BACKGROUND: Cerebral white matter lesions(WMLs), such as leukoaraiosis, may be related to damage from cerebral ischemia and may also be associated with the degenerative process. The apolipoprotein E (APOE) 4 allele is a risk factor for degenerative diseases, such as Alzheimer`s disease, and ischemic brain damage through acceleration of atherosclerosis. No study has been performed regarding WMLs and APOE genotype in Korea. We investigated the association between WMLs and APOE among Koreans. METHODS: Brain MRI was performed in 225 subjects(ages 61 to 85 years) without neuropsychiatric disease randomly selected from the Ansan Health Cohort Study. WMLs observed on 225 MRI scans were rated in terms of severity by 2 raters. All study subjects underwent APOE genotyping. RESULTS: WMLs were observed in 109(48.4%) of subjects. In the subjects with WMLs, the distribution of APOE genotypes was 0.9% for epsilon 2/epsilon 2, 11.0% for epsilon2/epsilon3, 1.8% for epsilon2/epsilon4, 61.5% for epsilon3/epsilon3, 22.9% for epsilon3/epsilon4, and 1.8% for epsilon4/epsilon4, respectively. The distribution of APOE genotypes did not differ between subjects with and without WMLs. CONCLUSION: These data suggest that there is no association between WMLs and APOE genotypes in Koreans.
Acceleration ; Alleles ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Brain ; Brain Ischemia ; Cohort Studies ; Genotype ; Gyeonggi-do ; Korea ; Leukoaraiosis ; Magnetic Resonance Imaging ; Risk Factors

Spontaneous pneumothorax is rarely occurred as an initial sign of primary lung cancer. As a lot of these cases have already advanced, even then surgical resection is performed, the prognosis is often undesirable. We happened to find a ruptured cavity on a 65-year-old male patient who had suffered from pulmonary tuberculosis in the past, while performing VATS bullectomy for simple spontaneous pneumothorax. Then, as a result of frozen biopsy, it was diagnosed as squamous cell cancer. Because the tumor was infiltrated from the upper lobe into the lower lobe passing by fissure, we should remove by pneumonectomy and the pathologic stage was found stage I (T2N0M0). When we made an follow-up observation for one year and a half, there was neither relapse nor complication. When there appears spontaneous pneumothorax to the high risk group for lung cancer who were smokers over forty-year old, with chronic bronchitis or pulmonary emphysema, it needs to have a closer observation on a base lung disease such as lung cancer through chest CT, and it is also necessary to make more active approach by performing the surgical operation through a thoracoscopy when there is a continued air release.
Aged ; Biopsy ; Bronchitis, Chronic ; Follow-Up Studies ; Humans ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Male ; Neoplasms, Squamous Cell ; Pneumonectomy ; Pneumothorax* ; Prognosis ; Pulmonary Emphysema ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

Coccidioidomycosis is a disease by airborne exposure of Coccidioides(C.) immitis, and endemic in the Southwest United States. Primary infection site is lung, and dissemination of the disease can occur depending on the host factors: race, immune status, pregnancy, etc. We report a Korean man with coccidioidomycosis disseminated to the skin, presenting the granulomatous papules on the face and trunk in addition to the pulmonary symptoms. Fungal spherules in the dermis were detected on the skin tissue section, and C. immitis were cultured from the skin tissue. The clinical symptoms were gradually improved with the systemic treatment of antifungal agents (amphotericin B and caspofungin). After more than 6 months of treatment, all of the pulmonary and cutaneous lesions were cleared, but fever persisted.
Antifungal Agents ; Coccidioidomycosis* ; Continental Population Groups ; Dermis ; Fever ; Humans ; Lung ; Pregnancy ; Skin ; United States

