Effects of a fall prevention exercise regimen on physical and psychosocial outcomes in elderly community dwellers: a randomized comparative study.

BACKGROUND: There is a need for comprehensive programs that address both the physical and psychosocial aspects of fall prevention for the elderly. OBJECTIVE: This study assessed the efficacy of the exercise regimen on various health metrics for elderly community dwellers. METHODS: Forty-four participants were divided into experimental and control groups. The experimental group adhered to a 9-step core exercise regimen for fall prevention, practicing three times a week for 30 minutes across 10 weeks, while the control group maintained their regular daily activities without any specific exercise program. Before and after the intervention, participants underwent the timed up-and-go t est to evaluate the physical function, the berg balance scale (BBS) and one-legged stance test (OLST) for balance assessment, the activity-specific balance confidence scale for fall-related self-efficacy, and measures for health-related quality of life. RESULTS: Participants in the experimental group showed significant improvements in physical function (p = .04, Cohen's effect size (d) = 0.2). and balance ability on BBS (p < .01, d = 0.2) and OLST (p < .01, d = 1.3) compared to the control group. Furthermore, there was a notable enhancement in the quality of life indicators for this group, especially in areas such as physical function (p = .04, d = 0.2), physical-role limitation (p = .04, d = 0.2), mental health (p = .01, d = 0.3), vitality (p = .02, d = 0.4), body pain (p = .04, d = 0.5), and general health (p = .04, d = 0.4). CONCLUSION: These findings highlight the potential of the fall prevention exercise program in improving physical health aspects, but its influence on specific psychosocial elements remains to be determined.

An electromyographical comparison of torso muscle activity and ratio during modified side bridge exercises.

BACKGROUND: Individualized exercise programs based on personal impairment could lead to successful rehabilitation. An effective way to train spine stability is to find exercises that take advantage of the synergistic relation between local and global stabilization systems. OBJECTIVE: This study aimed to investigate synergistic relationship between the muscles of the local and global systems during three modified side bridge exercises compared with traditional side bridge (TSB). METHODS: Twenty healthy participants performed TSB, both leg lift while side-lying (BLLS), torso lift on a 45∘ bench while side-lying (TLBS), and pelvic lift on side-lying (PLS) in random order. Surface electromyography data were analyzed. RESULTS: The results indicate that PLS was effective as TSB on trunk muscle activity. However, BLLS and TLBS demonstrated significantly less rectus abdominal (RA) muscle activity compared to TSB (p< .001). Additionally, BLLS and TLBS had a higher internal oblique (IO)/RA muscle activity ratio than TSB (p< .001). CONCLUSIONS: PLS could be a suitable alternative exercise for individuals who are unable to perform TSB, as it can effectively activate trunk muscles. BLLS and TLBS may be appropriate for training the local stability system, while limiting activation of the RA.

Impact of reduced night work on shift workers' sleep using difference-in-difference estimation.

OBJECTIVES: We used a quasi-experimental design to investigate the impact of a change in the shift work system by reducing overnight work on the sleep health of workers. METHODS: A difference-in-difference (DID) analysis was used to investigate changes in sleep time and sleep quality between the experimental group (shift workers, N = 116 in 2007 and N = 118 in 2013) and the control group (regular day workers, N = 256 in 2007 and N = 185 in 2013) before and after a change in the shift system that eliminated overnight work. The sleep outcomes were measured using a questionnaire that inquired about sleep duration, mid-sleep awakenings, and subjective sleep quality. We used a generalized estimating equation model to investigate differences in the prevalence of sleep-related outcomes between baseline and post-intervention. RESULTS: In the DID models, the sleep time per day (+0.5 h), the prevalence of awakening during sleep (-13.9%), and self-reported poor sleep quality (-34.9%) were improved with statistical significance during evening shifts in the experimental group, but there was no significant change during day shifts in the experimental group compared to the control group after the implementation of the new shift system without overnight shift. CONCLUSIONS: Quitting overnight work improved sleep health of shift workers.

Health Effects Associated With Humidifier Disinfectant Use: A Systematic Review for Exploration.

