Objectives Second-generation antipsychotics (SGAs) are frequently used in the treatment of bipolar disorder. However, there is still no consensus on their risk of tardive movement syndromes especially for first-generation antipsychotics (FGAs)-naïve patients. This study aimed to investigate the prevalence and associated factors of SGAs-related tardive dyskinesia and tardive dystonia in patients with bipolar disorder, in a naturalistic out-patient clinical setting. Methods The authors assessed 78 non-elderly patients with bipolar (n = 71) or schizoaffective disorder (n = 7) who received SGAs with a combined use of mood stabilizers for more than three months without previous exposure to FGAs. Multiple direct assessments were performed and hospital records longer than one recent year describing any observed tardive movement symptoms were also reviewed. Results The prevalence rates of tardive dyskinesia and tardive dystonia were 7.7% and 6.4%, respectively. These patients were being treated with ziprasidone, risperidone, olanzapine, quetiapine, or paliperidone at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly observed in the orolingual area, and tardive dystonia was most frequently detected in oromandibular area. A past history of acute dystonia was significantly associated with presence of both tardive movement syndromes. Conclusions Our findings suggest that SGAs-related tardive movement syndromes occur in a substantial portion of bipolar disorder patients. Acute dystonia, a reported risk factor of tardive movement syndromes in the era of FGAs is confirmed as a risk factor of both tardive dyskinesia and tardive dystonia that were induced-by SGAs.
Background: Evaluation of Human papilloma virus (HPV) and its association with promoter methylation of candidate genes, p53 and Aurora A in esophageal cancer. Materials and Methods: One hundred forty-one esophageal tissue samples from different pathologies were evaluated for HPV infection by PCR, while the promoter methylation status of p53 and Aurora A was assessed by methylation-specific restriction based PCR assay. Statistical analyses were performed with MedCalc and MDR software. Results: Based on endoscopy and histopathology, samples were categorized: cancers (n=56), precancers (n=7), esophagitis (n=19) and normals (n=59). HPV infection was found to be less common in cancers (19.6%), whereas its prevalence was relatively high in precancers (71.4%), esophagitis (57.8%) and normals (45.7%). p53 promoter methylation did not show any significant difference between cancer and normal tissues, whereas Aurora A promoter methylation demonstrated significant association with disease (p=0.00016, OR:5.6452, 95%CI:2.18 to 14.6) when compared to normals. Aurora A methylation and HPV infection was found in a higher percentages of precancer (66.6%), esophagitis (54.5%) and normal (45.2%) when compared to cancers (14.2%). Conclusions: Aurora A promoter methylation is significantly associated with esophageal cancer, but the effect of HPV infection on this epigenetic alteration is not significant. However MDR analysis showed that the hypostatic effect of HPV was nullified when the cases had Aurora methylation and tobacco exposure. Further HPV sub-typing may give an insight into its reduced prevalence in esophageal cancer verses normal tissue. However, with the present data it is difficult to assign any significant role to HPV in the etiopathology of esophageal cancer.
Objectives: The purpose of this study is to reveal the circumstances under which the cases of harm to health caused by humidifier disinfectant were neglected and show the points where the number of victims and the degree of damage could have been reduced. In addition, it attempts to describe how damage management proceeded immediately after the incident and actually exacerbated the damage. Finally, it explores the unfortunate aspects of the recent trial. By doing so, it attempts to take this as an opportunity to consider whether a tragic event such as the humidifier disinfectant incident could occur in the future. Methods: This study collected and analyzed data on chemical material characteristics related to humidifier disinfectants, data on health effect characteristics, data on related laws and regulations from the Ministry of Environment, data related to the damage investigation by the Korea Environmental Industry and Technology Institute, and current contents. Results: The lack of related systems and laws is the area where the greatest responsibility for the cause of the humidifier disinfectant disaster falls, so it is difficult for the government to escape this responsibility. Establishing a dedicated department to identify the prevalence of certain diseases within the functions of the Health Insurance Review and Assessment Service to monitor health can greatly contribute to the prevention and management of diseases through early detection and management of group outbreaks caused by harmful factors. Humidifier disinfectant damage relief should have been expanded earlier beyond HDLI (humidifier disinfectant lung injury) to include non-specific diseases such as asthma, pneumonia, and interstitial pneumonia. The scope of relief benefits should have also been expanded earlier to include the payment of disability benefits. Fortunately, with the 2020 revision of the Special Act, the conditions for estimating causal relations were eased and individual screening systems such as health impact assessment were reorganized along with the introduction of a rapid screening system. Conclusions: The management system for chemical substances in a country is clearly of paramount importance, and the ministry in charge must have a response system in case of damage to health effects. Administration that looks at the victims' situation from their point of view is needed, and technical countermeasures are required to quickly recognize the prevalence of certain diseases.