BACKGROUND: The primitive reflexes such as palmomental, glabella, snout, nuchocephalic reflexes may appear in a variety of diseases of the central nervous system. In this study, we investigated the frequencies of these primitive reflexes in the healthy elderly Korean population that have never been studied before. METHODS: Randomly selected 103 vol-unteers aged older than 60 years were examined by neurologists with a systemic neurological examination which included primitive reflexes and by radiologists with neuroimaging. Seven subjects were excluded from the study due to abnormal findings in the MRI of one subject and unusual neurological signs in 6 subjects. RESULTS: The overall mean age of the subjects was 66.5 years. One or more of the primitive reflexes were seen in 26 (24.9%) subjects. Eighteen (17.2%) subjects showed the palmomental reflex; eleven (10.5%) subjects showed the glabella reflex; five (4.8%) sub-jects showed the snout reflex; and one (1.0%) subject showed the nuchocephalic reflex. One subject had palmomental, glabella as well as snout reflexes, and five subjects had two primitive reflexes at the same time. CONCLUSIONS: Despite the normal findings from the neurological examinations and neuroimaging, 24.9% of healthy aged people had one or more primitive reflexes. The presence of these primitive reflexes as an isolated phenomenon may not imply brain lesions. (J Korean Neurol Assoc 19(4):380~383, 2001)
Aged* ; Brain ; Central Nervous System ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Neurologic Examination ; Reflex*

BACKGROUND AND OBJECTIVES: Primary percutaneous coronary intervention (PCI) has been reported to be effective reperfusion therapy for acute myocardial infarction (AMI). In the very thrombotic environment of AMI, primary PCI, with heparin-coated stents, has been known to reduce the early reocclusion of the stented vessel by preventing thrombosis. However, little data exist regarding the long-term clinical outcomes. The aim of our study was to evaluate the safety, feasibility and long-term efficacy of heparin-coated stents in AMI. SUBJECTS AND METHODS: Between January 1998 and July 2002, primary PCI with heparin-coated stents was performed in 132 consecutive patients (98 males, with a mean age of 56.3+/-0.7 years) admitted with the diagnosis of AMI within 12 hours from the onset of the chest pain. Major adverse cardiac events (MACE), including death, MI, TLR (target lesion revascularization) and CABG, were recorded during hospitalization and the follow-up period. Angiograms were obtained at the baseline, after stent implantation and at 6 months following implantation. RESULTS: The angiographic and procedure success rate was 96.2%. During hospitalization, there was no evidence of reocclusion of stented vessel, but 1 patient underwent a repeat PCI due to dissection. There were no bleeding complications. A six-month angiographic follow-up was completed in 47.2% of eligible patients and binary restenosis was present in 20.1%. During the long-term clinical follow-up (mean follow-up period 37.2+/-7.2 months), there were 12 deaths, 1 myocardial infarction and 18 TLR. The MACE free survival rate was 76.5%. CONCLUSION: Primary PCI, with heparin-coated stents, shows favorable long-term clinical outcomes.
Chest Pain ; Diagnosis ; Follow-Up Studies ; Hemorrhage ; Hospitalization ; Humans ; Male ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Reperfusion ; Stents* ; Survival Rate ; Thrombosis

BACKGROUND: Limited information about the effects of stroke on sexual functioning is available. The purpose of this study was to assess the influences of ischemic stroke on sexual functioning and to evaluate the clinical and psychological factors related to poststroke sexual dysfunctions. METHODS:Sixty-six male post-ischemic stroke patients and fifty-one age-matched healthy controls completed a self-administered questionnaire on sexual functioning. The localization of ischemic stroke was determined by neuroimaging findings as well as focal neurological signs. The degree of disability and the degree of depression were also assessed. RESULTS: All domains of sexual functioning, including erectile functions, orgas-mic functions, sexual desire, intercourse satisfaction, and overall satisfaction were decreased in poststroke patients. Patients with occipital lesions had a lesser degree of sexual dysfunctions than those with lesions affecting other areas (p<0.05). Also, sexual dysfunctions in stroke patients were related to the degree of physical disability and the presence of depression (p<0.05). CONCLUSIONS Sexual dysfunctions are common in stroke patients. The reasons for sexual dysfunc-tions after stroke are multifaceted, which include stroke lesion site, physiological factors, and psychosocial factors. (J Korean Neurol Assoc 19(4):342~348, 2001)
Depression ; Humans ; Male ; Neuroimaging ; Psychology ; Surveys and Questionnaires ; Stroke*