BACKGROUND: It has been 10 years since the outbreak of lung disease caused by humidifier disinfectants in Korea, but the health effects have not yet been summarized. Therefore, this study aims to systematically examine the health effects of humidifier disinfectants that have been discovered so far. METHODS: All literature with humidifier disinfectants and their representative components as the main words were collected based on the web, including PubMed, Research Information Sharing Service, and government publication reports. A total of 902 studies were searched, of which 196 were selected. They were divided into four groups: published human studies (group 1), published animal and cytotoxicology studies (group 2), technical reports (group 3), and gray literature (group 4). RESULTS: Out of the 196 studies, 97 (49.5%) were published in peer-reviewed journals as original research. Group 1 consisted of 49 articles (50.5%), while group 2 consisted of 48 articles (49.5%). Overall, respiratory diseases such as humidifier disinfectant associated lung injury, interstitial lung disease, and asthma have a clear correlation, but other effects such as liver, heart, thymus, thyroid, fetal growth, metabolic abnormalities, and eyes are observed in toxicological experimental studies, but have not yet been identified in epidemiologic studies. CONCLUSION: The current level of evidence does not completely rule out the effects of humidifier disinfectants on extrapulmonary disease. Based on the toxicological evidence so far, it is required to monitor the population of humidifier disinfectant exposure continuously to see if similar damage occurs.

Status and Risk of Noncompliance of Adherence to Medications for Metabolic Diseases According to Occupational Characteristics.

Thus far, little attention has been paid to adherence to medications focusing on the workers and occupational characteristics. This study aimed to assess the status and risk of noncompliance among workers compared to nonworkers, and the association between nonadherence to medication of metabolic diseases and occupational characteristics. Self-reported adherence to medications for hypertension, diabetes, or dyslipidemia and occupational characteristics were evaluated using the Korea Health Panel Study (2008-2018). The status of adherence to medications was evaluated based on working status, with detailed reasons provided for noncompliance. The risk of noncompliance was estimated using the generalized estimating equation, and a subgroup analysis with age-standardized prevalence ratio according to occupational characteristics was also conducted. During the follow-up period, 19,660 (13.9%) person years were noncompliant with medication adherence for 141,807 person years. Workers had a higher prevalence (15.0%) of noncompliance than nonworkers (13.0%). Workers (OR:1.10, 95% CI:1.04-1.14) showed an increased risk of noncompliance compared to nonworkers. Workers who were manual, unpaid family workers, irregular, or dispatched workers showed an increased prevalence of noncompliance. This study found that workers were susceptible to nonadherence to metabolic disease medication. Future research on the role of working conditions in medication adherence would benefit metabolic disease prevention.

Increased risk of gastric cancer in workers with occupational dust exposure.

BACKGROUND/AIMS: Workers who are exposed to dust in the workplace tend to show a higher incidence of gastric cancer. Nevertheless, scientific evidence to support an association between dust exposure and the risk of gastric cancer is inadequate. This study aimed to investigate whether or not occupational dust exposure influences the risk of gastric cancer. METHODS: We collected the electronic data from the Pneumoconiosis Health Examination (PHE) program, provided by the Ministry of Employment and Labor and the Korea Workers' Compensation and Welfare Service from 2002 to 2017. The PHE database was linked to the National Health Insurances databases. The age-standardized incidence ratio (SIR) and 95% confidence intervals (CIs) of the risk of gastric cancers were evaluated in workers with occupational dust exposure, and the results were compared to those in the general population. RESULTS: From 2004 to 2015, 1,543 cases of gastric cancer were observed in the male participants, as compared with 1,174 of expected cases, which yielded an SIR of 1.314 (95% CI, 1.249 to 1.380). Under dust exposure, the risk of gastric cancer was increased 23.9% in the male participants (95% CI, 19.9 to 27.5), and the degree of impairment of lung function was inversely related to the risk of gastric cancer. CONCLUSION: Workers with occupational dust exposure were at higher risk of developing gastric cancer than the general population. Thus, future efforts for the prevention of gastric cancer are necessary for dust exposed workers.

The Effect of Mechanical Tongue Cleaning on Oral Malodor and Tongue Coating.

BACKGROUND: Mechanical tongue cleaning is an important oral hygiene procedure; it is known that a significant cause of volatile sulfur compounds (VSCs), a major component of bad breath, is due to the bacteria coating the tongue. This study was conducted to identify the effect of mechanical tongue cleaning on reducing bad breath and tongue coating. METHODS: Various mechanical tongue-cleaning methods were studied, including removing tongue coating using a toothbrush, removing tongue coating using a tongue scraper, and removing tongue coating using a toothbrush and a tongue scraper together. The results were as follows. RESULTS: First, the organic bad breath measurement value after cleaning the tongue significantly decreased in the group using only the toothbrush, the group using only the tongue scraper, and the group using both the toothbrush and the tongue scraper. However, there was no difference between the groups. Second, after cleaning the tongue, the measured values of the tongue coating in the values of WTCI (Winkel's tongue coating index) and Qray view were significantly reduced in all three groups, and there was no difference between the groups. Third, the gas measurement value in the oral cavity using a machine significantly decreased only the H2S value of the group using the tongue scraper immediately after the mechanical tongue cleaning. CONCLUSIONS: From these results, it can be confirmed that mechanical tongue cleaning is effective at reducing bad breath and tongue coating. However, in this study, there was no difference in the reduction effect according to the tools (groups) used for mechanical tongue cleaning. It can therefore be seen that wiping accurately from the rear of the tongue to the front is more effective at reducing bad breath and tongue coating.