Objectives: We aimed to assess the risk of metabolic syndrome one year after the 2007 Hebei Spirit oil spill in Taean, Korea among people exposed to spilt oil during clean-up work. Methods: A total of 6,923 adults, including 3,019 males and 3,904 females, participated in the study. Health examinations and blood tests (total cholesterol, triglycerides, HDL, fasting blood sugar) were performed. A logistic regression model adjusting for age, gender, smoking history, drinking history, income, education, and marital status was used to estimate the risk of metabolic syndrome associated with the level of oil spill exposure. Results: The prevalence of metabolic syndrome was 24.9% among males and 18% among females. Compared with people living within 20 km of the coastline, the risk of metabolic syndrome among people living within 0.8 km of the coastline was significantly higher (male OR=1.696, 95% CI=1.320-2.178, female OR=1.992, 95% CI=1.549-2.561), including a significant dose-response relationship for distance from early contaminate coastline (p<0.001). The risk of metabolic syndrome was higher according to the increase of duration of cleaning work. The risk of metabolic syndrome among people who participated in the clean-up work for more than 116 days, compared with people who participated in the cleaning work for or less 14 days, was significantly higher (male OR=1.845, 95% CI=1.448-2.353, female OR=1.752, CI=1.378-2.228), with a significant dose-response relationship for days of clean-up work (p<0.001). Conclusion: This study showed that there is a significant association between exposure to the oil spill during the clean-up work, distance from early contaminate coastline and the risk of metabolic syndrome in a doseresponse manner.
Objectives: Radiation is one of the most important sources of free radical (such as reactive oxygen species) production, which plays an essential role in the etiology of over hundred diseases. The aim of the study was to investigate some immune parameters and hematological indices in healthy workers of the Radiology Department, University Hospital of Mashhad, Iran. Methods: The study was performed on 50 healthy workers: 30 radiology staff as the case group and 20 laboratory workers as the control group. The radiation dose received by the radiology staff participating in the study was less than the annual maximum permissible level, 50 millisievert. Hematological parameters, lymphocyte proliferation and cytokine production were studied in both groups. Results: Among healthy radiology workers, the hematological indices did not differ statistically; however, their proliferation indices and $IFN-{\gamma}$ levels showed significant increases in parallel with decreases in the IL-4 levels as compared to controls. The immune system of workers exposed to low-dose ionizing radiation was found to be shifted from a Type 2 to a Type 1 response to promote cellular immunity. Conclusion: Based on our data, exposure to low-dose ionizing radiation may decrease the prevalence, frequency, and recurrence of various cancers and infectious diseases because of an increase in Th1-cell-based response, thus leading to more protection of the human body against tumor cells and foreign agents and possibly increased longevity. However, due to high rate of fluoroscopy use for interventional radiology, we suggest continuing research projects on radiation protection and hazards to prevent irreversible damage. As a recommendation, in future studies, radiology staff with a weakened immunity due to high radiation exposure should be considered as good choices to be treated using acupuncture techniques because acupuncture has been demonstrated to enhance the function and the number of immune cells.