Background: The increased prevalence of obesity has led to increases in the prevalence of chronic diseases worldwide. There is interest whether probiotics have an effect on obesity, but the effectiveness and safety of only a few probiotics for the treatment of obesity have been reported. The purpose of this study was to investigate whether ingestion of Lactobacillus sakei (CJLS03) derived from kimchi causes weight loss in people with obesity. Methods: This randomized, double-blind, placebo-controlled, clinical trial involved 114 adults with a body mass index (BMI) ≥25 kg/m2 who were assigned randomly to a CJLS03 or placebo group. The groups received two allocations of either 5×109 colony-forming units of CJLS03/allocation or the equivalent vehicle for 12 weeks. Demographic and biochemical parameters, and body composition including fat and muscle mass were measured at baseline and after 12 weeks. Changes in body fat, weight, and waist circumference were compared between the two treatment groups. Adverse events were monitored during study period. Results: Body fat mass decreased by 0.2 kg in the CJLS03 group and increased by 0.6 kg in the placebo group (0.8 kg difference, P=0.018). After the 12 weeks, waist circumference was 0.8 cm smaller in the CJLS03 group than in the placebo group (P=0.013). BMI and body weight did not change after the 12 weeks. Adverse events were mild and did not differ between the two groups. Conclusion These data suggest that L. sakei (CJLS03) might help people with obesity reduce body fat mass without serious side effects (ClinicalTrials.gov: NCT03248414).

PURPOSE: This study aimed to investigate body shape perception, weight control behaviors and eating habits of adolescent girls in urban, suburban and rural areas of Korea to obtain basis for establishing adequate weight control program for adolescent. METHODS: From May 2002 to November 2002, a cross-sectional questionnaire survey and physical examination were conducted to examine body shape perception, weight control behaviors, eating habits and health status of 2,891 adolescent girls and 891 boys in Seoul, Ansan and Paju. RESULTS: The proportion of underweight adolescent girl was decreased in rural area than in urban area. 46.3% of girls considered themselves to be somehow or very obese. Notably 3.2% of underweight girls considered themselves obese. 57.9% were unsatisfied with their own body shape. The proportion of dissatisfaction increased with age and body mass index (BMI), but there were no differences among area. The experiences of weight control increased by age, BMI and dissatisfaction of own body shape. The eating attitudes test-26 (EAT-26) score of girls was significantly higher than that of boys. The girls with high risk of eating disorder were 10.9%. And risk factors of eating disorder were living in urban area, severe stress for weight control excessive expenditure for appearance and think themselves unhealthy. CONCLUSION: The findings of this study demonstrate that there were serious impairment of body shape perception of adolescent girls and unhealthy, inadequate weight control behaviors were widely done. Therefore adequate weight control program for adolescent girl should be established promptly.
Adolescent ; Body Image ; Body Mass Index ; Eating ; Feeding and Eating Disorders ; Feeding Behavior ; Female ; Health Expenditures ; Humans ; Korea ; Physical Examination ; Surveys and Questionnaires ; Risk Factors ; Thinness ; Weight Loss ; Weight Perception