A Taxonomy of the Common Tasks and the Development of a Risk Index for Physical Load Assessment in Nursing Job.

BACKGROUND: Nursing service is a nonroutine work with an excessive physical load and diverse tasks. This study derived representative common tasks based on the frequently occurring tasks with a high physical load in the nursing workers' daily work and developed indicators to evaluate the work risk by reflecting the characteristics of nonroutine work. METHODS: Common tasks were classified through the following stages: literature review, first focus group interview (FGI) with experts, first classification of common tasks, second FGI with hospital health managers, a survey of nursing service workers, and the final classification of common tasks for each task type. To develop an objective risk index for physical load assessment, we investigated the frequency and duration of the derived common tasks via survey. RESULTS: Nursing common tasks were categorized into six task types and 56 subtasks. To evaluate the risks of various tasks in nonroutine works, three frequencies and three working time levels were defined by examining the task frequency and working hours. Exposure time was defined to reflect the characteristics of a nonroutine job. The final risk assessment was the product of the exposure time level and job intensity level. From this, four risk action levels were derived. CONCLUSION: This study has the advantage of solving the problem of focusing on some tasks in evaluating the physical load. It was meaningful in that a new risk assessment index based on exposure time was proposed based on the development of an evaluation scale for frequency and time by reflecting the characteristics of nonroutine work.

Comparison of Trunk Muscle Activity During Modified Side-Bridge Exercises and Traditional Side Bridge Exercise.

CONTEXT: The modified side-bridge exercise is designed for some special situations in which it is impossible to tolerate the compressive load on the side supported during the side bridge, such as in the older people with a hip or knee replacement and even in athletes with shoulder pain. OBJECTIVES: To examine the effects of 3 modified side-bridge exercises on the spinal stability muscles compared with traditional side-bridge (TSB) exercises for healthy men. DESIGN: The effects of different exercises on the muscle activities of the external oblique (EO), internal oblique (IO), and quadratus lumborum (QL) during TSB exercise, both legs lift on side lying (BLLS), torso lift on a 45° bench while side lying (TLBS), and wall side bridge (WSB) were analyzed with the 1-way repeated-measures analysis of variance. SETTING: This study was conducted in a university hospital laboratory. PARTICIPANTS: A total of 20 healthy men were recruited for this study. INTERVENTIONS: The participants performed TSB, BLLS, TLBS, and WSB in a random order. MAIN OUTCOME MEASURES: Surface electromyography measured the muscle activity of the EO, IO, and QL. A 1-way repeated-measures analysis of variance assessed the statistical significance of the EO, IO, and QL muscle activity. When there was a significant difference, a Bonferroni adjustment was performed. RESULTS: BLLS and TLBS showed similar effects to TSB in the EO, IO, and QL muscle activity, whereas WSB showed significantly less QL muscle activity than TSB (P < .05). Moreover, TLBS was significantly greater in the muscle activity of QL and EO than WSB (P < .05). CONCLUSION: BLLS and TLBS may be effective rehabilitation techniques to activate EO, IO, and QL in patients who are unable to perform TSB as spine stability exercises.

Effect of Socioeconomic Factors on the Relationship Between Musculoskeletal Pain and Ill-Health Retirement in Korea: Results From the Korean Longitudinal Study of Aging.

OBJECTIVE: To investigate the relationship between musculoskeletal pain (MSP) and ill-health retirement (IHR) and modifying role of socioeconomic factors. METHODS: The data used were samples from the Korean Longitudinal Study of Aging from 2006 to 2014. IHR was defined as retirement due to health problems before regular retirement age. Hazard ratio (HR) was calculated using Cox proportional hazards model to determine the effects of MSP and covariance on IHR. RESULTS: People who have "any site of pain" were more likely to experience IHR than people with no pain. In the subgroup analysis, risk of IHR due to MSP was higher in the 60s, white-collar, and high-income earners than the other groups. CONCLUSIONS: MSP has a substantial negative impact on labor force participation, and there was a clear effect modification of socioeconomic status on IHR risk.