Objectives: Exposure to bioaerosols in the indoor environment could be associated with a variety adverse health effects, including allergic disease such atopy. The objectives of this study were to assess children's exposure to bioaerosol in home indoor environments and to evaluate the association between atopy and bioaerosol, environmental, and social factors in Ulsan, Korea. Methods: Samples of viable airborne bacteria and fungi were collected by impaction onto agar plates using a Quick Take TM 30 and were counted as colony forming units per cubic meter of air (CFU/$m^3$). Bioaerosols were identified using standard microbial techniques by differential stains and/or microscopy. The environmental factors and possible causes of atopy based on ISAAC (International Study of Allergy and Asthma in Childhood) were collected by questionnaire. Results: The bioaerosol concentrations in indoor environments showed log-normal distribution (p < 0.01). Geometric mean (GM) and geometric standard deviation (GSD) of airborne bacteria and fungi in homes were 189.0 (2.5), 346.1(2.0) CFU/$m^3$, respectively. Indoor fungal levels were significantly higher than those of bacteria (p < 0.001). The concentration of airborne bacteria exceeded the limit recommended by the Korean Ministry of Environment, 800 CFU/$m^3$, in three out of 92 samples (3.3%) from 52 homes. The means of indoor to outdoor ratio (I/O) for airborne bacteria and fungi were 8.15 and 1.13, respectively. The source of airborne bacteria was not outdoors but indoors. GM of airborne bacteria and fungi were 217.6, 291.8 CFU/$m^3$ in the case's home and 162.0, 415.2 CFU/$m^3$ in the control's home respectively. The difference in fungal distributions between case and control were significant (p = 0.004) and the odds ratio was 0.996 (p = 0.027). Atopy was significantly associated with type of house (odds ratio = 1.723, p = 0.047) and income (odds ratio = 1.891, p = 0.041). Some of the potential allergic fungal genera isolated in homes were Cladosporium spp., Botrytis spp., Aspergillus spp., Penicillium spp., and Alternatia spp. Conclusions: These results suggest that there this should be either 'was little' meaning 'basically no significant association was found' or 'was a small negative' mean that an association was found but it was minor. It's a very improtant distinction. Association between airborne fungal concentrations and atopy and certain socioeconomic factors may affect the prevalence of childhood atopy.
Limited studies are available concerning the effect of heavy metal exposure on cardiovascular diseases. As environmental pollution increases, food contamination, including heavy metal contamination of fish, also increases. However, researches based on the intake of heavy metals, cardiovascular disease, and fish intakes are inconclusive. We assessed an association of heavy metal exposure with cardiovascular disease and fish intake in a nationally representative group of general Korean adults. We used data from the combined 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES), and analyzed the data of 5,139 Koreans who participated in KNHANES. All participants were older than 20 years, and were diagnosed with stroke, ischemic heart disease, or hypertension. The mean blood cadmium, lead concentration, and mercury concentration of subjects were $1.07{\pm}0.01{\mu}g/L$, $2.49{\pm}0.02{\mu}g/dL$, and $5.19{\pm}0.08{\mu}g/L$, respectively. We used the survey logistic regression model to account for the complex sample design of the cardiovascular disease risk in order to estimate the odds ratios (OR). After adjusting for age, education, income, alcohol, smoking, and BMI, the increase of serum cadmium in blood was associated with the increase in the prevalence of hypertension. Further, the increase in blood cadmium concentration was associated with the increase of both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Although higher fish intakes were significantly associated with higher blood mercury concentration (p for trend < 0.0001), fish intakes did not affect either blood cadmium or lead concentration. Comparing the highest fish intake group with the lowest intake group, the OR of hypertension was 0.31 (95% CI: 0.19-0.59) in the crude model for total fish. However, these associations were no longer significant after the adjustment for potential confounding factors. In conclusion, cadmium in blood was associated with an increased risk of hypertension in the general Korean adult population. However, we found no evidence of a clear relationship between cardiovascular disease and frequency of fish consumption.