BACKGROUND: Although headaches are one of the most common discomfort worldwide, our understanding of headache distribution is incomplete. Moreover, epidemiologic studies on headache in Korea have not yet gone beyond finding mere prevalence. Therefore, this study not only aims to find the prevalence, subtypes of headache, but also the relationship between headache and such factors as socio-economic variables, demographics, life-styles among randomly selected Korean people. METHODS: In a face-to-face manner, trained personnel interviewed one thousand five subjects. The subtypes of headache included migraine, tension-type headache, mixed headache and unclassified headache. Furthermore, socio-economic features, demographics and life-styles were analyzed in each subgroup with logistic regression analysis. RESULTS: The prevalence of headache was 58.3%. Those with migraine, tension-type headache, and mixed headache were 12.3%, 44.3%, and 5.2%, respectively. Women (odds ratio [OR] 2.51, 95% confidence interval [CI] 1.91-3.30), negative perception about their health (OR 7.16, CI 1.59-32.18), and young age groups (OR 3.32, CI 2.03-5.42, when the group before 30-year-old was compared to the group after 61-year-old) had higher prevalence of headache. In respect of migraine and tension-type headache, women (OR 0.42, CI 0.22-0.78) and positive family history of headache (OR 2.13, CI 3.14-3.66) had more migraine. Migraineurs were more common among women (OR 6.04, CI 3.14-11.61) and young age groups (OR 17.42, CI 4.64-65.46) compared to non headache-sufferers. CONCLUSIONS: This study showed the prevalence and epidemiologic characteristics of headache and its subtypes in Korea.
Adult ; Demography ; Epidemiologic Studies* ; Epidemiology ; Female ; Gyeonggi-do* ; Headache* ; Humans ; Korea* ; Logistic Models ; Migraine Disorders ; Prevalence ; Tension-Type Headache

PURPOSE: We wanted to evaluate the safety and effectiveness of superselective transarterial embolization for the management of gastrointestinal bleeding. MATERIALS AND METHODS: We evaluated 97 of 115 patients who had undergone diagnostic angiography and transarterial embolization for gastrointestinal bleeding from February 2001 to July 2004, and they subsequently underwent superselective transarterial embolization. Their ages ranged from 17 to 88 years (mean age: 58.5 years), and 73 were men and 24 were women. The etiologies were a postoperative condition (n=31), ulcer (n=23), Mallory-Weiss syndrome (n=3), trauma (n=3), pseudoaneurysm from pancreatitis (n=3), diverticula (n=2), inflammatory bowel disease (n=2), tumor (n=2), Behcet's disease (n=2), hemobilia (n=1), and unknown origin (n=25). The regions of bleeding were the esophagus (n=3), stomach and duodenum (n=41), small bowel (n=38) and colon (n=15). All the patients underwent superselective transarterial embolization using microcoils, gelfoam or a combination of microcoils and gelfoam. Technical success was defined as devascularization of targeted vascular lesion or the disappearance of extravasation of the contrast media, as noted on the angiography after embolization. Clinical success was defined as the disappearance of clinical symptoms and the reestablishment of normal cardiovascular hemodynamics after transarterial embolization without any operation or endoscopic management. RESULTS: The technical success rate was 100%. The primary clinical success rate was 67% (65 of 97 patients). Of the 32 primary failures, fourteen patients underwent repeat embolization; of these, clinical success was achieved in all the patients and so the secondary clinical success rate was 81% (79 of 97 patients). Of the 18 patients with primary failures, five patients underwent operation, one patient underwent endoscopic management and the others died during the observation period due to disseminated coagulopathy or complications of their underlying diseases. During the follow up period, six patients of the 79 clinically successful patients died due to disseminated coagulopathy or complications of their underlying diseases, and so the total mortality rate was 19% (18 of 97 patients). Postembolization complications such as bowel ischemia or infarction did not occur during the observation period. CONCLUSION: Superselective transarterial embolization is an effective therapy for treating acute gastrointestinal hemorrhage, and it has a high technical rate and clinical success rate, and a low complication rate.
Aneurysm, False ; Angiography ; Colon ; Contrast Media ; Diverticulum ; Duodenum ; Esophagus ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemodynamics ; Hemorrhage* ; Humans ; Infarction ; Inflammatory Bowel Diseases ; Ischemia ; Male ; Mallory-Weiss Syndrome ; Mortality ; Pancreatitis ; Stomach ; Ulcer