Fixed night workers and failed smoking cessation.

BACKGROUND: The objective of this study was to examine the relationship between employee work schedule and failure in smoking cessation. METHODS: Logistic regression was used to estimate the association between work schedule and failed smoking cessation rate among 4927 male workers who had attempted smoking cessation. The data was obtained from the annual Korean National Health and Nutrition Examination Survey from 2007 to 2015 (excluding data from 2013). An adjusted model, including demographic and occupational variables, was constructed after stratifying the data into two subgroups by age (the 19- to 40-year-old group and the 41- to 60-year-old group). RESULTS: The percentage of smoking-cessation failure varied according to work schedule and age. The failure rate in the 19- to 40-year-old group was generally higher for all work schedule categories than in the 41- to 60-year-old group. In particular, the highest percentage (90.9%) of smoking-cessation failure was in the fixed overnight work group. After adjusting for demographic characteristics and work organization variables, the odds ratio for failed smoking cessation across all ages was 3.30 (95%CI 2.23-4.86) among the fixed overnight workers compared to the daytime workers. Both of the age-stratified subgroups maintained this relationship, with a notably higher OR in the 19- to 40-year-old group (OR 3.74, 95% CI 1.80-7.77). CONCLUSIONS: Fixed overnight work is likely to negatively affect smoking cessation compared to other work schedules. Tailored anti-smoking intervention programs are required based on work schedule.

Factors Associated with Cervical Cancer Screening among Married Female Immigrants with Korean Husbands in South Korea.

Background. The purpose of this study was to identify factors associated with the national cervical cancer screening behaviors of married female immigrants living in South Korea. Methods. The present study dataset was collected by the National Health Insurance Services in 2014⁻2015. A final study population of 15,935 was considered eligible for inclusion in this study if they met the criteria for participation in the national cervical cancer screening program in 2014⁻2015. Results. Of the 15,935 subjects, 7837 (49%) participated in cervical cancer screening. Based on the results of the logistic regression analysis of the association between cervical cancer screening behaviors and related factors, the odds ratio (OR) for participation in cervical cancer screening among individuals older than 50 years was the highest (OR: 2.13; 95% confidence interval (CI): 1.82⁻2.51), and the OR increased as their duration of stay in South Korea decreased. The OR of Chinese women for cervical cancer screening participation was higher than that of non-Chinese women (OR: 1.83; 95% CI: 1.69⁻1.99). The OR value was 29.4 (95% CI: 25.9⁻33.3) among those who participated in the general health screening compared with those who did not participate. Conclusions. To improve awareness about cervical cancer screening and reduce disparities in access to healthcare, appropriate programs should be developed to promote cervical cancer screening participation to socially vulnerable classes. Continuous social attention is needed to address these issues and encourage participation in general health screening to improve the rate of cervical cancer screening.

Differences in Metabolic Syndrome Prevalence by Employment Type and Sex.

Workers may sometimes do the same work, but differ in their risk of health-related problems depending on whether the employment type is standard or non-standard. Furthermore, even with similar job and employment types, there may be differences in risk factors for health-related problems depending on sex. This study aimed to determine the prevalence of metabolic syndrome (MetS) by employment type and sex using data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES Ⅴ) (2010⁻2012) and KNHANES Ⅵ (2013⁻2015) conducted by the Korea Centers for Disease Control and Prevention. Overall, 9523 adult wage workers (5523 standard workers and 4000 non-standard workers) aged ≥ 19 years were analyzed. To determine MetS prevalence odds ratios according to employment type, logistic regression analysis was performed disaggregated by sex. The prevalence of MetS significantly increased with age (p < 0.001), being married (p < 0.05), current smoking status (p < 0.05), and high-risk drinking (p < 0.001) among male subjects. The prevalence of MetS significantly increased among female manual workers (p < 0.001), those with lower educational level and household income (p < 0.001). Non-standard workers of either sex showed higher MetS prevalence than standard workers; only females showed significant difference (p < 0.001). Female non-standard workers showed 1.44, 1.33, and 1.34 (all p < 0.001) times higher odds of MetS prevalence in Models 1, 2, and 3, respectively, compared to standard workers, suggesting a difference in risk factors of MetS according to sex. Also, that employment type affects MetS prevalence suggests that employment pattern is an important risk factor especially in females. Therefore, to manage MetS in female non-standard workers, individual health care as well as social effort may be necessary.