이 연구의 목적은 외국인 범죄 뉴스 접촉이 수용자의 다문화수용성에 어떠한 방식으로 영향을 미치는지 체계적으로 규명하는 데 있다. 특히 미디어와 커뮤니케이션의 유형에 따라 외국인 범죄 뉴스 접촉의 효과가 어떻게 다르게 나타나는지 살폈다. 또한 범죄에 대한 위험지각을 매개변인으로 설정하여 외국인 범죄 뉴스가 어떠한 과정을 통해 수용자의 다문화수용성에 영향을 미치는지 밝혔다. 분석 결과 자신의 주변에서 외국인 범죄가 발생할 수 있다는 지각에는 다양한 정보원천과 커뮤니케이션 채널이 영향을 미치지만, 사회적으로 외국인 범죄가 만연해 있다는 지각에는 텔레비전의 영향력이 두드러지는 것으로 나타났다(연구문제 1). 대화형 매체를 통한 외국인 범죄 뉴스 접촉은 다문화수용성에 유의한 영향을 미치지 않는 반면 담론형 매체를 통한 접촉과 대면 대화를 통한 접촉은 수용자의 다문화수용성에 부정적인 영향을 미치는 것으로 나타났다(연구문제 2). 담론형 매체를 통한 범죄 뉴스 접촉이 다문화수용성에 영향을 미치는데 있어 사회 수준의 위험지각은 완전매개(full mediation) 역할을 하는 것으로 나타났다(연구문제 3). 이러한 결과를 바탕으로 이론적 함의와 실천적 함의를 논의하였다.
Objectives: This study describes the results of a mass screening and secondary questionnaire conducted among sampled residents around Camp Carroll. Methods: The subjects were sampled based on Waegwan groundwater ingestion history via a primary health questionnaire survey. However, the study population included voluntary participants and there were no grounds for disqualification. Among the 1,033 residents, excluding people living outside Waegwan, 844 subjects age 30 and over were analyzed. History of physician-diagnosed disease (including detailed history of cancer), eating habits, drinking and smoking histories were queried through questionnaires. Health screening consisted of a blood pressure check and blood test (complete blood cell, liver enzyme, lipid, blood sugar test, etc.). Results: The proportion of abnormal gamma-glutamyltransferase levels was higher in the groundwater ingesting female group than the non-ingesting female group. The odds ratios of the ingested '1 to 9 years' and '10 years and over' groups were 3.09 and 0.87, respectively. Proportions of hypertension in males, abnormal serum triglyceride levels in all and in females, and abnormal serum high density lipoprotein cholesterol levels in males were higher in the '10 to 29-year' resident group than in the '1 to 9 year' group. However, there were no significant trends according to length of residence. Conclusions: Physician-diagnosed prevalence and laboratory test results are not different by histories of Waegwan groundwater ingestion and by length of residence. Even if there are partially significant differences, they do not tend to follow increases of exposure amount and trends.
Objectives: The purpose of this study was to assess the validity of self-reported cigarette smoking status and investigate factors associated with the accuracy self-reported and measured urinary cotinine in Korean adults. Methods: We used data from the $1^{st}$ Korean National Environmental Health Survey (2009-2011) among adults aged ${\geq}19$ years (N=6,246). The survey examined self-reported smoking status, and urinary cotinine was regarded as the biomarker of exposure to tobacco smoke. Urinary cotinine was analyzed using a gas chromatography-mass spectrometry (GC/MS) and data analysis was conducted using IBM SPSS version 20.0, which uses the sample weight and calculates variance estimates to adjust for the unequal probability of selection into the survey. Results: We calculated a cut-off point (53.3 ug/L) by using a ROC (Receiver Operating Characteristic) curve. The smoking prevalence was 24.6% based on self-reported data and 28.2% based on urinary cotinine concentrations. When we assessed the agreement between self-reported and urinary cotinine, we found an average agreement of 97.7% among self-reported smokers and 94.5% among self-reported non-smokers. Among self-reported smokers, factors affected the discrepancy were age, household economic status and average number of cigarettes smoked per day. On the other hand, gender, former smoking experience, and exposure to SHS (second hand smoke) were associated with discrepancies among self-reported non-smokers. Conclusion: These results suggest that self-reported data on smoking status provide a valid estimate of actual smoking status. In future research, we will conduct a continuous monitoring study for reliability verification of the data to reduce potential interpretation errors.
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