few previous studies have documented the effects of alcohol on rhabdomyolysis. Therefore, the purpose of this study is to determine the effect of alcohol on rhabdomyolysis in doxylamine intoxicated patients. METHODS: This study was conducted on 91 patients admitted to an emergency department after doxylamine intoxication during the period from January 2001 to March 2012. Using the protocol developed beforehand, the amount of drug ingestion, past history, laboratory results, and whether or not alcohol was ingested were recorded. Rhabdomyolysis was defined as serum creatine kinase (CK) over 1,000 U/L. The SPSS package with logistic regression, t-test, and Fisher's test was used for analysis of data. RESULTS: Alcohol ingestion was detected in 52% of the study patients. The presence of hematuria and alcohol ingestion showed a significant association with development of rhabdomyolysis. CONCLUSION: Doxylamine intoxicated patients with alcohol ingestion may have a high rate of incidence of rhabdomyolysis. Therefore, doxylamine intoxicated patients who drink alcohol at the same time should be aware of rhabdomyolysis.

The Effects of Disabilities of the Upper Extremities on Daily Activities of Workers in Manufacturing Industry, and the Factors Influencing Those Disabilities / 대한산업의학회지

OBJECTIVES: Discomfort in the upper extremities affects and restricts the daily activities and work of many workers. This study was conducted to apply a standardized tool for identifying musculoskeletal symptoms and measuring how greatly these symptoms affect the performance of workers in small manufacturing industries as well as to analyze the relationships between the socio-demographic characteristics of the workers, the psychosocial factors, and ergonomic risk factors on the one hand and the reported musculoskeletal symptoms and their effects on work performance on the other. METHODS: Workers in small manufacturing companies were asked to self-evaluate musculoskeletal symptoms, restrictions on work performance, and the ergonomic risk in their working environments. A standardized tool (musculoskeletal symptoms table, DASH [Disability of the arm, shoulder, and hand]) was used to evaluate the musculoskeletal symptoms and the restrictions on work performance. RESULTS: 1) The DASH score was significantly higher among women, older workers who had been in that job for a long time, married workers, those with no leisure activities or hobbies, those with long hours of housework, those who had experienced a disease in the past, and those who had had an accident in the past; 2) the DASH score was also significantly higher for those workers who were unsatisfied with their work, who worked hard, who no control over their work, and whose work required heavy equipment, tools, and materials; 3) the DASH score was significantly higher in workers with major ergonomic risk factors; 4) the DASH score was significantly higher among workers with occupational musculoskeletal disease and was distributed as follows, from highest to lowest rates of occurrence; symptoms in the upper arms, difficulty sleeping, difficulty with work, restrictions in daily activities, restrictions in social activities, and difficulties in specific work performance; 5) explanatory power increased in the model with the addition of socio-demographic variables, i.e., in analyses with the DASH total score as the dependent variable and psychosocial factors, ergonomic risk factors, and upper extremity discomfort symptoms as the independent variables. The total explanatory power found a significant effect at 35.3%. CONCLUSIONS: The results of this study show that to enhance the upper extremity performance level of workers in the manufacturing industry, preventive measures should be based on a consideration of ergonomic risk factors, psychosocial factors, and the socio-demographic characterisitics of the individual workers.

The Effects of Disabilities of the Upper Extremities on Daily Activities of Workers in Manufacturing Industry, and the Factors Influencing Those Disabilities / 대한산업의학회지

OBJECTIVES: Discomfort in the upper extremities affects and restricts the daily activities and work of many workers. This study was conducted to apply a standardized tool for identifying musculoskeletal symptoms and measuring how greatly these symptoms affect the performance of workers in small manufacturing industries as well as to analyze the relationships between the socio-demographic characteristics of the workers, the psychosocial factors, and ergonomic risk factors on the one hand and the reported musculoskeletal symptoms and their effects on work performance on the other. METHODS: Workers in small manufacturing companies were asked to self-evaluate musculoskeletal symptoms, restrictions on work performance, and the ergonomic risk in their working environments. A standardized tool (musculoskeletal symptoms table, DASH [Disability of the arm, shoulder, and hand]) was used to evaluate the musculoskeletal symptoms and the restrictions on work performance. RESULTS: 1) The DASH score was significantly higher among women, older workers who had been in that job for a long time, married workers, those with no leisure activities or hobbies, those with long hours of housework, those who had experienced a disease in the past, and those who had had an accident in the past; 2) the DASH score was also significantly higher for those workers who were unsatisfied with their work, who worked hard, who no control over their work, and whose work required heavy equipment, tools, and materials; 3) the DASH score was significantly higher in workers with major ergonomic risk factors; 4) the DASH score was significantly higher among workers with occupational musculoskeletal disease and was distributed as follows, from highest to lowest rates of occurrence; symptoms in the upper arms, difficulty sleeping, difficulty with work, restrictions in daily activities, restrictions in social activities, and difficulties in specific work performance; 5) explanatory power increased in the model with the addition of socio-demographic variables, i.e., in analyses with the DASH total score as the dependent variable and psychosocial factors, ergonomic risk factors, and upper extremity discomfort symptoms as the independent variables. The total explanatory power found a significant effect at 35.3%. CONCLUSIONS: The results of this study show that to enhance the upper extremity performance level of workers in the manufacturing industry, preventive measures should be based on a consideration of ergonomic risk factors, psychosocial factors, and the socio-demographic characterisitics of the individual workers.