The Impact of Depression on Ill-Health Retirement and Its Moderating Factors: Analysis From the Korean Longitudinal Study of Aging (2006 to 2014).

OBJECTIVE: To investigate the effect of depressive symptoms on ill-health retirement (IHR). METHODS: Data were collected from the Korean Longitudinal Study of Ageing which conducted biennially from 2006 to 2014. IHR were defined as those who retired due to their health problems. The short-form Center for Epidemiological Studies-Depression scale served as outcome measure for definition of depressive symptoms. Hazard ratios of IHR were estimated by Cox regression. RESULTS: We observed that depressive symptoms significantly increased risk of IHR during 8-year follow-up period. Compared with those without depressive symptoms, depressed worker had 1.27-fold elevated risk for IHR. Subgroup analysis showed that the association between depressive symptoms and IHR is greater in the elders, women, and lower income group than the others. CONCLUSION: Depressive symptoms independently predicted IHR. Moreover, age, sex, and socioeconomic status modified these effects.

Predictors and estimation of risk for early exit from working life by poor health among middle and older aged workers in Korea.

The aims of this study were to investigate the predictors and estimate the risk for early exit from work owing to poor personal health status of the retirees. This study analysed the longitudinal data of 2,708 workers aged more than 45 years old from the Korean Longitudinal Study of Ageing. Multivariate Cox regression analyses were conducted to identify the predictors and to build a prediction model for early exit from work due to poor health. Internal validation was performed using random split, and external validation using the English Longitudinal Study of Ageing. Over the 8-year follow-up, 124 workers exited work early because of poor health. Significant predictors for early exit from work due to poor health included hypertension (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.01-2.28), abnormal body mass index (HR, 1.60; 95% CI, 1.10-2.35), decreased grasping power index, and perceived health status. The prediction model designed to estimate the risk of unwanted early exit from work because of poor health status showed fair performance in both the internal and external validations. The current study revealed the specific determinants and the possibility of prediction of shortened working life due to poor health status.

Reference Values for Spirometry Derived Using Lambda, Mu, Sigma (LMS) Method in Korean Adults: in Comparison with Previous References.

BACKGROUND: The present study aimed to update the prediction equations for spirometry and their lower limits of normal (LLN) by using the lambda, mu, sigma (LMS) method and to compare the outcomes with the values of previous spirometric reference equations. METHODS: Spirometric data of 10,249 healthy non-smokers (8,776 females) were extracted from the fourth and fifth versions of the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009; V, 2010-2012). Reference equations were derived using the LMS method which allows modeling skewness (lambda [L]), mean (mu [M]), and coefficient of variation (sigma [S]). The outcome equations were compared with previous reference values. RESULTS: Prediction equations were presented in the following form: predicted value = e{a + b × ln(height) + c × ln(age) + M - spline}. The new predicted values for spirometry and their LLN derived using the LMS method were shown to more accurately reflect transitions in pulmonary function in young adults than previous prediction equations derived using conventional regression analysis in 2013. There were partial discrepancies between the new reference values and the reference values from the Global Lung Function Initiative in 2012. CONCLUSION: The results should be interpreted with caution for young adults and elderly males, particularly in terms of the LLN for forced expiratory volume in one second/forced vital capacity in elderly males. Serial spirometry follow-up, together with correlations with other clinical findings, should be emphasized in evaluating the pulmonary function of individuals. Future studies are needed to improve the accuracy of reference data and to develop continuous reference values for spirometry across all ages.

Service and sales workers, are they vulnerable to smoking cessation?

The aim of the present study was to evaluate the association between failed smoking cessation and occupation by age stratification among Korean males and provide quantitative evidence of factors associated with failed smoking cessation. The study comprised 3,127 male workers who had attempted smoking cessation during their life time. Data were obtained from the Korea National Health and Nutrition Examination Survey from 2010 to 2012. Participants were stratified by age into two subgroups comprising a younger group (19-40 yr) and an older group (41-60 yr). Multiple logistic regression analyses were used to estimate odds ratios (ORs) for failed smoking cessation. In the younger group, failed smoking cessation was related to the occupational fields "service and sales" and "manual work" compared to "office work" (OR: 2.10, 95% confidence interval (CI): 1.34-3.29; and OR: 1.47, 95% CI: 1.02-2.12, respectively). In the older group, the ORs of failed smoking cessation occupational categories "service and sales" and "manual work" [ref: office workers] were 0.58 (0.40-0.85) and 0.90 (0.66-1.24), respectively. Failed smoking cessation is associated with occupational categories and age stratification. Policy makers need to create tailored anti-smoking policy considering the occupation and the age of the subjects.

The effect of an arm sling used for shoulder support on gait efficiency in hemiplegic patients with stroke using walking aids.

BACKGROUND: The effects of an arm sling on the physiological costs of walking are not known. Even though a previous study reported that an arm sling can improve gait efficiency, its entrance criteria was only hemiparetic patients able to walk without walking aids independently. AIM: The aim of this study was to investigate the effect of shoulder support by an arm sling on gait efficiency in hemiplegic stroke patients using walking aids. DESIGN: Randomized crossover design. SETTING: Rehabilitation department of a university hospital. POPULATION: A total of 57 hemiplegic patients with shoulder subluxation dependent on canes were grouped into single cane (N.=30) and quad cane groups (N.=27) as walking aids. METHODS: All patients performed a walk with their own walking aid with and without an arm sling in randomized order, on the same day. We measured the energy cost and energy expenditure using a portable gas analyzer and heart rate during a 6-minutes Walk Test and a 10-m Walk Test. We analyzed all outcomes measures with and without an arm sling between the patients who were grouped according to their walking aids using 2-way repeated ANOVA. RESULTS: The energy cost (0.068±0.023 mL/kg/m) and oxygen expenditure (8.609±2.155 mL/kg/minutes) were lower with the arm sling (P<0.05) than without the arm sling (0.074±0.029 mL/kg/m, and 9.109±2.406 mL/kg/minutes, respectively), and the walking endurance (138.942±47.043 m) were longer (P<0.05) with the arm sling among the hemiplegic patients with single cane. CONCLUSIONS: Among the hemiplegic patients with a single cane, the walking endurance achieved with an arm sling significantly improved than those achieved without an arm sling, and the energy expenditure and energy cost was significantly lower. CLINICAL REHABILITATION IMPACT: The hemiplegic arm support with an arm sling may be beneficial for gait efficiency in hemiplegic patients using a single cane, which lead to decreased oxygen use at a given speed.

Effect of chronic knee osteoarthritis on flexion-relaxation phenomenon of the erector spinae in elderly females.

[Purpose] This study investigated the flexion-relaxation phenomenon of the erector spinae in elderly women with chronic knee osteoarthritis and determined whether the flexion-relaxation phenomenon can be used as a pain evaluation tool in such cases. [Subjects and Methods] Seventeen elderly females with chronic knee osteoarthritis and 13 healthy young females voluntarily participated in this study. They performed three postural positions in 15 s: trunk flexion, complete trunk flexion, and trunk extension, each for 5 s. While these positions were held, muscle activation of the thoracic and lumbar erector spinae were measured using surface electromyography. The flexion-relaxation rate was determined by dividing the values for trunk extension by those of complete trunk flexion and by dividing the values for trunk flexion by those of complete trunk flexion. [Results] According to our results, the flexion-relaxation phenomenon was different between healthy young and elderly females with chronic knee osteoarthritis. Specifically, there was a difference in the left thoracic erector spinae muscle, but not in the left and right lumbar erector spinae or right thoracic spinae muscle. [Conclusion] Our study demonstrated that the erector spinae muscle flexion-relaxation phenomenon can be used as a pain evaluation tool in elderly females with chronic knee osteoarthritis.

Diagnosis of perinuclear anti-neutrophil cytoplasmic antibody-associated microscopic polyangiitis in silicotics: case report.

BACKGROUND: An association between silica exposure and autoimmune diseases including rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, and anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis has been made. CASE PRESENTATION: A 56-year-old male presented with silicosis and had an occupational history of precious metal processing for 30 years and a 30 pack-year smoking history. The patient was diagnosed with pneumoconiosis and received compensation. No other complications were reported for pneumoconiosis. The patient suddenly presented with a non-specific headache for several days and microscopic hematuria was identified upon examination in the outpatient clinic. Following several weeks, the patient presented with aggravated dyspnea and hemoptysis, and his Modification of Diet in Renal Disease estimated glomerular filtration rate indicated acute kidney injury. Diagnostic analysis revealed perinuclear ANCA-associated microscopic polyangiitis (p-ANCA-associated MPA). CONCLUSION: Exposure to silica dust was likely one of the cause of p-ANCA-associated MPA. Possible pathogenic mechanisms of autoimmune diseases in silicotics and emphasis of the necessity for early diagnosis are discussed.